Chapter 21 Managing Patient Care Fundamentals of Nursing 11th Edition (Potter & Perry) 50 NCLEX-Style Exam Questions with Detailed Rationales

1. A nurse manager delegates a dressing change to a licensed practical nurse (LPN). Which factor must the nurse manager consider when delegating this task? A) The patient's length of hospital stay B) The LPN's scope of practice and competency C) The physician’s preference for who performs the task D) The cost of nursing care Answer: B Rationale: Delegation must always be based on the LPN’s legal scope of practice and demonstrated competency. The RN retains accountability for appropriate delegation. ________________________________________ 2. Which leadership style is most effective when a nurse manager is leading a team through a crisis situation requiring quick decision-making? A) Transformational B) Democratic C) Autocratic D) Laissez-faire Answer: C Rationale: In crisis situations, autocratic leadership is effective because it allows quick decision-making and clear direction, which is essential during emergencies. ________________________________________ 3. A registered nurse (RN) working on a medical-surgical unit is prioritizing care. Which patient should be assessed first? A) A patient scheduled for discharge in one hour B) A patient complaining of new-onset chest pain C) A patient requesting a sleeping pill D) A patient with stable vital signs awaiting lab results Answer: B Rationale: New-onset chest pain may indicate a life-threatening cardiac event and should be addressed immediately, according to prioritization principles (ABC – Airway, Breathing, Circulation). 4. Which concept best describes the responsibility of a nurse to ensure continuity of care during a shift change? A) Supervision B) Delegation C) Accountability D) Handoff report Answer: D Rationale: The handoff report provides essential information about patients' conditions and ongoing needs, ensuring continuity and safety in care delivery. ________________________________________ 5. A charge nurse must decide how to assign staff for a shift. What is the first step the nurse should take? A) Assign tasks based on seniority B) Assess patient acuity and care needs C) Ask for staff preferences D) Randomly assign patients Answer: B Rationale: Effective staffing requires matching the needs of patients with the skills and experience of the staff. Patient acuity and complexity are key factors in this decision. 6. Which statement by a nurse indicates understanding of evidence-based practice (EBP) in patient care management? A) “I follow the physician’s preferences only.” B) “I use past experiences alone to make clinical decisions.” C) “I rely solely on nursing textbooks from my education.” D) “I integrate current research, clinical expertise, and patient preferences.” Answer: D Rationale: Evidence-based practice incorporates the best available evidence, clinical judgment, and patient values to improve care outcomes. ________________________________________ 7. What is the primary purpose of using a clinical pathway in managing patient care? A) To restrict provider autonomy B) To reduce patient choices C) To standardize evidence-based care for specific conditions D) To increase documentation time Answer: C Rationale: Clinical pathways outline standardized, evidence-based interventions for specific diagnoses, improving outcomes and reducing variation in care. ________________________________________ 8. What is the role of the nurse manager in promoting quality improvement? A) Focusing only on budget management B) Punishing staff for errors C) Collecting and analyzing unit performance data D) Delegating all tasks to others Answer: C Rationale: Nurse managers promote quality improvement by tracking performance metrics, identifying gaps, and implementing strategies to improve outcomes. 9. A nurse assigns a nursing assistant to ambulate a postoperative patient. What should the nurse do before delegating? A) Notify the physician B) Review the assistant’s job description C) Confirm the assistant’s comfort with the task D) Ensure the assistant has advanced cardiac life support (ACLS) certification Answer: C Rationale: The RN must confirm that the nursing assistant understands and is competent in the delegated task to ensure safe patient care. ________________________________________ 10. Which principle should guide nurses in time management during a busy shift? A) Perform the easiest tasks first B) Focus on documentation before care C) Prioritize care based on patient needs D) Let patients determine the schedule Answer: C Rationale: Effective time management involves prioritizing tasks based on urgency and patient condition to ensure timely, safe, and appropriate care. ________________________________________ 11. A nurse demonstrates accountability when: A) Ignoring a patient’s complaint B) Documenting care that was not provided C) Taking responsibility for errors and reporting them D) Avoiding interactions with difficult patients Answer: C Rationale: Accountability in nursing involves owning actions and outcomes, including acknowledging and reporting errors to improve patient safety. ________________________________________ 12. Which task is most appropriate to delegate to a nursing assistant? A) Administering IV antibiotics B) Performing a sterile dressing change C) Assisting a stable patient with bathing D) Teaching a patient about insulin injection Answer: C Rationale: Nursing assistants may assist with basic care tasks such as bathing. They cannot perform invasive procedures or provide patient education. ________________________________________ 13. A new nurse is struggling with prioritization. Which approach should a mentor suggest? A) Complete tasks in the order they were assigned B) Use critical thinking to assess which patient needs are urgent C) Focus only on documentation D) Ask a peer to complete tasks Answer: B Rationale: Critical thinking and clinical judgment help nurses identify and act on the most urgent patient needs first. ________________________________________ 14. The nurse manager wants to foster collaboration on the unit. What is the best strategy? A) Encourage staff to avoid conflict B) Implement individual goal-setting only C) Promote open communication and team goals D) Discourage team meetings Answer: C Rationale: Collaboration is enhanced through open communication, shared goals, and mutual respect among team members. ________________________________________ 15. What is the main goal of case management in nursing? A) Increase patient length of stay B) Focus on hospital billing C) Coordinate care across the health care continuum D) Perform all care independently Answer: C Rationale: Case managers coordinate services and resources to ensure timely, cost-effective, and high-quality care across settings.