RN Leadership Online Practice 2019 A questions verified with 100% correct answers, Exams of Leadership and Team Management

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RN Leadership Online Practice 2019

A

1. A nurse is caring for a client who is comatose. The client has a living will that declines the use of artificial enteral nutrition as a life-sustaining measure, but the client's family has requested that the staff begin tube feedings. Which of the following actions should the nurse take ANS Review the client's request with the family.
2. A nurse is developing a plan of care for a school-age child whose family is homeless. Which of the following findings should the nurse identify as the priority ANS The child has red fissures at the corners of the mouth.
3. A nurse manager needs to address an increased rate of client medica- tion errors. Which of the following strategies represents an authoritarian approach to managing this issue ANS Inform the staff of the penalties that can result from medication errors.

4. A charge nurse is leading a committee that is revising the policy for client discharge. After developing the initial plan, which of the following actions should the nurse take next ANS Determine goals and objectives.
5. A nurse is caring for a client who is terminally ill and receiving nutritional support. The client's adult children disagree about continuing nutritional support. The dilemma is referred to the ethics committee. Which of the following actions should the nurse expect the committee to take ANS Assist in weighing the options involved in the decision.
6. A nurse receives notification of a fire on the unit. Which of the following actions should the nurse take first ANS Assist clients who are in immediate danger to a safe location.
7. A nurse is caring for a client who reports vomiting and diarrhea for the past 6 hr. The nurse should identify that which of the following assessments is the priority ANS Obtain the client's serum potassium level.
8. A nurse is conducting an orientation class for new clients and their fam- ilies at a long-term care facility. Which of the following client rights should the nurse address at the

orientation? (Select all that apply.): ANS The right to be treated with respect and dignity The right to refuse their medications The right to leave regardless of provider recommendations The right to be fully informed of their health conditions

9. A nurse in an emergency department is admitting clients following an earthquake. The emergency disaster plan has been implemented due to the anticipated arrival of a large number of casualties. Which of the following

clients should the nurse recommend the provider evaluate first ANS A client who has a sucking chest wound 10.A nurse manager is teaching about confidentiality requirements to the staff. Which of the following staff comments indicates an understanding of the teaching ANS "Change-of-shift report can be given at the client's bedside." 11.A nurse is observing a newly licensed nurse perform a sterile dressing change on a client who has a central venous catheter. Which of the following actions should the newly licensed nurse take ANS Pick up the first sterile glove by grasping the folded cuff edge.

12. A nurse is caring for a client who is 3 days postoperative following open heart surgery and will be transferred to the medical-surgical unit. Which of the following information should the nurse plan to include in the verbal report ANS The client's level of consciousness 13.A nurse manager is planning an in-service for a group of nurses about caring for clients following stem cell transplants. Which of the following instructions should the nurse manager

include in the teaching ANS Place clients in positive-pressure airflow rooms. 14.A charge nurse is preparing to observe a newly licensed nurse perform a routine abdominal assessment. Which of the following actions should the charge nurse expect the newly licensed nurse to take ANS Place the client in a dorsal recumbent position for the examination. 15.A charge nurse is supervising the care of several clients. Which of the following actions requires intervention by the charge nurse ANS A nurse is photocopying their assigned client's diagnostic test results. 16.A nurse is reviewing a client's clinical pathway upon discharge following hip arthroplasty. Which of the following information can assist the nurse in evaluating the cost effectiveness of the care ANS The length of the client's stay 17.A nurse is caring for a client who has a terminal illness and voices concern about performing self-care after discharge.

Which of the following statements should the nurse make ANS "Your case manager will coordinate the resources you will need." 18.An assistive personnel (AP) tells a charge nurse that it is unfair that they have to take care of all the clients who are incontinent. Which of the following responses should the charge nurse make ANS "I delegate tasks to personnel based on their job descriptions."

19.A nurse is caring for a client who is scheduled for outpatient surgery. Which of the following actions should the nurse take to verify the client gave informed consent ANS Ask the client to explain the procedure that is being performed. 20.A nurse is caring for a client who is hospitalized and has expressive aphasia. The client's family reports that the nurse failed to obtain written informed consent before inserting an indwelling urinary catheter. Which of the following responses should the nurse make ANS "This is a procedure that does not require written informed consent." 21.A charge nurse observes that a staff nurse's behavior has changed over the past few weeks. Which of the following behaviors should the charge nurse identify as an indication that the staff nurse might be working while impaired ANS Frequent use of restroom 22.Two nurses on a unit each contend that the other is not doing a fair share of work. The conflict is affecting the functioning of the unit. A charge nurse should approach this conflict in which of the following ways ANS Explore alternative solutions to address unit workflow with the nurses.

23.A client is considering having a tubal ligation and reports being uncertain about if it is the right thing to do. Which of the following actions should the nurse take ANS Discuss the client's feelings about the procedure. 24.A nurse on a quality improvement team is implementing a plan to de- crease the rate of pressure injuries in a long-term care facility. Which of the following actions should the team take to evaluate the effectiveness of the plan ANS Compare data from client's records regarding skin integrity with established criteria. 25.A nurse is caring for four clients. Which of the following assessment findings is the priority ANS A client who has a femur fracture and reports feeling short of breath 26.A nurse is reviewing safe use of a wheelchair with a group of assistive personnel. Which of the following instructions should the nurse include ANS - Raise the footplates of the wheelchair before transferring the client.

27.A charge nurse is observing a nurse perform a sterile dressing change for a client. Which of the following actions should the charge nurse identify as demonstrating sterile technique ANS The nurse places the sterile package with the top flap opening away from the body.

28.A charge nurse is observing a newly licensed nurse's use of time-man- agement skills. Which of the following actions by the newly licensed nurse indicates effective use of this skill ANS Groups tasks that are in the same location 29.A nurse is planning the discharge of a newborn who requires apnea monitoring at home. To which of the following community agencies should the nurse anticipate referring the guardian of the newborn ANS Home health 30.A nurse is caring for a 19-year-old client who has just been informed that their cancer has metastasized. The client tells the nurse that they do not want to continue chemotherapy. Which of the following responses should the nurse make ANS "I will gather information about palliative care for you." 31.A nurse from a medical unit is asked to work on an orthopedic unit. The medical nurse has no orthopedic experience. Which of the following clients should be assigned the medical nurse ANS A client who had aright above-the-knee amputation 24 hr ago

32.A client who has back pain presents to an emergency department and is provided a prescription for oxycodone. A staff nurse tells the charge nurse that they think the client is seeking drugs and is not actually in distress. Which of the following responses should the charge nurse make ANS "Clients are the experts on their own pain." 33.A nurse is caring for a client who requests pain medication. The nurse fulfills a promise to return with the medication within 15 min. The nurse is demonstrating which of the following ethical principles ANS Fidelity 34.A client on a general surgical unit tells a nurse that staff members are not answering the call light promptly. The client requests to be transferred to another unit. Which of the following actions should the nurse take first ANS Ask the client to verbalize their expectations. 35.A nurse is planning discharge care for a client who had a stroke and now has left-sided weakness. Which of the following interventions should the nurse include in the plan of care ANS Advise the client to install grab bars in the bathroom at home. 36.A charge nurse recognizes a trend of poor attendance at mostly staff meetings. To address this issue, which of the following actions should the charge nurse take first ANS Explore the reasons that staff are not attending the meetings.

37. A nurse manager finds that there has been an increase in urinary tract infections on the unit. To address this problem, which of the following actions

should the nurse manager take first ANS Perform a chart review to gather data about the clients who developed infections.

38. A nurse on a medical-surgical unit is caring for a client transferred from another department. The nurse should verify that the client has given informed consent prior to which of the following procedure ANS Receiving mod- erate sedation 39.A nurse is receiving report from the assistive personnel (AP) assigned to the nurse's group of clients. Which of the following statements from the AP indicates the client the nurse should assess first ANS "The client who had an indwelling urinary catheter removed 8 hr ago reports an inability to void." 40.A charge nurse is planning client care assignments for a unit. Which of the following tasks should the nurse assign to a licensed practical nurse (LPN) ANS Provide an enteral feeding to a client who has Crohn's disease. 41.A facility has been notified of a train derailment resulting in multiple clients experiencing life-threatening injuries. The external disaster plan has been activated. Which of the following actions should a charge nurse on the PACU take ANS Identify stable clients for transfer to a surgical unit. 42.A nurse on a mental health unit is teaching a newly licensed nurse about client rights. Which of the following statements by the newly licensed nurse indicates an understanding of the

teaching ANS "Clients on a mental health unit can refuse their medication." 43.A charge nurse is observing a newly licensed nurse who is caring for a client who has pulmonary tuberculosis. The charge nurse should expect the newly licensed nurse to take which of the following actions ANS Wear an N95 respirator mask when in the client's room. 44.A nurse is preparing to administer medication to a client who has Crohn's disease. The client states, "I want to skip this dose of my medication. I am too tired to take it." Which of the following actions should the nurse take ANS Inform the client of the consequences of refusing the medication. 45.A nurse on a medical-surgical unit is caring for four clients. The nurse should recognize that which of the following clients is the priority ANS A client who has peripheral vascular disease and has an absent pulse in the right foot 46.A nursing unit is undergoing changes to accommodate new bariatric ser- vices that will be available on the unit. Some staff members have verbalized displeasure with the changes. Which of the following actions should the charge nurse take? (Select all that apply.): Role model a positive approach to

the changes. Encourage staff members who support the changes to discuss the issue with resistant staff. 47.A case manager is planning an inter professional conference for a client who is 3 days postoperative following an open reduction and internal fixation of the right hip. Which of the following concerns is the priority for discussion at the conference ANS The client refuses to attend physical therapy sessions. 48.A hospice nurse is planning care for a client who does not have advance directives. Which of the following interventions should the nurse include in the plan of care ANS Provide the client with information about advance directives. 49.A nurse is assigning care for four clients. Which of the following tasks should the nurse plan to delegate to an assistive personnel (AP) ANS Determine a client's intake and output. 50.A nurse manager is auditing client charts and identifies an increase in ventilator-associated pneumonia (VAP). Which of the following actions should the nurse manager take ANS Notify the quality improvement team. 51.A nurse walks into the nurses' station and sees several staff members looking at the electronic medical record for a celebrity client on another unit. Which of the following actions

should the nurse take first ANS Remind the staff members that this is a breach of confidentiality. 52.A nurse is caring for a client who is recovering from a stroke. The provider recommends an extra cranial-intracranial bypass, but the client tells the nurse that he will not have the surgery. Which of the following actions should the nurse take ANS Discuss the client's concerns about having the surgery. 53.A nurse asks a newly hired assistive personnel (AP) to remove a client's indwelling urinary catheter. Which of the following actions should the nurse take to ensure the AP is qualified to perform this task ANS Review the AP's skill competency checklist.

54. A nurse is reviewing the plan of care for a client following a total hip arthroplasty. Which of the following actions should the nurse plan to take?- : Inform the assistive personnel of the client's weight-bearing status. 55.A nurse is serving on a committee that is considering the creation of a policy that will allow nurses to insert peripherally inserted central catheters in the intensive care unit. Which of the following resources should the nurse consult in planning for this policy ANS State Nurse Practice Act (NPA)

56.A home health nurse is planning her daily visits and receives laboratory results for four adult clients. The nurse should first visit the client who has which of the following laboratory values ANS Platelets 100,000/mm

57. A nurse on a medical-surgical unit has arrived late to work multiple times over the past several weeks. Identify the sequence the nurse manager should follow when disciplining the employee. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.): Schedule a meeting with the nurse. Provide a written reprimand. Temporarily remove the nurse from scheduled shifts. Terminate the nurse's employment. 58.A nurse is providing preoperative teaching for a client who is scheduled for a total knee arthroplasty and speaks a different language than the nurse. Which of the following inter professional team members should the nurse include in the discussion ANS Interpreter 59.Which of the following instructions provided by a nurse reflects effective communication regarding delegation of a task to an assistive personnel (AP) ANS "Check the urinary output at 1100 for John Doe and report it to me immediately."

60.A nurse is caring for a client who has osteoarthritis and reports difficulty buttoning their clothes. The nurse should recommend a referral for the client to which of the following members of the interprofessional team ANS Occupa- tional therapist