NCLEX REVIEW AND MANAGEMENT OF CARE
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
A 90 year-old is readmited to the hospital, less than 2 weeks a�er being discharged, for the same health
concern. What factors contribute to hospital readmissions among older adults? (Select all that apply.)
1) Reconcilia�on of medica�ons
2) Poor communica�on among providers
3) Client health status
4) Family preferences
5) Excellent primary care - ans2, 3, 4
Ra�onale:
Avoidable hospitaliza�on, especially among older adults living in skilled nursing facili�es, usually results
from mul�ple system failures. The reasons most o�en cited include inadequate primary care (including
inadequate discharge planning and lack of reconcilia�on of medica�ons), poor care coordina�on, poor
skilled nursing facility quality of care, poor communica�on among providers and even family
preferences. Not all illnesses can be an�cipated and clients with more complex health issues are
readmited more o�en, regardless of quality or coordina�on of care.
A Bosnian Muslim woman who does not speak English seeks care at a community clinic. Through
physical gestures, the woman indicates that she has pain origina�ng in either the pelvic or genital region.
Assuming several people are available to interpret, who would be the most appropriate choice?
1) A female neighbor of the client who is also from Bosnia
2) A female interpreter who does not know the client
,NCLEX REVIEW AND MANAGEMENT OF CARE
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
3) The client's adult daughter
4) A Bosnian male, who is a cer�fied medical interpreter - ans2
Ra�onale:
When the nurse and the client do not speak the same language, or have limited fluency, the services of
an interpreter is needed. But, it may be inappropriate to have a male interpreter for a female client
because the client may not be as forthcoming. The client may also feel it is inappropriate to have private
maters interpreted by her daughter (especially if they are of a sexual nature or involve infidelity). To
avoid a breach of confiden�ality, the nurse should avoid using an interpreter from the same community
as the client. The best response is to have a female interpreter who does not know the client.
A client is admited with a diagnosis of schizophrenia. The client refuses to take any medica�on and
states, "I don't think I need those medica�ons. They make me too sleepy and drowsy. I want you to
explain their use and side effects of these medica�ons." The nurse should respond with an
understanding of which statement?
1) A referral is needed to the psychiatrist who should provide the client with answers to the request
2) Such educa�on is an independent decision of the individual nurse whether or not to teach clients
about their medica�ons
3) Clients with schizophrenia are at a higher risk of psychosocial complica�ons when they know about
their medica�on's uses and side effects
4) The client has a right to know about the use and side effects of the prescribed medica�ons - ans4
Ra�onale:
Clients have a right to informed consent, which includes detailed informa�on about medica�ons,
treatments and diagnos�c studies. The other op�ons are incorrect approaches.
, NCLEX REVIEW AND MANAGEMENT OF CARE
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
A client is being prepped for a surgical procedure and the nurse is reviewing the informed consent with
the client. The client asks, "Is there any other way to take care of this without having surgery?" The nurse
has a duty to first:
1) Reassure the client that the surgery is the best treatment op�on
2) Tell the client if they don't want the surgery, they don't have to have it
3) No�fy the surgeon that the client has addi�onal ques�ons about alterna�ves to surgery
4) Call the surgeon and cancel the surgery un�l the consent form is signed - ans3
Ra�onale:
The client has a right to an explana�on of the treatment and its expected results, an�cipated risks and
benefits, possible alterna�ve treatment op�ons and all ques�ons answered before a consent form is
signed. Remember, the client is not asking you for your opinion. The client is asking about alterna�ve
treatments for the condi�on. No�fy the appropriate health care provider if the client needs addi�onal
informa�on that you cannot answer. Once the client has all the necessary informa�on then they can
decide not to sign the informed content and cancel the surgery.
A newly graduated nurse, who has recently completed orienta�on, voices concern about her
assignment: "I have never taken care of anyone with a lumbar drain before." Which ac�on would be
most appropriate for the charge nurse?
1) Check with the nurse and the client o�en during the shi�
2) Provide an immediate one-on-one, personal in-service about the drain
3) Assign the graduated staff nurse to be transferred to another floor for the shi�
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
A 90 year-old is readmited to the hospital, less than 2 weeks a�er being discharged, for the same health
concern. What factors contribute to hospital readmissions among older adults? (Select all that apply.)
1) Reconcilia�on of medica�ons
2) Poor communica�on among providers
3) Client health status
4) Family preferences
5) Excellent primary care - ans2, 3, 4
Ra�onale:
Avoidable hospitaliza�on, especially among older adults living in skilled nursing facili�es, usually results
from mul�ple system failures. The reasons most o�en cited include inadequate primary care (including
inadequate discharge planning and lack of reconcilia�on of medica�ons), poor care coordina�on, poor
skilled nursing facility quality of care, poor communica�on among providers and even family
preferences. Not all illnesses can be an�cipated and clients with more complex health issues are
readmited more o�en, regardless of quality or coordina�on of care.
A Bosnian Muslim woman who does not speak English seeks care at a community clinic. Through
physical gestures, the woman indicates that she has pain origina�ng in either the pelvic or genital region.
Assuming several people are available to interpret, who would be the most appropriate choice?
1) A female neighbor of the client who is also from Bosnia
2) A female interpreter who does not know the client
,NCLEX REVIEW AND MANAGEMENT OF CARE
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
3) The client's adult daughter
4) A Bosnian male, who is a cer�fied medical interpreter - ans2
Ra�onale:
When the nurse and the client do not speak the same language, or have limited fluency, the services of
an interpreter is needed. But, it may be inappropriate to have a male interpreter for a female client
because the client may not be as forthcoming. The client may also feel it is inappropriate to have private
maters interpreted by her daughter (especially if they are of a sexual nature or involve infidelity). To
avoid a breach of confiden�ality, the nurse should avoid using an interpreter from the same community
as the client. The best response is to have a female interpreter who does not know the client.
A client is admited with a diagnosis of schizophrenia. The client refuses to take any medica�on and
states, "I don't think I need those medica�ons. They make me too sleepy and drowsy. I want you to
explain their use and side effects of these medica�ons." The nurse should respond with an
understanding of which statement?
1) A referral is needed to the psychiatrist who should provide the client with answers to the request
2) Such educa�on is an independent decision of the individual nurse whether or not to teach clients
about their medica�ons
3) Clients with schizophrenia are at a higher risk of psychosocial complica�ons when they know about
their medica�on's uses and side effects
4) The client has a right to know about the use and side effects of the prescribed medica�ons - ans4
Ra�onale:
Clients have a right to informed consent, which includes detailed informa�on about medica�ons,
treatments and diagnos�c studies. The other op�ons are incorrect approaches.
, NCLEX REVIEW AND MANAGEMENT OF CARE
QUESTIONS AND ANSWERS LATEST VERSION
VERIFIED RATIONALE GRADED A+
A client is being prepped for a surgical procedure and the nurse is reviewing the informed consent with
the client. The client asks, "Is there any other way to take care of this without having surgery?" The nurse
has a duty to first:
1) Reassure the client that the surgery is the best treatment op�on
2) Tell the client if they don't want the surgery, they don't have to have it
3) No�fy the surgeon that the client has addi�onal ques�ons about alterna�ves to surgery
4) Call the surgeon and cancel the surgery un�l the consent form is signed - ans3
Ra�onale:
The client has a right to an explana�on of the treatment and its expected results, an�cipated risks and
benefits, possible alterna�ve treatment op�ons and all ques�ons answered before a consent form is
signed. Remember, the client is not asking you for your opinion. The client is asking about alterna�ve
treatments for the condi�on. No�fy the appropriate health care provider if the client needs addi�onal
informa�on that you cannot answer. Once the client has all the necessary informa�on then they can
decide not to sign the informed content and cancel the surgery.
A newly graduated nurse, who has recently completed orienta�on, voices concern about her
assignment: "I have never taken care of anyone with a lumbar drain before." Which ac�on would be
most appropriate for the charge nurse?
1) Check with the nurse and the client o�en during the shi�
2) Provide an immediate one-on-one, personal in-service about the drain
3) Assign the graduated staff nurse to be transferred to another floor for the shi�
