CHAPTER 23 NCLEX Next Generation

. Drag and Drop ________________________________________________________________________________ Scenario: An older patient with early stage Alzheimer’s disease sustained a hip fracture after falling. He has been discharged and is returning home to live with his wife. He qualifies for home health visits through Medicare. The home health team includes: RN, LPN, physical therapist, social worker and a home health aide. Which member of the home health team is best to assign or delegate for each intervention?

Instructions: Staff members are listed in the left-hand column. In the right-hand column, in the space provided, write in the letter for the best member of the home health team for each intervention. Note that all responses will be used and may be used more than once.

Cloze

Scenario: The nurse is caring for a 57-year-old African American man who came to the ophthalmologist for his annual eye examination. The patient is aware that__________1__________ is the leading cause of blindness among African Americans. If the patient has the most common type, the first symptom is likely to be __________2__________. To assist the ophthalmologist in making the diagnosis, the nurse will prepare the patient for __________3__________.

Instructions: Complete the sentences by choosing the most probable option for the missing information that corresponds with the same numbered list of options provided

Scenario: A 72-year-old woman is brought to the emergency department by her daughter, who reports, “Mom seems more confused and irritable than usual. She is not eating or drinking very much. She is unusually restless during the day and doesn’t sleep throughout the night. She is spending a lot of time in the bathroom, but she gets mad when I ask her what she is doing in there. Her underwear has a strong urine odor and pink-tinged stains. She has mild dementia and she takes a blood pressure medication and a pill for diabetes.”

Instructions: Underline or highlight information (signs, symptoms, verbal reports, history, assessment findings) that indicates to the nurse that the patient may have a UTI with a possible risk for urosepsis

Scenario: In order to maximize efficiency and safely accomplish care for a group of patients, the charge nurse must assign or delegate patient care interventions to the nursing staff. Available staff includes an RN, LPN/ LVN, and an AP. All of these staff members are experienced and familiar with the routines of the unit.

Instructions: For each intervention place an X in the box to indicate whether the action is best delegated or assigned to the RN, LPN/LVN, or AP

Scenario: The charge nurse on a medical- surgical unit is making patient assignments for the day. The team for 10 patients includes 3 experienced staff members: RN, LPN/LVN and an assistive personnel (AP).

Which patients can be assigned to the LPN/LVN who will function under the supervision of an RN?

Instructions: Place an X, in the space provided, or highlight each patient that can be assigned to an LPN/LVN who will function under the supervision of an RN or charge nurse. Select all that apply.

Scenario: A 54-year-old male is admitted to the ED with a severe headache, nausea, vomiting, and blurred vision. He has a history of hypertension and smokes 2 packs of cigarettes a day. He is prescribed Lisinopril.

Instructions: Complete the sentences below by choosing the most probable option for the omitted information that corresponds with the same numbered list of options provided.

Vital Signs: Temperature 98.6°F (37°C) Oxygen saturation 95% on room air Respirations 20 breaths/min Mean arterial pressure (MAP) 160

Assessment findings: Alert, oriented, restless and states he is frightened. Chest sounds clear bilateral, diminished in the bases. Cardiac monitor shows sinus tachycardia with infrequent PVC’s. Bounding radial and femoral pulses are present bilateral. Auscultation of the heart reveals an S3. Pedal edema is 2+ pitting.

The nurse suspects the patient’s problem is ____1____. The first nursing action is to____2____ in order to ____3____. The nurse anticipates the healthcare provider (HCP) will order____4____.