NCLEX Leadership and Management
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Question 1 of 5.
The nurse in the emergency department (ED) is caring for a client diagnosed with acute pancreatitis. The nurse should prioritize obtaining a prescription for
A. intravenous fluids.
B. ondansetron.
C. the insertion of a nasogastric tube (NGT).
D. fentanyl via patient-controlled analgesia.
Explanation: IV fluids (A) are the priority in acute pancreatitis to correct hypovolemia and prevent organ failure, per clinical guidelines. Ondansetron (B), NGT (C), and fentanyl (D) address symptoms but are secondary to fluid resuscitation.
Question 2 of 5.
You are caring for a 33-year-old male client at the end of life. This married client has two children; the son is 14-years-old and the daughter is 8-years-old. Both of these children are being prepared for their father's imminent death. Which consideration should be incorporated into your explanations of death with these children?
A. Children before the age of 12 view death as terrifying so the nurse should not discuss death with these young children.
B. Children before the age of 12 do not have any perspectives about death, its meaning, and its finality or lack thereof.
C. The cognitive development of young children impacts their understanding of death.
D. The cognitive development of young children before 12 has no impact on their understanding of death
Explanation: Cognitive development (C) influences how children, like the 8-year-old, understand death. Younger children may view death as reversible or temporary, while adolescents, like the 14-year-old, grasp its finality. Tailoring explanations to their developmental stage is essential. Options A and B are incorrect as children do have perspectives, and avoiding discussion (A) is unhelpful. Option D contradicts developmental psychology.
Question 3 of 5.
The charge nurse is planning client care assignments for a licensed practical/vocational nurse (LPN/VN). Which of the following would be an appropriate assignment(s) for the LPN? Select all that apply.
A. A 67-year-old one-hour post-procedure from a cardiac catheterization.
B. An 88-year-old client who was just admitted for intractable pain secondary to metastatic cancer.
C. A 42-year-old being discharged following a diagnosis of type 2 diabetes mellitus.
D. A 75-year-old inpatient client with colon cancer needing colostomy care.
E. A 50-year-old client being treated for herpes zoster with prescribed oral antivirals.
Explanation: LPNs can manage stable clients with pain (B), colostomy care (D), and oral antivirals (E) within their scope. A client one-hour post-cardiac catheterization (A) requires RN monitoring for complications, and discharge teaching for diabetes (C) involves complex education best suited for an RN.
Question 4 of 5.
The nurse has been made aware of the following client situations. The nurse should first follow up with the client
A. receiving a chemotherapy infusion who reports nausea and vomiting.
B. newly diagnosed with polycystic kidney disease reporting hematuria and flank pain.
C. being treated for aplastic anemia and has a temperature of 101.1°F (38.4°C).
D. being treated for pulmonary tuberculosis and ambulating in the hallway wearing a surgical mask.
Explanation: A fever in a client with aplastic anemia (C) indicates potential infection, a life-threatening complication due to low white blood cells, requiring immediate attention. Nausea from chemotherapy (A), hematuria with kidney disease (B), and TB with a mask (D) are less urgent.
Question 5 of 5.
The nurse is preparing to insert an indwelling urinary catheter. Which action may be delegated to the unlicensed assistive personnel (UAP)?
A. Set up the sterile field
B. Palpate the bladder for distention
C. Explain the procedure to the client
D. Place the urinary catheter kit at the bedside
Explanation: Placing the catheter kit at the bedside (D) is a non-clinical task suitable for a UAP. Setting up a sterile field (A), palpating the bladder (B), and explaining the procedure (C) require clinical judgment or training beyond UAP scope.
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