PRIORITIZATION DELEGATION AND ASSIGNMENT PRACTICE EXERCISES FOR NCLEX EXAMINATION 3 UPGRADED A+ .

PRIORITIZATION DELEGATION AND ASSIGNMENT PRACTICE EXERCISES FOR NCLEX EXAMINATION 3 UPGRADED A+ . s Debra Bailey, RN, PhD candidate, FNP, CDE Associate Professor of Nursing, Department Head Health Sciences Colorado Mesa University Grand Junction, Colorado Patricia A. Bicknell, EdD, APRN, ACNS-BC, CNL Assistant Professor of Nursing; Track Coordinator for Clinical Nurse Leader (CNL) La Salle University Philadelphia, Pennsylvania Donna Bowles, EdD, MSN, CNE Associate Professor Indiana University Southeast New Albany, Indiana Diane Cohen, RN, MSN Professor MassBay Community College Framingham, Massachusetts Diane L. Cooper-McLean, RN, BSN, MSN Nursing Instructor Faulkner State Community College Bay Minette, Alabama Pamela DeWitt, RN, MN, CNE Residential Faculty Phoenix College Department of Nursing Phoenix, Arizona Kathleen Walsh Free, MSN, RN-C, APRN-BC Clinical Professor Indiana University Southeast New Albany, Indiana Lynn D. Kennedy, MSN, RN Assistant Professor of Nursing Francis Marion University Florence, South Carolina Maria McCormick, MSN, MS, RN Faculty Spencerian College Louisville, Kentucky Mary Ann Siciliano McLaughlin, MSN, RN Faculty, UMDNJ School of Nursing UMDNJ School of Nursing Stratford, New Jersey Elizabeth Murray, PhD, RN, CNE Assistant Professor Florida Gulf Coast University School of Nursing Fort Myers, Florida L. Jane Rosati, EdD, MSN, RN-BC Assistant Chair/Program Manager of the ADN Program Daytona State College Daytona Beach, Florida Faye Sigman, PhD Professor of Nursing Dyersburg State Dyersburg, Tennessee Thomas Worms, RN, MSN Professor of Nursing Truman College Chicago, Illinois Polly Gerber Zimmermann, RN, MS, MBA, CEN, FAEN Associate Professor Harry S Truman College Chicago, Illinois vii 1 Introduction to Prioritization, Assignment, Delegation, and Management 1 NCSBN BLUEPRINT FOR QUESTIONS 1 GUIDELINES FOR MAKING A DECISION 2 TYPES OF QUESTIONS 4 PUTTING THE PIECES TOGETHER 5 2 Cardiovascular Management 7 QUESTIONS 7 CARDIAC CLINICAL SCENARIO 20 ANSWERS AND RATIONALES 22 CLINICAL SCENARIO ANSWERS AND RATIONALES 40 3 Peripheral Vascular Management 43 QUESTIONS 43 PERIPHERAL VASCULAR DISEASES CLINICAL SCENARIO 54 ANSWERS AND RATIONALES 56 CLINICAL SCENARIO ANSWERS AND RATIONALES 74 4 Respiratory Management 77 QUESTIONS 77 RESPIRATORY CLINICAL SCENARIO 88 ANSWERS AND RATIONALES 90 CLINICAL SCENARIO ANSWERS AND RATIONALES 107 5 Gastrointestinal Management 109 QUESTIONS 109 GASTROINTESTINAL CLINICAL SCENARIO 120 ANSWERS AND RATIONALES 122 CLINICAL SCENARIO ANSWERS AND RATIONALES 139 6 Renal and Genitourinary Management 141 QUESTIONS 141 RENAL AND GENITOURINARY CLINICAL SCENARIO 152 ANSWERS AND RATIONALES 154 CLINICAL SCENARIO ANSWERS AND RATIONALES 171 ix x TABLE OF CONTENTS 7 Neurological Management 173 QUESTIONS 173 NEUROLOGICAL CLINICAL SCENARIO 185 ANSWERS AND RATIONALES 187 CLINICAL SCENARIO ANSWERS AND RATIONALES 204 8 Endocrine Management 207 QUESTIONS 207 ENDOCRINE CLINICAL SCENARIO 220 ANSWERS AND RATIONALES 221 CLINICAL SCENARIO ANSWERS AND RATIONALES 238 9 Integumentary Management 239 QUESTIONS 239 INTEGUMENTARY CLINICAL SCENARIO 250 ANSWERS AND RATIONALES 252 CLINICAL SCENARIO ANSWERS AND RATIONALES 269 10 Hematological and Immunological Management 271 QUESTIONS 271 HEMATOLOGICAL AND IMMUNOLOGICAL CLINICAL SCENARIO 282 ANSWERS AND RATIONALES 284 CLINICAL SCENARIO ANSWERS AND RATIONALES 299 11 Women’s Health Management 301 QUESTIONS 301 MATERNAL-CHILD CLINICAL SCENARIO 312 ANSWERS AND RATIONALES 314 CLINICAL SCENARIO ANSWERS AND RATIONALES 330 12 Pediatric Health Management 333 QUESTIONS 333 PEDIATRIC CLINICAL SCENARIO 345 ANSWERS AND RATIONALES 347 CLINICAL SCENARIO ANSWERS AND RATIONALES 361 13 Mental Health Management 363 QUESTIONS 363 MENTAL HEALTH CLINICAL SCENARIO 376 ANSWERS AND RATIONALES 378 CLINICAL SCENARIO ANSWERS AND RATIONALES 394 TABLE OF CONTENTS xi 14 Case Studies: Care of Clients in Various Settings 397 MEDICAL NURSING CASE STUDY 397 CRITICAL CARE NURSING CASE STUDY 400 OUTPATIENT NURSING CASE STUDY 403 HOME HEALTH CASE STUDY 406 MENTAL HEALTH NURSING CASE STUDY 409 MATERNAL-CHILD CASE STUDY 412 ANSWERS TO CASE STUDIES 414 15 Comprehensive Exam 429 QUESTIONS 429 ANSWERS AND RATIONALES 446 Appendix A: Normal Laboratory Values 469 Glossary of English Words Commonly Encountered on Nursing Examinations 471 Index 475 Introduction to Prioritization, Assignment, Delegation, and Management Each problem that I solved became a rule which served afterwards to solve other problems. —Rene Descartes This book is designed to assist the student nurse in nursing school and in taking nursing examinations, particularly the NCLEX-RN® exam for licensure as a registered nurse (RN). Prioritization, Delegation & Management of Care for the NCLEX-RN® Exam focuses on aspects of management such as setting priorities for client care, delegating and assigning nursing tasks, and managing clients and staff. It contains practice questions on these topics in a wide variety of nursing arenas, including medical, surgical, critical care, pediatric, geriatric, reha- bilitation, home health, and mental health nursing. Answers—and why each possible response is correct or incorrect—are given for all questions. Management, prioritizing, and delegation questions are some of the most difficult questions for the student and new graduate to answer because there is no reference book in which to find the correct answers. Answers to these types of questions require knowl- edge of basic scientific principles, standards of care, pathophysiology, and psychosocial behaviors, and leadership qualities and the ability to think critically. It is important to note that the test taker may not always agree with the authors’ rationale for the correct answer. It is poor test taking to read rationales for the incorrect answers; the students will remember reading the rationale but not if the rationale was for the correct or incor- rect answer. Many of the answers in this book include tips to help the test taker. Termed “Making Nursing Decisions,” these tips provide help for the student in identifying exactly what the question is asking, in analyzing the question, and in determining the correct response. A Comprehensive Examination with answers and rationales is also included for each field of nursing. Practice questions and answers and practice examinations are valuable in preparing for an examination, but the test taker should remember that there is no substitute for studying the material. (For general information on how to prepare for an examination and on the types of ques- tions used in nursing examinations, refer to Fundamentals Success: A Q&A Review Applying Critical Thinking to Test Taking by Patricia Nugent, RN, MA, MS, EdD, and Barbara Vitale, RN, MA.) NCSBN BLUEPRINT FOR QUESTIONS The National Council of State Boards of Nursing (NCSBN) provides a blueprint that assists nursing faculty in developing test questions for the NCLEX-RN®. Content included in management of care provides and directs nursing care that enhances the care delivery setting to protect clients, family/significant others, and healthcare personnel. Related content includes, but is not limited to, advance directives, advocacy, case management, client rights, collaboration with the interdisciplinary team, delegation, establishing priorities, ethical 1