WITH NGN |
COMPLETE TEST
BANK | 160
QUESTIONS WITH
VERIFIED ANSWERS
AND DETAILED
RATIONALES |
LATEST 2025/2026
,Question 1
The charge nurse is planning for the shift and has a registered nurse (RN) and
a practical nurse (PN) on the team. Which client should the charge nurse
assign to the RN?
A) A 75-year-old client with renal calculi who requires urine straining
B) A 64-year-old client who had a total hip replacement the previous day
C) A 30-year-old depressed client who admits to suicide ideation
D) An adolescent with multiple contusions due to a fall that occurred 2 days
ago
Correct Answer: C
Rationale:
Correct (C): A client who admits to suicide ideation requires ongoing
assessment, monitoring, and evaluation of suicidal risk, which is within the
RN's scope of practice. Suicide ideation requires complex nursing judgment,
crisis intervention, and safety planning. The RN must assess the client's risk
level, implement suicide precautions if needed, and evaluate the effectiveness
of interventions. This level of assessment and clinical judgment cannot be
delegated to an LPN/VN. The PN/LPN can care for stable clients with
predictable outcomes (options A, B, and D).
Incorrect (A): Urine straining for renal calculi is a routine task that can be
delegated to a PN/LPN.
Incorrect (B): A client one day post-hip replacement is stable with
predictable needs and can be assigned to a PN/LPN.
, Incorrect (D): An adolescent with contusions is stable and can be assigned
to a PN/LPN.
StudyTip: "Assign RN to unstable clients or those requiring complex
assessment (suicide ideation, new admissions, unstable vital signs)."
Question 2
The nurse is assigned to care for four surgical clients. After receiving report,
which client should the nurse see first?
A) An older client who is receiving packed red blood cells on the third day
postoperative for colon resection
B) An older client with continuous bladder irrigation who is two days
postoperative for bladder surgery
C) An adult who is in Buck's traction and scheduled for hip arthroplasty
within the next 12 hours
D) An adult one day postoperative laparoscopic cholecystectomy requesting
pain medication
Correct Answer: A
Rationale:
Correct (A): A client receiving a blood transfusion is at risk for transfusion
reactions (febrile, hemolytic, allergic, bacterial). The nurse must assess the
client during the first 15 minutes of the transfusion when most reactions
occur. The nurse should check vital signs before and after the transfusion and
, stay with the client during the initial phase. This client requires immediate
assessment to ensure no signs of transfusion reaction (fever, chills,
hypotension, back pain, dark urine). Clients receiving blood products are
prioritized over stable postoperative clients.
Incorrect (B): Continuous bladder irrigation is important but not
emergent; the nurse can assess after checking the transfusion client.
Incorrect (C): A client scheduled for surgery in 12 hours is stable and can
be seen later.
Incorrect (D): Pain medication is important but not an immediate life
threat.
StudyTip: "Blood transfusion priority = first 15 minutes (highest risk for
reaction) + assess vital signs + stay with client."
Question 3
The nurse is caring for a client who arrives in the emergency department with
reports of dizziness and difficulty walking. The nurse observes right-sided
weakness and sluggish speech. The nurse should immediately take which
action?
A) Maintain elevated positioning of the dependent joints on the affected side
B) Keep the bed in the lowest position and initiate seizure and fall precautions
C) Place an indwelling urinary catheter and measure strict intake and output