Test Bank for Saunders Comprehensive
Review for the NCLEX-RN Examination
Silvestri 6th Edition by Linda Anne Silvestri
| Latest Updated Version: 800 Exam-Style
Questions with correct answers graded A+
Section 1: Safe and Effective Care Environment – Management of Care (Questions 1-100)
1. The nurse is preparing to delegate tasks to a nursing assistant. Which task is most
appropriate for the nurse to delegate?
A. Administering oral medications to a stable client
B. Assessing a newly admitted client's pain level
C. Obtaining vital signs on a stable postoperative client
D. Teaching a client about a new medication regimen
ANS: C
Rationale: Obtaining vital signs on a stable client is a standard, unchanging procedure that falls
within the nursing assistant's scope of practice. Medication administration, assessment, and
client teaching require the clinical judgment and knowledge of a licensed nurse and cannot be
delegated to unlicensed assistive personnel.
,2. The nurse is caring for a client who speaks limited English and is scheduled for surgery.
Which action best demonstrates culturally competent care?
A. Asking the client's family member to interpret surgical consent
B. Using a certified medical interpreter to explain the procedure
C. Proceeding with the consent since the client nodded in agreement
D. Providing written materials in English only
ANS: B
Rationale: Using a certified medical interpreter ensures accurate communication and protects
the client's rights. Family members may not have medical terminology knowledge and may alter
information. Nodding does not confirm understanding, and written materials in a language the
client cannot read are ineffective.
3. A nurse manager is reviewing staffing for the upcoming shift. Which client should the nurse
assign to the most experienced RN?
A. A client awaiting discharge after uncomplicated appendectomy
B. A client with new-onset atrial fibrillation receiving IV amiodarone
C. A client requesting pain medication after hip replacement
D. A client needing assistance with ambulation
ANS: B
,Rationale: The client with new-onset atrial fibrillation receiving IV amiodarone requires complex
assessment, monitoring for adverse effects, and potential titration of a high-alert medication.
This client needs the expertise of an experienced RN. The other clients have predictable needs
appropriate for less experienced staff.
4. The nurse is prioritizing care for four clients. Which client should the nurse assess first?
A. A client reporting incisional pain rated 5/10 after surgery
B. A client with a new onset of confusion and restlessness
C. A client requesting assistance to the bathroom
D. A client awaiting discharge instructions
ANS: B
Rationale: New onset of confusion and restlessness may indicate hypoxia, infection, medication
reaction, or other serious complications requiring immediate assessment. Pain, toileting needs,
and discharge planning are important but not immediately life-threatening priorities.
5. The nurse is reviewing a client's advance directive. The client has designated a healthcare
proxy. What is the nurse's responsibility regarding this document?
A. Ensure the document is notarized by hospital administration
B. Verify the document is in the client's medical record and communicate it to the team
, C. Make a copy for the family to keep at home
D. Encourage the client to reconsider the decision
ANS: B
Rationale: The nurse's responsibility is to ensure the advance directive is documented in the
medical record and that all members of the healthcare team are aware of its contents. The
document does not require hospital notarization. The nurse should respect the client's
decisions.
6. A nurse is serving on a committee to improve client safety. Which strategy is most effective
in preventing medication errors?
A. Increasing the number of medication administration checks
B. Implementing a barcode medication administration system
C. Requiring nurses to work longer shifts
D. Reducing the number of pharmacy staff
ANS: B
Rationale: Barcode medication administration systems significantly reduce medication errors by
ensuring the right medication is given to the right client at the right time. Increased checks
alone do not address system failures. Longer shifts increase fatigue and error risk. Reducing
pharmacy staff decreases safety checks.
Review for the NCLEX-RN Examination
Silvestri 6th Edition by Linda Anne Silvestri
| Latest Updated Version: 800 Exam-Style
Questions with correct answers graded A+
Section 1: Safe and Effective Care Environment – Management of Care (Questions 1-100)
1. The nurse is preparing to delegate tasks to a nursing assistant. Which task is most
appropriate for the nurse to delegate?
A. Administering oral medications to a stable client
B. Assessing a newly admitted client's pain level
C. Obtaining vital signs on a stable postoperative client
D. Teaching a client about a new medication regimen
ANS: C
Rationale: Obtaining vital signs on a stable client is a standard, unchanging procedure that falls
within the nursing assistant's scope of practice. Medication administration, assessment, and
client teaching require the clinical judgment and knowledge of a licensed nurse and cannot be
delegated to unlicensed assistive personnel.
,2. The nurse is caring for a client who speaks limited English and is scheduled for surgery.
Which action best demonstrates culturally competent care?
A. Asking the client's family member to interpret surgical consent
B. Using a certified medical interpreter to explain the procedure
C. Proceeding with the consent since the client nodded in agreement
D. Providing written materials in English only
ANS: B
Rationale: Using a certified medical interpreter ensures accurate communication and protects
the client's rights. Family members may not have medical terminology knowledge and may alter
information. Nodding does not confirm understanding, and written materials in a language the
client cannot read are ineffective.
3. A nurse manager is reviewing staffing for the upcoming shift. Which client should the nurse
assign to the most experienced RN?
A. A client awaiting discharge after uncomplicated appendectomy
B. A client with new-onset atrial fibrillation receiving IV amiodarone
C. A client requesting pain medication after hip replacement
D. A client needing assistance with ambulation
ANS: B
,Rationale: The client with new-onset atrial fibrillation receiving IV amiodarone requires complex
assessment, monitoring for adverse effects, and potential titration of a high-alert medication.
This client needs the expertise of an experienced RN. The other clients have predictable needs
appropriate for less experienced staff.
4. The nurse is prioritizing care for four clients. Which client should the nurse assess first?
A. A client reporting incisional pain rated 5/10 after surgery
B. A client with a new onset of confusion and restlessness
C. A client requesting assistance to the bathroom
D. A client awaiting discharge instructions
ANS: B
Rationale: New onset of confusion and restlessness may indicate hypoxia, infection, medication
reaction, or other serious complications requiring immediate assessment. Pain, toileting needs,
and discharge planning are important but not immediately life-threatening priorities.
5. The nurse is reviewing a client's advance directive. The client has designated a healthcare
proxy. What is the nurse's responsibility regarding this document?
A. Ensure the document is notarized by hospital administration
B. Verify the document is in the client's medical record and communicate it to the team
, C. Make a copy for the family to keep at home
D. Encourage the client to reconsider the decision
ANS: B
Rationale: The nurse's responsibility is to ensure the advance directive is documented in the
medical record and that all members of the healthcare team are aware of its contents. The
document does not require hospital notarization. The nurse should respect the client's
decisions.
6. A nurse is serving on a committee to improve client safety. Which strategy is most effective
in preventing medication errors?
A. Increasing the number of medication administration checks
B. Implementing a barcode medication administration system
C. Requiring nurses to work longer shifts
D. Reducing the number of pharmacy staff
ANS: B
Rationale: Barcode medication administration systems significantly reduce medication errors by
ensuring the right medication is given to the right client at the right time. Increased checks
alone do not address system failures. Longer shifts increase fatigue and error risk. Reducing
pharmacy staff decreases safety checks.
