A.T.I Leadership Final: Guaranteed A+ with Certified Content from Trusted Global Sources, Exams of Nursing

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A nurse manager is observing the staff on her unit. which if the following observations should the nurse manger recognize as an example of paternalism? - - correct- - a nurse practitioner withholding information from a client who is dying to avoid causing the client distress 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- - " people age 18 and older have the right to decide to make an organ donation" 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 style is the nurse manager displaying? - - correct- - Democratic 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- - the person who will perform the procedure is responsible for obtaining informed consent. A home health nurse is conducting a home hazard assessment. For which of the following findings should the nurse intervene? - - correct- - The clients household lamps have 40 watt light bulbs A nurse is planning care for several clients. Which of the following clients should the nurse refer to a case manager? - - correct- - A client who has neurological deficits following a stroke. A nurse is caring for a client who has 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- - "would you like me to have a member of a breast cancer support group visit with you?" a nurse is caring for a client who is post-op and has an Hgb level of 8.0g/dL. the nurse delegates the administration of a unit of packed RBCs to a nurse floating from a psych unit who is unfamiliar with blood administration. which of the following actions should the float nurse take?

• • correct- - decline to hang the blood A nurse is caring for a client who is a local public official. A newspaper reporter repeatedly phones the unit seeking information and states, "The public has a right to know the health status of elected officials." Which of the following actions should the nurse take? A. Acknowledge that the person is a client on the unit but give no specific details of the client's condition. B. Refer any calls directly to the client's room so that the client and her family can decide what to tell the press. C. Refer all media inquiries to the nursing supervisor. D. Hang up on media callers because nursing staff members are not required to speak to them. -
• correct- - C. Refer all media inquiries to the nursing supervisor. The HIPAA Privacy Rule prohibits disclosing client information to individuals who are not involved in care without the client's express consent. The reporter should be told that, due to confidentiality issues, no information can be given about any client. The nurse should refer the reporter to the nursing supervisor.

Incorrect Answers: A. Hospice care is only appropriate for a client who has a terminal illness and a life expectancy of <6 months. C. Clients who live in an assisted-living facility need to be able to live independently and require minimal assistance. Clients can receive assistance with medication and are offered one prepared meal a day if needed. However, an assisted-living facility is not an option at this time since the family member wishes to keep the client at home. D. A long-term care facility is not an option at this time since the family member wishes to keep the client at home. / A nurse is performing a safety audit on all equipment used on the unit. Which of the following items should the nurse identify as a safety hazard? A. An electrical cord that is taped to the floor B. A protective cover that is placed over an unused outlet C. An electrical cord that is frayed toward the plug D. An electrical plug that has 3 prongs - - correct- - C. An electrical cord that is frayed toward the plug The nurse should identify that an electrical cord that is frayed toward the plug is damaged and should not be used. Using an electrical cord that is damaged can increase the client's risk of acquiring an electrical shock.

Incorrect Answers: A. An electrical cord taped to the floor prevents others from tripping over the cord or damaging it. B. A protective cover placed over an unused outlet prevents young children from playing with the outlet. D. An electrical plug with 3 prongs is a grounded piece of equipment, which provides a path of low resistance to stray electric currents. This is the only type of electrical equipment that should be used. / A nurse is planning care for several clients. Which of the following clients should the nurse refer to a case manager? A. A client who has neurological deficits following a stroke B. A married female client who has delivered a full-term newborn C. A client who is postoperative following a cholecystectomy D. A child who has a fracture of the dominant arm - - correct- - A. A client who has neurological deficits following a stroke The nurse should refer this client to the case manager for care. A client who had a stroke will likely require long-term treatment. A client who has ongoing needs for care or rehabilitation should receive care that is directed by a case manager due to the complexity and cost of the client's needs. Incorrect Answers:

A. Obtaining a daily weight is within the scope of practice of an LPN. While the RN could also perform this task, it should be delegated to an LPN so that the RN is available to perform other tasks. B. Oral care is considered part of routine hygiene and includes observing the membranes of the mouth for dryness. It is within the scope of practice for the LPN. While the RN could also perform this task, it should be delegated to an LPN so the RN is available to perform other tasks. // A nurse is making a client's bed and finds a capsule of medication in the sheets. Which of the following actions by the nurse is consistent with safe nursing practice? (Select all that apply.) A. Administer the medication to the client. B. Notify the provider. C. Complete a variance report. D. Document the finding in the client's electronic medical record. E. Place the medication back in the medication drawer. - - correct- - B. Notify the provider. C. Complete a variance report. B. Notifying the provider is correct. The nurse should notify the provider of the finding as a part of the variance reporting process.

C. Completing a variance report is correct. The nurse should complete an incident or variance report regarding the occurrence. Incorrect Answers: A. Administering the medication to the client is incorrect. The nurse should not administer the medication to the client, because the nurse does not know which dose of the medication the client missed. Administering the capsule now could result in an overdose if the client has recently taken the same medication. D. Documenting the finding in the client's electronic medical record is incorrect. The nurse should not document the finding in the client's electronic medical record. The nurse should identify that information in the client's medical record is subject to attorney review should the client decide, for any reason, to file suit against the facility or the healthcare staff. Instead, the nurse should follow facility policy and report the incident to the nurse manager and risk management through the use of a variance report. In addition, the nurse should avoid documenting in the medical record that a variance report was filed because this can also allow for the variance report to be subpoenaed should the client decide to file suit. E. Placing the medication back in the medication drawer is incorrect. The nurse should identify that medications that are no longer packaged are considered contaminated and should be discarded. /// A nurse is planning to perform a negotiation to manage a conflict between himself and another staff member. Which of the following actions should the nurse plan to take? A. Continue the negotiation process until all parties agree on a settlement. B. Establish equality in the concessions that each party makes.

C. A client's family member complained that a nurse was culturally insensitive. D. Surgery to the wrong site was stopped prior to a procedure. - - correct- - A. Paralysis of a client's lower extremities occurred following epidural anesthesia. An incident resulting in permanent harm, such as paralysis or death, is a sentinel event. Sentinel events are a high priority and indicate the need for an immediate investigation. Incorrect Answers: B. The committee should review this incident and policies to reduce the risk and occurrence of falls in the facility; however, a client fall that does not result in injury is not a sentinel event. C. The committee should review the incident and policies to promote culturally competent care. However, this type of adverse event is not identified as a sentinel event. D. The nurse should identify this type of incident as a near-miss, which happens when an error is caught and prevented before it occurs. // A charge nurse is teaching a group of clients in an assisted living facility about client rights. Which of the following pieces of information should the charge nurse include in the teaching? A. "You can request to review your personal medical records at any time." B. "A 20-day notice is required prior to you being transferred to long-term care." C. "An executor will be assigned to manage your financial affairs."

D. "You will have a provider other than your primary physician assigned to your care." - - correct-

• A. "You can request to review your personal medical records at any time." Clients have the right to request their own medical records and should expect adequate and appropriate care from the facility's personnel. Incorrect Answers: B. A client has the right to a 30-day notice if transfer to a long-term facility is required. The 30-day notice is to assist the client with financial preparations and to promote the client's welfare. C. A client has the right to make independent choices, such as managing personal financial affairs. D. A client has the right to keep his/her provider and to choose a different provider if necessary. / A nurse is discussing with a newly licensed nurse about how to obtain informed consent from a client who is scheduled to undergo an epidural procedure. Which of the following ethical principles should the nurse include in the teaching? A. Beneficence B. Autonomy C. Paternalism D. Justice - - correct- - Autonomy

The nurse should apply the survival potential priority-setting framework in mass casualty situations, when resources are scarce and resources must be allocated to save the greatest number of lives. While it could seem that the client who is most at risk should receive priority care, this client is the lowest priority. The nurse should assign the highest priority to the client with injuries that are severe who has the potential to survive with treatment. Therefore, the nurse should recommend that the client who has a hemothorax receives treatment first. A hemothorax is life-threatening, but with chest-tube insertion and stabilization, the client is likely to survive. Incorrect Answers: B. A client who has an open fracture does not have an immediate threat to life and can wait for treatment; therefore, the nurse should recommend that another client receive treatment first. C. A client who has multiple deep abrasions does not have an immediate threat to life and can wait for treatment; therefore, the nurse should recommend that another client receive treatment first. D. A client who has relatively minor burns does not have an immediate threat to life and can wait for treatment; therefore, the nurse should recommend that another client receive treatment first. / A charge nurse finds an increased incidence of health-care-associated infections (HAIs) on a long-term care unit. Which priority action should the charge nurse take to address the problem? A. Monitor the staff's hand hygiene techniques B. Hold a mandatory in-service training session about hand hygiene and infection rates C. Require nurses to take an online course on HAIs

D. Conduct a chart review to gather data about clients who developed HAIs - - correct- - Conduct a chart review to gather data about clients who developed HAIs The charge nurse should first conduct a chart review or audit in order to gather data about the clients who developed infections. This information will provide the charge nurse with potential indicators or factors that resulted in the increased incidence of HAIs. Incorrect Answers: A. The charge nurse should monitor staff members' hand hygiene techniques on the unit to encourage proper hand hygiene; however, this is not the first priority. B. The charge nurse should hold a mandatory in-service training session about hand hygiene and infection rates after conducting a chart review. C. The charge nurse should require nurses to take an online course on HAIs to enhance their knowledge of hand hygiene and infection control after conducting a chart review. /// A nurse is caring for a client who is in the bathroom. The nurse hears a loud thud and, after opening the bathroom door, finds the client on the floor. What is the priority nursing action? A. Notify the provider of the fall. B. Call for help. C. Determine the client's level of consciousness. D. Complete an incident report. - - correct- - C.

Incorrect Answers: B. This response seems automatic and does not address the client's concerns. The nurse should respond by listening to the client's concerns and act as an advocate for the client. C. This response changes the subject and does not address the client's concerns. The nurse should respond by listening to the client's concerns and act as an advocate for the client. D. This response provides a sense of false reassurance and does not address the client's concerns. The nurse should respond by listening to the client's concerns and act as an advocate for the client. / A nurse manager calls a meeting of the unit's staff members to discuss cost-containment issues. The nurse manager has asked for staff input regarding strategies to help reduce costs. Which of the following types of leadership is the nurse manager using? A. Autocratic B. Democratic C. Laissez-faire D. Moral - - correct- - B. Democratic This is an example of democratic leadership. A democratic leader guides staff toward an objective and shares responsibility with the staff. This is the ideal type of leadership in this situation because a great amount of creativity can occur, and many strategies can be developed.

Incorrect Answers: A. An autocratic leader makes decisions independently and notifies staff of the decisions made. An autocratic manager maintains a high degree of control and allows little freedom of staff members. C. A laissez-faire leader exerts little or no leadership and control. This manager is providing staff with direction and leadership. D. Moral leadership involves honesty and fairness under any circumstances. / A nurse is planning care for a client who has COPD, requires continuous oxygen therapy, and is being discharged to return home. Which of the following referrals should the nurse recommend? A. Spiritual advisor B. Social worker C. Physical therapist D. Occupational therapist - - correct- - B. Social worker The nurse should recommend a referral to a social worker when a client will require additional services, such as home health care, oxygen therapy, hospice care, or wound care. Incorrect Answers: A. The nurse should recommend a referral to a spiritual advisor for a client who requests spiritual counsel or guidance.

B. This does not allow the nurse manager to participate in and facilitate the creation of win-win solutions. It only allows approval or disapproval after the staff members have spent time and energy devising potential solutions. D. This approach does not allow the nurse manager to facilitate the creation of win-win solutions. /// A nurse on a medical-surgical unit is planning the care of assigned clients. Which of the following clients should the nurse attend to first? A. A client who is newly admitted and is scheduled for indwelling urinary catheter insertion B. A client who has kidney stones and reports flank pain of 6 on a pain scale of 0- 10 C. A client diagnosed with early stage chronic kidney disease with a serum creatinine level of 2. mg/dL D. A client who has a cast newly applied on the forearm and reports tingling of the fingers - correct- - D. A client who has a cast newly applied on the forearm and reports tingling of the fingers When using the airway, breathing, circulation (ABC) approach to client care, the nurse should first assess the client who has a newly applied cast on the forearm and reports tingling of the fingers. Tingling, numbness, pallor, paresthesia, and pain are clinical manifestations associated with compartment syndrome, a serious development in which increased tissue pressure in a confined anatomical space reduces blood flow, leading to ischemia, dysfunction, and eventual necrosis. The nurse should report this finding to the provider immediately. Incorrect Answers:

A. The nurse should assess a client who is newly admitted and is scheduled to have an indwelling urinary catheter to empty the bladder of urine; however, there is another client the nurse should attend to first. B. The nurse should assess a client who has kidney stones and reports a flank pain of 6 on a pain scale of 0-10 to address and treat the client's pain; however, there is another client the nurse should attend to first. C. The nurse should assess a client diagnosed early with early stage chronic kidney disease who has a serum creatinine of 2.0 mg/dL to determine kidney function; however, there is another client the nurse should attend to first. / A 13-year-old female client tells the charge nurse in the pediatric unit that she does not want the male nurse assigned to care for her. Which of the following responses should the nurse make? A. "I will need to discuss your request with your parents first." B. "I'll change the assignment so a female nurse is caring for you today." C. "A female assistive personnel will be helping with your bath." D. "The male nurse assigned is required to care for both male and female clients." - - correct- - B. "I'll change the assignment so a female nurse is caring for you today." The client has the right to respect and personal dignity and the ability to participate in decisions regarding her care. The charge nurse should change the assignment when possible to minimize any feelings of loss of control for this client. Incorrect Answers: