Chapter 19 Reflecting on Your Transition

Chapter 19  Reflecting on Your Transition

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. A toddler is brought to the well-child community clinic by her grandmother. The health history reveals recurrent nausea, vomiting, and diarrhea. Her physical exam reveals a negligible gain in height and weight, lethargy, and a delay in achieving milestones. As a result of the child’s delays, multiple disciplines would likely be involved in caring for the child. Which of the following represents the most effective role the nurse would play in caring for the child?
a.
Coordinator
b.
Teacher
c.
Counselor
d.
Advocate

ANS: A
One of nursing’s major contributions to the health care team is the role of the coordinator. Care can easily become fragmented when patients are seen by numerous specialists, each interested in a different aspect of the patient. A major risk of this situation is that the orders of different specialists may conflict with one another and be counterproductive. Therefore, it is important for the nurse to make rounds with other health care professionals and to read the results of the various consultations. The nurse can help interpret the specialists’ findings for the patient and family, prepare the family to participate in the patient’s plan of care, and serve as a liaison among the members of the health care team. Nurses also play the roles of teacher, counselor, and advocate, but this patient requires coordination of care.

DIF: Cognitive Level: Application REF: Page 296
OBJ: Apply the nursing process to transitioning from LPN/LVN to RN.
TOP: Transition and the Nursing Process
MSC: NCLEX: Safe, Effective Care Environment: Management of Care

2. A 43-year-old patient is scheduled for a laparoscopic cholecystectomy. A nurse has a plan to teach the preoperative patient how to splint his abdomen with a pillow and cough and deep breathe, so the patient can avoid fluid accumulation in the lungs postoperatively. When the nurse enters the room, it becomes evident that the patient is blind. What critical thinking skill would you recommend a scenario like this requires?
a.
Intellectual curiosity
b.
Flexibility
c.
Reflection
d.
Open-mindedness

ANS: B
Flexibility is the critical thinking skill that the nurse needs to teach the necessary information to the blind patient. In developing critical thinking, a graduate RN is encouraged to seek out situations that require thinking outside of the box to enhance and broaden the graduate RN’s nursing knowledge and experience. Intellectual curiosity, reflection, and open-mindedness are also skills of critical thinking but are not applicable to this scenario.

DIF: Cognitive Level: Application REF: Page 297
OBJ: Apply the nursing process to transitioning from LPN/LVN to RN.
TOP: Transition and the Nursing Process
MSC: NCLEX: Safe, Effective Care Environment: Management of Care

3. It is 0800 and the nurse just received report. Which patient situation demands the nurse’s immediate attention? The patient:
a.
with a blood glucose of 200.
b.
who needs a 0800 vancomycin level drawn.
c.
receiving a blood transfusion who reports slight itching and chills.
d.
with a serum potassium level of 4.3 mEq/dL who is receiving digoxin.

ANS: C
Slight itching and chills during a blood transfusion may indicate an allergic reaction and require immediate attention. A blood glucose of 200 and the need for a vancomycin level will eventually need attention. A potassium level of 4.3 mEq/dL is within normal range.

DIF: Cognitive Level: Application REF: Page 297
OBJ: Apply the nursing process to transitioning from LPN/LVN to RN.
TOP: Transition and the Nursing Process
MSC: NCLEX: Safe, Effective Care Environment: Management of Care

4. A patient who had recent abdominal surgery is becoming increasingly agitated and confused. He has pulled out his IV and his nasogastric tube. His skin is pale and clammy, heart rate 120 bpm, BP 130/60. The physician has been called. What nursing action is most important at this time?
a.
Gather needed supplies and assign the aide to remain with the patient.
b.
Stay with the patient and have another nurse obtain needed supplies.
c.
Administer pain medication and then recheck vital signs.
d.
Assign the aide to retake vital signs every 15 minutes.

ANS: B
Staying with the patient while another nurse obtains needed supplies is the best action because the patient’s condition is deteriorating. Asking the aide to stay with the patient and assigning the aide to take vital signs every 15 minutes are inappropriate delegations. Administering pain medication is an incorrect action because the patient is not complaining of pain.

DIF: Cognitive Level: Application REF: Page 296
OBJ: Apply the nursing process to transitioning from LPN/LVN to RN.
TOP: Transition and the Nursing Process
MSC: NCLEX: Safe, Effective Care Environment: Management of Care

5. Which patient is at greatest risk for injury and requires the nurse’s immediate attention? The patient who had a(n):
a.
paracentesis 20 minutes ago and is sitting in bed with the arms resting on the overbed tray.
b.
surgical repair of an incarcerated hernia yesterday and now has slight bruising at the incision site.
c.
echocardiogram that showed an ejection fraction of 40% and has a resting heart rate of 110 occasional PVCs.
d.
needle liver biopsy 1 hour ago and is now thrashing about in bed and complaining of severe abdominal pain.

ANS: D
The only scenario that illustrates a major risk for injury is the patient who had a needle liver biopsy 1 hour ago and is now complaining of severe abdominal pain. The patient may be bleeding internally, requiring immediate attention. The other scenarios illustrate normal expectations.

DIF: Cognitive Level: Application REF: Page 297
OBJ: Apply the nursing process to transitioning from LPN/LVN to RN.
TOP: Transition and the Nursing Process
MSC: NCLEX: Safe, Effective Care Environment: Management of Care