Question 1

A patient was restrained because the nurse was trying to prevent the patient from pulling out his IV that was being used to administer antibiotics. Instead of restraining the patient, what should the nurse have done?

Accepted Answer

Answer reason: Restraints require a clear safety necessity and should be avoided when less restrictive alternatives can maintain treatment adherence. Using a family member as a sitter/observer is a least-restrictive, patient-centered option that can reduce agitation and prevent line removal while preserving dignity. Chemical restraint with a sedative is not appropriate for convenience and adds risks like respiratory depression and delirium. Continuous 1:1 staff observation is a potential alternative but is a higher-resource intervention than leveraging available support persons when safe and feasible.

Question 2

The process of deciding the objectives of administrative effort and devising the means to achieve them, is known as-?

Accepted Answer

Answer reason: The stem describes both selecting objectives and developing the methods to achieve them, which is the core definition of planning. Organisation focuses on arranging resources and assigning roles after goals are set, while supervision focuses on directing and monitoring staff performance. Budgeting is a narrower financial planning activity and does not encompass the broader objective-setting and strategic decision-making described.

Question 3

A client tells his nurse that his tuberculosis medications are so expensive that he can’t afford to take them. What is the most appropriate intervention by the nurse?

Accepted Answer

Answer reason: Tuberculosis is a reportable communicable disease, and public health departments commonly provide TB medications and directly observed therapy at low or no cost to ensure adherence and reduce community transmission. This option directly addresses the financial barrier while aligning with mandated public health coordination for TB care. Social services and Medicaid may help with broader support, but they can be slower and are not as TB-specific for immediate access to treatment programs. Focusing on insurance rules does not solve the access problem and risks nonadherence, treatment failure, and drug resistance.

Question 4

The nurse is making a home health visit to an elderly blind client who is living with his daughter. While completing the visit, the daughter expresses concern about the cost of caring for her father. Which program could the client be referred to?

Accepted Answer

Answer reason: This client is elderly and blind, which meets disability criteria commonly associated with eligibility for income-support benefits when financial resources are limited. This option directly addresses the daughter’s concern about the cost of caring by providing monthly cash assistance that can be used for essentials. In contrast, meal delivery programs provide services rather than income support, and Medicare is health insurance coverage rather than a cash benefit to offset general caregiving costs. Aid to Families with Dependent Children is not applicable to an elderly adult client.

Question 5

The client diagnosed with esophageal cancer is having work-related problems that are interfering with the client's treatment. Which organization should the nurse advise the client to contact for assistance with these issues?

Accepted Answer

Answer reason: This organization specifically helps patients navigate workplace and insurance obstacles, appeals/denials, and access-to-care problems that can interfere with treatment plans. By linking the client to targeted advocacy and support services, the nurse promotes continuity of care and reduces nonclinical barriers to adherence. In contrast, disease-specific or informational organizations may educate but are less focused on resolving employment-related disruptions to treatment.

Question 6

The nurse is discussing discharge plans with a homeless client diagnosed with paranoid schizophrenia. What is the primary factor that will affect developing the discharge plan for this client?

Accepted Answer

Answer reason: For a homeless client with paranoid schizophrenia, lack of stable shelter and linkage to community mental health services is a major barrier that can undermine medication access, follow-up, and safety monitoring. Identifying these resources determines what plan elements are feasible and what referrals/case management must be arranged prior to discharge. A support system and expected adherence matter, but they are often contingent on having an accessible, stable community placement and service infrastructure.

Question 7

The nurse-manager is considering whether to change the unit’s nursing care delivery system (NCDS) from team nursing to primary nursing. Which of the following is a key aspect to determine whether primary nursing is appropriate?

Accepted Answer

Answer reason: If RN numbers are insufficient, continuity and responsibility for care planning/coordination break down and becomes unsafe or impractical. Training and documentation can be developed or modified to support implementation, but they do not compensate for inadequate RN capacity. Patient diagnoses influence acuity and workload, yet the decisive feasibility factor for this delivery model is having enough RNs to staff it.

Question 8

The nurse is aware of the American Nurses Association’s nursing-sensitive quality indicators regarding the management and prevention of hospital- acquired infections. Which nursing action is most likely to reduce hospital-acquired infection rates?

Accepted Answer

Answer reason: When ratios are unsafe, missed care and rushed practices increase, which is strongly associated with higher rates of CLABSI, CAUTI, and other hospital-acquired infections. This option directly targets a nursing-sensitive indicator and is a high-leverage management intervention. Team functioning helps overall care but is less directly tied to infection rates than staffing adequacy, and medication-safety surveillance primarily addresses adverse drug events rather than HAIs.

Question 9

A nurse notices soiled linen in the trash receptacle instead of in the soiled linen receptacle in a client’s room. The nurse first puts on gloves and then carefully separates the soiled linen from the trash and places it in the soiled linen receptacle to be cleaned by the facility’s laundry. This action by the nurse is an example of which principle of client care management?

Accepted Answer

Answer reason: Client-care management includes using facility supplies and services appropriately to support safe, efficient care. The nurse corrected improper disposal so the linen can be processed through the facility laundry system, which is the intended resource for contaminated items and helps prevent waste and contamination risk. This is not case management, which focuses on coordinating care across services and settings over time. It is also not primarily time or priority management because the key concept is proper use of institutional resources and processes.

Question 10

Attracting nursing staff to a facility, hiring, and orienting new nursing staff is a costly process. Implementing programs that result in retention of nursing staff is cost-effective for health care facilities. Programs that result in nursing job satisfaction and nursing staff retention are examples of what client care management principle?

Accepted Answer

Answer reason: Staffing is a core organizational resource, and minimizing turnover reduces recruitment and orientation costs while stabilizing care delivery capacity. Retention and job satisfaction programs are administrative strategies that allocate and preserve human resources to meet patient-care demands efficiently. This aligns with managing resources to optimize outcomes and control costs at the system level. Delegation concerns assigning tasks safely and appropriately, not long-term workforce retention planning.

Question 11

The home health nurse is assessing a client and determines that the client has an unsteady gait. The client tells the nurse that she has recently fallen. Which nursing action represents an advocacy role for the home health nurse?

Accepted Answer

Answer reason: With a recent fall and unsteady gait, promptly securing an assistive device reduces immediate risk while longer-term evaluation and procurement occur. This action demonstrates resource coordination and support access, which is a core advocacy function. Listening therapeutically supports coping but does not directly secure resources, and reassurance that a walker will “prevent” falls is inaccurate and can create false security.

Question 12

The client is scheduled to have a CXR and a pulmonary function test (PFT). The client tires easily. Which action should be taken by the nurse to best coordinate the client’s care?

Accepted Answer

Answer reason: A portable chest x-ray can be performed at the bedside, reducing transport demands, time off the unit, and physiologic stress for a client who tires easily. This preserves the client’s limited activity tolerance so they can still complete the higher-effort pulmonary function testing. Rescheduling or merely escorting does not address the primary problem of fatigue related to multiple transports and can delay needed evaluation without a clear clinical necessity.

Question 13

Resource management is the concept of?

Accepted Answer

Answer reason: Resource management in nursing focuses on using people, time, supplies, and services efficiently while maintaining safe, evidence-based outcomes. This includes cost-effective planning such as appropriate staffing mix, avoiding unnecessary tests/supplies, and coordinating care to prevent delays and complications. The correct choice preserves quality as the priority while explicitly incorporating cost containment through appropriate methods. In contrast, prioritizing care “regardless of cost” ignores stewardship responsibilities, and “minimum staffing” risks unsafe care rather than efficient allocation.

Question 14

At a staff meeting, the nurse manager shares that the unit is over budget by 2% and needs to reduce costs. A staff nurse suggests that reports could be shortened so that nurses could finish their shifts on time. How should the nurse manager measure the success of this idea once implemented?

Accepted Answer

Answer reason: Nursing hours per client day is a standard measure of staffing resource utilization and is closely tied to the largest controllable cost in most units—nursing labor. If shortening reports truly reduces paid time (eg, overtime or extended handoff time), this metric should decrease while patient volume is accounted for. Simply observing who leaves on time is less reliable and may miss hidden overtime, missed care, or documentation work completed off the clock.

Question 15

A health care facility uses the self-scheduling method for nursing schedules and individual unit staffing. Each nurse pencils in the preferred schedule by order of seniority, then all nurses are responsible to adjust scheduled days to cover that unit’s target number of licensed nurses per schedule. The assistant nurse manager approves each finalized schedule and makes minor adjustments if necessary. What concepts of staff management does the assistant nurse manager employ to achieve completion of the nursing schedule?

Accepted Answer

Answer reason: The core principle is that staffing and scheduling are management functions that require planning, organizing, and coordinating resources to meet patient care and unit coverage targets. Approving the final schedule and making minor adjustments reflects accountability for the staffing plan and ensuring adequate licensed nurse coverage, which is a classic management responsibility. The self-scheduling process also relies on leadership to facilitate staff participation, promote collaboration, and gain buy-in while balancing seniority preferences with unit needs. Delegation is not the primary concept here because the assistant nurse manager is not assigning patient-care tasks to others; the focus is completing a staffing schedule and guiding the team through the process.

Question 16

Which State is the easiest to apply for NCLEX? What are the requirements? How to apply for NCLEX-RN? What is the easiest State for NCLEX application?

Accepted Answer

Answer reason: S. state is “easiest” for NCLEX application, which is not a stable, evidence-based clinical or nursing-judgment question and varies over time by Board of Nursing policy. Among the options, only the referral-to-video choice is framed as the intended keyed response in this content format, while the named states have no supporting criteria provided to justify one as definitively easiest. Because the prompt does not specify applicant type (US graduate vs international), education pathway, SSN requirements, or endorsement vs examination, a single best state cannot be determined from the information given. Therefore the only internally supported selection is the option directing the viewer elsewhere for the answer.

Question 17

Ms. Caputo learns that some leaders are transactional leaders. Which of the following does NOT characterize a transactional leader?

Accepted Answer

Answer reason: A focus on management tasks and using trade-offs are classic transactional behaviors that emphasize structure and outcomes. The “caretaker” concept aligns with maintaining stability and ensuring day-to-day operations, which is consistent with transactional leadership’s emphasis on maintaining the status quo. Inspiring others with a compelling vision is a hallmark of transformational leadership, not transactional leadership.

Question 18

A new head nurse on a unit is distressed about the poor staffing on the 11 p.m. to 7 a.m. shift. What should she do?

Accepted Answer

Answer reason: Escalating the concern to the supervisor enables resource allocation decisions such as hiring, float pool use, skill-mix adjustments, or workload redistribution within policy. Complaining to peers does not resolve the systemic problem and can worsen morale without improving coverage. Waiting delays risk mitigation, and coercing staff to “volunteer” to rotate is inappropriate and may violate policy/contractual agreements while harming retention.

Question 19

SITUATION: A client was admitted to the hospital and assessed to have an elevated blood pressure of 170/120 mmHg. The healthcare provider ordered 1 mg of Clonidine (Catapres) to be given orally. The nurse sent the medication order to the pharmacy at 7:05 a.m. However, by 8:00 a.m., the medication had not yet been delivered. Which of the following actions is least appropriate based on standard medication administration protocols?

Accepted Answer

Answer reason: The nurse should first assess the client and follow facility protocols by checking for medication delivery and contacting the pharmacy. Personally retrieving the medication may bypass standard distribution and documentation systems unless explicitly allowed by facility policy. Therefore, it is generally the least appropriate initial action compared to assessment and proper communication.

Question 20

Functional nursing has some advantages, which one is an EXCEPTION?

Accepted Answer

Answer reason: Functional nursing is a task-oriented model that fragments care, so the primary benefit is efficiency and control rather than holistic, patient-centered attention. Emphasizing psychosocial needs requires continuity, individualized assessment, and coordinated planning, which functional nursing tends to undermine by having multiple staff perform separate tasks. Strong supervision and clear division of labor can improve control of activities and can reduce costs by using skill mix efficiently. A common drawback of is reduced holistic care and patient satisfaction, which is why highlighting psychosocial emphasis does not fit as an advantage.

Question 21

A facility has been notified of a train derailment resulting in multiple clients experiencing life-threatening injuries. The external disaster plan has been activated. Which of the following is an appropriate action of the charge nurse on the PACU?

Accepted Answer

Answer reason: Disaster response prioritizes rapid creation of surge capacity while maintaining safe continuity of care. The PACU charge nurse can immediately help decompress critical-care-capable space by assessing postoperative clients and expediting transfer of those who are hemodynamically stable to appropriate inpatient units, freeing PACU beds and staff for incoming unstable casualties. Sending assistive personnel to triage is inappropriate because triage requires skilled clinical assessment and is typically directed by the ED/disaster team. Bringing wheelchairs or merely awaiting instructions is less effective than proactively optimizing patient flow and bed availability within the PACU’s scope.

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