Leadership Dynamic Quiz
A nurse is caring for a client who received a sedative-hypnotic medication at bedtime. The client gets out of bed and falls, sustaining a laceration that requires suturing. Which of the following statements should be included as part of the nurse's documentation in the client's chart? A. "Client found sitting on floor with 3 cm laceration above left eyebrow. Oriented to name only. Provider notified." B. "Client found sitting on floor with blood running down face. Side rails had not been raised by assistive personnel when client was placed in bed." C. "Client fell due to confusion caused by sleeping medication." D. "Client got out of bed and fell, despite being told to call for assistance when ambulating."
A. "Client found sitting on floor with 3 cm laceration above left eyebrow. Oriented to name only. Provider notified."
A nurse is caring for a male client who is scheduled for a procedure. The client's son asks the nurse what medication is being given to the client. Which of the following responses should the nurse provide? A. "I am sorry, but you'll need to ask your father for that information." B. "Your father was given lorazepam to treat anxiety." C. "You will need to ask the charge nurse for that information." D. "Don't worry. We will give your father all pertinent information before discharge."
A. "I am sorry, but you'll need to ask your father for that information."
A nurse in a mental health clinic is interviewing a client who has a history of substance use disorder. The client reports his experiences from a previous voluntary hospitalization. Which of the following reported experiences constitutes assault? A. "I was threatened with a shot when I refused to take an oral medication I knew would make me groggy." B. "I was held down against my will so the staff could administer a shot." C. "I was told I had to stay in the facility despite asking to leave." D. "I was exposed as a substance abuser to other clients in a group session."
A. "I was threatened with a shot when I refused to take an oral medication I knew would make me groggy."
A nurse is caring for a client who is scheduled for a bilateral mastectomy. The client states, "I don't think I can go through with the surgery after all." Which of the following responses should the nurse offer? A. "I will let your surgeon know about your decision." B. "I recommend that you have the surgery so you don't require as much chemotherapy." C. "If you don't have the surgery, you will likely die from breast cancer." D. "If you are worried about your body image, that will pass with time."
A. "I will let your surgeon know about your decision."
A nurse is caring for a client who has a history of severe multiple sclerosis and asks the nurse about completing a living will. Which of the following statements should the nurse make? A. "I will provide you with the information you need to complete advance directives." B. "I will contact your provider to inform him of your desire to complete a living will." C. "Your attorney will need to review the document before it can be enacted." D. "Once your living will is complete and on file, the choices you make are final."
A. "I will provide you with the information you need to complete advance directives."
A nurse is transporting a client to the surgical suite for a procedure. The client tells the nurse he no longer wants to have the surgery. Which of the following responses should the nurse make? A. "Let me call your surgeon while you tell me about your concerns." B. "You should talk to your family before you make this decision." C. "I'll ask your surgeon to speak to you as soon as you are in the surgical suite." D. "Everything will be fine. The operation will be over soon, and you will be glad you had it done."
A. "Let me call your surgeon while you tell me about your concerns."
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 to administer a client's anticoagulant medication. The client states, "I don't like to take this medication. I always have to get my blood checked." Which of the following responses should the nurse make? A. "You can refuse the medication. I will notify your provider." B. "This medication is given all the time to clients, and they don't have a problem." C. "I will come back later to give you the medication." D. "You need to take this medication in order to feel better."
A. "You can refuse the medication. I will notify your provider."
A charge nurse is conducting an in-service training session on ethics to a group of newly licensed nurses. 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 admitting a client who has measles. This client should be placed in which of the following types of isolation? A. Airborne B. Contact C. Droplet D. Protective environment
A. Airborne
A nurse is caring for 4 clients who are scheduled for diagnostic tests. For which of the following tests should the nurse obtain written consent from the client? A. Cerebral arteriogram B. Magnetic resonance imaging (MRI) C. Computed tomography (CT) scan D. Carotid ultrasound
A. Cerebral arteriogram
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 community health nurse is performing client triage while participating in a disaster drill. The nurse should recommend that which of the following client injuries receives treatment first? A. Hemothorax B. Open humeral fracture C. Multiple deep abrasions on the arms and face D. Superficial partial-thickness burns on both legs
A. Hemothorax
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 nurse receives the morning change-of-shift report and delegates several tasks to an assistive personnel (AP) on the team. Which of the following tasks should the nurse instruct the AP to perform first? A. Obtain the morning capillary blood glucose tests B. Bathe a 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 a member of a quality-improvement committee seeking to reduce the risk of adverse events in a health care facility. When reviewing recently submitted incident reports, which of the following incidents should the nurse identify as a sentinel event? A. Paralysis of a client's lower extremities occurred following epidural anesthesia. B. A client fall during ambulation did not result in client injury. C. A client's family member complained that a nurse was culturally insensitive. D. Surgery to the wrong site was stopped prior to a procedure
A. Paralysis of a client's lower extremities occurred following epidural anesthesia.
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 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 school nurse is assessing a child who has multiple bruises on his trunk and extremities. The child reports falling out of a tree 2 days ago. The nurse's assessment findings show patterns of bruising that are not typically sustained during a fall from a tree. Which of the following actions should the nurse take? A. Report the findings to local police and social service agencies. B. Report the findings to the school district superintendent. C. Call the parents of the child and further assess the causative event. D. Reassess the child on a weekly basis for injuries.
A. Report the findings to local police and social service agencies.
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 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 nurse is caring for a child who has sustained extensive head injuries. The provider has diagnosed brain death. Which of the following statements should the nurse use to begin a conversation about the option of organ and tissue donation with the child's parents? A. "I want to talk to you about the importance of considering the donation of your child's organs for transplantation." B. "I want to give you some information about an option that you have regarding donating your child's organs to others who are in need." C. "I am legally required to inform you that you can donate your child's organs for transplantation." D. "Have you ever considered donating your organs for transplantation?"
B. "I want to give you some information about an option that you have regarding donating your child's organs to others who are in need."
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. "I'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 13-year-old female client tells the charge nurse in the pediatric unit that she does not want the male nurse assigned to care for her. Which of the following responses should the nurse make? A. "I will need to discuss your request with your parents first." B. "I'll change the assignment so a female nurse is caring for you today." C. "A female assistive personnel will be helping with your bath." D. "The male nurse assigned is required to care for both male and female clients."
B. "I'll change the assignment so a female nurse is caring for you today."
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 nurse is caring for a group of clients who have mobility issues. Which of the following clients is at the greatest risk for a complication? A. A 3-year-old client who has a burned foot B. An 80-year-old client who has a fractured hip C. A 30-year-old client who has a cast applied for a fractured ankle D. A 42-year-old client who has an indwelling urinary catheter
B. An 80-year-old client who has a fractured hip
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.
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 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 is updating the plan of care for a client who has celiac disease. Which of the following dietary selections should the nurse recommend for the client? A. Whole-wheat tortilla with black beans B. Baked chicken and rice C. Turkey and cheese sandwich D. Pasta with marinara sauce
B. Baked chicken and rice
A nurse is caring for a client who is undergoing a repair of an abdominal aortic aneurysm. After the surgery and immediate postoperative recovery, the nurse should expect which of the following team members to coordinate the client's ongoing and specific needs for care? A. Charge nurse B. Case manager C. Vascular surgeon D. Home health care nurse
B. Case manager
A nurse enters a client's room and finds the client lying on the floor next to the bed. Which of the following actions should the nurse take first? A. Determine the cause of the incident. B. Check the client for injuries. C. Call for assistance to get the client back into bed. D. Complete an incident report.
B. Check the client for injuries.
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 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
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 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 caring for a client who had a stroke and requires assistance performing ADLs. The nurse should collaborate with which of the following members of the interprofessional care team? A. Speech-language pathologist B. Occupational therapist C. Social worker D. Dietitian
B. Occupational therapist
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
A nurse is planning care for a client who has COPD, requires continuous oxygen therapy, and is being discharged to return home. Which of the following referrals should the nurse recommend? A. Spiritual advisor B. Social worker C. Physical therapist D. Occupational therapist
B. Social worker
A nurse working in a mental health facility is preparing to discharge a client who has schizophrenia and requires assistance with housing. Which of the following referrals should the nurse recommend to the provider? A. Occupational therapist B. Social worker C. Physical therapist D. Spiritual support
B. Social worker
A nurse is caring for an adult client who has pancreatitis. The client tells the nurse, "I've decided that I want to go home. I don't want any more treatment." The nurse should recognize that which of the following legal principles applies to the client? A. The admitting provider needs to approve the client's request to leave. B. The client has the right to make the decision to leave the hospital. C. The client should be detained if leaving presents a risk of loss of life or limb. D. The client must demonstrate self-care abilities prior to leaving the acute-care facility.
B. The client has the right to make the decision to leave the hospital.
A nurse is evaluating a client's understanding of discharge teaching about dressing changes. Which of the following actions by the client indicates an understanding of the teaching? A. The client nods and smiles in response to what is being said. B. The client restates the information in her own words. C. The client does not ask questions when given the opportunity. D. The client's body language shows that she is listening to the nurse.
B. The client restates the information in her own words.
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 nurse is caring for a client who asks if the client in the next room is in pain because she cries out frequently. Which of the following statements should the nurse make? A. "That client has cancer and is quite uncomfortable." B. "We are doing our best to keep that client as comfortable as possible." C. "Does the crying out bother you?" D. "Why don't you ask that client's family when they visit?"
C. "Does the crying out bother you?"
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 nurse is caring for a client who has cancer. The client tells the nurse he does not want any more chemotherapy treatments. Which of the following responses should the nurse provide? A. "I think you should finish this round of treatments and then see how you feel." B. "I will discuss this decision with the designee in your health care proxy." C. "I will inform your provider of your decision to discontinue the treatments." D. "I am so sorry to hear you are tired of fighting and have made this decision."
C. "I will inform your provider of your decision to discontinue the treatments."
A nurse is caring for a client who has breast cancer and is scheduled for a mastectomy. The client tells the nurse she is concerned about how her partner will react to the procedure. Which of the following responses should the nurse make? A. "I will inform your surgeon that you are having second thoughts." B. "I think you should postpone the surgery until you are certain you want to have it done." C. "Would you like me to have a member of a breast cancer support group visit you?" D. "This is a common concern of women who will be undergoing a mastectomy."
C. "Would you like me to have a member of a breast cancer support group visit you?"
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 is preparing to care for a group of clients after receiving change-of-shift reports. Which of the following clients should the nurse assess first? A. A client who has benign prostatic hyperplasia (BPH) and reports dysuria B. A client who has ulcerative colitis and reports diarrhea C. A client who has emphysema and reports dyspnea D. A client who has esophageal cancer and reports painful swallowing
C. A client who has emphysema and reports dyspnea
A nurse is caring for a group of clients on a medical-surgical unit. Which of the following clients should the nurse attend to first? A. A client who is receiving metoclopramide and reports diarrhea B. A client who is receiving tamsulosin and reports feeling dizzy C. A client who is receiving cephalexin and reports dyspnea D. A client who is receiving erythromycin and reports epigastric pain
C. A client who is receiving cephalexin and reports dyspnea
A school bus crash in the community creates an urgent need for pediatric hospital beds. Which of the following clients should the nurse manager recommend for discharge? A. A school-age child who was admitted the day before with status asthmaticus B. A toddler admitted the day before who has dehydration and is receiving IV fluids C. A preschooler admitted with tonsillitis who has been receiving oral antibiotics for 24 hr D. An adolescent with acute glomerulonephritis whose urine output is 20 mL/hr
C. A preschooler admitted with tonsillitis who has been receiving oral antibiotics for 24 hr
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
A nurse is performing a safety audit on all equipment used on the unit. Which of the following items should the nurse identify as a safety hazard? A. An electrical cord that is taped to the floor B. A protective cover that is placed over an unused outlet C. An electrical cord that is frayed toward the plug D. An electrical plug that has 3 prongs
C. An electrical cord that is frayed toward the plug
After assisting the client back into bed, which of the following actions should the nurse take next? A. Remind the client to use the call light. B. Restart the IV. C. Assess the client for injury. D. Put an identification bracelet on the client.
C. Assess the client for injury.
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 preparing to transfer an older adult client to a long-term care facility. To promote continuity of care, which of the following actions should the nurse plan to take? A. Discuss the client's long-term recovery goals with him B. Discuss the client's nursing care needs with his provider C. Give a written summary of the client's nursing plan of care to the long-term care facility D. Review the client's nursing care plan with his family members
C. Give a written summary of the client's nursing plan of care to the long-term care facility
A nurse is preparing an IM injection for a client who is preoperative when another client suddenly calls for assistance. The nurse asks another nurse to give the injection since an assistive personnel is waiting to take the client to surgery. Which of the following actions should the second nurse take? A. Prepare a new syringe for the client who is preoperative. B. Give the prepared medication to the client who is preoperative. C. Help the client requesting assistance so the first nurse can give the prepared injection. D. Report this request to the charge nurse.
C. Help the client requesting assistance so the first nurse can give the prepared injection.
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 nurse is caring for a client who is on bed rest and states, "I would prefer not to have all of the side rails on my bed raised." After assessing the client is safe without the four side rails raised, which of the following interventions should the nurse implement? A. Request a prescription from the provider to leave the client's side rails down. B. Inform the charge nurse of the client's feelings about the side rails. C. Leave the side rails down and document this decision as per the client's request. D. Arrange for the client to discuss these feelings with another client who uses side rails.
C. Leave the side rails down and document this decision as per the client's request.
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 an assertive response to resolve this conflict? A. Understanding that the unit nurse is misinformed and taking no action B. Assigning the unit nurse to work the night shift to facilitate direct experience with the night shift C. Meeting one-on-one with the unit nurse to discuss these 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 these concerns
A nurse is assisting with the informed consent process for a client who is scheduled for a below-the-knee amputation. The client asks the nurse, "Why are they making me have this surgery today? I don't understand why they are doing this." Which of the following actions should the nurse take? A. Complete an incident report. B. Administer an antianxiety medication. C. Notify the provider of the client's comments. D. Answer the client's questions and verify understanding.
C. Notify the provider of the client's comments.
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.
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 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 teaching a group of newly licensed nurse managers about the principle of justice. Which of the following statements by a nurse manager indicates an understanding of this teaching? A. "I will refer an unhappy employee to the individual with whom a conflict arose." B. "I will allow staff members to schedule their birthday holidays on alternate days, as long as staffing levels are maintained." C. "I will encourage staff participation in choosing new telemetry monitors for the unit." D. "I will compose staff schedules so that each person works two holidays a year."
D. "I will compose staff schedules so that each person works two holidays a year."
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."
nurse is providing discharge teaching about home safety to an older adult client and his family. Which of the following statements should the nurse include in the teaching? A. "You should set the water heater temperature to 125°F." B. "You should grasp the cord when unplugging items." C. "You should use a gas stove for cooking." D. "You should install a handrail on at least one side of the stairs."
D. "You should install a handrail on at least one side of the stairs."
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 (impetigo
A nurse is prioritizing care for a group of clients. The nurse should plan to attend to which of the following clients first? A. A client who requires a sterile dressing change B. A client who requires gastrostomy tube feeding C. A client who requires urinary catheter care D. A client who requires endotracheal suctioning
D. A client who requires endotracheal suctioning
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
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 (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
Based on recommendations following a regulatory agency visit, the nurse manager mandates a policy change. One of the staff nurses on the unit is resistant to the change, and the nurse manager notes that this nurse does not deliver care according to the new policy. Which of the following actions should the nurse manager take? A. Explain the disciplinary consequences of refusing to implement the new policy. B. Reinforce with the staff nurse the importance of implementing the policy change. C. Ignore the staff nurse's resistance and allow peer pressure to facilitate the change. D. Encourage the staff nurse to verbalize reasons for resisting the change.
D. Encourage the staff nurse to verbalize reasons for resisting the change.
A nurse is creating a plan of care for a client who adheres to Kosher dietary laws. Which of the following food selections should the nurse recommend? A. Baked pork chop B. Cheeseburger C. Ham and cheese omelet D. Grilled salmon
D. Grilled salmon
A nurse manager observes a nurse entering the room of a client who is on contact precautions without donning personal protective equipment (PPE). Which of the following is the priority action for the nurse manager to take? A. Speak with the nurse in a private location. B. Complete an incident report. C. Review competencies with the staff members regarding PPE. D. Have the nurse exit the room and don proper PPE.
D. Have the nurse exit the room and don proper PPE.
A nurse is completing an incident report after administering an incorrect dose of medication to a client, even though the client experienced no ill effects from the error. What is the purpose of completing the incident report? A. Alerting the facility administration of a possible litigation situation B. Tracking employee performance for possible disciplinary action C. Providing a detailed report of the occurrence for the client's family D. Identifying situations that contribute to the occurrence of medication errors
D. Identifying situations that contribute to the occurrence of medication errors
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 preparing to give a change-of-shift report to the oncoming nurse. Which of the following pieces of information should the nurse include? A. Routine care procedures for the client B. Biographical information C. Assumptions regarding relationships among the client's family members D. Objective measurements about the client's condition
D. Objective measurements about the client's condition
A nurse is planning care for a client who has aphasia following a stroke. Which of the following actions should the nurse take? A. Avoid the use of facial gestures when speaking to the client. B. Speak to the client in a loud tone of voice. C. Use child-like phrases to help the client understand commands. D. Offer pictures for the client to point to as an alternative form of communication.
D. Offer pictures for the client to point to as an alternative form of communication.
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
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 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 is planning care for a client who is newly admitted to the medical unit. Which of the following health care team members should the nurse plan to consult with regarding the benefit of chest physiotherapy for this client? A. Physical therapist B. Occupational therapist C. Speech-language pathologist D. Respiratory therapist
D. Respiratory therapist
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 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 (AP)? 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