(Med Surg II) Unit 1: Leadership Study Guide

The new nurse is having difficulty with time management. She is frustrated and always stays late to complete her work. What would be the first step to improve time management? 1. Ask for help if falling behind schedule 2. Stop socializing with colleagues 3. Reflect on how the time is being spent 4. Set goals every day and stick to them

3. Reflect on how the time is being spent

The patient had surgery in the morning; at bedtime, he requests pain medication. The nurse administers a preoperative dose of opioid medication. An hour later, the patient reports unrelieved pain and the nurse recognizes the error. What would the nurse do first? 1. Check the postoperative prescription and give the correct dose. 2. Inform the patient that additional medication cannot be given at this time. 3. Report the error to the HCP and ask for a one-time prescription for pain medication 4. Make out an incident report and document actions in the patient record

3. Report the error to the HCP and ask for a one-time prescription for pain medication

Identify the following type of leadership style: Takes into account the style of the leader and the characteristics of the group

Situational leadership

Normal range of creatinine (female)

0.5 - 1.1

Normal range of creatinine (male)

0.6 - 1.2

Normal range of INR

0.8 - 1.1

The nurse is caring for a client with a diagnosis of cancer who is immunosuppressed. The nurse would suggest to the registered nurse the need for implementing neutropenic precautions if the client's white blood cell count was which value? 1. 2000 mm3 2. 5800 mm3 3. 8400 mm3 4. 11,500 mm3

1. 2000 mm3

A client with a history of cardiac disease is due for a morning dose of furosemide. Which serum potassium level, if noted in the client's laboratory report, would be reported before administering the dose of furosemide? 1. 3.2 mEq/L 2. 3.8 mEq/L 3. 4.2 mEq/L 4. 4.8 mEq/L

1. 3.2 mEq/L

A client experiences cardiac arrest. The nurse leader quickly responds to the emergency and assigns clearly defined tasks to the work group. In this situation, the nurse is implementing which leadership style? 1. Autocratic 2. Situational 3. Democratic 4. Laissez-faire

1. Autocratic

These nurses have recently relocated from another state and are working at a new job. Which nurse has the greatest need to clarify the nurse practice act before acting on the request? 1. LPN/LVN gets a verbal order to insert a peripheral IV catheter; then push IV opioid medication. 2. Supervising RN asks LPN/LVN to train and supervise new unlicensed assistive personnel (UAP). 3. Patient requests that LPN/ LVN explain the difference between power of attorney and living will. 4. Another LPN/LVN asks if the nurse could switch a shift because of child-care issues.

1. LPN/LVN gets a verbal order to insert a peripheral IV catheter; then push IV opioid medication.

he nurse is caring for a client who takes ibuprofen for pain. The nurse is gathering information on the client's medication history and determines it is necessary to consult with the registered nurse if the client is also taking which medications? Select all that apply. 1. Warfarin 2. Glimepiride 3. Amlodipine 4. Simvastatin 5. Hydrochlorothiazide

1. Warfarin 2. Glimepiride 3. Amlodipine

Normal range of BUN

10-20

Normal range of PT

11.0 - 12.5 seconds

Normal range of hemoglobin/HGB (female)

12-16 g/dL

Normal range of sodium

135 - 145 mEq/L

Normal range of hemoglobin/HGB (male)

14-18 g/dL

Normal range of platelets/thrombocytes

150,000-400,000 cells/uL

A newly graduated nurse is interviewing for her first job. Which question is the most important for the nurse to ask? 1. "Is the employment contract verbal, implied or written?" 2. "What kind of internship or residency programs do you offer?" 3. "How would I fit into the existing organizational chart?" 4. "Would I have to take a competency test for medication or math?"

2. "What kind of internship or residency programs do you offer?"

Which action could be considered negligence by the nurse and could potentially result in the loss of the nursing license. 1. Fails to check patient allergies prior to administering medication, but patient suffers no harm 2. Fails to report change of status to HCP; the patient declines and resuscitation is required 3. Fails to give medication within the time limit establishes by the facility's policies and procedures 4. Fails to come to work on time and so offing nurse has to stay later to cover patient care 3. 4.

2. Fails to report change of status to HCP; the patient declines and resuscitation is required

A client with atrial fibrillation who is receiving maintenance therapy of warfarin sodium has a prothrombin time (PT) of 35 seconds and an international normalized ratio (INR) of 3.5. On the basis of these laboratory values, the nurse anticipates which prescription? 1. Adding a dose of heparin sodium 2. Holding the next dose of warfarin 3. Increasing the next dose of warfarin 4. Administering the next dose of warfarin

2. Holding the next dose of warfarin

A licensed practical nurse is explaining the appropriate methods for measuring an accurate temperature to an assistive personnel (AP). Which method, if noted by the AP as being an appropriate method, indicates the need for further teaching? 1. Taking a rectal temperature for a client who has undergone nasal surgery 2. Taking an oral temperature for a client with a cough and nasal congestion 3. Taking an axillary temperature on a client who has just consumed hot coffee 4. Taking a temporal temperature on the neck behind the ear on a client who is diaphoretic

2. Taking an oral temperature for a client with a cough and nasal congestion

A conscientious nursing student tearfully says, "The NCLEX-PN questions were hard and increasingly difficult. At 85 questions, the examination stopped. I think I failed." What is the instructor's best response? 1. "You seem really upset. Let's take a moment and talk about how you feel." 2. "So, worst-case scenario, if you failed, what can do you to take the next steps?" 3. "Difficult questions are selected by performance; this reflects a high competence level." 4. "Don't worry; generally having the system stops at 85 questions means that you passed."

3. "Difficult questions are selected by performance; this reflects a high competence level."

The nurse is attending an agency orientation meeting about the nursing model of practice implemented in the facility. The nurse is told that the nursing model is a team nursing approach. Which of the following describes the team-based model of nursing practice? 1. A task approach method is used to provide care to clients. 2. Managed care concepts and tools are used when providing client care. 3. Nursing staff are led by the nurse when providing care to a group of clients. 4. A single registered nurse is responsible for providing nursing care to a group of clients.

3. Nursing staff are led by the nurse when providing care to a group of clients.

Normal range of potassium

3.5 - 5 mEq/L

Normal range of hematocrit/HCT (female)

37% - 47%

A nurse is participating in a phone interview for a job at a pediatric walk-in clinic. Which question would be inappropriate for the interviewer to ask? 1. "Have you ever been arrested for a criminal activity?" 2. "Do you have hobbies or recreational activities that involve children?" 3. "Do you think that pediatrics is part of your long-term career goals?" 4. "Do you think that a person of your age could work with children?"

4. "Do you think that a person of your age could work with children?"

A licensed practical nurse (LPN) is precepting a student assigned to care for a client with chronic pain. Which statement, if made by the student, indicates the need for further teaching regarding pain management? 1. "I will be sure to ask my client what their pain level is on a scale of 0 to 10." 2. "I know that I need to follow up after giving medication to make sure it is effective." 3. "I know that pain in the older client might manifest as sleep disturbance or depression." 4. "I will be sure to cue in to any indicators that the client may be exaggerating their pain."

4. "I will be sure to cue in to any indicators that the client may be exaggerating their pain."

A client is receiving a continuous intravenous infusion of heparin sodium to treat deep vein thrombosis. The client's activated partial thromboplastin (aPTT) time is 65 seconds. The licensed practical nurse reviews the laboratory results with the registered nurse, anticipating that which action is needed? 1. Discontinuing the heparin infusion 2. Increasing the rate of the heparin infusion 3. Decreasing the rate of the heparin infusion 4. Leaving the rate of the heparin infusion as is

4. Leaving the rate of the heparin infusion as is

The nurse has delegated several nursing tasks to staff members. Which is the nurse's primary responsibility after the delegation of tasks? 1. Document that the task was completed. 2. Assign the tasks that were not completed to the next nursing shift. 3. Allow each staff member to make judgments when performing the tasks. 4. Perform follow-up with each staff member regarding the performance and outcome of the task.

4. Perform follow-up with each staff member regarding the performance and outcome of the task.

The nurse is assigned to be the chairman of a patient satisfaction committee. The committee will include nurses, UAPs, and unit secretaries from other units in the hospital. Which style of leadership would be the most useful? 1. Autocratic 2. Democratic 3. Laissez-faire 4. Situational

4. Situational

Normal range of RBC (female)

400,000- 490,000 mL

Normal range of hematocrit/HCT (male)

42% - 52%

Normal range of RBC (male)

450,000 - 550,000 mL

Normal range of WBC

5,000-10,000 mm^3

Normal range of PTT

60 - 70 seconds

Normal blood of blood pH

7.35 - 7.45

Normal range of glucose

70 - 110 mg/dL

Identify the following type of leadership style: Leader retains all authority and responsibility and has one-way communication with the group

Autocratic style

Identify the following type of leadership style: People-centered approach that allows employees to have more control and participation in decision making

Democratic style

Identify the following type of leadership style: Leader relinquishes all control and delegates responsibility to the group

Laissez-faire style

Advacement

a rise in rank or importance, a promotion progress, improvement

Burnout

a state of physical, emotional, and spiritual exhaustion

Endorsement

statement of recognition of the license of a health practitioner in one state by another

Nurse practice act

the licensing act

Transcribe

writes or types a copy of

There has been an earthquake in the area, and disaster victims are being brought into the emergency department. In this situation, which type of leadership would the nurse manager use? 1. Democratic 2. Autocratic 3. Situational 4. Laissez-faire

2. Autocratic

The nurse is recording a nursing hands-off (end-of-shift) report for a client. Which information needs to be included? 1. As-needed medications given that shift 2. Normal vital signs that have been the same since admission 3. All of the tests and treatments the client has had since admission 4. Total number of scheduled medications that the client received on that shift

1. As-needed medications given that shift

Which nurses are using strategies to prevent burnout? Select all that apply. 1. Nurse A asks colleagues and family if they notice signs of burnout. 2. Nurse B strives to meet the expectations of supervisor and coworkers. 3. Nurse C completes morning rounds before preparing routine medications. 4. Nurse D schedules time to spend with family doing fun activities. 5. Nurse E explores opportunities in different fields of nursing. 6. Nurse F sympathizes with other nurses and offers to help them.

1. Nurse A asks colleagues and family if they notice signs of burnout. 3. Nurse C completes morning rounds before preparing routine medications. 4. Nurse D schedules time to spend with family doing fun activities. 5. Nurse E explores opportunities in different fields of nursing.

Several laboratory tests are prescribed for a client, and the nurse reviews the results of the tests. Which laboratory test results would the nurse report? Select all that apply. 1. Platelets 35,000 mm3 2. Sodium 150 mEq/L 3. Potassium 5.0 mEq/L 4. Segmented neutrophils 40% 5. Serum creatinine, 1 mg/dL 6. White blood cells, 3000 mm3

1. Platelets 35,000 mm3 2. Sodium 150 mEq/L 4. Segmented neutrophils 40% 6. White blood cells, 3000 mm3

The nurse is educating a new nurse about mass casualty events (disasters). Which statement by the new nurse indicates a need for further teaching? Select all that apply. 1. "An event is termed a mass casualty when it overwhelms local medical capabilities." 2. "Mass casualty events do not require an increase in the number of staff that are needed." 3. "A mass casualty event occurs only within the health care facility and could endanger staff." 4. "Mass casualty events may require the collaboration of many local agencies to handle the situation." 5. "A mass casualty event occurs if a fight between visitors occurs in the emergency department."

2. "Mass casualty events do not require an increase in the number of staff that are needed." 3. "A mass casualty event occurs only within the health care facility and could endanger staff." 5. "A mass casualty event occurs if a fight between visitors occurs in the emergency department."

A client has been admitted to the hospital for urinary tract infection and dehydration. The nurse determines that the client has received adequate volume replacement if the blood urea nitrogen (BUN) level drops to which value? 1. 3 mg/dL 2. 15 mg/dL 3. 29 mg/dL 4. 35 mg/dL

2. 15 mg/dL

The nurse is assigned to care for four clients. When planning client rounds, which client would the nurse check first? 1. A client in skeletal traction 2. A client who is dependent on a ventilator 3. A postoperative client preparing for discharge 4. A client admitted during the previous shift with a diagnosis of gastroenteritis

2. A client who is dependent on a ventilator

The nurse is planning the client assignments for the day. Which is the most appropriate assignment for the assistive personnel (AP)? 1. A client who requires wound irrigation 2. A client who requires frequent ambulation 3. A client who is receiving continuous tube feedings 4. A client who requires frequent vital signs after a cardiac catheterization

2. A client who requires frequent ambulation

The nurse is working in a long-term care facility and instructs the UAP to assist several patients with morning hygiene and report back if anyone is having any problems. Which delegation error has the nurse made? 1. Has assigned the UAP too many patients 2 Has given the UAP a task that is not within scope of practice 3. Has given broad and generalized instructions to the UAP 4. Has failed to give feedback on the UAP's performance

3. Has given broad and generalized instructions to the UAP

The nurse employed in an emergency department (ED) is assigned to assist with the triage of clients arriving at the ED. The nurse would assign priority to which client? 1. A client complaining of muscle ache, headache, and malaise 2. A client who twisted their ankle when they fell in-line skating 3. A client with a minor laceration on the index finger sustained while cutting an eggplant 4. A client with chest pain who states that they just ate pizza that was made with a very spicy sauce

4. A client with chest pain who states that they just ate pizza that was made with a very spicy sauce

The newly graduated nurse has taken a new job, but the facility does not have a mentoring program. Which action would be the best for nurse to accomplish self-monitoring? 1. Shadow an experienced nurse for several days 2. Ask for an extended probationary period 3. Offer to work weekends or night shifts 4. Ask questions and observe experienced nurses.

4. Ask questions and observe experienced nurses.

A client brought to the emergency department states that he has accidentally been taking two times his prescribed dose of warfarin for the past week. After noting that the client has no evidence of obvious bleeding, the nurse plans to assist the registered nurse with which action? 1. Administering an antidote 2. Drawing a sample for type and crossmatching and transfusing the client 3. Drawing a sample for an activated partial thromboplastin time (aPTT) level 4. Drawing a sample for prothrombin time (PT) and international normalized ratio (INR)

4. Drawing a sample for prothrombin time (PT) and international normalized ratio (INR)

A client with a history of gastrointestinal bleeding has a platelet count of 300,000 mm3. The nurse needs to take which action after seeing the laboratory results? 1. Report the abnormally low count 2. Report the abnormally high count 3. Place the client on bleeding precautions 4. Place the normal report in the client's medical record

4. Place the normal report in the client's medical record

Under which circumstance would it be most appropriate for the nurse to contact the state board of nursing, if the nurse has already tried to go up the chain of command at the place of employment? 1. LPN/LVN feels the competency testing was unfair because of culturally biased questions. 2. Charge nurse shows favoritism to her friends when making out the patient assignments. 3. Patient has threatened to name LPN/LVN in a lawsuit that involves physician malpractice 4. Supervising RN is making assignments that fall outside the LPN/LVN's scope of practice.

4. Supervising RN is making assignments that fall outside the LPN/LVN's scope of practice.

The nurse overhears an RN, who is a friend discussing patient information in the cafeteria. There are visitors nearby and they appear to be listening. What would the nurse do first? 1. Take the RN aside and tell her the others are listening 2. Report the RN to the office of risk management 3. Walk over to the RN and quickly change the subject 4. Write an incident report and submit it anonymously

1. Take the RN aside and tell her the others are listening

The nurse is caring for several patients. Which tasks can be delegated to the UAP? Select all that apply. 1. Taking the morning vital signs 2. Changing the linens for isolation patients 3. Restocking the medications and intravenous solutions 4. Ambulating patients in the hallway 5. Assessing skin conditions while bathing 6. Transcribing orders during the night shift

1. Taking the morning vital signs 2. Changing the linens for isolation patients 4. Ambulating patients in the hallway

The nurse delegates the task of charging the surgical dressing to the certified nursing assistant (CNA). Which right of delegation in the nurse not following? (Select all that apply) 1. Task 2. Direction 3. Person 4. Supervision

1. Task 2. Direction 3. Person 4. Supervision

The nurse employed in a long-term care facility is planning the client assignments for the shift. Which client would the nurse assign to the assistive personnel (AP)? 1. A client who requires a 24-hour urine collection 2. A client who requires twice-daily dressing changes 3. A client with diabetes mellitus who requires daily insulin and the reinforcement of dietary measures 4. A client who has been placed on a bowel management program and requires rectal suppositories and a daily enema

1. A client who requires a 24-hour urine collection

Which nurse needs a reminder about how to handle confidential information? 1. Nurse A discusses patient information during change-of-shift report 2. Nurse B makes notes during the shift and shreds notes before leaving the unit 3. Nurse C discusses the patient's condition with the wife and adult children 4. Nurse D monitors the UAP's and intervenes as needed to safeguard patients' privacy

3. Nurse C discusses the patient's condition with the wife and adult children

The nurse is assigned to care for four clients. When planning client rounds, which client would the nurse collect data from first? 1. A client scheduled for a chest x-ray 2. A client requiring daily dressing changes 3. A postoperative client preparing for discharge 4. A client receiving oxygen who is having difficulty breathing

4. A client receiving oxygen who is having difficulty breathing

A new nurse is unsure of a prescription that is handwritten but believes that it is appropriate. What would the nurse do first? 1. Transcribe it to the medication administration record 2. Report the problem to the nursing supervisor 3. Wait for the health care provider (HCP) to return and clarify prescription 4. Ask the charge nurse or senior nurse to look at the prescription

4. Ask the charge nurse or senior nurse to look at the prescription

The LPN/LVN desires to improve knowledge and skills in IV therapy. Which educational opportunity would be the best route? 1. Associate nursing degree 2. In-service education 3. Refresher course 4. Certification

4. Certification

A client with diabetes mellitus has a glycosylated hemoglobin A1C level of 9%. On the basis of this test result, the nurse plans to reinforce teaching the client about the need for which measure? 1. Avoiding infection 2. Taking in adequate fluids 3. Preventing and recognizing hypoglycemia 4. Preventing and recognizing hyperglycemia

4. Preventing and recognizing hyperglycemia

Which actions are considered part of the responsibilities of the nurse manager? Select all that apply. 1. Submits staffing schedules for the unit 2. Conducts regular staff meetings 3. Role-models nursing care for a group of assigned patients 4. Recruits, interviews, and hires new employees 5. Conducts routine staff evaluations 6. Establishes necessary staff and interdisciplinary committees

1. Submits staffing schedules for the unit 2. Conducts regular staff meetings 4. Recruits, interviews, and hires new employees 5. Conducts routine staff evaluations 6. Establishes necessary staff and interdisciplinary committees

An adult female client has a hemoglobin level of 10.8 g/dL. The nurse interprets that this result is most likely caused by which condition noted in the client's history? 1. Dehydration 2. Heart failure 3. Iron deficiency anemia 4. Chronic obstructive pulmonary disease

3. Iron deficiency anemia

The nursing student will be able to take the NCLEX-PN within a few months. However, the student's fiancé is likely to be transferred to another state within the next year. What would the student do? 1. Wait until the fiancé has moved and then apply to that state board of nursing to take NCLEX-PN®. 2. Wait until after legally married to take the NCLEX-PN® so that the license will be issued under the married name. 3. Apply to take the NCLEX-PN® in the current state of residency and investigate reciprocity or endorsement with other states. 4. Apply to take the NCLEX-PN® in the current state of residency and then retake theNCLEX-PN® in the permanent state of residency

3. Apply to take the NCLEX-PN® in the current state of residency and investigate reciprocity or endorsement with other states.

A client with diabetes mellitus has a blood sample drawn for the determination of a fasting blood glucose level. When reviewing the client's results, the nurse determines that which requires a call to the primary health care provider for intervention? 1. 75 mg/dL 2. 92 mg/dL 3. 120 mg/dL 4. 240 mg/dL

4. 240 mg/dL

A licensed practical nurse is caring for a postoperative client who is receiving demand-dose hydromorphone via a patient-controlled analgesia (PCA) pump for pain control. The nurse enters the client's room and finds the client drowsy and records the following vital signs: temperature 36.2°C (97.2°F) orally, pulse 52 beats per minute, blood pressure 101/58 mm Hg, respiratory rate 11 breaths per minute, and SpO2 of 93% on 3 liters of oxygen via nasal cannula. Which action must the nurse take first? 1. Document the findings 2. Attempt to arouse the client 3. Contact the registered nurse immediately 4. Check the medication administration history on the PCA pump

2. Attempt to arouse the client