Care Coordination and Delegation
A patient with multiple chronic conditions is being discharged from the hospital. Which action by the nurse best exemplifies care coordination?
A) Providing the patient with a list of their medications.
B) Scheduling follow-up appointments with various specialists and ensuring the patient understands the schedule.
C) Arranging for transportation to the patient's home.
D) Educating the patient on their diagnoses.
Answer: B
Rationale: Care coordination involves organizing activities to deliver services and information across settings and over time.
A nurse witnesses a colleague taking pain medication from the medication cart for personal use. The nurse confronts the colleague, who becomes defensive. Which professional identity theme is the nurse demonstrating?
A) Compassion
B) Humility
C) Integrity
D) Advocacy
Answer: C
Rationale: Integrity involves being honest and adhering to moral principles. In this scenario, the nurse is demonstrating integrity by addressing the colleague's unethical behavior.
A nurse is providing education to a couple experiencing infertility. Which statement indicates a correct understanding of infertility?
A) "Infertility is primarily a female issue."
B) "If you haven't conceived after 6 months of trying, you are infertile."
C) "Infertility can be related to factors affecting both the male and female partner."
D) "Infertility is only caused by genetic factors."
Answer: C
Rationale: Infertility can indeed arise from factors affecting either the male or female partner. It is defined as not being able to get pregnant after one year of unprotected, well-timed intercourse for women under 35, or 6 months for those over 35.
The nurse is reviewing the lab results of a patient with hyperkalemia. Which finding would the nurse expect to see on the ECG?
A) Prolonged QT interval
B) Flattened T wave
C) Peaked T wave
D) Prominent U wave
Answer: C
Rationale: Hyperkalemia can cause peaked T waves on an ECG. It's a significant finding as hyperkalemia can lead to dangerous cardiac arrhythmias.
A patient reports experiencing increased heart rate, sweating, and rapid breathing when faced with a stressful situation. Which physiological response is the patient describing?
A) General Adaptation Syndrome (GAS) - Exhaustion stage
B) Fight-or-flight response
C) Resistance stage of stress
D) Normal coping mechanism
Answer: B
Rationale: The fight-or-flight response is the body's immediate reaction to a perceived threat, characterized by the symptoms described.
Which patient is most likely to benefit from comprehensive care coordination?
A) A young adult with an uncomplicated fracture.
B) A middle-aged adult scheduled for an elective surgery.
C) An older adult with diabetes, heart failure, and arthritis.
D) A child with a mild upper respiratory infection.
Answer: C
Rationale: Individuals with multiple chronic conditions benefit most from care coordination
A patient with a history of heart failure is admitted with shortness of breath, crackles in the lungs, and edema. The nurse suspects fluid volume excess. Which intervention is a priority?
A) Administering a bolus of intravenous fluids.
B) Encouraging oral fluid intake.
C) Monitoring serum sodium levels.
D) Monitoring fluid intake and output.
Answer: D
Rationale: Patients with heart failure are at risk for fluid volume excess. Monitoring fluid intake and output is crucial for assessing and managing fluid balance.
A pregnant woman in her first trimester reports experiencing emotional lability. Which response by the nurse is most appropriate?
A) "This is unusual and requires immediate evaluation."
B) "Emotional changes are common during pregnancy due to hormonal shifts."
C) "You should avoid discussing these feelings to prevent further distress."
D) "This indicates a risk of postpartum depression."
Answer: B
Rationale: Hormonal changes during pregnancy can lead to emotional lability. It's a common experience, especially in the earlier trimesters.
An older adult patient reports frequent urination at night. The nurse documents this as:
A) Dysuria
B) Hematuria
C) Nocturia
D) Polyuria
Answer: C
Rationale: Nocturia is the term for excessive urination at night.
Which of the following is a risk factor for developing anxiety?
A) Advanced age
B) Male gender
C) History of substance use
D) High socioeconomic status
Answer: C
Rationale: Substance use is a risk factor for anxiety. Other risk factors include genetics, temperament, and certain medical conditions.
A home health nurse is working with a patient who requires assistance with activities of daily living (ADLs). Which of the following best describes the nurse's role in this situation?
A) The nurse provides all direct care to the patient.
B) The nurse solely focuses on the patient's medical needs.
C) The nurse coordinates and manages the patient's care, including ADL assistance.
D) The nurse primarily educates the family on how to care for the patient.
Answer: C
Rationale: Nurses often play a role in coordinating health care services, including ADL assistance.
An elderly patient reports frequent urination at night and occasional leakage of urine when coughing. Which condition is the patient most likely experiencing?
A) Anuria
B) Urge incontinence
C) Stress incontinence
D) Overflow incontinence
Answer: C
Rationale: Stress incontinence is the leakage of urine that occurs with coughing, laughing, or sneezing. This is common in older adults due to weakened urinary sphincters.
A nurse is caring for a patient who is scheduled for surgery. The patient expresses fear and anxiety. Which action best demonstrates the theme of compassion?
A) Providing detailed medical information about the surgical procedure.
B) Acknowledging the patient's feelings and offering emotional support.
C) Ensuring the patient's room is clean and organized.
D) Focusing solely on the tasks required to prepare the patient for surgery.
Answer: B
Rationale: Compassion involves empathy and a genuine concern for the patient's well-being. Addressing their emotional needs is a key aspect of compassionate care.
Question 8:
A patient is recovering from surgery and has not urinated in 8 hours. The nurse notes lower abdominal distention. Which condition should the nurse suspect?
A) Urinary tract infection
B) Urinary incontinence
C) Urinary retention
D) Urinary frequency
Answer: C
Rationale: Urinary retention is the inability to empty the bladder, which can lead to distention.
An RN delegates the task of ambulating a stable post-operative patient to a UAP. Which action by the RN demonstrates proper delegation?
A) Assigning the task without verifying the UAP's competency.
B) Instructing the UAP to ambulate the patient without specifying distance or frequency.
C) Checking with the UAP later to ensure the task was completed and to receive feedback on patient tolerance.
D) Delegating ambulation to the UAP for all subsequent shifts.
Answer: C
Rationale: Right supervision and evaluation: Monitor the task, provide feedback, and evaluate the client’s outcomes afterward.
A registered nurse (RN) is caring for a group of patients. Which task is most appropriate for the RN to delegate to a unlicensed assistive personnel (UAP)?
A) Administering oral medication to a stable patient.
B) Assessing a patient's surgical wound.
C) Assisting a stable patient with a bath.
D) Providing teaching to a newly diagnosed diabetic patient.
Answer: C
Rationale: UAPs can assist with activities of daily living, such as bathing. Assessment, teaching, and medication administration are typically within the scope of practice for licensed nurses.
A nurse identifies an error in a medication prescription written by a physician. The nurse immediately notifies the physician and clarifies the order. Which professional identity theme is the nurse demonstrating?
A) Humility
B) Advocacy
C) Courage
D) Compassion
Answer: C
Rationale: It takes courage to speak up and challenge a medical order, especially when it involves a potential error. The nurse is acting ethically and prioritizing patient safety.
Which of the following is a primary goal of care coordination?
A) To increase the cost of healthcare services
B) To improve and optimize patient care
C) To limit patient independence
D) To focus solely on medical needs, ignoring social needs
Answer: B
Rationale: The goals of care coordination include improving and optimizing care, promoting health and independence, and reducing unnecessary service utilization.
Which task would be inappropriate for an RN to delegate to an LPN?
A) Administering oral medications
B) Performing a sterile dressing change
C) Providing patient teaching on a new diagnosis
D) Monitoring a stable patient's vital signs
Answer: C
Rationale: LPNs cannot provide initial or complex teaching.
A patient experiencing a panic attack is brought to the emergency department. Which physiological response is likely occurring?
A) Decreased heart rate
B) Increased concentration
C) Activation of the fight-or-flight response
D) Decreased muscle tension
Answer: C
Rationale: Panic attacks are a severe form of anxiety, and anxiety triggers the fight-or-flight response.
A patient is admitted with dehydration. Which assessment finding is consistent with this condition?
A) Increased urine output
B) Bounding pulse
C) Decreased skin turgor
D) Crackles in the lungs
Answer: C
Rationale: Dehydration leads to decreased skin turgor due to reduced fluid volume in the tissues. Other signs of dehydration include tachycardia, hypotension, dry mucous membranes, and low urine volume.
A registered nurse (RN) is delegating tasks to a licensed practical nurse (LPN). Which task is appropriate for the RN to delegate to the LPN?
A) Developing a patient's plan of care
B) Administering an IV push medication
C) Providing initial teaching to a patient about a new diagnosis
D) Administering an oral medication
Answer: D
Rationale: LPNs can typically administer oral medications. Developing a care plan, administering IV push medications, and providing initial teaching are usually within the RN's scope of practice.