NCLEX Trainer Test 3
Question 1 of 5.
The hospital is planning to downsize and eliminate a number of staff positions as a cost-saving measure. To assist staff in this change process, the nurse manager is preparing for the 'unfreezing' phase of change. With this approach the nurse manager should:
A. Discuss with the staff how to deal with any defensive behavior
B. Explain to the unit staff why change is necessary
C. Assist the staff during the acceptance of the new changes
D. Clarify what the changes mean to the community and hospital
Explanation: Explain to the unit staff why change is necessary. The first phase of change, unfreezing, begins with awareness of the need for change. This can be facilitated by the manager who clearly understands the need and stands behind it.
Question 2 of 5.
An alert adult who has terminal cancer says to the home care nurse, 'When the time comes for me to go, I don't want to be in pain and I don't want you to try to resuscitate me. Please promise me you won't.' How should the nurse respond?
A. Of course, I will do as you wish.
B. I am obligated to try and preserve life.
C. Do you have advance directives? These need to be in your record.
D. Be sure to tell each nurse your desires.
Explanation: Asking about advance directives ensures the client's wishes are documented and legally binding, facilitating appropriate end-of-life care.
Question 3 of 5.
An adult is receiving lithium carbonate 600 mg tid. Which of the following observations is of greatest concern to the nurse?
A. The serum lithium level is 1.0 mEq/L.
B. The client states that she is going to go on a low-sodium diet.
C. The client has gaining 10 lb in the last three months.
D. The client says, 'I always drink a lot of water when I take the pills.'
Explanation: A low-sodium diet increases lithium retention, risking toxicity, a serious concern requiring immediate education or intervention.
Question 4 of 5.
An adult has the following blood gasses: pH=7.52, pCO2=50, HCO3=35, and pO2=90. What is most likely to be in the client's history of presenting signs and symptoms?
A. Persistent diarrhea
B. Frequent vomiting
C. Anxiety attack
D. Emphysema
Explanation: High pH and HCO3 indicate metabolic alkalosis, commonly caused by frequent vomiting, losing gastric acid.
Question 5 of 5.
Docusate sodium (Colace) is ordered for an adult who had a myocardial infarction yesterday. The client asks the nurse why docusate sodium is prescribed. The nurse's response should include which information?
A. Colace is prescribed to make it take longer for blood to clot.
B. Colace makes it easier for the client to relax and reduce stress.
C. Colace helps lower cholesterol levels.
D. Colace reduces straining at stool.
Explanation: Docusate sodium is a stool softener, reducing straining during bowel movements, which decreases cardiac strain post-MI.
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