Another behavior that commonly occurs in the real world is notifying the primary health care provider. In nursing school you were encouraged to notify your instructor of changes in your client’s condition. Be very careful how you handle this on the NCLEX-PN® exam. More often than not, the answer choice that states “notify the primary health care provider,” “contact the social worker,” or “refer to the chaplain” is the WRONG answer. Usually there is something you need to do first before you notify them. The NCLEX-PN® exam does not want to know what the primary health care provider is going to do. The NCLEX-PN® exam wants to know what you, the LPN/LVN, will do in a given situation.
Answer this question.
THE REWORDED QUESTION: What should you do first for this client? Have this client’s kidneys stopped producing urine? Is there an obstruction in the urinary drainage system?
“Check for kinks in urinary drainage tubing.” If there is no urine in the urinary drainage bag, could there be an obstruction in the drainage system? Checking for kinks in the urinary drainage tubing could provide a simple explanation for your observations.
“Insert a new indwelling urinary catheter.” Inserting a new indwelling urinary catheter may address a possible catheter obstruction but increases the client's risk for catheter-associated urinary tract infection. Are you sure you want to do this first?
“Irrigate existing indwelling urinary catheter.” Irrigating the indwelling urinary catheter in hopes of dislodging a possible obstruction increases the client's risk for catheter-associated urinary tract infection. Are you sure you want to do this first?
“Notify client’s primary health care provider.” If you notify the client’s primary health care provider of “no urinary output in 3 hours” as your first action, will you be able to answer potential questions regarding the client's lack of urine output? Are you transferring your responsibility to the primary health care provider? Is there something YOU should do first?
The correct answer is (1).
Before you choose the answer choice that involves “call the primary health care provider,” look at the other answer choices very carefully. Make sure that there isn’t an answer that contains data collection or an action you should take before making the phone call. The test makers want to know what you would do in a situation, not what the primary health care provider
would do!
Here is one more real-world question.
THE REWORDED QUESTION: What should an LPN/LVN do when asked about a client by a hospital employee?
“Answer employee’s questions softly to prevent others from overhearing”. Discussing client information in a public place breaches confidentiality. Eliminate.
“Refuse to discuss the friend’s medical condition with the employee.” This does not violate the client’s right to privacy and confidentiality. Keep in consideration.
“Refer the employee to the
client's primary health care provider for information.” Providing any information about a client to someone not directly involved in the client’s care breaches privacy. Eliminate.
“Tell the employee the client's normal test results.” Sharing any information without the client's permission breaches confidentiality. Eliminate.
The correct answer is (2).
Expect to see real-world situations on your NCLEX-PN® exam, but make sure that you do not choose real-world answers! These strategies should help you use your previous nursing experience without encountering any pitfalls.