Reference no: EM133909827

Questions

1. A nurse manager is reviewing the rate of medication errors on a surgical floor and finds that it is 20% above the national average. After setting a standard of care, which of the following actions should the nurse manager take first using the quality improvement process?

A. Re-evaluate staff performance in relation to the established standard

B. Require staff to complete medication administration review module

C. Identity data that should be collected related to medication errors

D. Observe staff medication administration procedures

2. A nurse is caring for a client who has cancer. The client's adult child asks the nurse for information about the client's treatment plan. Which of the following responses should the nurse make?

A. "I will ask your mother's primary care provider to speak with you."

B. "What would you like to know about your mother's treatment?"

C. "You will have to speak directly to your mother about her treatment."

D. "I cannot provide this information to you without your mother's consent."

3. A nurse is performing triage at the site of a mass casualty. For which of the following clients should the nurse assign a yellow tag?

A. The client who has a deep laceration to the leg

B. The client who has a large bruise to the shoulder

C. The client who is unable to breathe without manual ventilation

D. The client who is experiencing chest pain with radiation to the arm

4. A nurse working in the emergency department is assessing several clients. Which of the following clients is the highest priority?

A. A client who has active bleeding from a puncture wound of the left groin area

B. A client who reports shortness of breath and left neck and shoulder pain

C. A client who has a raised red skin rash on his arms, neck and face

D. A client who reports right-sided flank pain and is diaphoretic

5. A nurse in a long-term care facility is caring for a client who reports the assistive personnel repositioned him in bed using excessive force. Which of the following actions should the nurse take?

A. Reassure the client that the staff is well trained

B. Contact the nurse manager

C. Document in the client's chart that an incident report has been filed

D. Call risk management to interview the client.

6. A nurse manager is teaching an in-service about methods to implement advocacy in the client care setting. Which of the following statements should the nurse manager include?

A. "Staff nurses should resolve ethical situations involving clients without seeking external help."

B. "Charge nurses should report concerns about working conditions to the nursing supervisor"

C. "Use the same communication techniques with clients regardless of cultural differences"

D. "It is acceptable to give personal advice when clients can't make a decision about treatment"

7. A nurse manager is preparing an in-service for unit staff about protective environment precautions. Which of the following should the nurse manager include in the teaching?

A. Provide visitors with N95 respirator masks

B. Place clients in a positive pressure airflow room.

C. Permit children over 5 years of age to visit

D. Maintain surgical asepsis when providing care.

8. A nurse is delegating oral care for a client who is unconscious to an assistive personnel (AP). The AP tells the nurse that APs are not allowed to perform the delegated task. Which of the following actions should the nurse take?

A. Ask the nurse manager who should perform the task.

B. Ask a licensed practical nurse to perform the task

C. Perform the oral care

D. Check the AP job description

9. A nurse is providing teaching to an assistive personnel about the application of wrist restraints to a client. Which of the following instructions should the nurse include in the teaching?

A. Allow 1 fingerbreadth between the restraint and the client's wrist.

B. Remove the client's restraints every 2 hr.

C. Attach the restraints to the fixed portion of the frame of the client's bed.

D. Secure the client's restraints with a square knot

10. A charge nurse is reviewing the plan of care with a newly licensed nurse for a child who is experiencing sickle cell crisis. The charge nurse should Intervene for which of the following actions planned by the newly licensed nurse?

A. Position cold compresses on the child's extremities.

B. Elevate the head of the child's bed to 30%

C. Gently palate the client's abdomen.

D. Reinforce teaching with the parents about signs of dehydration

11. A client who is febrile is admitted to the hospital for treatment of pneumonia. In accordance with the care pathway, antibiotic therapy is prescribed. Which of the following situations requires the nurse to complete variance report with regard to the care pathway?

A. Antibiotic therapy was initiated 2 hr after implementation of the care pathway

B. The route of antibiotic therapy on the care pathway was changed from IV to PO.

C. An allergy to penicillin required an alternative antibiotic to be prescribed

D. A blood culture was obtained after antibiotic therapy had been initiated.

12. A charge nurse discovers that a staff nurse on the unit has made repeated medication errors. Which of the following actions should the charge nurse take first?

A. Ask the nurse to describe her medication administration procedure

B. Notify the risk management department of the situation

C. Identify education opportunities for the nurse regarding safe medication administration

D. Review with the nurse the principles of medication administration

13. A nurse from the labor and delivery unit is assigned to float to medical surgical unit. Which of the following actions should the nurse take first?

A. Inform the nursing supervisor of the lack of experience on the medical surgical

B. Request orientation to medical surgical unit

C. Refer to assigned resource nurse regarding client assignments

D. Clarify competencies with the medical-surgical charge nurse

14. A hospice nurse is caring for a client who has a terminal illness and reports severe pain. After the nurse administers the prescribed opioid and benzodiazepine, the client becomes somnolent and difficult to arouse. Which of the following actions should the nurse take?

A. Withhold the benzodiazepine but continue the opioid.

B. Contact the provider about replacing the opioid with an NSAID.

C. Administer the benzodiazepine but withhold the opioid.

D. Continue the medication dosages that relieve the client's pain.

15. A nurse is observing an assistive personnel (AP) administer 0.9% sodium chloride enema to an adult client. For which of the following actions by the AP should the nurse intervene?

A. Administers the solution at room temperature

B. Points tubing in the direction of the umbilicus during insertion

C. Position the client on her left side with knees flexed

D. Inserts the tubing 8 cm (3.1 in) into the rectum

16.  A nurse manager observes an assistive personnel (AP) incorrectly transferring a client to the bedside commode. Which of the following actions should the nurse take first?

A. Refer the AP to the facility procedure manual.

B. Instruct the AP to request assistance when unsure about a task.

C. Help the AP assist the client with the transfer.

D. Demonstrate the proper client transfer technique for the AP.

17. A nurse manager is reviewing the nursing code of ethics with the staff nurses. Which of the following statements by a staff nurse indicate understanding of the teaching? (Select all that apply)

A. "I will attend continuing education classes for professional growth"

B. "The family of a newly admitted client recently treated me to lunch in the hospital cafeteria"

C. "Administer pain medication to my clients even if they have a history of narcotic addiction"

D. "I can delegate the removal of an IV catheter to an LPN on the unit"

E. "I have the assistive personnel double check packed RBCs when the nurses are busy"