Leadership Quizes

1

A nurse answering the phone at the nurse's station receives a bomb threat. What should the nurse say? 1. "Where is the bomb and when is it set to explode? 2. "That is not funny, you shouldn't joke about something like that." 3. "Why would you do something like that?" 4. "You sound like you are angry at something, why would you want to kill us?"

2

A nurse asks if a patient who has a a new diagnosis of lung cancer would like medication to help treat nicotine withdrawal symptoms. The patient refuses by saying, "I have smoked since I was 12 years old. I am not going to stop now." What is the appropriate response by the nurse? 1. "You need to stop smoking for us to effectively combat this disease." 2. "Please tell me how you plan on treating this problem." 3. "What are your plans after discharge?" 4. "Do you want to be discharged without treatment?"

4

A postpartum nurse palpates a client's fundus, and notes it is 1 in. (3 cm) above the umbilicus and displaced to the right. Which of the following would be priority nursing actions? 1. Assist to semi-Fowler's position and reassess the fundus. 2. Carefully observe the client for any discomfort. 3. Massage the fundus and express clots. 4. Have the client void and reassess the fundus.

4

After the physician explains the surgery to the client, the nurses provides the client with information about surgery, answers the client's questions, and allows the client to agree or refuse to have surgery. Which of the following ethical principles is best described by the nurse's actions? 1. Nonmaleficence 2. Beneficence 3. Truth telling 4. Autonomy

2

Risk management includes 1. the management of all employees 2. the identification of financial risk 3. oversight of all PI activities 4. improving nursing satisfaction scores

4

The nurse leader who empowers the staff to participate in decision-making activities is exhibiting which of the following leadership styles? 1. Laissez-faire 2. Situational 3. Autocratic 4. Democratic

2

The primary focus of the Joint Commission is which of the following? 1. Remaining within the proposed budget 2. Safe, high-quality patient care 3. Providing employment opportunities 4. Providing a structure for collaboration among employees

1, 2, 4, 5

A nurse is serving on a task force to update the electronic health record. The task force should ensure that revisions of the medical record will: (Select all that apply.) 1. aid in client care. 2. serve as a legal document. 3. have sufficient room for charting nurses' notes. 4. Facilitate data collection for clinical research 5. guide performance improvement 6. be written so the client can understand what is written.

4

A nurse who has just assumed a position as a unit manager is examining her skills fostering interprofessional collaboration on the unit. Which action supports interprofessional collaboration? 1. The manager rounds with each physician daily so the nurses can deal with the patient problems. 2. Keep all of the paper charts in the manager's office so the physicians make contact to obtain them. 3. Make sure that the charge nurse is the facilitator of all interdisciplinary meetings. 4. Encourage team member's referral requests.

1

A small airplane crashes in a neighborhood of 10 houses. One of the victims appears to have a cervical spine injury. A nurse responds to the scene. What should first-aid for this victim include? 1. Establish an airway with the jaw-thrust maneuver. 2. Logroll the victim to a side-lying position. 3. Elevate the feet 6 inches (15.2 cm). 4. Place a cervical collar around the neck.

1

A student nurse asks the nurse, "Why did my advisor recommend an ethics course for me?" Which of the following is the best response by the nurse? 1. "It is the responsibility of nurses to recognize ethical dilemmas in clinical situations." 2. "Ethics must be learned in order to obey the law." 3. "You must have misunderstood because nurses do not have to study ethics." 4. "You may find studying ethics interesting."

2

The National Patient Safety Goals 1. form the basis of all PI activities 2. are a nationwide initiative 3. are mandated by the Institute of Medicine 4. will improve patient safety

1

The astute nurse manager who wishes to empower the nurses on the unit recognizes that strategies must be found to promote their leadership ability. Which of the following supports the nurse manager's knowledge of leadership? 1. Leadership qualities are demonstrated by those in formal and informal management positions. 2. Nurses at all levels of the organizational chart are not responsible for leadership traits. 3. Leadership characteristics are not measurable on performance appraisals. 4. Only top-level managers have the passion, vision, and integrity to demonstrate leadership.

2

Which of the following are examples of national evidence-based practice guidelines? 1. Hospital policy on how to staff a nursing unit 2. AHRQ pressure ulcer treatment guidelines 3. Hospital procedure on how to insert a catheter 4. JC accreditation standards

1

A benefit of accreditation by the Joint Commission is that it 1. leads to improved patient care and demonstrates the organization's commitment to safety and quality. 2. allows for increased financial gain through Medicare and Medicaid reimbursement and offers employee assistance programs. 3. influences the improved design of care processes, creating a nonpunitive environment to enhance error reporting and allow participation in error reporting and analysis. 4. offers an educational off-site survey experience.

2, 4, 5

A client is brought to the emergency department dead on arrival (DOA) from a gunshot wound. The client's family arrives and is escorted to a private area. A multidisciplinary team composed of a physician, nurse, and social worker interacts with the family. All members work together to complete the following tasks. Which are the priority nursing responsibilities? Select all that apply. 1. Explaining the cause of the client's death 2. Providing therapeutic touch and support as needed 3. Arranging disposition of the client's personal belongings 4. Caring for body organs which are appropriate for transplantation 5. Escorting the client's family for viewing of the body

3

A client is scheduled for an elective splenectomy. The last thing the nurse should do before the client goes to surgery is to determine that the client has 1. voided completely. 2. signed the consent. 3. vital signs recorded. 4. name band on wrist.

2, 3, 4

A client with schizophrenia is frequently admitted to a local hospital. The client has identified in a mental health advance directive that the client "does not want to be admitted to ward 4 West". What factors should the nurse admitting this client in a state of acute crisis recognize? (Select all that apply.) 1. A mental health advance directive is not valid after discharge. 2. A mental health advance directive is a legally binding document. 3. A mental health advance directive is not valid for a client in crisis. 4. A client with schizophrenia is eligible to sign a mental health advance directive. 5. A client with schizophrenia is ineligible to sign a mental health advance directive.

2

A client's family just completed a care conference with the health care team. The family has decided to withdraw treatment. What is the nurse's next step? 1. Transfer the client to a hospice floor. 2. Document the decision in the client's electronic record. 3. Contact the pharmacy to remove all medication from the medication administration record. 4. Describe the events of the conference with other family members who visit.

A

A client, who underwent femoral-popliteal (fem-pop) bypass surgery, is scheduled to return from the post-anesthesia care unit. Which staff member should receive this client? A. Registered nurse with one year of experience B. Licensed practical nurse (LPN) with five years of experience. C. Nursing assistant with 15 years of experience D. Charge nurse with 10 years of experience

4

A nurse has discovered a colleague pocketing a partial dose of an opioid despite documenting it as a waste. When confronted, the colleague acknowledges the behavior. What is the nurse's best action? 1. Initiate a dialogue with the colleague about the problem of substance misuse among nurses. 2. Encourage the colleague to seek outside help for substance misuse. 3. Explain to the colleague that this is a serious violation of policy. 4. Report the colleague's actions because of legal and ethical obligations.

2

A nurse is assisting a physician during anesthesia. What is the advantage of epidural anesthesia? 1. It counteracts the effects of conscious sedation. 2. It decreases the risk of gastrointestinal complications. 3. It acts on the parasympathetic nervous system to produce loss of sensation. 4. It prevents clients from remembering the initial surgical period.

2, 3

A nurse is caring for a 14-year-old client who was admitted with cellulitis and has been ordered warm compresses. The nurse delegates the treatment to the unlicensed assistive personnel (UAP). The compress causes a first-degree burn to the area. Which of the following actions should the nurse initiate? Select all that apply 1. Initiate a disciplinary action toward the UAP 2. Complete an incident report regarding the event 3. Notify the healthcare provider of the injury 4. Place cold compresses on the injured area 5. Document the injury indicating that the UAP is liable.

1

A nurse is caring for a client who has atelectasis. What is the nurse's priority intervention to resolve the atelectasis? 1. Implement the use of an incentive spirometer every hour 2. Give increased IV fluids 3. Administer oxygen 4. Obtain arterial blood gas (ABG) levels

2, 3, 5

A nurse is explaining client rights for psychiatric patients to a client who has voluntarily sought admission to an inpatient psychiatric facility. Which rights would the nurse include in the discussion? Select all that apply. 1. Right to select health care team members. 2. Right to refuse treatment. 3. Right to a written treatment plan. 4. Right to obtain disability benefits. 5. Right to confidentiality.

1

A nurse is hired to replace a staff member who resigned. After working on the unit for several weeks, 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 strategies is the manager demonstrating? 1. Avoidance 2. Smoothing 3. Cooperating 4. Negotiating

2, 6, 1, 3, 5, 4

A nurse is leaving a room of a patient who is on contact isolation with a draining wound. Place the items in order for removing the personal protective equipment when leaving the room. 1. Untie the neck ties/remove the neck loop on the gown. 2. Untie the gown at the waist 3. Remove the gown 4. Remove the mask 5. Place the gown in the trash 6. Remove the gloves

D, E

A nurse is making assignments for the unlicensed assistive person (UAP). Which tasks can be safely assigned to UAP? Select all that apply. A. Assisting a client with a chest tube during ambulation. B. Feeding a client with swallowing difficulty C. Showing a client how to use a cane D. Bathing a client with Alzheimer's disease E. Turning a client who has protein malnutrition

2

A nurse is observing a newly licensed nurse and a UAP pull a patient up in bed. Which of the following statements indicates appropriate feedback by the observing nurse? 1. "I noticed you pulled the patient up with your legs apart. For the safety of the patient, and yourself, put your feet together when pulling." 2. "You used your body weight appropriately to counter the patient's weight when pulling the patient up." 3. "You have great body mechanics. I noticed your feet were pointing towards the center of the bed when lifting." 4. "The muscles in your arm are really big, do you lift in the gym?"

B

A nurse manager is delegating the revision of the unit's educational policies to staff nurses. What is the best instructional guidance the nurse manager can offer? A. "Let me know if you need anything." B. "Complete the revision in six weeks."- C. "Give me your suggestions and I'll decide if I like them." D. "Tell me what you think after looking at everything that has been done."

1

A nurse manager is working as part of a quality improvement team focusing on catheter-associated urinary tract infection. As part of the risk assessment and infection surveillance program, the team is evaluating the appropriate use of indwelling urinary catheters. The team identifies the need for corrective action when review of the medical records reveals use of an indwelling catheter for which situation? 1. Checking for residual urine in the bladder 2. Managing urinary incontinence with sacral pressure ulcer 3. Accurately measuring urine output in a client with multiple traumas. 4. Relieving an acute bladder outlet obstruction

4

A nurse on a telemetry unit is caring for a patient who was admitted with chest pain. The patient becomes angry, stating that there is nothing wrong with him and that he is leaving. What statement should the nurse use when talking to the patient? 1. "Let me get the risk manager and they can talk to you." 2. "I am sorry that you are upset, but I need to get the 'against medical advice' form for you to sign first." 3. "I'll call security to wait outside your door if you try to leave." 4. "You came in here with chest pain and until the doctor finds out the reason for that, it is a good idea to stay here so we can treat you immediately."

2

A patient is admitted to the unit who has bacterial meningitis, What is the priority nursing action? 1. Protecting self and others from possible infection 2. Administering intravenous antibiotics 3. Reducing environmental stimuli 4. Avoiding lifting the client's head

1

A patient is admitted with a potassium level of 2.8 mEq/L. Which of the following assessments findings is most likely to be seen in this patient? 1) Irregular pulse and shallow respirations 2) Respiratory rate of 16/minute and two loose stools 3) Pink nail beds and an ECG that shows normal sinus rhythm 4) Elastic skin turgor and vomiting a small amount of bile-colored emesis

3

A patient who had a transurethral resection of the prostate (TURP), has a three-way indwelling urinary catheter with continuous bladder irrigation. In which circumstance should the nurse increase the flow rate of the continuous bladder irrigation? 1. When drainage is continuous but slow. 2. When drainage appears cloudy and dark yellow. 3. When drainage becomes bright red. 4. When there is no drainage of urine and irrigating solution.

2

A sentinel event 1. is the basis for all PI 2. must be reported to The Joint Commission 3. evidences poor patient care 4. is a medical error

1

A young female client with a history of sickle cell disease reports abdominal pain. What is the priority action by the nurse? 1. Obtaining a history of the sequence of symptoms 2. Keeping the patient nothing by mouth (NPO) 3. Administering IV fluids 4. Preparing the client for a computed tomography (CT) scan of the abdomen

1

At the completion of a shift, the nurse is participating in the nursing handoff during the transition from day shift to evening shift. At the time of shift change, there are not enough evening nurses to meet mandated nurse-client ratios. What is the nurse's best action? 1. Document the situation, and remain on the unit until sufficient staffing levels are achieved. 2. Document the number of nurses on the unit at shift change before leaving the unit. 3. Document efforts to find short-term replacement staffing before leaving the unit. 4. Temporarily delegate nursing care to unlicensed care providers.

4

During her morning assessment, a nurse notes that a client is awake, alert, and has severe dyspnea; his respirations are 34 breaths/minute and labored. Oxygen saturation is 79% on 3 L of oxygen. The nurse notes that the client's chart includes his living will. When considering best practice, the nurse should: 1. follow the living will order and stop all treatments. 2. increase the oxygen flow rate to 4 L, but avoid initiating other interventions. 3. call the client's family and ask what they think is best. 4. initiate potentially life-prolonging treatment unless the client refuses.

3, 5

Fluoxetine has been prescribed for a client who has depression. Which symptoms would alert the nurse to adverse reactions to this medication? Select all that apply. 1. Sleepiness 2. Fever 3. Anxiety 4. Tremors 5. Diaphoresis

4

Following a sentinel event, which step would be initiated first? 1. No action required 2. Taking corrective action on personnel 3. Reporting the event to legislative authorities 4. Immediate investigation

1, 3, 6

Nurses note: 2 year old brought to emergency department by maternal grandparents, concerned about multiple physical injuries. Grandparents report that child has multiple bruises on torso and arms which was reported as injuries from a recent fall by parents. The emergency room nurse documents progress notes in the above note. When completing the documentation, which information would be included? Select all that apply. 1. Diagram of site of injuries 2. Information about parent's mental health 3. Description, including color and measurement, of injuries 4. Quotes from toddler of what happened 5. Documentation of notifying Children and Youth Services 6. Objective findings from a head to toe assessment

3

The charge nurse finds the mother of a child with a chronic bladder condition requiring clean intermittent catheterization (CIC) visibly upset. The mother states, "That other nurse said parents are not allowed to perform CIC in the hospital because of increased infection risk." The charge nurse should tell the parent: 1. "Your child is exposed to additional bacteria in the hospital that makes CIC unsafe." 2. "You can catheterize your child as long as you use sterile technique." 3. "You can use CIC on your child. I will talk with your nurse to clarify the policy." 4. "I can tell you are having a conflict with this nurse. I will switch assignments."

2

The charge nurse observes that a nurse caring for a very sick infant is making inappropriate remarks and acting bizarrely. What is the first action the charge nurse should take? 1. Report this nurse to the supervisor. 2. Remove this nurse from the client assignment. 3. Call security. 4. Talk with the nurse to determine why this behavior is occurring.

1

The electronic health record may include 1. medication order entry 2. patient statistics 3. an incident report 4. patient census data

3

The expected outcome for a patient with a new diagnosis of type 2 diabetes is "Patient will describe appropriate actions when using the prescribed medications". Which statement by the patient indicates that the expected outcome has been met? 1. "I will mix insulin glargine with insulin lispro at bedtime." 2. "I will take insulin until my blood sugar levels are normal." 3. "I will test my glucose level before meals and use sliding scale insulin." 4. "I will take my medications between meals for maximum effect."

2

The home health nurse is assessing a client and determines that she has an unsteady gait. The client tells the nurse that she has a history of falls. Which nursing action represents an advocacy role for the home health nurse? 1. Listening to a client express feelings of frustration over increasing limitations. 2. Contacting a health care equipment resource to rent a walker for the client to use. 3. Instructing the client to contact a senior day care service. 4. Reassuring the client that using a walker will prevent falls in the future.

1, 2, 3, 4

The nurse in an emergency department reports there is a possibility of having had direct contact with blood of a client who is suspected of having HIV/AIDS. The nurse requests that the client have a blood test. Consent for human immunodeficiency virus (HIV) testing can only be completed when which circumstances are present? Select all that apply. 1. An emergency medical provider has been exposed to the client's blood or body fluids. 2. Testing is prescribed by a health care provider (HCP) under emergency circumstances. 3. Testing is ordered by a court, based on evidence that the client poses a threat to others. 4. Testing is done on blood collected anonymously in an epidemiologic survey. 5. A health care provider (HCP) who is taking care of a client suspected of having HIV/AIDS requests a blood test.

2, 4, 5

The nurse is caring for a client who had an open cholecystectomy 24 hours ago. The client's vital signs have been stable for the last 24 hours, but the client now has a temperature of 101.1 F (38.4 C), a heart rate of 116 beats/min, and a respiratory rate of 26 breaths/min. Using SBAR communication, which of the following recommendations should the nurse make when calling the physician? Select all that apply. 1. Continue to check vital signs every 4 hours. 2. Draw stat blood cultures x 2. 3. Prepare for a CT scan of the abdomen. 4. Start broad-spectrum IV antibiotics 4 hours after blood cultures are drawn. 5. Draw CBC, CRP, ESR, UA with culture and sensitivity if indicated.

C, D

The nurse is making assignments for the next shift. Which client can be assigned to a licensed practical nurse/licensed vocational nurse (LPN/LVN)? Select all that apply. A. A client who just had coronary artery bypass graft (CABG) B. A client who needs initial admission assessment C. A client who needs assistance with colostomy irrigation D. A client who is receiving glargine subcutaneously E. An LPN/LVN can administer subcutaneous injections. F. A client who has C3 to C5 spine injury

2

The nurse is monitoring a client, who is six hours post embolectomy, for an acute arterial occlusion of the left leg. When a Doppler ultrasound fails to detect a pedal pulse, the nurse notifies the surgeon who requests that the client be prepared for immediate surgery. The client refuses to consider additional surgery. What is the nurse's initial intervention? 1. Reinforce the risks of not having the surgery 2. Notify the provider immediately 3. Notify the nursing supervisor 4. Record the client's refusal in the nurses' notes

1

The nurse manager introduces the staff to a new organizational policy and procedural changes for administering blood products. According to Lewin's model of implementing change, which of the following steps of the change process is the nurse manager addressing? 1. Unfreeze 2. Move 3. Refreeze 4. Evaluate

2

The nurse manager on the orthopedic unit evaluates a new staff nurse on the night shift as a "born leader", based on which of the following true leadership qualities? 1. Having incomplete intake and output records on the night shift was a problem; records have been consistently complete since the new staff nurse arrived. 2. The new staff nurse has scheduled staff journal club discussions once a month to increase current knowledge about client care issues. 3. The new staff nurse always works overtime when asked by a the nurse manager. 4. Incomplete shift counts for medications was first noticed by the new staff nurse.

1, 4

To ensure safe postoperative care of a client after a total hip arthroplasty, which actions are most appropriate for the nurse to perform? Select all that apply. 1. Limit movements resulting in internal rotation and adduction of the affected hip. 2. Use a pillow under the knees to prevent hip flexion. 3. Reduce extension and hyperextension of the affected hip. 4. Teach the client not to cross their legs. 5. Elevate the client's legs above the level of the heart.

3

Which of the following should the nurse manager include in staff development classes related to ethical decision making? 1. The practice of ethics is the philosophy of individual opinion and values. 2. Ethical decisions made in client care are based on the opinion of the client and family. 3. Ethical decision making is based on knowledge, facts, and a strong commitment to right and wrong. 4. Ethical decision making in client care can only be made by an interdisciplinary team.

2

While the nurse is transferring a confused client from the chair to the bed, the client bites the nurse on the arm. Out of frustration, the nurse slaps the client across the face, leaving a large bruise. The nurse's behavior is reported to the nurse manager. What is the most appropriate action for the nurse manager to take? 1. Reprimand the nurse for the outburst of abusive behavior. 2. Support the claim of battery brought by the client's family. 3. Suspend the nurse from work for negligent behavior. 4. Send the nurse to an anger management workshop.