Leadership 3

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."

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

A charge nurse is planning a department in-service training session about radioactive implants for a group of staff nurses. Which of the following points should the charge nurse include in the presentation? (Select all that apply.) A. Clients should be placed in a private room. B. Throw away an implant that has fallen out in the client's trash can. C. Staff members should wear a dosimeter badge when caring for the client. D. Clients should be on bed rest. E. Children over the age of 12 years can visit if they are accompanied by an adult.

A. Clients should be placed in a private room. C. Staff members should wear a dosimeter badge when caring for the client. D. Clients should be on bed rest.

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 nurse working at a rehabilitation facility is attending an interdisciplinary team meeting for a client who had a left hemispheric stroke. Which of the following members of the interdisciplinary team should the nurse recommend to assist this client? (Select all that apply.) A. Nurse B. Occupational therapist C. Speech therapist D. Physical therapist E. Respiratory therapist

A. Nurse B. Occupational therapist C. Speech therapist D. Physical therapist

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.

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.

A. Provide the AP with a manual on how the transfer should be done.

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 manager notes that a full-time nurse has been absent from work 6 times over the last 6 weeks. Using a nonpunitive 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 standards.

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 providing discharge teaching about wound care to a client who has a leg wound. Which of the following pieces of information should the nurse include in the teaching? (Select all that apply.) A. Use cotton balls to clean the infected areas. B. Cleanse the wound with tap water. C. Dry the leg wound after cleaning. D. Microwave the cleaning solution before applying to the wound. E. Discard soiled bandages in a moisture-proof bag.

B. Cleanse the wound with tap water. E. Discard soiled bandages in a moisture-proof bag.

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 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

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 a client for a lumbar puncture. The client has signed the consent form but tells the nurse that she does not remember what the doctor will do during the procedure. Which of the following actions should the nurse take? A. Page the provider stat to come and explain the procedure to the client. B. Remind the client that the doctor will insert a needle to get a sample of fluid from her spine. C. Explain how the assistant will position the client for the procedure. D. Tell the client that someone will explain the procedure when it is time to begin.

B. Remind the client that the doctor will insert a needle to get a sample of fluid from her spine.

A nurse on a medical-surgical unit is caring for a group of clients. For which of the following situations should the nurse complete a variance report? A. A clarification of a medication dosage prescribed by a provider B. The discovery that a preoperative client has received and eaten breakfast C. The identification of a safety concern with a piece of equipment D. A dispute with a coworker about client assignments

B. The discovery that a preoperative client has received and eaten breakfast

A nurse in a community health clinic is planning an in-service staff training session on nationally notifiable infectious conditions. Which of the following conditions should the nurse include in the teaching? A. Clostridioides difficile B. Varicella C. HIV exposure D. Influenza

B. Varicella

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 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

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 charge nurse is coordinating the evacuation of clients from a facility following a bomb threat. Which of the following actions should the nurse take when implementing the evacuation process? A. Call the clients' family members to provide additional help with moving the clients. B. Ask clients who are able to ambulate to assist in moving the unstable clients. C. Instruct clients who are able to ambulate to leave. D. Direct staff members to close the doors and windows as each room is evacuated.

C. Instruct clients who are able to ambulate to leave.

A charge nurse is teaching a group of unit nurses about alternative restraints for clients who are confused and wandering. Which of the following pieces of information should the nurse include in the teaching? A. Distract the client by leaving on the television B. Plan to administer a sedative to the client C. Provide the client with a rocking chair D. Place full-length side rails on the client's bed

C. Provide the client with a rocking chair

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 home health care nurse is conducting a home hazard assessment. For which of the following findings should the nurse intervene? A. The client's hot water heater temperature is set to 46.1°C (115°F). B. There are 8 steps to enter the client's home. C. The client's household lamps have 40-watt light bulbs installed. D. The bathroom has a handheld shower attachment for bathing.

C. The client's household lamps have 40-watt light bulbs installed.

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. Clostridioides 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 nurse is selecting clients for discharge following an environmental disaster. Which of the following clients should the nurse select? A. A client who had a cast removal due to compartment syndrome B. A client who is scheduled for dialysis and has a potassium level of 6.2 mEq/L C. A client who has type 1 diabetes mellitus and a blood glucose of 320 mg/dL D. A client who is 1 day postoperative following an inguinal hernia repair

D. A client who is 1 day postoperative following an inguinal hernia repair

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 charge nurse finds an increased incidence of health-care-associated infections (HAIs) 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 HAIs D. Conduct a chart review to gather data about clients who developed HAIs

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 manager is implementing a team nursing approach on his unit, hiring licensed practical nurses (LPNs) 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 nurse is caring for a client who has recently been prescribed lithium carbonate. Which of the following assessment findings is the priority for this client? A. Fine hand tremors B. Weight gain of 2.7 kg (6 lb) C. Report of nausea D. Poor motor coordination

D. Poor motor coordination

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 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

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 reviewing laboratory results for a client who is at 12 weeks gestation. Which of the following findings should the nurse report to the provider? A. Hgb 12 g/dL B. WBC 15,000/mm^3 C. Fasting blood glucose 80 mg/dL D. Serum creatinine 0.4 mg/dL

D. Serum creatinine 0.4 mg/dL

A nurse is caring for several clients who require diagnostic testing and is delegating tasks to an assistive personnel (AP). Which of the following 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 of fresh water to a client who has 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