Leadership Questions
A nurse manager is developing an orientation plan for newly licensed nurses. Which of the following information should the manager include in the plan? SATA a) Skill proficiency b) Assignment to a preceptor c) Budgetary principles d) Computerized charting e) Socialization into the unit culture f) Facility policies and procedures
a) Skill proficiency b) Assignment to a preceptor d) Computerized charting e) Socialization into the unit culture f) Facility policies and procedures
A PN ending their shift reports to the RN that a newly hired AP has not calculated the intake and output for several clients. Which of the following actions should the RN take? a) Complete an incident report b) Delegate this task to the PN c) Ask the AP if they need assistance d) Notify the nurse manager
c) Ask the AP if they need assistance
An assistive personnel tells a charge nurse that it is unfair that she has to take care of all the clients who are incontinent. Which of the following responses by the charge nurse is appropriate? a) "I delegate tasks to personnel based on their job descriptions." b) "Everyone working here has to care for clients who are incontinent." c) "Let's talk about organizing the workflow so you can care for fewer of these clients." d) "Why do you not want to care for clients who are incontinent?"
a) "I delegate tasks to personnel based on their job descriptions."
A nurse is conducting an in service for a group of newly licensed nurses about delegation. Which of the following instructions should the nurse include in the teaching? a) "Teaching a newly diagnosed diabetic" b) "Completion of a dressing change on a central venous catheter can be delegated to an assistive personnel." c) "Obtaining vital signs on a client who has new onset of left-sided weakness can be assigned to an assistive personnel." d) "Caring for a client who is postoperative following a hysterectomy can be delegated to a nurse floating from the maternal newborn unit."
d) "Caring for a client who is postoperative following a hysterectomy can be delegated to a nurse floating from the maternal newborn unit."
A nurse is acting as a preceptor for a newly-graduated RN during the second week of orientation. The nurse would assign and supervise the new RN to provide nursing care for which patients? SATA a) A 38 year old patient with moderate persistent asthma awaiting discharge b) A 63 year old patient with a tracheostomy needing tracheostomy care every shift c) A 56 year old patient with lung cancer who has just undergone left lower lobe lobectomy d) A 49 year old patient just admitted with a new diagnosis of esophageal cancer e) A 76 year old patient with newly diagnosed diabetes f) A 69 year old patient with emphysema to be discharged tomorrow
a) A 38 year old patient with moderate persistent asthma awaiting discharge b) A 63 year old patient with a tracheostomy needing tracheostomy care every shift f) A 69 year old patient with emphysema to be discharged tomorrow
The charge nurse would assign the nursing care of which patient to an LPN/LVN working under the supervision of an RN? a) A 48 year old patient with cystitis who is taking oral antibiotics b) A 64 year old patient with kidney stones who has a new order for lithotripsy c) A 72 year old patient with urinary incontinence who needs bladder training d) A 52 year old patient with pyelonephritis who has severe acute flank pain
a) A 48 year old patient with cystitis who is taking oral antibiotics
A nurse manager is explaining the use of incident reports to a group of nurses in an orientation program. Which of the following information should the nurse manager include? SATA a) A description of the incident should be documented in the client's health care record b) The client should sign as a witness on the incident report c) Incident reports include a description of the incident and actions taken d) A copy of the incident report should be placed in the client's health care record e) The risk management department investigates the incident
a) A description of the incident should be documented in the client's health care record c) Incident reports include a description of the incident and actions taken e) The risk management department investigates the incident
A nurse manager is providing information about the audit process to members of the nursing team. Which of the following information should the nurse manager include? SATA a) A structure audit evaluates the setting and resources available to provide care b) An outcome audit evaluates the results of nursing care provided c) A root cause analysis is indicated when a sentinel event occurs d) Retrospective audits are conducted while the client is receiving care e) After data collection is completed, it is compared to a benchmark
a) A structure audit evaluates the setting and resources available to provide care b) An outcome audit evaluates the results of nursing care provided c) A root causes analysis is indicated when a sentinel event occurs e) After data collection is completed, it is compared to a benchmark
A nurse witnesses an AP they are supervising reprimanding a client for not using the urinal properly. The AP threatens to put a diaper on the client if the urinal is not used more carefully next time. Which of the following torts is the AP committing? a) Assault b) Battery c) False imprisonment d) Invasion of privacy
a) Assault
A nurse is hired to replace a staff member who has resigned. After working on the unit for several weeks, the nurse notices that the unit manager does not intervene when there is a conflict between team members, even when it escalates. Which of the following conflict resolution strategies is the unit manager demonstrating? a) Avoidance b) Smoothing c) Cooperating d) Negotiating
a) Avoidance
A nurse discovers that a client was administered an antihypertensive medication in error. Identify the appropriate sequence of steps that the nurse should take using the following actions a) Call the provider b) Check vital signs c) Notify the risk manager d) Complete an incident report e) Instruct the client to remain in bed until further notice
a) Call the provider - 3 b) Check vital signs - 1 c) Notify the risk manager - 5 d) Complete an incident report - 4 e) Instruct the client to remain in bed until further notice - 2
The nurse is providing care for a patient after a kidney biopsy. Which actions should the nurse delegate to an experienced unlicensed assistive personnel? SATA a) Check vital signs every 4 hours for 24 hours b) Remind the patient about strict rest for 2-6 hours c) Reposition the patient by log rolling with supporting backroll d) Measure and record urine output e) Assess the dressing site for bleeding and check complete blood count results f) Teach the patient to resume normal activities after 24 hours if not bleeding
a) Check vital signs every 4 hours for 24 hours b) Remind the patient about strict rest for 2-6 hours c) Reposition the patient by log rolling with supporting backroll d) Measure and record urine output
A nurse is assisting with the discharge planning for a client. Which of the following actions should the nurse take? SATA a) Determine the client's need for home medical equipment b) Provide a list of all the medications the client received in the facility c) Obtain printed instructions for medication self-administration d) Provide the family with a list of community agencies that can provide assistance e) Discuss the importance of attending follow-up appointments
a) Determine the client's need for home medical equipment c) Obtain printed instructions for medication self-administration d) Provide the family with a list of community agencies that can provide assistance e) Discuss the importance of attending follow-up appointments
A nurse is planning safety interventions at a new clinic. Which of the following interventions should the nurse include? a) Have staff who will be performing x-rays wear dosimeters b) Provide both latex and non latex gloves for employees c) Place sharps containers outside client rooms d) Provide electrical tape for staff to repair frayed cords
a) Have staff who will be performing x-rays wear dosimeters
A home health nurse is assessing the safety of a client's home. The nurse should identify which of the following factors as increasing the client's risk for falls? a) History of a previous fall b) Reduced vision c) Impaired memory d) Takes rosuvastatin e) Uses a night light f) Kyphosis
a) History of previous fall b) Reduced vision c) Impaired memory f) Kyphosis
An RN on a medical-surgical unit is making assignments at the beginning of the shift. Which of the following tasks should the nurse delegate to the PN? a) Obtain vital signs for a client who is 2 hours post procedure following a cardiac catheterization b) Administer a unit of packed red blood cells to a client who has cancer c) Instruct a client who is scheduled for discharge in the performance of wound care d) Develop a plan of care for a newly admitted client with pneumonia
a) Obtain vital signs for a client who is 2 hours post procedure following a cardiac catheterization
A nurse manager is observing the actions of a nurse they are supervising. Which of the following actions by the nurse requires the nurse manager to intervene? SATA a) Reviewing the health care record of a client assigned to a different nurse b) Making a copy of the client's most current laboratory results for the provider during rounds c) Providing information about a client's condition to hospital clergy d) Discussing a client's condition over the phone with an individual who has provided the client's information code e) Participating in walking rounds that involve the exchange of client-related information outside client's rooms
a) Reviewing the health care record of a client assigned to a different nurse b) Making a copy of the client's most current laboratory results for the provider during rounds c) Providing information about a client's condition to hospital clergy e) Participating in walking rounds that involve the exchange of client-related information outside client's rooms
A nurse on an acute care unit is caring for a client following a total hip arthroplasty. The client is confused, moving the affected leg into positions that could dislocate the new hip joint and repeatedly attempting to get out of bed. After determining that restraint application is indicated, which of the following actions should the nurse take? SATA a) Secure the restraints to the frame of the bed b) Get a prescription for restraints from the provider c) Have a family member sign the consent for restraints d) Tie the restraints to the side rail using a double knot e) Ensure that only one finger can be inserted between the restraint and the client
a) Secure the restraints to the frame of the bed b) Get a prescription for restraints from the provider c) Have a family member sign the consent for restraints
A nurse is developing a plan of care for a school-age child whose family is homeless. Which of the following findings should the nurse identify as the priority? a) The child has inflamed fissures at the corner of her mouth b) The child is shy when interacting with staff c) The child verbalizes not having many friends d) The child reports having her book bag stolen at school
a) The child has inflamed fissures at the corner of her mouth
A nurse is serving as a preceptor to a newly licensed nurse and is explaining the role of the nurse as advocate. Which of the following situations illustrates the advocacy role? SATA a) Verifying that a client understands what is done during a cardiac catheterization b) Discussing treatment options for a terminal diagnosis c) Informing members of the health care team that a client has do-not-resuscitate status d) Reporting that a health team member on the previous shift did not provide care as prescribed e) Assisting a client to make a decision about their care based on the nurse's recommendations
a) Verifying that a client understands what is done during a cardiac catheterization c) Informing members of the health care team that a client has do-not-resuscitate status d) Reporting that a health team member on the previous shift did not provide care as prescribed
Which of the following instructions provided by a nurse reflects effective communication regarding delegation of a task to an assistive personnel? a) "Take vital signs every 2 hours for the client who has a cholecystectomy in room 6122." b) "Check the urinary output in 1100 for John Doe and report it to me immediately." c) "Report to me if the chest tube drainage is excessive for Jane Doe in room 2438." d) "Please notify me of any clients whose vital signs or blood glucose levels are significant."
b) "Check the urinary output in 1100 for John Doe and report it to me immediately."
A case manager is discussing critical pathways with a group of newly hired nurses. Which of the following statements indicates understanding? a) "The time to fill out the pathways often increases the cost of care." b) "The pathway shows an estimate of the number of days the client will be hospitalized." c) "Deviance from the pathway is a sign of improved care quality." d) "The pathway includes information about the client's history."
b) "The pathway shows an estimate of the number of days the client will be hospitalized."
A nurse is receiving change of shift report. Which of the following clients should the nurse assess first? a) A client who has a WBC count of 15,000/mm and is receiving antibiotics b) A client who had abdominal surgery 6 hours ago and had a heart rate of 120 BPM for the last 2 hours c) A client who is requesting pain medication 24 hours after an ORIF of the left ankle d) A client who has pneumonia and oxygen saturation of 95% is refusing prescribed medication
b) A client who had abdominal surgery 6 hours ago and had a heart rate of 120 BPM for the last 2 hours
A nurse just received report on four clients on a medical-surgical unit. Which of the following clients should the nurse plan to assess first? a) A client who has COPD and an oxygen saturation level of 92% b) A client who is postoperative following a total knee arthroplasty and has a capillary refill of 4 seconds c) A client who has diabetes mellitus and a blood glucose of 150 mg/dL d) A client who is 12 hours postoperative following abdominal surgery and has absent bowel sounds
b) A client who is postoperative following a total knee arthroplasty and has a capillary refill of 4 seconds
A community experiences an outbreak of meningitis, and hospital beds are urgently needed. Which of the following clients should the nurse recommend for discharge? a) A client newly admitted with angina and a history of myocardial infarction 1 year ago b) A client who was preadmitted for rotator cuff surgery and has diabetes mellitus type 2 c) A client admitted the day before with pneumonia and dehydration d) A client who has a fractured hip and is scheduled for total hip replacement the next day
b) A client who was preadmitted for rotator cuff surgery and has diabetes mellitus type 2
A nurse is preparing to transfer a client who is 72 hours postoperative to a long term care facility. Which of the following information should the nurse include in the transfer report? SATA a) Type of anesthesia used b) Advance directives status c) Vital signs on day of admission d) Medical diagnosis e) Need for specific equipment
b) Advance directives status d) Medical diagnosis e) Need for specific equipment
A nurse is caring for a client who has chest pain. The client says, "I am going home immediately." Which of the following actions should the nurse take? SATA a) Notify the client's family of their intent to leave the facility b) Document the client's intent to leave the facility against medical advice c) Explain to the client the risks involved if they choose to leave d) Ask the client to sign a form relinquishing responsibility of the facility e) Prevent the client from leaving the facility until the provider arrives
b) Document the client's intent to leave the facility against medical advice c) Explain to the client the risks involved if they choose to leave d) Ask the client to sign a form relinquishing responsibility of the facility
A newly licensed nurse is preparing to insert an IV catheter in a client. Which of the following sources should the nurse use to review the procedure and standard at which it should be performed? a) Website b) Institutional policy and procedure manual c) More experienced nurse d) State nurse practice act
b) Institutional policy and procedure manual
A nurse is discussing disaster planning with the board members of a hospital. Which of the following individuals should the nurse expect to request extra supplies and staffing for the facility a) Incident commander b) Medical command physician c) Triage officer d) Media liaison
b) Medical command physician
A nurse on a sixth-floor medical-surgical unit is advised that a severe weather alert code has been activated. Which of the following actions should the nurse take? SATA a) Open window shades or drapes to provide better visibility of the external environment b) Move beds of nonambulatory clients away from windows c) Relocate ambulatory clients into the hallways d) Use the elevators to move clients to lower levels e) Turn the radio on for severe weather warnings
b) Move beds of nonambulatory clients away from windows c) Relocate ambulatory clients into the hallways e) Turn the radio on for severe weather warnings
A charge nurse is planning client care assignments for a unit. Which of the following task should the nurse assign to a LPN? a) Determine the swallowing ability of a patient who had a stroke b) Provide enteral feeding to a client who has Crohn's disease c) Develop a teaching plan for a patient who has a new diagnosis of type 2 diabetes mellitus d) Weigh a client who is 3 days postoperative following coronary artery bypass grafting
b) Provide enteral feeding to a client who has Crohn's disease
A nurse who has just assumed the role of unit manager is examining the skills necessary for interprofessional collaboration. Which of the following actions support the nurse's interprofessional collaboration? SATA a) Use aggressive communication when addressing the team b) Recognize the knowledge and skills of each member of the team c) Ensure that a nurse is assigned to serve as the group facilitator for all interprofessional meetings d) Encourage the client and family to participate in the team meeting e) Support team member requests for referral
b) Recognize the knowledge and skills of each member of the team d) Encourage the client and family to participate in the team meeting e) Support team member requests for referral
A nurse is observing a newly licensed nurse and an AP pull a client up in bed using a drawsheet. Which of the following actions by the newly licensed nurse indicates an understanding of this technique? a) The nurse stands with both feet together b) The nurse uses their body weight to counter the client's weight c) The nurse's feet are facing inward toward the center of the bed d) The nurse rotates the waist while pulling the client upward
b) The nurse uses their body weight to counter the client's weight
A nurse is caring for a client who is scheduled for surgery. The client hands the nurse information about advance directives and states, "Here, I dont need this. I am too young to worry about life-sustaining measures and what I want done for me." Which of the following actions should the nurse take? a) Return the papers to the admitting department with a note stating that the client does not wish to address the issue at this time b) Explain to the client that you never know what can happen during surgery and to fill out the papers just in case c) Contact a client representative to talk with the client and offer additional information about the purpose of advance directives d) Inform the client that surgery cannot be conducted unless the advance directive forms are completed
c) Contact a client representative to talk with the client and offer additional information about the purpose of advance directives
A nurse is participating in a quality improvement study of a procedure frequently performed on the unit. Which pf the following information will provide data regarding the efficacy of the procedure? a Frequency with which the procedure was performed b) Client satisfaction with performance of procedure c) Incidence of complications related to procedure d) Accurate documentation of how the procedure was performed
c) Incidence of complications related to procedure
A nurse enters the room of a client and finds the client lying on the floor. Which of the following actions should the nurse take first? a) Call the provider b) Ask a staff member for assistance getting the client back into bed c) Inspect the client for injuries d) Instruct the client to ask for help if they need to get out of bed
c) Inspect the client for injuries
A nurse is reviewing the hospital's fire safety policies and procedures with newly hired assistive personnel. The nurse is describing what to do when there is a fire in a client's trash can. Which of the following information should the nurse include? SATA a) The first step is to pull the alarm b) Use a Class C fire extinguisher to put out the fire c) Instruct ambulatory patients to evacuate to a safe place d) Pull the pin on the fire extinguisher prior to use e) Close all doors
c) Instruct ambulatory patients to evacuate to a safe place d) Pull the pin on the fire extinguisher prior to use e) Close all doors
A nurse is assigning care for four clients. Which of the following tasks should the nurse plan to delegate to an assistive personnel? a) Perform an admission assessment on a client b) Administer subcutaneous medications to the client c) Record a client's meal intake d) Develop a plan of care for the client
c) Record a client's meal intake
A nurse is caring for a child who is being treated in the emergency department following a head contusion from a fall. History reveals the child lives at home with one parent. The provider's discharge instructions include waking the child every hour to assess for indications of a possible head injury. In which of the following situations should the nurse intervene and attempt to prevent discharge? a) The parent states that they do not have insurance or money for a follow up visit b) The child states, "My head hurts and I want to go home." c) The nurse smells alcohol on the parent's breath d) The parent verbalizes fear about taking the child home and requests they be kept overnight
c) The nurse smells alcohol on the parent's breath
A nurse is reviewing a client's health care record and discovers that the client's do-not-resuscitate prescription has expired. The client's condition is not stable. Which of the following actions should the nurse take? a) Assume that the client does not want to be resuscitated, and take no action if they experience cardiac arrest b) Write a note on the front of the provider prescription sheet asking that the DNR be represcribed c) Anticipate that CPR will be instituted if the client goes into cardiopulmonary arrest d) Call the provider to determine whether the prescription should be immediately reinstated
d) Call the provider to determine whether the prescription should be immediately reinstated
A nurse manager is providing information to the nurses on the unit about ensuring client rights. Which of the following regulations outlines the rights of individuals in health care settings? a) American Nurses Association Code of Ethics b) HIPAA c) Patient Self-Determination Act d) Patient Care Partnership
d) Patient Care Partnership
The nurse is providing care for a patient with reflux urinary incontinence. Which action could be appropriately assigned to a new LPN/LVN? a) Teaching the patient bladder emptying by the Crede method b) Demonstrating how to perform intermittent self catheterization c) Discussing when to report side effects of bethanechol chloride to the health care provider d) Reinforcing the importance of proper handwashing to prevent infection
d) Reinforcing the importance of proper handwashing to prevent infection
