Leadership 1

A nurse is talking with a family member who is unhappy about the care his mother is receiving. Which of the following responses should the nurse make?

"Can you give me a specific example of the care that caused dissatisfaction?"

A nurse is caring for a client who received a sedative-hypnotic medication at bedtime. The client gets out of bed and falls, sustaining a laceration that requires suturing. Which of the following statements should be included as part of the nurse's documentation in the client's chart?

"Client found sitting on the floor with 2 cm laceration above the left eyebrow. Oriented to name only. Provider notified.

A nurse manager believes that a nurse is taking breaks that are too frequent and lengthy. Which assertive statement should the charge nurse use to initiate a discussion of the issue?

"I understand you are allowed to take scheduled breaks during each shift, but you are taking more than the number allocated. Let's set a time when we can discuss this behavior."

A nurse is teaching a newly licensed nurse about advanced directives. Which of the following statements by the newly licensed nurse indicates an understanding of this teaching?

"I will assess the client's understanding of life-sustaining measures."

A nurse is teaching a group of newly licensed nurse managers about the principle of justice. Which of the following statements by a nurse manager indicates an understanding of this teaching?

"I will compose staff schedules so that each person works two holidays a year."

A nurse is caring for a client who has a history of severe multiple sclerosis and asks the nurse about completing a living will. Which of the following statements should the nurse make?

"I will provide you with the information you need to complete advance directives."

A 13-year-old female client tells the charge nurse in the pediatric unit that she does not want the male nurse assigned to care for her. Which of the following responses should the nurse make?

"I'll change the assignment, so a female nurse is caring for you today."

A nurse is caring for a male client who is scheduled for a procedure. The client's son asks the nurse what medication is being given to the client. Which of the following responses should the nurse provide?

"I'm sorry but you'll need to ask your father for that information."

A charge nurse is reviewing the code of ethics for nurses during the staff meeting. Which of the following statements should the charge nurse include in the teaching?

"The code of ethics for nurses is a guide for professional actions."

A nurse is preparing to administer a client's anticoagulant medication. The client states I don't like to take this medication. I always have to get my blood checked. Which of the following responses should the nurse make?

"You can refuse the medication. I will notify your provider."

A charge nurse is teaching a group of clients in an assisted living facility about client rights. Which of the following pieces of information should the charge nurse include in the teaching?

"You can request to review your personal medical records at any time."

A charge nurse is planning a department in-service training session about radioactive implants for a group of staff nurses. Which of the following points should the charge nurse include in the presentation? (SATA).

1. A client should be placed in a private room. 2. Staff members should wear a dosimeter badge when caring for the client. 3. Clients should be on bed rest.

A nurse is providing discharge teaching about wound care to a client who has a leg wound. Which of the following pieces of information should the nurse include in the teaching? (SATA).

1. Cleanse the wound with tap water. 2. Discard soiled bandages in a moisture-proof bag.

A nurse is caring for a group of clients on a medical-surgical unit. Which of the following tasks should the nurse delegate to assistive personnel? (SATA).

1. Collecting stool specimens 2. measuring oral intake 3. providing postmortem care.

A nurse manager is evaluating the time management strategies of a newly licensed nurse on the pediatric unit. Which of the following actions taken by the nurse are effective time management strategies? (SATA).

1. Completing one task before beginning another task. 2. Taking time to plan care at the beginning of the shift. 3. Mentally visualizing a procedure prior to gathering equipment.

A charge nurse on a medical surgical unit is assigning client care to the upcoming chef. Which of the following tasks should the nurse delegate to an assistive personnel? (SATA)

1. Measuring a client's input and output period providing postmortem care to a client.

A charge nurse planning and in-service training session about client advocacy with a group of staff nurses. Which of the following situations should the nurse include as an example of client advocacy? (SATA).

1. Notifying the provider when a client has questions about the procedure. Helping the client make a list of questions to ask the provider. 2. Clarifying the dosage of a medication prescribed for a client who has impaired liver function. 3. Carrying out the end-of-life wishes outlined in the living will of an older adult client who has end-stage renal disease.

A nurse working at a rehabilitation facility is attending an interdisciplinary team meeting for a client who had a left hemispheric stroke. Which of the following members of the interdisciplinary team should the nurse recommend to assist this client? (SATA).

1. Nurse, Occupational therapist 2. speech therapist 3. physical therapist

A charge nurse on a pediatric unit is delegating tasks to assistive personnel who is pregnant and reports that she is unsure of her immune status. Which of the following clients should the charge nurse assign to the AP?

A 2-year-old child who has impetigo contagiosa (impetigo).

A nurse in an emergency department is caring for 4 clients. Which of the following findings requires the nurse to act as a mandatory reporter?

A child who was left unsupervised for several hours at home is being treated for a fractured leg.

A charge nurse on a medical surgical unit is making client assessments for the oncoming shift. Which of the following clients should the charge nurse assign to an LPN?

A client who has a prescription for irrigation of an underline urinary catheter.

A charge nurse is making shift assignments for a team that includes RNs, licensed practical nurses (LPNs), and assistive personnel. Which of the following clients should the nurse assign to an LPN?

A client who has emphysema and pneumonia is receiving oxygen.

A nurse is planning care for several clients. Which of the following clients should the nurse refer to a case manager?

A client who has neurological deficits following a stroke.

A charge nurse is making assignments for an oncoming shift. Which of the following clients should the charge nurse assign to an LPN?

A client who is disoriented and awaiting a transfer to a long-term care facility.

A nurse is caring for a group of clients on a medical-surgical unit. Which of the following clients should the nurse attend first?

A client who is receiving cephalexin and reports dyspnea.

A nurse is prioritizing care for a group of clients. The nurse should plan to attend to which of the following clients first?

A client who requires endotracheal suctioning.

A nurse is preparing to teach the health care team about the concept of critical pathways. Which of the following statements about the purpose of a critical pathway should the nurse plan to include?

A critical pathway is a multidisciplinary tool that guides client care and bases outcomes on an externally imposed timeline.

Nurse manager notes that a full-time nurse has been absent from work six times over the last six weeks. Using a nonpunitive approach, which of the following actions should the nurse manager take?

A verbally remind the employee about the facilities employment standards.

A change nurse is evaluating conflict resolution between two staff nurses. Which of the following conflict-resolution styles is an example of one nurse putting aside personal goals to satisfy the other nurse?

Accommodation

A nurse is speaking with the family member of a client who has early Alzheimer's disease. The family member would like to keep the client living at home, but the client requires assistance while the family member is away at work period which of the following services should the nurse include in the discussion?

Adult daycare.

A nurse is caring for a client with the stage of ovarian cancer who has decided to start treatment and enter the Hospice care period which of the following ethical principles is the nurse displaying by supporting the client in her decision?

Advocacy

A nurse is preparing to provide discharge teaching to an older adult client. Which of the following teaching considerations should the nurse include?

Allow frequent rest periods during teaching.

A nurse enters the room of an older adult client and finds him attempting to crawl over the side of rail of his bed. Which of the following actions should the nurse take?

Ask assistant personnel to sit with the client.

A nurse is caring for a client who refuses to take her prescribed oral medication. The nurse states, "if you don't take this pill, I am going to give you the medication by injection." Which of the following types of torts has the nurse committed?

Assault

Due to staffing shortages, a nurse manager floats a medical-surgical nurse to the pediatric unit. This nurse has limited experience with children. Which of the following actions should the nurse manager take?

Assign a unit nurse to act as a resource for the medical-surgical nurse.

In nurses delegating a task to an assistive personnel. They assisted personnel to transfer a client who has a below-the-knee amputation from a bed to a wheelchair. The assistant personnel has never transferred a client with an amputation before which of the following actions should the nurse take?

Assist the assistive personnel after he has practiced the transfer.

A nurse has several tasks to complete while preparing a client scheduled for surgery. Which of the following tasks can the nurse delegate to an assistive personnel?

Assist with placing the client onto the stretcher for transport to the surgical suite.

A nurse is updating the plan of care for a client who has celiac disease. Which of the following dietary selection should the nurse recommend for the client?

Baked chicken and rice.

A nurse is caring for a client who is undergoing repair of an abdominal aortic aneurysm. After the surgery and immediate postoperative recovery, the nurse should expect which of the following team members to coordinate the client's ongoing and specific needs for care?

Case manager.

A nurse is caring for four clients who are scheduled for diagnostic tests. For which of the following tests should the nurse obtain written consent from the client?

Cerebral arteriogram.

After entering the client's room, a nurse notices the client has fallen on the bathroom floor. Which of the following actions should the nurse perform first?

Check the client for injuries.

A healthcare facilities leadership team is implementing a new computerized charting system. When preparing for the implementation date, which of the following actions should the nurse manager take first?

Collect a staff member's input about planning and implementing the change.

A nurse discovers that the wrong medication was given to a confused client who answered to the name the nurse stated when entering the room. The provider is notified and reports that the medication the client received will not cause any harm. Which of the following actions should the nurse take?

Complete an incident report documenting the occurrence.

A charge nurse finds an increased incidence of health care-associated infections (HAIs) in a long-term care unit. Which priority action should the charge nurse take to address the problem?

Conduct a chart review to gather data about clients who developed HAIs.

A nurse is planning to perform a negotiation to manage a conflict between himself and another staff member. Which of the following actions should the nurse plan to take?

Create a solution in which all parties are satisfied.

A nurse is caring for a poster operative client who has an HGB of 8.0. The nurse delegates the administration of a unit of packed RBC to a nurse floating from a psychiatric unit who is unfamiliar with blood administration. Which of the following actions should the nurse take?

Decline to hang the blood.

A nurse manager calls a meeting of a unit's staff members to discuss cost-containing issues. The nurse manager has asked for staff input regarding strategies to help reduce costs. Which of the following types of leadership is the nurse manager using?

Democratic

The nurses came for a client who is in the bathroom. The nurse hears a loud thought and, after opening the bathroom door, finds the client on the floor. What is the priority nursing action?

Determine the client's level of consciousness.

A nurse manager is planning staff development activities for the unit's new unlicensed assistive personnel. Which of the following activities should the nurse manager perform first?

Determine the learning needs of the UAPs.

Using high-quality monitoring tools, a facility committee identifies that clients who have congestive heart failure have an average length of stay of 5 days instead of the established standard of 3 days. Which step should the nurse implement next in the quality improvement process?

Determine which actions can be instituted to address this problem.

A nurse is assisting a provider with an amniotomy on a client who is in labor. Which of the following is the priority nursing assessment following the procedure?

Fetal heart rate.

A nurse is creating a plan of care for a client who adheres to Kosher dietary laws. Which of the following food selections should the nurse recommend?

Grilled salmon

A nurse manager observes a nurse entering the room of a client who is on contact precautions without donning personal protective equipment (PPE). Which of the following is the priority action for the nurse manager to take?

Have the nurse exit the room and don proper PPE.

A nurse is preparing an I am injection for a client who is preoperative when another client suddenly calls for assistance. The nurse asks another nurse to give the injection since assistive personnel is waiting to take the client to surgery. Which of the following actions should the second nurse take?

Help the client requesting assistance so the first nurse can give the prepared injection.

A community health nurse is performing client triage while participating in a disaster drill. The nurse should recommend that which of the following client injuries receives treatment first?

Hemothorax

A nurse is completing an accident report after administrating an incorrect dose of medication to a client comma even though the client experienced no ill effects from the error. What is the purpose of completing the incident report?

Identifying situations that contribute to the current medical errors.

A charge nurse is coordinating the evaluation of clients from the facility following a bomb threat. Which of the following actions should the nurse take when implementing the evaluation process?

Instruct clients who are able to ambulate to leave.

A nurse manager is implementing a team nursing approach on his unit, hiring LPNs and assistive personnel as additional staff. Which of the following actions should the nurse manager take to facilitate acceptance of this change?

Introduce the new approach and facilitate the development of a task force to plan implementation.

A home health nurse is caring for a client who asks about the purpose of a living will. Which of the following statements should the nurse include in the teaching?

It allows the client to express personal wishes regarding healthcare decisions.

A charge nurse overhears a unit nurse informing other unit nurses that the charge nurse is giving preferential treatment to the unit's nurses on the night shift. Which of the following approaches by the charge nurse reflects an assertive response to resolve this conflict?

Meeting one on one with the unit nurse to discuss these concerns.

A nurse enters a client's room and discovers a small fire in a trash can. Which of the following actions should the nurse take first?

Move the client out of the room.

A client in a long-term care facility falls out of bed, fracturing his left hip. The side rails on the bed were not raised at bedtime, although the client was identified to be at risk of falling. Which of the following torts has occurred?

Negligence.

A nurse assisting with the informed consent process for a client who is scheduled for a below-the-knee amputation. The client asks the nurse, "Why are they making me have this surgery today? I don't understand why they are doing this". Which of the following actions should the nurse take?

Notify the provider of the client's comments.

A nurse is preparing to give a change of shift report to the oncoming nurse. Which of the following pieces of information should the nurse include?

Objective measurements about the client's condition.

A nurse is caring for a client who had a stroke and requires assistance performing ADLs. The nurse should collaborate with which of the following members of the interprofessional care team?

Occupational therapist.

A nurse is planning care for a client who has aphasia following a stroke. Which of the following actions should the nurse take?

Offer pictures for the client to point to as an alternative form of communication.

A nurse is providing teaching to a client about organ donation. Which of the following statements by the client indicates an understanding of the teaching?

People age 18 and over have the right to decide to make an organ donation.

A charge nurse is preparing assignments for the upcoming shift. Which of the following tasks should the charge nurse delegate to assistive personnel?

Perform a simple dressing change.

A RN preparing and assignments for the upcoming shift. Which of the following tasks should the charge nurse delegate to an LPN?

Performing tracheostomy suctioning for a client with stable.

A nurse is writing a goal for a client's reaction following the administration of medication. This action should take place during which of the following phases of the nursing process?

Planning

While participating in a continuous quality-improvement program, a nurse is reviewing medical records to determine the time of first postoperative ambulation of clients who had abdominal surgery. In which type of quality audit is the nurse participating?

Process

A nurse is planning to delegate the postoperative care of a client following an appendectomy. Which of the following actions should the nurse assign to an assistive personnel?

Recording urinary output after emptying the indwelling urinary catheter.

A nurse is caring for a client who is a local public official. A newspaper reporter repeatedly phones the unit seeking information and states. "The public has a right to know the health status of elected officials." Which of the following actions should the nurse take?

Refer all media inquiries to the nursing supervisor.

A nurse is preparing a client for discharge. The client states, "My partner hurts me. I don't want to go home." Which of the following actions should the nurse take?

Refer the client to social services for assistance in seeking safe housing.

A nurse is preparing a client for a lumbar puncture. The client has signed the consent form but tells the nurse that she does not remember what the doctor will do during the procedure. Which of the following actions should the nurse take?

Remind the client that the doctor will insert a needle to get a sample of fluid from her spine.

A school nurse is assessing a child who has multiple bruises on his trunk and extremities. The child reports falling out of a tree two days ago. The nurse's assessment findings show patterns of bruising that are not typically sustained during a fall from a tree. Which of the following actions should the nurse take?

Report the findings to local police and social services agencies.

A nurse is planning to care for a client who is newly admitted to the medical unit. Which of the following healthcare team members should the nurse plan to consult with regarding the benefit of chest physiotherapy for his client?

Respiratory Therapist.

A nurse is providing teaching for new parents on safe sleeping recommendations to reduce the risk of sudden infant death syndrome. Which of the following instructions should the nurse include?

Room sharing is recommended while the infant sleeps.

An experienced nurse is serving as a mentor to a newly licensed nurse. Which of the following actions should the mentor take?

Serve a guide and teacher for the newly licensed nurse in an established relationship.

A nurse manager notes several recent conflicts among nurses on different shifts. Which of the following strategies should the nurse manager use to resolve this conflict?

Set up a series of meetings for all staff members to attend to discuss issues.

A nurse is planning care for a client who has COPD, requires continuous oxygen therapy, and is being discharged to return home. Which of the following referrals should the nurse recommend?

Social worker.

A nurse working in a mental health facility is preparing to discharge a client who has schizophrenia and requires assistance with housing. Which of the following referrals should the nurse recommend to the provider?

Social worker.

A nurse in a provider's office observes A newly licensed nurse taking a client's health history while in the waiting area which of the following actions should the nurse take?

Speak to the nurse immediately in private.

A nurse is walking with a client who falls after the facility-issued walker loses a wheel. Which of the following actions should the nurse take regarding the completed incident report?

Submit the variance report to the risk manager.

A charge nurse is observing a group of newly licensed nurses. Which of the following actions should the charge nurse report to the nurse manager as a violation of HIPAA?

Talking about clients with other nurses in the cafeteria.

A charge nurse is providing teaching to a new staff nurse about the management of a team consisting of a licensed practical nurse (LPN) and assistive personnel. Which of the following pieces of information should the charge nurse include in the teaching?

The LPN should be familiar with the task she plans to delegate.

A charge nurse is planning a performance appraisal for a newly hired assistive personnel. Which of the following factors should the charge nurse take into consideration when planning a performance appraisal interview for the assisted personnel?

The assisted personnel should have a copy of the performance standards before the appraisal interview.

A nurse is planning care for a client following their coronary artery bypass graft procedure. The nerve places the referral form and case manager to visit the client. Which of the following pieces of information should the nurse share with the client about the role of a case manager?

The case manager will coordinate and plan your care while you recover from your surgery.

A charge nurse is performing a quality assurance audit on the documentation of several client's charts. Which of the following documentation items should the charge nurse identify as a correct entry in the client's medical record?

The client ambulated for 10 min three times during the shift.

A nurse is providing teaching about a living will for a client who has end stage breast cancer. Which of the following pieces of information should the nurse include int eh teaching?

The client has the right to change the living will at any time.

A nurse is caring for an adult client who has pancreatitis. The client tells the nurse, "I've decided that I want to go home. I don't want any more treatment." The nurse should recognize which of the following legal principles applies to the client?

The client has the right to make the decision to leave the hospital.

A nurse is caring for a client who is dying and unable to make decisions for himself. The client's adult children disagree about this code status. Which of the following sources should the nurse depend on for decisions regarding the client's end-of-life care?

The client's health care proxy.

A home health care nurse is conducting a home hazard assessment. For which of the following findings should the nurse intervene?

The client's household lamps have 40-watt light bulbs installed.

A nurse Is working with assistant personnel in a long-term care facility. According to the five rights of delegation, which of the following determinations should the nurse make prior to assigning tasks?

The degree of supervision that the assistive personnel were required to complete the task.

The nurse on a medical-surgical unit scale for a group of clients. For which of the following situations should the nurse complete A variance report?

The discovery that a preoperative client has received and eaten breakfast.

A nurse is teaching a newly licensed nurse about the informed consent process for a client who is scheduled for a surgical procedure. Which of the following pieces of information should the nurse include in the teaching?

The person who will perform the procedure is responsible for obtaining informed consent.

A nurse is teaching a group of union nurses about the health insurance portability and accountability act. Which of the following pieces of information should the nurse include in the teaching?

The security rule provides a uniform level of security to protect client records.

A group of nurses on a telemetry unit informs a nurse manager of the need to update the cardiac monitoring system to improve arrhythmia detention. Which of the following responses should the nurse manager make?

This purchase will need to be addressed in the capital budget plan for the unit.

A nurse on a medical-surgical unit is delegating tasks to nursing team members. Which of the following tasks should the nurse delegate to an assistive personnel?

Transferring a client who is postoperative from a bed to a chair.

A nurse is ambulating a client who has an IV with an infusion pump. After the nurse returns the client to his room and plugs in the infusion pump, the client reports a slight tingling in his hand. Which of the following actions should the nurse take?

Turn off the pump.