Leadership 2019 Version A
A nurse working in a community health clinic is caring for four clients who each have a communicable disease. Which of the following conditions is considered a nationally notifiable infectious disease?
Chlamydia trachomatis
A charge nurse is assigning tasks to a RN, a licensed practical nurse (LPN), and an assistive personnel (AP). Which of the following tasks should the charge nurse delegate to the RN?
Completing an admission assessment for a client who has just transferred from the emergency department
A nurse case manager is planning a teaching session on use of critical pathways with a group of newly licensed nurses. The nurse should include which of the following in the teaching about critical pathways?
Critical pathways prevent unnecessary expense.
A client is considering having a tubal ligation, and she tells the nurse that she is uncertain if it is the right thing to do. Which of the following is an appropriate response by the nurse?
Discuss with the client her feelings about the procedure.
An older adult client is being discharged with a postoperative infection, requiring daily home IV antibiotics through a PICC line. Which of the following actions should the case manager perform prior to discharge?
Ensure that home infusion therapy has been arranged
A case manager is initiating the plan of care for a client receiving warfarin who had a stroke. Which of the following is most important for the case manager to include in the client's plan of care?
Scheduling follow-up tests for PT/INR
A client presents to the emergency department with weakness, vomiting, and diarrhea for the past 3 days. Which of the following is the highest priority assessment for this client?
Serum Potassium Levels
A nurse is reviewing facility data on hand hygiene adherence and finds that nurses are not performing hand hygiene after client contact 28% of the time. Which of the following is the first action the nurse should take when developing a plan to increase employee hand hygiene adherence?
Set a goal for improvement in adherence
A nurse is caring for a client who is refusing a blood transfusion due to religious beliefs. The provider discusses this treatment and likely outcomes with the client, who remains opposed to the transfusion. Which of the following is the appropriate intervention for the nurse?
Support the clients decision to forego the transfusion.
A nurse is caring for several clients. Which of the following actions should the nurse take to maintain client confidentiality?
Tell a client's partner that the results of his wife's laboratory tests cannot be disclosed without her permission.
A nurse is caring for a client who has metastatic cancer and decides not to continue treatment. Which of the following is an appropriate response by the nurse?
Tell me what this is like for you.
A charge nurse is responsible for a caseload of clients on a surgical unit. Which of the following occurrences during the shift requires the completion of an incident report?
The client did not receive the IV according to the provider's prescription and requires the nurse to complete an incident report.
A nurse is caring for a school-age client who is seeking treatment for a laceration to the right forearm that occurred during soccer practice. The client was transported to the emergency department by a friend's parent and the soccer coach. The nurse should ensure that informed consent is given by
The client's guardian
A nurse is caring for a client who is 3 days postoperative following open heart surgery and is to transfer to the medical-surgical unit. Which of the following should the nurse plan to include in the verbal report?
The client's level of consciousness
A nurse finds that a new IV pump has infused 400 mL of solution over 2 hr when the rate was set at 100 mL/hr. After notifying the provider and verifying that the pump was properly programmed, which of the following is the nurse's highest priority?
The greatest risk is the potential for injury to a client if the nurse uses the pump again before repair; therefore, the priority intervention is to tag the pump for maintenance and acquire a new pump for the client.
A client seen in the emergency department for back pain is provided a prescription for oxycodone. A staff nurse tells the charge nurse that she thinks the client is seeking drugs and is not actually in distress. Which of the following responses by the charge nurse is appropriate?
"Clients are the experts on their own pain."
An assistive personnel (AP) tells the charge nurse that it is unfair that she has to take care of all the clients who are incontinent. Which of the following responses by the charge nurse is appropriate?
"I delegate tasks to personnel based on their job descriptions."
A nurse has a friend who is a client on another unit. The nurse is concerned about the friend's prognosis. Which of the following is an appropriate action by the nurse?
Ask the friend what the provider has told her.
A charge nurse is delegating tasks on a nursing unit that is short staffed. A client has a prescription for a wound irrigation twice a day. Which of the following is an appropriate action for the charge nurse to take?
Assign the procedure to an LPN
A home health nurse is performing a home safety assessment for a family who has a toddler. Which of the following findings is a potential environmental hazard the nurse should discuss with the parents?
The toilet seat lid is raised (drowning)
A nurse case manager is developing a critical pathway for clients who have pneumonia. Which of the following data should the nurse include
Treatment milestones
A nurse receives report on four clients. Which of the following clients should the nurse assess first?
A client admitted for a fractured hip who has developed slurred speech
A nurse from a medical unit is asked to work on an orthopedic unit. The medical nurse has no orthopedic experience. Which of the following clients should be assigned to the medical nurse?
A client who had a right above-the-knee amputation 24 hr ago
A nurse is receiving change-of-shift report at the start of the shift. Which of the following clients should the nurse assess first?
A client who had abdominal surgery 6 hr ago and has a heart rate of 120/min for the last 2 hr
A charge nurse is planning client care assignments for the unit. Which of the following clients should the nurse assign to a licensed practical nurse (LPN)?
A client who has Crohn's disease and requires an enteral feeding.
A nurse in the emergency department is performing triage for a group of clients following a motor vehicle crash. Which of the following clients should the nurse request the provider assess first?
A client who has arm contusions and manifests asymmetrical thoracic movement.
A nurse on a medical-surgical unit is caring for four clients. The nurse should recognize that which of the following clients is the highest priority?
A client who has peripheral vascular disease and has an absent pulse in the right foot
A nurse is caring for a group of clients on a unit. Which of the following assessment findings should the nurse recognize as the priority to report to the charge nurse?
A client who is 2 days postoperative and has a urine output of 20 mL/hr
A charge nurse is supervising the care of several clients. Which of the following actions requires intervention by the charge nurse?
A student photocopying his assigned client's diagnostic rest results.
A nurse manager is presenting an inservice about preventing readmission of clients due to complications after joint replacement surgery. Which of the following leadership tasks is the nurse performing?
Advocacy
A nurse is witnessing a client sign the consent form for a surgical procedure. The client has a question regarding alternative treatments. Which of the following actions should the nurse take?
Call the surgeon to discuss alternative treatments with the client.
A facility has identified an increase in health care-associated urinary tract infections (UTIs) on the medical-surgical unit. A nurse is participating in a quality improvement process to address this problem. Which of the following should be the first step in the process?
Establish best practice guidelines for reducing the incidence of UTIs.
A charge nurse is talking with a staff nurse following a workshop on advance directives. Which of the following statements by the staff nurse demonstrates understanding of advance directives?
Family members have the right to question the mental capacity of the client at the time a living will was completed; evidence that the client was incompetent could result in the living will being revoked.
A charge nurse is discussing issues with a staff nurse. When evaluating statements by the staff nurse, the charge nurse should recognize that which of the following reflects an intrapersonal conflict?
I'm not sure whether I want to apply for the unit manager's position or start a family this year.
A hospital has been notified of a train derailment resulting in multiple clients experiencing life-threatening injuries. The external disaster plan has been activated. Which of the following is an appropriate action of the charge nurse on the PACU?
ID stable clients for transfer to a surgical unit
A nurse is caring for a client who has acute diverticulitis and is scheduled for surgery within the next 2 hr. The client tells the nurse that she has called a taxicab and is leaving the hospital. After notifying the surgeon, which of the following actions should the nurse take next?
Inform the client about the risks she may encounter by leaving the facility.
A nurse manager needs to address an increased rate of client medication errors. Which of the following strategies represents an authoritarian approach to managing this issue?
Inform the staff of the penalties that can result from medication errors.
A nurse manager is coordinating staff assignments for RNs and licensed practical nurses (LPNs) following a local disaster. Which of the following is an appropriate assignment by the nurse manager to provide safe and effective client care?
LPNs provide care to class III (green tag) clients.
A nurse manager is reviewing the stages of conflict resolution with the nursing staff. The nurse manager should instruct the staff to expect the stages of the conflict to occur in what order? (Order the steps of the process by placing the letters in the correct sequence.)
Latent, perceived, felt, manifest, aftermath
A charge nurse is evaluating a newly licensed nurse at the end of orientation. Which of the following behaviors indicates the nurse is using effective time management skills?
Makes a list of non-essential tasks to perform later
A nurse has four client assignments on a maternal newborn unit. Which of the following tasks can be delegated to an assistive personnel (AP)?
Measuring output of the mother's first voiding
An older adult client is brought to an emergency department by family members. The client has stage IV pressure ulcers, and a close inspection of the wounds reveals the presence of maggots. Which of the following is the nurse's legal responsibility regarding this situation?
Notify Adult Protective Services
A staff nurse detects alcohol on the breath of another nurse working on the unit. He observes that her gait seems unsteady, and she occasionally slurs her speech. Which of the following actions should the nurse take if he suspects that his colleague is under the influence of alcohol?
Notify the charge nurse of his assessment.
A nurse assumes care of a client following morning report and notes that the client's morning laboratory results have not been received. Which of the following actions should the nurse take? (Click on the "Exhibit" button below for additional client information. There are three tabs that contain separate categories of data.)
Obtain a glucose
A nurse is planning discharge care for an older adult client who has rheumatoid arthritis. The nurse notes that the client is having difficulty buttoning her clothing. Which of the following is an appropriate referral for the client?
Occupational Therapy
A nurse is observing a newly licensed nurse who is performing a sterile dressing change on a client who has a central venous catheter. Which of the following is an appropriate action by the newly licensed nurse?
Picks up first sterile glove by grasping the folded cuff edge
A staff nurse at a long-term care facility is evaluating an assistive personnel (AP) caring for a group of clients who require restraints. Which of the following is an appropriate action by the AP?
Placing the restraint tie on a moveable part of the bed frame
A nurse working in a long-term care facility is making a room assignment for a client who has dementia and is easily agitated. Which of the following rooms should the nurse select for the client?
Private room near nurses station
A client who is being discharged today asks the nurse for supplies for his wound dressing. Which of the following actions should the nurse take to ensure quality, cost-effective care?
Provide enough supplies for 1 to 2 days.
A charge nurse on a medical unit hears the fire alarm and announcement that a fire is occurring on the unit. Which of the following is the priority action by the charge nurse?
RACE: Instruct ambulatory pts to safe area
A nurse is reviewing safe use of a wheelchair with a group of assistive personnel. Which of the following should the nurse include?
Raise the footplates
An RN delegates the task of obtaining the blood pressure of a client who is 2 hr postoperative following a cholecystectomy to a licensed practical nurse (LPN). The LPN reports a blood pressure that is significantly higher than the client's previous reading. Which of the following actions should the RN take first?
Recheck the client's blood pressure.
A nursing unit is undergoing changes to accommodate new bariatric services that will be available on the unit. Some staff members have verbalized displeasure with the changes. Which of the following should the charge nurse do? (Select all that apply.)
Role model, encourage staff members who support
A nurse manager is developing a class for newly licensed nurses on strategies to promote client rights. Which of the following should the nurse manager include in the teaching?
Verify provider prescription in MR for restraints.
A charge nurse is reviewing the plan care for a client who has active herpes simplex lesions. Which of the following interventions is appropriate for the plan of care?
Wear a gown and gloves when caring for the client
A nurse is caring for a client who asks for information about advance directives. Which of the following is an appropriate response by the nurse?
Your advance directives will take effect when you are unable to make health care decisions."
A charge nurse is planning care for a group of clients. Which of the following tasks should be delegated to an assistive personnel (AP)? (Select all that apply.)
ambulating walker client, adding thickener
A nurse manager finds that there has been an increase in urinary tract infections on the unit. To address this problem, the first action the nurse manager should take is to
perform a chart review
A nurse is conducting an orientation class for new clients and their families at a long-term care facility. Which of the following client rights should the nurse address at the orientation? (Select all that apply.)
respect and dignity, refuse their meds, leave AMA, and fully informed of their health condition
A charge nurse is performing chart reviews on infection control precautions implemented by nursing personnel during the admission of clients to the unit. Which of the following is an appropriate infection control precaution?
droplet precautions for a client who has meningococcal pneumonia