Management of Care; HURST Exam Review
100% Correct Answers
A client on the in-patient psychiatric unit was found to have lacerations on the wrist
when the nurse made rounds. Which change in routine on the unit is most likely to
prevent such an event from occurring in the future?
1. During the end-of-shift report, assign specific staff to check on each client.
2. Place newly admitted clients close to the nursing station.
3. Monitor level of suicide precaution needed on each client daily.
4. Ask clients to check on each other throughout the shift. - correct answer-Answer: 1.
Assigning specific staff to perform client checks during the shift will assure that the
clients, that the staff are concerned about their welfare. In addition, it assures that
someone is specifically monitoring the client each shift, therefore, promoting the clients
right to a safe environment. Client safety is a priority in Maslow's Hierarchy of Needs.
The nurses will play a key role in reducing these self-harming behaviors through
recognition of the problem, being alert to risk factors when assessing the client, and
ultimately guiding the client into more acceptable outlets for stress, anxiety, anger, low-
self esteem, or other related causes.
Rationale:
2. Incorrect: This routine may or may not prevent an injury. The clients may learn the
"routine" of the nurses and will perform the self-harming behaviors when the nurses are
not likely to be making individualized checks on them.
3. Incorrect: Each client should be monitored daily at irregular intervals. Self-harming
behaviors typically increase the risk of suicide in the client. The nurse should determine
the level of imminent risk of suicide in the client. This should be routinely performed with
client checks, not simply assessed on a daily basis.
4. Incorrect: It is not the clients' responsibility to check on each other. All clients have
the right to a safe environment, and it is the responsibility of the nurses and healthcare
team to provide this safety.
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
100% Correct Answers
A client on the in-patient psychiatric unit was found to have lacerations on the wrist
when the nurse made rounds. Which change in routine on the unit is most likely to
prevent such an event from occurring in the future?
1. During the end-of-shift report, assign specific staff to check on each client.
2. Place newly admitted clients close to the nursing station.
3. Monitor level of suicide precaution needed on each client daily.
4. Ask clients to check on each other throughout the shift. - correct answer-Answer: 1.
Assigning specific staff to perform client checks during the shift will assure that the
clients, that the staff are concerned about their welfare. In addition, it assures that
someone is specifically monitoring the client each shift, therefore, promoting the clients
right to a safe environment. Client safety is a priority in Maslow's Hierarchy of Needs.
The nurses will play a key role in reducing these self-harming behaviors through
recognition of the problem, being alert to risk factors when assessing the client, and
ultimately guiding the client into more acceptable outlets for stress, anxiety, anger, low-
self esteem, or other related causes.
Rationale:
2. Incorrect: This routine may or may not prevent an injury. The clients may learn the
"routine" of the nurses and will perform the self-harming behaviors when the nurses are
not likely to be making individualized checks on them.
3. Incorrect: Each client should be monitored daily at irregular intervals. Self-harming
behaviors typically increase the risk of suicide in the client. The nurse should determine
the level of imminent risk of suicide in the client. This should be routinely performed with
client checks, not simply assessed on a daily basis.
4. Incorrect: It is not the clients' responsibility to check on each other. All clients have
the right to a safe environment, and it is the responsibility of the nurses and healthcare
team to provide this safety.
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
