Management Quiz #9

The female client diagnosed with pancreatic cancer has an advance directive stipulating no CPR. Which intervention should the nurse implement first?

Notify the HCP about the advance directive.

The ICU nurse is caring for a client and notes blood oozing out from under the tegadermz dressing over the IV site, bleeding gums, and blood in the indwelling urinary catheter bag. Which intervention should the nurse implement first?

Notify the HCP.

Which action would be most appropriate for the clinic nurse who suspects another staff nurse of stealing narcotics from the clinic?

Notify the director of nurses immediately.

The female client in the pre-op holding area tells the nurse that she had a reaction to a latex diaphragm. Which intervention should the nurse perform first?

Notify the operating room personnel.

The female nurse is discussing an upcoming surgical procedure with a 76-year-old make client diagnosed with cancer. Which action is an example of the ethical principle of fidelity?

The nurse refuses to disclose the client's personal information to the CNO.

The critical care charge nurse is making client assignments. Which client should the charge nurse assign to the nurse who is pregnant?

The client who is HIS positive and admitted for chest pain R/O MI.

The home health hospice nurse is making rounds. Which client should the nurse assess first?

The client with end-stage heart failure who has increasing difficulty breathing.

Which task should the critical care nurse delegate to the UAP?

Take the client's sterile urine specimen to the lab.

The client was admitted to the orthopedic unit for injuries received during a domestic argument. The client tells the nurse, "I am afraid my husband will kill me if I leave him. It was my fault anyway." Which statement is the nurse's best response?

"Do you have a plan for safety if you go back?"

The client tells the nurse, "I am not sure my surgeon is telling me the truth about my prognosis." The nurse knows the client has terminal cancer but the healthcare provider is not telling the client per the family's request. Which statement is the nurse's best response?

"I think you should talk to your surgeon about your concerns."

The client tells the home health nurse, "My oncologist told me they can't do anything else for my cancer. I don't want my children to know, but I had to tell someone. You won't tell them, will you?" Which statement is the nurse's best response?

"I will not say anything to your children, bu I will contact the home health doctor."

The home healthcare agency director is teaching a class to the aides concerning safety in home health nursing. Which statement by the aide indicates the director needs to re-teach safety information?

"It is alright if I don't wear gloves when touching bodily fluids."

The client diagnosed with breast cancer who is positive for the BRCA gene is requesting advice from the nurse about treatment options. Which statement is the nurse's best response?

"What treatment options has your HCP discussed with you?"

The nurse administered pain medication 30 minutes ago to a client diagnosed with terminal cancer. Thirty minutes after the medication, the client tells the nurse "I don't think you gave me anything. My pain is even worse than before." Which interventions should the nurse implement? Select all that apply.

Attempt to determine whether the client is experiencing spiritual distress. Reposition the client to relieve pressure on the pain site. Call the HCP to request an increase in pain medication.

The client diagnosed with ovarian cancer has had 5 courses of chemo. Which lab data warrant immediate intervention by the nurse?

Absolute neutrophil count of 681 mm/dL.

The graduate nurse is working with the UAP who has been an employee of the hospital for 12 years. However, tasks delegated to the UAP by the graduate nurse are frequently not completed. Which action should the graduate nurse take first?

Address the UAP to discuss why the tasks are not being done as requested.

The nurse identifies a problem of "anticipatory grieving" for a client diagnosed with stage IV ovarian cancer. Which nursing intervention is priority for this client?

Allow the client to verbalize feelings about having cancer.

The infection control nurse notices a rise in nosocomial infection rates on the surgical unit. Which action should the infection control nurse implement first?

Arrange to observe the staff at work for several shifts.

The nurse hung the wrong IV antibiotic for the post-op client. Which intervention should the nurse implement first?

Assess the client for any adverse reactions.

The client diagnosed with sickle cell disease complains of joint pain rated 10 on a pain scale of 1 to 10. Which interventions should the nurse implement first?

Assess the client to rule out complications.

The nurse is called to the room of a male client diagnosed with lung cancer by the client's wife because the client is not breathing. The client has discussed having a DNR order written but has not made a decision. Which interventions should the nurse implement first?

Assess the client's breathing and call a code from the room.

The nurse is caring for a client that is 1 day post-op sigmoid resection and notes bright red bleeding on the midline abdominal incision. Which intervention should the nurse implement first?

Assess the client's vital signs.

The nurse is performing an assessment on a Hispanic client diagnosed with prostate cancer. The nurse notes an irregular-shaped lesion with some scabbed-over areas surrounding the lesion. Which intervention should the nurse implement first?

Assess the lesion by completing the ABCDs of skin cancer.

The nurse administered erythropoietin alpha (Epogen), a biological response modifier, to a client diagnosed with anemia. Which of the following data indicates the client may be experiencing an adverse reaction?

BP 200/124

The nurse is completing a head-to-toe assessment on a client diagnosed with breast cancer and notes a systolic murmur that the nurse was not informed of during report. Which action should the nurse implement first?

Check the chart to determine whether this is the first time a murmur has been identified.

The husband of a client on the surgical unit comes to the desk and asks the nurse, "Wha is my wife's biopsy report?" Which intervention is the nurse's best action?

Check the chart to see whether the client has allowed the spouse to have information.

The client diagnosed with CHF and iron-deficiency anemia is prescribed a unit of packed RBC. Rank the interventions in order of performance.

Check the client's H&H. Have the client sign a permit to receive blood. assess the client's lung sounds and periphery. Administer furosemide (Lasix), a loop diuretic, between units. Return the empty blood bags to the lab.

The older adult client receiving chemo complains that food just doesn't taste like it used to. Which intervention should the medical unit nurse implement first?

Check the client's current weight with the client's usual weight.

The female client who is dying asks to see her son, but the son refused to come to the hospital. Which action should the nurse implement first?

Check with the family to see whether they can discuss the issue with the son.

The client diagnosed with lung cancer has a H&H of 13.4mg/dL and 40.1, a WBC count of 7800, and a neutrophil count of 62%. Which action should the nurse implement?

Continue to monitor the client.

A client diagnosed with AIDS dementia is angry and yells at everyone entering the room. None of the critical care staff want to be assigned to this client. Which intervention would be most appropriate for the nurse manager to use in resolving this situation?

Discuss some possible options with the nursing staff.

The 24-year-old male client diagnosed with testicular cancer is scheduled for a unilateral orchiectomy. Which priority intervention should the clinic nurse implement?

Discuss the importance of sperm banking.

The home healthcare nurse is visiting a female client diagnosed with colon cancer who has had a sigmoid colostomy. The client is crying and tells the nurse that she was told the cancer has spread and she will die very soon. Which intervention should the nurse implement?

Discuss the possibility of being placed on hospice services.

The unit manager on an oncology unit receives a complaint about the care a client received from the night shift nurse. Which action should the unit manager implement first?

Discuss the situation with the client making the complaint.

The charge nurse in a long-term care facility is reviewing the male resident's lab data and notes the following: H&H 13/39, WBC count 5.25 (10^3), platelets 39 (10^3). Which instructions should the nurse give to the UAP caring for the client?

Do not shave the resident with a safety razor.

The staff nurse answers the phone on a medical unit and the caller tells the nurse that he has planted a bomb in the facility. Which action should the nurse implement? Select all that apply?

Do not touch any suspicious object. Try to get the caller to provide additional information. Write down exactly what the caller says.

Which nursing task should the nurse delegate to the UAP?

Empty the Jackson-Pratt drainage tube and record amount.

The 28-year-old female client in the outpatient clinic has been told that her test for HIV is positive. Which interventions should the nurse implement? Select all that apply.

Discuss having regular gynecological exams. Encourage the client to take the highly active antiretroviral therapy (HAART) Teach the client to follow a healthy lifestyle.

The female client with osteoarthritis is 6 weeks post-op for open reduction and internal fixation of the right hip. The home health aide tells the nurse the client will not get in the shower in the morning because she "hurts all over." Which action would be most appropriate by the nurse?

Explain to the aide that the client should get up and take a warm shower.

The staff nurse is caring for a client who was diagnosed with pancreatic cancer during an exploratory laparotomy. Which client problem is priority for post-op day 1?

Fluid and electrolyte imbalance.

The male client who was just told he has 6 months to live tells the nurse, "This can't be happening. I'm too young to die." Which statement is the nurse's best response?

If it's alright with you I am going to sit here with you."

The clinic nurse administered 200,000 units of intramuscular penicillin to a client. Which priority intervention should the nurse implement?

Inform the client to stay in the waiting room for 30 minutes..

Which tasks should the long-term care nurse delegate to the UAP? Select all that apply.

Instruct the UAP to perform the morning care for the clients. Tell the UAP to wash the hair of the female clients.

The charge nurse observes two UAPs arguing in the hallway. Which action should the nurse implement first in this situation?

Instruct the UAPs to stop arguing in the hallway.

The home health nurse is discussing the care of a client with an aide. Which task can the nurse delegate to the aide?

Instruct the aide to assist the client with a shower.

A new graduate nurse is assigned to work with the UAP to provide care for a group of clients. Which action by the graduate nurse is the best method to evaluate whether delegated care is being provided?

Make rounds to see that the clients are being turned.

The clinic RN manager is discussing osteoporosis with the clinic staff. Which activity is an example of a secondary nursing intervention when discussing osteoporosis?

Obtain a bone density evaluation test on a female client older than 50.

The nurse is caring for a client newly diagnosed with protein calorie malnutrition secondary to AIDS writes a nursing problem of "altered nutrition: less than body requirements." Which nursing interventions should the nurse implement? Select all that apply.

Place the client on daily weights. Have the client identify preferred foods. Refer to the dietician.

The female home health aide calls the office and reports pain after feeling a pulling sensation in her back when she was transferring the client from the bed to the wheelchair. Which priority action should the home health nurse tell the aide?

Recommend that she apply an ice pack to the back.

A client had an allergic reaction to penicillin, an antibiotic, and was admitted to the hospital 2 weeks ago. The client is being seen at the clinic for a follow-up visit. Which priority intervention should the nurse implement?

Recommend the client wear a medical alert bracelet.

The client is diagnosed with laryngeal cancer and is scheduled for a laryngectomy next week. Which intervention would be priority for the clinic nurse?

Refer the client to a speech therapist.

The nurse notes the UAP tied a sheet around the client in the chair so the client will not fall out. Which action should the nurse implement first?

Remove the sheet from the client immediately.

The nurse is caring for clients on a skilled nursing unit. Which task should not be delegated to the UAP?

Request the UAP to prepare the client for a wound debridement at the bedside.

The confused client in the critical care unit is attempting to pull out the IV line and the indwelling urinary catheter. Which action should the nurse implement first?

Request the UAP to stay with the client.

The nurse is caring for a client diagnosed with AIDS. Which client problem is priority?

Risk for infection.

A client diagnosed with cancer and receiving chemo is brought to the ED after vomiting bright red blood. Which intervention should the nurse implement first?

Start an IV of normal saline with an 18-gauge IV catheter.

The nurse is assigned to a quality improvement committee to decide on a quality improvement project for the unit. Which issue should the nurse discuss at the committee meetings?

Systems that make it difficult for the nurses to do their jobs.

The primary nurse informs the shift manager that one of the UAPs is falsifying vital signs. Which action should the shift manager implement first?

Take the assigned client's vital signs and compare them with the UAPs results.

The new graduate working on a medical unit night shift is concerned that the charge nurse is drinking alcohol on duty. On more than one occasion, the new graduate has smelled alcohol when the charge nurse returns from a break. Which action should the new graduate nurse implement first?

Talk with the night supervisor about the concerns.

The nurse working in a rheumatology clinic is teaching a 34-year-old female client with RA about the disease-modifying anti rheumatic drug methotrexate. Which information has highest priority?

Teach the client to take measures to ensure she does not become pregnant.

Which task is most appropriate for the surgical nurse to assign to the LPN?

Tell the LPN to administer the aminoglycoside antibiotic to the client.

The charge nurse in the long-term care center is making assignments for LPNs and UAPs on the day shift. Which task if most appropriate to assign to the LPN?

Tell the LPN to administer the tube feeding to the client.

The nurse, a LPN, and the UAPare caring for clients in the critical care unit. Which task would be most appropriate for the nurse to assign/delegate?

Tell the UAP to obtain urine output for the 12-hour shift.

The charge nurse is making assignments on a pediatric unit. Which client should be assigned to the LPN?

The 11-year-old client diagnosed with pneumonia.

The charge nurse is making assignments for the surgical unit. Which client should be assigned to the new graduate nurse?

The 42-year-old client who has just returned to the unit after a breast biopsy.

Which member of the healthcare team should be assigned to a dying client who is having frequent symptoms of distress?

The RN who has experience as a hospice nurse.

The nurse and UAP are caring for a group of clients on a medical unit. Which action by the UAP requires immediate intervention by the nurse?

The UAP massages the client's trochanter when turning the client.

The UAP is preparing to provide postmortem care to a client with a questionable diagnosis of anthrax. Which instruction is priority for the nurse to provide to the UAP?

The UAP should wear a mask, gown, and gloves.

The nurse is caring for clients on an oncology unit is administering medications. Which medication should the nurse administer first?

The anti nausea medication to the male client who thinks he may get sick.

The nurse and LPN are caring for clients on an oncology unit. Which client should be assigned to the LPN?

The client diagnosed with an ovarian tumor weighing 22 pounds who is being prepared for surgery in the morning.

The nurse has received the morning shift report on an oncology unit. Which client should the nurse assess first?

The client diagnosed with breast cancer who is upset and crying.

Which client should the charge nurse assign to the med-surg nurse who is being pulled to work on the oncology unit for this shift?

The client diagnosed with ovarian cancer who is 1 day post-op total abdominal hysterectomy.

The client is 2 days post-op ureterosigmoidostomy for cancer of the bladder. Which assessment data warrants the nurse notifying the HCP?

The client has a low-grade fever and a hard, rigid abdomen.

The nurse is caring for a female client diagnosed with systemic lupus erythematous. Which of the following client-reported data has priority?

The client notices a bright red color in the bedside commode.

The charge nurse is making assignments on a surgical unit. Which client should be assigned to the least experienced nurse?

The client who had a vaginal hysterectomy and still has an indwelling urinary catheter.

The home healthcare agency director is making assignments. Which client should be assigned to the most experienced nurse?

The client who has multiple stage 3 and 4 pressure ulcers on the sacral area.

The nurse is caring for clients on an oncology unit. Which client should the nurse assess first?

The client who has undergone four rounds of chemo and is nauseated.

A nurse and a LPN are caring for clients. Which client should be assigned to the LPN?

The client who is 4 hours post-op bone marrow biopsy.

A nurse and the UAP are caring for a group of clients. Which information provided by the UAP warrants immediate intervention by the nurse?

The client with a biological response modifier who has a temperature 99.2, pulse 68, respirations 24, and BP 198/102.

Which situation would prompt the healthcare team to utilize the client's advanced directive when needing to make decisions for the client?

The client with a head injury who is exhibiting decerebrate posturing.

The client on a medical unit died of a communicable disease. Which information should the nurse provide to the mortuary workers?

The nurse should tell the funeral home the client's diagnosis.

Which staff nurse should the charge nurse in the ICU send to the medical unit?

The nurse who has worked in the unit for 18 months.

Which client lab data should the nurse report to the HCP immediately?

The urinalysis report showing many bacteria in a client receiving chemo.