Exam (elaborations)
NGN/NCLEX PREP QUESTIONS/RATIONALES QUESTONS AND ANSWERS WITH SOLUTIONS 2024
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NGN/NCLEX PREP QUESTIONS/RATIONALES QUESTONS AND ANSWERS WITH SOLUTIONS 2024
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NGN/NCLEX PREPQUESTIONS/RATIONALES QUESTONS
AND ANSWERS WITH SOLUTIONS 2024
TheTnurseTnotesTtheTpresenceTofTaTPTwave,TQRSTcomplex,TflattenedTTTwaves,TandToccasionalTUTwavesTonTaT
client'sTcardiacTmonitorTscreen.TFillTinTtheTcorrectTmissingTinformationTbyTchoosingTfromTtheTlistsTofToption
sTinTtheTdrop-downTmenus.T-TANSWERTTheTnurseTshouldTsuspect
YourTAnswer:ThypokalemiaCorrectTAnswer:Thypokalemia
becauseTofTthe
YourTAnswer:TflattenedTTTwavesTandToccasionalTUTwavesCorrectTAnswer:TflattenedTTTwavesTandToccasional
TUTwaves
Rationale:CardiacTchangesTinThypokalemiaTincludeTimpairedTrepolarization,TresultingTinTaTflatteningTofTtheT
TTwaveTandTeventuallyTtheTemergenceTofTaTUTwave.TTherefore,TtheTnurseTshouldTsuspectThypokalemia.TTh
eTincidenceTofTpotentiallyTlethalTventricularTdysrhythmiasTisTincreasedTinThypokalemia.TTheTnurseTshouldTi
mmediatelyTassessTtheTclient'sTvitalTsignsTandTcardiacTstatusTforTsignsTofThypokalemia.TTheTnurseTshouldTal
soTcheckTtheTclient'sTmostTrecentTserumTpotassiumTlevelTandTthenTcontactTtheTprimaryThealthTcareTprovid
erTtoTreportTtheTfindingsTandTobtainTprescriptionsTtoTtreatTtheThypokalemicTstate.
TheTnurseTisTpreparingTaTclientTforTaTchestTx-
rayTandTnotesTthatTtheTclientTisTwearingTaTreligiousTmedalTonTaTchainTaroundTtheTneck.TWhatTshouldTtheTnu
rseTdoTwithTregardTtoTthisTpersonalTitem?TClickTtoThighlightTtheTcorrectTanswerTfromTtheToptionsTprovided.T
-TANSWERTTheTnurseTshould:T(SelectT1Toption)
✓AskTtheTclientTifTtheTchainTandTmedalTcanTbeTremovedTduringTtheTprocedure.
Because:T(SelectT1Toption)
✓TheTchainTandTmedalTmayThaveTculturalTsignificance.
Rationale:BeforeTcertainTdiagnosticTprocedures,TitTisTtypicalTtoThaveTaTclientTremoveTpersonalTobjectsTthatT
areTwornTonTtheTbodyTbecauseTofTclientTsafetyTandTtheTpossibilityTofTcompromisingTtestTresults.TTherefore,
TtheTnurseTshouldTaskTtheTclientTaboutTtheTsignificanceTofTsuchTanTitemTandTitsTremovalTbecauseTitTmayThav
eTculturalTorTspiritualTsignificance.TIfTso,TtheTnurseTshouldTaskTtheTclientTifTtheTitemTcanTbeTeitherTremovedT
temporarilyTorTplacedTonTanotherTpartTofTtheTbodyTduringTtheTprocedureTifTappropriate.
,WhileTpreparingTaTclientTforTsurgeryTscheduledTinT1Thour,TtheTclientTstatesTtoTtheTnurse:T"IThaveTchangedTm
yTmind.TITdon'tTwantTthisTsurgery."TClickTtoThighlightTtheTcorrectTanswerTfromTtheToptionsTprovided.T-
TANSWERTTheTnurseTshould:T(SelectT1Toption)
CancelTtheTsurgery.
ContactTtheTsurgeon.
✓DiscussTtheTclient'sTconcerns.
CallTtheTidentifiedTsupportTperson.
Because:T(SelectT1Toption)
ClientTconsentTisTrequiredTpriorTtoTanyTprocedure.
✓FurtherTquestionsTorTconcernsTshouldTbeTdeterminedTandTaddressed.T
EthicalTconsiderationsTareTimportantTforTaTclientTundergoingTsurgery.T
TheTnursingTscopeTofTpracticeTplacesTlimitationsTonThowTtheTnurseTcanTrespond.
Rationale:IfTtheTclientTindicatesTthatTheTorTsheTdoesTnotTwantTaTprescribedTtherapy,Ttreatment,TorTprocedu
reTsuchTasTsurgery,TtheTnurseTshouldTfurtherTinvestigateTtheTclient'sTrequest.TIfTtheTclientTindicatesTthatTheT
orTsheThasTchangedThisTorTherTmindTaboutTsurgery,TtheTnurseTshouldTassessTtheTclientTandTexploreTwithTth
eTclientThisTorTherTconcernsTaboutTnotTwantingTtheTsurgery.TTheTnurseTwouldTthenTwithholdTfurtherTsurgic
alTpreparationTandTcontactTtheTsurgeonTtoTreportTtheTclient'sTrequestTsoTthatTtheTsurgeonTcanTdiscussTtheT
consequencesTofTnotThavingTtheTsurgeryTwithTtheTclient.TFurtherTassessmentTandTfollow-
upTrelatedTtoTtheTclient'sTrequestTneedTtoTbeTdone.TItTisTtheTclient'sTrightTtoTrefuseTtreatment;Thowever,Tfur
therTinvestigationTisTneededTsoTtheTinterventionsTcanTbeTtailoredTtoTspecificTneeds.
TheTnurseTnotesTthatTthereThasTbeenTanTincreaseTinTtheTnumberTofTintravenousT(IV)TsiteTinfectionsTthatTde
velopedTinTtheTclientsTbeingTcaredTforTonTtheTnursingTunit.THowTshouldTtheTnurseTproceedTtoTimplementTaT
qualityTimprovementTprogram?ForTeachTaction,TclickTtoTspecifyTwhetherTtheTactionTwouldTbe:
Indicated:TanTactionTthatTtheTnurseTshouldTtakeTtoTresolveTtheTproblem
Non-
essential:TanTactionTthatTtheTnurseTcouldTtakeTwithoutTharmingTtheTclient,TbutTtheTactionTwouldTnotTbeTlike
lyTtoTaddressTtheTproblem
Contraindicated:TanTactionTthatTcouldTharmTtheTclientTandTshouldTnotTbeTtakenT-
TANSWERTCollectTidentifyingTpatientTinformation
Contraindicated
NoteTtheTmentalTstatusTofTtheTclient
Non-essential
, NoteTprimaryTandTsecondaryTdiagnosesTofTclientsTaffected
Indicated
NoteTtheTtypeTofTIVTcatheterTused
Indicated
NoteTtheTtypeTofTIVTsiteTdressingsTbeingTused
Indicated
NoteTtheTmedicationTtypesTbeingTinfused
Non-essential
NoteTfrequencyTofTassessmentsTofTIVTsites
Indicated
NoteTtheTexpectedTdurationTofTtheTIVTsite
Non-essential
NoteTcareTproceduresTtoTtheTIVTsite
Indicated
NoteTfrequencyTofTchangingTIVTsites
Indicated
Rationale:QualityTimprovement,TalsoTknownTasTperformanceTimprovement,TfocusesTonTprocessesTorTsyste
msTthatTsignificantlyTcontributeTtoTclientTsafetyTandTeffectiveTclientTcareToutcomes;TcriteriaTareTusedTtoTmo
nitorToutcomesTofTcareTandTtoTdetermineTtheTneedTforTchangeTtoTimproveTtheTqualityTofTcare.TIfTtheTnurseT
notesTaTparticularTproblem,TsuchTasTanTincreaseTinTtheTnumberTofTintravenousT(IV)TsiteTinfections,TtheTnurs
eTshouldTcollectTdataTaboutTtheTproblem.TThisTshouldTincludeTinformationTsuchTasTtheTprimaryTandTsecond
aryTdiagnosesTofTtheTclientsTdevelopingTtheTinfection,TtheTtypeTofTIVTcathetersTbeingTused,TtheTsiteTofTtheTc
atheter,TIVTsiteTdressingsTbeingTused,TfrequencyTofTassessmentTandTmethodsTofTcareTtoTtheTIVTsite,TandTlen
gthTofTtimeTthatTtheTIVTcatheterTwasTinserted.TOnceTtheseTdataTareTcollectedTandTanalyzed,TtheTnurseTshou
ldTexamineTevidence-
basedTpracticeTprotocolsTtoTidentifyTtheTbestTpracticesTforTcareTtoTIVTsitesTtoTpreventTinfection.TTheseTprac
ticesTcanTthenTbeTimplementedTandTfollowedTbyTevaluationTofTresultsTbasedTonTtheTevidence-
basedTpracticeTprotocolsTused.TCollectingTidentifyingTclientTinformationTisTcontraindicatedTbecauseTofTconf
identialityTandTisTunnecessaryTinTthisTqualityTimprovementTeffort.TNotingTtheTmentalTstatusTofTtheTclientsTc
anTbeTdoneTbutTisTnotTlikelyTtoTaddressTthe
TheTnurseTperformsTanTAllen'sTtestTonTaTclientTscheduledTforTanTarterialTbloodTgasTdrawTfromTtheTradialTart
ery.TOnTreleaseTofTpressureTfromTtheTulnarTartery,TcolorTinTtheThandTreturnsTafterT20Tseconds.THowTshouldT
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