LEADERSHIP EXAM RETAKE 1 SET 1
70+ QUESTIONS & ANSWERS
WITH WELL EXPLAINED RATIONALES
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1) Scenario: A local community disaster has occurred, and your facility must
rapidly discharge stable clients to free beds for new casualties. As the charge
nurse, you are deciding which client can safely be discharged.
Which of the following clients is safe for discharge?
A. A client with multiple sclerosis who reports ataxia
B. A client with right lower quadrant pain and rebound tenderness
C. A client with deep vein thrombosis (DVT) who requires daily aPTT readings
D. A client with amylase and lipase levels twice the expected values
Answer: A. A client with multiple sclerosis who reports ataxia
Explanation: Multiple sclerosis is a chronic condition, and occasional ataxia is
an expected finding; this client is stable for discharge. The other listed
manifestations indicate potential acute or serious complications (appendicitis,
risk of pulmonary embolism, or pancreatitis) requiring continued
hospitalization.
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2) Scenario: You are working on a busy medical-surgical unit and need to
determine which client to see first based on priority. Review the following
clients’ situations:
Which client is the priority to assess first?
A. A client who has peripheral vascular disease with an absent right foot pulse
B. A client who has type 1 diabetes mellitus needing a first dressing change for
a foot ulcer
C. A client who has methicillin-resistant Staphylococcus aureus (MRSA)
reporting a low-grade fever
D. A client scheduled for a tubal ligation in 2 hours who is crying
Answer: A. A client who has peripheral vascular disease with an absent right
foot pulse
Explanation: Using the ABC (airway, breathing, circulation) framework, an
absent pulse indicates a potential circulatory compromise and is a priority over
the other concerns.
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3) Scenario: A nurse discovers that a new IV pump infused 400 mL over 2 hours
while it was set to infuse at 100 mL/hr. After confirming the settings and
contacting the provider, the nurse must decide on the next immediate step.
What should the nurse do first?
A. Fill out an incident report and submit it to the nurse manager
B. Consult experienced nurses for step-by-step instructions
C. Tag the pump for maintenance and acquire a new pump for the client
D. Call the biomedical engineering department to report the problem
Answer: C. Tag the pump for maintenance and acquire a new pump for the
client
Explanation: The priority is to prevent further risk to clients. Removing the
faulty equipment from service immediately (tagging for repair) and obtaining a
functioning pump takes precedence before documentation and reporting.
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4) Scenario: You are a charge nurse assigning tasks to the assistive personnel
(AP). One of your clients is older and uses a walker for mobility. Another client
, requires teaching about incentive spirometry. A third client has thickened
liquids. A fourth client has a saline lock that needs flushing.
Which of the following is the most appropriate task to delegate to an AP?
A. Flushing a client’s saline lock
B. Ambulating a client who uses a walker
C. Teaching incentive spirometry to a client
D. Evaluating a client’s gag reflex
Answer: B. Ambulating a client who uses a walker
Explanation: Assisting with ambulation is within the scope of an AP. Flushing a
saline lock, teaching, and evaluating a client’s gag reflex are nursing
responsibilities requiring a nurse’s clinical judgment or licensure.
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5) Scenario: A client has just undergone a total hip arthroplasty and is on your
surgical unit. You are preparing to delegate tasks to the assistive personnel (AP)
and plan the client’s care.
Which of the following actions should the nurse take regarding the client’s
plan of care?
70+ QUESTIONS & ANSWERS
WITH WELL EXPLAINED RATIONALES
─────────────────────────────────
1) Scenario: A local community disaster has occurred, and your facility must
rapidly discharge stable clients to free beds for new casualties. As the charge
nurse, you are deciding which client can safely be discharged.
Which of the following clients is safe for discharge?
A. A client with multiple sclerosis who reports ataxia
B. A client with right lower quadrant pain and rebound tenderness
C. A client with deep vein thrombosis (DVT) who requires daily aPTT readings
D. A client with amylase and lipase levels twice the expected values
Answer: A. A client with multiple sclerosis who reports ataxia
Explanation: Multiple sclerosis is a chronic condition, and occasional ataxia is
an expected finding; this client is stable for discharge. The other listed
manifestations indicate potential acute or serious complications (appendicitis,
risk of pulmonary embolism, or pancreatitis) requiring continued
hospitalization.
,─────────────────────────────────
───────────────────────
2) Scenario: You are working on a busy medical-surgical unit and need to
determine which client to see first based on priority. Review the following
clients’ situations:
Which client is the priority to assess first?
A. A client who has peripheral vascular disease with an absent right foot pulse
B. A client who has type 1 diabetes mellitus needing a first dressing change for
a foot ulcer
C. A client who has methicillin-resistant Staphylococcus aureus (MRSA)
reporting a low-grade fever
D. A client scheduled for a tubal ligation in 2 hours who is crying
Answer: A. A client who has peripheral vascular disease with an absent right
foot pulse
Explanation: Using the ABC (airway, breathing, circulation) framework, an
absent pulse indicates a potential circulatory compromise and is a priority over
the other concerns.
,─────────────────────────────────
───────────────────────
3) Scenario: A nurse discovers that a new IV pump infused 400 mL over 2 hours
while it was set to infuse at 100 mL/hr. After confirming the settings and
contacting the provider, the nurse must decide on the next immediate step.
What should the nurse do first?
A. Fill out an incident report and submit it to the nurse manager
B. Consult experienced nurses for step-by-step instructions
C. Tag the pump for maintenance and acquire a new pump for the client
D. Call the biomedical engineering department to report the problem
Answer: C. Tag the pump for maintenance and acquire a new pump for the
client
Explanation: The priority is to prevent further risk to clients. Removing the
faulty equipment from service immediately (tagging for repair) and obtaining a
functioning pump takes precedence before documentation and reporting.
─────────────────────────────────
───────────────────────
4) Scenario: You are a charge nurse assigning tasks to the assistive personnel
(AP). One of your clients is older and uses a walker for mobility. Another client
, requires teaching about incentive spirometry. A third client has thickened
liquids. A fourth client has a saline lock that needs flushing.
Which of the following is the most appropriate task to delegate to an AP?
A. Flushing a client’s saline lock
B. Ambulating a client who uses a walker
C. Teaching incentive spirometry to a client
D. Evaluating a client’s gag reflex
Answer: B. Ambulating a client who uses a walker
Explanation: Assisting with ambulation is within the scope of an AP. Flushing a
saline lock, teaching, and evaluating a client’s gag reflex are nursing
responsibilities requiring a nurse’s clinical judgment or licensure.
─────────────────────────────────
───────────────────────
5) Scenario: A client has just undergone a total hip arthroplasty and is on your
surgical unit. You are preparing to delegate tasks to the assistive personnel (AP)
and plan the client’s care.
Which of the following actions should the nurse take regarding the client’s
plan of care?
