Leadership and Management Practice Questions

A nursing diagnosis for a patient with newly-diagnosed diabetes is Risk for Injury related to sensory alterations. Which key points should you include in the teaching plan for this patient? Select all that apply. a. "Clean and inspect your feet every day." b. "Be sure that your shoes fit properly." c. "Nylon socks are best to prevent friction on your toes from shoes." d. "Only a podiatrist should trim your toenails." e. "Report any non-healing skin breaks to your health care provider."

a. "Clean and inspect your feet every day." b. "Be sure that your shoes fit properly." e. "Report any non-healing skin breaks to your health care provider."

13. You are performing a sterile dressing change for a client with infected deep partial-thickness burns of the chest and abdomen. List the steps of the care plan in the order in which each should be accomplished. 1. Apply silver sulfadiazine (Silvadene) ointment. 2. Obtain specimens for aerobic and anaerobic wound cultures. 3. Administer morphine sulfate 10 mg IV. 4. Debride the wound of eschar using gauze sponges. 5. Cover the wound with a sterile gauze dressing a. 3, 4, 2, 1, 5 b. 2, 1, 5, 4, 3 c. 1, 2, 3 ,5, 4 d. 5, 3, 4, 2, 1

a. 3, 4, 2, 1, 5

20. As charge nurse, you would assign the nursing care of which patient to an LPN/LVN, working under the supervision of an RN? a. 48-year-old with cystitis who is taking oral antibiotics. b. 64-year-old with kidney stones who has a new order for lithotripsy. c. 72-year-old with urinary incontinence who needs bladder training. d. 52-year-old with pyelonephritis who has severe acute flank pain.

a. 48-year-old with cystitis who is taking oral antibiotics.

16. LPN Jane is the charge nurse in an LTC facility that employs RNs, LPNs/LVNs, and UAPs as staff members. An 80-year-old client has candidiasis in the skinfolds of the abdomen and groin. Which intervention is best to delegate to another LPN/LVN? a. Applying nystatin (Mycostatin) powder to the area three times daily. b. Cleaning the skinfolds every 8 hours with mild soap and drying thoroughly. c. Evaluating the need for further antifungal treatment at least weekly. d. Assessing for ongoing risk factors for skin breakdown and infection.

a. Applying nystatin (Mycostatin) powder to the area three times daily.

You are caring for a diabetic patient who is developing diabetic ketoacidosis (DKA). Which task delegation is most appropriate? a. Ask the unit clerk to page the physician to come to the unit. b. Ask the LPN/LVN to administer IV push insulin according to a sliding scale. c. Ask the UAP to hang a new bag of normal saline. d. Ask the UAP to get the patient a cup of orange juice.

a. Ask the unit clerk to page the physician to come to the unit.

1. You are caring for a patient with esophageal cancer. Which task could be delegated to a UAP? a. Assisting the patient with oral hygiene. b. Observing the patient's response to feedings. c. Facilitating expression of grief or anxiety. d. Initiating daily weighing.

a. Assisting the patient with oral hygiene.

Which situation( s) are classified as natural disasters? Select all that apply. a. Blizzards b. Terrorist attacks c. Volcanic eruptions d. Structural collapse e. Communicable diseases

a. Blizzards c. Volcanic eruptions e. Communicable diseases

14. Which observation by an LPN calls for the most immediate further observation or intervention? a. Bluish color around the lips and earlobes. b. Yellow color of the skin and sclera. c. Bilateral erythema of the face and neck. d. Dark brown spotting on the chest and back.

a. Bluish color around the lips and earlobes.

The plan of care for a diabetic patient includes all of these interventions. Which intervention should you delegate to a UAP? a. Checking to make sure that the patient's bath water is not too hot. b. Discussing community resources for diabetic outpatient care. c. Teaching the patient to perform daily foot inspection. d. Assessing the patient's technique for drawing insulin into a syringe.

a. Checking to make sure that the patient's bath water is not too hot.

When caring for a group of clients, the nurse considers which priority factor( s) in order to determine which client to care for first? Select all that apply. a. Complexity of illness. b. Stability of condition. c. Basic needs of the client. d. Client feelings regarding care. e. Time required for care delivery.

a. Complexity of illness. b. Stability of condition. c. Basic needs of the client.

The case manager is responsible for which aspect( s) of client care? Select all that apply. a. Coordinating consultations and referrals. b. Delivering competent bedside client care. c. Establishing a plan of care with the client. d. Addressing client concerns and facilitating discharge. e. Supervising care provided by unlicensed assistive personnel (UAP).

a. Coordinating consultations and referrals. c. Establishing a plan of care with the client. d. Addressing client concerns and facilitating discharge.

With regard to advance directives, which situation( s) identify an aspect of the nurse's role? Select all that apply. a. Determining whether an advance directive exists upon admission b. Signing as a prescriber or enforcer of the client's wishes on the advance directive c. Ensuring that all health care workers caring for the client are aware of the code status d. Ensuring that the health care provider is aware of the presence of an advance directive e. Ensuring that the client has been provided with the necessary information to make the decision regarding life-saving measures

a. Determining whether an advance directive exists upon admission c. Ensuring that all health care workers caring for the client are aware of the code status d. Ensuring that the health care provider is aware of the presence of an advance directive e. Ensuring that the client has been provided with the necessary information to make the decision regarding life-saving measures

6. When staff assignments are made for the care of patients who are receiving chemotherapy, what is the major consideration regarding chemotherapeutic drugs? a. During preparation, drugs may be absorbed through the skin or inhaled. b. Many chemotherapeutic drugs are vesicants. c. Chemotherapeutic drugs are frequently given through central venous access devices. d. Oral and venous routes of administration are the most common.

a. During preparation, drugs may be absorbed through the skin or inhaled.

An LPN/LVN is to administer rapid-acting insulin (Lispro) to a patient with type 1 diabetes. What essential information would you be sure to tell the LPN/LVN? a. Give this insulin after the patient's food tray has been delivered and the patient is ready to eat. b. Only give this insulin if the patient's fingerstick glucose reading is above 200 mg/dL. c. This insulin mimics the basal glucose control of the pancreas. d. Rapid-acting insulin is the only insulin that can be given subcutaneously or IV.

a. Give this insulin after the patient's food tray has been delivered and the patient is ready to eat.

You are preparing to change the linens on the bed of a client who has a draining sacral wound infected by MRSA. Which PPE items will you plan to use? (Select all that apply.) a. Gown. b. Gloves. c. Goggles. d. Surgical mask. e. N95 respirator.

a. Gown. b. Gloves.

A client with atrial fibrillation is ambulating in the hallway on the coronary step-down unit and suddenly tells you, "I feel really dizzy." Which action should you take first? a. Help the client to sit down. b . Check the client's apical pulse. c. Take the client's blood pressure. d. Have the client breathe deeply.

a. Help the client to sit down.

The charge nurse on a medical-surgical unit is using the concepts of leadership and management to ensure functionality of the unit. The nurse understands that, as a leader or manager (as opposed to a follower), it is necessary to have which primary ability? a. Influence others. b. Follow guidelines. c. Use the chain of command. d. Provide feedback to supervisors.

a. Influence others.

The nurse gives an inaccurate dose of a medication to a client. Following observing the client, the nurse completes an incident report, calls the health care provider, and then notifies the nursing supervisor of the medication error. The nurse who administered the inaccurate medication dose understands which about the incident report? a. Is a method of promoting quality care. b. Will result in temporary job suspension. c. Is reported to the State Board of Nursing. d. Will be a part of the client" s permanent medical record.

a. Is a method of promoting quality care.

The nurse is caring for the assigned clients for the day. The nurse fulfills the wishes of three of the four clients, and due to time constraints is unable to fulfill the wishes of the fourth client. Which ethical principle has the nurse violated? a. Justice. b. Fidelity. c. Veracity. d. Beneficence.

a. Justice.

You are providing nursing care for a patient with acute kidney failure for whom a nursing diagnosis of Excess Fluid Volume related to compromised regulatory mechanisms has been identified. Which actions should you delegate to an experienced UAP? (Select all that apply.) a. Measuring and recording vital sign values every 4 hours. b. Weighing the patient every morning using a standing scale. c. Administering furosemide (Lasix) 40 mg orally twice a day. d. Reminding the patient to save all urine for intake and output measurement. e. Assessing breath sounds every 4 hours. f. Ensuring that the patient's urinal is within reach.

a. Measuring and recording vital sign values every 4 hours. b. Weighing the patient every morning using a standing scale. d. Reminding the patient to save all urine for intake and output measurement. f. Ensuring that the patient's urinal is within reach.

Which are example( s) of a negligent act? Select all that apply. a. Medication errors resulting in injury. b. Failure to monitor an intravenous flow rate resulting in injury. c. A decline in a client's condition resulting in a longer hospital stay. d. A fall that occurs as a result of failure to provide safety measures to a client. e. Failure to report a change in a client's condition to the health care provider (HCP).

a. Medication errors resulting in injury. b. Failure to monitor an intravenous flow rate resulting in injury. d. A fall that occurs as a result of failure to provide safety measures to a client. e. Failure to report a change in a client's condition to the health care provider (HCP).

The nurse manager is attending a session at a conference on effective leader and management behaviors. The manager understands that which are characteristic of these effective behaviors? Select all that apply. a. Motivates employees to achieve goals. b. Treats employees as unique individuals. c. Inspires employees and stimulates critical thinking. d. Shows employees how to always think about problems in the same way. e. Remains distant from employees and encourages independence from the manager

a. Motivates employees to achieve goals. b. Treats employees as unique individuals. c. Inspires employees and stimulates critical thinking.

The patient with COPD has a nursing diagnosis of Ineffective Breathing Pattern. Which is an appropriate action to delegate to the experienced LPN/LVN under your supervision? a. Observing how well the patient performs pursed-lip breathing. b. Planning a nursing care regimen that gradually increases activity tolerance c. Assisting the patient with basic activities of daily living (ADLs). d. Consulting with the physical therapy department about reconditioning exercises

a. Observing how well the patient performs pursed-lip breathing.

In the care of a patient with type 2 diabetes, which actions can you delegate to a UAP? (Select all that apply.) a. Providing the patient with extra packets of artificial sweetener for coffee. b. Assessing how well the patient's shoes fit. c. Recording the liquid intake from the patient's breakfast tray. d. Teaching the patient what to do if dizziness or lightheadedness occurs. e. Checking and recording the patient's blood pressure.

a. Providing the patient with extra packets of artificial sweetener for coffee. c. Recording the liquid intake from the patient's breakfast tray. e. Checking and recording the patient's blood pressure.

The nurse is signing as a witness on an informed consent form for a client who is undergoing surgery. The nurse understands that in most states, signing as a witness indicates which condition? a. Signing as a witness to the client's signature. b. Signing as confirmation of the client's understanding of the. procedure. c. Signing as confirmation of the client's understanding of risks and benefits. d. Signing as confirmation that all of the client's questions have been answered.

a. Signing as a witness to the client's signature.

8. In the care of a patient with neutropenia, what tasks can be delegated to a UAP? (Select all that apply.) a. Taking vital signs every 4 hours. b. Reporting temperature of more than 100.4° F (38° C). c. Assessing for sore throat, cough, or burning with urination. d. Gathering the supplies to prepare the room for protective isolation. e. Reporting super-infections, such as candidiasis. f. Practicing good hand-washing technique.

a. Taking vital signs every 4 hours. b. Reporting temperature of more than 100.4° F (38° C). d. Gathering the supplies to prepare the room for protective isolation. f. Practicing good hand-washing technique.

Malpractice is determined if the nurse owed the client a duty and did not carry out the duty. What other aspect is required for malpractice to have occurred? a. The client was injured. b. The client felt neglected. c. The client's family was affected. d. The client's state was unchanged.

a. The client was injured.

In the process of delegation, the nurse understands that the primary person who maintains accountability for the accuracy, safety, and completion of the task delegated remains with whom? a. The delegator of the task. b. The delegatee of the task. c. Those who assisted with task completion. d. The person who documented task completion.

a. The delegator of the task.

Which accurately describes the principle of respondent superior? a. The employer is ultimately responsible for any negligent act of an employee that is within the employee's scope of responsibility. b. The employer is ultimately responsible for any negligent act of an employee, even if the act is outside the employee's scope of responsibility. c. The employee rather than the employer is ultimately responsible for any negligent act, even if the act is within the employee's scope of responsibility. d. The employee rather than the employer is ultimately responsible for any negligent act, even if the act is outside of the employee's scope of responsibility.

a. The employer is ultimately responsible for any negligent act of an employee that is within the employee's scope of responsibility.

Which best describes nursing standards of care? Select all that apply. a. They are guidelines for nursing practice. b. Nursing standards of care are defined in Nurse Practice Acts. c. The law upholds the standards of care that the nurse must follow. d. They are specific guidelines only for unlicensed assistive personnel. e. They are used to measure nursing conduct in a malpractice lawsuit. f. They are used to determine whether the nurse acted as any reasonably prudent nurse under the same or similar conditions.

a. They are guidelines for nursing practice. b. Nursing standards of care are defined in Nurse Practice Acts. c. The law upholds the standards of care that the nurse must follow. e. They are used to measure nursing conduct in a malpractice lawsuit. f. They are used to determine whether the nurse acted as any reasonably prudent nurse under the same or similar conditions.

5. For a patient who is receiving chemotherapy, which laboratory result is of particular importance that the LPN should monitor? a. White blood cell (WBC) count. b. Prothrombin time and partial thromboplastin time. c. Electrolyte levels. d. Blood urea nitrogen level.

a. White blood cell (WBC) count.

The nursing instructor is conducting a teaching session regarding the role of a case manager. Which statement, if made by a student, indicates a need for further instruction? a. "A case manager is a professional nurse." b. "A case manager's involvement ceases after discharge." c. "A case manager establishes a plan of care with the client." d. "A case manager assumes responsibility for coordinating client care."

b. "A case manager's involvement ceases after discharge."

3. When care assignments are being made for patients with alterations related to gastrointestinal (GI) cancer, which patient would be the most appropriate to assign to an LPN/LVN under the supervision of a team leader RN? a. A patient with severe anemia secondary to GI bleeding. b. A patient who needs enemas and antibiotics to control GI bacteria. c. A patient who needs preoperative teaching for bowel resection surgery. d. A patient who needs central line insertion for chemotherapy.

b. A patient who needs enemas and antibiotics to control GI bacteria.

The nurse understands that which is accurate regarding the Occupational Safety and Health Administration (OSHA)? a. Reports are not confidential. b. A safe and conducive workplace must be provided by the employer. c. An employee who reports unsafe working conditions can be retaliated against. d. The board of nursing is notified only if nursing administration cannot handle the issue.

b. A safe and conducive workplace must be provided by the employer.

17. After reviewing the medical record for a client who has an oral herpes simplex infection following chemotherapy, which nursing diagnosis will you address as the priority? a. Social Isolation related to anxiety about herpes infection. b. Acute Pain related to the presence of extensive herpes simplex lesions. c. Imbalanced Nutrition: Less than Body Requirements related to decreased oral intake. d. Disturbed Body Image related to the appearance of oral lesions.

b. Acute Pain related to the presence of extensive herpes simplex lesions.

Which information about a client who has meningococcal meningitis is the best indicator that you can discontinue droplet precautions? a. Pupils are equal and reactive to light. b. Appropriate antibiotics have been given for 24 hours. c. Cough is productive of clear, nonpurulent mucus. d. Temperature is lower than 100° F (37.8° C).

b. Appropriate antibiotics have been given for 24 hours.

12. You have just received a change-of-shift report for the burn unit. Which client should you check on first? a. Client with deep partial-thickness burns on both legs who reports severe and continuous leg pain. b. Client who has just arrived from the emergency department with facial burns sustained in a house fire. c. Client who has just been transferred from the postanesthesia care unit after having skin grafts applied to the anterior chest. d. Client admitted 3 weeks ago with full-thickness leg and buttock burns who has been waiting for 3 hours to receive discharge teaching.

b. Client who has just arrived from the emergency department with facial burns sustained in a house fire.

As the infection control nurse in an acute care hospital, which action will you take to most effectively reduce the incidence of health care-associated infections? a. Require nursing staff to don gowns to change wound dressings for all clients. b. Ensure that dispensers for alcohol-based hand rubs are readily available in all client care areas of the hospital. c. Screen all newly admitted clients for colonization or infection with MRSA. d. Develop policies that automatically start antibiotic therapy for clients colonized by multidrug-resistant organisms.

b. Ensure that dispensers for alcohol-based hand rubs are readily available in all client care areas of the hospital.

7. A patient with lung cancer develops syndrome of inappropriate antidiuretic hormone secretion (SIADH). After reporting symptoms of weight gain, weakness, and nausea and vomiting to the physician, you would anticipate which initial order for the treatment of this patient? a. A fluid bolus. b. Fluid restrictions. c. Urinalysis. d. Sodium-restricted diet.

b. Fluid restrictions.

While riding the elevator to their assigned unit, two nurses are talking about a client who is hospitalized in the mental health unit. Which description(s) are accurate about confidentiality in this situation? Select all that apply. a. The client's right to confidentiality does not apply to the mental health unit. b. Talking about clients in public places is a violation of the client's confidentiality. c. Talking about clients in public places can result in disciplinary action for the nurses. d. The client's right to confidentiality does not apply to the personal break time of employees. e. It is acceptable for the nurses to talk about the client because they are on the same treatment team.

b. Talking about clients in public places is a violation of the client's confidentiality. c. Talking about clients in public places can result in disciplinary action for the nurses.

The newly-employed nurse is attending orientation and is learning about accountability. Which description is accurate with regard to this professional responsibility? a. The individual ensures that mistakes are never associated with care provided. b. The individual has an obligation to the client and is answerable for his or her actions. c. The individual does not admit to fault and focuses on avoidance of malpractice suits. d. The individual assumes responsibilities within and outside of his or her scope of practice.

b. The individual has an obligation to the client and is answerable for his or her actions.

A client is involuntarily admitted to the mental health unit because of episodes of extremely violent behavior toward himself and others. The client is now demanding to be discharged from the hospital immediately and threatens to "break every window in my room" if stopped. The nurse tells the client he will not be allowed to leave and calls security to the unit. The client states, "This is false imprisonment. I'll sue!" Which represents the legal ramifications associated with the nurse's interventions? a. This is false imprisonment and so the client has grounds to sue. b. The nurse is reacting responsibly, so there are no legal consequences. c. The nurse has failed to provide a therapeutic environment, and the client can sue. d. The nurse has failed to help deescalate the situation, but there are no legal consequences.

b. The nurse is reacting responsibly, so there are no legal consequences.

From the following list of nursing activities, select those that may be delegated to the licensed practical nurse or licensed vocational nurse (LPN/ LVN). Select all that apply. a. Assessment. b. Urinary catheterization. c. Endotracheal suctioning. d. Intramuscular medication administration. e. Subcutaneous medication administration. f. Medication administration by intravenous push.

b. Urinary catheterization. c. Endotracheal suctioning. d. Intramuscular medication administration. e. Subcutaneous medication administration.

A student nurse is concerned about delegation practices and wonders why hospitals employ nursing assistive personnel (NAP) and LPN/LVNs. The student nurse refers to the National Council of State Boards of Nursing and learns that the role of these personnel is to: a. supplement the staffing pattern when an RN is not available. b. aid the RN by performing simple, routine patient care tasks. c. replace the RN when the health care facility provides long-term care. d. provide patient teaching, allowing more direct care to be provided by the RN.

b. aid the RN by performing simple, routine patient care tasks.

The graduate nurse is told that the nurse manager's leadership style is one of letting the staff nurses make the decisions about the unit's operations. When the graduate nurse meets with the nursing staff, which question should the graduate nurse ask to confirm that the nurse manager's leadership style is laissez-faire? a. "Does the manager facilitate decision making by the group?" b. "Does the manager maintain control and make all decisions?" c. "Does the manager assume a passive, nondirective approach?" d. "Does the manager change her style according to needs of the group?"

c. "Does the manager assume a passive, nondirective approach?"

The LPN/LVN whom you are supervising comes to you and says, "I gave the client with myasthenia gravis 90 mg of neostigmine (Prostigmin) instead of the ordered 45 mg!" In which order should you perform the following actions? 1. Check the client's heart rate. 2. Complete a medication error report. 3. Ask the LPN/LVN to explain how the error occurred. 4. Notify the physician of the incorrect medication dose. a. 4, 2, 1, 3 b. 3, 1, 2, 4 c. 1, 4, 3, 2 d. 2, 3, 4, 1

c. 1, 4, 3, 2

An adolescent asks the nurse if she is of age to make an organ donation. The nurse should tell the adolescent that the individual must be at least which age to make an organ donation? a. 13 b. 16 c. 18 d. 21

c. 18

18. You have just received the change-of-shift report in the burn unit. Which client would you check on first? a. 22-year-old admitted 4 days previously with facial burns due to a house fire who has been crying since recent visitors left. b. 34-year-old who returned from skin-graft surgery 3 hours ago and is reporting level 8 pain (on a scale of 0 to 10). c. 45-year-old with partial-thickness leg burns who has a temperature of 102.6° F (39.2° C) and a blood pressure of 98/46 mm Hg. d. 57-year-old who was admitted with electrical burns 24 hours ago and has a blood potassium level of 5.1 mEq/L.

c. 45-year-old with partial-thickness leg burns who has a temperature of 102.6° F (39.2° C) and a blood pressure of 98/46 mm Hg.

A client who has frequent watery stools and a possible Clostridium difficile infection is hospitalized with dehydration. Which nursing action should the charge nurse delegate to an LPN/LVN? a. Performing ongoing assessments to determine the client's hydration status. b. Explaining the purpose of ordered stool cultures to the client and family. c. Administering the ordered metronidazole (Flagyl) 500 mg PO to the client. d. Reviewing the client's medical history for any risk factors for diarrhea.

c. Administering the ordered metronidazole (Flagyl) 500 mg PO to the client.

9. You are the charge nurse. Two hours into the shift you discover that two nurses have switched patients because Nurse A does "not like to take care of patients with prostate cancer." Which action should you take first? a. Insist that they switch back to the original patient assignments and talk to each of them at the end of the shift. b. Allow them this flexibility; as long as the patients are well cared for it doesn't matter if the assignments are changed. c. Ask Nurse A to explain her position regarding prostate cancer patients and seek alternatives to prevent future issues. d. Explain to Nurse A and B that all patients deserve kindness and care regardless of their condition or the nurses' personal feelings.

c. Ask Nurse A to explain her position regarding prostate cancer patients and seek alternatives to prevent future issues.

A 23-year-old client comes to the outpatient clinic reporting increasing shortness of breath, diarrhea, abdominal pain, and epistaxis. Which action should you take first? a. Assist the client to pinch the anterior nares firmly for 5 minutes. b. Call an ambulance to take the client immediately to the hospital. c. Ask the client about any recent travel to Asia or the Middle East. d. Determine whether the client has had recommended immunizations.

c. Ask the client about any recent travel to Asia or the Middle East.

The nurse is using concepts of time management to organize the workday. Which action will assist the nurse to effectively implement time management strategies? a. Complete nonessential activities first to reduce interruptions. b. Plan the day so that all time is accounted for in task completion. c. Identify tasks that must be completed within a specific time frame. d. Assist others in the completion of their assigned tasks when asked.

c. Identify tasks that must be completed within a specific time frame.

A client with a vancomycin-resistant enterococcus (VRE) infection is admitted to the medical unit. Which action can be delegated to the UAP who is assisting with the client's care? a. Teaching the client and family members about means to prevent transmission of VRE. b. Communicating with other departments when the client is transported for ordered tests. c. Implementing contact precautions when providing care for the client. d. Monitoring the results of ordered laboratory culture and sensitivity tests.

c. Implementing contact precautions when providing care for the client.

The LPN who works on the dementia unit is told to float to the skilled unit for the day because of short-staffing in the ICU. This nurse who has never worked in the skilled should take which action? a. Go to employee health services for permission to go home. b. Call the ICU to let them know that an experienced staff nurse is not available. c. Inform the nursing supervisor of the lack of experience for working on the skilled unit. d. Ask another staff member who has floated to the skilled unit the previous short-staffing situations to report to the skilled unit.

c. Inform the nursing supervisor of the lack of experience for working on the skilled unit.

10. You are caring for a client who has just had a squamous cell carcinoma removed from the face. Which activity can you delegate to an experienced LPN/LVN? a. Teaching the client about risk factors for squamous cell carcinoma. b. Showing the client how to care for the surgical site at home. c. Monitoring the surgical site for swelling, bleeding, or pain. d. Discussing the reasons for avoiding aspirin use for a week after surgery.

c. Monitoring the surgical site for swelling, bleeding, or pain.

You are caring for a client who has been admitted to the hospital with a leg ulcer that is infected with vancomycin-resistant S. aureus (VRSA). Which nursing action can be delegated to an LPN/LVN? a. Planning ways to improve the client's oral protein intake. b. Teaching the client about home care of the leg ulcer. c. Obtaining wound cultures during dressing changes. d. Assessing the risk for further skin breakdown.

c. Obtaining wound cultures during dressing changes.

A client who has recently traveled to China comes to the emergency department (ED) with increasing shortness of breath and is strongly suspected of having severe acute respiratory syndrome (SARS). Which of these prescribed actions will you take first? a. Infuse normal saline at 75 mL/hr. b. Obtain blood, urine, and sputum for cultures. c. Place the client on airborne and contact precautions. d. Give methylprednisolone (Solu-Medrol) 1 g IV.

c. Place the client on airborne and contact precautions.

The nurse assigned to four clients reviews client data at the beginning of the shift. Which client data should be further obtained as the highest priority? a. Hemoglobin 12.2 g/ dL b. Potassium level 3.6 mEq/ L c. Pulse oximetry reading 89% d. Urine output 240 mL/ 8 hours

c. Pulse oximetry reading 89%

15. As a home health nurse, you are caring for a 72-year-old client who has a nursing diagnosis of Impaired Skin Integrity related to poor nutrition, bladder incontinence, and immobility. Which nursing actions should you delegate to the UAP? a. Telling the client and family to apply the skin barrier cream in a smooth, even layer. b. Completing a diet assessment and suggesting changes in diet to improve the client's nutrition. c. Reminding the family to help the client to the commode every 2 hours during the day. d. Evaluating the client for improvement in documented areas of skin breakdown or damage.

c. Reminding the family to help the client to the commode every 2 hours during the day.

4. For a patient who is experiencing side effects of radiation therapy, which task would be the most appropriate to delegate to the UAP? a. Helping the patient to identify patterns of fatigue. b. Recommending participation in a walking program. c. Reporting the amount and type of food consumed from the tray. d. Checking the skin for redness and irritation after the treatment.

c. Reporting the amount and type of food consumed from the tray.

A client with Alzheimer's dementia is being admitted to a long-term care facility. The client is widowed and previously lived at home alone. Which person would be acceptable to sign an advance directive, specifically with regard to resuscitative orders on behalf of this client? a. The client. b. The social worker. c. The client's daughter. d. The health care provider.

c. The client's daughter.

The nurse manager working in the intensive care unit (ICU) has adopted a bureaucratic leadership style. Which description is characteristic of this leadership style? a. Decision making is left to the group, and the manager provides little feedback. b. Leadership is derived from the needs of the group and the tasks to be achieved. c. The manager relies on organizational policies and procedures for decision making. d. The manager dominates the group and commands rather than seeks input from the group.

c. The manager relies on organizational policies and procedures for decision making.

The nurse has filed an incident report after a client sustained a fall. The nurse should place the report in which location? a. The client's medical record. b. The quality assurance team's mailbox. c. The nursing supervisor's locked mailbox. d. Outgoing mail to be sent to the health care provider's office.

c. The nursing supervisor's locked mailbox.

The nurse is caring for older clients and suspects physical abuse. Which client is most at risk for abuse? a. The older client who is independent with activities of daily living. b. The older client who attends many church activities and volunteers on a regular basis. c. The older client who is dependent on children to manage instrumental activities of daily living. d. The older client whose caregiver states, "I really enjoy spending so much time with my mother."

c. The older client who is dependent on children to manage instrumental activities of daily living.

In differentiating between a leader and a manager, a: a. leader has legitimate authority. b. manager motivates and inspires others. c. manager focuses on coordinating resources. d. leader focuses on accomplishing goals of the organization.

c. manager focuses on coordinating resources.

The nurse employed in a mental health clinic is greeted by a neighbor who says, "How is Michelle doing? She is my best friend and is seen at your clinic every week." Which is the most appropriate nursing response? a. "I know you are really concerned, so I will share with you that she is doing much better than before." b. "I'm not supposed to discuss this, but because you are her best friend I can tell you that she really has problems!" c. "If you want to know about Michelle's progress, I suggest you ask her yourself. I'm not allowed to discuss this with you." d "I'm sorry and I'm sure you will understand, but as a nurse, I'm obligated to protect the privacy of all the clients I encounter. I cannot disclose any client information."

d "I'm sorry and I'm sure you will understand, but as a nurse, I'm obligated to protect the privacy of all the clients I encounter. I cannot disclose any client information."

You are caring for a patient admitted with dehydration secondary to deficient antidiuretic hormone (ADH). Which specific gravity value supports this diagnosis? a. 1.010 b. 1.035 c. 1.020 d. 1.002

d. 1.002

The LPN is preparing to leave the room after performing oral suctioning on a client who is on contact and airborne precautions. In which order will you perform the following actions? 1. Remove N95 respirator. 2. Take off goggles. 3. Remove gloves. 4. Take off gown. 5. Perform hand hygiene. a. 1, 2, 5, 4, 3 b. 5, 3, 2, 1, 4 c. 4, 5, 1, 3, 2, d. 3, 2, 4, 1, 5 e. 2, 4, 5, 3, 1

d. 3, 2, 4, 1, 5

The nurse who is off-duty stops at the scene of an accident and provides first aid care to injured clients. One of the clients develops complications associated with the injuries obtained by the accident. The nurse is immune from a malpractice lawsuit unless the nurse took which action? a. Followed state practice laws. b. Provided care in a reasonable manner. c. Provided care that was not intentionally negligent. d. Administered care outside of the scope of practice based on experience.

d. Administered care outside of the scope of practice based on experience.

The nursing diagnosis of Constipation related to compression of the intestinal tract has been identified in a patient with polycystic kidney disease. Which nursing care action should you delegate to a newly-trained LPN/LVN? a. Instructing the patient about foods that are high in fiber. b. Teaching the patient about foods that assist in promoting bowel regularity. c. Assessing the patient for previous bowel problems and bowel routine. d. Administering docusate sodium (Colace) 100 mg by mouth twice a day.

d. Administering docusate sodium (Colace) 100 mg by mouth twice a day.

2. A 56-year-old patient comes to the walk-in clinic reporting scant rectal bleeding and intermittent diarrhea and constipation for the past several months. There is a history of polyps and a family history of colorectal cancer. While you are trying to instruct the client about colonoscopy, the patient becomes angry and threatens to leave. What is the priority diagnosis? a. Diarrhea/Constipation related to altered bowel patterns. b. Deficient Knowledge related to the disease process and diagnostic procedure. c. Risk for Deficient Fluid Volume related to rectal bleeding and diarrhea. d. Anxiety related to unknown outcomes and perceived threats to body integrity.

d. Anxiety related to unknown outcomes and perceived threats to body integrity.

The nurse caring for clients gives the clients an opportunity to make decisions about their care. The nurse understands that respect for an individual's right to self-determination is identified by which term? a. Justice b. Fidelity c. Veracity d. Autonomy

d. Autonomy

11. You are employed as the charge nurse in a long-term care (LTC) facility that employs RNs, LPNs/LVNs, and UAPs. When you are planning care for a resident with a stage III sacral pressure ulcer, which nursing intervention is best to delegate to an LPN/LVN? a. Choosing the type of dressing to be used on the ulcer. b. Using the Norton scale to assess for pressure ulcer risk factors. c. Assisting the client in changing position at frequent intervals. d. Cleaning and changing the dressing on the ulcer every morning.

d. Cleaning and changing the dressing on the ulcer every morning.

The nurse understands that in order to effectively use concepts of time management, which skills need to be utilized? a. Performing activities one at a time. b. Documentation at the end of the workday. c. Addressing all nonessential activities as they arise. d. Deciding on the most important tasks to complete first.

d. Deciding on the most important tasks to complete first.

The experienced UAP has been delegated to take vital signs and check fingerstick glucose on a diabetic patient who is postoperative. Which data change would you instruct the UAP to report immediately? a. Blood pressure increase from 132/80 mm Hg to 138/84 mm Hg. b. Temperature increase from 98.4° F (36.8° C) to 99° F (37.2° C). c. Respiratory rate increase from 18 breaths/min to 22 breaths/min. d. Glucose increase from 190 mg/dL to 236 mg/dL.

d. Glucose increase from 190 mg/dL to 236 mg/dL.

A hospitalized 88-year-old client who has been receiving antibiotics for 10 days tells you that he is having frequent watery stools. Which action will you take first? a. Notify the physician about the loose stools. b. Obtain stool specimens for culture. c. Instruct the client about correct hand washing. d. Place the client on contact precautions.

d. Place the client on contact precautions.

19. You are providing nursing care for a 24-year-old female patient admitted to the unit with a diagnosis of cystitis. Which intervention should you delegate to the UAP? a. Teaching the patient how to secure a clean-catch urine sample. b. Assessing the patient's urine for color, odor, and sediment. c. Reviewing the nursing care plan and add nursing interventions. d. Providing the patient with a clean-catch urine sample container.

d. Providing the patient with a clean-catch urine sample container.

You are providing care for a patient with reflex urinary incontinence. Which action could be appropriately delegated to a new LPN/LVN? a. Teaching the patient bladder emptying by the Crede method. b. Demonstrating how to perform intermittent self-catheterization. c. Discussing the side effects of bethanechol chloride (Urecholine). d. Reinforcing the importance of proper hand washing to prevent infection.

d. Reinforcing the importance of proper hand washing to prevent infection.

A patient has newly-diagnosed type 2 diabetes. Which task should you delegate to a UAP? a. Arranging a consult with the dietitian. b. Assessing the patient's insulin injection technique. c. Teaching the patient to use a glucometer to monitor glucose at home. d. Reminding the patient to check glucose level before each meal.

d. Reminding the patient to check glucose level before each meal.

Which is an example of a client assault? a. Taking photographs of a client without the client's consent. b. Administering an injection that the client refused to receive. c. Taking the client for an x-ray when the client refused consent. d. Threatening to administer a sedative to a client who is restless.

d. Threatening to administer a sedative to a client who is restless.