Nursing Scenarios: Ethical Dilemmas and Client Care, Exams of Nursing

Download Nursing Scenarios: Ethical Dilemmas and Client Care and more Exams Nursing in PDF only on Docsity! RN 2.0 Leadership Practice Questions with full marking 1. A group of providers are participating in a cardiopulmonary resuscitation effort for a client who is in cardiac arrest. Which of the following types of leadership is required for this group to function efficiently? - Correct answer Autocratic 2. *Autocratic leadership is most efficient in an emergency situation. An autocratic leader will direct and issues commands necessary for successful cardiopulmonary resuscitation. 3. 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 nurses first step to asses? - Correct answer Determine level of consciousness Assertive communication uses "I" statements that describe the person's observations and feelings. It allows the person being confronted to respond to the issue with her own perceptions and feelings instead of feeling verbally assaulted. Subsequently, a verbal discourse that allows an open discussion of the issue can follow. 4. A nurse manager calls a meeting of the unit's staff members to discuss cost- contaminment issues - Correct answer Democratic 5. *This is an example of democratic leadership. A democratic leader guides staff toward reaching 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. 6. A nurse is preparing to give change of shift report to the oncoming nurse. Which of the following information should the nurse include? - Correct answer Objective measurements about the client's condition 7. A nurse is caring for a client who is a local public official. A local newspaper reporter repeatedly phones the unit seeking information and states, "it is the public's right to know the health status of elected officials." Which action should the nurse take? - Correct answer Refer media inquiries to nursing supervisor 8. *The HIPAA Privacy Rule prohibits disclosing client information to individuals not involved in client care without that client's express consent. The reporter should be told that, due to confidentiality issues, no information can be given out about any clients. The nurse should refer the reporter to the nursing supervisor. 9. A nurse is delegating a client care task to an assistive personnel. Which of the following directions should the nurse give the AP? - Correct answer This client needs to ambulate using a walker three times today 10.*These directions include the type of task to be done, the frequency with which the task is to be performed, the duration of the task, and information about the mechanics of ambulating the client. 11.A nurse is caring for a client who has stage 4 ovarian cancer and has decided to stop treatment and enter hospice care - Correct answer Advocacy 12.*By following the ethical principle of advocacy, the nurse supports the client in the decisions she makes about her own health care. 13.A charge nurse on a pediatric unit is delegating tasks to an assistive personnel who is pregnant and reports that she is unsure of her immune status. Which of the following clients should the charge nurse assign to the AP? - Correct answer A 2 year old child who has impetigo contagiosa 14.*This is a safe assignment. If the AP practices universal precautions, there is no risk for contracting impetigo. Impetigo is a superficial skin infection caused by either staphylococcus or streptococcus. 15.A nurse is working with an assistive personnel who appears to be under the influence of alcohol during the night shift. - Correct answer Ask the nursing supervisor to observe the AP and validate the nurse's suspicion 16.*After gathering data, the nurse must first validate suspicions with another observer, take the appropriate action to safeguard clients, and then document the incident. 17.A nurse is ambulating a client who has an IV with an infusion pump - Correct answer Turn the pump off 18.*The pump must be turned off immediately to protect the client and the nurse from the risk of electrical injury and fire. The nurse should consider any electrical equipment that shows a sign of malfunction unsafe and place it out of service until the equipment can be checked by the facility's maintenance department. 19.A nurse is discussing with a newly licensed nurse about how to obtain informed consent from a client who is to undergo an epidural procedure. Which of the following principles should the nurse include in the teaching? - Correct answer autonomy 20.*Informed consent is based on the ethical principle of autonomy, which is the right to self-determination, independence, and freedom of choice. 41.A charge nurse is making assignments for an oncoming shift. Which of the following clients should the charge nurse assign to a LPN? - Correct answer A client who is disoriented and awaiting transfer to a long term care facility 42.*A client who is disoriented will need observation and reality orientation, which is within the LPN's scope of practice. The client's condition can also be categorized as stable since discharge to a long-term care facility is scheduled. 43.A nurse is caring for several clients who require diagnostic testing and is delegating tasks to an assistive personnel. Which of the following tasks should the nurse direct the AP to perform first? - Correct answer Take an arterial blood gas specimen to the laboratory 44.*Arterial blood gas specimens are placed on ice and must be transported to the laboratory immediately to prevent degradation of the sample. Since this task needs to be done within a specified time frame, it is the first task the AP should perform. 45.A nurse on a medical surgical unit is caring for a group of clients. For which of the following situations should the nurse complete a variance report? - Correct answer The discovery that a preoperative client has received and eaten breakfast 46.*This situation represents a variation from the standard of care. A change in the client's plan of care is necessary for this client because the surgical procedure will need to be delayed. The nurse should complete a variance report for this situation. 47.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? - Correct answer Notify the provider of missed dose 48.Complete a variance report 49.Document the missed dose of medication on clients MAR 50.A nurse is caring for a client who received a sedative hypnotic medication at bedtime. The client gets out of bed and falls, sustaining a laceration that requires suturing - Correct answer Client found sitting on the floor with 3 cm laceration above left eyebrow. Oriented to name only. Provider notified. 51.*This statement is appropriate to include in the documentation. It presents objective facts and assessments related to this event. The nurse should also include vital signs, further assessments, the name of the provider that was notified, treatments or procedures that were done per the provider's prescription, and the client's response. 52.A nurse is preparing to provide discharge teaching to an older adult client. Which of the following teaching considerations should the nurse include? - Correct answer Allow frequent rest periods during teaching 53.*due to slower information processing 54.A charge nurse is observing a group of newly licensed nurses. Which of the following observations should the charge nurse report to the nurse manager as a violation of HIPAA? - Correct answer Talking about clients with other nurses in the cafeteria. 55.*The nurse should not discuss information about clients, including their personal concerns, diagnoses, and treatments, with anyone who is not directly involved in the client's care. Doing so is a violation of HIPAA regulations. Nurses should take special care not to compromise this right by discussing client care in such places as elevators, restaurants, or other areas that are accessible to the public in which the discussion might be overheard. 56.A nurse is delegating a task to an assistive personnel. The AP is to transfer a client who has a below the knee amputation from a bed to a wheelchair. the AP has never transferred a client with an amputation before. which of the following actions should the nurse take? - Correct answer Assist the Ap after he has practiced the transfer. 57.*The safest way for the nurse to determine if the AP has the knowledge and skill to transfer the client who has an amputation is by having the AP practice and demonstrate the task. By assisting the AP the first time a transfer is done, the nurse ensures that delegated care is safely provided. 58.A charge nurse in an emergency department is making assignments for an assistive personnel for a shift with unexpected staff absences. Which of the following assignments should the charge assign to a float AP from the med-surg unit? - Correct answer Escort clients from the emergency department to other areas of the facility for tests 59.*Typically, transporting stable clients will be a task that may be delegated to AP. Escorting clients is likely a normal part of the AP's regular routine. This is an appropriate assignment. 60.Based on recommendations following a regulatory agency visit, the nurse manager mandates a policy change. One of the staff members on the unit is resistant to the change - Correct answer Encourage the nurse to verbalize reasons for resisting the change 61.A charge nurse receives a call from his nursing supervisor about an explosion at a local factory and an urgent need for facility beds - Correct answer a 44 year old client who has asthma and admitted for carpal tunnel surgery 62.*A client who is admitted for carpal tunnel surgery is a stable client having an elective procedure. Therefore, the nurse should recommend this client for discharge. 63.A nurse manager is planning staff development activities for the unit's new unlicensed assistive personnel. Which of the following activities should the nurse manager perform first? - Correct answer Determine the learning needs of the APs 64.*The nurse should apply the nursing process priority-setting framework. The nurse can use the nursing process to plan client care and prioritize nursing actions. Each step of the nursing process builds on the previous step, beginning with assessment or data collection. Before the nurse can formulate a plan of action, she must first collect adequate data. Assessing or collecting additional data will provide the nurse with knowledge to make an appropriate decision; therefore, the nurse manager should first determine the learning needs of the APs. 65.A nurse is caring for a client who is dying and unable to make decisions for himself. The client's adult children disagree on his code status. Which of the following sources should the nurse depend on for decisions regarding the client's end of life care? - Correct answer The client's health care proxy 66.*In the event that the client cannot speak for himself, the nurse should follow the directions of the client's health care proxy, as this is the person the client chose to make decisions under these circumstances. 67.A nurse is completing an incident report after administering an incorrect dose of medication to a client, even though the client experienced no ill effects from the error. which of the following should the nurse recognize as the purpose for completing the incident report? - Correct answer Identifies situations that contribute to the occurrence of medications errors 68.*The purpose of completing incident reports is to identify factors that contribute to the occurrence of the problem. This is one aspect of quality improvement efforts in health care facilities. 69.A nurse is reviewing laboratory results for a client who is at 12 weeks gestation. - Correct answer Serum creatinine 0.4mg/dL