Leadership Dynamic Quizzes

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? 1. "Let me call your surgeon while you tell me about your concerns." 2. "You should talk to your family before you make this decision." 3. "I'll ask your surgeon to speak to you as soon as you are in the surgical suite." 4. "Everything will be fine. The operation will be over soon, and you will be glad you had it done."

1. "Let me call your surgeon while you tell me about your concerns." The client has the right to refuse treatment. Speaking with the nurse and the provider about concerns or questions could relieve anxieties and allow the client to continue with the procedure. Consent may be withdrawn after being given. It is the nurse's responsibility to notify the surgeon if the client verbalizes a desire to stop or delay a medical procedure or treatment.

A nurse is providing teaching for new parents on safe sleeping recommendations to reduce the risk of sudden infant death syndrome (SIDS). Which of the following instructions should the nurse include? 1. "Room sharing is recommended while the infant sleeps." 2. "Bundle the infant snugly in 2 blankets at bedtime." 3. "Only use bumper pad that can be securely attached to the crib rails." 4. "The side-lying position is safest for infant sleeping."

1. "Room sharing is recommended while the infant sleeps." Sharing a room during sleep has been found to decrease the incidence of SIDS. However, infants should have their own sleeping space, such as a crib or bassinet. Bed sharing is not recommended. To decrease the risk of suffocation, infants should be kept warm by dressing them in a one-piece sleep sack. Avoiding the use of bumper pads, blankets, pillows, comforters, and stuffed toys reduces the risk for SIDS. The supine position is recommended for reducing the risk of SIDs

A charge nurse is teaching a group of clients in an assisted living facility about client rights. Which of the following pieces of information should the charge nurse include in the teaching? 1. "You can request to review your personal medical records at any time." 2. "A 20-day notice is required prior to you being transferred to long-term care." 3. "An executor will be assigned to manage your financial affairs." 4. "You will have a provider other than your primary physician assigned to your care."

1. "You can request to review your personal medical records at any time." Clients have the right to request their own medical records and should expect adequate and appropriate care from the facility's personnel. A client has the right to a 30-day notice if transfer to a long-term facility is required. The 30-day notice is to assist the client with financial preparations and to promote the client's welfare. A client has the right to make independent choices, such as managing personal financial affairs A client has the right to keep his/her provider and to choose a different provider if necessary.

A nurse is participating in an ethics committee meeting about a client who has a history of alcohol use disorder and needs a liver transplant. Which of the following actions should the committee take first? 1. Collect information related to the issue 2. Consider the possible choices of action 3. Make a decision regarding transplant recommendation 4. Justify the recommendation for or against a transplant

1. Collect information related to the issue According to evidence-based practice, the committee should take the first step in ethical decision-making by identifying the ethical issue and problem. This step includes asking questions to define the issue and the complexities of the situation.

A client in a long-term care facility falls out of bed, fracturing his left hip. The side rails on the bed were not raised at bedtime, although this client was identified to be at risk of falling. Which of the following torts has occurred. 1. Negligence 2. Battery 3. Intentional tort 4. Slander

1. Negligence Negligence occurs when a client is exposed to an unreasonable risk of injury. Raised side rails help decrease the risk of falling out of bed and are a standard of care for clients who have been identified as at risk for falling. Battery is defined as touching a client without consent An intentional tort occurs when a person willfully injures another in some manner Slander is an injury to one's reputation caused by spoken word.

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) 1. Performing tracheostomy suctioning for a client who is stable 2. Preparing an admission assessment for a client who is preoperative 3. Creating a plan of care for a client who has COPD 4. Interpreting a client's digoxin level

1. Performing tracheostomy suctioning for a client who is stable An RN may delegate the task of performing a tracheostomy suctioning for a client who is stable or whose tracheostomy is not new to the LPN. This task is within the LPN's scope of practice.

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? 1. Report the findings to local police and social service agencies. 2. Report the findings to the school district superintendent 3. Call the parents of the child and further assess the causative event. 4. Reassess the child on a weekly basis for injuries.

1. Report the findings to local police and social service agencies. Health care providers are required to report suspected child abuse. The nurse's primary concern is the safety of the child. procedures for reporting differ in various locations, but procedures involve notification of police and social services personnel who can investigate the situation.

A nurse is walking with a client who falls after the facility-issued walker loses a wheel. Which of the following actions should the nurse take regarding the completed incident report? 1. Submit the variance report to the risk manager 2. Place the variance report in the client's chart. 3. Document the completion of the incident report in the client's medical record. 4. Make a copy of the variance report for the provider.

1. Submit the variance report to the risk manager Incident reports are confidential documents used by the institution to improve client care. Filing an incident report does not supersede the need for documenting the assessment in the client's medical record and notifying the provider. Once completed, the variance form should be submitted to he institution's risk manager.

A nurse suspects that a coworker is under the influence of alcohol. Which of the following behaviors in the workplace are consistent with substance use disorder? (select all that apply) 1. Taking extended lunch periods and breaks 2. Calling in sick frequently on Mondays or Fridays 3. Expressing frustration with work assignments 4. Demonstrating decreased concern about personal appearance and grooming. 5. Using excessive amounts of cologne or mouthwash.

1. Taking extended lunch periods and breaks 2. Calling in sick frequently on Mondays or Fridays 4. Demonstrating decreased concern about personal appearance and grooming. 5. Using excessive amounts of cologne or mouthwash. Extended lunch periods and breaks may indicate that the individual is ingesting alcohol in a remote location. Calling in sick frequently on Mondays or Fridays may imply that the individual is binge drinking on weekends and is too ill to come to work. Decreased concern about personal appearance and grooming and excessive use of cologne or mouthwash are signs of substance use disorder.

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? 1. Verbally remind the employee about the facility's employment standards 2. Recommend that the employee review the facility's policy regarding absences 3. Inform the employee in writing about the facility's employment policy 4. Ask the employee for a written action plan after discussing the reasons for these absences.

1. Verbally remind the employee about the facility's employment standards Verbal admonishment is the first step in the disciplinary process for this type of infraction. The employee might not know or remember the existing standard, and a verbal reminder may be sufficient to change the employee's behavior.

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? 1. "This purchase will require the completion of a variance analysis? 2 "This purchase will need to be addressed in the capital budget plan for the unit." 3." This purchase will result in a reduction in the operating budget." 4. "This purchase can be reimbursed by Medicare funds, as clients who use Medicare will benefit from the equipment."

2 "This purchase will need to be addressed in the capital budget plan for the unit." The capital budget involves planning for spending related to equipment and major purchases that have a long life of use.

A nurse is planning care for a client following a coronary artery bypass graft procedure. The nurse places a referral for a case manager to visit the client. Which of the following pieces of information should the nurse share with the client about the role of a case manager? 1 "The case manager will provide your direct care for the remainder of your stay in the facility." 2. "The case manager will coordinate and plan your care while you recover from your surgery." 3. "The case manager will meet you on the day before your scheduled discharge date." 4. "The case manager is responsible for completing your insurance claim forms."

2. "The case manager will coordinate and plan your care while you recover from your surgery." The role of the case manager is to coordinate and plan client care, collaborate with other health professionals, and monitor costs and quality of care. The case manager is involved in client care throughout the client's stay in the facility, serving as a facilitator and care coordinator. The case manager does not wait until the time of discharge to meet with the client. The case manager is responsible for facilitating the use of cost-effective care measures during hospitalization but is not responsible for completing incus4rance claim forms.

A nurse is delegating tasks to assistive personnel (AP) for the care of a group of clients. Which of the following directions should the nurse provide? 1. "Take the temperature of the client in room 200." 2. "Transport the client in room 203 to the radiology department at 1000." 3. "Obtain the vital signs of the client in room 205 when he returns from surgery." 4. "Contact the provider of the client in room 208 regarding her decreased hemoglobin level."

2. "Transport the client in room 203 to the radiology department at 1000." This statement observes the rights of delegation. it provides an appropriate task within the AP's scope of practice and offers the right communication by telling the AP which client to transport, where to take the client, and what time the client needs to be at the radiology department.

A charge nurse is evaluating conflict resolution between two staff nurses. Which of the following conflict-resolution styles is an example of one nurse putting aside personal goals to satisfy the other nurse? 1. Avoidance 2. Accommodation 3. Compromise 4. Collaboration

2. Accommodation Accommodation is when one person puts aside personal goals to satisfy the needs of another individual. This nurse is using accommodation in order to resolve the conflict. Avoidance is when one person uses passive behaviors and withdraws from a conflict, preventing either individual from pursuing personal goals Compromise is when both individuals give up something to achieve a common goal. Collaboration is when both individuals actively try to find a solution that is acceptable to all parties.

A nurse enters the room of an older adult client and finds him attempting to crawl over the side rail of his bed. Which of the following actions should the nurse take? 1. Tell the client that he will be put in restraint if he attempts to get out of bed again 2. Ask an assistive personnel to sit with the client 3. remind the client to stay in bed 4. Restrain the client immediately to prevent self-harm

2. Ask an assistive personnel to sit with the client This client is at risk of falling. Having an assistive personnel sit with the client protects him from harm. Then, the nurse can contact the provider to discuss care options for this client. (e.g. restraints or placing an audible alarm)

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? (SATA) 1. use cotton balls to clean the infected areas 2. Cleanse the wound with tap water. 3. Dry the leg wound after cleaning. 4. Microwave the cleaning solution before applying it to the wound 5. Discard soiled bandages in a moisture-proof bag.

2. Cleanse the wound with tap water. 5. Discard soiled bandages in a moisture-proof bag. Tap water or 0.9% sodium chloride should be used to cleanse the wound. Soiled bandages and gloves should be placed in double-bagged, moisture-proof bags and not in the regular trash. This prevents the spread of contamination to other members within the household.

A nurse in an acute care facility is implementing the facility's disaster plan following a flood in the community. Which of the following actions should the nurse take? 1. Turn on client's television so they can learn about the disaster 2. Identify stable clients in the ICU to transfer to the medical-surgical unit 3. Ask family members to come to the hospital to provide support to clients 4. Make announcements of the status of the disaster on the public address system.

2. Identify stable clients in the ICU to transfer to the medical-surgical unit

A charge nurse on a medical-surgical unit is assigning client care to the upcoming shift. Which of the following tasks should the nurse delegate to unlicensed assistive personnel (UAP) (SATA) 1. Performing colostomy care 2. Measuring a client's intake and output 3. Interpreting a client's laboratory values following surgery 4. Providing postmortem care to a client 5. Checking nasogastric tube patency.

2. Measuring a client's intake and output 4. Providing postmortem care to a client Measuring the intake and output of a client and providing postmortem care is within the range of functions for a UAP.

A nurse is making a client's bed and finds a capsule of medication in the sheets. Which of the following actions by the nurse is consistent with safe nursing practice? (SATA) 1. Administer the medication to the client 2. Notify the provider 3. Complete a variance report 4. Document the finding in the client's electronic medical record 5. Place the medication back in the medication drawer.

2. Notify the provider 3. Complete a variance report Notifying the provider is correct. The nurse should notify the provider of the finding as a part of the variance reporting process. Completing a variance report is correct. The nurse should complete an incident or variance report regarding the occurrence.

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? 1. Obtain consent from the client 2. Obtain consent from a relative of the client 3. Consent is implied because the client agreed to be transported to the emergency department. 4. Delay the surgery until the medication has been metabolized.

2. Obtain consent from a relative of the client A client who has received meperidine cannot give consent because the medication can alter the ability to understand the consent process. The nurse should obtain consent from a relative of the client. If a relative is unavailable and the surgery is determined to be critical, the surgery can proceed without client's consent. Consent for transfer to another facility for evaluation by a specialist does not assume consent for any further procedures, surgery, or care. Delaying surgery until the medication is metabolized may cause the client unnecessary pain and increase the risk of complications and client demise. If a relative is unavailable and the surgery is determined to be critical, the surgery can proceed without client's consent.

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? 1. The planning process for the conference is centered on the nursing staff 2. Other health care professionals are in attendance at the conference 3. Controversial opinions regarding the plan of care are not tolerated during the conference 4. The conference is focused on a discussion of the client's health care issues with minimal attention to resolving them.

2. Other health care professionals are in attendance at the conference The nurse should identify that an effective conference should consist of other health care professionals who contribute to the plan of care for goal setting and seek to establish positive client outcomes. The members of the conference consist of the nursing team who should invite other health professionals (e.g. physical therapists, dieticians, and occupational therapists) to contribute to the plan of care.

A nurse is planning to delegate the postoperative care of a client following an appendectomy. Which of the following actions should the nurse assign to an assistive personnel (AP) 1. Showing the client how to use the patient-controlled analgesia pump. 2. Recording urinary output after emptying the indwelling urinary catheter 3. Assisting the client out of bed and into a chair for the first time after surgery 4. Checking the client's abdominal wound dressing.

2. Recording urinary output after emptying the indwelling urinary catheter Emptying an indwelling urinary catheter and recording intake and output are within the scope of practice of an AP. These tasks are routine and have predictable outcomes; therefore, the nurse may delegate this task to an AP.

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? 1. Occupational therapist 2. Social worker 3. Physical therapist 4. Spiritual support

2. 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? 1. The admitting provider needs to approve the client's request to leave. 2. The client has the right to make the decision to leave the hospital 3. The client should be detained if leaving presents a risk of loss or life or limb 4. The client must demonstrate self-care abilities prior to leaving the acute-care facility.

2. The client has the right to make the decision to leave the hospital

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? 1. A clarification of a medication dosage prescribed by a provider 2. The discovery that a preoperative client has received and eaten breakfast 3. The identification of a safety concern with a piece of equipment 4. A dispute with a coworker about client assignments.

2. The discovery that a preoperative client has received and eaten breakfast This situation represents a variation from the standard of care. A change in the client's plan of care is necessary because the surgical procedure will need to be delayed. The nurse should complete a variance report for this situation.

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? 1. Clostridioides difficile 2. Varicella 3 HIV exposure 4 Influenza

2. Varicella The nurse should identify that varicella [chicken pox] is a nationally notifiable infectious condition.

A group of providers is participating in a cardiopulmonary resuscitation effort for a client who is in cardiac arrest. Which of the following types of leadership is required for this group to function efficiently? 1. Transformational 2 Participative 3 Autocratic 4 Laissez-faire

3 Autocratic Autocratic leadership is most effective in an emergency situation. An autocratic leader will direct and issues commands that are necessary for successful cardiopulmonary resuscitation. A transformational leader gives group members responsibilities that will enhance their professional development. Participative leadership/democratic leadership serves as a resource person and facilitator and in non-directive Laissez-faire leader demonstrates a non-directive approach.

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? 1. Prepare a new syringe for the client who is preoperative 2. Give the prepared medication to the client who is preoperative 3 Help the client requesting assistance so the first nurse can give the prepared injection 4. report this request to the charge nurse.

3 Help the client requesting assistance so the first nurse can give the prepared injection

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) 1. A client who requires an updated plan of care following a diagnosis of cancer 2. A client who is postoperative following a total hip replacement and requires discharge teaching 3. A client who has a prescription for irrigation of an indwelling urinary catheter. 4. A client who has just arrived from PACU and requires a head-to-toe assessment.

3. A client who has a prescription for irrigation of an indwelling urinary catheter. IT is within the scope of practice of an LPN to irrigate an indwelling urinary catheter when prescribed by a provider.

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? 1. A root cause analysis assists in preparing a legal defense for the event. 2. A root cause analysis estimates the costs involved in the event. 3. A root cause analysis investigates deviations from standards of care surrounding the event. 4. A root cause analysis determines if employees involved in the event should be terminated.

3. A root cause analysis investigates deviations from standards of care surrounding the event A root cause analysis is a function of quality improvement seeking to determine what factors led to a deviation from established standards of care that resulted in errors in client care.

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? 1. Responsibility 2. Accountability 3. Advocacy 4. Confidentiality

3. Advocacy By following the ethical principle of advocacy, the nurse supports the client in the decisions she makes about her own health care. Responsibility - upholding obligations Accountability - nurse answers for personal actions confidentiality - nurse protects the client's privacy and health care information.

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? 1. An electrical cord that is taped to the floor 2. A protective cover that is placed over an unused outlet 3. An electrical cord that is frayed toward the plug. 4. An electrical plug that has 3 prongs.

3. An electrical cord that is frayed toward the plug. The nurse should identify that an electrical cord that is frayed toward the plug is damaged and should not be used. Using an electrical cord that is damaged can increase the client's risk of acquiring an electrical shock.

A nurse finds a client standing next to his bed with the side rails raised. The client is visibly confused and not wearing an identification bracelet, and his IV is detached. The client states, "I can't remember my name." After assisting the client back into bed, which of the following actions should the nurse take next? 1. Remind the client to use the call light 2. Restart the IV 3. Assess the client for injury 4. Put an identification bracelet on the client.

3. Assess the client for injury The nurse should apply the nursing process priority-setting framework when caring for this client. Each step of the nursing process builds on the previous step, beginning with an assessment or data collection. Before the nurse can formulate a plan of action, implement a nursing intervention, or notify a provider of a change in the client's status, he/she must first collect adequate data from the client. Assessing or collecting additional data will provide the nurse with the knowledge needed to make an appropriate decision.

A nurse is reviewing the medication administration record for a client and notes that the nurse from the previous shift gave double the does of antihypertensive medication prescribed to the client. Which of the following actions should the nurse take first? 1. File an incident report with factual information about the error. 2 Report the incident to the nurse supervisor 3. Check the client's condition 4. Notify the client's provider about the incident.

3. Check the client's condition The greatest risk to this client is an injury from low blood pressure due to a double dose of antihypertensive medication. Therefore, the first action the nurse should take is to check the client's condition and obtain the client's vital signs, including blood pressure.

A nurse is caring for a client who is in the bathroom. The nurse hears a loud thud and, after opening the bathroom door, finds the client on the floor. What is the priority nursing action? 1. Notify the provider of the fall 2. Call for help 3. Determine the clients' level of consciousness 4. Complete an incident report

3. Determine the clients' level of consciousness Checking the client's level of consciousness is the first action the nurse should take after a fall. This client might have had a vasovagal response while defecating, resulting in a temporary loss of consciousness that does not require CPR

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? 1. Call the clients' family members to provide additional help with moving the clients. 2. Ask client who are able to ambulate to assist in moving the unstable clients 3. Instruct clients who are able to ambulate to leave 4. Direct staff members to close the doors and windows as each room is evacuated.

3. Instruct clients who are able to ambulate to leave Clients who are able to ambulate should leave first in an evacuation process, as this quickly reduces the number of clients who require evacuation assistance.

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? 1. Understanding that the unit nurse is misinformed and taking no action 2. Assigning the unit nurse to work the night shift to facilitate direct experience with the night shift 3. Meeting one-on one with the unit nurse to discuss these concerns 4. Confronting the unit nurse during the next unit meeting regarding this statement.

3. Meeting one-on one with the unit nurse to discuss these concerns

A charge nurse is teaching a group of unit nurses about alternative restraints for clients who are confused and wandering. Which of the following pieces of information should the nurse include in the teaching? 1. Distract the client by leaving on the television 2. Plan to administer a sedative to the client 3. Provide the client with a rocking chair 4. Place full-length side rails on the client's bed.

3. Provide the client with a rocking chair The nurse should advise providing the client with a rocking chair to expend some of the client's energy through rocking rather that walking, which leads to wandering.

A nurse manager notes several recent conflicts among nurses on different shifts. Which of the following strategies should the nurse manager use to resolve these conflicts? 1. Have the charge nurses for each shift get together and discuss the issues between shifts 2. Direct the nurses from each shift to discuss their issues and present solutions to the nurse manager 3. Set up a series of meetings for all staff members to attend to discuss issues 4. Remain uninvolved and allow the nurses from each shift to resolve the issues among themselves.

3. Set up a series of meetings for all staff members to attend to discuss issues Through this approach, the nurse manager is using the conflict-resolution strategy of collaboration by encouraging all staff members associated with the conflict to communicate and work together to devise and implement win-win solutions. By having a the charge nurses from each shift get together and discuss the issues, it does not allow any of the staff members involved in the conflict to contribute t o solutions. Directing the nurses from each shift to discuss their issues and present solutions does not allow the nurse manager to participate in and facilitate the creation of win-win solutions. It only allows approval or disapproval after the staff members have spent time and energy devising potential solutions.

A nurse is caring for a client who is dying and unable to make decisions for himself. The client's adult children disagree about his code status. Which of the following sources should the nurse depend on for decisions regarding the client's end-of-life care? 1. The client's oldest child 2. The attending provider 3. The client's health care proxy 4. The facility's ethics committee

3. The client's health care proxy If the client cannot speak for himself, the nurse should follow the directions of the client's health care proxy, as this is the person the client chose to make decisions under these circumstances. In the absence of advanced directives, the facility's ethics committee may be called upon to intervene if a conflict occurs regarding end-of-life decisions.

A home health care nurse is conducting a home hazard assessment. For which of the following findings should the nurse intervene? 1. The client's hot water heater temperature is set to 46.1 (115 F) 2. There are 8 steps to enter the client's home 3. The client's household lamps have 40 watt light bulbs installed 4. The bathroom has a handheld shower attachment for bathing.

3. The client's household lamps have 40 watt light bulbs installed The nurse needs to intervene for low-wattage light bulbs. Inadequate lighting increases the risk of falls and presents a safety hazard for the client. Hot-water heater temperatures should be set to a maximum of 49 [120F] The nurse does not need to intervene for the steps leading into the client's home.

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 t o report to the CDC? 1. Clostridioides difficile 2. Candidiasis 3. Vancomycin-resistant Staphylococcus aureus 4. Trichomoniasis

3. Vancomycin-resistant Staphylococcus aureus The nurse should follow policy and procedure for reporting a client who has Vancomycin-resistant S. aureus (a communicable disease) to the CDC. trichomoniasis is not a communicable disease that needs to be reported to the CDC.

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? 1. "I will inform your surgeon that you are having second thoughts." 2. "I think you should postpone the surgery until you are certain you want to have it done." 3." Would you like me to have a member of a breast cancer support group visit you." 4. "This is a common concern of women who will be undergoing a mastectomy."

3." Would you like me to have a member of a breast cancer support group visit you." The nurse should serve as an advocate for this client. Offering to have a member of a breast cancer support group visit the client allows the client to speak with someone who has been through the same experiences and can assist with the emotional aspects of having a mastectomy.

A nurse is prioritizing care for a group of clients. The nurse should plan to attend to which of the following clients first? 1. A client who requires a sterile dressing change. 2. A client who requires gastrostomy tube feeding. 3. A client who requires urinary catheter care. 4. A client who requires endotracheal suctioning.

4. A client who requires endotracheal suctioning. When using the airway, breathing, and circulation approach to client care, the nurse should attend to a client who requires endotracheal suctioning first. Without this intervention, mucus and secretions could accumulate and block the client's airway.

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? 1. A nurse asking to care for an older adult client every day who reminds the nurse of a favorite grandparent. 2. A male nurse caring for an adolescent male client because the client is uncomfortable around female nurses. 3. A middle-aged adult assistive personnel (AP) mentoring a younger less-experienced AP on the unit. 4. A nurse practitioner withhold information from a client who is dying to avoid causing the client distress.

4. A nurse practitioner withhold information from a client who is dying to avoid causing the client distress. Paternalism is a type of relationship between clients and health care providers in which the health care providers believe they know what is best for the client. In this example, the nurse practitioner withholds information so as not to cause the client distress. This practitioner is making the decision for the client and denying the client the right to be informed.

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? 1. Monitor the staff's hand hygiene techniques 2. Hold a mandatory in-service training session about hand hygiene and infection rates 3. Require nurses to take an online course on HAIs 4. Conduct a chart review to gather data about clients who developed HAIs

4. Conduct a chart review to gather data about clients who developed HAIs The charge nurse should first conduct a chart review or audit in order to gather data about the clients who developed infections. This information will provide the charge nurse with potential indicators of factors that resulted in the increased incidence of 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? 1. Explain the disciplinary consequences of refusing to implement the new policy. 2. Reinforce with the staff nurse the importance of implementing the policy change. 3. Ignore the staff nurse's resistance and allow peer pressure to facilitate the change. 4. Encourage the staff nurse to verbalize reasons for resisting the change.

4. Encourage the staff nurse to verbalize reasons for resisting the change. The nurse manager should realize that if the nurses who must implement the change are not invested in the change process, resistance is likely. This is especially problematic when the change is unplanned or imposed by outside forces. The resistant staff nurse has likely rejected the change due to prior habits, fear of the unknown, and lack of time to learn something new. A meeting between the nurse manager and the staff nurse will provide an open forum for the staff nurse to verbalize the reasons for reluctance in adopting the new policy.

A nurse is having difficulty completing care and documentation without staying past the end of the shift. The nurse manager suggests focusing on time-management skills. Which of the following strategies should the nurse plan to use? 1. Practice multitasking throughout the shift. 2. Postpone completing documentation until the end of the shift. 3. Occasionally skip a break time 4. Identify tasks in order of their priority.

4. Identify tasks in order of their priority. Prioritizing is an important time-management strategy. The nurse should prioritize each client's needs and tasks and attend to the highest priority client first.

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? 1. Alerting the facility administration of a possible litigation situation 2. Tracking employee performance for possible disciplinary action 3. Providing a detailed report of the occurrence for the client's family 4. Identifying situations that contribute to the occurrence of medication errors.

4. Identifying situations that contribute to the occurrence of medication errors. The purpose of completing incident reports is to identify factors that contribute to the occurrence of the problem. This is one aspect of quality-improvement efforts in health care facilities. Incident reports are not completed to alert the facility administration of possible litigation situations. Using incident reports as a means for employee discipline will hinder the reporting of problems and inhibit the finding of solutions to improve the quality of client care. an incident report should not be given to the client's family as a means of providing detailed information about the error.

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? 1. Routine care procedures for the client 2. Biographical information 3. Assumptions regarding relationships among the client's family members 4. Objective measurements about the client's condition

4. Objective measurements about the client's condition The nurse should include objective observations and measurements about the client's condition in the report.

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? 1. Outcome 2. Structure 3. Strategic planning 4. Process

4. Process A process audit measures the interventions used to facilitate expected and desired outcomes for clients. Early ambulation is essential for the prevention of postoperative complications. An outcomes audit evaluates how the client's health status changed as a result of an intervention. A structure audit evaluates the relationship between quality care and appropriate structure and includes inputs such as the environment in which care is delivered. Strategic planning is done as a part of the planning process. It typically examines the purpose, mission, philosophy, and goals of an organization.

A nurse manager notes that several staff members are late in completing an annual mandatory educational session about extremity restraint safety. Which of the following actions should the nurse manager plan to take? 1. Make a general announcement at the next staff meeting asking all employees to check their adherence to the requirement 2. Post a list of the employees' break room naming those who are non-adherent and the date by which they must complete the requirement 3. Schedule a disciplinary conference with each of the non-adherent employees. 4. Send an email to each non-adherent employee that includes a link to upcoming educational sessions.

4. Send an email to each non-adherent employee that includes a link to upcoming educational sessions. Email provides a simple yet efficient way for the nurse manager to inform non-adherent employees about options for achieving adherence without embarrassing anyone with a public announcement. In addition, including the appropriate link in the email facilitates adherence by helping each employee identify an upcoming session that coordinates with his/her work schedule.

A nurse is caring for several clients who require diagnostic testing and is delegating tasks to unlicensed assistive personnel (UAP) Which of the following tasks should the nurse direct the UAP to perform first? 1. Change the transparent dressing on a client who has a stage 2 pressure ulcer 2. Bring a pitcher of fresh water to a client who has just had a lumbar puncture. 3. Transport a client to the radiology department for a routine chest X-ray. 4. Take an arterial blood gas specimen to the laboratory.

4. Take an arterial blood gas specimen to the laboratory. Arterial blood gas specimens are placed on ice and must be transported to the laboratory immediately to prevent degradation of the sample. Since this task needs to be done within a specified timeframe, it is the first task the UAP should perform. A routine chest X-ray can be delayed. If the client was experiencing respiratory difficulty, then the chest X-ray would be a higher priority. While a client who has just had a lumbar puncture will need to force fluids to help prevent a post-lumbar puncture headache, this is not the first task the UAP should perform.