Management of Care; HURST Review
UPDATED ACTUAL Questions and
CORRECT Answers
Which task would be appropriate for the Labor, Delivery, Recovery, Postpartum (LDRP) charge nurse to
assign to an LPN/VN?
1. Administering IV pain medication to a client three days postopertive cesarean section.
2. Drawing a trough vancomycin level on a client 3 days postpartum with bilaterial mastitis.
3. Reinforce how to perform perineal care to a primipara who is four hours postpartum.
4. Drawing routine admission labs on a client admitted in final stages of labor. - CORRECT
ANSWER - Answer: 3. Client teaching may be reinforced by an LPN/VN on a stable client.
Rationale:
1. Incorrect: Administering IV pain medications is out of the scope of practice of LPN/VN.
2. Incorrect: Drawing lab work on a client with severe infection and only 3 days postpartum is an unstable
client and needs care from the RN.
4. Incorrect: Drawing routine admission labs on a client in final stages of labor would be inappropriate
because the client is potentially unstable and needs experienced LDRP nursing care.
The nurse delegated feeding of a client to the unlicensed assistive personnel (UAP). Two hours after other
trays were picked up from the rooms, the nurse notes that the client's untouched tray is still at the bedside.
What should the nurse do first?
1. Feed the client after warming the food.
2. Speak to the UAP to determine what happened with the feeding.
3. Pick up the tray and tell the UAP that they didn't do a good job.
4. Provide a between meal supplement to the client. - CORRECT ANSWER - Answer: 2.
Communication is important in delegation, as is follow-up. There may be a good reason that the tray was
not served. The key word in the stem is first. The other options may be correct but are not the best first
action.
,Rationale:
1. Incorrect: The client does need to have food; however, there is another action that should be performed
first. The reason for the UAP not feeding the client needs to be determined. 3. Incorrect: The nurse retains
the responsibility for the delegated task. The nurse should not assume that the UAP just did not do their
job, but needs to ascertain the reason for not feeding the client. 4. Incorrect: The concern here is the client
being fed their meal. Speak to the UAP first and then decide if a between meal supplement is needed.
How closely monitored is access to a facility's health information system?
1. No monitoring; the system is password protected.
2. Monitored intermittently.
3. Monitored closely and constantly for inappropriate use.
4. Monitored daily and sporadically. - CORRECT ANSWER - Answer: 3. Access to a health care
facility's computerized health information system is monitored closely and constantly. Records of each
healthcare team member's time and date of access, as well as the information that was accessed, are kept
by the information technology services department. Access can be suspended, restricted, or revoked for
unauthorized or inappropriate use.
Rationale:
1. Incorrect: This is like doing nothing. Healthcare providers must be diligent about maintaining
confidentiality, which includes the use of technology that contains confidential client information. 2.
Incorrect: Intermittent monitoring is not adequate. Access should be monitored closely and constantly. A
breach of confidentiality could occur if intermittent monitoring was done.4. Incorrect: Access should be
monitored closely and constantly. Sporadically and once daily is not adequate for protecting client
confidentiatlity.
A client who is ventilator dependent is scheduled to be discharged home. What is the most critical
assessment for the nurse case manager to make?
1. Financial stability for home health care.
2. Long-term home care needs.
3. Safe home environment.
4. Home medical equipment needed. - CORRECT ANSWER - Answer: 3. The most critical
assessment is to make sure that the client is going home to a safe environment. Then the other
assessments could be made. Without a safe environment the client does not need to go home. Information
, about electrical wiring, back-up power, hygiene and infection control needs all provide a safe
environment for this client.
Rationale:
1. Incorrect: This is not the most critical assessment and can be done after making certain the client will
be safe. Remember Maslow's Hierarchy of Needs. After you determine needed resources (#4) then
financial stability would be next.
2. Incorrect: Long term goals are very important but we are worried about short term needs right now.
Remember in a priority question all options are plausible but only one is critical now.
4. Incorrect: Once the environment is considered safe for the needed or required care of the client, then
the needed equipment would be next.
The nurse manager on a medical-surgical unit receives official notification that staff overtime must be
decreased as a cost-saving measure. In order to reorganize staffing, the nurse manager should initiate
which action first?
1. Announce the new changes at the monthly staff meeting.
2. Ask for any staff objections to rearranging work hours.
3. Invite staff to contribute ideas on scheduling changes.
4. Explain administration is demanding a decreased overtime. - CORRECT ANSWER - Answer: 3.
The nurse manager is aware that open communication with staff is vital to increase workplace satisfaction
and staff retention. One important aspect is encouraging the flow of ideas between management and staff
members. Open communication and brainstorming sessions in which staff can freely share thoughts or
ideas creates a positive work environment while helping decrease dissatisfaction.
Rationale:
1. Incorrect: While it is true that the nurse manager is ultimately responsible for implementing and
announcing new schedule changes, doing so without any staff input can create discontent in the work
environment. When staff do not feel vested in any new process, there is a sense of underappreciation. This
perceived lack of control can create distrust and frustration among personnel, ultimately impacting client
care.
2. Incorrect: Although this action appears to be opening lines of communication, the nurse manager is
actually fostering animosity in a situation where the outcome is already pre-determined. Allowing staff to
vent is acceptable but the nurse manager should focus on constructive methods of adjustment to the
impending mandated changes.
4. Incorrect: The nurse manager is aware that health care facilities often face both political and financial
issues that impact staff and clients simultaneously. The responsibility of the nurse manager is to
UPDATED ACTUAL Questions and
CORRECT Answers
Which task would be appropriate for the Labor, Delivery, Recovery, Postpartum (LDRP) charge nurse to
assign to an LPN/VN?
1. Administering IV pain medication to a client three days postopertive cesarean section.
2. Drawing a trough vancomycin level on a client 3 days postpartum with bilaterial mastitis.
3. Reinforce how to perform perineal care to a primipara who is four hours postpartum.
4. Drawing routine admission labs on a client admitted in final stages of labor. - CORRECT
ANSWER - Answer: 3. Client teaching may be reinforced by an LPN/VN on a stable client.
Rationale:
1. Incorrect: Administering IV pain medications is out of the scope of practice of LPN/VN.
2. Incorrect: Drawing lab work on a client with severe infection and only 3 days postpartum is an unstable
client and needs care from the RN.
4. Incorrect: Drawing routine admission labs on a client in final stages of labor would be inappropriate
because the client is potentially unstable and needs experienced LDRP nursing care.
The nurse delegated feeding of a client to the unlicensed assistive personnel (UAP). Two hours after other
trays were picked up from the rooms, the nurse notes that the client's untouched tray is still at the bedside.
What should the nurse do first?
1. Feed the client after warming the food.
2. Speak to the UAP to determine what happened with the feeding.
3. Pick up the tray and tell the UAP that they didn't do a good job.
4. Provide a between meal supplement to the client. - CORRECT ANSWER - Answer: 2.
Communication is important in delegation, as is follow-up. There may be a good reason that the tray was
not served. The key word in the stem is first. The other options may be correct but are not the best first
action.
,Rationale:
1. Incorrect: The client does need to have food; however, there is another action that should be performed
first. The reason for the UAP not feeding the client needs to be determined. 3. Incorrect: The nurse retains
the responsibility for the delegated task. The nurse should not assume that the UAP just did not do their
job, but needs to ascertain the reason for not feeding the client. 4. Incorrect: The concern here is the client
being fed their meal. Speak to the UAP first and then decide if a between meal supplement is needed.
How closely monitored is access to a facility's health information system?
1. No monitoring; the system is password protected.
2. Monitored intermittently.
3. Monitored closely and constantly for inappropriate use.
4. Monitored daily and sporadically. - CORRECT ANSWER - Answer: 3. Access to a health care
facility's computerized health information system is monitored closely and constantly. Records of each
healthcare team member's time and date of access, as well as the information that was accessed, are kept
by the information technology services department. Access can be suspended, restricted, or revoked for
unauthorized or inappropriate use.
Rationale:
1. Incorrect: This is like doing nothing. Healthcare providers must be diligent about maintaining
confidentiality, which includes the use of technology that contains confidential client information. 2.
Incorrect: Intermittent monitoring is not adequate. Access should be monitored closely and constantly. A
breach of confidentiality could occur if intermittent monitoring was done.4. Incorrect: Access should be
monitored closely and constantly. Sporadically and once daily is not adequate for protecting client
confidentiatlity.
A client who is ventilator dependent is scheduled to be discharged home. What is the most critical
assessment for the nurse case manager to make?
1. Financial stability for home health care.
2. Long-term home care needs.
3. Safe home environment.
4. Home medical equipment needed. - CORRECT ANSWER - Answer: 3. The most critical
assessment is to make sure that the client is going home to a safe environment. Then the other
assessments could be made. Without a safe environment the client does not need to go home. Information
, about electrical wiring, back-up power, hygiene and infection control needs all provide a safe
environment for this client.
Rationale:
1. Incorrect: This is not the most critical assessment and can be done after making certain the client will
be safe. Remember Maslow's Hierarchy of Needs. After you determine needed resources (#4) then
financial stability would be next.
2. Incorrect: Long term goals are very important but we are worried about short term needs right now.
Remember in a priority question all options are plausible but only one is critical now.
4. Incorrect: Once the environment is considered safe for the needed or required care of the client, then
the needed equipment would be next.
The nurse manager on a medical-surgical unit receives official notification that staff overtime must be
decreased as a cost-saving measure. In order to reorganize staffing, the nurse manager should initiate
which action first?
1. Announce the new changes at the monthly staff meeting.
2. Ask for any staff objections to rearranging work hours.
3. Invite staff to contribute ideas on scheduling changes.
4. Explain administration is demanding a decreased overtime. - CORRECT ANSWER - Answer: 3.
The nurse manager is aware that open communication with staff is vital to increase workplace satisfaction
and staff retention. One important aspect is encouraging the flow of ideas between management and staff
members. Open communication and brainstorming sessions in which staff can freely share thoughts or
ideas creates a positive work environment while helping decrease dissatisfaction.
Rationale:
1. Incorrect: While it is true that the nurse manager is ultimately responsible for implementing and
announcing new schedule changes, doing so without any staff input can create discontent in the work
environment. When staff do not feel vested in any new process, there is a sense of underappreciation. This
perceived lack of control can create distrust and frustration among personnel, ultimately impacting client
care.
2. Incorrect: Although this action appears to be opening lines of communication, the nurse manager is
actually fostering animosity in a situation where the outcome is already pre-determined. Allowing staff to
vent is acceptable but the nurse manager should focus on constructive methods of adjustment to the
impending mandated changes.
4. Incorrect: The nurse manager is aware that health care facilities often face both political and financial
issues that impact staff and clients simultaneously. The responsibility of the nurse manager is to
