a gastroenterologist should be consulted for clients suffering from

NCLEX-PN

Nclex Questions Management of Care

1. A gastroenterologist should be consulted for clients suffering from:

A. digestive system diseases
B. urinary system diseases
C. female reproductive system diseases
D. nervous system diseases

Correct answer: A

Rationale: A gastroenterologist specializes in treating diseases and disorders of the digestive system, including the stomach, intestines, liver, and pancreas. Therefore, clients with digestive system diseases should consult a gastroenterologist. Choices B, C, and D are incorrect because urinary system diseases are managed by urologists, female reproductive system diseases by gynecologists, and nervous system diseases by neurologists.

2. A client is having a seizure; his blood oxygen saturation drops from 92% to 82%. What should the nurse do first?

A. Open the airway.
B. Administer oxygen.
C. Suction the client.
D. Check for breathing.

Correct answer: A

Rationale: When a client is having a seizure and their blood oxygen saturation drops significantly, the priority action for the nurse is to open the airway. This allows for adequate oxygenation and ventilation. Administering oxygen can come after ensuring the airway is clear. Suctioning the client should be done if there is an airway obstruction, and checking for breathing is part of the assessment but opening the airway takes precedence to ensure proper oxygenation and ventilation during a critical event like a seizure.

3. An example of a process standard on a med-surg unit is:

A. a procedure for changing IV tubing.
B. a policy for staffing.
C. the job description of the CEO (chief executive officer).
D. a procedure for checking waveforms on a client being treated with an intra-aortic balloon pump.

Correct answer: D

Rationale: Process standards define the actions and behaviors required by staff to provide care on a med-surg unit. A procedure for changing IV tubing is a critical psychomotor skill necessary for safe and effective patient care in this setting. Choice B, a policy for staffing, pertains more to organizational management rather than specific care processes on the unit. Choice C, the job description of the CEO, delineates the responsibilities of the organization's top executive and is not a process standard for frontline staff. Choice D, a procedure for checking waveforms on a client with an intra-aortic balloon pump, is more specific to a cardiac care unit and not typically performed on a med-surg unit.

4. A client expresses anxiety about having magnetic resonance imaging performed. Which of the following is an appropriate response by the nurse?

A. "You can receive a sedative to help you relax during the test."?
B. "There is absolutely nothing to worry about."?
C. "There is no discomfort with this test, so don't be anxious."?
D. "The test won't last long, so you can handle it."?

Correct answer: A

Rationale: The correct response acknowledges the client's anxiety and offers a practical solution to alleviate it, showing empathy and addressing the client's concerns. Offering a sedative to help relax during the test is a proactive approach to managing the client's anxiety. Choices B and C dismiss the client's feelings by invalidating their anxiety, which can further escalate their distress. Choice D downplays the client's feelings by implying they should not be worried, which does not effectively address the client's emotional state.

5. In an emergency situation where a client is unconscious and requires immediate surgery, what action is necessary with regard to informed consent?

A. The healthcare team will proceed with the surgery as consent is not needed in emergencies.
B. The healthcare team will wait until the client's family can be contacted for consent.
C. The healthcare team will contact the hospital clergy to provide informed consent.
D. The healthcare team will obtain consent from the client's legal guardian before proceeding.

Correct answer: A

Rationale: In emergency situations where obtaining consent is not possible due to the client's condition, healthcare providers are allowed to perform life-saving procedures without informed consent. It is assumed that the client would want to receive necessary treatment to save their life. Therefore, the correct action is for the healthcare team to proceed with the surgery as consent is not needed. Waiting to contact the client's family for consent can delay life-saving treatment, risking the client's life. Contacting the hospital clergy for consent is unnecessary and can cause further delays. Obtaining consent from the client's legal guardian is not feasible in this critical situation and may lead to a delay in providing essential care.