NCLEX NCLEX Certifications NCLEX-PN Questions & Answers

• Question 641:

  To manage time most effectively, the nurse responds to which of the following stimuli first __________.

  A. the physician's loud verbal direction

  B. the nursing supervisor who is going to a meeting

  C. unit staff leaving on a break

  D. the care needs of the returning postoperative client just exiting the elevator

  Correct Answer: D

  While many environmental stimuli might compete for attention and time, the client care needs of complex or unstable clients and those requiring assessment and care must take priority.

• Question 642:

  People-related supervisory tasks include all of the following except __________.

  A. coaching

  B. encouraging

  C. target setting

  D. rewarding

  Correct Answer: D

  Target-setting is the projection of goals or objectives to be accomplished and is considered to be a task-centered, supervisory responsibility. Coaching, encouraging, rewarding, evaluating, and facilitating are supervisory activities that are people related as they involve direct interaction with those doing the work.

• Question 643:

  An 85-year-old client is eligible for Medicare reimbursable home care services.

  Referral is contingent on meeting which of the following criteria?

  A. homebound status, requiring skilled therapy care

  B. immediate previous hospitalization for acute care

  C. age

  D. requirement of nursing and social work support

  Correct Answer: A

  The requirements for Medicare-reimbursable home care services include the client being homebound and requiring a skilled service, such as PT/OT/ST/nursing/social work.

• Question 644:

  The ICU nurse caring for a client who has just been declared brain dead can expect to find evidence of the client's wishes regarding organ donation __________.

  A. on the driver's license of the client

  B. in the client's safety deposit box

  C. in the client's last will and testament

  D. on the client's insurance card

  Correct Answer: A

  In most states, indication of organ donor status is found on the driver's license.

  Evidence in a last will and testament or in a safety deposit box is not readily accessible for decision-

  making if the need arises.

  Insurance cards do not contain such information.

  Another source might be the client's primary care physician's health record documentation.

• Question 645:

  The acts enacted by states to provide immunity from liability to persons who provide emergency care at an accident scene are called __________.

  A. Good Samaritan laws

  B. HIPAA

  C. Patient Self-Determination Act (PSDA)

  D. OBRA

  Correct Answer: A

  The Good Samaritan laws protect providers of care in an emergency situation.

  HIPAA's focus is confidentiality of information and right to privacy.

  The PSDA concerns a client's autonomous decision-making.

  OBRA was passed in the late 1980s to promote nursing home reform due to quality issues.

• Question 646:

  The only time that an individual may receive medical care without giving informed consent is __________.

  A. when the durable power of attorney for health care is not available

  B. in an emergency, life-or-death situation

  C. when the physician is not available for discussion with the client

  D. when they (clients) are not able to speak for themselves

  Correct Answer: B

  Treatment may be given without consent in a life-threatening situation. Choices "when the durable power of attorney for health care is not available", "when the physician is not available for discussion with the client", "when they (clients) are not able to speak for themselves" are incorrect. All attempts to notify a durable power of attorney for health care should be made. If unavailable, the physician assumes responsibility for treatment within facility protocol. The physician is obligated to have a discussion with the client in all non- life-threatening situations. If clients are not able to speak for themselves, their power of attorney for health care or responsible party is involved in the consent process.

• Question 647:

  Issues addressed in ethics committees include all of the following except __________.

  A. nonpayment of bills

  B. euthanasia

  C. starting or stopping treatment

  D. use of feeding tubes

  Correct Answer: A

  Ethics committees do not deal with financial matters of payment.

  Euthanasia, starting or stopping treatment, and use of feeding tubes to maintain nutritional status are

  topics within the ethical scope of the committee's function.

• Question 648:

  Priorities to be considered intermediate are __________.

  A. the nonemergency, non-life-threatening needs of the client.

  B. those tasks that can be delegated to assistive personnel.

  C. those tasks that can be performed at the end of the shift.

  D. those task that can be performed at any time.

  Correct Answer: A

  Priorities designated as intermediate by the nurse are those that are not urgent. They do not affect the client's immediate physiological status. This does not imply that they are not important or not necessary.

  Intermediate priorities might still require the skill level of an RN for completion. There might be specific time requirements for completion as well.

• Question 649:

  Which direction given to the nursing assistant is most likely to accomplish the task of getting a urine specimen delivered to the lab immediately after collection?

  A. "Make it a stat delivery."

  B. "Please do it as soon as you can after break."

  C. "This client is delirious, and we're worried about a urinary sepsis."

  D. "Take this client to the bathroom now and collect a urine specimen from this voiding. Take the specimen to the lab immediately."

  Correct Answer: D

  Effective delegation depends on clear, concise direction that leaves no room for question or interpretation on the part of the one being delegated to. Nursing assistants have a limited understanding of medical conditions and terminology, and should not be relied on to prioritize such tasks.

• Question 650:

  An example of a process standard on a med-surg unit is __________.

  A. a procedure for changing IV tubing.

  B. a policy for staffing.

  C. the job description of the CEO (chief executive officer).

  D. a procedure for checking waveforms on a client being treated on an intra-aortic balloon pump.

  Correct Answer: A

  Process standards define the actions and behaviors required by staff to provide care.

  A procedure for changing IV tubing is a psychomotor skill that is applied to helping clients meet their goals.