RN Management Practice Exam 2022

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HESI Management Practice Exam 2022 The nurse is preparing assignments for the day shift. It is most important that the client with which diagnosis and description is assigned to a RN? A. Menorrhagia... : 24 hrs post vaginal hysterectomy. B. MI: 4-days post infarction, transferred from ICU yesterday. C. Depression: Admitted during the night following a suicide attempt with an OD of Tylenol D. Pneumonia: A 4 yo who is receiving IB antibiotics Correct Answer- C. Depression: Admitted during the night following a suicide attempt with an OD of Tylenol Rationale: Requires communication skills and assessment skills beyond the educational level of a PN or UAP. Establishing a therapeutic, one-on-one relationship with a depressed client is beyond the scope of practice for a PN. Additionally, Tylenol is extemely hepatotoxic and careful assessment is essential. During report, the charge nurse informs a nurse that she must work on another unit. The nurse begins to sigh deeply and tosses about her belongings as she is preparing to leave, making it known that she is very unhappy about having to "float." What is the best immediate action for the charge nurse to take? A. Continue with report, and talk to the nurse about the incident at a later time. B. Ask the nurse to call the supervisor to see if she can be reassigned. C. Stop report and remind the nurse that all staff must "float" at some time. D. In the presences of other staff members, inform the nurse that her behavior is inappropriate. Correct Answer- A. Continue with report, and talk to the nurse about the incident at a later time. Rationale: This is the best immediate action. At a later time the charge nurse should discuss with the nurse in private her inappropriate conduct. A 15yo sexually active girl diagnosed with PID is admitted to the hospital with a temp of 101.6 F and purulent vaginal discharge. She has no insurance and tells the nurse she enjoys small children. Which room should the nurse assign this client? A. A semi-private room with a 4yo girl who is currently receiving chemotherapy. B. A semi-private room with an older adolescent girl who had surgery yesterday. C. A room close to the nurse's station. D. A private room. Correct Answer- D. A private room. Rationale: Despite the fact that the client has no insurance and enjoys small children, she in infected and should be placed in a private room. The client is not acutely ill and does not need to be assigned next to the nurse's station. The RN and UAP are working together to provide care for a bedfast client needing total care, medications, and Foley catheter irrigation. How should the RN assign the client's care? A. UAP: Personal care, catheter irrigation, I&O. RN: Medications. B. UAP: Personal care. RN: Medications, catheter irrigation, I&O. C. UAP: Catheter irrigation, I&O. RN: Medications. Both provide personal care. D. UAP: Personal care, I&O. RN: Catheter irrigation, medications. Correct Answer- D. UAP: Personal care, I&O. RN: Catheter irrigation, medications. Rationale: The RN is reponsible to med administration and sterile procedures such as catheter irrigation. The UAP is qualified to provide personal care and measure I&O. The charge nurse assigns the care of a client with diabetes who has hyperglycemia to a PN. In supervising the PN, what is the charge nurse's most important action? A. Decide which sliding scale insulin dose should be administered. B. Obtain the blood sugar results via skin puncture and glucometer. C. Notify the healthcare provider of the daily serum glucose results. D. Confer with the PN about any manifestations the client is exhibiting. Correct Answer- D. Confer with the PN about any manifestations the client is exhibiting. Rationale: The nurse's expertise in needed to perform a critical assessment, such as assessing the client for signs of hyperglycemia and to supervise the ongoing monitoring of the client by the PN. A RN is caring for several clients on a progressive care "step-down" unit. After assessing the clients, which clerical task should the nurse assign to a UAP? A. Chart pulse ox readings and type of breath sounds auscultated in the medical record. B. Record the presence of blood-tinged urine and the hourly Foley output on the flow sheet. C. Document the type and amount of drainage on a new surgical dressing in the progress note. D. Transcribe the vital signs from a unit worksheet to the individual graphic page in the client charts. Correct Answer- D. Transcribe the vital signs from a unit worksheet to the individual graphic page in the client charts. Rationale: Recording the VS on the graphic record does not entail assessment or evaluation of the findings, so the UAP may perform. RNs may not delegate assessment or documentation responsibilities to UAPs. RNs must complere assessment activities and record findings in the medical record. Which situation requires intervention by the nurse who is caring for a terminally ill client in a hospital? A. The case manager notifies the family that the critical pathway requires transfer to a hospice facility. B. The case manager notifies the social worker of the client's financial needs r/t hospice care. C. The social worker describes the client's feelings of the grief to the spiritual counselor. D. The social worker provides info about long-term care facilities to the client. Correct Answer- A. The case manager notifies the family that the critical pathway requires transfer to a hospice facility. Rationale: Critical pathways provide care guidelines, rather than required methods of care. The nurse should intervene to ensure that the client and family are aware of options available. The UAP reports morning vital signs to the primary nurse. Which client should the nurse assess first? The client who is A. diagnosed with myxedema with a temp of 96.8 F. B. one-day postop abdominal surgery with a pulse of 104. C. diagnosed with HTN and has a BP of 154/94. D. diagnosed with pneumonia and has a respiratory rate of 26. Correct Answer- D. diagnosed with pneumonia and has a respiratory rate of 26. Rationale: The normal RR is 12-20, so a client with respiratory compromise (pneumonia) who has increased RR should be assessed immediately. A, B, and C are expected for patient condition. A female client is receiving an enteral feeding via nasogastric feeding tube. The daughter reports to the charge nurse that her mother is coughing vigorously and sounds congested. Which staff member should the charge nurse ask the check on the client? A. RN who is admitting a new postop client to the unit. B. PN who is giving routine medications. C. PN who is talking with anxious family members. D. RN who is entering nursing notes at the computer. Correct Answer- D. RN who is entering nursing notes at the computer. Rationale: The RN who is entering notes is working on a task that has less priority than A. The client requires advanced, problem solving assessment skills and the RN is best qualified to assess the client's lungs, position of NGT, and the possibility that the feeding tube has moved or kninked, allowing the tube feeding to enter the lungs. The charge nurse, along with two RNs, one PN, and one UAP, is working in an ED. Wh [Show More]

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