Saunders Leadership/ Management/ Delegating/ Prioritizing Questions

146. When a manager is interviewing a newly graduated nurse for an evening position on an orthopedic unit, the manager states that she makes client assignments for the evening and night staff so that the staff members can immediately focus on client care. The graduated meets with the evening staff and asks which question to validate the graduate's impression that the manager is autocratic? 1. "Does the manager foster dependency?" 2. "Does the manager promote planning by the group?" 3. "Does the manager ask for ideas from staff when decisions need to be made?" 4. "Does the manager show different leadership styles depending on the needs of the staff?"

1. "Does the manager foster dependency?"

137. The nurse has responded to the scene of a disaster and the first victim that the nurse encounters is one who had a large wound on the leg that is actively bleeding. The nurse should identify the victim as belonging to which classification? 1. Urgent 2. Delayed 3. Emergent 4. Non-urgent

3. Emergent

138. A hospitalized client with a history of alcohol abuse tells a nurse, "I'm leaving now. I have to go. I don't want any more treatment. I have things that I have to do right away." What action should the nurse take when a client decides to leave against medical advice (AMA)? 1. Call the nursing supervisor. 2. Call security to block all exit areas. 3. Place the client in seclusion, and contact the health care provider for further instruction. 4. Tell the client that he or she must contact the health care provider before leaving the hospital.

1. Call the nursing supervisor.

140. The nurse on the postsurgical unit receives a client that was transferred from the post anesthesia care unit (PACU) and is planning care for this client. The nurse understands that staff should begin planning for this client's discharge at which point during the hospitalization? 1. Is admitted to the surgical unit. 2. Is transferred from the PACU to the postsurgical unit. 3. Is able to perform activities of daily living independently. 4. Has been assessed by the health care provider for the first time after surgery.

1. Is admitted to the surgical unit.

132. A disaster that results in significant damage and presidential disaster declaration is classified by the federal emergency management agency. (FEMA) as which level? 1. Level I 2. Level II 3. Level III 4. level IV

1. Level I

139. Which client(s) may be assigned to a licensed practical nurse. licensed vocational nurse (LPN/LVN)? Select all that apply. 1. The client requiring oral medications. 2. The client requiring admission assessments. 3. The client requiring an intravenous injection. 4. The client requiring a subcutaneous injection. 5. The client requiring an intramuscular injection. 6. The client requiring insertion of a Foley catheter.

1. The client requiring oral medications. 4. The client requiring a subcutaneous injection. 5. The client requiring an intramuscular injection. 6. The client requiring insertion of a Foley catheter.

222. Which are example(s) of a negligent act? Select all that apply. 1. Medication errors resulting in injury. 2. Failure to monitor an intravenous flow rate resulting in injury. 3. A decline in a client's condition resulting in a longer hospital stay. 4. A fall that occurs as a result of failure to provide safety measures to a client. 5. Failure to report a change in a client's condition to the health care provider (HCO).

1. Medication errors resulting in injury. 2. Failure to monitor an intravenous flow rate resulting in injury. 4. A fall that occurs as a result of failure to provide safety measures to a client. 5. Failure to report a change in a client's condition to the health care provider (HCO).

147. The nurse is caring for an involuntarily committed client who had been premedicated for scheduled electroconvulsive therapy (ECT). When reviewing the chart, the nurse fails to find an informed consent for the procedure. Based on this information, the nurse should give which intervention priority? 1. Notify the client's health care provider. 2. Have the client sign an informed consent for the scheduled procedure. 3. Realize that an informed consent is not required when the admission is involuntary. 4. Explain to the client that the health care provider will be in to obtain an informed consent.

1. Notify the client's health care provider.

131. Which nursing action(s) can result in disciplinary action by state board of nursing? Select all that apply 1. Release of client health information to a client's neighbor. 2. Delegation of a dressing changes to unlicensed assistive personnel (UAP). 3. Release of client health information to the client's durable power of attorney. 4. Administration of a routine immunization that resulted in an allergic reaction. 5. Administration of an injection to a client who stated refusal of the medication.

1. Release of client health information to a client's neighbor. 2. Delegation of a dressing changes to unlicensed assistive personnel (UAP) 5. Administration of an injection to a client who stated refusal of the medication.

135. The nurse is assisting in responding to a disaster. Which personal item(s) should the nurse ensure are taken too the scene? Select all that apply. 1. Warm clothing. 2. Large jugs of water. 3. Copy of nursing license. 4. Record-keeping materials. 5. Personal health care equipment.

1. Warm clothing. 3. Copy of nursing license. 4. Record-keeping materials. 5. Personal health care equipment.

223. The new nursing graduate employed in the acute care setting asks experienced nurses about professional liability insurance. Which most appropriate response should the experienced nurse make to the graduate? 1. "It is really expensive and unnecessary." 2. "It will provide protection to you as an individual." 3. "You are covered under the hospital's insurance policy." 4. " I don't have it and have never found it to be necessary."

2. "It will provide protection to you as an individual."

136. A client admitted to the hospital has a diagnosis of syncope. The client is taking enalapril (Vasotect), atenolol (Tenormin), and aspirin (ASA) daily but says that the medications were prescribed by different health care providers. The admitting health care provider wrote in the client's prescription sheet, " Administer medications as taken at home." Which is the most appropriate action for the nurse to take? 1. Administer the medications as prescribed by the health care provider. 2. Call the health care provider, describe the medications, and request prescription clarification. 3. Refuse to give any medications, and wait until the health care provider makes rounds to clarify the prescriptions. 4. Send the client's medication bottles to the pharmacy for identification, and then administer the medications as prescribed.

2. Call the health care provider, describe the medications, and request prescription clarification.

141. The nurse acts as a client advocate in which situation(s)? Select all that apply. 1. Pulling the curtain around the client's bed while changing a dressing. 2. Contacting the health care provider to request a meeting for the client. 3. Ensuring access to medical information by appropriate personnel only. 4. Providing client with requested information regarding support groups. 5. Questioning the health care provider regarding a discrepancy in reported medication dosages between the home and hospital setting.

2. Contacting the health care provider to request a meeting for the client. 5. Questioning the health care provider regarding a discrepancy in reported medication dosages between the home and hospital setting.

148. The nurse manager is confronted by an angry health care provider who states, " You run the most inefficient unit in the hospital. I asked for my charts to be pulled and set up in a rack for rounds, and it is never ready when I arrive!" What is the manager's most appropriate response/ action to the health care provider? 1. Smile and ask," Having a bad day?" 2. Remain silent, and then make a neutral response. 3. "Stop. I have no idea what you are talking about." 4. "The hardest working people in this hospital are on this unit, and we are not here to simply respond to your every wish."

2. Remain silent, and then make a neutral response.

142. The night nurse received report from the evening nurse on assigned clients. Which client should the nurse determine as highest priority? 1. The client is postoperative following an appendectomy, has complained of incisional pain of 5/10, received pain medication 1 hour ago, and is sleeping soundly. 2. The client who has diabetes mellitus, had a fasting blood glucose of 56 mg/dL at 6:00 am and denies signs or symptoms of hypoglycemia; the last 15-minute blood glucose check after intervention was 65 mg/dL. 3. The client who had heart failure, complained of shortness of breath during the night, and had fine crackles noted on auscultation in the lung bases; intravenous furosemide (Lasix) was prescribed, and vital signs are currently stable. 4. The client who was admitted during the night following an asthma attack and whose vital signs are: temperature 98.6 F; blood pressure (BP) 125/ 84 mm Hg; respiration 18 breaths per minute; heart rate 77 beats per minute; and pulse oximetry 98% with 2 L of oxygen.

2. The client who has diabetes mellitus, had a fasting blood glucose of 56 mg/dL at 6:00 am and denies signs or symptoms of hypoglycemia; the last 15-minute blood glucose check after intervention was 65 mg/dL.

133. The unlicensed assistive personnel (UAP) reports to the registered nurse (RN) that an assigned client is experiencing difficulty breathing. Which action should the RN take first? 1. Call respiratory therapy. 2. Notify the client's family. 3. Obtain a set of vitals. 4. Call the health care provider (HCP).

3. Obtain a set of vitals

134. The nurse uses the principle of beneficence in which situation? 1. The nurse is fair in providing resources to all clients. 2. The nurse follows through with care offered to a client. 3. The nurse respects the client's right to determine a course of action. 4. The nurse tells the client that the flue shot may cause some discomfort but describes the benefits of the immunization.

4. The nurse tells the client that the flue shot may cause some discomfort but describes the benefits of the immunization.

220. Which type of law is concerned with enforcement of agreements among private individuals? 1. Tort 2. Civil 3. Criminal 4. Contract

4. Contract

143. The nurse enters a client's room and the client is demanding release from the hospital. The nurse reviews the client's record and notes that the client was admitted 2 days ago for treatment of an anxiety disorder and that the admission was voluntary. Which intervention should the nurse initiate first? 1. Telephone that client's family, and have them persuade the client to stay. 2. Have the client read and sign all of the appropriate self-discharge papers. 3. Explain to the client that he cannot leave because he asked for treatment. 4. Notify the client's heath care provider of the client's stated intent to leave the hospital.

4. Notify the client's heath care provider of the client's stated intent to leave the hospital.

144. A client scheduled for surgery cannot sign the operative consent form because he had been sedated with opioid analgesics. The nursed should take which best action regarding the informed consent? 1. Obtain a court order for the surgery. 2. Sign the informed consent on behalf of the client. 3. Send the client to surgery without the consent form being signed. 4. Obtain a telephone consent from the family member, with the consent being witnessed by two health care providers.

4. Obtain a telephone consent from the family member, with the consent being witnessed by two health care providers.

145. Which client(s) should the emergency department triage nurse classify as urgent? Select all that apply. 1. A client with a swollen ankle after a fall. 2. A client with an acute exacerbation of asthma. 3. A client with an open fracture of the left femur. 4. A client with abdominal pain and no other symptoms. 5. A client with the "worst headache of (the client's) life".

1. A client with a swollen ankle after a fall. 4. A client with abdominal pain and no other symptoms.

221. Malpractice is determine if the nurse owed the client a duty and did not carry out the duty. What other aspect is required for malpractice to have occurred? 1. The client was injured. 2. The client felt neglected. 3. The client's family was affected. 4. The client's state was unchanged.

1. The client was injured.