NR446 Exam 2 Actual Exam Style V3 | NR
446 Collaborative Healthcare |
Chamberlain
1. A nurse manager is discussing the concept of ‘just culture’ during a staff meeting. Which
statement by a staff nurse indicates an understanding of this concept?
A. In a just culture, individuals are never held accountable for errors made during patient
care.
B. The focus of just culture is to identify and punish the individual who made a mistake.
C. It encourages reporting of errors and near misses to identify systemic issues without
fear of retaliation.
D. Just culture means that all errors are treated as human errors and no discipline is ever
used.
Correct Answer: C
Expert Explanation: Just culture recognizes that individual professionals should not be
held accountable for system failings over which they have no control. It fosters an
environment where staff feel safe reporting errors or near misses, which allows the
organization to learn and improve. This approach balances a non-punitive environment
with the need for individual accountability in cases of reckless behavior.
,2. A charge nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is
most appropriate for the nurse to delegate?
A. Assisting a stable client with a bed bath and oral hygiene.
B. Performing a skin assessment on a newly admitted client.
C. Feeding a client who was admitted with dysphagia following a stroke.
D. Teaching a client how to use an incentive spirometer.
Correct Answer: A
Expert Explanation: Assisting with hygiene and activities of daily living for stable patients
is within the scope of practice for a UAP. Feeding a client with dysphagia or performing
assessments requires the clinical judgment of a licensed nurse. Teaching is a professional
nursing responsibility that cannot be delegated to unlicensed personnel.
3. An RN is working with a Licensed Practical Nurse (LPN) on a surgical unit. Which client
should the RN assign to the LPN?
A. A client who is 4 hours post-operative and has a heart rate of 120 bpm.
B. A client scheduled for discharge today who needs final instructions on wound care.
C. A client with a chronic stage 3 pressure ulcer requiring a sterile dressing change.
D. A client who was just admitted from the emergency department with unstable vitals.
Correct Answer: C
,Expert Explanation: LPNs are generally assigned to stable clients with predictable
outcomes and can perform tasks like sterile dressing changes. The post-operative client
with tachycardia and the unstable admission require the advanced assessment skills of an
RN. Discharge teaching is a complex task that involves evaluation and must be performed
by the RN.
4. A nurse is prioritizing care for four clients. Which client should the nurse see first?
A. A client with diabetes mellitus who has a fasting blood glucose of 150 mg/dL.
B. A client with asthma who is complaining of shortness of breath and has a silent chest.
C. A client who is 2 days post-appendectomy and requesting pain medication.
D. A client with chronic heart failure who has 2+ pitting edema in the lower extremities.
Correct Answer: B
Expert Explanation: A silent chest in a client with asthma is a medical emergency
indicating a lack of air movement and potential respiratory failure. This client takes
priority over others based on the ABC (Airway, Breathing, Circulation) framework. The
other clients are relatively stable or have symptoms consistent with chronic or recovering
conditions.
5. Which of the following leadership styles is characterized by a leader who makes all
decisions without seeking input from the team?
A. Democratic
B. Laissez-faire
, C. Transformational
D. Autocratic
Correct Answer: D
Expert Explanation: Autocratic leadership involves centralized decision-making where
the leader maintains full control and gives orders to the staff. This style can be effective in
emergency situations where quick decisions are necessary but can decrease staff morale
over time. It is the opposite of democratic leadership, which encourages group
participation and consensus.
6. A nurse is caring for a client who refuses a life-saving blood transfusion due to religious
beliefs. The nurse supports the client’s decision. Which ethical principle is the nurse
demonstrating?
A. Autonomy
B. Nonmaleficence
C. Justice
D. Beneficence
Correct Answer: A
Expert Explanation: Autonomy is the right of the client to make their own healthcare
decisions, even if those decisions conflict with the healthcare provider’s recommendations.
The nurse demonstrates respect for autonomy by supporting the client’s informed choice
446 Collaborative Healthcare |
Chamberlain
1. A nurse manager is discussing the concept of ‘just culture’ during a staff meeting. Which
statement by a staff nurse indicates an understanding of this concept?
A. In a just culture, individuals are never held accountable for errors made during patient
care.
B. The focus of just culture is to identify and punish the individual who made a mistake.
C. It encourages reporting of errors and near misses to identify systemic issues without
fear of retaliation.
D. Just culture means that all errors are treated as human errors and no discipline is ever
used.
Correct Answer: C
Expert Explanation: Just culture recognizes that individual professionals should not be
held accountable for system failings over which they have no control. It fosters an
environment where staff feel safe reporting errors or near misses, which allows the
organization to learn and improve. This approach balances a non-punitive environment
with the need for individual accountability in cases of reckless behavior.
,2. A charge nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is
most appropriate for the nurse to delegate?
A. Assisting a stable client with a bed bath and oral hygiene.
B. Performing a skin assessment on a newly admitted client.
C. Feeding a client who was admitted with dysphagia following a stroke.
D. Teaching a client how to use an incentive spirometer.
Correct Answer: A
Expert Explanation: Assisting with hygiene and activities of daily living for stable patients
is within the scope of practice for a UAP. Feeding a client with dysphagia or performing
assessments requires the clinical judgment of a licensed nurse. Teaching is a professional
nursing responsibility that cannot be delegated to unlicensed personnel.
3. An RN is working with a Licensed Practical Nurse (LPN) on a surgical unit. Which client
should the RN assign to the LPN?
A. A client who is 4 hours post-operative and has a heart rate of 120 bpm.
B. A client scheduled for discharge today who needs final instructions on wound care.
C. A client with a chronic stage 3 pressure ulcer requiring a sterile dressing change.
D. A client who was just admitted from the emergency department with unstable vitals.
Correct Answer: C
,Expert Explanation: LPNs are generally assigned to stable clients with predictable
outcomes and can perform tasks like sterile dressing changes. The post-operative client
with tachycardia and the unstable admission require the advanced assessment skills of an
RN. Discharge teaching is a complex task that involves evaluation and must be performed
by the RN.
4. A nurse is prioritizing care for four clients. Which client should the nurse see first?
A. A client with diabetes mellitus who has a fasting blood glucose of 150 mg/dL.
B. A client with asthma who is complaining of shortness of breath and has a silent chest.
C. A client who is 2 days post-appendectomy and requesting pain medication.
D. A client with chronic heart failure who has 2+ pitting edema in the lower extremities.
Correct Answer: B
Expert Explanation: A silent chest in a client with asthma is a medical emergency
indicating a lack of air movement and potential respiratory failure. This client takes
priority over others based on the ABC (Airway, Breathing, Circulation) framework. The
other clients are relatively stable or have symptoms consistent with chronic or recovering
conditions.
5. Which of the following leadership styles is characterized by a leader who makes all
decisions without seeking input from the team?
A. Democratic
B. Laissez-faire
, C. Transformational
D. Autocratic
Correct Answer: D
Expert Explanation: Autocratic leadership involves centralized decision-making where
the leader maintains full control and gives orders to the staff. This style can be effective in
emergency situations where quick decisions are necessary but can decrease staff morale
over time. It is the opposite of democratic leadership, which encourages group
participation and consensus.
6. A nurse is caring for a client who refuses a life-saving blood transfusion due to religious
beliefs. The nurse supports the client’s decision. Which ethical principle is the nurse
demonstrating?
A. Autonomy
B. Nonmaleficence
C. Justice
D. Beneficence
Correct Answer: A
Expert Explanation: Autonomy is the right of the client to make their own healthcare
decisions, even if those decisions conflict with the healthcare provider’s recommendations.
The nurse demonstrates respect for autonomy by supporting the client’s informed choice
