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Leadership Exam 2
A nurse should initiate discharge planning for a client at what time period?
Immediately after a client's condition is stabilized on the
assigned unit
When the client or family demonstrate readiness to learn self-
care modalities
Upon admission to a hospital unit or the
emergency room When a date for discharge has
been determined
A client who is admitted for suspected abuse is quiet and withdrawn. Which of the
following should the nurse implement to promote client communication?
Invite a family member to be present for the nursing
history Provide basic wound care for obvious physical
injuries
Probe the client to offer an actual account of the abuse
Provide privacy and be direct and honest when communicating
with the client
A nurse manager is explaining the importance and guidelines for use of incident
reports to new graduate RNs during their orientation. In assessing their understanding
of what she has told them, which of the following statements would indicate that more
explanation/reinforcement is needed about incident reports?
A manager usually reviews the incident report and investigates the incident
before sending it on to the risk manager for follow-up.
Incident reports should not be shared with the client and the family.
A copy of the incident report should be made by the person who initiates the report
for future reference if there is a lawsuit.
Only a factual description of the event should be documented in the client's
health care record without any mention of an incident report.
A client has just joined a health care maintenance organization (HMO) and asks for
information about the payment obligations with this plan. The most accurate
description of health care costs is that the client will be charged in which manner?
A pre-determined fee for
all services
Assault
Invasion
of
privacy
Batter
y
False
imprisonment
A nurse calls the physician regarding a new medication prescription because the
dosage prescribed is higher than the recommended dosage. The nurse has called the
physician several times without reaching him, and the medication is due to be
administered. Which action should the nurse take first?
Administer the prescribed dose now.
Continue trying to reach the physician and document
attempts made.
Inform the nursing supervisor.
Administer the recommended dose until the physician
can be contacted.
When referring to the standard of care, which phrase best describes the meaning
of a nursing standard of care?
The belief that nurses will always behave in a wise/prudent manner.
The directive that ensures all nurses will always act in ways that help
patients get better.
The ethical principle that states that a nurse shall do no harm.
The minimal level of nursing care and expertise that is expected to be
delivered to a patient.
A client states: "I do not want to be awakened for breakfast-I didn't sleep at all last
night." What is the first action for the RN to take?
Notify the client's provider
Talk with the client to work out a
mutual plan
Consult with the patient's family to
get suggestions
Contact the dietitian
Which of the following statements made by a senior nursing student to his nursing
instructor about an incident/unusual occurrence report indicates a need for further
education?
When a patient is involved in an incident, a copy of the incident report should be
placed in the patient's medical record for hospital staff reference only.
Because these reports are considered confidential and privileged information for
the
capital
budget
These reports help to document incident details/persons involved that could be
used for legal purposes at some future time should an organization be involved
in a lawsuit.
A nurse who keeps her promise and returns to a patient's room to answer the
patient's questions on her next rounds is demonstrating the ethical principle of:
Fidelity
Veracit
y
Autono
m y
Paterna
li sm
The expense of buying a new MRI machine would most likely be included
in which type of a budget?
contingency
budget operating
budget
minor equipment budget
A healthcare worker anonymously reports through his organization's
Corporate hotline that coworkers are steeling supplies and taking them
home for their own use. This reporting would be called:
Lateral Whistle
Blowing External
Whistle Blowing
Vertical Whistle
Internal Whistle
Blowing
Blowing
A nurse has received morning report on the following four clients. Which client should
the nurse see first?
A client who has blood glucose of 68 mg/dL and reports mild
sweating and is hungry.
Availability of the chart rack and dictation equipment for healthcare
providers.
Distance from clients' rooms and number of chairs
regarding an installation of a computer work station. Which factor is a priority for
staff ergonomics?
Height of the counter top and adjustable task chairs
Location of the elevator relevant to the entrance of the
nurse's station
RNs who unintentionally fail to meet professional standards of care and do not act in
a prudent and reasonable manner may be accused of which one of the following?
Maleficen
c e
Malpracti
c e
Paternali
s m
Non-
diligenc
e
The Board of Registered Nurses' role includes the protection of citizens. Which of the
following is NOT a way that the BRN protects citizens?
Monitoring of RN educational standards and accrediting
nursing schools
Hiring and firing RNs involved in unethical
practice Issuing, suspending, and revoking
RN Licenses
Overseeing RN continuing education requirements/CE
Provider Approval
Nursing staff members are in the lounge on their morning break. A nursing assistant
thinks that a unit secretary has acquired HIV and then tells the staff that the secretary
probably caught it from her husband who is a drug addict. Which legal tort has she
violated?
Libel
Slande
r
Assaul
t
Neglige
Distance to the nearest hospital/
emergency care
Family's understanding of the client's
needs
There are two types of torts. These are intentional and unintentional. Which of the
following is an example of an unintentional tort?
False
imprisonment
Assault and
battery
Professional
negligence
Defamation
of character
An RN accidentally sticks her hand with the syringe needle after administering an IM
injection to a client. Which one of the following should the nurse do first?
Notify the charge nurse of
the incident.
Go to employee health
services. Complete an
incident report.
Wash hand thoroughly with soap and
water.
Nursing staff sometimes need support and guidance when facing challenging patient
care ethical dilemmas. Nurse Managers can support staff in working through ethical
dilemmas by consulting which of the following?
American Nurses Association (ANA) Social
Policy Statement
Joint Commission
Standards Patient Bill of
Rights
Hospital/Healthcare Agency's Ethics Committee
An elderly client who has a documented history of dementia is intermittently
alert and can currently tell you her name. Who should sign the client's informed
consent for an invasive diagnostic procedure?
The client's husband, who is blind.
The client herself, who has an advance directive.
Which one of the following characteristics describes a "reasonable and prudent RN"?
At least 5 years of applicable RN experience
Specialized RN skills for the assigned nursing
area.
medic motion. Release the restraints and perform bilateral range of Average RN judgment and skill level in delivering patient care. A BSN degree Which of the following is a principle of ethical decision making that refers to the idea of doing "good"? Fidelity Benefic e nce Veracity Justice When orienting a nurse manager to the budgeting process, what should the nursing director tell the nurse manager is the second largest budget expenditure for health- care organizations? Short -term capital acquisition budget Fixed operating budget Supplies budget Personnel budget A nurse is caring for several clients in a walk-in clinic. Which client should the nurse have the provider see immediately? A diaphoretic, obese middle-aged man with epigastric pain. A disruptive teenager with alcohol on her breath who is vomiting profusely. A crying toddler with a forehead scrape wound that is bleeding. A young adult presenting with extremely painful sunburned face. A RN is planning care for a client this shift who was placed last night in wrist restraints for a behavior change that threatened the safety of others. Which one of the following actions should the RN do FIRST?
Assess the patient and review current laboratory data.
Where can a nurse manager find standards of ethical behavior specifically written for
the nursing profession?
The Joint Commission
Department of Health
Services American Nurses
Association
Centers for Medicare/Medicaid
Services (CMS)
A client voluntarily admits himself to a hospital's mental health unit with the diagnosis
of suicidal ideation, but is not on a legal hold. The client has been on the unit for two
days and states, "I demand to be released now!" The appropriate response from the
RN should be which of these statements?
"Let's discuss your decision to leave and then we can prepare you for discharge."
"You have a right to sign out as soon as we get the health care
provider's discharge order."
"You cannot be released because you are still at risk of being suicidal."
"You can be released only if you sign a no suicide contract before you leave."
A RN in the emergency department is assessing an elderly client. The client's son
states that the client has glaucoma, is extremely hard of hearing, and has been
experiencing severe abdominal cramping and diarrhea for the past 24 hours. Which
of the following actions is most appropriate for the nurse to do FIRST?
Ask the client if he is wearing or has with him a hearing aid.
Ask the patient if he has taken any medication for the
diarrhea in the past 24 hours.
Using a numeric 1-10 rating scale, ask the client to rate his
abdominal pain.
Ask the client if he has talked to his physician yet about his condition.
Which phrase best describes the meaning of the standard of care?
The directive that ensures that all nurses
will act prudently
The minimal level of expertise that may be
delivered to a patient
