Coordinated Care Practice Test with Answers

Answer Summary 1 A B C D 21 A B C D 41 A B C D 2 A B C D 22 A B C D 42 A B C D 3 A B C D 23 A B C D 43 A B C D 4 A B C D 24 A B C D 44 A B C D 5 A B C D 25 A B C D 45 A B C D 6 A B C D 26 A B C D 46 A B C D 7 A B C D 27 A B C D 47 A B C D 8 A B C D 28 A B C D 48 A B C D 9 A B C D 29 A B C D 49 A B C D 10 A B C D 30 A B C D 50 A B C D 11 A B C D 31 A B C D 12 A B C D 32 A B C D 13 A B C D 33 A B C D 14 A B C D 34 A B C D 15 A B C D 35 A B C D 16 A B C D 36 A B C D 17 A B C D 37 A B C D 18 A B C D 38 A B C D 19 A B C D 39 A B C D 20 A B C D 40 A B C D Questions 1) Note: These questions include ones similar to alternative format questions as seen on the NCLEX-PN exam. An LPN works on an adult medical/surgical unit and has been pulled to work on the burn unit, which cares for clients of all ages. What should he do? A) He should take the assignment, but make it clear he will only care for adult clients. B) He should take the assignment, but explain the situation to the charge nurse and ask for a quick orientation before starting. C) He should refuse to take the assignment, as caring for infant and child population is not within his scope of practice. D) He should take the assignment, but ask to be paired with a more experienced LPN. 2) Which of the following tasks are appropriate for an LPN to perform? Select all that apply. A. Adjust the cervical traction device of a 68-year-old client as instructed by the charge nurse. B. Teaching a 24-year-old first-time mother how to properly care for her new baby. C. Assess a 36-year-old man newly admitted for chest pain. D. Obtain an occult blood sample from a 16-year-old client with ulcerative colitis. E. Document the administration of acetaminophen to a stable 43-year-old, status post-op knee arthroplasty. A) B, D, E B) A, C, D C) B, C, D. E D) A, B, C, D, E 3) Which of these would be an appropriate assignment for the LPN/LVN? A) an 18-year-old femur fracture client who is just returning to the floor from the recovery unit B) an 84-year-old client 2 days post-op after knee replacement surgery who needs help ambulating C) a 35-year-old client who is suffering from an acute asthma attack D) a 20-year-old client with Cystic Fibrosis who needs an early morning sputum sample collection 4) Which of these clients should the LPN/LVN see first? A) a client with a newly placed NG who is complaining of pain around the face and a plugged nose B) a post-op prostatectomy client who complains of bladder spasms and blood in his foley bag C) a client in an arm cast who is 2 days post-op and reports feelings of numbness and tingling in her affected arm D) a client newly diagnosed with Hepatitis A who reports stomach pain and itchy skin 5) An LPN is talking with a client scheduled to undergo a vasectomy in the next few minutes. He states, “I know I signed the form and all, but I’m not feeling so sure of this. It can be reversed pretty easily, right?” What is the LPN’s best response? A) “Yes, vasectomies can be reversed, but I’m sure once you have it you won’t regret it.” B) “It’s normal to feel a little nervous before a procedure like this one.” C) “It sounds like you have a few more questions you’d like answered. Let me grab the doctor quickly so he can answer them for you.” D) “It sounds like you might be a little nervous. Don’t worry, this is a pretty minor procedure, and the doctor doing it is the best we have. You’re in great hands.” 6) Which of these is true regarding advance directives? A) They must be reviewed and re-signed every 10 years in order to remain valid. B) An advanced directive is legally valid in every state, no matter which state it was created in. C) A physician must determine when a client is unable to make medical decisions for himself. D) They cannot be honored by EMTs (emergency medical technicians) unless signed by a doctor. 7) Which of the following scenarios are considered violations of HIPAA laws? Select all that apply. A. Discussing discharge plans with a client in a multi-bed recovery room with the curtain drawn around the client’s bed. B. Looking up the medical information of a friend not in your care but who gave you permission. C. Checking on your spouse’s medical record because you are listed as her power of attorney. D. Avoiding conversations about clients while in line in the cafeteria with a mutual caregiver of that client. E. Looking up only the address of a co-worker who delivered a baby so you can surprise her with a gift. A) A, B, D B) A, D C) B, C D) B, C, E 8) An LPN is working on the care plan for a client with diabetes mellitus. Which of these outcomes would be the most appropriate? A) The client will maintain a blood glucose level within the normal range of 70–110 (per facility policy). B) The client will maintain a blood glucose level within normal range limits today. C) The client will maintain a blood glucose level within the normal range of 70–110 (per facility policy) throughout my shift. D) The client will maintain a blood glucose level within normal limits throughout my shift. 9) The LPN notices a client with poor gait and balance. She is currently being treated for hypertension, but the nurse is concerned. What should the nurse do? A) Add this issue to the nursing care plan and have daily gait/balance training as an intervention. B) Do nothing as this has nothing to do with why the client was hospitalized. C) Speak with the attending physician about his concerns and request a referral for the client to go to the hospital gym. D) Speak with the attending physician about his concerns and request a referral to physical therapy. 10) A client being treated for sickle cell disease has an order for pain medication. Morphine was ordered, but the nurse is having difficulty deciphering the dose. The nurse should ____. A) ask the attending physician to come back to the unit and to help read what the order states regarding the correct medication, dose, route, and frequency B) call the charge nurse to reach out to the attending physician to verify the order including the correct medication, dose, route, and frequency C) call the attending physician to verbally verify the order including correct medication, dose, route, and frequency D) just go with his or her gut on what the typical dose is for this medication and administer to the client so they do not have to wait on the physician 11) Which of these would be the most appropriate way to document a client’s refusal of medication? A) “Heparin refused during shift. Risks reviewed.” B) “The client refused the heparin injection when I tried to administer it. She yelled at me saying, ‘I do not want that injection right now!’ and told me to leave the room. I explained the risks of not taking the medication. She seemed very annoyed that I tried to give it at that time. I will attempt again later in my shift.” C) “Subcutaneous Heparin injection was attempted to be given to the client per the physician’s order. Client refused, stating, ‘I do not want that injection.’ Potential risks for refusing the medication were reviewed with the client and client verbalized understanding.” D) “Ct stated she did not want the SQ heparin inj at this time. Risks of not taking this med were reviewed with the ct and ct verbalized understanding.” 12) The LPN needs to delegate a task to the nurse aide who is new to the unit. Which of these is the best option for the nurse to choose in proceeding? A) Delegate the task to the nurse aide, confirm understanding, and follow up to ensure the task was safely/correctly done. B) Delegate the task to the nurse aide, watch them perform the task without them seeing you, and follow up to ensure the task was done safely/accurately. C) Delegate the task to the nurse aide, supervise if needed and check in after the task to see if help is needed. D) Delegate the task to the nurse aide, ensure understanding of the task, and supervise task being performed. 13) An LPN is having conflict with another nurse during her shift. She has tried to discuss the issues with the nurse with no resolution. What is the most appropriate way for the nurse to proceed? A) Report the conflict to the director of nursing over the unit. B) Report the conflict to the assigned charge nurse of the unit. C) Report the conflict to the nurse manager of the unit. D) Discuss the conflict with the other nurse to attempt resolution of issue. 14) A nurse is giving shift report off to the oncoming LPN. Which of these is an inappropriate shift report? A) The nurse gives report to the oncoming LPN, checking a wound vac and dressing together. B) The nurse reports in SBAR format, noting that the client was noncompliant with their diet during the shift. C) The nurse reports in the hallway, SBAR format, and alerts the oncoming LPN about how rude the client was throughout the shift. D) The nurse reports at bedside with the oncoming LPN and discusses the client’s concerns after the chart has been reviewed. 15) A nurse witnesses a client sign the consent form for surgery with the surgeon. As the surgeon leaves, the client starts to speak and then stops. The nurse asks if the client has further questions and he says, “I don’t want to bother the surgeon.” The nurse should ____. A) acknowledge the client’s wish not to bother the surgeon and tell the client to let you know if they change their mind B) acknowledge the client’s wish not to bother the surgeon and answer all of their questions, as appropriate C) go get the surgeon to answer all of the client’s questions D) answer any questions as appropriate as well as have the surgeon come back to answer any questions if needed 16) An LPN on a Continuous Quality Improvement (CQI) team is tasked with implementing strategies to reduce medication errors. Which of the following strategies would be most beneficial for the LPN to implement? A) Track individuals with medication errors and report them to administration. B) Remind staff of the five rights of medication administration. C) Ensure that all staff members are proficient in completing incident reports if a medication error occurs. D) Double check that staff document medication administration in the electronic medical record. 17) In what order should the LPN see the following clients? Use appropriate letters to match the correct order A. a 72-year-old client with pneumonia asking to order her dinner. B. a 23-year-old client with left arm fracture after an MVA complaining of 6 out of 10 pain in his arm. C. a 53-year-old client with lower leg swelling complaining of sudden onset headache and blurry vision. D. a 47-year-old client requesting more information regarding her surgery scheduled in three hours A) A, D, B, C B) C, B, D, A C) D, C, B, A D) B, C, A, D 18) The LPN on shift notices a client come in to the clinic with bruises on his arm. The client seems very afraid and doesn’t speak much which concerns the nurse because these are signs of physical abuse. The nurse should ____. A) use therapeutic communication to talk to the client and attempt to get evidence of suspected abuse B) report the findings to the appropriate authorities based on the state requirements and protocols C) ignore the bruises, as this is not why the client is being treated and is not appropriate for the nurse to address D) report the suspected abuse to one of the other nurses and work together on how to handle it 19) A client is having an abortion in a women’s clinic and the nurse caring for the client does not think the reasoning is appropriate. The nurse asks, “Are you sure you want to do this, it can’t be undone. Have you read about your other options? Adoption is always a good choice.” The client states she understands all options and is comfortable with her choice. The nurse nods and leaves the room to discuss the procedure with the physician. Which client right did the nurse violate with her actions? A) the client’s right to make personal health decisions without interference, as the nurse tried to sway the client’s decision-making and healthcare choice in the direction of not having an abortion B) the client’s right to be left alone without unsolicited attention, as the nurse inserted herself in the client’s healthcare scenario and offered uninvited advice C) the client’s right to confidentiality, as the nurse is talking to the physician about the client and the abortion D) the client’s right to respectful care, as the nurse clearly made it known that she did not approve of the abortion 20) A client is refusing to stay in the hospital because he does not agree with his healthcare treatment plan. The nurse stops the client from leaving due to concern for his health. Which of these legal charges could the nurse face? A) False imprisonment, as the nurse is not allowing the client to leave as he has decided to. B) Malpractice, as the nurse is intentionally keeping the patient from making his own decisions, thus violating that nursing duty. C) Invasion of privacy, as the nurse is getting involved in the patient’s private decisions regarding healthcare. D) Negligence, as the nurse ignored the clients right to choose with regard to his healthcare. 21) While taking care of a client, the nurse thinks that physical therapy in the hospital might be beneficial to their condition. Which of the following is the ideal referral process? A. Transport the client to the physical therapy room for treatment. B. Provide the client’s medical record to the physical therapist. C. Contact the client’s primary care provider to suggest a physical therapy referral. A) A, C, B B) A, B, C C) C, A, B D) C, B, A 22) The team is in the client’s room to insert a chest tube, and the nurse suspects that the attending physician who is going to perform the procedure is intoxicated. Which of the following actions is most appropriate? A) Report the concern to the charge nurse. B) Leave the room immediately so as not to be held liable for any complications. C) During the procedure, begin writing an incident report. D) Observe the physician while performing the procedure with extra attention to make sure no mistakes occur. 23) Which of the following is not an advanced directive? A) informed consent B) living will C) durable power of attorney for health care D) health care proxy 24) The nurse has a client who is being transferred to another floor right around change of shift. Which of the following actions is least appropriate? A) Inform the staff on the other floor of any unresolved issues with the client. B) Ask the charge nurse if overtime would be permitted to complete the client’s transfer to the other floor. C) Ask the new nurse to take care of the transfer since the client’s medical record has all of the information and a report should not be needed. D) Complete the transfer paperwork before the client is transferred. 25) Which of the following is true about use of technology when caring for a client? A) If the nurse does not have time to complete their charting, it is appropriate to take a lunch break and then return to charting. B) Medications should be reported promptly. C) When researching a client’s condition, any available sources can be used. D) Computers should only be used for charting purposes during the shift. 26) The nurse is caring for a non-English speaking client. The surgeon has asked the nurse to hurry up and prepare the client for their scheduled procedure, which is running late. Which of the following is least appropriate? A) Explain to the client’s family member that the procedure may be delayed further. B) Inform the surgeon that the procedure will be delayed further because getting a staff interpreter will take additional time. C) Allow the client’s family member to serve as the interpreter. D) Ask if a phone-service interpreting service is available to expedite the client preparation. 27) While on the wound care team, the nurse notices that a fellow nurse opens extra colloid dressing that are often thrown away when they are not needed. What should the nurse do? A) Nothing, as it is not impacting client care. B) Discuss with the colleague the concern about wasting supplies. C) Tell the charge nurse to stop ordering these dressings. D) Remove the colloid dressing from the shelf so that the nurse will find other supplies to use. 28) The nurse is caring for a client who has just tested positive for HIV. The client asks the nurse not to tell anyone outside of the care team about his diagnosis. What response is most appropriate? A) “I have to inform all clients on the unit of your diagnosis as it is transmissible.” B) “I will not communicate your diagnosis to anyone without your permission.” C) “Because this is a communicable disease, it may need to be reported to the CDC.” D) “You should not be concerned with who I share your diagnosis with.” 29) Which of the following behaviors is least appropriate when dealing with fellow staff members? A) Provide positive feedback and constructive criticism. B) Serve as a resource. C) Only report conflicts that interfere with client care. D) Provide input for performance evaluations. 30) Which of the following statements is true about a post-discharge follow-up? A) The nurse should ensure the client is educated on their discharge instructions. B) If the client seems stable, they likely do not need a follow-up visit. C) The physician is responsible for making sure the client has their prescriptions upon discharge. D) If the client has questions, the nurse should instruct the client to bring them up at their follow-up appointment. 31) The nurse is caring for a client who is unsure they will be able to make medical decisions as their disease progresses and would like to appoint another individual to have the authority to make these decisions. Which of the following options would be most appropriate? A) a living will B) informed consent C) a healthcare proxy D) non-informed consent 32) Which of the following activities is not part of client advocacy? A) involving the client in treatment and decision making B) standing up for what is right for the client C) sharing your personal opinions to help provide additional information D) encouraging the client to advocate for themselves 33) The nursing staff has a normal nurse-to-client ratio of three clients per nurse on the floor. Nurse Ann tells nurse Christine that one of her client’s status is declining but that she will do her best to juggle her other two clients. Which action is most appropriate? A) Nurse Christine should offer to give medications to nurse Ann’s other two clients. B) Nurse Christine should inform their supervisor that assignments may need to be changed. C) Nurse Christine should ask the other nurses who might be able to help nurse Ann. D) Nurse Ann should try not to burden the other nurses and continue caring for her assigned clients. 34) Who is responsible for obtaining the signature from the client on the informed consent? A) the staff nurse B) the charge nurse C) the LPN D) the physician 35) The nurse is preparing a client for surgery who says it is against their religion to accept blood transfusions. Which of the following statements would be most appropriate? A) “I can ask pastoral care to send someone to speak with you about this concern since it would not be safe to refuse a blood transfusion.” B) “I understand, and you have the right to refuse blood transfusions.” C) “While I understand, if there is excessive bleeding during surgery, we may need to transfuse blood to stabilize you.” D) “I have received a blood transfusion before, and I do not think you understand the risks versus the benefits of refusing this.” 36) Which is the correct order regarding the hierarchy of members of the nursing team from least authority to highest authority? A. staff nurse B. nurse manager C. LPN D. charge nurse A) C, D, A, B B) A, C, B, D C) C, A, B, D D) C, A, D, B 37) Which of the following is not one of the four categories related to client care plans? A) privacy B) evaluation C) diagnosis D) outcome 38) What is the best definition for ethics in nursing? A) advocating for the client B) knowing your scope of practice C) being able to differentiate right from wrong D) being willing to report violations 39) Which of the following is true of advanced directives? A) They should be appropriately documented in the client’s chart. B) They are only applicable if the client has a terminal illness. C) They are required if the client is unconscious. D) They are non-legal requests. 40) When documenting in the client’s record, what type of information should be recorded? A) educated predictions of outcomes B) personal opinions C) objective information D) subjective information 41) The nurse is caring for a client recovering from a stroke who recently regained consciousness. The client is having difficulty communicating verbally with the team. Which of the following would be least appropriate? A) Begin client data collection prior to receiving the physician’s order for the referral. B) Use documents to contribute information for the referral. C) Wait for the physician to order speech therapy and then assist with the appropriate documentation. D) Participate in the client referral process. 42) The nurse is admitting a client to the unit who says they would feel more reassured with an extra oxygen tank in their room because of a past incident when they were short of breath. Which of the following statements is the best response? A) “I will make sure there is always an extra oxygen tank in your room.” B) “I will ask the previous nurse if the extra tank was needed.” C) “I will need to check if your insurance benefits would cover an additional oxygen tank.” D) “The first priority is ensuring there are enough oxygen tanks for everyone who needs them. I am not sure we will be able to provide an extra on standby.” 43) The nurse in the emergency room is admitting a client who has sustained a gunshot wound and will require immediate surgery. The client is unconscious and by themselves. Which of the following actions is most appropriate? A) Call the charge nurse and request that the facility’s legal counsel provide a waiver for informed consent. B) Attempt to stabilize the client in the emergency room until they are conscious enough to provide informed consent. C) Try to locate the client’s family to obtain informed consent before transporting the client to the operating room. D) Proceed with transporting the client to the operating room without obtaining informed consent. 44) The nurse is working the same shift two days in a row. On the first of these days, while caring for one assigned client, the client says, “Will you promise me you will be my nurse tomorrow?” Which response is most appropriate. A) “Yes, I promise you I will be your nurse during my shift tomorrow.” B) “You will need to speak to my supervisor about this request.” C) “While I cannot promise that I will be your nurse tomorrow, I can talk to the charge nurse about this request.” D) “Because of confidentiality, I cannot discuss tomorrow’s assignments with you.” 45) While documenting on a paper form, the nurse realizes they have made a mistake writing the progress note. What should the nurse do? A) Mark through the mistake with a single line, then add initials and the date and time. B) Use a black marker to fully cover up the mistake. C) Do not make any changes to the progress note but explain later in the note that a mistake was made and note what should have been written. D) Use whiteout to cover over the mistake and write over it. 46) Which of the following is not true of clinical pathways? A) They need to be updated daily. B) They show how the client is expected to respond to their diagnosis. C) The goal is improvement or discharge from the facility. D) They are evidence based. 47) The nurse is caring for a client awaiting test results on a biopsy. The client is unconscious, and the physician informs the client’s spouse that the biopsy came back positive for cancer. The spouse asks the nurse if they will not share this news with the client because they would prefer the client be unaware of the diagnosis. Which of the following responses is most appropriate? A) “I will have a psychiatrist confirm that the news will cause negative effects, and if so, I will comply with your request.” B) “For ethical reasons, I am unable to withhold this information from the client.” C) “You will need to sign paperwork stating you are accepting the risk of not sharing this with the client.” D) “ You must have a durable power of attorney for health care advanced directive in place before I can consider this request.” 48) The nurse receives an assignment of three clients. Which of the following should the nurse consider as highest priority when determining which client to assess first? A) the client who most recently rang their call bell B) the client who has been waiting the longest for their call bell to be answered C) the client who is in the most pain D) the client who may have a risk for an airway obstruction 49) During an emergency procedure, is the surgical timeout a requirement? A) As long as the surgical timeout would not cause a delay leading to injury or death, the time-out should be performed by the surgical team. B) No, in an emergency procedure, the timeout does not need to be performed. C) No, the surgical timeout is optional depending on the surgeon’s preferences. D) Yes, the surgical timeout should be performed in all cases. 50) Which of the following provides the framework for confidentiality and the client’s right to privacy? A) Health Insurance Portability and Accountability Act B) CDC Surveillance Programs C) American Nurses Association Code of Ethics D) durable power of attorney for health care Hints Be alert for words like better, best, most, main, major, and primary/primarily in questions. They indicate that there might be other answers that could work, but the correct answer is the one that is the best of the choices given. Be alert for words like better, best, most/mostly, main/mainly, major, greatest, largest, priority, and primary/primarily in questions. They indicate that there might be other answers that could work, but the correct answer is the one that is the best of the choices given. Be alert for words like better, best, most/mostly, main/mainly, major, highest, greatest, largest, priority, and primary/primarily in questions. They indicate that there might be other answers that could work, but the correct answer is the one that is the best of the choices given. Be alert for words like not, cannot, except, false, incorrect(ly), least (likely), without, and other negative word forms in questions. These words change the purpose of your search for the correct answer. Be alert for words like not, except, false, incorrect, least (likely), and other negative word forms in questions. (In this case, the word is inappropriate.) These words change the purpose of your search for the correct answer. Be sure to consider describing words like first, next, before, and after in questions. They indicate that there is one particular correct answer, even if the other answer choices may be related to the question. When you encounter a term like most nearly, closest, or most appropriate in a question, it is a signal that there may be very fine differences in the answer choices or that even the correct answer choice is not a perfect match. In either case, you should look for the answer that is best at meeting the terms of the question. Answer Explanations 1) B He should take the assignment, but explain the situation to the charge nurse and ask for a quick orientation before starting. Explanation While the LPN may specialize in a certain type of nursing or feel more comfortable caring for a specific client population, he should be able to use his skill set to safely and independently care for other populations as well. However, the LPN should let the charge nurse know his background before beginning his shift so he can familiarize himself with new equipment, ask questions, and identify resources. 2) A B, D, E Explanation While LPNs are expected to perform assessments, initial assessments should always be performed by a registered nurse or attending physician. LPNs should take orders for client care and equipment adjustment from prescribing providers directly, not the charge nurse. Teaching, obtaining stool samples, and documenting medication administration are all within the scope of practice of an LPN. 3) D a 20-year-old client with Cystic Fibrosis who needs an early morning sputum sample collection Explanation Collecting sputum samples on stable clients are within the scope of practice for an LPN. An RN should do the initial assessment on any client immediately post-op. An RN or medical provider should attend to any client suffering from an acute asthma attack. A client who is medically stable and needs help ambulating is best assigned to a nursing assistant. 4) C a client in an arm cast who is 2 days post-op and reports feelings of numbness and tingling in her affected arm Explanation Numbness and tingling hours or days after a cast is applied may indicate compartment syndrome and should be reported to a medical provider right away. The other options all feature expected or typical symptoms related to their diagnosis. 5) C “It sounds like you have a few more questions you’d like answered. Let me grab the doctor quickly so he can answer them for you.” Explanation This is the only option that validates the client’s concerns and also respects his right to informed consent. 6) D They cannot be honored by EMTs (emergency medical technicians) unless signed by a doctor. Explanation If summoned, EMTs are legally obligated to provide emergency care to a client, regardless of advance directive status, unless the directive is signed by a doctor. If the client is brought to the hospital, physicians will evaluate the client and implement the advance directive, if necessary. Two physicians, not one, are needed to determine if a client is unable to make decisions for himself/herself. Advance directives do not expire and remain in effect until they are changed. Some states do not honor advance directives created in other states, so if a client moves, he/she should check with his/her new state policies on this topic. 7) D B, C, E Explanation Reviewing or obtaining any information regarding clients not in your care or discussing sensitive client information in non-secure environments are violations of HIPAA. Discussing discharge plans in a multi-bed recovery room is considered an “incidental disclosure” and is not considered a HIPAA violation. 8) C The client will maintain a blood glucose level within the normal range of 70–110 (per facility policy) throughout my shift. Explanation Outcomes in nursing care plans should be objective, obtainable, observable, and measurable. 9) D Speak with the attending physician about his concerns and request a referral to physical therapy. Explanation Nurses need to be aware of clients’ needs even if they do not pertain to the reason for hospitalization and treatment. It is important to advocate for clients and request referrals when concerns and/or issues arise during care. 10) C call the attending physician to verbally verify the order including correct medication, dose, route, and frequency Explanation It is the nurse’s responsibility to fully comprehend an attending physician’s order prior to carrying it out. This includes verifying any confusing or indiscernible directions/orders via calling or discussing in person with the attending physician. 11) C “Subcutaneous Heparin injection was attempted to be given to the client per the physician’s order. Client refused, stating, ‘I do not want that injection.’ Potential risks for refusing the medication were reviewed with the client and client verbalized understanding.” Explanation Documentation in healthcare should be objective, thorough, but direct. It should be articulate, with correct grammar and spelling. 12) A Delegate the task to the nurse aide, confirm understanding, and follow up to ensure the task was safely/correctly done. Explanation Delegation is transferring responsibility for a task but sharing its accountability. It is the delegator’s responsibility to make sure the delegatee understands the task prior and to follow up after to make sure it was done correctly and safely. 13) B Report the conflict to the assigned charge nurse of the unit. Explanation It is important to follow the appropriate chain of command in a professional setting and to not overstep any levels when moving the issue up the ladder. It would not be appropriate to discuss the conflict with a nurse on your own level of authority. 14) C The nurse reports in the hallway, SBAR format, and alerts the oncoming LPN about how rude the client was throughout the shift. Explanation Report should be at the bedside, in SBAR format, and given in an objective way. 15) D answer any questions as appropriate as well as have the surgeon come back to answer any questions if needed Explanation Nurses should always advocate for their clients, making sure they understand everything involving their health as well as ensuring all questions are answered appropriately and thoroughly. 16) C Ensure that all staff members are proficient in completing incident reports if a medication error occurs. Explanation Organized, accurate incident reports are important in tracking and understanding why errors occurred. CQI teams use incident reports to create new or build upon existing policies to help standardize medical processes to help reduce errors. 17) B C, B, D, A Explanation Prioritizing client care is a critical skill to learn as a LPN. The 53-year-old is at highest risk for serious healthcare complications and should be seen first. The 23-year-old’s pain should be addressed second, prior to answering questions about the 47-year-old’s surgery. Finally, the LPN should address the needs of the 72year-old client. 18) B report the findings to the appropriate authorities based on the state requirements and protocols Explanation It is the responsibility of any healthcare provider/team member to report any type of suspected abuse to the police or dictated agency per the state policy. 19) A the client’s right to make personal health decisions without interference, as the nurse tried to sway the client’s decision-making and healthcare choice in the direction of not having an abortion Explanation A client has the right to make decisions about his or her healthcare without interference from health team members. It is our duty to respect those decisions and not try to influence patients based on our beliefs. 20) A False imprisonment, as the nurse is not allowing the client to leave as he has decided to. Explanation Refusing to let a client leave against medical advice (AMA) is a form of false imprisonment and is a legal issue for nurses. 21) D C, B, A Explanation For the client’s referral to physical therapy, the nurse should first contact the primary care provider to discuss. Once the primary care provider provides the official referral, the physical therapist should have an opportunity to review the client’s condition and medical record. Once the physical therapist has completed their review and is ready to see the client, the nurse can transport the client to physical therapy. 22) A Report the concern to the charge nurse. Explanation When there is a concern about a potentially unsafe health care provider, the nurse should intervene immediately and not allow the physician to continue with the procedure until the concern is investigated; the concern should be reported to the next person in the chain of command. An incident report can be written following reporting and an investigation. 23) A informed consent Explanation Informed consent is not a type of advanced directive but is a process for obtaining consent to care or treatment. 24) C Ask the new nurse to take care of the transfer since the client’s medical record has all of the information and a report should not be needed. Explanation The nurse should ensure a safe handoff of care during the transfer. The nurse on the next shift should not be asked to complete the transfer for the client without a full handoff of care. 25) B Medications should be reported promptly. Explanation All charting should be accurate and timely. Computers can be used to look up information related to a client’s condition or treatment, but the reliability of sources should be confirmed. 26) C Allow the client’s family member to serve as the interpreter. Explanation The client’s family member should not be relied on as an interpreter. 27) B Discuss with the colleague the concern about wasting supplies. Explanation To ensure cost effective care, the nurse should discuss this wastage with the colleague as throwing away unused supplies may impact the unit’s supply cost. 28) C “Because this is a communicable disease, it may need to be reported to the CDC.” Explanation Many communicable diseases, such as HIV, have surveillance programs that require mandatory reporting. 29) C Only report conflicts that interfere with client care. Explanation When conflicts are recognized, they should be reported. Conflicts can involve all components of healthcare practice including client care, nursing staff interaction, interactions with other hospital staff, and resource use/availability. 30) A The nurse should ensure the client is educated on their discharge instructions. Explanation The nurse is responsible for ensuring the client is educated, they have their prescriptions, and all their questions are addressed prior to discharge. A client should always have a follow-up visit scheduled with their provider. 31) C a healthcare proxy Explanation A healthcare proxy involves the client appointing an individual to make medical decisions with regard to their treatment if they are unable to do so themselves. 32) C sharing your personal opinions to help provide additional information Explanation To be a good client advocate, the nurse should not tell the client what they personally think about a decision the client is making. 33) B Nurse Christine should inform their supervisor that assignments may need to be changed. Explanation When there is a change in the client’s status, the supervisor should be made aware so that client care assignments can be changed as needed. 34) D the physician Explanation It is the physician’s responsibility to obtain the client’s signature. The nurse is responsible for verifying that this occurred. 35) B “I understand, and you have the right to refuse blood transfusions.” Explanation The client has the right to refuse treatments or procedures, such as a blood transfusion, for religious reasons, and the nurse should confirm this. 36) D C, A, D, B Explanation Nurse managers oversee charge nurses who oversee staff nurses who oversee LPNs. 37) A privacy Explanation The four categories of client care plans are diagnosis, intervention, outcome, and evaluation. 38) C being able to differentiate right from wrong Explanation Ethics in nursing is being able to differentiate right from wrong. 39) A They should be appropriately documented in the client’s chart. Explanation Advanced directives are legal requests regarding a client’s health care regardless of the severity of their illness or level of consciousness. They should be verified on admission and documented in the client’s chart. 40) C objective information Explanation Objective, factual information should be recorded in the client’s chart. 41) C Wait for the physician to order speech therapy and then assist with the appropriate documentation. Explanation The nurse should participate in the client referral process, collect client data, and use appropriate documents to contribute information. It is not necessary to wait for the physician’s order if the nurse recognizes the need for client referral. 42) D “The first priority is ensuring there are enough oxygen tanks for everyone who needs them. I am not sure we will be able to provide an extra on standby.” Explanation The nurse should recognize the appropriate need for materials and equipment. The client’s preference for extra equipment that other clients may need is not appropriate. 43) D Proceed with transporting the client to the operating room without obtaining informed consent. Explanation In an emergency situation, the client can receive treatment without informed consent if delaying care would potentially cause injury or death. In this scenario, the nurse can proceed with transporting to the operating room without informed consent. 44) C “While I cannot promise that I will be your nurse tomorrow, I can talk to the charge nurse about this request.” Explanation While the nurse should not make any promises to the client, they can attempt to accommodate this request by speaking with their supervisor. 45) A Mark through the mistake with a single line, then add initials and the date and time. Explanation If a mistake has been made, it should be corrected with a line through the mistake along with the nurse’s initials and the date and time. Whiteout or a black marker that fully covers up the previous documentation is not as legally defensible and is not necessary. 46) A They need to be updated daily. Explanation Clinical pathways may be daily or weekly, so they may not need to be updated every day. 47) B “For ethical reasons, I am unable to withhold this information from the client.” Explanation The ethical principle of veracity requires that the nurse is truthful with the client and does not withhold information even if it is requested by the family. 48) D the client who may have a risk for an airway obstruction Explanation The nurse should use the ABCs (airway, breathing, circulation) to prioritize assessing a client with an airway risk first. 49) A As long as the surgical timeout would not cause a delay leading to injury or death, the time-out should be performed by the surgical team. Explanation The surgical timeout should be performed as long as the delay in performing the timeout would not have negative consequences. 50) A Health Insurance Portability and Accountability Act Explanation HIPAA is the federal statute that outlines client confidentiality and the client’s right to privacy.