Leadership and Management NCLEX
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Question 1 of 5.
The nurse has administered prescribed medications to assigned clients. Which follow-up assessment requires immediate follow-up? A client who received prescribed
A. intravenous hydromorphone for chronic back pain and is drowsy.
B. intravenous metoclopramide for nausea and vomiting and now has involuntary movements of the jaw.
C. intravenous dexamethasone for chronic bronchitis reporting perineal itching.
D. nitroglycerin infusion for chest pain and reports a headache.
Explanation: Involuntary jaw movements after intravenous metoclopramide (B) indicate extrapyramidal symptoms, a serious adverse reaction that may progress to dystonia, requiring immediate intervention like stopping the drug or administering an antidote (e.g., diphenhydramine). Drowsiness with hydromorphone (A), perineal itching with dexamethasone (C), and headache with nitroglycerin (D) are expected side effects and less urgent.
Question 2 of 5.
The nurse is caring for assigned clients with newly received prescriptions. Which prescription should the nurse administer first? See the exhibit.
A. Levofloxacin 750 mg IVPB Q12 hours
B. 0.9% Saline 125 ml/hr
C. Metoclopramide 10 mg IV Push Q8 hours
D. Ketorolac 15 mg IV Push Q8 hours
Explanation: Pneumonia in an elderly client can be particularly severe due to age-related immune system decline and potential for complications like acute respiratory distress syndrome (ARDS) and/or sepsis.
Question 3 of 5.
The nurse is caring for four clients on a medical-surgical unit. Which of the following tasks would be a priority for the nurse to complete?
A. teaching a client scheduled for discharge how to ambulate with crutches
B. witnessing informed consent for a client needing an emergency laparotomy
C. irrigating a client's ostomy who reports abdominal cramping
D. calculating the intake and output of a client with diabetes insipidus (DI)
Explanation: Witnessing informed consent for an emergency laparotomy (B) is a priority, as it ensures legal and ethical requirements are met for urgent surgery. Crutch training (A), ostomy irrigation (C), and intake/output calculation (D) are important but less time-sensitive.
Question 4 of 5.
The nurse recognizes that the most effective way to resolve a conflict is through
A. compromising.
B. accommodating.
C. avoiding.
D. a win-win solution.
Explanation: A win-win solution (D) resolves conflict by addressing all parties' needs, fostering collaboration and long-term resolution. Compromising (A) and accommodating (B) may leave issues unresolved, and avoiding (C) delays resolution.
Question 5 of 5.
A charge nurse is preparing client assignments for the shift. Which client is most appropriate to assign to a licensed practical/vocational nurse (LPN/VN)?
A. A client with a chest tube requiring frequent oral suctioning.
B. A client receiving continuous IV heparin for a pulmonary embolism (PE).
C. A client 24 hours post-abdominal surgery requiring daily wound care.
D. A client with new-onset seizures awaiting diagnostic tests.
Explanation: A client 24 hours post-abdominal surgery needing wound care (C) is stable and within the LPN scope. Chest tube suctioning (A) and heparin infusion (B) require RN monitoring for complications. New-onset seizures (D) require RN assessment due to instability.
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