LEADERSHIP EXAM
B. manager."
Rationale:This statement is punitive.
C. "You have been very inconsiderate of others by not completing your share of the work."
Rationale:This statement is punitive.
4.A nurse is providing care for a surgeon on a medical-surgical unit. A nurse from another unit asks the nurse about
the surgeon’s medical diagnosis. The nurse responds that he is unable to provide the information requested. The
nurse is displaying which of the following ethical principles?
A. Utility
Rationale:Utility is the ethical principle that the good of many people outweighs the good of one person.
B. Paternalism
Rationale:Paternalism is the belief that one individual has the right to make decisions for another. It
negates the client’s right to autonomy.
C. Justice
Rationale:Justice is the ethical principled based on the belief that everyone should be treated fairly.
D. Nonmaleficence
Rationale:The nurse is obligated to protect the client’s confidential information. A breach of confidentiality
can place the client at risk of harm. Nonmaleficence is the ethical duty to prevent harm to the
client.
5.When planning delegation of tasks to assistive personnel (AP), a nurse considers the five rights of delegation.
Which of the following should the nurse consider when using one of the five rights of delegation?
A. The AP's ability to prioritize
Rationale:Although the nurse could determine the AP’s ability to prioritize, this is not one of the rights of
delegation.
B. The AP has the knowledge and skill to perform the task
Rationale:The right person is one of the five rights of delegation. The nurse should seek information from
the AP about his individual skill level before delegating the task.
C. The AP's rapport with clients
Rationale:Although a positive rapport with clients is important, this is not one of the five rights of
delegation.
Created on:11/29/2018 Page 1
, Detailed Answer Key
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D. The AP’s ability to complete the task without assistance
Rationale:
The nurse does not relinquish accountability for supervising the AP; therefore, this is not one of
the five rights of delegation.
6.While caring for a client, the nurse experiences a needle stick injury. Which of the following actions should the nurse
take first?
A. Complete an incident report.
Rationale:The nurse should complete an incident report; however, there is another action the nurse should
take first.
B. Request the risk manager obtain consent for HIV testing from the client.
Rationale:Although it is important that the client’s HIV status is determined, there is another action the
nurse should take first.
C. Wash the site of injury with soap and water.
Rationale:The greatest risk to the nurse is infection transmission; therefore, the nurse should first wash the
area with soap and water to reduce the risk of transmission. D. Consent to postexposure treatment with
antiretroviral medications.
Rationale:Although treatment with antiretroviral medications should be started within 1 to 2 hr after a
needle stick injury and be continued for 28 days if the client’s HIV status is positive, there is
another action the nurse should take first.
7.A nurse is caring for a client who has named a person to serve as his health care proxy. The client states he needs
clarification about this type of advance directives. Which of the following statements by the client indicates a need
for clarification?
A. "I can change who I designate as my health care proxy at any time."
Rationale:This is a correct statement regarding a health care proxy.
B. "If I become incapacitated, end-of-life choices will be made by my proxy."
Rationale:This is a correct statement regarding a health care proxy.
C. "I have to choose a family member as my health proxy."
Rationale:The client should choose someone he trusts an1.A nurse is preparing an in-service for an annual skills fair
at a community medical facility about fire safety. Place the steps in the order in which they should be performed in
the case of a fire emergency. (Move the steps into the box on the right, placing them in the selected order of
performance. Use all the steps.)
D. Rescue the clients.
Created on:11/29/2018 Page 2
, LEADERSHIP EXAM
A. Pull the fire alarm.
B. Confine the fire.
C. Extinguish the fire.
2.A nurse is caring for a client who is dying of metastatic breast cancer. She has a prescription for an opioid pain
medication PRN. The nurse is concerned that administering a dose of pain medication might hasten the client's
death. Which of the following ethical principles should the nurse use to support the decision not to administer the
medication?
A. Utilitarianism
Rationale:Utilitarianism refers to actions that are right when they contribute to the greatest good.
B. Nonmaleficence
Rationale:Nonmaleficence is the duty to do no harm. The ethical mandate of nonmaleficence is that health
care workers refrain from intentionally inflicting harm to clients.
C. Fidelity
Rationale:Fidelity is the duty to keep one's promises or word. It refers to the obligation to be faithful to the
agreements, commitments, and responsibilities that one has made to oneself and others.
D. Veracity
Rationale:Veracity is the duty to tell the truth. It means that one does not intentionally deceive or mislead
clients.
3.A charge nurse notes that a staff nurse delegates an unfair share of tasks to the assistive personnel (AP) and the
nurses on next shift report the staff nurse frequently leaves tasks uncompleted. Which of the following statements
should the charge nurse make to resolve this conflict?
A. "I need to talk to you about unit expectations regarding delegating and completing tasks."
Rationale:This statement opens the conversation in a nonthreatening way. The focus is on the issue of the
equity of the assignment rather than on any personal characteristic of the individual.
D. "Several staff members have commented that you don't do your fair share of the work."
Rationale:This statement is accusatory.
"If you don't do your share of the work, I will have to inform the nurse d knows about his wishes for day-to-
day and end-of-life care. It can be a family member, but it does not have to be a family member.
D. "The health care proxy does not go into effect until I am incapable of making decisions."
Rationale:This is a correct statement regarding a health care proxy.
Created on:11/29/2018 Page 3
, Detailed Answer Key
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8.A nurse is serving on a continuous quality improvement (CQI) committee that has been assigned to develop a
program to reduce the number of medication administration errors following a sentinel event at the facility. Which of
the following strategies should the committee plan to initiate first?
A. Provide an inservice on medication administration to all the nurses.
Rationale:A recommendation for staff education may be indicated, but this does not assist the committee
to identify factors that lead to medication errors.
B. Require staff nurses to demonstrate competency by passing a medication administration examination.
Rationale:Ensuring competency in medication administration may be indicated, but this does not assist the
committee to identify factors that lead to medication errors. C. Review the events leading up to each medication
administration error.
Rationale:After a sentinel event, the first step the committee should plan to take is to use root cause
analysis to identify the underlying cause or causes that led to the medication errors. D. Develop a quality
improvement program for nurses involved in medication administration errors.
Rationale:Although development of a quality improvement program for nurses involved in medication
errors may be indicated, this does not assist the committee to identify factors that lead to
medication errors.
9.A charge nurse has access to the facility’s electronic client records. It is appropriate for the charge nurse to share
her personal password with whom? A. The nurse manager
Rationale:A nurse manager authorized to have access to a computer will have a personal password.
B. No one
Rationale:Computer passwords cannot be shared with others for any reason. Any facility employee
authorized to have access to the database on a computer will have a personal password.
C. A nursing student who is completing a preceptorship on the unit
Rationale:A nursing student who is authorized to have access to the database on a computer will have a
personal password. D. The unit clerk
Rationale:A unit clerk authorized to have access to a computer will have a personal password.
10.A nurse on a medical-surgical unit is reconciling a newly admitted client’s medication. The nurse is reviewing the
process of medication reconciliation with a newly licensed nurse. The nurse should include which of the following
information?
A. The American Hospital Association requires accredited facilities to have protocols in place requiring
medication reconciliation.
Created on:11/29/2018 Page 4
B. manager."
Rationale:This statement is punitive.
C. "You have been very inconsiderate of others by not completing your share of the work."
Rationale:This statement is punitive.
4.A nurse is providing care for a surgeon on a medical-surgical unit. A nurse from another unit asks the nurse about
the surgeon’s medical diagnosis. The nurse responds that he is unable to provide the information requested. The
nurse is displaying which of the following ethical principles?
A. Utility
Rationale:Utility is the ethical principle that the good of many people outweighs the good of one person.
B. Paternalism
Rationale:Paternalism is the belief that one individual has the right to make decisions for another. It
negates the client’s right to autonomy.
C. Justice
Rationale:Justice is the ethical principled based on the belief that everyone should be treated fairly.
D. Nonmaleficence
Rationale:The nurse is obligated to protect the client’s confidential information. A breach of confidentiality
can place the client at risk of harm. Nonmaleficence is the ethical duty to prevent harm to the
client.
5.When planning delegation of tasks to assistive personnel (AP), a nurse considers the five rights of delegation.
Which of the following should the nurse consider when using one of the five rights of delegation?
A. The AP's ability to prioritize
Rationale:Although the nurse could determine the AP’s ability to prioritize, this is not one of the rights of
delegation.
B. The AP has the knowledge and skill to perform the task
Rationale:The right person is one of the five rights of delegation. The nurse should seek information from
the AP about his individual skill level before delegating the task.
C. The AP's rapport with clients
Rationale:Although a positive rapport with clients is important, this is not one of the five rights of
delegation.
Created on:11/29/2018 Page 1
, Detailed Answer Key
meds
D. The AP’s ability to complete the task without assistance
Rationale:
The nurse does not relinquish accountability for supervising the AP; therefore, this is not one of
the five rights of delegation.
6.While caring for a client, the nurse experiences a needle stick injury. Which of the following actions should the nurse
take first?
A. Complete an incident report.
Rationale:The nurse should complete an incident report; however, there is another action the nurse should
take first.
B. Request the risk manager obtain consent for HIV testing from the client.
Rationale:Although it is important that the client’s HIV status is determined, there is another action the
nurse should take first.
C. Wash the site of injury with soap and water.
Rationale:The greatest risk to the nurse is infection transmission; therefore, the nurse should first wash the
area with soap and water to reduce the risk of transmission. D. Consent to postexposure treatment with
antiretroviral medications.
Rationale:Although treatment with antiretroviral medications should be started within 1 to 2 hr after a
needle stick injury and be continued for 28 days if the client’s HIV status is positive, there is
another action the nurse should take first.
7.A nurse is caring for a client who has named a person to serve as his health care proxy. The client states he needs
clarification about this type of advance directives. Which of the following statements by the client indicates a need
for clarification?
A. "I can change who I designate as my health care proxy at any time."
Rationale:This is a correct statement regarding a health care proxy.
B. "If I become incapacitated, end-of-life choices will be made by my proxy."
Rationale:This is a correct statement regarding a health care proxy.
C. "I have to choose a family member as my health proxy."
Rationale:The client should choose someone he trusts an1.A nurse is preparing an in-service for an annual skills fair
at a community medical facility about fire safety. Place the steps in the order in which they should be performed in
the case of a fire emergency. (Move the steps into the box on the right, placing them in the selected order of
performance. Use all the steps.)
D. Rescue the clients.
Created on:11/29/2018 Page 2
, LEADERSHIP EXAM
A. Pull the fire alarm.
B. Confine the fire.
C. Extinguish the fire.
2.A nurse is caring for a client who is dying of metastatic breast cancer. She has a prescription for an opioid pain
medication PRN. The nurse is concerned that administering a dose of pain medication might hasten the client's
death. Which of the following ethical principles should the nurse use to support the decision not to administer the
medication?
A. Utilitarianism
Rationale:Utilitarianism refers to actions that are right when they contribute to the greatest good.
B. Nonmaleficence
Rationale:Nonmaleficence is the duty to do no harm. The ethical mandate of nonmaleficence is that health
care workers refrain from intentionally inflicting harm to clients.
C. Fidelity
Rationale:Fidelity is the duty to keep one's promises or word. It refers to the obligation to be faithful to the
agreements, commitments, and responsibilities that one has made to oneself and others.
D. Veracity
Rationale:Veracity is the duty to tell the truth. It means that one does not intentionally deceive or mislead
clients.
3.A charge nurse notes that a staff nurse delegates an unfair share of tasks to the assistive personnel (AP) and the
nurses on next shift report the staff nurse frequently leaves tasks uncompleted. Which of the following statements
should the charge nurse make to resolve this conflict?
A. "I need to talk to you about unit expectations regarding delegating and completing tasks."
Rationale:This statement opens the conversation in a nonthreatening way. The focus is on the issue of the
equity of the assignment rather than on any personal characteristic of the individual.
D. "Several staff members have commented that you don't do your fair share of the work."
Rationale:This statement is accusatory.
"If you don't do your share of the work, I will have to inform the nurse d knows about his wishes for day-to-
day and end-of-life care. It can be a family member, but it does not have to be a family member.
D. "The health care proxy does not go into effect until I am incapable of making decisions."
Rationale:This is a correct statement regarding a health care proxy.
Created on:11/29/2018 Page 3
, Detailed Answer Key
meds
8.A nurse is serving on a continuous quality improvement (CQI) committee that has been assigned to develop a
program to reduce the number of medication administration errors following a sentinel event at the facility. Which of
the following strategies should the committee plan to initiate first?
A. Provide an inservice on medication administration to all the nurses.
Rationale:A recommendation for staff education may be indicated, but this does not assist the committee
to identify factors that lead to medication errors.
B. Require staff nurses to demonstrate competency by passing a medication administration examination.
Rationale:Ensuring competency in medication administration may be indicated, but this does not assist the
committee to identify factors that lead to medication errors. C. Review the events leading up to each medication
administration error.
Rationale:After a sentinel event, the first step the committee should plan to take is to use root cause
analysis to identify the underlying cause or causes that led to the medication errors. D. Develop a quality
improvement program for nurses involved in medication administration errors.
Rationale:Although development of a quality improvement program for nurses involved in medication
errors may be indicated, this does not assist the committee to identify factors that lead to
medication errors.
9.A charge nurse has access to the facility’s electronic client records. It is appropriate for the charge nurse to share
her personal password with whom? A. The nurse manager
Rationale:A nurse manager authorized to have access to a computer will have a personal password.
B. No one
Rationale:Computer passwords cannot be shared with others for any reason. Any facility employee
authorized to have access to the database on a computer will have a personal password.
C. A nursing student who is completing a preceptorship on the unit
Rationale:A nursing student who is authorized to have access to the database on a computer will have a
personal password. D. The unit clerk
Rationale:A unit clerk authorized to have access to a computer will have a personal password.
10.A nurse on a medical-surgical unit is reconciling a newly admitted client’s medication. The nurse is reviewing the
process of medication reconciliation with a newly licensed nurse. The nurse should include which of the following
information?
A. The American Hospital Association requires accredited facilities to have protocols in place requiring
medication reconciliation.
Created on:11/29/2018 Page 4
