Nursing Acceleration Challenge Exam I PN-RN Management of Care Questions and Answers

Question 1

An RN on a medical-surgical unit is planning assignments for the upcoming shift. The team consists of another RN, a licensed practical nurse (LPN), and an unlicensed assistive personnel (UAP). Which task is most appropriate for the RN to delegate to the LPN?

Accepted Answer

Performing a sterile dressing change on a client's 10-day old surgical wound.

Answer

The scope of practice for an LPN typically includes performing routine procedures like sterile dressing changes on chronic or stable wounds. Initial assessments, developing the plan of care, and administering IV push medications are complex tasks that require the advanced assessment and clinical judgment of an RN.

Question 2

A nurse receives a change-of-shift report on four clients. Which client should the nurse assess first?

Accepted Answer

A client with pneumonia who has a new onset of confusion and an oxygen saturation of 88% on 2L of oxygen.

Answer

The client with pneumonia showing a new onset of confusion and low oxygen saturation is the highest priority. These are signs of worsening respiratory status and hypoxia, which is a life-threatening condition requiring immediate assessment and intervention. The other clients are more stable.

Question 3

A client who is scheduled for a cardiac catheterization in the morning tells the nurse, 'My doctor explained the procedure, but I'm still not sure what all the risks are.' The signed consent form is in the client's chart. What is the nurse's most appropriate action?

Accepted Answer

Notify the healthcare provider that the client does not fully understand the procedure.

Answer

It is the provider's legal responsibility to obtain informed consent, which means ensuring the client understands the risks, benefits, and alternatives to the procedure. If the client expresses a lack of understanding, the nurse must act as an advocate and notify the provider to give further clarification. The nurse's role is to witness the signature, not to provide the primary explanation of risks.

Question 4

The nurse is coordinating care for a client being discharged after a stroke, which resulted in moderate dysphagia. To ensure a safe transition home, which of the following referrals is the nurse's priority?

Accepted Answer

A speech-language pathologist for a home swallowing therapy plan.

Answer

Dysphagia (difficulty swallowing) places the client at high risk for aspiration and pneumonia. The speech-language pathologist is the specialist who assesses swallowing function and creates a safe plan for eating, drinking, and taking medications. While the other referrals are also important for this client's overall recovery, preventing aspiration is a critical safety priority.

Question 5

A nurse is caring for a client who refuses a prescribed blood transfusion due to religious beliefs. The client is hemodynamically unstable. Which action best illustrates the nurse's role as a client advocate while upholding ethical principles?

Accepted Answer

Documenting the refusal and notifying the healthcare provider of the client's decision.

Answer

A competent adult has the right to refuse medical treatment (autonomy), even if it is life-sustaining. The nurse's role is to respect this right, ensure the client is fully informed, document the decision, and communicate it to the provider so that alternative treatment plans can be explored. Overriding the client's wishes or coercing them violates ethical principles.

Nursing Acceleration Challenge Exam (NACE) I PN-RN Practice Test

Nursing Acceleration Challenge Exam (NACE) I PN-RN Practice Test

Nursing Acceleration Challenge Exam I PN-RN Management of Care Questions and Answers