NCLEX-NCBSN MANAGEMENT OF
CARE EXAM QUESTIONS & ACTUAL
CORRECT ANSWERS
The charge nurse is making assignment for the health care team. Which of these tasks
can be safely delegated to the licensed practical nurse (LPN)?
Teach the initial ostomy care to a client and family members
Care for a recent complicated double barrel colostomy
Provide stoma care for a client with a well-functioning ostomy
Assess the function of a newly created ileostomy - CORRECT ANSWER PROVIDE
STOMA CARE FOR A CLIENT WITH A WELL-FXN OSTOMY
The care of a mature stoma and the application of an ostomy appliance may be
delegated to a LPN. The condition of this client is stable, there's a low likelihood of any
emergency and care of this client is not too complex. The other options require higher
level care by the RN. The RN is the manager of care and is responsible for any initial
teaching; the LPN can reinforce information once it has been introduced by the RN.
A nurse receives an illegible hand-written medication order. Which statement to the
health care provider reflects assertive communication?
"Would you please clarify what you have written so I am sure I am reading it correctly?"
"Please print in the future so I do not have to spend extra time attempting to read your
writing."
"I cannot give this medication as it is written. I have no idea of what you mean."
"I am having difficulty reading your handwriting. It would save me time if you would be
more careful." - CORRECT ANSWER WOULD YOU PLEASE CLARIFY WHAT YOU
HAVE WRITTEN SO I AM SURE I AM READING IT CORRECTLY
Assertive communication respects the rights and responsibilities of both parties. This
statement is an honest expression of concern for safe practice and a request for
clarification without self-depreciation. It reflects the right of the professional to give and
receive information.
,The 83 year-old client, who lives in a retirement community, is admitted to the hospital.
The daughter reports the client no longer calls her every day, has not been participating
in previously enjoyed activities, such as weekly card games, and has allowed the
garden to become overgrown with weeds. The nurse should assign this client to a room
with which of the following clients?
A young adult who was admitted 24 hours ago for treatment following detoxification
An elderly person who was admitted three hours ago with a diagnosis of cyclothymia
An adolescent who was admitted the day before with a diagnosis of disruptive mood
dysregulation
A middle-aged person who has been on the unit for 72 hours with a diagnosis of
persistent depressive disorder - CORRECT ANSWER A MIDDLE-AGED PERSON
WHO HAS BEEN ON THE UNIT FOR 72 HOURS WITH A DIAGNOSIS OF
PERSISTENT DEPRESSIVE DISORDER
These findings suggest depression. The most therapeutic milieu for this client includes
double occupancy with someone who has similar issues and/or whose condition is more
stable. A secondary consideration is matching roommates' ages as closely as possible,
because they potentially would share similar developmental challenges and needs. The
most stable client is the one with persistent depressive disorder. Cyclothymia is an
illness that's similar to bipolar disorder and disruptive mood dysregulation disorder is
characterized by irritability and episodes of extreme, out-of-control behavior.
A registered nurse from the float pool is assigned to the critical care unit on the evening
shift. Which of these clients should be assigned to the float pool nurse?
Tracheostomy of 24 hours with the client showing some respiratory distress
Report of unstable angina with continuous telemetry monitoring
Dopamine IV drip with vital signs monitored every five minutes
Pacemaker insertion on the day shift - CORRECT ANSWER The nurse from the float
pool should be assigned to care for the most stable client, which is the client who had
the pacemaker inserted on the day shift. The other clients are unstable and have
potentially life-threatening conditions. In most critical care units, the nurse can titrate
dopamine upward or downward; this requires the expertise of the nurse who normally
works on this unit. Although tracheostomies are not limited to critical care units, a nurse
unexperienced in critical care should not be assigned to the client with a newly created
tracheostomy
, A woman dressed in a business suit with no visible identification is at the nurses station
looking at client charts. What nursing action is most appropriate?
Immediately call security for this breach in client confidentiality
Request to see identification and an explanation as to why the woman is viewing client
charts
Ignore the person; many outside vendors check charts to set up a transfer or to
coordinate care
Report to the nurse manager about the witnessed suspicious activity - CORRECT
ANSWER REQUEST TO SEE ID AND AN EXPLANATION AS TO WHY THE WOMAN
IS VIEWING CLIENT CHARTS
Nurses have a duty to protect the confidentiality of client records. In fact, HIPAA and
other confidentiality laws require that nurses verify the identity and authority of
individuals requesting information. Acceptable verification may include a photo ID and a
copy of the documentation supporting legal authority to access information. The nurse
needs to determine who the person is, ask to see a valid ID, and ask for the reason for
reading the chart. Security may need to be called, but the nurse first needs more
information. It is each nurse's duty to do this and no one should pass it off to a manager
or ignore the situation.
A 90 year-old is readmitted to the hospital, less than 2 weeks after being discharged, for
the same health concern. What factors contribute to hospital readmissions among older
adults? (Select all that apply.)
Family preferences
Client health status
Excellent primary care
Reconciliation of medications
Poor communication among providers - CORRECT ANSWER FAMILY PREF
CLIENT HEALTH STATUS
POOR COMMUNICATION AMONG PROVIDERS
Avoidable hospitalization, especially among older adults living in skilled nursing
facilities, usually results from multiple system failures. The reasons most often cited
include inadequate primary care (including inadequate discharge planning and lack of
CARE EXAM QUESTIONS & ACTUAL
CORRECT ANSWERS
The charge nurse is making assignment for the health care team. Which of these tasks
can be safely delegated to the licensed practical nurse (LPN)?
Teach the initial ostomy care to a client and family members
Care for a recent complicated double barrel colostomy
Provide stoma care for a client with a well-functioning ostomy
Assess the function of a newly created ileostomy - CORRECT ANSWER PROVIDE
STOMA CARE FOR A CLIENT WITH A WELL-FXN OSTOMY
The care of a mature stoma and the application of an ostomy appliance may be
delegated to a LPN. The condition of this client is stable, there's a low likelihood of any
emergency and care of this client is not too complex. The other options require higher
level care by the RN. The RN is the manager of care and is responsible for any initial
teaching; the LPN can reinforce information once it has been introduced by the RN.
A nurse receives an illegible hand-written medication order. Which statement to the
health care provider reflects assertive communication?
"Would you please clarify what you have written so I am sure I am reading it correctly?"
"Please print in the future so I do not have to spend extra time attempting to read your
writing."
"I cannot give this medication as it is written. I have no idea of what you mean."
"I am having difficulty reading your handwriting. It would save me time if you would be
more careful." - CORRECT ANSWER WOULD YOU PLEASE CLARIFY WHAT YOU
HAVE WRITTEN SO I AM SURE I AM READING IT CORRECTLY
Assertive communication respects the rights and responsibilities of both parties. This
statement is an honest expression of concern for safe practice and a request for
clarification without self-depreciation. It reflects the right of the professional to give and
receive information.
,The 83 year-old client, who lives in a retirement community, is admitted to the hospital.
The daughter reports the client no longer calls her every day, has not been participating
in previously enjoyed activities, such as weekly card games, and has allowed the
garden to become overgrown with weeds. The nurse should assign this client to a room
with which of the following clients?
A young adult who was admitted 24 hours ago for treatment following detoxification
An elderly person who was admitted three hours ago with a diagnosis of cyclothymia
An adolescent who was admitted the day before with a diagnosis of disruptive mood
dysregulation
A middle-aged person who has been on the unit for 72 hours with a diagnosis of
persistent depressive disorder - CORRECT ANSWER A MIDDLE-AGED PERSON
WHO HAS BEEN ON THE UNIT FOR 72 HOURS WITH A DIAGNOSIS OF
PERSISTENT DEPRESSIVE DISORDER
These findings suggest depression. The most therapeutic milieu for this client includes
double occupancy with someone who has similar issues and/or whose condition is more
stable. A secondary consideration is matching roommates' ages as closely as possible,
because they potentially would share similar developmental challenges and needs. The
most stable client is the one with persistent depressive disorder. Cyclothymia is an
illness that's similar to bipolar disorder and disruptive mood dysregulation disorder is
characterized by irritability and episodes of extreme, out-of-control behavior.
A registered nurse from the float pool is assigned to the critical care unit on the evening
shift. Which of these clients should be assigned to the float pool nurse?
Tracheostomy of 24 hours with the client showing some respiratory distress
Report of unstable angina with continuous telemetry monitoring
Dopamine IV drip with vital signs monitored every five minutes
Pacemaker insertion on the day shift - CORRECT ANSWER The nurse from the float
pool should be assigned to care for the most stable client, which is the client who had
the pacemaker inserted on the day shift. The other clients are unstable and have
potentially life-threatening conditions. In most critical care units, the nurse can titrate
dopamine upward or downward; this requires the expertise of the nurse who normally
works on this unit. Although tracheostomies are not limited to critical care units, a nurse
unexperienced in critical care should not be assigned to the client with a newly created
tracheostomy
, A woman dressed in a business suit with no visible identification is at the nurses station
looking at client charts. What nursing action is most appropriate?
Immediately call security for this breach in client confidentiality
Request to see identification and an explanation as to why the woman is viewing client
charts
Ignore the person; many outside vendors check charts to set up a transfer or to
coordinate care
Report to the nurse manager about the witnessed suspicious activity - CORRECT
ANSWER REQUEST TO SEE ID AND AN EXPLANATION AS TO WHY THE WOMAN
IS VIEWING CLIENT CHARTS
Nurses have a duty to protect the confidentiality of client records. In fact, HIPAA and
other confidentiality laws require that nurses verify the identity and authority of
individuals requesting information. Acceptable verification may include a photo ID and a
copy of the documentation supporting legal authority to access information. The nurse
needs to determine who the person is, ask to see a valid ID, and ask for the reason for
reading the chart. Security may need to be called, but the nurse first needs more
information. It is each nurse's duty to do this and no one should pass it off to a manager
or ignore the situation.
A 90 year-old is readmitted to the hospital, less than 2 weeks after being discharged, for
the same health concern. What factors contribute to hospital readmissions among older
adults? (Select all that apply.)
Family preferences
Client health status
Excellent primary care
Reconciliation of medications
Poor communication among providers - CORRECT ANSWER FAMILY PREF
CLIENT HEALTH STATUS
POOR COMMUNICATION AMONG PROVIDERS
Avoidable hospitalization, especially among older adults living in skilled nursing
facilities, usually results from multiple system failures. The reasons most often cited
include inadequate primary care (including inadequate discharge planning and lack of
