an lpn is tasked with checking the narcotic count on a medical surgical unit which statement by the lpn requires further investigation

NCLEX-PN

Best NCLEX Next Gen Prep

1. An LPN is tasked with checking the narcotic count on a medical-surgical unit. Which statement by the LPN requires further investigation?

A. "I need a witness when I waste the leftover narcotics in the client's PCA pump."?
B. "I am going to check the facility's policy for how to dispose of this controlled substance."?
C. "I left the narcotics box unlocked after confirming the beginning of shift count was correct."?
D. "The end of shift narcotics count is incorrect and needs to be reported."?

Correct answer: C

Rationale: The LPN's statement about leaving the narcotics box unlocked after confirming the beginning of shift count was correct requires further investigation. Narcotics should be locked and kept in a secure place during the shift to prevent unauthorized access and ensure patient safety. This statement raises concerns about medication security, which is critical in preventing diversion and ensuring patient safety. The other statements demonstrate appropriate actions: A) The LPN acknowledges the need for a witness when wasting leftover narcotics, ensuring proper documentation and accountability during medication waste. B) Checking the facility's policy for proper disposal of controlled substances shows awareness of regulatory compliance regarding controlled substances. D) Recognizing an incorrect end-of-shift narcotics count and planning to report it reflects the LPN's responsibility in maintaining accurate records and addressing discrepancies, which is essential for medication safety and accountability.

2. A nurse is assisting with data collection regarding the motor development of a 24-month-old child. Which activities would the nurse expect the mother to report that the child can perform?

A. Go to the bathroom without help
B. Dress himself appropriately
C. Put on and tie his shoes
D. Align two or more blocks

Correct answer: A

Rationale: By 24 months of age, a child can perform various activities. While the child may be able to put on simple items of clothing, distinguishing front from back might still be a challenge. They may also be able to zip large zippers, put on shoes, wash and dry their hands, align two or more blocks, and turn book pages one at a time. However, the fine motor skill required to tie shoes is usually not developed at this age. Full independence in dressing, using the bathroom, and eating typically occurs around 4 to 5 years of age. Therefore, the correct expectation for a 24-month-old child would be aligning two or more blocks. Choices A, B, and C are incorrect as they represent skills that are usually achieved at a later age.

3. When should rehabilitation services begin?

A. when the client enters the health care system.
B. after the client requests rehabilitation services.
C. after the client's physical condition stabilizes.
D. when the client is discharged from the hospital.

Correct answer: A

Rationale: Rehabilitation services should begin when the client enters the health care system to ensure early intervention and optimal outcomes. Initiating rehabilitation early can prevent complications, maximize recovery potential, and improve overall health outcomes. Choice B is incorrect because delaying rehabilitation until the client requests it may result in missed opportunities for timely intervention. Choice C is incorrect as waiting for the client's physical condition to stabilize can lead to unnecessary delays in starting the rehabilitation process, potentially slowing down recovery progress. Choice D is incorrect because starting rehabilitation only after discharge can hinder the recovery process by missing out on crucial early stages of intervention and support.

4. The nurse is observing a client self-administer two crushable medications through their G-tube. Which of the following would indicate a need for further instruction?

A. The client flushes the G-tube before administering the medications, in between the two medications, and after the medications.
B. The client states they will remain in the Semi-Fowler's position for 30 minutes following the administration of the medications.
C. The client mixes each medication separately in warm water.
D. The client mixes their medications with their tube-feeding formula.

Correct answer: D

Rationale: The correct answer is that the client mixes their medications with their tube-feeding formula. Medications should not be mixed with tube-feeding formula or other medications as it may alter their effectiveness. The G-tube should be flushed before, between, and after the medications to prevent clogging and ensure proper administration. The client should remain in the Semi-Fowler's position for at least 30 minutes after medication administration to prevent reflux. Choice B is correct as it aligns with the proper post-administration positioning. Choices A and C are incorrect as flushing the G-tube before, between, and after medications, and mixing each medication separately in warm water are appropriate procedures that do not indicate a need for further instruction.

5. An appraisal of self-care practices involves an assessment of:

A. all diagnostic tests.
B. home treatment practices, including nurse visits for the sick or disabled.
C. the family's capability to get health insurance.
D. caregiving needs and the potential for strain.

Correct answer: D

Rationale: An appraisal of self-care practices focuses on assessing caregiving needs and the potential for strain. This involves evaluating the support system in place for individuals requiring care, the level of strain experienced by caregivers, and the overall impact of caregiving responsibilities on both the caregiver and the care recipient. The other options presented do not directly relate to the assessment of self-care practices. Diagnostic tests, home treatment practices, and the family's capability to obtain health insurance are important aspects of healthcare but do not specifically pertain to the evaluation of self-care practices.