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NURS 2207 Basics of Nursing Practice (NCLEX-PN Remediation) Study Guide, Exams of Nursing

This study guide provides a comprehensive overview of basic nursing practice concepts, focusing on nclex-pn remediation. It includes multiple-choice questions with rationales, covering topics such as the philosophy of alcoholics anonymous, documentation rules, conflict resolution, preoperative medication administration, consent for autopsy, delegation principles, practical nurse education, body mechanics, client introductions, postoperative positioning, grieving process, and client care. The guide aims to help students prepare for the nclex-pn exam by reinforcing key concepts and providing practice questions.

Typology: Exams

2023/2024

Available from 11/06/2024

CHARITHWENTON
CHARITHWENTON 🇺🇸

174 documents

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NURS 2207 Basics of NursingPractice

(NCLEX-PN Remediation).

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Basics of Nursing Practice

  • A nurse discusses the philosophy of Alcoholics Anonymous (AA) with the client who has a history of alcoholism. What need must self-help groups such as AA meet to be successful? o Belonging

Rationale

Self-help groups are successful because they support a basic human need for acceptance. A feeling of comfort and safety and a sense of belonging may be achieved in a nonjudgmental, supportive, sharing experience with others. AA meets dependency needs rather than focusing on independence, trust, and growth.

  • The registered nurse is explaining basic rules for documentation to a licensed practical nurse (LPN). Which statements made by the LPN indicate effective learning? Select all that apply. o "I will document the details when observed."

o "I will record in the chart using black ink pen."

Rationale The LPN should document the details when they are observed, but the details should not be written based on opinions. Black ink pen should be used to record in the chart. The LPN should not include generalized empty phrases in the details. The LPN should never leave empty lines in the chart because another person may enter additional or incorrect information. The LPN should not wait until end of shift to record important changes that occurred several hours earlier,but record the events when they occur.

  • The nurse resolves a conflict with another nurse by using accommodation. In what situations is accommodation appropriate for resolving conflict? Select all that apply. o When facing trivial issues o When the other person's solutions appear better o When harmonious relationships have to be preserved

Rationale

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Appropriate reasons for accommodating to resolve conflict include when the issues are trivial or not important, when the other person's ideas or solutions are better, or when harmonious relationships have to be preserved. Avoiding defensiveness is not an appropriate reason to accommodate when resolving conflict. Gathering more information is not an appropriate reason to accommodate when resolving conflicts, unless that additional information has shown that the nurse has made a mistake.

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  • What does the nurse plan to do before administering preoperative medication to a client? o Verifying consent

Rationale

Consent must be acquired when the client is fully oriented and in a clear mental state. Although important, having the client void can be implemented before surgery even if the client has received medication. Although important, checking the vital signs can be implemented before surgery even if the client has received medication. Although important, removing the client's dentures can be implemented before surgery even if the client has received medication.

  • A nursing student is recalling the order of priority for giving consent to perform an autopsy in cases where a medical examiner review is not needed. Which person receives the highest priority for giving consent? o The client in writing before death

Rationale

If a medical examiner's review is not necessary, the highest priority is given to the client. The client may provide the consent in writing before death. If the client or the surviving spouse is unable to give consent for the autopsy, a surviving child may be requested to give consent. The surviving parent may give consent for an autopsy if the client, the surviving spouse, and the surviving child are unable to do so. In case the client has not provided written consent before death, the nurse may obtain consent from the surviving spouse.

  • A registered nurse delegates a task to a licensed practical nurse (LPN). The nurse manager asks the registered nurse, "Are the equipment and resources available for the LPN to complete the task?" Which right of delegation is the nurse manager preserving? o Right Circumstance

Rationale Questions such as, "Is the environment conducive to completing the task safely?" and, "Are the equipment and resources available to complete the task?" ensure the right circumstance for delegation. Right task is ensured with a question such as, "Is the task appropriate to the delegate, according to institutional policies and procedures?" Delegation is taking the right direction if the answer to a question such as, "Do the

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delegator and delegatee understand a common work-related language?" is positive. Right supervision is evaluated with a question such as, "Is the delegator able to monitor and evaluate the client appropriately?"

  • Which organization acts as the guiding force in the development of practical nurse education?

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o National Association for Practical Nurse Education and Service (NAPNES)

Rationale

Currently, the National Association for Practical Nurse Education and Service is regarded as the guiding force in the development of practical nursing education. Though not considered the guiding force in practical nursing education, the other organizations make contributions to nursing education as well. The National League for Nursing accredits nursing programs. The Young Women’s Christian Association established the first school of practical nursing in Brooklyn, New York. The National Federation of Licensed Practical Nurses is the official membership organization for licensed practical nurses and licensed vocational nurses.

  • Two nurses are planning to help a client with one-sided weakness to move up in bed. What should the nurses do to conform to proper body mechanics? o Position the nurses on either side of the bed with their feet apart, gather the pull sheet close to the client, turn toward the head of the bed, and then move the client.

Rationale

Positioning the nurses on either side of the bed with their feet apart, gathering the pull sheet close to the client, turning toward the head of the bed, and then moving the client places both nurses in a stable position in functional alignment, thereby minimizing stress on muscles, joints, ligaments, and tendons. The client should be instructed to fold the arms across the chest; this keeps the client's weight toward the center of the mass being moved and keeps the arms safe during the move up in bed. The nurses should assist the client in flexing the knees and placing the feet flat on the bed; this enables the client to push the body upward using a major muscle group. The client's assistance to the best of his or her ability reduces physical stress on the nurses as they move the client up in bed. On the count of three, weight should be shifted from the back to the front leg, not the front to the back leg. This action generates movement in the direction that the client is being moved.

  • The nurse introduces himself or herself to the client while measuring the client’s body temperature. What is the reason for this introduction? o To decrease the client’s anxiety

Rationale When the nurse introduces herself or himself to the client, this action decreases anxiety in the client. Explaining the procedure to the client will help to gain the

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client’s cooperation. Identifying a client by his or her identification band will help to ensure the correct client is receiving the correct procedure. Assembling the thermometer, providing soft disposable tissues, having a lubricant pen and note pad, having disposable gloves, and having a plastic sleeve will promote an efficiently completed procedure.

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  • In what position should the nurse place a client recovering from general anesthesia? o Side-lying

Rationale

Turning the client to the side promotes drainage of secretions and prevents aspiration, especially when the gag reflex is not intact. This position also brings the tongue forward, preventing it from occluding the airway when it is in the relaxed state. The risk for aspiration is increased when the supine position is assumed by a semi-alert client. High Fowler position may cause the neck to flex in a client who is not alert, interfering with respirations. Trendelenburg position is not used for a postoperative client, because it interferes with breathing.

  • A client who has reached the stage of acceptance in the grieving process appears peaceful, but demonstrates a lack of involvement with the environment. How should the nurse address this behavior? o Accept the behavior the client is exhibiting

Rationale

Detachment is a coping mechanism that the client needs, especially when faced with the inevitability of death; the nurse should accept this behavior. Ignoring the behavior does not convey a willingness to listen and denies the client's feelings. The client is in acceptance. It is unnecessary to point out the reality of the situation. It is counterproductive to encourage the client to become involved with the environment.

  • A client is being admitted to a medical unit with a diagnosis of pulmonary tuberculosis. Which type of room should the nurse assign the client? o Negative airflow room

Rationale

Tuberculosis is an airborne contagious disease that is best contained in a negative airflow room. Negative airflow rooms are always private. A private room, semiprivate room, and a room with windows that can be opened are not appropriate for the standard of care for a client diagnosed with tuberculosis. Additionally, opening windows would present a possible safety hazard in a client's room.

  • The client is about to leave the hospital, with home health nursing. Where should the nurse document the physiologic status of the client? o Discharge and transfer forms

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Rationale

The nurse should document the physiologic status of the client in discharge and transfer forms. The nurse documents the client’s laboratory and radiology results in flow sheets. The nurse documents the functional status of the client in progress notes.

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Judgment related to the nursing diagnosis of the client should be documented in the client care plan.

  • A nursing student is learning about the cultural beliefs and practices of Muslim Americans, Chinese Americans, African Americans, and Native Americans. Which statement by the nursing student is correct? o Chinese Americans prefer to sit at right angles to carry on conversation and African Americans tend to have a small comfort area of personal space.

Rationale Chinese Americans are uncomfortable in face-to-face situations; they prefer to sit side by side or at right angles to carry on a conversation. For African Americans, the personal space comfort area tends to be close. Mexican Americans often use touch and value closeness and physical contact in familiar situations. African Americans, especially those belonging to the older generation, often find eye contact uncomfortable. Muslim American women do not usually shake hands with men; Native Americans, not Chinese Americans, extend a hand and lightly touch the hand of the person they are greeting instead of shaking hands. Native Americans are initially silent and reserved when meeting someone but demonstrate warmth once someone becomes familiar to them. When introducing themselves by name, Native Americans give honor to their ancestors by stating the clan and the location of their home area.

  • Which nursing interventions should the nurse provide to an older client with hypertension? Select all that apply. o Advise the client to limit salt intake o Teach stress management

o Instruct the client to quit smoking

Rationale

Proper nursing interventions for an older client with hypertension include advising the client to limit salt intake, teaching stress management, and instructing the client to quit smoking. Skin care is an appropriate intervention for clients at risk of pressure ulcers. Information about immunization is provided to older adults at a risk for developing influenza. The nurse should advise a client with dementia to eat finger foods such as sandwiches because these foods are easy to eat.

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  • A nurse manager is selecting direct care nurses for a client-care project. The manager asks a direct care nurse about treatment priorities. Which answer provided by the direct care nurse would be appropriate? o "I will give preference to the problems that have the greatest urgency."

Rationale

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The preference for treatment should be always given to problems that have the greatest urgency such as life-threatening conditions. Secondary preference should be given to problems that are encountered first, problems that appear to be easiest to resolve, and problems that take the shortest amount of time to resolve.

  • Which nursing action is in accordance with the Health Insurance Portability and Accountability Act (HIPAA)? o A nurse avoids discussing a client’s reports anywhere outside the health-care facility.

Rationale The Health Insurance Portability and Accountability Act (HIPAA) protects the confidentiality of health information. The nurse is following the law by avoiding discussion of a client’s reports outside the health-care facility. The Patient Self- Determination Act (PSDA) emphasizes the right to accept or refuse treatment and requires institutions to maintain written policies and procedures regarding advance directives; this is the law the nurse is following by advocating for a client’s wish to donate organs after death. This law also calls for the health-care provider to seek permission to apply life support in an incapacitated client. A nurse who discusses a client’s condition with a primary health-care provider in another facility may be in breach of HIPAA if the client has not explicitly signed a release form for the nurse to do so.

  • A nurse is caring for four different clients. Which client is the most likely recipient of Medicare? o Client with permanent kidney failure

Rationale Medicare is a health insurance program administered by the U.S. government as part of the Social Security Act. Based on the disorders alone, a client with permanent kidney failure is the most likely to receive Medicare. Dementia, depression, and type 2 diabetes mellitus are considered lower-priority disorders in terms of Medicare eligibility.

  • What is the most fundamental ethical principle in the health care setting? o Respect for people

Rationale

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The most fundamental ethical principle in the health care setting is respect for people. Justice is the concept of fairness. Truthfulness is telling the client the truth. Freedom of personal choice or autonomy is the right to be independent and make decisions freely. These are all important but not as fundamental.

  • A nurse discusses situational leadership roles with a nursing student. Which statement by the nursing student is correct?

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o "The basis of this leadership style is the manager’s flexibility in adapting to the needs of the group or individual."

Rationale

In situational leadership theory, the manager has flexibility in adapting to the needs of the group or individual. Laissez-faire leadership is termed free-run style. This type of leadership style fosters professional growth of the manager and staff. It does not work well with highly motivated professional groups.

  • A nurse identifies that an older adult has not achieved the desired outcome from a prescribed medication. When assessing the situation, the client shares that the medication is too expensive and the prescription was never filled. What is an appropriate nursing response? o Inform the health care provider of the inability to afford the medication. Rationale
  • A nurse is caring for a client that has been admitted with right sided heart failure. The nurse notes that the client has dependent edema around the area of the feet and ankles. In order to characterize the severity of the edema, the nurse presses the medial malleolus area and notes an 8 mm depression after release. How does this nurse understand that the edema should be documented? o +

Rationale Dependent edema around the area of feet and ankles often indicates right sided heart failure or venous insufficiency. The nurse should assess for pitting edema by pressing firmly for several seconds then release to assess for any depression left on the skin. The grading of 1+ to 4+ characterizes the severity of the edema. A grade of grade of 4+ indicates an 8 mm depression. A grade of 1+ indicates a 2 mm depression. A grade of 2+ indicates a 4 mm depression. A grade of 3+ indicates a 6 mm depression.

  • After assessing the delegatee's inability to perform an assigned task, the delegator explains the procedure and demonstrates the task to the delegatee. What can be inferred about the delegatee? o The delegatee may have an ongoing relationship with the delegator, but a new task is assigned. Rationale

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When the delegatee has an ongoing relationship with the delegator, but a new task is assigned, the delegator should explain and demonstrate the procedure. When the delegatee has limited knowledge and ability to perform the task, the delegator should provide more guidance. When the delegatee has an established relationship with the delegator and the expertise, little guidance is needed from the delegator to perform the task. When the delegatee has the willingness and ability to perform a task, but the

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relationship is new, it requires both individuals to create mutual expectations and the conditions for performance.

  • A client who has a long leg cast for a fractured bone is to be discharged from the emergency department. When discussing pain management, when does the nurse advise the client to take the prescribed as-needed oxycodone? o When the discomfort begins Rationale

Pain is most effectively relieved when an analgesic is administered at the onset of pain, before it becomes intense; this prevents a pain cycle from occurring. Analgesics are less effective if administered when pain is at its peak. Before going to sleep, it may or may not be necessary; the medication should be taken when the client begins to feel uncomfortable within the parameters specified by the healthcare provider's prescription. Analgesics are less effective if administered when pain is at its peak.

  • A registered nurse teaches a licensed practical nurse about the roles of a team leader. Which of these statements made by the licensed practical nurse indicate effective learning? Select all that apply. o "I will receive reports on assigned clients." o "I will assist in administering medications."

o "I will make assignments for team members."

Rationale A licensed practical nurse (LPN) who serves as team leader has certain duties, which include administering medications, receiving reports on assigned clients, and delegating assignments to team members. Conducting routine staff evaluations and submitting staffing schedules for the unit are responsibilities of the nurse manager.

  • Which nursing action is appropriate when conducting a secondary survey during the emergency assessment? o Assigning a nurse to support family members

Rationale A nursing action that is appropriate during the secondary survey is assigning a nurse, or other team member, to support family members. Maintaining privacy, having suction available, and giving supplemental oxygen are all interventions during the

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primary survey.

  • A 2-g sodium diet is prescribed for a client with stage 2 hypertension. The client reports distaste for the food. The primary nurse hears the client request that the family “bring in a ham and cheese sandwich and fries.” What is the most effective nursing intervention? o Discuss the diet with the client and family.

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Rationale The client and significant family members should be included in dietary teaching; families provide support that promotes adherence. The client already has received information about why salty foods should not be eaten. Explaining the dietary restriction to the client's visitors could violate confidentiality. The client should be involved in his or her own care; the client ultimately will assume the responsibility. The dietitian is a resource person who can give specific, practical information about diet and food preparation once there is a basic understanding of the reasons for the diet.

  • What is the responsibility of a hospice volunteer on the hospice team? o Providing companionship to the client and caregiver.

Rationale A hospice volunteer is responsible for providing companionship to a client and caregiver. A volunteer coordinator recruits and trains volunteers. A bereavement coordinator is responsible for assessing and supporting the bereaved survivor. A primary spiritual leader is responsible for supporting the client and the caregiver in coping with fears.

  • Which staff members are part of a core interdisciplinary hospice team? Select all that apply. o Social Worker o Medical Director o Nursing Coordinator

Rationale

A core interdisciplinary hospice team includes the social worker, medical director, and nursing coordinator. A hospice pharmacist and a volunteer coordinator are members of a primary hospice team.

  • A client is admitted with a diagnosis of premature labor. The nurse discovers that the client has been using heroin throughout her pregnancy. What is the most appropriate action for the nurse to take? o Inform the client’s healthcare provider

Rationale

The fetus of a heroin-addicted mother is at risk for serious complications such as

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hypoxia and meconium aspiration. It is important to notify the healthcare provider of the client's heroin use, because this information will influence the care of the client and newborn. This information is used only in relation to the client's care. With the client's consent, it may be shared with other social service or health agencies that become involved with the client's long-term care. The nurse manager of the unit may be notified as it relates to the care of the client and her newborn. Client information is

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confidential and only necessary staff should be privileged to such information. Hospital security would only be notified if actual illicit substances were discovered on hospital premises.

  • Which responsibility of the nurse manager differs from the responsibilities of a nurse leader? o Planning the budget Rationale

Budgeting is the responsibility of a nurse manager. The role of nurse leader is to motivate the nursing subordinates. Resolving conflicts is the responsibility of both the nurse leader and the nurse manager. Penalizing for poor performance is a behavior of transactional leadership.

  • An individual is verbally inflicting anguish, emotional pain, and distress on an older adult. Which type of abuse is this? o Psychological Rationale

Psychological or emotional abuse involves the infliction of anguish, emotional pain, or distress through verbal or nonverbal acts. Sexual abuse is nonconsensual sexual contact including with someone who is incapable of giving consent. Physical abuse involves the use of physical force that may cause bodily injury, physical pain, or impairment. Material abuse is defined as illegal or improper exploitation of an older adult’s funds, property, or other assets.

  • Which action of the nurse leader while preparing to share any information with followers is accurate? o Determining which information is to be shared

Rationale The nurse leader should determine the information that has to be shared with followers,but should not give all information at once. The nurse leader should give only limited information; giving too much at once can create disinterest in the listeners. The nurse leader can share information through mail as it is a primary communication method. The nurse leader should use face-to-face communication over text messages.

  • The registered nurse considers the qualification of the unlicensed nursing personnel

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(UNP) before delegating a task. Which right of delegation is followed by the nurse? o Person Rationale

The knowledge and experience to perform the specific task safely by the delegatee is assessed by the qualification of the delegatee, which determines whether he or she is

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the right person. The right task involves assessing whether the task is legally appropriate to delegate or whether it is appropriate under institutional policies. The right direction involves the delegator providing clear and concise directions to perform the task. The right supervision is determined by whether the delegator is able to monitor and evaluate the client appropriately.

  • Which statement is true regarding home care services? o Home care services are cost effective

Rationale Home care services are cost effective. Home health services are for all age groups. Social workers take an active role in home health care. Intravenous therapy is included in home care services.

  • A nurse gathers data about the success of keeping the side rails of clients' beds up at nighttime to reduce the risk of falls. Which competency does the nurse display according to the Institute of Medicine (IOM) competencies of the 21st century? o Applying quality improvement

Rationale According to the Institute of Medicine (IOM) competencies of the twenty-first century, nurses are required to incorporate quality improvement into their work. A nurse performs this task by identifying potential hazards, designing interventions to improve quality, and evaluating the success of the strategies. In the given situation, the nurse is evaluating the success of a strategy to minimize clients' risks of falls. Using informatics involves the use of information technology for the purposes of communication, management of knowledge, and reduction of errors. Using evidence- based practice involves participating in research activities and integrating results of research with client care. A nurse is required to work with interdisciplinary teams to provide better care to clients. This action is done by cooperating and collaborating with the client, caregivers, and other health care workers.

  • When a client files a lawsuit against a nurse for malpractice, the client must prove that there is a link between the harm suffered and actions performed by the nurse that were negligent. What is this known as? o Proximate cause Rationale

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Proximate cause is the legal concept meaning that the client must prove that the nurse's actions contributed to or caused the client's injury. Evidence is data presented in proof of the facts, which may include witness testimony, records, documents, or objects. A tort is a wrongful act, not including a breach of contract or trust that results in injury to another person. Common cause means to unite one's interest with another's.

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  • As a nurse prepares an older adult client for sleep, actions are taken to help reduce the likelihood of a fall during the night. What nursing action is most appropriate when targeting older adult’s most frequent cause of falls? o Instructing the client to call the nurse before going to the bathroom

Rationale Statistics indicate that the most frequent cause of falls in hospitalized clients is getting up or attempting to get up to the bathroom unassisted. Although moving the bedside table closer to the bed is helpful in reducing falls because it moves the bedside table closer to the client's center of gravity, it is not the primary intervention to prevent falls. Sedatives contribute to the risk for falls by altering the client's sensorial abilities. Although talking to the spouse may calm the client and contribute to sleep, it does not reduce the incidence of falls.

  • While communicating with the primary health-care provider via phone, the nurse wants to repeat the order to ensure better understanding. Which method of communication of SBARR should the nurse choose? o Read-back

Rationale SBARR stands for Situation, Background, Assessment, Recommendation, and Read- back. In read-back, the nurse may repeat the order back to the primary health care provider to confirm correct understanding. In situation, the nurse discusses an aspect of the client’s care with the primary health-care provider. In assessment, the nurse discusses the previous medication details of the client. In recommendation, the nurse explains her plan of care to the primary health-care provider.

  • A hospitalized client feels drowsy and dizzy due to the administration of multiple doses of antihistamines over a 24-hour period. Which client need would the nurse leader address according to Maslow’s subcategories? o Safety and security needs

Rationale A client suffering from side effects of antihistamines should be provided safety needs. Because the client is drowsy and dizzy, he or she may lose a sense of balance and fall. Therefore, the client should be protected from any physical harm. Self-esteem needs are addressed when dignity and recognition are taken into consideration. Self- actualization needs involve personal growth and maturity. Love and belonging needs

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also would not be applicable here.

  • Which professionals in a healthcare organization can be delegators? o Registered Nurses

Rationale