Coordinated Care & Client Advocacy practice test: free NCLEX-PN questions

Sample Practice Questions for Coordinated Care & Client Advocacy

1. Question 1Ref: Safe/Effective Care — Coordinated Care, 18-24%

   A client signs a living will but later tells the nurse they want full treatment regardless. How should the nurse respond?

   AFollow the living will since it is a legal documentBNotify the physician that the will is now invalidCDocument the client's new verbal wishes and clarify them with the healthcare teamDIgnore the verbal statement because the document is legally binding
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   C. Document the client's new verbal wishes and clarify them with the healthcare team

   The nurse should document the new verbal wishes and communicate them to the interdisciplinary team because the client retains the right to make healthcare decisions at any time Option A is incorrect because following an outdated document ignores the client's current wishes. Option D is incorrect because verbal statements take precedence over a previously signed document when the client is competent..

2. Question 2Ref: Safe/Effective Care — Coordinated Care, 18-24%

   A nurse is preparing to transfer a client to a rehabilitation facility. Which action should the nurse take first?

   AArrange transportation for the clientBComplete the transfer documentationCEnsure the receiving facility has accepted the clientDNotify the client's family of the transfer time
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   C. Ensure the receiving facility has accepted the client

   The nurse should first confirm acceptance by the receiving facility to prevent delays or gaps in care before proceeding with other transfer tasks Option A is incorrect because transportation arrangements come after confirming the facility can accept the client. Option D is incorrect because family notification is not the priority before transfer logistics are confirmed..

3. Question 3Ref: Safe/Effective Care — Coordinated Care, 18-24%

   A client refuses a blood transfusion on religious grounds. The nurse notes that the physician has ordered the transfusion. What is the nurse's priority action?

   AAdminister the transfusion because it is physician-orderedBDocument the refusal and report it to the physician immediatelyCPersuade the client to change their mindDContact a patient advocate to override the refusal
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   B. Document the refusal and report it to the physician immediately

   The nurse must document the refusal and notify the physician. The client has the right to refuse treatment, and the nurse advocates for informed decisions. Option A is incorrect because a physician order does not override a competent client's right to refuse. Option C is incorrect because persuading or coercing the client violates autonomy and informed consent. Option D is incorrect because an advocate cannot override a competent client's refusal.

4. Question 4Ref: Safe/Effective Care — Coordinated Care, 18-24%

   A nurse is reviewing the medical record of a newly admitted client. The nurse sees a do-not-resuscitate order. What should the nurse do first?

   ANotify the entire nursing staff about the orderBRequest that the physician re-evaluate the client's conditionCPlace a prominent alert on the client's door and chartDVerify the order is signed and current, then communicate it to the care team
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   D. Verify the order is signed and current, then communicate it to the care team

   The nurse should verify the DNR order is valid and then communicate it to the interdisciplinary team to ensure consistent care Option A is incorrect because only relevant staff need to know about the DNR order, not the entire nursing staff. Option C is incorrect because alerts should be placed only after the order is verified and communicated..

5. Question 5Ref: Safe/Effective Care — Coordinated Care, 18-24%

   A nurse is caring for a client who speaks only Spanish. An interpreter is not available. The nurse should use which approach?

   AAsk a family member to interpret for the clientBWait until an interpreter becomes available before providing careCAttempt to communicate with gestures and body language onlyDUse a translation app and document it in the chart
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   D. Use a translation app and document it in the chart

   Using a translation app with documentation is appropriate when a qualified interpreter is unavailable. Family members should not interpret due to confidentiality concerns. Option A is incorrect because family members may misinterpret and confidentiality is breached. Option B is incorrect because delaying needed care while waiting is unsafe. Option C is incorrect because gestures alone cannot ensure accurate clinical communication.

6. Question 6Ref: Safe/Effective Care — Coordinated Care, 18-24%

   A nurse is conducting a shift report using bedside handoff. Which element should the nurse include first?

   AA full review of the client's medication historyBCurrent vital signs and any changes in conditionCThe results of all diagnostic testsDA summary of the client's psychosocial needs only
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   B. Current vital signs and any changes in condition

   Bedside handoff should begin with current vital signs and changes in condition to ensure continuity of care and early identification of deterioration Option A is incorrect because a full medication history review is not the priority during bedside handoff. Option C is incorrect because diagnostic test results are not typically included in bedside handoff reports..

7. Question 7Ref: Safe/Effective Care — Coordinated Care, 18-24%

   A nurse discovers that a colleague has been taking medication from a client's prescription. What is the nurse's responsibility?

   AReport it to the charge nurse or supervisor immediatelyBConfront the colleague privately and ask them to return the medicationCIgnore it because it does not affect the nurse directlyDDocument it anonymously without reporting to management
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   A. Report it to the charge nurse or supervisor immediately

   The nurse has a legal and ethical obligation to report suspected diversion or substance abuse to a supervisor to protect client safety Option B is incorrect because confronting the colleague privately may not stop the diversion and does not fulfill the reporting obligation. Option D is incorrect because anonymous documentation without reporting does not protect client safety..

8. Question 8Ref: Safe/Effective Care — Coordinated Care, 18-24%

   A nurse is preparing discharge instructions for a client with heart failure. The teach-back method is used. The client repeats the information incorrectly. What should the nurse do?

   AProvide the information again using the same teaching methodBDocument that teaching was completed and move onCRe-teach using different methods until the client demonstrates understandingDAsk the family to review the instructions at home
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   C. Re-teach using different methods until the client demonstrates understanding

   The nurse should use alternative teaching methods and repeat until the client accurately demonstrates understanding, ensuring safe self-care after discharge Option A is incorrect because repeating the same failed teaching method is ineffective. Option B is incorrect because documenting incomplete teaching is unsafe and dishonest..

9. Question 9Ref: Safe/Effective Care — Coordinated Care, 18-24%

   A nurse is reviewing advance directives with a client who has designated a healthcare proxy. What does this document mean for the proxy?

   AThe proxy can make all financial decisions for the clientBThe proxy may make healthcare decisions only when the client cannotCThe proxy must be a licensed attorney in the stateDThe proxy takes full control of all medical care immediately upon signing
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   B. The proxy may make healthcare decisions only when the client cannot

   A healthcare proxy is legally authorized to make healthcare decisions only when the client is unable to make them independently Option A is incorrect because a healthcare proxy makes healthcare, not financial, decisions. Option C is incorrect because the proxy does not need to be a licensed attorney..