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

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RN Leadership Online Practice 2019

B

1. A nurse in an emergency department is performing triage for a group of clients following a motor-vehicle crash. Which of the following clients should the nurse request the provider to assess first? a. A client who has a closed leg fracture and reports peripheral paresthesia. b. A client who reports a sprained ankle and has a laceration over the medial ankle. c. A client who has arm contusions and manifests asymmetrical thoracic movement. d. A client who has abrasions to the face and is requesting medication for severe pain ANS c. A client who has arm contusions and manifests asymmetrical thoracic movement.
2. A nurse is caring for a client who has acute diverticulitis and is scheduled for surgery within the next 2 hr. The client tells the nurse that she has called a taxicab and is leaving the hospital. After notifying the surgeon, which of the following

actions should the nurse take next? a. Have the client sign the "Against Medical Advice" (AMA) form. b. Inform the client about the risks she may encounter by leaving the facility. c. Document the client's statements in the medical record. d. Notify the risk manager ANS b. Inform the client about the risks she may encounter by leaving the facility.

3. A nurse case manager is planning a teaching session on the use of critical pathways with a group of newly licensed nurses. Which of the following information should the nurse include in the teaching? a. Critical pathways promote individualized care. b. Critical pathways decrease administrative work time. c. Critical pathways prevent unnecessary expense. d. Critical pathways incorporate provider preferences ANS c. Critical pathways prevent unnecessary expense.
4. A nurse is caring for a client who has an informed consent form for an upcoming procedure in his health record. Which of the following actions should the nurse take to validate that the client understands the procedure?

a. Review documentation by the provider of discussing the procedure with the client. b. Verify that the client's signature is on the informed consent form.

c. Ask the client to verbalize the purpose, risks, and benefits of the proce- dure. d. Document the client's completed pre-procedure checklist in the medical record ANS c. Ask the client to verbalize the purpose, risks, and benefits of the procedure.

5. A nurse at an urgent care clinic notices that a pain assessment is not being performed for all clients as required by policy. Which of the following actions should the nurse take to ensure care is provided according to policy? a. Check client satisfaction surveys for feedback on this issue. b. Post an article on pain assessment on the bulletin board. c. Document this finding on an incident report. d. Report this issue to the nurse manager ANS d. Report this issue to the nurse manager.
6. A client is being discharged with a postoperative infection, requiring daily home IV antibiotics through a peripherally inserted central catheter (PICC) line. Which of the following actions should the case manager perform prior to discharge? a. Assess the client's home environment for possible reservoirs of infection. b. Verify the patency of the PICC line.

c. Provide dressing change and wound assessment teaching. d. Ensure that home infusion therapy has been arranged ANS d. Ensure that home infusion therapy has been arranged.

7. A nurse manager is completing a performance improvement audit and de- termines documentation of client discharge teaching is below the expected benchmark. Which of the following actions should the nurse implement first? a. Offer incentives for the staff once the unit's benchmark is above average. b. Train specific nurses to use a standard discharge teaching plan. c. Determine the factors that interfere with the documentation of client education. d. Include client discharge teaching as part of the annual performance eval- uation ANS c. Determine the factors that interfere with the documentation of client education.
8. A charge nurse is orienting a newly licensed nurse to the facility's policies regarding electronic medical records. Which of the following statements by the newly licensed nurse indicates an understanding of the instructions?

a. "I will make sure the monitor is turned off when I have to leave the computer terminal." b. "I can share my password with nursing students assigned to my unit." c. "I will allow a client to make changes directly to their medical record." d. "After I finish with the printout of my assignment, I'll put it in the shredder receptacle." ANS d. "After I finish with the printout of my assignment, I'll put it in the shredder receptacle."

9. A charge nurse is delegating tasks on a nursing unit that is short staffed. A client has a prescription for a wound irrigation twice per day. Which of the following actions should the charge nurse take? a. Perform wound irrigation during rounds. b. Delegate the procedure to an assistive personnel (AP). c. Assign the procedure to a licensed practical nurse (LPN). d. Reschedule the procedure to be performed once daily ANS c. Assign the pro- cedure to a licensed practical nurse (LPN).
10. A staff nurse detects alcohol on the breath of another nurse working on the unit. The staff nurse observes that the nurse's speech is slurred and their gait is unsteady. Which of

the following actions should the nurse take? a. Notify the charge nurse of the nurse's behavior. b. Confront the nurse about their behavior. c. Wait to see if the behavior occurs again before acting. d. Suggest the nurse request sick leave for the rest of the shift ANS a. Notify the charge nurse of the nurse's behavior.

11. An RN delegates the task of obtaining the blood pressure of a client who is 2 hr postoperative following a cholecystectomy to a licensed practical nurse (LPN). The LPN reports a blood pressure that is significantly higher than the client's previous reading. Which of the following actions should the RN take first? a. Recheck the client's blood pressure. b. Treat the client's blood pressure with a prescribed antihypertensive. c. Ask the LPN to review the technique for obtaining blood pressure. d. Review the client's medical record for other episodes of elevated blood pressure ANS a. Recheck the client's blood pressure.

12. A nurse is caring for several clients. Which of the following actions should the nurse take to maintain client confidentiality? a. Tell a client's partner that the client's laboratory tests cannot be disclosed without permission. b. Ask the assistive personnel to refer to clients by room number in public areas. c. Explain to a student nurse that verbal permission must be obtained before using a client's name in school assignments. d. Share information about a client with immediate family members after personal identification has been provided ANS a. Tell a client's partner that the client's laboratory tests cannot be disclosed without permission.
13. A nurse manager is conducting an annual performance review for a staff nurse. Which of the following strategies should the nurse use in the review process? (Select all that apply.) a. Base the review on the nurse's performance during the past 90 days. b. Include peer evaluations completed by other staff nurses. c. Evaluate the nurse's performance based on a comparison of the nurse to others on the unit.

d. Have the nurse conduct a self-appraisal prior to the review. e. Complete a performance checklist ANS b. Include peer evaluations completed by other staff nurses. d. Have the nurse conduct a self-appraisal prior to the review. e. Complete a performance checklist.

14. A nurse is teaching a newly licensed nurse about using electronic med- ical records. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? a. "There is a 24-hour delay for client data to update in the medical record." b "My access to client electronic records might be tracked by my nurse manager." c. "A client's medical record can only be accessed by one person at a time." d. "I can look at every client's medical record on the unit." ANS b "My access to client electronic records might be tracked by my nurse manager."
15. A nurse is delegating tasks for a group of clients to an assistive personnel (AP). Which of the following statements by the nurse provides the right direction of communication with the AP?

a. "Please take the vital signs of the clients in rooms 200 through 208." b. "Obtain the weight of the client in room 202 using the bed scales." c. "Tell me what time the client in room 205 voids for the first time after the catheter is removed." d. "The client in room 201 needs to have anti embolic stockings applied." ANS c. "Tell me what time the client in room 205 voids for the first time after the catheter is removed."

16. A nurse is reviewing a client's medication administration record and finds that the client has not received a prescribed dose of warfarin in 2 days. Which of the following actions should the nurse take first? a. Check the client's last INR. b. Notify the client's provider. c. Notify the risk manager. d. Complete an incident report ANS a. Check the client's last INR.
17. A charge nurse has been asked to determine staff adherence to estab- lished standards for postoperative vital sign measurement. Which of the following actions should the nurse take to collect information?

a. Distribute a questionnaire asking staff to rate adherence to the standard. b. Conduct a retrospect chart audit of all surgical clients for the past 6 months. c. Ask the nurse manager to examine staff performance reviews. d. Review client satisfaction surveys for all surgical clients for the past 6 months ANS b. Conduct a retrospect chart audit of all surgical clients for the past 6 months.

18. A charge nurse is discussing issues with a staff nurse. When evaluating statements by the staff nurse, the charge nurse should recognize that which of the following reflects an intrapersonal conflict? a. "I'm not sure whether I want to apply for the unit manager's position or start a family this year." b. "I feel frustrated because I just readmitted a client who refuses to take their insulin." c. "The unit manager is more concerned with saving money than with clients getting quality care." d. "Every time I request an extra day off I'm denied, but other nurses' requests

are approved." ANS a. "I'm not sure whether I want to apply for the unit manager's position or start a family this year."

19. A charge nurse is observing a newly licensed nurse care for a client who has a prescription for application of an aquathermia pad to the right lower leg. Which of the following actions should indicate to the charge nurse that the nurse understands how to use the device? (Select all that apply.) a. Asks the client to report if the aquathermia pad gets too warm. b. Checks the client's leg 30 min after applying the aquathermia pad. c. Shows the client how to adjust the temperature. d. Ensures that the client's call light is in reach. e. Decreases the temperature by 2.8C (5F) if the client's skin becomes reddened ANS a. Asks the client to report if the aquathermia pad gets too warm. d. Ensures that the client's call light is in reach.
20. A nurse is planning discharge care for a client who has rheumatoid arthritis and has difficulty buttoning clothing. Which of the following referrals should the nurse recommend for the client?

a. Pain management clinic b. Physical therapy c. Arthritis support group d. Occupational therapy ANS d. Occupational therapy

21. A nurse is presenting information on health care law to a group of newly licensed nurses. Which of the following information should the nurse include? a. Good samaritan laws provide protection for nurses who are negligent when providing volunteer services. b. The Emergency Medical Treatment and Active Labor Act (EMTALA) pro- vides nursing guidelines for providing client care outside the health care facility. c. The Patient Self-Determination Act (PSDA) requires a nurse to give clients information about end-of-life options. d. State nurse practice acts are informal guidelines that direct professional nursing practice ANS c. The Patient Self- Determination Act (PSDA) requires a nurse to give clients information about end-of-life options.
22. A nurse is caring for four clients. Which of the following tasks can the nurse assign to an assistive personnel (AP)?

a. Perform chest compressions on a client who is in cardiac arrest. b. Change a sterile dressing on a client's leg wound. c. Check the residual of a client's gastrostomy tube. d. Instruct the client on the use of a blood glucose machine ANS a. Perform chest compressions on a client who is in cardiac arrest.

23. A nurse is caring for a client who has a potassium level of 3.2 mEq/L. The nurse has been paging the provider for 1 hr to attempt to report the potassium level. Which of the following actions should the nurse take next? a. Continue to attempt to contact the provider. b. Notify the nursing supervisor. c. Administer an emergency dose of potassium. d. Consult with the pharmacist ANS b. Notify the nursing supervisor.
24. A charge nurse is planning assignments for the upcoming shift. Which of the following tasks should the charge nurse delegate to an assistive personnel (AP)? a. Assisting a client who had a hip arthroplasty to a chair.

b. Instructing a client on the use of a glucometer. c. Interpreting the vital signs of a client who fell. d. Cleansing the site of a midline catheter ANS a. Assisting a client who had a hip arthroplasty to a chair.

25. A charge nurse is evaluating a plan of care that a newly licensed nurse developed for a client who is to receive a continuous NG tube feeding. Which of the following interventions should the charge nurse ensure is part of the plan of care? a. Flush the tube every 8 hr with 0.9% sodium chloride irrigation. b. Use an acidic juice to unclog a blocked tube. c. Add dissolved medications to the enteral feeding. d. Use a 60-mL syringe to flush out a clogged tube ANS d. Use a 60-mL syringe to flush out a clogged tube.
26. A nurse has just received report on four clients on a medical-surgical unit. Which of the following clients should the nurse plan to assess first? a. A client who has COPD and oxygen saturation level of 92%. b. A client who is postoperative following a total knee arthroplasty and has

a capillary refill of 4 seconds. c. A client who has diabetes mellitus and a blood glucose of 150 mg/dL. d. A client who is 12 hr postoperative following abdominal surgery and has absent bowel sounds ANS b. A client who is postoperative following a total knee arthroplasty and has a capillary refill of 4 seconds.

27. A nurse is assessing a client who is postoperative and has a PCA. The client exhibits restlessness, an elevated pulse, and decreased blood pressure. Which of the following actions should the nurse take? a. Assign an assistive personnel to monitor the client's vital signs. b. Encourage increased use of the PCA for comfort. c. Have the client's provider prescribe a sedative. d. Place the client in a modified Trendelenburg position ANS d. Place the client in a modified Trendelenburg position.
28. A nurse is caring for a client who is experiencing adverse effects after receiving a new medication. Which of the following communication tools should the nurse use for management of this complication? a. Critical pathway

b. Incident reporting c. SBAR framework d. Root cause analysis ANS c. SBAR framework

29. A nurse in a mental health facility is teaching a newly licensed nurse about the use of mechanical restraints. Which of the following statements by the newly licensed nurse indicates understanding of the teaching? a. "I should use mechanical restraints when a client who is manic starts pacing." b. "I should document every hour when a client is in mechanical restraints." c. "I should request the provider to examine the client within 1 hour of applying mechanical restraints." d. "I should check the client every 30 minutes while in mechanical re- straints." ANS c. "I should request the provider to examine the client within 1 hour of applying mechanical restraints."
30. An RN is working on the surgical unit when a client who has abdominal pain is admitted. Which of the following activities must be performed by the RN?

a. Obtaining a urinalysis from the client b. Completing the client's initial admission assessment c. Administering PO pain medications to the client d. Assembling the client's medical record ANS b. Completing the client's initial admission assessment

31. A nurse manager is reviewing the actions a staff nurse took when they observed smoking coming from a wastebasket in a client's room. The nurse manager should verify that the nurse acted appropriately when they per- formed which of the following actions first? a. Closed the door to the client's room b. Initiated the fire alarm system c. Transported the client to the hallway. d. Attempted to extinguish the fire ANS c. Transported the client to the hallway.
32. A nurse manager is reviewing the stages of conflict resolution with the nursing staff. The nurse manager should instruct the staff to expect the stages of the conflict to occur in what order? Perceived conflict Felt conflict Manifest

conflict Latent conflict Conflict aftermath ANS Latent conflict Perceived conflict Felt conflict Manifest conflict Conflict aftermath

33. A public health nurse is developing a list of recommendations for super- visor about how to use evidence- based practice to improve community out- comes. Which of the following should the nurse recommend as a qualitative research method? a. Meta-analysis b. Experimental study c. Phenomenology d. Secondary analysis ANS c. Phenomenology
34. A nurse is teaching a client about the Patient Protection and Affordable Care Act and their rights regarding insurance coverage. Which of the follow-

ing statements by the client indicates an understanding of the teaching? a. "My insurance coverage no longer has lifetime coverage limits." b. "I can provide health insurance coverage for my children on my policy until they turn 21 years old." c. "My insurance will not provide coverage for preexisting conditions." d. "I can lose my insurance coverage since I have been sick so much this year." ANS a. "My insurance coverage no longer has lifetime coverage limits."

35. A nurse is caring for a client who has breast cancer and is deciding on a plan of treatment. Which of the following statements should the nurse make? a. "Let's talk about the benefits of each treatment." b. "You should follow your provider's order recommendation." c. "We should talk about this later after you've had time to think." d. "I am sure you'll make the right decision." ANS a. "Let's talk about the benefits of each treatment."
36. A nurse is reviewing the components of a surgical informed consent with a newly licensed nurse. Which of the following statements should the nurse include?

a. "The surgeon should briefly describe the surgical procedure to the client." b. "The nurse should ensure the client understands the information given by the surgeon." c. "The surgeon does not need to inform the client of the risks if they aren't life threatening." d. "The nurse should answer any questions the client might have once the consent is signed." ANS b. "The nurse should ensure the client understands the information given by the surgeon."

37. A nurse is teaching a newly licensed nurse about incident reports. Which of the following statements by the newly licensed nurse indicates an under- standing of the teaching? a. "I should place a copy of an incident report in the client's medical record." b. "I should document the completion of an incident report in the client's medical record." c. "I should complete an incident report for an unexpected client occur- rence."

d. "I should ask the risk manager to complete the incident reports." ANS c. "I should complete an incident report for an unexpected client occurrence."

38. A nurse is speaking with the adult child of a client who has severe Alzheimer's disease. The child is crying and tells the nurse, "I don't know how much longer I can keep this up." Which of the following responses should the nurse make? a. "I understand how you must be feeling." b. "You should speak with your parent's doctor about this." c. "Let's discuss options for respite care." d. "You'll need to get help if your parent becomes combative." ANS c. "Let's discuss options for respite care."
39. A nurse is caring for a group of clients on a unit. Which of the following assessment findings should the nurse recognize as the priority to report to the charge nurse? a. A client who has heart failure and 2+ edema of the lower extremities. b. A client who is 2 days postoperative and has a urine output of 20 mL/hr c. A client who started taking verapamil and has a heart rate of 75/min. d. A client who is receiving morphine and reports nausea ANS b. A client who is 2 days postoperative and has a urine output of 20

mL/hr

40. A charge nurse notices that a newly hired nurse consistently does not finish client care tasks by the end of the shift. Which of the following state- ments should the charge nurse make? a. "You should set aside time to plan your day at the beginning of your shift." b. "You should take an extended break once your documentation is complet- ed." c. "You should prioritize your tasks according to your personal preferences." d. "You should save your charting for the end of the shift." ANS a. "You should set aside time to plan your day at the beginning of your shift."
41. A nurse manager is presenting an in-service about preventing readmis- sion of clients due to complications following joint arthroplasty. Which of the following leadership tasks is the nurse performing? a. Collaboration b. Compromising

c. Smoothing d. Advocacy ANS d. Advocacy

42. A charge nurse is planning care for a group of clients. Which of the following tasks should be delegated to an assistive personnel (AP)? (Select all that apply.) a. Flushing a client's saline lock b. Ambulating a client who uses a walker c. Adding thickener to thin liquids on a client's food tray d. Showing a client how to use an incentive spirometer e. Evaluating a client's gag reflex before mealtime ANS b. Ambulating a client who uses a walker c. Adding thickener to thin liquids on a client's food tray
43. A charge nurse on a medical unit hears the fire alarm and announcement that a fire is occurring on the unit. Which of the following is the priority action by the charge nurse? a. Turn off the oxygen supply valve to the unit. b. Instruct ambulatory clients to go to a safe area. c. Verify that the unit fire doors are closed. d. Direct personnel to use fire extinguishers ANS b. Instruct ambulatory clients to go to a safe area
44. A nurse manager sends home a nurse who is chemically impaired. Which of the following actions should the nurse

manager take? a. Provide a series of counseling sessions with the nurse. b. Talk with the nurse's coworkers to determine a potential cause for the impairment. c. Set up a formal meeting with the nurse within 24 hours. d. Report the nurse's chemical impairment to the risk manager ANS c. Set up a formal meeting with the nurse within 24 hours.

45. A nurse is receiving change-of-shift report. Which of the following clients should the nurse assess first? a. A client who has a WBC count of 15,000/mm3 and is receiving antibiotics. b. A client who had abdominal surgery 6 hours ago and has had a heart rate of 120/min for the last 2 hr. c. A client who is requesting pain medication after 24 hr after an open