Leadership Exam #3 (Ch 11-13)

A nurse accidentally administers the wrong medication to a client, which results in a severe allergic reaction and prolongs the client's hospital stay. The client could rightfully sue the nurse for which of the following? a.Abuse b.Malpractice c.Assault d.Battery

B. Malpractice

A nurse is discussing disaster planning with the board members of a hospital. Which of the following individuals should the nurse expect to request extra supplies and staffing for the facility? A. Incident commander B. Medical command physician C. Triage officer D. Media liaison

B. Medical command physician

Following a tornado, a nurse is determining which of the clients assigned to her care can be discharged to free up beds for injured clients. Which of the following clients should the nurse recommend for discharge? a.A young adult client who has Crohn's disease and is one day preoperative for an ileostomy b.An adolescent client who was admitted 24 hours ago due to a spontaneous pneumothorax c.A middle aged adult who is 36 hours postoperative from an open laminectomy d.An older adult client who was admitted for diabetic ketoacidosis and his most recent ABGs show his pH is now 7.32

A

A nurse is hired to replace a staff member who has resigned. After working on the unit for several wees, the nurse notices that the unit manager does not intervene when there is conflict between team members, even when it escalates. Which of the following conflict resolution strategies is the unit manager demonstrating? A. Avoidance B. Smoothing C. Cooperating D. Negotiating

A. Avoidance

A nurse is providing staff education about small pox as a bioterrorism threat. Which of the following statements indicates an understanding of this agent? (Select all that apply). a.Smallpox is transmitted person to person. b.Infection is characterized by severe respiratory distress c.Smallpox vaccination ensures lifelong immunity d.Naturally occurring smallpox has been eradicated from the world. e.Smallpox is often confused with varicella

A, D, E

A nurse is preparing a response protocol for botulism as a bioterrorism agent. The nurse should prepare the protocol based on which of the following information? (Select all that apply). a.Botulism can produce paralysis within 12-72 hours following exposure b.Notify the CDC when more than 3 cases are confirmed c.Botulism is acquired through direct contact with an infected person d.Vomiting and diarrhea are expected findings following exposure e.Botulism is a toxin found in castor beans

A,D

A nurse manager is explaining the use of incident reports to a group of nurses in an orientation program. Which of the following information should the nurse manager include? SATA A. A description of the incident should be documented in the client's health care record B. The client should sign as a witness on the incident report C. Incident reports include a description o the incident and actions taken D. A copy of the incident report should be placed in the client's health care record E. The risk management department investigates the incident

A. A description of the incident should be documented in the client's health care record C. Incident reports include a description o the incident and actions taken E. The risk management department investigates the incident

Which of the following events should be reported? SATA A. A patient is place din a broken wheelchair that tips over B. A staff member tells a neighbor about the famous athlete who is a patient C. An employee reports to work under the influence of alcohol D. A patient spills her supplemental protein drink on the floor; the CNA mops it up

A. A patient is placed in a broken wheelchair that tips over B. A staff member tells a neighbor about the famous athlete who is a patient C. An employee reports to work under the influence of alcohol

A nurse manager is providing information about the audit process to members of the nursing team. Which of the following information should the nurse manager include? SATA A. A structure audit evaluates the setting and resources available to provide care B. An outcome audit evaluates the results of the nursing care provided C. A root cause analysis is indicated when a sentinel event occurs D. Retrospective audits are conducted while the client is receiving care E. After data collection is completed, it is compared to a benchmark

A. A structure audit evaluates the setting and resources available to provide care B. An outcome audit evaluates the results of the nursing care provided C. A root cause analysis is indicated when a sentinel event occurs

Factors found to increases nurses' joy at work include;SATA A. Ability to provide quality care B. Consistently high workload C. A pattern of continuous conflict and disagreement D. Civility and respect

A. Ability to provide quality care D. Civility and respect

A suburban hospital recently announced that staff nurses could no longer choose their shift. Instead, they would be assignment to either a 12 hour day or night shift on an as-needed basis. An informal group of staff nurses met to discuss this new policy. They came up with several arguments against it. Which of the following suggestions would help to alleviate the deleterious effects of this new facility? SATA A. Allow self-scheduling by staff nurses in each unit B. Provide free dinner for nursing staff at the end of the night shift C. Allow staff to request consistent days off D. End visiting hours before the day shift ends so that the night shift nurses do not have to deal with visitors.

A. Allow self-scheduling by staff nurses in each unit C. Allow staff to request consistent days off

Enhancing the quality of work life can be achieved by: A. Encouraging critical thinking and new ideas B. Discouraging a working relationship with one's peers C. Being negative D. Endangering a client's health or safety

A. Encouraging critical thinking and new ideas

Burnout at work can be identified best by: A. Expressions of frustration and powerlessness B. Fatigue and refusal to work double shifts C. Allergic reactions D. A preference for efficiency

A. Expressions of frustration and powerlessness

The RN has just finished a wound irrigation for a client who requires contact precautions. Which of the following pieces of personal protective equipment (PPE) should the nurse remove first? a.Gloves b.Gown c.Face shield d.Mask

A. Gloves

A home health nurse is assessing the safety of a client's home. The nurse should identify which of the following factors as increasing the client's risk for falls? SATA A. History of a previous fall B. Reduced vision C. Impaired memory D. Takes rosuvastatin E. Uses a night light F. Kyphosis

A. History of a previous fall B. Reduced vision C. Impaired memory F. Kyphosis

Actions to address violence in the healthcare workplace include: SATA A. Identifying the factors that contribute to violence and controlling as many as possible B. Allowing the violence to escalate C. Assessing staff attitudes and knowledge regarding responses to violence D. Providing weapons training to those identified as having a potential for physical violence

A. Identifying the factors that contribute to violence and controlling as many as possible C. Assessing staff attitudes and knowledge regarding responses to violence

Which of the following are considered reasonable accommodations for an employee with a disability? SATA A. Modification of the work schedule B. Salary reduction to reflect lower output C. Additional days off and extended vacations D. Adjustment of work procedures

A. Modification of the work schedule D. Adjustment of work procedures

The HHS is charged with protecting the healht of all Americans and providing essential health services. Which of the following HHS quality initiatives is currently under way? A. Post-acute care reform initiative B. National health-care research and quality indicators aimed at helping improve access to care C. NDNQI D. Health IT

A. Post-acute care reform initiative

An effective way to help a diverse staff work together is to: A. Provide equal opportunities for advancement B. Pretend there are no cultural differences C. Promote uniformity in communication styles D. Establish an English-only policy institution wide

A. Provide equal opportunities for advancement

A nurse is caring for a client who has diabetes mellitus and had a morning BG of 285. An AP reports that a client's finger stick BG reading 30 min before lunch is 58. Which of the following actions should the nurse take? A. Recheck the client's BG B. Complete a facility incident report C. Inform the AP to give the client 120 mL of orange juice D. Administer insulin as prescribed

A. Recheck the client's BG

Medical errors account for 250,000 deaths per year. It is estimated that as many as 50% of these errors may be preventable. What steps would you take to avoid a medication error? A. Review the patient's medication administration record during bedside shift report B. Ask your colleagues to get your medication so you can give it on time C. Call the pharmacist D. Review the med admin policy

A. Review the patient's medication administration record during bedside shift report

A nurse manager is developing an orientation plan for newly licensed nurses. Which of the following information should the manager include in the plan? SATA A. SKill proficiency B. Assingment to a preceptor C. Budgetary principles D. Computerized charting E. Socialization into unit culture F. Facility policies and procedures

A. SKill proficiency B. Assingment to a preceptor D. Computerized charting E. Socialization into unit culture F. Facility policies and procedures

A nurse on an acute care unit is caring for a client following a total hip arthroplasty. The client is confused, is moving his leg into positions that could dislocate the new hip joint, and he repeatedly attempts to get out of bed. After determining that restraint application is indicated, which of the following actions should the nurse take? SATA A. Secure the restrain to the frame of the bed B. Get a prescription for restraints from the provider C. Have a family member signs the consent for restraints D. Use a square knot to secure the restraints to the bed E. Ensure that only one finger can be inserted between the restraint and the client

A. Secure the restrain to the frame of the bed B. Get a prescription for restraints from the provider

An incident of sexual harassment as identified by the EEOC is: SATA A. Telling jokes about sexual identity issues B. Separate restrooms C. Providing coffee and doughnuts to the nursing staff D. Demanding a daily kiss for writing a favorable evaluation

A. Telling jokes about sexual identity issues D. Demanding a daily kiss for writing a favorable evaluation

You are a new nurse. The hospital where you work is committed to providing safe, high-quality care. Wich of the following activities would let you know that your organization is a committed to improving patient safety? A. The hospital has a good catch program for staff who recognize errors and near misses B. The hospital subscribes to TJC safety publications C. The hospital measures performance every month, monitors quality indicators, and regularly reports on quality. D. All of the above

A. The hospital has a good catch program for staff who recognize errors and near misses

To achieve safe patient care, a culture of safety must exist. What are characteristics of an organization with a culture of safety? A. Transparency, openness, reporting of errors is rewarded, blame-free environmnent B. Honesty, studying of serious events C. Privacy, reporting of errors appreciated D. Blame-free environment, openness, and reporting of errors is encouraged

A. Transparency, openness, reporting of errors is rewarded, blame-free environmnent

An RN on a medical-surgical unit is making assignments at the beginning of the shift. Which of the following tasks should the nurse delegate to the LPN? A. obtain vital signs for a client who is 2 hr postprocedure following a cardiac catheterization B. Administer a unit of packed RBCs to a client who has cancer C. Instruct a client who is scheduled a discharge in the performance of wound care D. Develop a plan of care for a newly admitted client who has pneumonia

A. obtain vital signs for a client who is 2 hr postprocedure following a cardiac catheterization

A nurse is working with a limited staff because of a severe storm in the area. The facility incident commander has initiated disaster protocols. Which of the following actions should the nurse take? a.Focus on providing care that prevents life-threatening emergencies b.Reinforce discharge teaching to clients c.Instruct the assistive personnel (AP) to focus on clients ADLs d.Stock additional unit supplies

A...focus on providing care that prevents life threatening emergencies

Which of the following procedures and modifications contributes to reducing indoor air pollution? A. Windows that may be opened by staff as needed B. More powerful ventilation systems and air filtration C. Selecting products with more PVC D. Increased use of medical waste incinderators

B. More powerful ventilation systems and air filtration

A nurse is planning to care for a client who requires airborne precautions. Which of the following actions should the nurse take? a.Provide a positive-pressure airflow room b.Wear an N95 respirator mask c.Allow the client to ambulate in the hall d.Stand 1.8 m (6 feet) away from the client

B wear a mask

A nurse discovers that a client was administer an antihypertensive medication in error. Identify the appropriate sequence of steps that the nurse should take using the following actions. A. Call the provider B. Check VS C. Notify the risk manager D. Complete an incident report D. Instruct the client to remain in bed until further noticeuk

B, E, A, D, C

A nurse is preparing an in-service for an annual skills fair at a community medical facility about fire safety. Place the steps in the order in which they should be performed in the case of a fire emergency. a.Confine the fire b.Rescue the clients c.Pull the alarm d.Extinguish the fire

B,C,A,D

A community experiences an outbreak of meningitis, and hospital beds are urgently needed. Which of the following clients should the nurse recommend for discharge? A. 58-year-old man admitted this morning with angina and a history of a coronary artery bypass grafting (CABG) 1 year ago B. 50-year-old adult with type 2 diabetes mellitus being admitted for rotator cuff surgery C. 70-year-old adult admitted yesterday with pneumonia and dehydration D. 65-year-old woman who fell and broke her hip and is scheduled for total hip replacement tomorrow

B. 50-year-old adult with type 2 diabetes mellitus being admitted for rotator cuff surgery

According to NIOSH, a common reaction to a latex allergy is: A. Increased appetite B. Allergic contact dermatitis C. Increased falls D. An increase in violent outbursts

B. Allergic contact dermatitis

The purpose of QI is to continuously improve the capability of everyone involved to provide safe, high-quality patient care. What is important to know about the QI process? A. It is independent of teamwork B. It is data driven approach to improving process C. Common safety indicators are not used to evaluate quality of care D. Opportunities for QI are selected by organization leadership

B. It is data driven approach to improving process

A nurse on a sixth-floor medical surgical unit is advised that a severe weather alert code has been activated. Which of the following actions should the nurse take? (Select all that apply.) A. Draw window shades and close drapes as protection against shattering glass. B. Move beds of nonambulatory clients away from windows. C. Relocate ambulatory clients into the hallways. D. Use the elevators to move clients to lower levels. E. Turn the radio on for severe weather warnings

B. Move beds of nonambulatory clients away from windows. C. Relocate ambulatory clients into the hallways. E. Turn the radio on for severe weather warnings

When evaluating the quality of care, a healthcare organization must consider structures, processes, and outcomes of care delivery. Which of the following is a good example of an organization process? A.Budgeting adequate money for nursing salaries B. Preparing a patient for discharge C. Monitoring for infections D. Increasing times between clinic visits

B. Preparing a patient for discharge

A nurse is observing a newly licensed nurse and an assistive personnel pull a client up in bed using a drawsheet.. Which of the following actions by the newly licensed nurse indicates an understanding of this technique? A. The nurse stands with his feet together B. The nurse uses his body weight to counter the client's weight C. The nurse's feet are facing inward, toward the center of the bed D. The nurse uses the muscle in his back to lift the client off the bed using the drawsheet

B. The nurse uses his body weight to counter the client's weight

Structured care methodologies are A. Nursing tools designed to identify best practices and facilitate standard of care B. used to create a stable set of performance indicators to measure outcomes C. Used to assist employees with wellness and injury prevention D. Helpful when making staffing assignments

B. used to create a stable set of performance indicators to measure outcomes

A surprisingly dangerous job in the US is working A. in a coal mine B. as a window cleaner in NYC C. in a health care facility D. As a police officer

C

A nurse is working with an emergency response team in caring for a group of people who may have been exposed to anthrax while doing farm work, but are not exhibiting manifestation of illness. Which of the following is the appropriate action for the nurse to take? a.Place the clients in isolation b.Initiate client decontamination c.Administer antibiotic therapy d.Treat clients with an antitoxin

C-administer ABO therapy

A colleague tells you "I'm so burned out, I think it's time for me to resign" What can you tell your colleague? A. "you probably need a break fro work. Why don't you ask for a 6 month leave of absence?" B. "Why don't you apply for a position at our rival hospital?" C. "Tell me how you take care of yourself and what you like about your work" D. "We're all burned out. Welcome to the club."

C. "Tell me how you take care of yourself and what you like about your work"

A PN ending her shift reports to the RN that a newly hired AP has not calculated the intake and output for several clients. Which of the following actions should the RN take? A. complete an incident report B. Delegate the task to the PN C. Ask the AP if she needs assistance D. Notify the nurse manager

C. Ask the AP if she needs assistance

The occurrence of sexual harassment may be reported to: A. IHI B. ANA C. EEOC D. CDC

C. EEOC

A nurse is participating in a quality improvement study of a procedure frequently on the unit. Which of the following information will provide data regarding the efficacy of the procedure? A. Frequency with which procedure is performed B. Client satisfaction with performance of procedure C. Incidence of complications related to procedure D. Accurate documentation of how procedure was performed

C. Incidence of complications related to procedure

A nurse enters the room of a client who is on contact precautions and finds the client lying on the floor. Which of the following actions should the nurse take first? A. Call the provider B. Ask a staff member for assistance getting the client back in bed C. Inspect the client for injuries D. Instruct the client to ask for help if he needs to get out of bed

C. Inspect the client for injuries

A nurse is reviewing the hospital's fire safety policies and procedures with newly hired AP. The nurse is describing what to do when there is a fire in a client's trash can. Which of the following information should the nurse include? SATA A. The first step is to pull the alarm B. Use a Class C fire extinguisher to put out the fire C. Instruct ambulatory patients to evacuate to a safe place D. Pull the pin on the fire extinguisher prior to sue E. Close all doors

C. Instruct ambulatory patients to evacuate to a safe place D. Pull the pin on the fire extinguisher prior to sue E. Close all doors

Studying errors and identify how they occur helps organizations improve patient safety. Which category of errors is the most useful in identify and remedying vulnerabilities in an organization? A. Sentinel event B. Adverse event C. Near miss event D. Wrong procedure event

C. Near miss event

¡A nurse is participating in a disaster simulation in which a toxic substance is released into a crowded stadium. Multiple clients are transported to the facility. Which of the following activities would be the lowest priority for the nurse? a.Preventing cross-contamination of clients b.Performing concise client assessment c.Transferring a client to the discharge location d.Maintaining a client tracking system

C. Transferring a client to the discharge location

The family of an older adult client brings him to the emergency department after finding him wandering outside. During the initial assessment, the nurse notes that the client flinches when she palpates his abdomen, yet responds to questions only by nodding and smiling. Which of the following factors should the nurse identify as a likely explanation for the client's behavior? a.He is hard of hearing b.Pain c.Confusion d.Language barrier

C. confusion

Stephanie Beals was a little nervous during her first week of work as a licensed nurse. Distracted by a lead nurse behind her, her hand slipped, and she was stuck by the needle she had just used. What is most important for Stephanie to do? A. Disinfect the site of the neeldlestick B. Apologize to the patient, clean the site, and properly dispose of the needle C. Update her Hep B immunization D. Report the incident and obtain post exposure prophylaxis within 2 hours

D. Report the incident and obtain post exposure prophylaxis within 2 hours

A federal agency that partners with other agencies throughout the nation to investigate health problems, conduct research, implement prevention strategies, and promote safe and healthy environments is known as the: A. FDA B. IOM C. ANA D. CDC

D

Nursing standard of care and the organization's policies and procedures greatly decrease risk in patient safety. Which of the following steps can a nurse take to further reduce risk? A. Submit event or incident reports for near misses B. Follow medication administration policies and procedures C. Always report significant data on care to patients and providers in a timely manner D. All of the above

D

Your new organization is committed to quality patient care. Which of these are considered characteristic of quality healthcare? A. The nurses uuse evidence-based research to guide care delivery B. The nurses are respectful and responsive to their clients' individual preferences C. The nurses perform an independent double check when administering chemo medication D. All of the above

D

A nurse is participating in a biological disaster simulation where citizens are exposed to pneumonic plague. Which of the following isolation precautions should the nurse plan to use while caring for these clients? a.Airborne b.Contact c.Droplet d.Protective

D droplet

A nurse is triaging clients in an urgent care clinic. Which of the following clients should the nurse have the provider care for immediately? a.An adolescent female client who is belligerent and has slurred speech b.A toddler who has a laceration on his forehead and is screaming c.A young adult with a painful sunburn on his face and arms d.A middle age adult man who is diaphoretic and reports epigastric pain

D- urgent vs Nonurgent priority setting

A common ergonomic occupation-related risk in the healthcare environment is: A. Indoor air pollution B. Active shooters C. Nosocomial infection D. Back injuries

D. Back injuries

A new nurse manager has observed several instances of horizontal violence between staff members on her unit, primarily verbal abuse and malicious gossip. What should she do? A. Ignore it because it is not physical violence and will not hurt anyone B. Model this bullying behavior so that staff can see how it affects people C. Keep a log of observed bullying behavior to discuss during the employee's annual evaluation D. Confront the bullying behavior and discuss strategies for responding to it

D. Confront the bullying behavior and discuss strategies for responding to it

OSHA, a federal government agency, is responsible for A. Providing training to handle difficult clients and their families B. Providing research and education training C. Upholding the standards of nursing practice D. Developing and enforcing workplace safety and health regulations

D. Developing and enforcing workplace safety and health regulations

New graduates usually experience a "honeymoon" period at their first job, which is characterized by: A. Extreme criticism from colleagues B. Long hours and low pay C. Feeling undervalued D. Excitement about the new position

D. Excitement about the new position

A nurse is among the first responders to a mass-casualty incident and does not know what type of personal protective equipment (PPE) is needed. Which of the following actions should the nurse take? a.Choose the highest level of protection equipment available b.Wait until the type of equipment is known c.Decontaminate victims before intervening d.Use a dosimeter to measure the level of radiation in the area before intervening

a.Choose the highest level available.

A nurse is working in the emergency room department is assessing a client who recently returned from Nigeria and presented complaining of a fever at home, fatigue, muscle pain, and abdominal pain. Which action should the nurse take next? ● a.Check the client's temperature b.Isolate the client in a private room c.Check a complete set of vital signs d.Contact the primary health care provider

b.Isolate the client in a private room