2024 Leadership Final Exam New Latest Version Updated 2023-2024, Exams of Nursing

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2023 ATI Leadership Final Exam New Latest

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A NURSE ON A MEDICAL-SURGICAL UNIT IS PLANNING CARE FOR A GROUP OF

CLIENTS. THE NURSE SHOULD IDENTIFY WHICH OF THE FOLLOWING CLIENTS

AS BEING AT THE HIGHEST RISK FOR FALLS? --------- Correct Answer --------- A. correct An older adult client who is confused and has urinary incontinence b. An adult client whit visual impairment who has a leg ulcer c. A client who is 1 day postoperative and has a nursing assistant helping him out of bed d. An adolescent client who has a leg fracture and has been using crutches for the past 2 days A NURSE ON A MEDICAL UNIT IS CARING FOR A CLIENT WHO REQUIRES SEIZURE PRECAUTIONS. WHICH OF THE FOLLOWING INTERVENTIONS SHOULD THE NURSE INCLUDE IN THE CLIENT'S PLAN OF CARE? --------- Correct Answer ---- ----- A. Pad the bed's side rails b. Keep the lights on when the client is sleeping c. correct. Keep the client's bed in the lowest position d. Have a padded tongue blade available at the bedside A NURSE IS REVIEWING A CLIENT'S HEALTH CARE RECORD AND DISCOVERS THAT THE CLIENT'S DO-NOT-RESUSCITATE (DNR) ORDER HAS EXPIRED. THE CLIENT'S CONDITION IS NOT STABLE. WHICH OF THE FOLLOWING ACTIONS SHOULD THE NURSE TAKE? --------- Correct Answer --------- a. Assume that the client does not want to be resuscitated, and take no action if she experiences cardiac arrest b. Write a note on the front of the provider order sheet asking that the DNR be reordered c. Anticipate that CPR will be instituted if the client goes into cardiopulmonary arrest d. Call the provider to determine whether the order should be immediately reinstated

A NURSE IS CARING FOR A CLIENT WHO IS BEING PREPARED FOR SURGERY.

THE CLIENT HANDS THE NURSE INFORMATION ABOUT ADVANCED DIRECTIVES

AND STATES, "HERE, I DON'T NEED THIS. I AM TOO YOUNG TO WORRY ABOUT

LIFE SUSTAINING MEASURES AND WHAT I WANT DONE FOR ME". WHICH OF

THE FOLLOWING ACTIONS SHOULD THE NURSE TAKE? --------- Correct Answer --- ------ a. Return the papers to the admitting department with a note stating that the client does not wish to address the issue at this time. b. Explain to the client that you never know what can happen during surgery and that he should fill out the papers "just in case" c. correct Contact a client representative to talk with the client and offer additional information about the purpose of advanced directives d. Inform the client that surgery cannot be conducted unless he completes the advanced directives forms a group of nurses on telemetry unit informs a nurse manager that there is a need to update the cardiac monitoring system to improve arrhythmia detection. which of the following responses should the nurse manager make? -------- Correct Answer --------- this purchase will need to be addressed in the capital budget plan for the unit the capital budget plans for the expenditure of money for equipment and major purchases that have a long life of use. a nurse is caring for a pt with breast cancer and is to have 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? -------- Correct Answer --------- would you like me to have a member of a breast cancer support group visit with you nurse should serve as an advocate for this client. a home health care nurse is conducting a home hazard assessment. for which of the following findings should the nurse intervene? -------- Correct Answer --------- the clients household lamps have 40 watt light bulbs installed the nurse needs to intervene for low wattage light bulbs. inadequate lighting increases the risk for falls and presents a safety hazard for the client. delegates administration of a unit of packed red blood cells -------- Correct Answer ------- -- decline to hang the blood the nurse has a legal duty to decline performing tasks that she cannot perform safely and competently. a float nurse from a psychiatric unit whould not be familiar with the current policy regarding blood administration, and this nurse might have limited experience with this procedure.

which of the following reported experiences by the client constitutes assault -------- Correct Answer --------- i was threatened with a shot when i refused to take an oral medication i knew would make me groggy he no longer wants to have the surgery -------- Correct Answer --------- let me call your surgeon while you tell me about your concerns a nurse is providing teaching to a client about organ donation. which of the following statements by the client indicates an understanding of the teaching? -------- Correct Answer --------- people age 18 and over have the right to decide to make an organ donation under the uniform anatomical gift act, individuals must be at least 18 years or older to make an anatomical gift. A nurse is planning care for several clients. which of the following clients should the nurse refer to a case manager? -------- Correct Answer --------- a client who has neurological deficits following a stroke in need of a liver transplant -------- Correct Answer --------- collect information related to the issue a nurse manager is implementing a team nursing approach on his unit, with licensed practical nurses (LPNs) and assistive personnel (AP) hired as additional staff. which of the following actions should the nurse manager take to facilitate acceptance of this change? -------- Correct Answer --------- introduce the new approach and facilitate the development of a task force to plan for implementation after a disaster plan is put into effect, a nurse in a pediatric unit is asked to prepare a list of clients who can be discharged to home due to local incident involving many children. which of the following clients should the nurse place on the potential discharge list. ------ -- Correct Answer --------- a preschooler who has asthma and has scattered wheezes that resolve with prn use of albuterol. a school-age child who has a femur fracture in an external fixation device and whose pain is controlled with PRN oral codeine an adolescent client who is developmentally delayed, has a PICC line, and needs 6 more weeks of antibiotics conflict between himself and another staff member -------- Correct Answer --------- create a solution in which all parties are satisfied does not want a male nurse assigned to care for her -------- Correct Answer --------- i'll change the assignment so a female nurse is caring for you today

A NURSE IS DISCUSSING RESTRAINTS WITH A NEWLY LICENSED NURSE.

WHICH OF THE FOLLOWING SHOULD THE NURSE IDENTIFY AS AN

ACCEPTABLE INDICATION FOR PLACING A CLIENT IN MECHANICAL

RESTRAINTS? --------- Correct Answer --------- A. correct. Continued self-destructive behavior B. Coercion to take prescribed medications c. Discipline for throwing chairs at staff d. Punishment for verbal abuse of other clients WHICH OF THE FOLLOWING FINDINGS SHOULD CONCERN A NURSE CARING FOR A CLIENT IN WRIST RESTRAINTS? --------- Correct Answer --------- A.correct. The straps of the restraint are tied in a knot B. The restraint is tied to a nonmovable part of the bed frame c. The padding of the restraint is against the client's bony prominences d. The nurse can insert two fingers between the client's wrist and the restraint A NURSE IS REINFORCING HOME SAFETY INFORMATION TO AN OLDER ADULT CLIENT. WHICH OF THE FOLLOWING STATEMENTS INDICATE A NEED FOR FURTHER INSTRUCTION? --------- Correct Answer --------- A. "I should have grab bars installed in my bathroom" b. "I should leave a nightlight on when I retire for the night" c.correct. "I should use the handrail instead of my cane when going downstairs" d. "I should have the batteries changed in my smoke detector twice a year" A NURSE HAS TO LIFT A CARTON IN A SUPPLY ROOM THAT IS BLOCKING HIS WAY TO AN ITEM HE NEEDS FOR CLIENT CARE. WHICH OF THE FOLLOWING ACTIONS SHOULD HELP PREVENT INJURY AS HE LIFTS THE BOX? --------- Correct Answer --------- A. correct Keeping the box close to his body as he lifts it b. Standing with his feet close together when lifting

c. Bending at the waist to pick up the box d. Twisting to place the box to his side AN INDIVIDUAL APPROACHES THE DOOR OF THE MATERNAL NEWBORN UNIT, STATES THAT HE IS THE UNCLE OF THE NEWBORN, AND ASKS TO BE ADMITTED TO THE UNIT. WHICH OF THE FOLLOWING ACTIONS SHOULD THE NURSE TAKE? --------- Correct Answer --------- a. Admit the individual after he provides the mother's full name and the date and time of the infant's birth B. Call security to remove the individual from the area c.correct. Instruct the individual to obtain the access code from the family and then return d. Call a code pink because the man could be attempting to abduct the infant A COMMUNITY EXPERIENCES AN OUTBREAK OF MENINGITIS, AND HOSPITAL BEDS ARE URGENTLY NEEDED. WHICH OF THE FOLLOWING CLIENTS SHOULD THE NURSE RECOMMEND FOR DISCHARGE? --------- Correct Answer --------- A. 58 year old man admitted this morning with angina and a history of coronary artery bypass grafting (CABG) 1 year ago b. correct 50 year old adult with type 2 diabetes mellitus being admitted for rotator cuff surgery c. 70 year old adult admitted yesterday with pneumonia and dehydration d. 65 year old woman who fell and broke her hip is scheduled for total hip replacement tomorrow A NURSE WITNESSES ANOTHER NURSE NOT WORKING WITHIN THE STANDARDS OF PRACTICE. THE NURSE SHOULD REPORT THE INCIDENT TO WHICH OF THE FOLLOWING? --------- Correct Answer --------- A. Hospital ethics committee b. Quality improvement committee c. Clinical education specialist d. correct. Unit manager

A NURSE IS REVIEWING THE MEDICATION ADMINISTRATION RECORDS FROM

THE PREVIOUS SHIFT. WHICH OF THE FOLLOWING SHOULD INDICATE THE

NEED FOR AN INCIDENT/VARIANCE REPORT? --------- Correct Answer --------- A. An aminoglycoside IV antibiotic is administered over 1 hour b. An ear drop administration is secured with a cotton ball to the outer ear for 5 min c. An IM medication is injected to the vastus lateralis site of an adult d. corrects An extended release capsule is mixed with applesauce A CHARGE NURSE IS DISCUSSING DISASTER RESPONSE WITH NURSING STAFF. WHICH OF THE FOLLOWING STATEMENTS INDICATES STAFF UNDERSTANDING OF THE HOSPITAL INCIDENT COMMAND SYSTEM (HICS)? ----- ---- Correct Answer --------- A. HICS ensure that necessary antibiotics and antidotes are available. b. HICS is focused on having mulit-disciplinary responders available. c. correct HICS identifies facility responsibilities and channels of reporting d. HICS provides additional responders when needs exceed the ability of local or state agencies. A NURSE IS PERFORMING TRIAGE FOR A GROUP OF CLIENTS FOLLOWING A MASS CASUALTY INCIDENT (MCI). WHICH OF THE FOLLOWING CLIENT SHOULD THE NURSE PLAN TO CARE FOR FIRST? --------- Correct Answer --------- A.correct A client with a tension pneumothorax b. A client with a closed upper extremity fracture c. A client with 3rd degree burns over 80% of his body d. A client with agonal respirations A NURSE IS AMONG THE FIRST RESPONDERS TO A MASS-CASUALTY INCIDENT AND DOES NOT KNOW WHAT TYPE OF PERSONAL PROTECTION GEAR IS NEEDED, WHICH OF THE FOLLOWING ACTIONS SHOULD THE NURSE TAKE? ----- ---- Correct Answer --------- A. Wait until the type of equipment needed is known b. Decontaminate victims before intervening c.correct? Choose the highest level of protection equipment available d. Wear a radiation and biological device before entering the area

A HOME HEALTH NURSE IS ASSESSING THE SAFETY OF A CLIENT'S HOME.

WHICH OF THE FOLLOWING FACTORS MAY INCREASE THE CLIENT'S RISK FOR

FALLS? (SELECT ALL THAT APPLY) --------- Correct Answer --------- a. History of a previous fall b. Reduced vision c. Impaired memory d. Takes rosuvastain (Crestor) e. Wears house slippers f. Kyphosis abcef a nurse is hired to replace a staff member who has resigned after working on the unit for several weeks, the nurse notices that the unit manager , does not intervene when there is conflict between team members, even when it escalates. Which of the following conflict resolution strategies is the unit manager demonstrating? --------- Correct Answer --------- Avoidance a nurse has received a performance appraisal from the nurse manager. WHich of the following actions by the nurse manager required intervention? --------- Correct Answer -- ------- a. The evaluation was conducted in the unit manager's office b. Correct: verbal concerns provided by a staff member were incorporated into the date. c. Data was collected for the previous 12 months was present d. The nurse was asked to review the performance appraisal tool and complete a self- evaluation a nurse manager is preparing to report disciplinary action of a staff nurse for substance abuse. Which of the following has the authority to revoke a professional nurses license? --------- Correct Answer --------- a. civil judicial process b. chief nursing officer of a hospital c. correct state board of nursing d. american nurses association which of the following examples display interpersonal conflict? --------- Correct Answer -- ------- a. nurses on the day and night shift are conflicting regarding who should do daily weights b. nurses throughout the hospital disagree on having 8hr-12hr shifts c. nurse hones is deciding between going to a professional meeting or attending play d.correct. nurse lee is professionally threatened by nurse doe. a charge nurse hears a provider speaking to a staff nurse in ager concerning incorrect supplies that are available. which of these following actions by the charge nurse

displays conflict resolution. --------- Correct Answer --------- address the situation as soon as possible a charge nurse allows to nurses ho are arguing about who gets to go to lunch first, go together, The charge nurse agrees to cover both nurses' client care. the charge nurse displayed which of the following types of conflict management? --------- Correct Answer - -------- cooperating a nurse at a long-term mental health facility is caring for a client who is verbally upset about the loss of privileges due to negative behavior. which of the following statements demonstrates the effective use o assertive communication? --------- Correct Answer ----- ---- A"You were made aware of the consequences of negative behavior" B: correct "I understand that you are angry; however, I followed the appropriate protocol" c "You need to calm down before discussing this matter any further" d "Why did you make the choice to behave negatively?" an older adult client who is on fall precautions is found lying on the floor of his hospital room. which of the following actions is most appropriate for the nurse to take first? ------- -- Correct Answer --------- a. Call the client's provider b. Ask a staff member for assistance getting the client back in bed c. correct Inspect the client for injuries d.Ask the client why he got out of bed without assistance a nurse is preparing to initiate IV therapy for a client who has a prescription for morphine 10MG IV bolus. using time management which of the actions should the nurse take first? --------- Correct Answer --------- A. correct. Mentally envision the procedure when collecting supplies b.Enter the room and perform hand hygiene c.Eject excessive medication from the prefilled syringe d.Explain the procedure to the client a LPN ending her shift reports to the RN that a newly hired assistive personnel has not calculated the intake an output for several clients. which of the following actions should the RN take? --------- Correct Answer --------- A. Complete an incident report b. Delegate this task to the LPN

c. correct. Ask the AP if assistance is needed to complete the I&O records d. Notify the nurse manager a nurse is planning care for 4 clients and is assigning tasks to a licensed practical nurse (LPN) and an assistive personal (AP). which of the following should the nurse assign to the LPN. --------- Correct Answer --------- A. Compete an admission assessment for a client who has COPD B.Measure I&O for a client with an indwelling urinary catheter C. correct.Administer an enteral tube feeding to a client who has a gastrostomy tube D. Develop a plan of care for a client who has cholecystitis a nurse manager is assigning responsibilities for the upcoming shift. a client is awaiting transfer back to the unit from the PACU following hip arthroplasty. to which staff member should the nurse assign to this client. --------- Correct Answer --------- a. Charge nurse b. LPN c. correct. RN d. Assistive personnel a nurse has listened to a report at the start of the shift. which of the following statements by the RN during this report indicates that the nurse should assume total care for the client, rather than assigning tasks to the assistive personnel? --------- Correct Answer --- ------ a. "The client's family members have been present most of the day" b. Correct? "The client's blood pressure and pulse have been unstable" c. Correct? "The client discussed having prior thoughts of suicide" d."The client works in the hospital radiology department" a nurse is delegating client care assignments for the shift. which of the following tasks would be appropriate for the nurse to delegate to the assistive personnel? --------- Correct Answer --------- a. Providing a dressing change b. Evaluating pain relief after administering pain medication c. Collecting I&O d. correct. Selecting a menu for a low-sodium diet

a nurse is planning to delegate tasks to a licensed practical nurse (LPN). which of the following is important for the nurse to understand when delegating tasks to the LPN? ---- ----- Correct Answer --------- A. correct The state Nurse Practice Act b. The National Association for Practical Nurse Education and Services Standards c. The National Council of State Boards of Nursing Decision Tree d.The Omnibus Budget Reconciliation Act of 1987 a nurse is asked to assist in continuous quality improvement (CQI) program to reduce the number of medication errors. the nurse should recognize that which of the following strategies is apropraite initially? --------- Correct Answer --------- a. Offer an in-service on medication administration for all nurses b. Have all the nurses take a medication administration examination c. correct. Review the events leading up to each medication administration error d. Develop a disciplinary policy for nurses involved in medication administration errors A NURSE MANAGER IS PROVIDING INFORMATION TO THE NURSES ON THE UNIT ABOUT ENSURING CLIENT RIGHTS. WHICH OF THE FOLLOWING OUTLINES THE RIGHTS OF INDIVIDUALS IN HEALTH CARE SETTINGS? --------- Correct Answer --------- A. American Nurses Association Code of Ethics B. HIPAA c. Patient Self-Determination Act d. correct. Patient Care Partnership A NURSE IS REVIEWING A CLIENT'S HEALTH CARE RECORD AND DISCOVERS THAT THE CLIENT'S DO-NOT-RESUSCITATE (DNR) ORDER HAS EXPIRED. THE CLIENT'S CONDITION IS NOT STABLE. WHICH OF THE FOLLOWING ACTIONS SHOULD THE NURSE TAKE? --------- Correct Answer --------- A. Assume that the client does not want to be resuscitated, and take no action if she experiences cardiac arrest b. Write a note on the front of the provider order sheet asking that the DNR be reordered C.Anticipate that CPR will be instituted if the client goes into cardiopulmonary arrest d. Call the provider to determine whether the order should be immediately reinstated

A NEWLY LICENSED NURSE IS PREPARING TO INSERT AN IV CATHETER IN A

CLIENT. WHICH OF THE FOLLOWING SOURCES SHOULD THE NURSE USE TO

REVIEW THE PROCEDURE AND THE STANDARD AT WHICH IT SHOULD BE

PERFORMED? --------- Correct Answer --------- A. Website B. correct. Institutional policy & procedure manual c. More experienced nurse d. State nurse practice act A NURSE WITNESSES AN ASSISTIVE PERSONNEL (AP) UNDER HER SUPERVISION REPRIMANDING A CLIENT FOR NOT USING THE URINAL PROPERLY. THE AP THREATENS TO PUT A DIAPER ON THE CLIENT IF HE DOES NOT USE THE URINAL MORE CAREFULLY NEXT TIME. WHICH OF THE FOLLOWING TORTS IS THE AP COMMITTING? --------- Correct Answer --------- A. correct. Assault B. Battery C. False imprisonment D. Invasion of privacy A NURSE IS CARING FOR A CLIENT WHO PLANS TO PARTICIPATE IN A RESEARCH STUDY FOR AN EXPERIMENTAL MEDICATION. WHICH OF THE FOLLOWING SHOULD THE NURSE RECOGNIZE AS PART OF OBTAINING INFORMED CONSENT FOR PARTICIPATION? --------- Correct Answer --------- A. Providing the name of the company that is developing the medication B. Providing written statement that participation is mandatory C. Providing legal counsel prior to participation Providing disclosure of D.correct potential risks and benefits of participation A CLIENT IS ABOUT TO UNDERGO AN ELECTIVE SURGICAL PROCEDURE. WHICH OF THE FOLLOWING IS THE ROLE OF THE NURSE PROVIDING PREOPERATIVE CARE REGARDING INFORMED CONSENT? --------- Correct Answer --------- A. Obtain the client's consent b. Witness the client's signature c. correct. Explain the risks and benefits of the procedure

d. Describe the consequences of choosing to do nothing A NURSE IS PREPARING AN INSERVICE FOR A GROUP OF NEWLY LICENSED NURSES ABOUT CLIENT CONFIDENTIALITY. THE NURSE SHOULD EXPLAIN THAT THEY MAY SHARE A CLIENT'S PROTECTED HEALTH INFORMATION WITH WHICH OF THE FOLLOWING GROUPS? --------- Correct Answer --------- A. The client's immediate family members B. Clergy affiliated with the family c. The facility's administrators d. correct. Health care team members caring for the client A NURSE PLANS TO LEAVE HER SCHEDULED SHIFT AN HOUR EARLY WITHOUT PERMISSION AND NOTIFICATION OF THE CHARGE NURSE. THE CLIENT ASSIGNED TO THE NURSE ARE IN STABLE CONDITION. WHICH OF THE FOLLOWING LEGAL TORT SHOULD APPLY TO THIS SITUATION? --------- Correct Answer --------- A. correct.Negligence b. Libel c. Battery d.Slander A NURSE IS CARING FOR A CLIENT. THE NURSE DEMONSTRATES ADHERENCE TO THE ETHICAL PRINCIPLE OF FIDELITY IN PRACTICE BY DOING WHICH OF THE FOLLOWING? --------- Correct Answer --------- A.correct Keeping an appointment with a client b. Allowing a new mother to hold her stillborn infant c. Confirming that a client going for surgery has a signed consent form d. Refusing to disclose information about a client to the media A NURSE IS CARING FOR A CLIENT WHO IS PARTICIPATING IN A RESEARCH STUDY FOR AN EXPERIMENTAL CHEMOTHERAPY MEDICATION. AFTER THREE TREATMENTS, THE EXPERIMENTAL MEDICATION IS DISCONTINUED DUE TO EVIDENCE OF RAPIDLY ADVANCING KIDNEY FAILURE. THE NURSE SHOULD UNDERSTAND THAT THE ETHICAL PRINCIPLE USED IN THIS SITUATION IS --------

• Correct Answer - -------- A. Veracity B. Autonomy

c. Fidelity d. correct Nonmaleficence A NURSE IS OBSERVING A NEWLY LICENSED NURSE AND AN ASSISTIVE PERSONNEL PULL A CLIENT UP IN BED USING A DRAW SHEET. WHICH OF THE FOLLOWING ACTIONS BY THE NEWLY LICENSED NURSE INDICATES A NEED FOR FURTHER EDUCATION? --------- Correct Answer --------- A. The nurse spreads his legs apart b. The nurse uses his body weight to counter the client's weight c. correct. The nurse's feed are facing inward, towards the center of the bed d. The nurse uses the muscles in his arms to lift the client off the bed using the drawsheet AN ASSISTIVE PERSONNEL REPORTS THAT THE CLIENT'S FINGER STICK BLOOD GLUCOSE READING 30 MIN BEFORE LUNCH IS 58 MG/DL. THE CLIENT'S MORNING FINGER-STICK BLOOD GLUCOSE WAS 285 MG/DL. THE CLIENT IS ASYMPTOMATIC FOR HYPOGLYCEMIA, AND HIS NEXT DOSE OF INSULIN IS SCHEDULED TO BE ADMINISTERED AT THIS TIME. WHICH OF THE FOLLOWING ACTIONS SHOULD THE NURSE TAKE FIRST? --------- Correct Answer --------- A. correct. Recalibrate the glucometer, and recheck the client's blood glucose b. Have the laboratory draw a stat serum glucose c. Inform the AP to give the client 120 mL of orange juice d. Administer the insulin as prescribed A NURSE WHO IS ORIENTING A NEWLY HIRED GROUP OF ASSISTIVE PERSONNEL IS BRIEFING THEM ABOUT INFECTION CONTROL MEASURES ON THE UNIT. IT IS CRUCIAL FOR THE NURSE TO REMIND THEM THAT THE SINGLE MOST IMPORTANT WAY TO PREVENT THE SPREAD OF PATHOGENS IN CLIENT CARE IS --------- Correct Answer --------- A. Property disposing of contaminated equipment b. Discarding used syringes in appropriate containers c. Changing soiled linens daily for clients with draining wounds d. correct Performing hand hygiene frequently and consistently A HOME HEALTH NURSE IS CONDUCTING A HOME SAFETY ASSESSMENT FOR AN OLDER ADULT CLIENT. WHICH OF THE FOLLOWING INDICATES A SAFETY

RISK FOR THE CLIENT? --------- Correct Answer --------- A. The home includes a bath tub with rails b. Electric cords are behind the furniture c. correct Space heaters are present to ensure adequate heating d. There is an absence of throw rugs in the home NEW IV PUMPS ARE BEING DELIVERED TO A MEDICAL-SURGICAL FLOOR. WHICH OF THE FOLLOWING TRAINING OPTIONS SHOULD THE CHARGE NURSE USE TO BEST EVALUATE STAFF COMPETENCY WITH THE NEW EQUIPMENT? --- ------ Correct Answer --------- A. Ask each nurse to read the procedure and sign a form acknowledging competency b. correct.Allow time during the workday when each nurse can demonstrate proficiency c. Require each nurse to attend a mandatory in-service after work hours d. Place a demonstration video of the new IV pump on the hospital website A NURSE IS ASKED TO ASSIST IN A CONTINUOUS QUALITY IMPROVEMENT (CQI) PROGRAM TO REDUCE THE NUMBER OF MEDICATION ERRORS. THE NURSE SHOULD RECOGNIZE THAT WHICH OF THE FOLLOWING STRATEGIES IS APPROPRIATE INITIALLY? --------- Correct Answer --------- A. Offer an in-service on medication administration for all nurses B. Have all the nurses take a medication administration examination C. correct Review the events leading up to each medication administration error D. Develop a disciplinary policy for nurses involved in medication administration errors A NURSE MANAGER IS PROVIDING INFORMATION ABOUT THE AUDIT PROCESS TO MEMBERS OF THE NURSING TEAM. WHICH OF THE FOLLOWING STATEMENTS SHOULD THE NURSE MANAGER INCLUDE? (SELECT ALL THAT APPLY) --------- Correct Answer --------- A. A structure audit evaluates the setting & resources available to provide care B. An outcome audit evaluates the results of the nursing care provided C. A root cause analysis is indicated when a sentinel event occurs D. Retrospective audits are conducted while the client is receiving care E. After data collection is completed, it is compared to a benchmark

a,b,c,e, A NURSE IS ASSISTING WITH THE DELIVERY OF TWINS. THE FIRST INFANT IS PLACED ON THE SCALE TO BE WEIGHED. THE PROVIDER REQUEST AN INSTRUMENT STAT. THE NURSE TURNS TO HAND THE PROVIDER THE INSTRUMENT AND THE INFANT FALLS OFF OF THE SCALE. WHEN EVALUATING THE INCIDENT, THE NURSE AND HER MANGER LIST CONTRIBUTORY FACTORS SUCH AS THE NEED TO FOR TWO NURSES WHEN MULTIPLE BIRTHS ARE KNOWN, AND THE LOCATION OF THE SCALE SO FAR FROM THE DELIVERY FIELD. THESE NURSES ARE PERFORMING A(N): --------- Correct Answer --------- a. Standardization of care b. correct Root cause analysis c. Process variation d. Analysis of deployment flowchart Quality improvement --------- Correct Answer --------- - QI/PI includes measuring performance against a set of predetermined standards (set by the facility, accrediting, professional standards)

• Should be based on best evidence
• Process focuses on assessment of outcomes & determines ways to improve the delivery of care & everyone is involved!
• JC standards require evidence of QI/PI in order to be accredited Root Cause Analysis (RCA). a factor in performance improvement --------- Correct Answer --------- - Investigates the consequence & possible causes
• Analyzes the possible causes & relationships that may exist
• Determines additional influences at each level of relationship
• Determines the root cause/causes The nurse's role in performance improvement --------- Correct Answer --------- - Serve as unit rep on committees developing policies & procedures, using reliable resources
• Enhance knowledge & understanding of the policies & procedures
• Provide care consistent with policies & procedures
• Document care according to guidelines

• Participate in collection of data related to adherence to policies & procedures
• Assist with data analysis Compare results to the benchmark
• Make a judgement about performance regarding the findings
• Assist with provision of education/training related to performance
• Act as a role model
• Assist with re-evaluation of performance seclusions and restraints: use and legal considerations --------- Correct Answer --------- used: to prevent client from injuring themselves or others legal considerations: false imprisonment is the confinement of a person without consent how often do you need to do a neuro check with restrains --------- Correct Answer --------
• q 2 hrs A NURSE APPLIES WRIST RESTRAINTS TO A CLIENT WHO IS CONFUSED AND ATTEMPTING TO PULL OUT A CHEST TUBE. WHICH OF THE FOLLOWING WOULD BE AN APPROPRIATE ACTION? --------- Correct Answer --------- a Notify the provider within 24 hours b. Plan to remove the restraints every 4 hours c. Secure restraints to the lower side rails d. correct. Document the client action that necessitated the restraints A NURSE IS CARING FOR A CLIENT. HOW SHOULD THE NURSE VERIFY THE CLIENT'S DURABLE POWER OF ATTORNEY? --------- Correct Answer --------- A. Question the healthcare provider b. Check the original chart from a prior hospitalization c. Review paperwork completed upon admission d.Obtain verbal verification from family members ONE DIFFERENCE BETWEEN A LEADER AND MANAGER IS THAT A: --------- Correct Answer --------- a. Leader has legitimate authority

b. Manger motivates and inspires others c. correctManager focuses on coordinating resources d. Leader focuses on accomplishing goals of the organization A NURSE MANAGER WANTS HIS NURSING UNIT TO BE A PLACE WHERE ALL NURSES WANT TO WORK, WHERE PATIENT SATISFACTION IS HIGH, AND CARE IS INNOVATIVE AND INTERDISCIPLINARY. STAFF ARE ENCOURAGED TO CHAIR TASK FORCES TO IMPROVE QUALITY OF CARE AND HE COUNSELS STAFF IN AREAS OF MEASURING PATIENT OUTCOMES. OTHER MANAGERS WANT TO MIMIC THIS MANAGERS APPROACH TO IMPROVE THEIR OWN UNITS. THIS NURSE IS WHICH TYPE OF LEADER? --------- Correct Answer --------- A. correct transformational b. Transactional c. Laissez-faire D. authoritative A NURSE MANAGER IS WORKING WITH A COMMITTEE OF NURSES WHOSE TASK IS TO UPDATE THE POLICIES FOR NEW EMPLOYEE ORIENTATION. THE NURSE MANAGER DIRECTS THE TEAM TO COLLECT AS MUCH DATA AS POSSIBLE AND RECOMMEND SEVERAL OPTIONS. WHICH OF THE FOLLOWING DECISION-MAKING STYLES IS BEING DEMONSTRATED BY THE NURSE MANAGER? --------- Correct Answer --------- a. Decisive b. Flexible c. Hierarchical d. correct Integrative when the integrative decision-making style is used, the team uses a large amount of data and generates on option. A HOME HEALTH NURSE IS PROVIDING CARE TO A CLIENT WHOSE PARTNER REPORTS NEEDING MORE TIME TO COMPLETE HER ERRANDS. WHICH OF THE FOLLOWING SHOULD THE NURSE IDENTIFY AS AN APPROPRIATE REFERRAL? - -------- Correct Answer --------- a. Hospice care b. Restorative care c. Mental health care

d. correct Respite care A NURSE IS CARING FOR A CLIENT WHO IS EXPERIENCING DYSPHAGIA. WHICH OF THE FOLLOWING REFERRALS IS APPROPRIATE AT THIS TIME --------- Correct Answer --------- a. correct Speech therapist b. Social worker c. Registered dietician d. Occupational therapist FOLLOWING A TORNADO, A NURSE IS DETERMINING WHICH OF THE CLIENTS ASSIGNED TO HER CARE CAN BE DISCHARGED TO FREE UP BEDS FOR INJURED CLIENTS. THE NURSE SHOULD DETERMINE THAT, OF THE FOUR CLIENTS ASSIGNED, IT IS POSSIBLE TO DISCHARGE A CLIENT WHO --------- Correct Answer --------- a. correct. Has chronic Crohn's disease and is 1 day preoperative for an ileostomy b. Is 3 days post-operative following a lobectomy and has a chest tube scheduled to be removed today c. Is 2 days post-operative following a lumbar laminectomy and has a PCA pump d. Is in a persistent vegetative state following head trauma and is preoperative fore a gastric feeding tube A NURSE IS PROVIDING TEACHING TO A CLIENT WHO HAS AN ABDOMINAL WOUND HEALING BY SECONDARY INTENTION. WHICH OF THE FOLLOWING ACTIONS SHOULD BE THE NURSE'S PRIORITY TO FACILITATE CLIENT SAFETY AFTER DISCHARGE? --------- Correct Answer --------- A. Perform a sterile dressing change prior to discharge b. correct Schedule a follow-up visit by home health for dressing changes c. Provide a dietary list of foods which promote would heeling d. Establish a follow-up apt with the client's provider A HOSPITAL IS PARTICIPATING IN A DISASTER SIMULATION IN WHICH A TOXIC SUBSTANCE IS RELEASED INTO A CROWDED STADIUM. MULTIPLE CLIENTS ARE TRANSPORTED TO THE HOSPITAL. WHICH OF THE FOLLOWING WOULD BE OF LOWEST PRIORITY FOR THE TRIAGE NURSE IN THE EVENT OF A DISASTER? --------- Correct Answer --------- a. Preventing cross-contamination of clients b. Performing concise client assessment

c. correct Educating the client and the family [lowest priority] d. Maintaining calm amidst the chaos Therefore, the priority action is to promote the safety of the clients by separating them to prevent cross contamination and limit the spread of the unknown toxin. NURSES CARING FOR THE VICTIMS OF A MASS CASUALTY INCIDENT: --------- Correct Answer --------- A. Determine the common terminology to be used by hospitals and participating agencies b. Take charge of communicating with the news media c. Determine whether there is a credible threat of a terrorist attack d. correct. Give priority for care to those with the greatest chance of survival rather than those most critically ill Which of the following behaviors in the workplace should the nurse recognize are consistent with substance use disorder? -------- Correct Answer --------- extended lunch periods and breaks calling in sick frequently on mondays or fridays decrease in concern about personal appearance and grooming excessive use of cologne or mouthwash a school nurse is assessing a child who has multiple bruises to the trunk and extremities. the child reports he fell out of a tree 2 days ago. the nurse's assessment findings show patterns of bruising not typically sustained during a fall from a tree. -------- Correct Answer --------- report the findings to local police and social service agencies HCP are required to report suspected child abuse. The nurse's primary concern is for the safety of the child. procedures for reporting ill differ in various locations, but procedures involve notification of police and social services personnel who can investigate the situation. A nurse is participating in a continuous quality improvement program. the nurse is reviewing medical records to determine the time of first postoperative ambulation of clients who had abdominal surgery. in which of the following quality audits is the nurse participating? -------- Correct Answer --------- process a nurse manager establishes staff nurse committees to address unit issues, institutes an open-door policy for speaking about concerns, and supports the professional development of the staff. which of the following leadership styles is the nurse manager displaying? -------- Correct Answer --------- democratic

democratic manager encourages the staff to participate in decision making, communicates effectively, offers constructive criticism, and believes in the best in people. A nurse is caring for a client who has a history of severe multiple sclerosis and asks the nurse about competing a living will. which of the following statements should the nurse make? -------- Correct Answer --------- i will provide you with the information you need to complete advanced directives under the patient self-determination act, health care institutions are required to provide educational materials advising clients of their rights to make their personal wishes known regarding treatment. which of the following information should the charge nurse include in the teaching -------- Correct Answer --------- the nurse should be familiar with the task she plans to delegate a nurse manager is observing the staff working on her unit. which of the following observations should the nurse manager recognize as an example or paternalism? -------

• Correct Answer --------- a nurse practitioner withholding 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 clients. 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 her right to be informed. a nurse in a provider's office observes a newly licensed nurse taking a client's health history while in the waiting area. which of the following actions should the nurse take? -- ------ Correct Answer --------- speak to the nurse immediately in private violating confidentiality and federal HIPAA regulations. a nurse is admitting a client who has active gastrointestinal bleeding. which of the following tasks is appropriate for the nurse to delegate to an assistive personnel (AP)? - ------- Correct Answer --------- show the client how to use the nurse call light should not delegate obtaining initial set of vital signs. nurse should assess client prior to delegating tasks to determine if the client is medically stable. AP can not listen to bowl sounds (not in scope of practice) asking pt if they have allergies is part of admission assessment, no within ap scope of practice clients right to respect and personal dignity

a nurse enters the room of an older adult client and finds him attempting to crawl over the side rail. which of the following actions should the nurse take? -------- Correct Answer --------- ask an assistive personnel to sit with the client this client is at risk for falling. having an AP sit with the client protects him from harm. a nurse is planning care for a client following a coronary arterial bypass graft procedure. the nurse places a referral for a case manager to visit with the client. which of the following information should the nurse provide the client about the role of case manager. -------- Correct Answer --------- the case manager will coordinate and plan your care while you recover from your surgery role is to coordinate and plan the client care, collaborate with other health professionals, and monitor costs and quality of care. float nurse tells the charge nurse on the unit that she has never worked on this unit ------ -- Correct Answer --------- i will assign you to work with a registered nurse on the unit who is experienced and will act as a resource for you "My partner hurts me. I don't want to go home." -------- Correct Answer --------- refer the client to social services for assistance in seeking safe housing it is the duty of the nurse to assist the client in finding safe housing and protection from the offending partner. call light cord is frayed -------- Correct Answer --------- replace the call light and send the frayed one to the repair department a nurse is teaching a group of newly licensed nurses about violations of clients rights. which of the following examples should the nurse include in the teaching as an example of violation of client rights? -------- Correct Answer --------- a client who has schizophrenia is placed in the seclusion room of the psychiatric unit for making frequent outbursts of obscenities directed at nurses of the opposite sex. a nurse is walking with a client who falls after the wheel on a facility-issued walker falls off. which of the following actions should the nurse take regarding the completed incident report? -------- Correct Answer --------- submit the variance report to the risk manager a nurse is preparing to teach the health care team about the concept of critical pathways. which of the following statements about the purpose of a critical pathway should the nurse plan to include? -------- Correct Answer --------- a critical pathway is a multidisciplinary tool that guides client care and bases outcomes on an externally imposed timeline

a nurse is teaching a newly licensed nurse about advanced directives. which of the following statements. by the nurse indicates an understanding of the teaching? -------- Correct Answer --------- i will assess the clients understanding of life-sustaining measures promote continuity of care -------- Correct Answer --------- provide a written summary of the clients nursing plan of care prepare a client scheduled for surgery -------- Correct Answer --------- assist with placing the client onto the stretcher for transport to the surgical suite is a skill that is within the scope of practice for the AP. A nurse manager observes a nurse entering the room of a client who is on contact precautions without donning personal protective equipment (PPE). which of the following is the priority action for the nurse manager to take? -------- Correct Answer ----- ---- have the nurse exit the room and don proper PPE safety vs reduction framwork a nurse is planning care for a client who is newly admitted to the medical unit. which of the following health care team members should the nurse pal to consult with regarding the benefit of chest physiotherapy for this client? -------- Correct Answer --------- respiratory therapist a complete respiratory assessment is necessary to confirm the need for cpt. i cant remember my name -------- Correct Answer --------- assess the client for injury a nurse manager notes that a full-time nurse has been absent from work six times over the last 6 weeks. to take a non-punitive approach, which of the following actions should the nurse manager take? -------- Correct Answer --------- 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 verbal reminder might be all that the employee needs to change the behavior. does not want any more chemo treatments -------- Correct Answer --------- i will inform your provider of your decision to discontinue the treatments a new nurse manager on a busy oncology unit keeps her office door closed when she is in the office, and does not off to help resolve daily staffing issues. which of the following types of leadership behavior is the nurse manager displaying? -------- Correct Answer --- ------ laissez-faire

laissez-faire leader provides little support of guidance. the leader's activity is minimal and makes for a less efficient staff. a nurse is delegating tasks to an AP for the care of a group of clients. which of the following statements should the nurse make? -------- Correct Answer --------- transport the client in room 203 to the radiology department at 1000 a nurse is planning care for a client who has aphasia following a stroke. which of the following actions should the nurse plan to take? -------- Correct Answer --------- offer pictures the client can point to as an alternative form of communication. the nurse should use alternative forms of communication as needed with the client such as offering pictures the client can point to or a communication board. mentor to a newly licensed nurse -------- Correct Answer --------- serve as a guide and teacher for the newly licensed nurse in an established relationship a nurse enters a client's room and discovers a small fire in a trash can. what does nurse do first. -------- Correct Answer --------- move the client out of the room safety and risk reduction framework. A nurse receives the morning change-of-shift report and delegates several tasks to an assistive personnel (AP) on the team. which of the following tasks should the nurse instruct the AP to perform first? -------- Correct Answer --------- obtain the morning capillary blood glucose tests use the urgent vs non-urgent framework a nurse is participating on a facility committee charged with developing and implementing new documentation forms. the nurse should recognize which of the following factors as a potential restraining force for implementing this change? -------- Correct Answer --------- staff resistance to learn new forms for documentation a nurse is administering medications to a client who is recovering from a stroke and has right-sided paralysis. the nurse places the client's medication on the left side of the mouth and administers pills one at a time. which of the following ethical prinicples is the nurse displaying? -------- Correct Answer --------- nonmaleficence a nurse is teaching a newly licensed nurse about the informed consent process for a client scheduled for a surgical procedure. which of the following information should the nurse include in the teaching? -------- Correct Answer --------- the person who will perform the procedure is responsible for obtaining informed consent the person performing the procedure is legally responsible for obtaining informed consent. Informed consent includes telling the client about the risks and benefits of the

procedure, alternative treatments available, and possible outcomes if the procedure is not performed. principle of justice -------- Correct Answer --------- i will schedule staff so that each person works two holidays a year justice means treating everyone fairly. by scheduling each person to work two holidays per year, the nurse manager is requiring staff members to work their fair share of holidays. a nurse is planning care for a group of clients. which of the following actions should the nurse plan to take? -------- Correct Answer --------- delegate the administration of an intermittent tube feeding to a LPN a nurse is caring for a client who asks if the client in the next room is in pain because she cries out frequently. which of the following statements should the nurse make? ------ -- Correct Answer --------- does the crying out bother you? autocratic leader -------- Correct Answer --------- is controlling and makes all of the decisions. this type of leader maintains a high degree of control and allows little freedom among group members. democratic leader -------- Correct Answer --------- acts as a facilitator and resource person and maintains a moderate degree of control among group members transformational leader -------- Correct Answer --------- is one who motivates employees by creating a work environment in which goals of the leader are shared by the employees. this common perception of unit goals allows the manager to provide opportunities for employees to feel like they are contributing on a high level, as well as developing personal goals that can be achieved by opportunities created or supported by the manager. autonomy -------- Correct Answer --------- is the right to self-determination, independence, and freedom of choice. Non-maleficence -------- Correct Answer --------- is the duty to do no harm and to protect clients from harm by eliminating threats. the actions taken by the nurse are important for the safety of the client by preventing aspiration. Fidelity -------- Correct Answer --------- is the obligation to be faithful to commitments made to self and others. Justice -------- Correct Answer --------- is the obligation to be fair and treat people in an equal manner

process audit -------- Correct Answer --------- measures the interventions used to facilitate expected and desired outcomes in clients. early ambulation is essential for the p outcome audit -------- Correct Answer --------- evaluates how the client's health status changed as a result of an intervention structure audit -------- Correct Answer --------- evaluates the relationship between quality care and appropriate structure and includes inputs such as the environment where the health care is delivered. strategic planning -------- Correct Answer --------- is done as a part of the planning process. it typically examines the purpose, mission, philosophy, and goals of the organization. Includes the group when decisions are made. Motivates by supporting staff achievements. Communication occurs up and down the chain of command. Work output by staff is usually a good quality - good one cooperation and collaboration are necessary. ------- Correct Answer --------- Democratic Makes decisions for the group. Motivates by coercion. Communication occurs down the chain of command. Work output by staff is usually high- good for crisis situations and bureaucratic settings. Effective for employees with little or no formal education. ------- Correct Answer --------- Authoritative. Makes very few decisions, and does little planning. Motivation is largely the responsibility of individual staff members. Communication occurs up and down the chain of command and between group members. Work output is low unless an informal leader evolves from the group. Effective with professional employees. ------- Correct Answer --------- Laissez-faire Empower followers to assume responsibility for a communal vision, and personal development as a secondary outcome. ------- Correct Answer --------- Transformational leadees Focus on immediate problems, maintaining the status quo and using rewards to motivate followers. ------- Correct Answer --------- Transactional leaders The ability of an individual to perceive and manage the emotions of self and others. Also important characteristic of the successful nurse leader. Has insight into their emotions of members of the team, understands the perspective of others, encourages a constructive criticism and is open to new ideas, is able to maintain focus while multitasking, manage his emotions and channels them in a positive direction which in turn helps the team accomplish its goals, Is committed to the delivery of high-quality client care, and refrains from judgment and controversial or emotionally charged situations until facts are gathered. ------- Correct Answer --------- Emotional intelligence