MS4: Exam 4 Practice

A nurse is providing teaching for new parents on safe sleeping recommendations to reduce the risk of sudden infant death syndrome (SIDS). Which of the following instructions should the nurse include? A. "Room sharing is recommended while the infant sleeps." B. "Bundle the infant snugly in 2 blankets at bedtime." • c. "Only use bumper pads that can be securely attached to the crib rails." • D. "The side-lying position is safest for infant sleeping."

A. "Room sharing is recommended while the infant sleeps."

A nurse is delegating a client care task to an assistive personnel (AP). Which of the following directions should the nurse give the AP? A. "This client needs to ambulate using a walker three times today." B. "Please record strict intake and output for this client." C. "This client needs to have blood glucose monitoring before each meal." D. "Please obtain vital signs from all the clients to whom you are assigned today."

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

A nurse is preparing a client for discharge. The client states, "My partner hurts me. I don't want to go home." Which of the following actions should the nurse take? A. Refer the client to social services for assistance in seeking safe housing B. Delay the discharge until the client's partner can be interviewed C. Ask the client to document any further violence for the authorities D. Contact the facility security officer to escort the client to the vehicle

A. Refer the client to social services for assistance in seeking safe housing

A charge nurse on a medical-surgical unit is assigning client care to the upcoming shift. Which of the following tasks should the nurse delegate to an assistive personnel (AP)? (Select all that apply.) A. Performing colostomy care B. Measuring a client's intake and output C. Interpreting a client's laboratory values following surgery D. Providing postmortem care to a client E. Checking nasogastric tube patency

B. Measuring a client's intake and output D. Providing postmortem care to a client

A nurse is administering medications to a client who is recovering from a stroke and has right-sided paralysis. The nurse places the client's medications on the left side of the mouth and administers pills one at a time. Which of the following ethical principles is the nurse displaying? A. Autonomy B. Nonmaleficence C. Fidelity D. Justice

B. Nonmaleficence

A nurse suspects that a coworker is under the influence of alcohol. Which of the following behaviors in the workplace are consistent with substance use disorder? (Select all that apply.) A. Taking extended lunch periods and breaks B. Calling in sick frequently on Mondays or Fridays C. Expressing frustration with work assignments D. Demonstrating decreased concern about personal appearance and grooming E. Using excessive amounts of cologne or mouthwash

A. Taking extended lunch periods and breaks B. Calling in sick frequently on Mondays or Fridays D. Demonstrating decreased concern about personal appearance and grooming E. Using excessive amounts of cologne or mouthwash

A nurse is discussing with a newly licensed nurse about how to obtain informed consent from a client who is scheduled to undergo an epidural procedure. Which of the following ethical principles should the nurse include in the teaching? A. Beneficence B. Autonomy C. Paternalism D. Justice

B. Autonomy

A nurse manager believes that a nurse is taking breaks that are too frequent and lengthy. Which assertive statement should the charge nurse use to initiate a discussion of the issue? • A. "I understand you are allowed to take scheduled breaks during each shift, but you are taking more than the number allocated. Let's set a time when we can discuss this behavior. B. "You are taking more breaks during each shift than hospital policy allows. You will need to take only the number of breaks specified and ensure you are back on time." C. "You have been taking too many breaks during each shift and do not return on time after your break. I will have to make a formal note about this issue that will be reflected on your next performance appraisal." D. "Why do you take so many breaks? Are you aware there is a policy that designates how many breaks you can take?"

A. "I understand you are allowed to take scheduled breaks during each shift, but you are taking more than the number allocated. Let's set a time when we can discuss this behavior.

A nurse manager calls a meeting of the unit's staff members to discuss cost-containment issues. The nurse manager has asked for staff input regarding strategies to help reduce costs. Which of the following types of leadership is the nurse manager using? A. Autocratic •B. Democratic C. Laissez-faire • D. Moral

B. Democratic

A nurse is talking with a family member who is unhappy about the care his mother is receiving. Which of the following responses should nurse make? A. "Can you give me a specific example of care that caused dissatisfaction?" B. "Your mother has a lot of complex medical conditions." C. "We'll talk later when you have calmed down." D. "We're very busy with all the clients on this unit."

A. "Can you give me a specific example of care that caused dissatisfaction?"

A nurse manager establishes staff nurse committees to address unit issues, institutes an open-door policy for speaking about concerns, and supports professional staff development. Which of the following leadership styles is this nurse manager displaying? A. Laissez-faire B. Democratic C. Autocratic D. Transactional,

B. Democratic

After a disaster plan is enacted, a nurse in a pediatric unit is asked to prepare a list of clients who can be discharged home due to a local incident involving many children. Which of the following clients should the nurse place on the potential discharge list? (Select all that apply.) A. A preschooler with asthma who has scattered wheezes that resolve with PRN albuterol B. A school-age child with a femur fracture in an external fixation device whose pain is controlled with PRN oral codeine C. An adolescent client who is developmentally delayed, has a PICC line, and needs 6 more weeks of antibiotics D. A toddler with a ventricular septal defect and bronchiolitis who is on 28% oxygen by oxyhood E. An adolescent client who is 1 day postoperative following scoliosis repair and is on a PCA pump

A. A preschooler with asthma who has scattered wheezes that resolve with PRN albuterol B. A school-age child with a femur fracture in an external fixation device whose pain is controlled with PRN oral codeine C. An adolescent client who is developmentally delayed, has a PICC line, and needs 6 more weeks of antibiotics

What is involved in systematic thinking? A. Being able to consider the "big picture" beyond the needs of your unit B. Considering what nursing tasks need to be completed before the next medication pass C. Focusing on the number of patients each nurse is assigned, unrelated to patient acuity D. Refusing to come to staff meetings on your day off

A. Being able to consider the "big picture" beyond the needs of your unit

What is the most important component of role transition? A. Clear delineation of role expectations and accountabilities B. A supportive manager C. A detailed position description D. Orientation

A. Clear delineation of role expectations and accountabilities

A nurse is participating in an ethics committee meeting about a client who has a history of alcohol use disorder and needs a liver transplant. Which of the following actions should the committee take first? A. Collect information related to the issue. B. Consider the possible choices of action. C. Make a decision regarding transplant recommendation. D. Justify the recommendation for or against a transplant.

A. Collect information related to the issue.

A nurse is caring for a group of clients on a medical-surgical unit. Which of the following tasks should the nurse delegate to an assistive personnel (AP)? (Select all that apply.) A. Collecting a stool specimen B. Providing instructions about using a spirometer C. Measuring oral intake D. Providing postmortem care E. Changing a sterile dressing

A. Collecting a stool specimen C. Measuring oral intake D. Providing postmortem care

A nurse discovers that the wrong medication was given to a confused client who answered to the name the nurse stated when entering the room. The provider is notified and reports that the medication the client received will not cause any harm. Which of the following actions should the nurse take? A. Complete an incident report documenting the occurrence. B. Make a note in the client's medical record that an incident report was completed. C. Request that another nurse administer medications to this client for the remainder of the shift. D. Report the medication error to the Joint Commission.

A. Complete an incident report documenting the occurrence.

A nurse manager is evaluating the time-management strategies of a newly licensed nurse on the pediatric unit. Which of the following actions taken by the nurse are effective time-management strategies? (Select all that apply.) A. Completing one task before beginning another task B. Documenting client care at the end of the shift C. Taking time to plan care at the beginning of the shift D. Completing more time-consuming tasks at the end of the shift E. Mentally visualizing a procedure prior to gathering equipment

A. Completing one task before beginning another task C. Taking time to plan care at the beginning of the shift E. Mentally visualizing a procedure prior to gathering equipment

A nurse is planning care for a group of clients. Which of the following actions should the nurse plan to take? A. Delegate the administration of an intermittent tube feeding to a licensed practical nurse (LPN) B. Assign an assistive personnel (AP) to monitor a client's dressing for evidence of bleeding C. Ask an AP to explain to a client how to empty a urinary leg bag D. Delegate the administration of a unit of packed RBCs to a client to an LPN

A. Delegate the administration of an intermittent tube feeding to a licensed practical nurse (LPN)

A nurse manager is planning staff development activities for the unit's new unlicensed assistive personnel (UAP). Which of the following activities should the nurse manager perform first? A. Determine the leaming needs of the UAPs B. Administer a skills pretest to the new UAPs C. Provide the new UAPs with a performance checklist D. Ask the UAPs about any weaknesses they may have

A. Determine the learning needs of the UAPs

A charge nurse in an emergency department is making assignments for an assistive personnel (AP) during a shift with unexpected staff absences. Which of the following assignments should the charge give to a float AP from the medical-surgical unit? A. Escorting clients from the emergency department to other areas of the facility for tests B. Sitting at the reception desk answering telephones and directing clients C. Restocking the examination rooms after each client is discharged D. Shadowing an.AP who is regularly assigned to the emergency department

A. Escorting clients from the emergency department to other areas of the facility for tests

A charge nurse is preparing assignments for the upcoming shift. Which of the following tasks should the charge nurse delegate to an assistive personnel (AP)? A. Perform a simple dressing change. B. Interpreting a client's blood glucose reading C. Providing advice when speaking to a client's family member on the phone D. Determining the effectiveness of a client's urinary catheter

A. Perform a simple dressing change.

An RN is preparing assignments for the upcoming shift. Which of the following tasks should the charge nurse delegate to a licensed practical nurse (LPN)? A. Performing tracheostomy suctioning for a client who is stable B. Preparing an admission assessment for a client who is preoperative C. Creating a plan of care for a client who has COPD D. Interpreting a client's digoxin level

A. Performing tracheostomy suctioning for a client who is stable

A nurse is writing a goal for a client's reaction following the administration of a medication. This action should take place during which of the following phases of the nursing process? A. Planning B. Evaluation C. Analyzing D. Assessment

A. Planning

A nurse is providing teaching about a living will for a client who has end-stage breast cancer. Which of the following pieces of information should the nurse include in the teaching? A. The client has the right to change the living will at any time. B. The client should be certain of the decision because the document establishes guidelines for refusing resuscitation. C. A durable power of attorney is required with a living will. D. The handwritten living will is not a legal document and cannot be included in the client's medical record.

A. The client has the right to change the living will at any time.

A nurse manager notes that a full-time nurse has been absent from work 6 times over the last 6 weeks. Using a non punitive approach, which of the following actions should the nurse manager take? A. Verbally remind the employee about the facility's employment standards. B. Recommend that the employee review the facility's policy regarding absences C. Inform the employee in writing about the facility's employment policy.• D. Ask the employee for a written action plan after discussing the reasons for these absences.

A. Verbally remind the employee about the facility's employment

Which of the following situations should the charge nurse include as an example of the ethical principle of veracity? A. a nurse truthfully answers the client's questions about upcoming chemotherapy B. a nurse stops inserting an NG tube when the client refuses the procedure C. A nurse provides the same amount of time to all clients regardless of condition D. a nurse reports an assistive personnel who transfers a client without using a gait belt

A. a nurse truthfully answers the client's questions about upcoming chemotherapy

a nurse is planning care for several clients. which of the following clients should the nurse refer to a case manager? A. client has neurological deficit following stroke B. married female who has delivered a full-term newborn C. Client is postoperative following cholecystectomy D. child who has a fracture of the dominant arm

A. client has neurological deficit following stroke

A nurse recieves change of shift report and delegates several tasks to an assistive personnel on the team. Which of the following tasks should the nurse instruct AP to perform first? A. obtain the morning capillary blood glucose tests B. bathe the client scheduled for physical therapy at 0900 C. Distribute the breakfast trays D. fill pitchers with fresh water and ice

A. obtain the morning capillary blood glucose tests

a nurse is teaching a group of newly licensed nurses about violations of client rights. Which of the following examples of a violation of client rights should the nurse include in the teaching? A. A client who is confused and recovering from abdominal trauma has mitten restraints placed to prevent disruption of an abdominal wound. B. A client who has schizophrenia is placed in the seclusion room of the psychiatric unit for making frequent outbursts of obscenities directed at nurses of the opposite sex. C. A health care proxy releases the medical records of a client to a long-term care facility for a placement evaluation. D. The parents of a 16-year-old who has gunshot wounds decide to limit their child's visitors to family members only.

Answer: B. A client who has schizophrenia is placed in the seclusion room of the psychiatric unit for making frequent outbursts of obscenities directed at nurses of the opposite sex.

A nurse from a facility's float pool receives an assignment to float on a nursing unit. The float nurse tells the charge nurse that she has never worked on this unit before. How should the charge nurse respond? A. "I'll be sure to give you an easy assignment so you won't have any difficulty adjusting to our unit." B. "I will assign you to work with a registered nurse on the unit who is experienced and will act as a resource for you." C. "Don't worry about that. Come find me if you have any questions, and I will try to help." D. "T'll call the supervisor and ask if another float nurse is working who has experience with our unit."

B. "I will assign you to work with a registered nurse on the unit who is experienced and will act as a resource for you."

A nurse is planning care for a client following a coronary arterial bypass graft procedure. The nurse places a referral for a case manager to visit the client. Which of the following pieces of information should the nurse share with the client about the role of a case manager? A. "The case manager will provide your direct care for the remainder of your stay in the facility." B. The case manager will coordinate and plan your care while you recover from your surgery." c. "The case manager will meet with you on the day before your scheduled discharge date." • D. "The case manager is responsible for completing your insurance claim forms."

B. "The case manager will coordinate and plan your care while you recover from your surgery."

A charge nurse is performing a quality-assurance audit on the documentation of several clients' charts. Which of the following documentation items should the charge nurse identify as a correct entry in the client's medical record? A. "The client appeared angry when family members were visiting." B. "The client ambulated for 10 min three times during the shift." •c. "The client seemed to be upset about the diagnosis." • D. "An incident report was completed when the client fell at 1000."

B. "The client ambulated for 10 min three times during the shift."

A group of nurses on a telemetry unit informs a nurse manager of a need to update the cardiac monitoring system to improve arrhythmia detection. Which of the following responses should the nurse manager make? A. "This purchase will require the completion of a variance analysis." B. "This purchase will need to be addressed in the capital budget plan for the unit." C. "This purchase will result in a reduction in the operating budget." D. "This purchase can be reimbursed by Medicare funds, as clients who use Medicare will benefit from the equipment."

B. "This purchase will need to be addressed in the capital budget plan for the unit."

A nurse is delegating tasks to an assistive personnel (AP) for the care of a group of clients. Which of the following directions should the nurse provide? A. "Take the temperature of the client in room 200." B. "Transport the client in room 203 to the radiology department at 1000." C. "Obtain the vital signs of the client in room 205 when he returns from surgery." D. "Contact the provider of the client in room 208 regarding her decreased hemoglobin level."

B. "Transport the client in room 203 to the radiology department at 1000."

A charge nurse is making shift assignments for a team that includes RNs, licensed practical nurses (LPs), and assistive personnel. Which of the following clients should the nurse assign to an LPN? A. A client who was just admitted by the unit staff for recurring angina B. A client who has emphysema and pneumonia and is receiving oxygen C. A client who has breast cancer and is receiving chemotherapy D. A client who was just admitted by the unit staff for a cerebrovascular accident

B. A client who has emphysema and pneumonia and is receiving oxygen

A charge nurse is making assignments for an oncoming shift. Which of the following clients should the charge nurse assign to a licensed practical nurse (LPN)? A. A client who is to be discharged with a peripherally inserted central catheter (PICC) line B. A client who is disoriented and awaiting a transfer to a long term care facility C. A client who is 16 hours postoperative following a total laryngectomy D. A client who is newly admitted for abdominal pain of unknown origin

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

A charge nurse is evaluating conflict resolution between two staff nurses. Which of the following conflict-resolution styles is an example of one nurse putting aside personal goals to satisfy the other nurse? A. Avoidance B. Accommodation C. Compromise D. Collaboration.

B. Accommodation

A nurse enters the room of an older adult client and finds him attempting to crawl over the side rail of his bed. Which of the following actions should the nurse take? A. Tell the client that he will be put in restraints if he attempts to get out of bed again. B. Ask an assistive personnel to sit with the client. C. Remind the client to stay in bed. D. Restrain the client immediately to prevent self-harm.

B. Ask an assistive personnel to sit with the client.

A nurse is working with an assistive personnel (AP) who appears to be under the influence of alcohol during the night shift. Which of the following is the priority action for the nurse? A. Confront the AP regarding alcohol use and remove him from client care. B. Ask the nursing supervisor to observe the AP and validate these suspicions. C. Document observations made about the AP's behavior in a factual manner. D. Report the incident to the nurse manager in the morning. Correct Answer: B. Ask the nursing supervisor to observe the AP and validate these suspicions.

B. Ask the nursing supervisor to observe the AP and validate these suspicions.

A nurse is delegating a task to an assistive personnel (AP). The AP is to transfer a client who has a below-the-knee amputation from a bed to a wheelchair. The AP has never transferred a client with an amputation before. Which of the following actions should the nurse take? A. Provide the AP with a manual on how the transfer should be done. B. Assist the AP after he has practiced the transfer. C. Transfer the client while the AP observes. D. Ask another AP to transfer the client.

B. Assist the AP after he has practiced the transfer.

A nurse has several tasks to complete while preparing a client scheduled for surgery. Which of the following tasks can the nurse delegate to an assistive personnel (AP)? A. Verify the client's list of allergies in the medical record B. Assist with placing the client onto the stretcher for transport to the surgical suite C. Complete the preoperative checklist for the client D. Call to inform the provider about the client's preoperative elevated blood glucose level

B. Assist with placing the client onto the stretcher for transport to the surgical suite

A nurse is making a client's bed and finds a capsule of medication in the sheets. Which of the following actions by the nurse is consistent with safe nursing practice? (Select all that apply.) A. Administer the medication to the client. B. Notify the provider. C. Complete a variance report. D. Document the finding in the client's electronic medical record. E. Place the medication back in the medication drawer.

B. Notify the provider. C. Complete a variance report.

A charge nurse is planning an in-service training session about client advocacy with a group of staff nurses. Which of the following situations should the nurse include as an example of client advocacy? (Select all that apply.) A. Discussing treatment options with a client who was diagnosed with pancreatic cancer B. Notifying the provider when a client has questions about the procedure C. Helping a client make a list of questions to ask the provider D. Clarifying the dosage of a medication prescribed for a client who has impaired liver function E. Carrying out the end-of-life wishes outlined in the living will of an older adult client who has end-stage renal disease

B. Notifying the provider when a client has questions about the procedure C. Helping a client make a list of questions to ask the provider D. Clarifying the dosage of a medication prescribed for a client who has impaired liver function E. Carrying out the end-of-life wishes outlined in the living will of an older adult client who has end-stage renal disease

Which statement is true regarding complexity theory? A. Complexity theory is used to predict the health and illness trajectory of critically ill patients. B. Nurses can understand the dynamic nature of health care processes using complexity theory. C. The need for additional staff can be justified based on complexity theory. D. Complexity theory is used to explain the relationships among leading, managing, and following.

B. Nurses can understand the dynamic nature of health care processes using complexity theory.

A nurse in the emergency department is preparing to obtain informed consent for surgery from a client who received a meperidine hydrochloride IV during transport from a rural hospital. Which of the following actions should the nurse take to obtain consent for surgery? A. Obtain consent from the client. B. Obtain consent from a relative of the client. C. Consent is implied because the client agreed to be transported to the emergency department. D. Delay the surgery until the medication has been metabolized.

B. Obtain consent from a relative of the client.

A nurse is preparing to attend a care plan conference for a client who has severe burns. Which of the following criteria should the nurse identify as part of an effective conference? A. The planning process for the conference is centered on the nursing staff. B. Other health care professionals are in attendance at the conference. C. Controversial opinions regarding the plan of care are not tolerated during the conference. D. The conference is focused on a discussion of the client's health care issues with minimal attention to resolving them.

B. Other health care professionals are in attendance at the conference.

Which best demonstrates the concept of followership? A. Completing the tasks associated with your patient assignment without deviation with the intent of receiving praise from your manager B. Preparing for a committee meeting by reviewing the agenda and supplemental materials, so that you can be an active participant in the meeting C. Assessing a clinical situation and following a set of guidelines in order to delegate tasks to unlicensed personnel D. Administering medications to patients in conjunction with other nursing actions in order to make effective use of your time

B. Preparing for a committee meeting by reviewing the agenda and supplemental materials, so that you can be an active participant in the meeting

A nurse in a provider's office observes a newly licensed nurse taking a client's health history while in the waiting area. Which of the following actions should the nurse take? A. Continue to observe the nurse B. Speak to the nurse immediately in private C. Consider using the same practice to make efficient use of time and office space D. Report the nurse's actions to the provider

B. Speak to the nurse immediately in private

A nurse is part of a facility committee charged with developing and implementing new documentation forms. The nurse should recognize which of the following factors as a potential restraining force for implementing this change? A. Approval of the forms by the nursing administration B. Staff members' resistance to learning new forms of documentation • C. Recognition of the facility unit that completes the implementation first • D. Development of high-quality monitoring tools for compliance with new documentation

B. Staff members' resistance to learning new forms of documentation

A charge nurse is providing teaching to a new staff nurse about the management of a team consisting of a licensed practice nurse (LPN) and assistive personell (AP). which of the following pieces of information should the charge nurse include in the teaching? A. The LPN can delegate the task of teaching a client about foot care to the AP B. The LPN should be familiar with the task she plans to delegate C. The person who accepts the delegated task also assumes accountability for the task D. The LPN can delegate an initial assessment of a clinet to the LPN

B. The LPN should be familiar with the task she plans to delegate

Nurses were long viewed by physicians, legislators, the media, and others as powerless because nurses: A. declined to participate in political activities in the earliest years of the profession in the United States. B. as women were subject to control by medicine and other paternalistic groups; women had limited legal rights in late 19th-century America. C. and nursing leaders in the mid-20th century did not wish to be viewed by those outside of nursing as pushy or demanding. D. were subject to nursing practice acts that limited their ability to take political action.

B. as women were subject to control by medicine and other paternalistic groups; women had limited legal rights in late 19th-century America.

A nurse is preparing to teach the health care team about the concept of critical pathways. Which of the following statements about the purpose of a critical pathway should the nurse plan to include? A. "A critical pathway is a plan of care specific to the nursing interventions necessary for client care." B. "A critical pathway is a tool that legally binds the health care facility to provide services as outlined." C. "A critical pathway is a multidisciplinary tool that guides client care and bases outcomes on an externally imposed timeline." D. "A critical pathway is a plan that may be the same for several similar diagnoses."

C. "A critical pathway is a multidisciplinary tool that guides client care and bases outcomes on an externally imposed timeline."

A nurse is teaching a newly licensed nurse about advanced directives. Which of the following statements by the newly licensed nurse indicates an understanding of this teaching? A. "Clients are required to complete an advance directive prior to discharge." B. "If the client has a health care proxy, he/she is no longer consulted for health care decisions." C. "I will assess the client's understanding of life-sustaining measures." D. "I will ask the next of kin if I should honor the client's advance directive."

C. "I will assess the client's understanding of life-sustaining measures."

A charge nurse on a medical-surgical unit is making client assignments for the oncoming shift. Which of the following clients should the charge nurse assign to a licensed practical nurse (LPN)? A. A client who requires an updated plan of care following a diagnosis of cancer B. A client who is postoperative following a total hip replacement and requires discharge teaching C. A client who has a prescription for irrigation of an indwelling urinary catheter D. A client who has just arrived from PACU and requires a head-to-toe assessment

C. A client who has a prescription for irrigation of an indwelling urinary catheter

A nurse manager is participating in a root cause analysis following a sentinel event on the unit. Which of the following statements defines the purpose of a root cause analysis? A. A root cause analysis assists in preparing a legal defense for the event. B. A root cause analysis estimates the costs involved in the event. C. A root cause analysis investigates deviations from standards of care surrounding the event. D. A root cause analysis determines if employees involved in the event should be terminated.

C. A root cause analysis investigates deviations from standards of care surrounding the event.

A nurse is caring for a client with stage 4 ovarian cancer who has decided to stop treatment and enter hospice care. Which of the following ethical principles is the nurse displaying by supporting the client in her decision? A. Responsibility B. Accountability C. Advocacy D. Confidentiality

C. Advocacy

When entering the postoperative care unit, the nurse manager notices that the temporary agency nurse has incorrectly entered the rate of infusion for the patient's vasopressor medication, and the arterial line blood pressure has a reading of 76/4 0mm Hg. After discontinuing the intravenous medication infusion, what is the nurse manager's next intervention? A. Notify the nurse in charge of the unit. B. Ask if there is an assigned resource nurse to serve as mentor for the temporary nurse. C. Ask if there are standing orders for interventions for hypotension. D. Ask if the temporary nurse has had an orientation to the unit.

C. Ask if there are standing orders for interventions for hypotension.

A group of providers is participating in a cardiopulmonary resuscitation effort for a client who is in cardiac arrest. Which of the following types of leadership is required for this group to function efficiently? A. Transformational B. Participative C. Autocratic D. Laissez-faire

C. Autocratic

Which of the following types of leadership is required for an emergency group to function efficiently? A. Transformational B. Participative C. Autocratic D. Laissez-faire

C. Autocratic

Using high-quality monitoring tools, a facility committee identifies that clients who have congestive heart failure have an average length of stay of 5 days instead of the established standard of 3 days. Which step should the nurse implement next in the quality-improvement process? A. Educate staff members on shortening the length of stay for these clients B. Collect data regarding the length of stay for these clients C. Determine which actions can be instituted to address this problem D. Research the accuracy of the standard of care that has been accepted

C. Determine which actions can be instituted to address this problem

A nurse is caring for a client who is a local public official. A newspaper reporter repeatedly phones the unit seeking information and states, "The public has a right to know the health status of elected officials." Which of the following actions should the nurse take? A. Acknowledge that the person is a client on the unit but give no specific details of the client's condition. B. Refer any calls directly to the client's room so that the client and her family can decide what to tell the press. C. Refer all media inquiries to the nursing supervisor. D. Hang up on media callers because nursing staff members are not required to speak to them.

C. Refer all media inquiries to the nursing supervisor.

A nurse is caring for a client who is a local public official. A newspaper reporter repeatedly phones the unit seeking information and states, "The public has a right to know the health status of elected officials." Which of the following actions should the nurse take? A. Acknowledge that the person is a client on the unit but give no specific details of the client's condition. B. Refer any calls directly to the client's room so that the client and her family can decide what to tell the press. C. Refer all media inquiries to the nursing supervisor. D. Hang up on media callers because nursing staff members are not required to speak to them.

C. Refer all media inquiries to the nursing supervisor.

A nurse suspects that a coworker may be in an impaired state when providing care to clients. Which of the following actions should the nurse take? A. Ask other coworkers if they feel the same way. B. Speak directly with the impaired coworker. C. Report these observations to the nurse manager. D. Refuse to work with the impaired coworker.

C. Report these observations to the nurse manager.

Mr. Grandion was admitted to a rehabilitation center after discharge from a hospital. He has not walked in the 5 days while he was hospitalized and is provided a wheelchair. Dining with other residents is expected, and staffing is limited on a holiday weekend. What is the best strategy to ensure Mr. Grandion has sufficient nutrition and exercise? A. Tell Mr. Grandion to stay in bed and someone will bring a tray to his room because the staff can't get him to the dining room in time for dinner. B. Assist Mr. Grandion into his wheelchair and remind him that in 2 hours he must be in the dining room if he wished to eat. C. Request help from another unit before dinner and indicate the nature of help needed. D. Order a lift device to transfer Mr. Grandion from his bed to the wheelchair.

C. Request help from another unit before dinner and indicate the nature of help needed.

An experienced nurse is serving as a mentor to a newly licensed nurse. Which of the following actions should the mentor take? A. Establish a set of goals for the newly licensed nurse to achieve. B. Establish a set timeframe with the newly licensed nurse for the mentorship process. C. Serve as a guide and teacher for the newly licensed nurse in an established relationship. D. Develop a program of study for the newly licensed nurse to follow.

C. Serve as a guide and teacher for the newly licensed nurse in an established relationship.

A nurse manager notes several recent conflicts among nurses on different shifts. Which of the following strategies should the nurse manager use to resolve these conflicts? A. Have the charge nurses for each shift get together and discuss the issues between shifts. B. Direct the nurses from each shift to discuss their issues and present solutions to the nurse manager. C. Set up a series of meetings for all staff members to attend to discuss issues. D. Remain uninvolved and allow the nurses from each shift to resolve the issues among themselves.

C. Set up a series of meetings for all staff members to attend to discuss issues.

A new graduate nurse is employed in a small community hospital. The nurse notices practices which seem to be very physician driven and that patients have little input into their care. Families are seen as a nuisance rather than as partners in potential care provision. What is the best approach for the new nurse to use for improving care in this setting? A. Do nothing. They are too new to the organization to make change. B. Share with the physician the recommendations from various IOM reports. C. Share with their team members what they know about the aims of providing health care. D. Report the team members to the chief nursing officer who is unlikely to know the lack of details on this unit.

C. Share with their team members what they know about the aims of providing health care.

A nurse is admitting a client who has active gastrointestinal bleeding. Which of the following tasks is appropriate for the nurse to delegate to an assistive personnel (AP)? A. Obtain the initial set of vital signs B. Listen for bowel sounds C. Show the client how to use the nurse call light • D. Ask the client if he has any allergies

C. Show the client how to use the nurse call light

A nurse is caring for a client who is dying and unable to make decisions for himself. The client's adult children disagree about his code status. Which of the following sources should the nurse depend on for decisions regarding the client's end-of-life care? A. The client's oldest child B. The attending provider C. The client's health care proxy D. The facility's ethics committee

C. The client's health care proxy

A nurse is following standard policy and procedure for reporting a client who has a communicable disease. Which of the following infections should the nurse plan to report to the CDC? A. Clostridium difficile B. Candidiasis C. Vancomycin-resistant Staphylococcus aureus D. Trichomoniasis

C. Vancomycin-resistant Staphylococcus aureus

A nurse overhears two other nurses discussing a conflict they are having about who should complete certain client-care tasks. The nurses agree that they are tired of the conflict and will let the nurse manager decide who should complete the tasks. The nurse should identify this outcome as which of the following approaches to conflict management? A. Win-win B. Win-lose C. Win-yield D. Lose-lose

C. Win-yield A win-yield approach involves both parties no longer trying to resolve the conflict. Instead of taking the initiative to end the conflict, they agree to honor whatever the nurse manager decides.

Due to staffing shortages, a nurse manager floats a med-surg nurse to peds unit. nurse has limited experience with children. which action should nurse manager take A. provide constant supervision for med-surg nurse B. heave med-surg nurse provide relief for unit nurses during break and lunch times C. assign a unit nurse to act as a resource for med-surg nurse D. delegate assistive personnel taks to med-surg nurse

C. assign a unit nurse to act as a resource for med-surg nurse

A charge nurse overhears a unit nurse informing other unit nurses that the charge nurse is giving preferential treatment to the unit nurses on the night shift. which of the following approaches by the charge nurse reflects n assertive response to resolve the conflict A. understanding that the unit nurse is misinformed and taking no action B. assigning the unit nurse to work the night shift the facilitate direct experience with the night shift C. meeting one-on-one with the unit nurse to discuss the concerns D. confronting the unit nurse during the next unit meeting regarding this statement

C. meeting one-on-one with the unit nurse to discuss the concerns

A nurse is tracking the outcomes of clients on the unit who have received postoperative pain management. This activity demonstrates which of the following competencies of the Quality and Safety Education for Nurses (QSEN) initiative? A. Safety B. Informatics C. Patient-centered care D. Quality improvement

D. Quality improvement This QSEN competency involves using data to track outcomes with the goal of devising processes to improve clients' outcomes.

A charge nurse is reviewing the Code of Ethics for Nurses during a staff meeting. Which of the following statements should the charge nurse include in the teaching? A. "The Code of Ethics for Nurses is legally binding." B. "The Code of Ethics for Nurses is mandatory for the practice of nursing." C. "The Code of Ethics for Nurses is a description of licensure requirements." D. "The Code of Ethics for Nurses is a guide for professional actions."

D. "The Code of Ethics for Nurses is a guide for professional actions."

A charge nurse on a pediatric unit is delegating tasks to an assistive personnel (AP) who is pregnant and reports that she is unsure of her immune status. Which of the following clients should the charge nurse assign to the AP? A. A 9-year-old child who has fifth disease B. A 4-year-old child who has varicella (chicken pox) C. A 6-year-old child who has rubella D. A 2-year-old child who has impetigo contagiosa (impetigo)

D. A 2-year-old child who has impetigo contagiosa

A nurse manager is observing the staff members working on her unit. Which of the following actions should the nurse manager recognize as an example of paternalism? A. A nurse asking to care for an older adult client every day who reminds the nurse of a favorite grandparent B. A male nurse caring for an adolescent male client because the client is uncomfortable around female nurses • C. A middle-aged adult assistive personnel (AP) mentoring a younger less-experienced AP on the unit D. A nurse practitioner withholding information from a client who is dying to avoid causing the client distress

D. A nurse practitioner withholding information from a client who is dying to avoid causing the client distress

A nurse is caring for a client who refuses to take her prescribed oral medication. The nurse states, "If you don't take this pill, I'm going to give you the medication by injection." Which of the following types of tort has the nurse committed? A. Slander B. Battery C. Negligence D. Assault

D. Assault

An RN and a licensed practical nurse (LPN) are caring for a client who has a small bowel obstruction and is NPO with a nasogastric (NG) tube set to continuous suction. Which of the following tasks should the RN perform? A. Obtain daily weight B. Inspect the client's oral cavity for dryness hourly C. Measure and record the NG tube output every 4 hours D. Assess for bowel sounds every 2 hours

D. Assess for bowel sounds every 2 hours

A health care facility's leadership team is implementing a new computerized charting system. When preparing for the implementation date, which of the following actions should the nurse manager take first? A. Discuss with the charge nurses their responsibility in implementing the change. B. Post a sign-up sheet for in-service training sessions about the new system. C. Ask informal leaders to participate in the early implementation process. D. Collect the staff members' input about planning and implementing the change.

D. Collect the staff members' input about planning and implementing the change.

A charge nurse finds an increased incidence of health-care-associated infections (HAls) on a long-term care unit. Which priority action should the charge nurse take to address the problem? A. Monitor the staff's hand hygiene techniques B. Hold a mandatory in-service training session about hand hygiene and infection rates C. Require nurses to take an online course on HAls / D. Conduct a chart review to gather data about clients who developed HAls

D. Conduct a chart review to gather data about clients who developed HAIs

A nurse is planning to perform a negotiation to manage a conflict between himself and another staff member. Which of the following actions should the nurse plan to take? A. Continue the negotiation process until all parties agree on a settlement. B. Establish equality in the concessions that each party makes. C. Make as many concessions as needed to make everyone happy. D. Create a solution in which all parties are satisfied.

D. Create a solution in which all parties are satisfied.

A nurse is having difficulty completing care and documentation without staying past the end of the shift. The nurse manager suggests focusing on time-management skills. Which of the following strategies should the nurse plan to use? A. Practice multitasking throughout the shift B. Postpone completing documentation until the end of the shift C. Occasionally skip a break time D. Identify tasks in order of their priority

D. Identify tasks in order of their priority

A nurse manager is implementing a team nursing approach on his unit, hiring licensed practical nurses (LNs) and assistive personnel (AP) as additional staff. Which of the following actions should the nurse manager take to facilitate acceptance of this change? A. Develop a plan for the change and present it during a staff meeting. • B. Explain that this change is a request from the administration and will be carried out. C. Hire new LPNs and APs and gradually integrate them into the staff. D. Introduce the new approach and facilitate the development of a task force to plan implementation.

D. Introduce the new approach and facilitate the development of a task force to plan implementation.

A new nurse manager on a busy oncology unit keeps her door closed when she is in the office and does not offer to help resolve daily staffing issues. Which of the following types of leadership behavior is this nurse manager displaying? A. Transformational B. Democratic C. Autocratic D. Laissez-faire

D. Laissez-faire

A nurse is receiving report on a client who has Clostridium difficile and is being transferred from another unit. Which of the following precautions should the nurse take? A. Place the client in a negative-airflow room. B. Clean the client's room with antibacterial disinfectant. C. Wear a mask when entering the client's room. D. Perform hand hygiene with nonantimicrobial soap and water after client care.

D. Perform hand hygiene with nonantimicrobial soap and water after client care.

While participating in a continuous quality-improvement program, a nurse is reviewing medical records to determine the time of first postoperative ambulation of clients who had abdominal surgery. In which type of quality audit is the nurse participating? A. Outcome B. Structure C. Strategic planning D. Process

D. Process

A nurse manager is orientating newly licensed nurses to a facility and is emphasizing the importance of practicing within standards of care. To which of the following legal concepts is the nurse manager referring? A. Punitive damages B. Intentional torts C. Good Samaritan laws D. Professional negligence

D. Professional negligence

A nurse manager notes that several staff members are late in completing an annual mandatory educational session about extremity restraint safety. Which of the following actions should the nurse manager plan to take? A. Make a general announcement at the next staff meeting asking all employees to check their adherence to the requirement. B. Post a list in the employees' break room naming those who are non-adherent and the date by which they must complete the requirement. c. Schedule a disciplinary conference with each of the non-adherent employees. D. Send an email to each non-adherent employee that includes a link to upcoming educational sessions.

D. Send an email to each non-adherent employee that includes a link to upcoming educational sessions

A nurse is teaching a group of unit nurses about the Health Insurance Portability and Accountability Act (HIPAA). Which of the following pieces of information should the nurse include in the teaching? A. The Privacy Rule limits the client's rights to personal health information. •B. The electronic transfer of information allows each provider to use his her own electronic format for claim transactions. • c. Standardized numbers can have a varied format for identifying health plans. • D. The Security Rule provides a uniform level of security to protect client records.

D. The Security Rule provides a uniform level of security to protect client records.

A nurse is working with an assistive personnel (AP) in a long-term care facility. According to the 5 rights of delegation, which of the following determinations should the nurse make prior to assigning tasks? A. Whether the AP has consented to the performance of delegated tasks B. The client's willingness to consent to care from the AP C. Whether the task can be more efficiently completed by the nurse D. The degree of supervision that the AP will require to complete the task

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

A nurse is teaching a newly licensed nurse about the informed consent process for a client who is scheduled for a surgical procedure. Which of the following pieces of information should the nurse include in the teaching? A. Clerical staff in the facility can witness the signature of a client on a consent form. B. The nurse caring for a client is responsible for explaining the procedure. C. A family member should be present when a client signs a consent form. D. The person who will perform the procedure is responsible for obtaining informed consent.

D. The person who will perform the procedure is responsible for obtaining informed consent.

A nurse on a medical-surgical unit is delegating tasks to nursing team members. Which of the following tasks should the nurse delegate to an assistive personnel? A. Instructing a client how to use a glucometer B. Instilling lubricating eye drops for a client C. Evaluating the effectiveness of a client's pain medication D. Transferring a client who is postoperative from a bed to a chair

D. Transferring a client who is postoperative from a bed to a chair

A nurse is reviewing informed consent with a client who is scheduled for a cardiac catheterization. Which of the following is the responsibility of the nurse? A. Explaining the procedure to the client B. Offering alternative treatments C. Informing the client of the consequences of refusing the procedure D. Verifying the client's understanding of the procedure being performed

D. Verifying the client's understanding of the procedure being performed

A nurse caring for a postop client who has an Hgb of 8.0 g/dL. The nurse delegates the administraion of a unit of packed RBCs to a nurse floating from a psychiatric unit who is unfamiliar with blood administration. Which of the following actions should the float nurse take? A. call the provider to clarify the prescription for administering the unit of packed RBCs B. hand the unit of blood if the charge nurse agrees to be a resource C. question the nurse regarding this prescription due to the client's reported Hgb level D. decline to hang the blood

D. decline to hang the blood

A nurse is tracking the outcomes of clients on the unit who have recieved postop pain management. this activity demonstrates which of the following competencies of the quality and safety education for nurses (QSEN) initiative? A. safety B. informatics C. patient-centered care D. quality improvement

D. quality improvement

Nurse is caring for several clients who require diagnostic testing and is delegating taks to an AP, which tasks should the nurse direct the AP to perform first? A. change the transparent dressing on a client who has a stage 2 pressure ulcer B. Bring a pitcher oof fresh water to a client who just had a lumbar puncture C. transport a client to the radiology department for a routine chest x-ray D. take an arterial blood gas specimen to the laboratory

D. take an arterial blood gas specimen to the laboratory

"Power in nursing" refers to the nurse's ability to: A. protest unfair working conditions through walkouts and strikes. B. demonstrate knowledge about organizational behavior. C. act on issues that influence nursing licensure but not patient care. D. use one's influence to create change in pursuit of goals.

D. use one's influence to create change in pursuit of goals.

Which of the following is a professional role transition? Purchasing a car Marriage Starting a new job Retirement

Starting a new job