PrepU Questions for Professional Nursing Exam 3
A nurse is successful in promoting change on the nursing division. This nurse would be considered a:
leader
The primary responsibility of the nurse manager is to:
create unit plans and budgets.
An experienced nurse is educating a client about the client's disease and how best to promote optimal health. The nurse is focusing the education on the cognitive domain of learning. Given this focus, the nurse would incorporate the client's:
critical thinking
The preoperative nurse is teaching a client about deep-breathing exercises. The client asks, "Why do I need to learn about this?" Which response by the nurse is correct?
"After surgery, deep-breathing exercises help to remove anesthetic gases and mucus and improve oxygen supply to body tissues."
A nurse is educating a 4-year-old client about cast care following a tibia-fibula fracture. Which action is not developmentally appropriate to include in the nurse's teaching?
Blocking 30 minutes of time for skill teaching
A staff nurse works on a medical unit where staff retention is very high. There is a sense of equality between the leader and the staff nurses. The unit decisions and activities are shared between the leader and the group. The designated nurse leader practices which leadership style?
Democratic
The new nurse is having difficulty managing the time required to care for a group of complex clients and is several hours behind in completing nursing interventions. Which intervention should the nurse complete first?
Administer a dose of digoxin that is two hours behind schedule.
A nurse explains the effects of conscious sedation to a client undergoing a colonoscopy. Which of the following occurs with conscious sedation?
Altered mood
Which perioperative client will the nurse monitor most closely for signs and symptoms of hypothermia?
An older adult client have hip replacement surgery
A toddler will be undergoing hernia repair surgery. What nursing action will best reduce the client's anxiety?
Apply equipment and perform preparation after anesethetic has taken effect
The nurse enters a postoperative client's room and finds that the client is bleeding profusely from the surgical incision. What would be the nurse's most appropriate initial response?
Apply pressure to the surgical site to decrease bleeding.
The charge nurse on a postoperative surgical unit is responsible for making client assignments for staff nurses. Two staff nurses have voiced not wanting to assume care for any new postoperative surgical clients during their shifts. How can the charge nurse resolve this conflict using the strategy of compromise to address the immediate concerns of the two staff nurses?
Approach both nurses to discuss incentives that can be given for agreeing to accept new postoperative surgical clients.
The client has Alzheimer disease and is a new admission to the nursing home. The client was transferred from the hospital. When first meeting the client, what technique(s) will the nurse use to facilitate communication with this client? Select all that apply
Approach the client from the front of the client. Call the client by the client's preferred name. Use simple words and short sentences when talking with the client.
Conflict has emerged on a nursing unit because new graduates have found that some of the more experienced nurses are manipulating the client assignment to ensure a lighter workload during night shifts. How should the manager of the unit best address this conflict?
Arrange a meeting where the issue can be discussed and addressed by as many of the nurses as possible.
The nurse is teaching a client with diabetes how to inject daily insulin. Which method is most effective in evaluating the teaching?
Ask the client to demonstrate how to self-inject the morning insulin.
The nurse is developing a plan of care for a client who had a splenectomy. The outcome is prevention of surgical site infection. Which interventions should be included in the client's plan of care? Select all that apply.
Assess vital signs. Monitor white blood cell count. Use asepsis with dressing change. maintain hydration
A nurse is in charge of a large group of employees on a busy surgical floor. Today's care must be completed early due to a special event involving most of the employees. Which management style would work best in this situation?
Authoritarian
A nurse manager informs the staff members during a meeting that unlicensed assistive personnel will no longer be allowed to check clients' blood glucose levels. The nurse manager informs the group that this is a new policy on the unit and that discussions will not change the enforcement of this policy. What type of leadership style is the nurse manager demonstrating?
Autocratic
On a medical unit, the nurses complain that they have no voice in the decisions that are made in the operation of the unit. The nurses state they are always told by the nurse manager to perform tasks instead of being asked. Which of these best describes the leadership style of the nurse manager?
Autocratic
A client reads the nutritional chart and follows it accurately. The nurse also notes that the client understands the need for a balanced diet and its relationship with a quick recovery. In which domain is the client demonstrating successful learning?
Cognitive
When caring for a client, the nurse observes that the client enjoys reading books and magazines. In which learning domain does the client's learning style fall?
Cognitive
The nurse manager for the psychiatric unit sees that there are major conflicts between the day and night shift staff. The nurse manager suggests that each shift put aside their differences for a time and determine a common major goal. Which conflict resolution style does the nurse manager display?
Collaborating
The nurse has recently been promoted to nurse manager on a pediatric unit and has decided to accept input from staff regarding changes they would like to see on the unit. Which type of leadership style is the nurse embodying?
Democratic
The nurse manager who asks staff members to give suggestions on how to improve collaboration between nurses and health care providers is exhibiting what style of leadership?
Democratic
A nurse informs the client that the client has no choice and must take a bath in the morning. What type of leadership does this exemplify?
Directive Leadership
The nurse is caring for a client with a new diagnosis of osteoarthritis and degenerative joint disease. Which action should the nurse perform when addressing the client's cognitive learning needs?
Educate the client about the pathophysiology of the disease process
A client is undergoing surgery for an appendectomy. This would be considered what type of surgery?
Emergency surgery
As the nurse enters the room to teach the client about self-care at home, the client states, "I am glad you are here. I need some pain medicine. I can't stand it anymore." What is the best action of the nurse?
Have the client rate pain level, and reschedule the teaching session.
A nurse is preparing to teach a 6-year-old client with a broken arm and the client's mother about caring for the child's cast. Which statement reflects the best education plan for these clients?
Include the child in the education; ask questions of both the mother and the child.
A client is scheduled for hip replacement surgery this morning but admits to the nurse that he had a small piece of toast and some water after waking up. What is the nurse's most appropriate response?
Inform the anesthesiologist or surgeon of this fact.
A nurse leader on a unit allows the staff to make all decisions and direct themselves, including filling out the work schedule. The nurse leader is practicing which leadership style?
Laissez-faire
The charge nurse on the orthopedic unit believes in giving the staff as much power as possible. The nurses are allowed, among other things, to create their own work schedules, provide dates and times for unit meetings, and create the agendas, to which the charge nurse contributes. The charge nurse's style of leadership can be described as which?
Laissez-faire
The nurse manager calls a staff into a unit meeting to discuss client satisfaction. During the meeting, several staff members assume control. The nurse manager does not intervene to regain control of the group. Which type of leadership style is the nurse embodying?
Laissez-faire
Which style of leadership is rarely used in a hospital setting because of the difficulty of task achievement by independent nurses?
Laissez-faire
The nurse cares for an adult client following surgery to repair an abdominal aortic aneurysm. Which nursing intervention should the nurse perform to assist with healing and maintaining client comfort?
Maintain a calm environment
A nurse manager is changing the policy for scheduling staff on a critical care unit. The schedules will be changed and an announcement was made regarding this to the staff. Based on Lewin's change theory, in what stage of change is the manager participating?
Moving
Which nursing action is applicable to the psychomotor domain of learning when conducting a teaching session for breastfeeding mothers?
Observing a mother expressing the breast milk
A nurse on a telemetry unit is admitting a client and has an unlicensed assistive person (UAP) helping with the admission process. Which task can the nurse delegate to the UAP?
Obtaining an admission weight for the client utilizing the client's bed scale
A nurse is caring for a client with pneumonia. Which task is most appropriate for the nurse to delegate to an experienced unlicensed assistive personnel (UAP)?
Obtaining vital signs every 4 hours.
An active, otherwise healthy, older adult client presents to the clinic with severe osteoarthritis in both knees. The nurse knows this client does not want to be a burden on the family, and the client remains stoic despite reporting the pain as severe. The client avoids the topic of surgery and attends church weekly. The client's family is supportive of any decisions the client makes regarding health. Which of the assessment data is most important to forming an individualized education plan for this client concerning treatment for osteoarthritis?
Personal perception of health and aging
Which measure would the nurse implement for prevention of deep vein thrombosis (DVT) in a postoperative client?
Place graduated compression stockings on the client.
A 46-year-old obese client has been diagnosed with hypertension and type 2 diabetes. The client acknowledges the need to lose weight. The client recently visited a local fitness club, obtained a membership, and has signed up for their next water aerobics class. According to the Transtheoretical Model of Change, what stage of change is this client in related to her weight loss?
Preparation
As a circulating nurse caring for a 45-year-old man undergoing left knee arthroscopic exploratory surgery, which task ensures that the team is on the same page and will perform the procedure on the right client and at the right site?
Procedural pause (time out)
The nurse is providing postoperative education to a client with an abdominal incision and is coaching the client to perform coughing exercises, as pictured above. What is the nurse's best action?
Provide the client with a pillow or folded blanket to hug.
The nurse is teaching the client who recently experienced abdominal surgery to deep breathe and cough effectively. What observable action serves to best minimize pain that may result from the intervention?
Providing support to abdominal and accessory respiratory muscles
A client describes pain in the lower leg and has been diagnosed with a herniated lumbar disk. The pain in the leg is what type of pain?
Referred pain
Which nursing action will assist in pain management for a client in the postoperative phase?
Relaxation technique
The nurse has provided teaching for a client with a sinus infection who has been prescribed antibiotics and a decongestant. The client states, "I'm not sure how many days I'm supposed to take this antibiotic." What is the nurse's appropriate response?
Reteach the length of time to take the prescription.
The nurse is helping to prepare a client for surgery. Who is legally responsible for obtaining the client's informed consent for the surgical procedure?
The Surgeon
The registered nurse (RN) has received orders to perform an unsafe practice on a client. The RN voices concern with the health care provider who gave the order, but the health care provider refuses to change the order. Whom should the nurse consult next regarding the order?
The charge nurse
The registered nurse (RN) notices that client assignments are not being made fairly. The charge nurse is responsible for making the client assignments and has a reputation for being argumentative. Who should the RN consult regarding the unfair client assignments?
The charge nurse
A charge nurse on a medical-surgical unit is asked by the nurse manager to serve as a mentor to another staff nurse who is less experienced. Which of these would best describe this role?
The charge nurse is providing support for the staff nurse in new responsibilities.
The nurse is advising a client about health problems related to being overweight. The client acknowledges the need to lose weight. The nurse provides education on how to count calories in food and the importance of daily exercise. The client states an intention to begin counting calories with the next meal. The client also states an intention to begin an exercise program with friends. Which statement associated with this scenario illustrates Lewin's stage of unfreezing?
The client acknowledges the need to lose weight.
Which observation during the nursing assessment of a client supports the documentation of low health literacy?
The client avoids health care screenings and seeks care in the local emergency department.
A nurse is reviewing postoperative protocols with the client, including an explanation and a demonstration of how to use an incentive spirometer. How does the nurse know that the teaching on the use of the incentive spirometer was effective?
The client completes a return demonstration and inhales with lips tightly sealed around the mouthpiece while sitting upright in bed.
The nurse recognizes that a new mother is having difficulty breastfeeding. The nurse demonstrates various positions in which to hold the infant while feeding. The nurse also educates the mother on ways to ensure proper latching. The new mother attempts to breastfeed the infant again using the new techniques and is successful. Which statement in this scenario illustrates Lewin's stage of refreezing?
The new mother attempts to breastfeed the infant again using the new techniques and is successful.
When a nurse is planning for learning, who must decide who should be included in the learning sessions?
The nurse and the client
Two new nurses are requesting the same preceptor for unit orientation. Both new nurses have been very vocal about being unhappy if they do not receive their choice of preceptor. Which illustrates the nurses using a compromise approach to conflict resolution?
The nurses agree to have the preceptor precept one nurse at the beginning of the orientation and the other at the end.
The registered nurse (RN) wants to delegate measuring a client's urinary output to an unlicensed assistive personnel (UAP). Which factors should the nurse consider before delegating the task?
The stability of the client's condition, potential for harm, and complexity of the activity
A nurse is teaching an older adult client to use an incentive spirometer following hip replacement surgery when the client asks why using this machine is necessary. How will the nurse respond?
This exercise helps prevent pneumonia
The nurse is caring for a new older adult client who states the need to use the restroom. Which safety intervention must the nurse perform first?
Assess the need for assistance with ambulation.
A postoperative vaginal hysterectomy client complains of pain that is more intense than this morning. This factor should be explained to the client as
"Acute pain tends to increase during the day and is called a routine pain response"
Which statement, if made by an adolescent preparing for abdominal surgery, would indicate to the nurse that the client requires additional instruction?
"After this fasting, I'm looking forward to a hamburger and fries once I wake up."
The nurse is preparing a client for a total hip arthroplasty and is obtaining data preoperatively. Which statement made by the client is most important for the nurse to immediately report to the health care provider?
"I have been taking ibuprofen for my hip pain twice a day."
The nurse is teaching a client how to manage postoperative pain through a patient controlled analgesia (PCA) pump. The nurse determines that additional teaching is needed when the client make which statement?
"I should only take medication when my pain is intense."
A client receiving epidural analgesia asks the nurse to put the head of the bed all the way down to sleep better. What is the correct response by the nurse?
"It is important that we keep the head of your bed elevated at least 30 degrees because this position helps to minimize the risk of respiratory depression."
A client has been prescribed patient-controlled analgesia and the nurse is setting up the system and educating the client about safe and effective use of PCA. Which teaching point should the nurse provide to the client?
"The pump is programmed with safeguards to limit the possibility overmedication."
A nurse is assessing an adult client with back pain. The client is unable to speak the dominant language. Which pain scale is most appropriate for the nurse to use in assessing the client's pain?
0 to 10 numeric rating scale
Which medical client is most likely to be experiencing diffuse pain?
A client with shingles affecting her entire torso
The nurse is caring for a client on their first postoperative day after chest surgery. The client appears stoic and does not request analgesia, The nurse should perform what action?
Actively solicit information about the client's pain level
How should the nurse position the head of the bed for a client receiving epidural opioids?
Elevated 30 degrees
A client is prescribed pain medication every 4 to 6 hours as needed. When the nurse enters the client's room to administer the medication, the client is laughing with visitors. The client's pulse rate is 64, respirations 16, and blood pressure 120/80. The client reports pain and wants the medication. What is the most appropriate action by the nurse?
Administer pain medication
A client reports pain and requests the prescribed pain medication. When entering the client's room, the client is laughing with visitors and does not appear to be in pain. What is the appropriate action by the nurse?
Administer pain medication
A client with a herniated disc is enjoying a rare visit from friends and family, resulting in the release of endorphins. The release of endorphins will produce what effect?
Analgesia
Which of the following is considered to be the most potent neuromodulators?
Endorphins
A client with chronic pain uses a machine to monitor his physiologic responses to pain. The unit transforms the data into a visual display and through seeing the pain responses, the client is taught to regulate his physiologic response and control pain through relaxation, imagery, or breathing exercises. This technique for pain control is known as:
Biofeedback
The nurse is implementing environmental changes to promote a client's comfort and pain management. Which action is an example of this type of intervention?
Closing the client's room door to reduce unnecessary noises
What type of pain will the client experience as a result of the intervention being preformed?
Cutaneous
The nurse manager is concerned about the large number of adolescent mothers being seen in the obstetrics clinic. How can the nurse manager use the transformational leadership style to address the concern?
Enlist volunteers to help develop a community outreach project that will educate adolescents on methods to prevent pregnancy.
A nurse can improve one's skill with time management by taking which action?
Evaluating success with accomplishment of goals in client care
A 77-year-old woman is on the nurse's unit s/p left knee replacement. The client typically stools every morning but has not had a bowel movement in 3 days. The nurse knows that which medication places the client at increased risk for constipation?
Hydromorphone
Which attributes should be characteristic of a nurse mentor? Select all that apply.
Is supportive Is resourceful Demonstrates leadership abilities Is an experienced, licensed professional
The nurse preparing to admit a client receiving epidural opioids should make sure that which of the following medications is readily available on the unit?
Naloxone
A nurse is taking care of a client who requests acetaminophen to help with a headache. The nurse checks to see if there is an order for acetaminophen and notices that the client is able to have 650 mg every 4 hours as needed for pain. What type of order is this considered?
PRN order
The nurse is performing an assessment for a client related to pain. To determine the need for pain medication, on what primary source will the nurse base the decision?
The client's verbal report
A client has been admitted to a post-surgical unit with a patient-controlled analgesia (PCA) system. Which statement is true of this medication delivery system?
The dose that is delivered when the client activates the machine is preset.
Which statement accurately describes a consideration when using a patient-controlled analgesia (PCA) pump to relieve client pain?
The pump mechanism can be programmed to deliver a specified amount of analgesic within a given time interval.
A nurse is caring for a client who complains of an aching pain in the abdomen. The nurse also noted that the client is guarding the area. The client is experiencing:
visceral pain
Which statement describes the person who is likely the most motivated to learn?
A 70-year-old female who is the client's spouse and is learning the care so the client can come home
The client reports to the clinic as ordered by the primary care provider for counseling on weight loss to improve overall health. The client received printed information in the mail to review before the session, and reports having read through it before the appointment. Which client statement alerts the nurse to a need for clarification and further education?
"I will be doing well if I lose between 5 and 10 lb (2.3 and 4.5 kg) per week."
Which response from the client enables the nurse to determine the effectiveness of a recent medication teaching session for an older adult client who is diagnosed with tuberculosis (TB)?
"I will be taking the TB medication for at least 6 months, because it takes a long time to kill the TB germs."
A client who is scheduled to undergo coronary bypass surgery in a week asks the nurse whether he should discontinue taking his cholesterol medicine ahead of the surgery. Which should be the nurse's response?
"I will need to check with your health care provider about that."
The nurse is caring for the postoperative client in the Post Anesthesia Care Unit (PACU). The client is concerned the staples on the incision failing or becoming infected. What is an appropriate response by the nurse? Select all that apply
"Staples are actually considered to be more secure than sutures." "Please inform us immediately if you observe any redness, drainage, or opening between the staples " "There is always a small possibility of this, but we will work together to protect your incision
A 56-year-old client meets with the nurse for education about a recently diagnosed atrial fibrillation. The client verbalizes concerns about being away from work too long and doubts about the necessity of having blood tests every week, as the client has no symptoms. Which is the bestmotivational statement by the nurse for this client?
"The medicine and blood work can help prevent blood clots, which can lead to strokes. What do you know about warfarin therapy?"
The nurse is teaching an 80-year-old client how to instill eye drops for glaucoma. The client's daughter asks, "How do you know that my mother understands what to do?" What is the appropriate nursing response?
"When 15 minutes have passed, I will ask your mother to show me how to instill the drops."
The nurse needs to evaluate the effectiveness of a preoperative teaching session with a client scheduled for abdominal surgery. Which client statement indicates the need for further clarification?
"While my pneumatic compression device is on, I don't need to do leg exercises."
The nurse is caring for a client after breast augmentation. Before performing a bowel assessment, what education will the nurse provide the client?
"You can have decreased or absent bowel movement, called peristalsis because of administration of anesthetic agents or opioids. By listening for bowel sounds, I can check for a return of peristalsis."
The nurse is visiting a client who was released from inpatient rehabilitation 6 weeks ago after a 5-month recovery from a motor vehicle accident that left the client immobile. As the nurse enters the home, the client braces hands on the arms of a chair to rise and uses crutches to walk across the room. What is the best response by the nurse?
"You have made an amazing recovery."
A nurse is counseling several clients for depression. Four of them do not seem to be improving, which leads the nurse to suggest a referral to a psychiatric nurse practitioner. Which of these clients would be most likely to attend the scheduled appointment?
A 28-year-old female who works nights, is willing to try, and asks about insurance coverage of the appointment
A nurse is assessing a nonverbal client's pain. Which assessment finding will the nurse interpret as potentially indicating acute pain?
increased blood pressure
Which nurse leader most clearly exemplifies transformational leadership?
A leader who is dynamic and inspiring and promotes change by the power of the leader's convictions
A nurse is working with a 15-year-old client with sickle cell anemia. The client was started on a new pain management plan today, and the nurse is evaluating the effectiveness of the plan. Which is not appropriate to include in the nursing care?
Asking only the client's parents to be present at the education session
A nurse is teaching a client about the rationale for fasting from food and fluids prior to surgery. What condition does this measure attempt to avoid?
Aspiration
A client prescribed pain medication around the clock experiences pain 1 hour before the next dose of the pain medication is due. Which is the most appropriate action by the nurse?
Assess for medication prescription for breakthrough pain.
A client has presented to the outpatient surgical center for a scheduled procedure. Which action should the nurse perform prior to the procedure?
Assess the client's allergy status.
When performing a pain assessment on a client, the nurse observes that the client guards his arm, which was fractured in a car accident, and he refuses to move out of his chair. The nurse notes this reaction as what type of pain response?
Behavioral
After a nurse manager implements a solution to the problem of delays in obtaining supplies, the first task for the manager is to:
assess whether the desired results have occurred.
The nurse is caring for several postoperative clients and is planning their care. Which surgical client will likely resume activities of daily living most quickly?
client who has had a laparoscopic cholecystectomy
A perioperative nurse is assessing a client scheduled for surgery. The client mentions taking aspirin on a daily basis since having a heart attack several years ago. In addition to ensuring the surgeon is aware of the medication use and prior myocardial infarction, what is the nurse's mostappropriate action?
Monitor the client closely for signs of hemorrhage.
The nurse is caring for a confused older adult client who requires surgery for a broken hip. What steps does the nurse take to determine if the client has a durable power of attorney for health care and how to contact that person?
Review the medical chart for a copy of a durable power of attorney for health care or permission for disclosure contact.
A nurse manager best demonstrates effective leadership characteristic by which action?
Sharing a vision for the unit and enlisting support
A nurse may attempt to help a client solve a situational crisis during what type of counseling session?
Short-term counseling
A nurse graduate applies for a job working in a hospital that achieved Magnet® status. Which conditions would this nurse expect? Select all that apply.
Supportive nurse managers Autonomous, accountable professional nursing practice Focus on positive client care outcomes
The nurse is caring for a client who had a procedure under moderate sedation at the ambulatory surgical center. Which assessment finding indicates to the nurse that the client may be ready for discharge to home?
The client is alert and oriented with a blood pressure 118/70 mm Hg and respirations 18 breaths/minute, is able to ambulate, is not nauseated or vomiting, pain is controlled with medication, and has no excessive bleeding and drainage is as expected.
A female client age 54 years has been scheduled for a bunionectomy (removal of bone tissue from the base of the great toe) which will be conducted on an ambulatory basis. Which characteristic applies to this type of surgery?
The client will be admitted the day of surgery and return home the same day.
A nurse is writing learner objectives for a client who was recently diagnosed with type 2 diabetes. Which statement best describes the proper method for writing objectives?
The nurse writes one long-term objective for each diagnosis, followed by several specific objectives.
The nurse manager in a critical care unit actively listens to the staff and engages the staff to offer decisions regarding problem solving and implementing these decisions. What type of managerial mindset does this manager exhibit?
collaborative mindset
A nurse is discussing the benefits of smoking cessation with a client. The nurse informs the client that smoking cessation will reduce the client's risk for cancer, improve respiratory status, and enhance the quality of life. The nurse also shares a personal story of smoking cessation, provides information on other individuals who have successfully quit, and encourages the client to attend a support group for smoking cessation. The client discusses feelings on smoking cessation and verbalizes a desire to quit smoking. What type of counseling did the nurse provide to this client?
motivational
A nurse manager reviews an employee's contribution to the nursing division annually. This process is:
performance appraisal
The nurse recognizes the value of leg exercises in the prevention of postoperative thrombophlebitis. When should the nurse teach the correct technique for leg exercises to a client?
prior to surgery
A nurse is working with a group of clients in the preoperative area. Which client task would be the highest priority?
raising the stretcher side rails when administering a sedative
The nurse recognizes that palliative surgery is performed for what purpose?
to lessen the intensity of an illness
