leadership

By the middle of a shift, two of the three nurses working have gone home ill, leaving the nursing unit short staffed. Which of the following is the most appropriate action for the charge nurse?

Call the nursing supervisor and request additional staff.

Which of the following observations made by a nurse should be reported to the nurse manager as a violation against HIPAA?

Talking about clients with other nurses in the cafeteria

A group of providers is participating in a resuscitation effort for a client who is in cardiac arrest. Which of the following types of leadership is required for this group to function most efficiently?

autocratic

An adult client who has an injury that requires immediate surgical intervention is being transferred from a small, rural hospital to a Level I emergency department. The client has been medicated during transport with intravenous meperidine (Demerol). The receiving nurse understands that consent for the surgery

should be obtained from a relative of the client.

A client who received a sedative-hypnotic medication at bedtime becomes confused during the night. 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 3 cm laceration above left eyebrow. Oriented to name only. Primary care provider notified."

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

"I understand that you are allowed to take scheduled breaks during each shift, but I have noticed that you are taking more than the number allocated. I would like to schedule a time when we could discuss this behavior."

A nurse wants to support a health related bill that is due to be addressed by the state legislature. Which of the following statements by the nurse is appropriate to include in a letter to the state legislator?

"I would like to request your support of State Bill 132 regarding appropriations for rural health clinic funding."

A nurse is delegating a client care task to an assistive personnel (AP). Which of the following is an appropriately stated direction?

"This client needs to ambulate using a walker three times today."

A nurse is caring for a child who has sustained extensive head injuries and is declared brain dead. Which of the following statements is appropriate for the nurse to use to begin a conversation about the option of organ and tissue donation with the child's parents?

"i want to give you some information about an option that you have regarding donating your child's organs to others who are in need."

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

Allow for rest periods

A member of an interdisciplinary health care team approaches a nurse and begins to shout loudly about a radiology test that has been delayed. Which of the following responses is appropriate?

Ask the team member to lower his voice and restate his concern.

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 states that the medication the client received will not cause any harm, so nothing needs to be done. Which of the following actions should the nurse take?

Complete a variance (or incident) report documenting the occurrence.

An assistive personnel (AP) is floated to the emergency department due to unexpected staff absences. The AP has never been assigned to the emergency department before and finds it to be extremely busy with multiple clients waiting to be seen. Which of the following is an appropriate assignment for the charge nurse to give to the AP?

Escort clients from the emergency department to other areas of the hospital for tests.

A nurse is reviewing client assignments and wishes to delegate several tasks to an assistive personnel (AP). The nurse is unsure if a certain task is within the scope of practice for the AP. Which of the following sources of information should the nurse consult to determine if the task can be delegated?

Hospital policy manual

While making a client's bed, a nurse finds a capsule of medication in the sheets. Which of the following actions by the nurse are consistent with safe nursing practice? (Select all that apply.)

Notifying the provider of the missed dose Determining what medication the capsule contains Documenting the missed dose of medication on the client's MAR is correct

A nurse is working with an assistive personnel (AP) in a long term care facility. According to the five rights of delegation, which of the following determinations should the nurse make prior to assignment of tasks?

The degree of supervision that the AP will require to complete the task

Which of the following situations, encountered by a nurse, requires the completion of a variance report?

The discovery that a preoperative client has received and eaten breakfast

A nurse manager is preparing to perform teaching with a nurse. Which of the following behaviors, exhibited by the nurse, should indicate to the nurse manager that the nurse is an auditory learner?

The nurse attends optional discussion sessions about how to use a new piece of equipment.

A client receiving care from a home health nurse asks what is included in a living will. The nurse explains that a living will is a document that

allows the client to express personal wishes regarding health care decisions.

A nurse is caring for a client who is in the bathroom. The nurse hears a loud thud and, after opening the bathroom door, sees the client on the floor. The nurse's first action should be to

determine unresponsiveness.

Using quality monitoring tools, a hospital committee identifies that clients who have congestive heart failure have a length of stay that is five days instead of the established standard of three days. The next action of the continuous quality improvement committee addressing this issue should be to

determine which actions can be instituted to correct this problem.

A client in a long term care facility falls out of bed, fracturing the left hip. The side rails on the bed were not raised at bedtime, although this client was identified to be at risk for falling. The nurse recognizes this incident as an example of

negligence.

A nurse in an emergency department has admitted several clients for further observation and assessment. Which of the following clients requires the nurse to inform the proper agency, secondary to the nurse's role as a mandated reporter?

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

A charge nurse is making assignments for the oncoming shift. Which of the following clients is appropriate for the charge nurse to assign to a licensed practical nurse (LPN)?

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

An assistive personnel (AP) in a pediatric unit may be pregnant and the charge nurse is unsure of the AP's immune status. Which of the following hospitalized children should the charge nurse safely assign the AP to care for?

A two-year-old child who has impetigo contagiosa (impetigo)

An assistive personnel (AP) who appears to be under the influence of alcohol reports to duty on the night shift. Which of the following is an appropriate response by the charge nurse?

Ask the nursing supervisor to observe the AP and validate the charge nurse's suspicions.

An RN is part of a team that consists of a licensed practical nurse (LPN) and an assistive personnel (AP). One of the clients the team is assigned to care for has a small bowel obstruction and is NPO with a nasogastric (NG) tube set to continuous drainage. Which of the following tasks must be retained by the RN?

Assess for bowel sounds every 2 hr.

A nurse is delegating a task to an assistive personnel (AP). The AP is to transfer a client who has a below the knee amputation from a bed to a wheelchair. The AP has never transferred a client with an amputation before. Which of the following is an appropriate nursing action?

Assist the AP after he has practiced the transfer.

A nurse is caring for four clients who are scheduled for diagnostic tests. The nurse will need to obtain written consent from the client who is to receive which of the following tests?

Cerebral arteriogram

A nurse manager calls a meeting of the unit's staff members to discuss cost containment issues. The nurse manager has asked for member input regarding strategies that might help reduce costs. The nurse understands that this is an example of which of the following types of leadership?Democratic

Democratic

Because of recommendations following a regulatory agency visit, the nurse manager mandates a policy change. One of the nurses on the unit is very resistant to the change, and the nurse manager notes that the nurse does not deliver care according to the new policy. Which of the following actions is appropriate to take with the nurse who is resisting the change?

Encourage the nurse to verbalize reasons for resisting the change.

An adolescent client in a rehabilitation setting has a computer, radio, DVD player, and video game unit all turned on at the same time for most of the day. The nurse notes that there are not enough electrical outlets and that extension cords with multiple outlets are in use to accommodate this equipment. Which of the following is an appropriate nursing action?

Explain to the client that extension cords cannot be used for safety reasons and that she may call the staff if the she wants something plugged in that is not currently connected.

A nurse who is preparing a client teaching session is interrupted to admit a new client. By the end of the shift, the nurse still has not completed the teaching and reports this to the night shift nurse. The day shift nurse expresses frustration at not meeting the client's needs due to workload. The night shift nurse recognizes this nurse is most likely experiencing which of the following?

Intrapersonal conflict is the tension or stress that exists within an individual as a result of unmet needs, expectations, or goals.

A nurse obtains blood samples for type and cross match from two clients who are both scheduled for surgical procedures in the morning. Later in the shift, the nurse becomes concerned that the labels on the specimens may have been accidentally switched. Due to the nature of the procedures, the nurse believes that neither client is likely to require a transfusion. Which of the following is an appropriate nursing action at this time?

Redraw both specimens, label them, and inform the blood bank of the possible error.

A mayor has been admitted to an oncology unit. A local newspaper reporter phones the unit seeking information and states, "It is the public's right to know the health status of elected officials." Which of the following is an appropriate response by the nurse in relation to this statement from the news media?

Refer all inquiries to the nursing supervisor.

A nurse is caring for several clients who require diagnostic testing, and is delegating tasks to the assistive personnel (AP). Which of the following tasks should the nurse direct the AP to perform first?

Take an arterial blood gas specimen to the laboratory.

A nurse is ambulating a client who has an IV with an infusion pump. Upon returning and plugging the infusion pump back in, the nurse notices a slight tingling in his hand. Which of the following is an appropriate nursing action at this time?

Turn the pump off immediately.

Two nurses on the same shift request the same weekend off, and no other nurses are available to cover the request. The nurse manager decides the nurse who put in the request first will be granted time off, and the other nurse will need to work. Using this conflict resolution strategy, the nurse manager's actions should produce which of the following outcome results?

Win-lose

A nurse is orienting a newly licensed nurse to the procedure involved in obtaining informed consent. The nurse knows informed consent is based on the ethical principle of

autonomy

A nurse is completing a variance (or incident) report after administering an incorrect dose of medication to a client, even though the client experienced no ill effects from the error. The nurse should understand that the purpose of completing the variance report is to

identify situations that contribute to the occurrence of medication errors.

A nurse is concerned that some of the behaviors of the night charge nurse seem to be unprofessional. The charge nurse repeatedly asks the nurse for assistance with client care and brushes up against the nurse during the completion of the task. One night, the charge nurse asks the nurse to go out on a date and indicates that a sexual relationship between them would mean a better schedule for the nurse. The first action that the nurse should take in this situation is to

tell the charge nurse in clear terms that this conduct is causing feelings of discomfort and that the behaviors are to stop immediately.