RN Leadership 2023 Proctored

A nurse is assisting a newly licensed nurse with delegating tasks to an assistive personnel on the unit. Which of the following statements by the nurse explains the purpose of delegation?

"Delegation permits a designated individual to meet a goal on your behalf."

A nurse has assigned client care activities to an assistive personnel (AP). Which of the following statements by the AP indicates a need for assistance in establishing priorities?

"I have my assignment and will start with room 1, then work my way to room 10."

A nurse in a long-term care facility has assigned a task to an assistive personnel (AP). The AP refuses to perform the task. Which of the following is an appropriate statement for the nurse to make?

"I need to talk to you about the unit policies regarding client assignments."

A nurse is caring for a client who has advanced lung cancer. The client's provider hasrecommended hospice services for the client. Which of the following statements by the client indicates a correct understanding of hospice care?

"I should expect the hospice team to help me manage my dyspnea."

A nurse manager is reviewing the Good Samaritan laws with a group of newly licensed nurses. Which of the following statements by the nurse manager is appropriate?

"If you render aid in an accident, do not leave the scene until another competent person can take over."

A nurse manager hears a staff nurse on the unit speak openly about her dislike of a recent policy change regarding client care. When discussing the issue with the nurse, which of the following statements by the nurse manager is appropriate?

"Let's talk about your concerns about the new policy."

A coworker puts an arm around a nurse and says, "I bet you are a great lover." Which of the following is an appropriate response by the nurse?

"Speaking to me like that makes me uncomfortable."

.A client who is terminally ill tells a nurse on the medical-surgical unit that she feels hopeless. Which of the following statements by the nurse is appropriate?

"Tell me what you understand about your illness."

A nurse is planning to use the SBAR communication tool when calling a provider. Which of the following statements should the nurse include in the B step?

"The client was found unconscious on the floor in her home."

A nurse is receiving change-of-shift report at the start of the shift. Which of the following statements by the nurse giving report indicates to the oncoming nurse that she should assume total care for the client, rather than assigning tasks to the assistive personnel (AP)?

"The client's blood pressure and pulse have been fluctuating throughout the day."

An assistive personnel (AP) comes to work with a new set of artificial nails. The nurse takes the AP to a private location to discuss the issue. Which of the following statements by the nurse is appropriate?

"There is a higher risk of infection for our clients associated with artificial nails."

.A nurse is planning to assign care activities to the assistive personnel (AP) on her team. Which of the following activities can the nurse assign to the AP? (Select all that apply.)

-Accompany a client who has depression to occupational therapy. -Check the position of a client in soft wrist restraints. -Sit with a client who has alcohol use disorder and whose last drink was five days ago.

A nurse on a medical-surgical unit is assigning tasks to an assistive personnel (AP). Which of the following tasks should the nurse delegate to the AP? (Select all that apply.)

-Ambulate a client who has a cane. -Transfer a client to a stretcher -Record urinary output.

A nurse and an experienced licensed practical nurse (LPN) are caring for a group of clients. Which of the following tasks should the nurse delegate to the LPN? (Select all that apply.

-Obtain vitalsigns from a client who is 6 hr postoperative. -Administer a tap-water enema to a client who is preoperative. -Catheterize a client who has not voided in 8 hr.

.A nurse is obtaining informed consent from a client who is preoperative. Which of the following actions should the nurse take? (Select all that apply.)

-Validate the signature is authentic -Verify that the client understands the surgical procedure -Confirm that the consent is voluntary is correct.

A nurse is caring for four postoperative clients. The nurse can delegate obtaining vital signs to an assistive personnel (AP) for which of the following clients?

. A client who is 3 days postoperative following gastric bypass surgery

A nurse is planning client care for herself and an assistive personnel (AP) working with her. Which of the following tasks should the nurse plan to perform?

. Assessing a client's sacrum for edema

.A charge nurse is delegating tasks to nursing personnel on a 10-bed medical-surgical nursing unit. Which of the following assignments is an example of overdelegation?

. Assigning the most efficient AP to perform glucometer monitoring for each client

A nurse is planning to delegate a task to an assistive personnel (AP). Which of the following actions should the nurse plan to take?

. Provide a clear description of the task to the AP.

A nurse on the pediatric unit is providing room assignments for children who are to be admitted to the unit. The nurse should plan to place a child who is postoperative from an appendectomy with which of the following clients?

A child who has a new diagnosis of type 1 diabetes mellitus

.A nurse is assigned a group of clients at the start of the shift. Which of the following clients should the nurse plan to care for first?

A client asking about his PCA pump that contains morphine

A nurse is caring for several clients. For which of the following situations should the nurse complete an incident report?

A client discovers that his dentures are missing.

A nurse is caring for four clients on a medical-surgical unit. Which of the following clients should the nurse assess first?

A client who had an indwelling urinary catheter removed 5 hr ago and has not voided

A nurse is assessing four clients on a medical-surgical unit. Which of the following clients should the nurse care for first?

A client who has a cast on the left leg and reports numbness and paresthesia

A nurse and an assistive personnel (AP) are providing care for four clients who were admitted to the medicalsurgical unit on the previous shift. The nurse should delegate meal assistance for which of the following clients to the AP?

A client who has a lumbosacral spinal tumor

A nurse is assessing a group of clients for hospice services. The nurse should recommend hospice care for which of the following clients?

A client who has terminal cancer and needs assistance with pain management

An RN from the maternal-newborn unit is being floated to a medical-surgical unit. Which of the following clients should the charge nurse on the medical-surgical unit plan to assign to the RN?

A client who is one-day postoperative following a total abdominal hysterectomy

A nurse manager is reviewing the admission history of four adults who were admitted to the medical-surgical unit during the shift. Which of the following situations is the nurse required to disclose information to an outside agency about the client or the client's circumstances?

A dependent adult admitted for the treatment of a spiral fracture

A nurse is triaging clients in an urgent care clinic. Which of the following clients should the nurse have the provider care for immediately?

A middle adult male who is diaphoretic and reports epigastric pain

A nurse manager is addressing reports of conflict within a nursing unit. The nurse should identify which of the following situations as an example of interpersonal conflict?

A nurse experiences insulting comments directed at them by another nurse

A nurse is triaging clients in the emergency department. Which of the following clients should the nurse ask the provider to care for first?

A school-age child who has acute epiglottitis, is drooling, and has an absence of spontaneous cough

Following a tornado, a nurse is determining which of the clients assigned to her care can be discharged to free up beds for injured clients. Which of the following clients should the nurse recommend for discharge?

A young adult client who has Crohn's disease and is 1 day preoperative for an ileostomy

A nurse is preparing an in-service for a group of nurses about malpractice issues in nursing. Which of the following examples should the nurse include in the teaching as an example of malpractice?

Administering potassium IV bolus

A nurse on a pediatric unit is reviewing her client assignment following the shift report. Which of the following clients should the nurse plan to assess first?

An infant who has pertussis and is receiving oxygen via nasal cannula

.A client who fell and broke his hip while being assisted to the bathroom by a nurse states he plans to sue the nurse. The nurse should know that, in a legal proceeding, the standard that will be used to determine if the nurse was negligent is which of the following?

Another staff nurse provides testimony about how a reasonable, prudent nurse would have handled the situation

A nurse asks the assistive personnel (AP) to take a specimen to the laboratory and the AP refuses. Which of the following actions should the nurse take?

Ask the AP about her concerns with the assignment.

A nurse has been reassigned from her regular area of work to a unit that is short staffed. Which of the following actions should the nurse take first?

Ask what she will be assigned to do.

A nurse on a medical-surgical unit is preparing to contact a provider about a client's condition. The client is 6 hr postoperative from a total hysterectomy. The nurse notesthe client's postoperative oxygen saturation is 94% and her apical heart rate is 110. The nurse should include information about the client's oxygen saturation level and heart rate in which component of the SBAR report?

Assessment

A nurse is planning care for a group of clients at the beginning of the shift. Which of the following tasks should the nurse assign to the licensed practical nurse (LPN)?

Assisting a client with crutch walking following knee replacement surgery

A nurse is planning care for a client who has anorexia nervosa. The nurse should make which of the following client goals the priority?

Attain a weight that is greater than the 75th percentile for age and height

A nurse is caring for an older adult client who has a terminal illness and is ventilatordependent. The client is alert and oriented and he wants to discontinue use of the ventilator. The nurse should be aware that continued treatment against the client's wishes is a violation of which of the following ethical principles?

Autonomy

0.A nurse is teaching a class on torts. The nurse should instruct the class that administering an antibiotic medication to a competent client after the client has refused it is an example of which of the following torts?

Battery

.A nurse enters a client's room and finds the client pulseless. The family hasrequested a do-not-resuscitate (DNR) order from the provider, but he has not written the order yet. Which of the following actions should the nurse take?

Call the emergency response team.

A nurse is preparing to administer a soap suds enema to a client who has constipation. As the nurse explains the procedure, the client states, "The doctor didn't tell me I was supposed to receive an enema." Which of the following nursing actions is appropriate at this time?

Check the client's medical record for the provider's prescription.

A nurse is working with an assistive personnel (AP) to care for a group of clients on the pediatric unit. Which of the following tasks should the nurse have the AP perform first?

Check to see if the elbow restraint is in place for an infant who is postoperative from a surgical correction of a cleft palate.

A nurse is planning a community diabetes mellitus management program. Which of the following goalsshould the nurse include for the program?

Clients will have a decreased incidence of foot amputations.

A nurse is caring for a client who is preoperative. The nurse signs as a witness on the client's consent form. The nurse's signature on the consent form indicates which of the following?

Confirms the client appears competent to provide consent

A nurse manager is preparing an inservice program for the nurses on the unit about the use of a new infusion pump. Which of the following teaching strategies is the most effective way to ensure that the staff can use the device correctly?

Demonstrate using the device and observe the staff returning the demonstration.

A nurse is planning care for a group of clients and is working with one licensed practical nurse and one assistive personnel. Which of the following actions should the nurse take first to manage her time effectively?

Determine goals of the day

A nurse is caring for a group of clients. She plans to delegate obtaining morning vitalsigns to an assistive personnel (AP) on her team. Which of the following actions should the nurse plan to take? A. Verify the AP's educational preparation prior to delegating the task

Determine the time frame the AP should report the results.

A nurse is caring for a client who is scheduled for surgery. The nurse's role in regard to informed consent is which of the following?

Determining the client'slevel of understanding about the procedure

A nurse manager has received information from the facility's risk management department that a former client is pursuing a lawsuit. The nurse manager should anticipate a deposition will be required during which phase of the legal process?

Discovery phase

A charge nurse is observing a conflict between two nurses who both insist that the charge nurse favors the other making assignments. Which of the following conflict-resolution strategies should the charge nurse use?

Encourage collaboration between the two nurses when making the assignments.

A nurse suspects that a coworker is diverting opioid analgesics. Which of the following is an adverse effect of opioid medications?

Euphoria

A nurse is caring for a client on the medical-surgical unit. The client has been taking warfarin at home and her laboratory values reveal her INR is 3.5. The client states she is checking herself out of the hospital and refuses to wait until her provider can discuss the situation with her. Which of the following actions should the nurse take?

Explain the risk the client faces if she leaves the facility

A nurse is caring for a client who is scheduled to have surgery. In preparing the client for surgery, which of the following actions is considered outside the nurse's responsibilities?

Explaining the operative procedure, risks, and benefits

A nurse is caring for a client who is confused and uncooperative. The client hit the nurse when she attempted to give him his medication. The nurse asks the charge nurse if she can restrain the client. The charge nurse should tell the nurse this action is a violation of the client's rights and is an example of which of the following?

False imprisonment

A nurse is working with a limited staff because of a severe storm in the area. The facility incident commander has initiated disaster protocols. Which of the following actions should the nurse take?

Focus on providing care that prevents life-threatening emergencies.

An assistive personnel (AP) tells the nurse manager that she observed a nurse on the unit removing a small amount of morphine from syringes prior to administering the medication to clients. Which of the following actions should the nurse manager take first?

Gather data about the nurse's work performance and attendance history

A charge nurse is working with an assistive personnel (AP) who provides excellent care to clients and is an effective team member. Which of the following actions should the nurse take first to recognize the AP's contributions to client care?

Give positive feedback directly to the AP

At the beginning of the shift, an RN is preparing assignments for a licensed practical nurse (LPN) and an assistive personnel (AP). Which of the following tasks should the nurse assign to the LPN?

Inserting a nasogastric tube for a client

A nurse in the emergency department is caring for a client who has a compression fracture of a spinal vertebra. During transport to the facility, the client was medicated with intravenous morphine. On arrival, the neurosurgeon determined urgent surgical intervention is indicated for the fracture. Staff members have been unable to reach the client'sfamily. Which of the following actions should the nurse anticipate the neurosurgeon taking?

Invoking implied consent

A nurse is caring for a group of clients. The nurse demonstrates adherence to the ethical principle of fidelity by doing which of the following?

Keeping an appointment with a client

.A nurse in an acute care setting is planning care for a group of clients at the beginning of the shift. Which of the following tasks should the nurse assign to the assistive personnel (AP)?

Monitoring vital signs of a client who had an appendectomy 12 hr ago

A charge nurse has access to the facility's electronic client records. It is appropriate for the charge nurse to share her personal password with whom?

No one

A nurse is caring for a client who is participating in a research study for an experimental chemotherapy medication. After three treatments, the experimental medication is discontinued due to evidence of rapidly advancing kidney failure. The nurse should understand discontinuing this medication demonstrates which of the following ethical principles?

Nonmaleficence

A nurse on a medical-surgical unit has accepted a transfer to the intensive care unit (ICU). Prior to transfer to the ICU, the nurse completes an online critical care and emergency nursing course. The nurse is demonstrating which of the following ethical principles?

Nonmaleficence

A nurse on a pediatric unit is caring for a child and his family. His parents define family as a husband, wife, and child. This definition is which type of family form?

Nuclear family

A nurse on a medical-surgical unit is planning to delegate tasks to an adult volunteer. Which of the following tasks should the charge nurse avoid assigning to the volunteer?

Observing a postoperative client who is confused

An assistive personnel (AP) reports to the nurse that a client who is 3 days postoperative following an abdominal hysterectomy has a dressing that is saturated with blood. Which of the following tasks should the nurse delegate to the AP?

Obtain vital signs.

A charge nurse is delegating care for a group of clients. Which of the following tasks should the charge nurse assign to a licensed practical nurse?

Perform a sterile dressing change for a client who has an abdominal wound

A nurse has received change-of-shift report and is delegating tasks to the assistive personnel (AP). The nurse should tell the AP to complete which of the following tasks first?

Perform blood glucose monitoring of a client who has a prescription for short-acting insulin prior to breakfast.

A nurse in a provider's office is reviewing the laboratory findings for a client who is scheduled for surgery. Which of the following findings requires follow up by the nurse?

Platelet count 60,000/mm3

A charge nurse is planning to conduct a performance appraisal of a staff member on her unit. Which of the following actions should the nurse take?

Provide the staff member with a copy of the appraisal form in advance.

A nurse is preparing to bathe a client. Which of the following actions should the nurse plan to take?

Pull the curtain around the client's bed.

A nurse in an acute care setting is serving on a committee whose charge is to use the auditing process to client care. Which of the following aspects of client care is measured by a process audit?

Quality of nursing care provided

A nurse overhears two assistive personnel (AP) from the medical-surgical unit discussing a hospitalized client while in the cafeteria. Which of the following is the priority nursing action?

Quietly tell the APs that this is not appropriate.

A nurse on a medical-surgical unit is providing care for a group of clients. The nurse should delegate collection of which of the following specimens to the assistive personnel (AP)?

Random stool specimen

A nurse is planning care for four clients and is assigning tasks to a licensed practical nurse (LPN) and an assistive personnel (AP). Which of the following should the nurse assign to the LPN?

Reinforce teaching to a client to begin taking enoxaparin at home following a hip arthroplasty.

.A charge nurse is reviewing the list of tasks that have been delegated to the assistive personnel (AP) by the staff nurse. Which of the following tasks should the charge nurse reassign to a licensed nurse?

Removing and cleaning the cannula of a client who has a new tracheostomy

A nurse is serving on a continuous quality improvement committee that has been assigned to develop a program to reduce the number of medication administration errors following a sentinel event at the facility. Which of the followng strategies should the comnittee plan to initiate first?

Review the events leading up to each medication administration error

A nurse checks with assistive personnel on the unit throughout the shift to determine if they are completing tasks. The nurse is demonstrating which of the following rights of delegation?

Right supervision

.A nurse who is leading a team of nurse managers is planning to make a major announcement. The nurse should use which of the following nonverbal communication techniques to enhance the importance of the announcement?

Sit in front of the group for the meeting and then stand for the announcement.

An RN is delegating care activities to a licensed practical nurse (LPN). Which of the following is the priority criterion the RN should consider when delegating?

State Nurse Practice Act for the LPN

A nurse has several tasks to delegate to an assistive personnel (AP). Which of the following tasks should the nurse ask the AP to perform first?

Take an arterial blood gas(ABG) specimen to the laboratory

A charge nurse has assigned a group of clients to a licensed practical nurse (LPN). The charge nurse receives reports from her assigned clients about the LPN's lack of care. Which of the following actions should the charge nurse take?

Talk with the clients who have reported the LPN's lack of care.

A staff nurse has applied for a promotion. The hiring manager insinuates that if there was a sexual relationship between the two of them, the nurse's promotion request would get increased consideration. Which of the following actions should the staff nurse take first?

Tell the hiring manager in clear terms that this conduct causes feelings of discomfort and that the behavior should stop immediately.

An RN is making nursing staff assignments for his team consisting of himself, two licensed practical nurses (LPNs), and an assistive personnel (AP). Which of the following clients should he assume responsibility for?

The client who is actively dying and requires IV pain medication

A nurse in an acute care mental health facility is participating in a medication education group. The leader of the group uses a laissez-faire leadership style. Which of the following actions should the nurse expect from the leader during the session?

The leader allows the group to discuss whatever they would like to regarding their medications.

A nurse manager is providing an inservice program about delegation to assistive personnel (AP) with staff nurses on the unit. Which of the following statements by a staff nurse indicates an understanding of the teaching?

The nurse should consider the AP's level of experience when making delegation decisions."

A charge nurse is making assignments for nursing personnel who will be caring for clients during the oncoming shift. Which of the following factors should the charge nurse consider?

The physiologic status of the clients on the unit

A nurse is caring for a client who falls in his room. After the nurse assesses the client, notifies the client's provider, and completes an incident report, which of the following actions should the nurse take?

The purpose of an incident report is to provide information to the risk manager who will investigate the incident and work with other members of the health care team to control risks of client injury.

A nurse on a medical-surgical unit is reconciling a newly admitted client's medication. The nurse is reviewing the process of medication reconciliation with a newly licensed nurse. The nurse should include which of the following information?

The purpose of medication reconciliation is to prevent adverse medication reactions.

A nurse is planning to delegate tasks to a licensed practical nurse (LPN). Which of the following entities is important for the nurse to understand when delegating tasks to the LPN?

The state Nurse Practice Act

A nurse is participating in a disaster simulation in which a toxic substance is released into a crowded stadium. Multiple clients are transported to the facility. Which of the following activities would be the lowest priority for the nurse?

Transferring a client to the discharge location

A volunteer assigned to the pediatric unit reports to the charge nurse for an assignment. Which of the following assignments is unsafe for the volunteer?

Transporting a school-age client who is in traction to another department

.A charge nurse delegates to a licensed practical nurse (LPN) the task of changing a client's dressing. Several hours later the client reportsthe dressing has not been changed. Which of the following actions should the charge nurse take?

Verify the LPN knows how to do a dressing change

A staff nurse is observing a newly licensed nurse suction a client's tracheostomy. Which of the following actions by the newly licensed nurse requires intervention by the staff nurse?

Waits for 2 min between suctions

A nurse is caring for a client who has severe head injuries and is declared brain dead. The transplant coordinator has spoken with the client's family about organ donation. The client's spouse states she is confused and does not know what she should do. Which of the following responses by the nurse is appropriate?

What do you think your spouse would have wanted?

A nurse is caring for a client who is dying. The nurse should incorporate the principle of nonmaleficence into practice by taking which of the following actions?

Withholding a dose of narcotic pain medication when the client has respiratory depression