Chamberlain College of Nursing: NR 446 Leadership Proctored Questions and Answers,100% CORRECT

Chamberlain College of Nursing: NR 446 Leadership Proctored Questions and Answers 1. NR 446A nurse is providing an in-service about client right for a group of nurses. Which of the following statements should the nurse include in the service? a. A nurse can disclose information to a family member with the client’s permission b. A nurse can apply restraints on a PRN basis c. A nurse can administer medications without consent to a client as a part of a research study d. A nurse is responsible for informing clients about treatment options 2. A nurse manager observes an assistive personnel (AP) incorrectly transferring a client to the bedside commode. Which of the following should the nurse take first? a. Refer the AP to the facility procedure manual b. Demonstrate the proper client transfer technique for the AP? c. Instruct the AP to request assistance when unsure about a task d. Help the AP assist the client with the transfer 3. A nurse enters a client room to witness an informed consent for a gastroscopy. The client states he does not understand the procedure. Which of the following actions should the nurse take? a. Educate the client about the risks of refusing medications b. Complete an incident report c. Answer the client question concerning the procedure d. Inform the provider that the client requires clarification about the procedure 4. A nurse is developing a discharge plan for a client who is postoperative and will require a wheelchair in the home. The nurse should place a referral to which of the following resources to assist the client with this need? a. Physical therapy b. Social services c. Occupational therapy d. Home health 5. A nurse is preparing a teaching session with a client who speaks a different language than the nurse. Which of the following interventions should the nurse plan to make? a. Provider an interpreter when obtaining consent from the client b. Validate understanding by interpreting the client’s body language c. Include the client’s partner to assist with the teaching session d. Incorporate gestures and hand signals when presenting information 6. A nurse on a surgical unit is preparing to transfer a client to a rehabilitation facility. Which of the following information should the nurse include in the change of shift report? a. The steps to follow when providing wound care b. The clients preferred time for bathing c. The belief that client has a difficult relationship with his son d. The time the client received his last dose of pain medication 7. A nurse is preparing to discharge a client who as end stage heart failure. The client’s partner tells the nurse she can no longer handle caring for the client. Which of the following action should the nurse take? a. Request another family member assist the client’s partner with care b. Recommend the partner place the client in long term-care facility c. Contact the case manager to discuss discharge options d. Ask the provider to delay the clients discharge home for a few more days 8. A nurse working in an emergency department is performing triage. To which of the following clients should the nurse assign priority? a. A client who reports night sweats and fever for the last week b. A client who has compound fractures of the tibia and humerus c. A client who reports severe vomiting and diarrhea d. A client who has soot markings around each naris following a house fire 9. To resolve a conflict between staff members regarding potential changes in policy, a nurse manager decides to implement the changes regardless of the feelings of those who oppose those changes. Which of the following conflict resolution strategies is the nurse manager using? a. Competing b. Collaborating. c. Compromising. d. Cooperating. 10. A nurse is assessing an older adult client who was brought to the emergency department by his son, who reports that that client fell at home. The nurse suspects elder abuse. Which of the following actions should the nurse take? a. File an incident report. b. Ask the client about his injuries with the son present. c. Ask the clients son to go to the waiting area . d. Treat and discharge the client 11. A nurse in the emergency department is assessing a client who is unconscious following a motor-vehicle crash. the client requires immediate surgery. Which of the following actions should the nurse take? a. a. Transport the client to the operating room without verifying informed consent b. b. ask the anesthesiologist to sign the consent c. c. obtain telephone consent from the facility administrator before the surgery d. d. delay the surgery until the nurse can obtain informed consent 12. A nurse in a prenatal clinic is caring for a group of clients. Which of the following clients should the nurse recommend for conference? a. A. A client who is at 28 weeks gestation and has a negative Coombs’ titer b. B. A client who is 39 weeks of gestation and has a negative contraction stress test c. C. A client who is at 35 weeks of gestation and has a biophysical profile of 6 d. D. A client who is at 37 weeks of gestation and has an L/S ratio of 2:1 13. A nurse is receiving a verbal prescription from the provider for a client who is having increased pain. The nurse should transcribe which of the following prescriptions in the clients medical record? a. A. Morphine sulfate 10 mg IV q 4 IV prn for pain b. B. MS 10 mg IV every 4 ‘ prn for pain c. C. MSO4 10 mg IVP q 4 ‘ prn for pain d. D. Morphine sulfate 10.0 mg every 4 hours IV prn for pain 14. A nurse is assessing a client who has meningitis. Which of the following findings should the nurse report to the provider immediately? a. A. Generalized rash over trunk b. B. Increased temperature c. C. Decreased level of consciousness d. D. Report of photophobia 15. A nurse in the emergency department is performing triage for a group of clients who were in a train crash. Which of the following clients should the nurse tag as emergent? a. A. A client who has an open fracture of the femur b. B. A client who has periorbital ecchymosis c. C. A client who has asymmetrical thorax d. D. A client who has a deep-partial thickness burn on the lower extremities 16. A nurse manager is leading a discussion about ethical dilemmas. Which of the following situations should the nurse manager include as an example of ethical dilemma? a. A. A visitor experiences a minor burn after spilling coffee b. B. A client receives an operation on the wrong side of her body c. C. A parent wants her 14-year-old adolescent to receive radiation treatment against his will d. D. A nurse witnesses another nurse administer an incorrect medication 17. A nurse is supervising an assistive personnel (AP) who is feeding a client who has dysphagia. Which of the following actions by the AP should the nurse identify as correct technique? a. A. Elevating the head of the clients bed to 30 degrees during mealtime b. B. Withholding fluids until the end of the meal c. C. Providing a 10 min rest period prior to meals d. D. Instructing the client to place her chin toward her chest when swallowing 18. A nurse is caring for a client who has a prescription for a transcutaneous electrical nerve stimulation (TENS). Which of the following members of the interdisciplinary team should the nurse contact for assistance. a. a. Physical Therapist b. b. Pharmacist c. c. Respiratory therapist d. D. Occupational Therapist 19. A nurse is caring for a client who reports acute pain but refuses IM medication. The nurse distracts the client and quickly administers the injection. This illustrates which of the following? a. A. Assault b. B. False imprisonment c. C. Battery d. D. Libel 20. A nurse is orientating a newly licensed nurse about client confidentiality. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? a. A. “I can use another nurse’s password as long as I log off after using the computer” b. B. “I should encrypt personal health information when sending emails” c. C. “I can post the client’s vital signs in the client’s room” d. D. “I should discard personal health information documents in the trash before leaving the unit” 21. A case manager is preparing discharge plan for a client following coronary artery bypass grafting surgery. Which of the following client issues should the nurse address first? a. A. Inadequate food supply b. B. Low pain tolerance c. C. Limited social support d. D. Decreased self-esteem 22. A charge nurse is making staff assignments on a medical-surgical unit. Which of the following tasks should the nurse plan to delegate to an assistive personnel? a. A. Measuring oxygen saturation for a client who has dyspnea b. B. Inserting a rectal suppository for a client who is vomiting c. C. Performing nasal hygiene for a client who has an NG tube d. D. Pouching a client’s ostomy bag for a new colostomy 23. A charge nurse making rounds observes that an assistive personnel (AP) has applied wrist restraints to a client who is agitated and does not have a prescription for restraints. Which of the following actions should the nurse take first? a. A. Remove the restraints from the client’s wrists b. B. Review the chart for nonrestraint alternatives for agitation c. C. Speak with the AP about the incident d. D. Inform the unit manager of the incident 24. A nurse is delegating care for a group of clients. Which of the following clients should the nurse assign to a licensed practical nurse? a. A. A client who had a myocardial infarction and will be transferring to the unit from the CCU b. B. A newly admitted client who has diabetes mellitus and requires initial teaching on self-administration c. C. A newly admitted client who has sickle cell anemia and requires the development of an initial plan of care d. D. A client who is scheduled for an endoscopy later today and requires an enema 25. A nurse is assisting with the orientation of a newly licensed nurse. The newly licensed nurse is having trouble focusing and has difficulty (completing?) care for his assigned clients. Which of the following interventions is appropriate? a. A. Offer to provide care for his clients while he takes a break b. B. Advise him to complete less time-consuming tasks first c. C. Ask other staff members to take over some of his tasks d. D. Recommend that he take time to plan at the beginning of his shift 26. A nurse is caring for a client who wanders through the halls yelling obscenities at staff, other clients, and visitors. Which of the following actions should the nurse take. a. A. Keep the client in her room with the door closed b. B. Contact a family member to come and sit with the client c. C. Place the client in a wheelchair with a lap tray d. D. Administer a sedative to the client 27. A nurse on a medical-surgical unit is caring for a client who asks about advance directives and states that he wants to appoint a health care proxy. Which of the following responses should the nurse make? a. A. “it is necessary for an attorney to approve your health care proxy” b. B. “You must choose a member of your family to serve as your health care proxy” c. C. “A health care proxy can make decisions for you when you are unable to do so” d. D. “You should appoint a health care proxy before undergoing an invasive procedure” 28. A nurse in the emergency department is preparing to care for a client who arrived via ambulance. The client is disoriented and has a cardiac arrhythmia. Which of the following actions should the nurse take? a. A. Proceed with treatment without obtaining writing consent b. B. Contact the client’s next of kin to obtain consent for treatment c. C. Have the client sign a consent for treatment d. D. Notify risk management before initiating treatment 29. A nurse is caring for a client who requests information about the prevalence of Tay-Sachs disease. Which of the following resources should the nurse use to obtain this information? a. A. The clients health care provider b. B. A Collaborative, user-edited website c. C. The facility’s case manager d. D. An evidence-based nursing journal 30. A nurse on a medical-surgical unit is evaluating an assistive personnel (AP) use of infection control precautions. Which of the following actions by the AP indicates the correct use of the precautions? a. A. Thee AP removes her gloves before leaving the room of a client who has methicillin- resistant Staphylococcus aureus (MRSA) b. B. The AP wears a surgical mask when caring for a client who has respiratory tuberculosis c. C. The AP bundles the clean side of the linen inward when changing the sheets for a client who has an infected surgical wound d. D. The AP uses alcohol-based hand sanitizer after emptying the bed pan of a client who has Clostridium difficile 31. a charge nurse on an obstetrical unit is preparing the shift assignment. Which of the following clients should be assigned to an RN who has floated from a medical-surgical unit? a. A client who is at 32 weeks of gestation and has premature rupture of membranes b. A multigravida client who has preeclampsia and is receiving misoprostol for induction of labor c. A primigravida client who is 1 day postoperative following a Cesarean section and has a PCA pump d. A client who has gestational diabetes and is receiving biweekly nonstress tests 32. A charge nurse notices that two staff nurses are not taking meal breaks during their shifts. Which of the following actions should the nurse take first? a. Discuss time management strategies with the nurses b. Provide coverage for the nurse’s breaks c. Determine the reasons the nurses are not taking scheduled breaks d. Review policies for taking scheduled breaks 33. A nurse in the emergency department admits a client who has been exposed to cutaneuous anthrax. Which of the following actions should the nurse take? a. Plan to administer an antiviral medication to the client b. Prepare to administer antibiotics to the client c. Place a surgical mask on the client during transfer to the unit d. Wear an N95 respirator mask while caring for the client 34. A nurse is providing change of shift report for an oncoming nurse. Which of the following information should the nurse include in the report? a. The clients partner came to visit him 2 hours ago b. The client is the president of a local bank c. The client has routine vital signs prescribed d. The client is in the radiology department for a chest x ray 35. A nurse on a medical-surgical unit is caring for four clients. The nurse should recognize that which of the following clients is the highest priority? a. A client who has methicillin-resistant staphylococcus aureus (MRSA) and has an axillary temperature of 38C (101 F) b. A client who has peripheral vascular disease and has an absent pedal pulse in the right foot c. A client who is newly diagnosed with pancreatic cancer and is scheduled to begin IV chemotherapy d. A client who is postoperative following a laminectomy 12 hours ago and is unable to void. 36. A nurse is preparing to discharge a client who requires home oxygen. The equipment company has not yet delivered the oxygen tank. Which of the following actions should the nurse take? a. Send an oxygen tank from the facility home with the client b. Instruct the client’s family to contact the insurance provider about the oxygen equipment c. Contact social services about the delivery of the oxygen equipment d. Notify the provider about the delayed oxygen tank delivery 37. A nurse is assessing a client who is postoperative following a left leg below-the-knee amputation. Which of the following client statements indicates the potential need for a referral to an occupational therapist? a. I hope I can adjust to using crutches while I am recovering b. I am worried about taking care of my toddler at home c. I just don’t think I can handle looking at my leg d. I am not sure how I will pay for all the therapy I will need 38. A nurse is preparing an educational program for staff members regarding a new intravenous pump. Identify the sequence of actions the nurse should take when developing the program. (Move the steps into the box on the right, placing them in the selected order of the performance) a. Develop learning objectives for the program b. Identify what skills to teach the staff members c. Conduct program evaluation with staff members d. Schedule several sessions of the program 39. A nurse is caring for a client who has a tumor. The provider recommends surgery. The client refuses, but the client’s partner wants the surgery performed. Which of the following is the deciding factor in determining if the surgery will be done? a. Whether the partner is the client’s durable power of attorney for health care b. Whether the client understand the risk of refusing the procedure c. Whether the clients refusal is based on religious belief d. Whether the faculty ethnic committee reaches a consensus on the case 40. 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 mothers treatment? c. I cannot provide this information to you without your mother’s consent d. You will have to speak directly to your mother about her treatment 41. A nurse is caring for a client who has anorexia nervosa. Which of the following interdisciplinary team members should be consulted in regards to client care? (select all that apply) e. A. Occupational therapist f. B. case manager g. c. nutritional therapist h. d. physical therapist i. e. mental health counselor 42. A nurse is participating in the development of a disaster management plan for a hospital. The nurse should recognize that which of the following resources is the highest priority to have available in response to a bioterrorism event? a. A. A mental health specialist on the response team b. b. a sufficient supply of ppe c. c. a system for tracking client information d. d. a network for communication between staff members and families 43. A nurse manager is receiving report and is faced with the following situations that require intervention. Which of the following should the nurse manager address first? a. A. no transport assistance is available to take the client to PT b. B. A client is refusing care from an AP of the opposite gender. c. C. Three staff members have called to say they will be absent d. D. two nurses had a heated disagreement about a scheduling issue 44. A nurse is teaching a newly licensed nurse about implementing droplet precautions for a client who has influenza. Which of the following statements by the newly licensed nurse indicated an understanding of the teaching? a. A. “I will check that the room has a high-efficiency participate air filtration system.” b. b. “I will wear an N95 respirator when providing care for the client.” c. c. “I will wear a surgical mask within 3 feet of the client.” d. d. “I will assign the client to a room with a positive airflow.” 45. A nurse enters the hallway and discovers a visitor looking at a client’s medical information on a computer. Which of the following actions should the nurse take first? a. A. Tell the care nurse that a visitor viewed a client’s protected health information. b. B. Close the documentation program on the computer. c. C. Inform the visitor the client records are confidential. d. D. Find out which staff member left the documentation program on the screen. 46. A nurse working on a med-surg unit is managing the care of four clients. The nurse should schedule an interdisciplinary conference for which of the following clients? a. a. a client who is at risk for pressure ulcers and has a albumin level of 4.2g/dl b. b. a client has type 1 DM and uses an insulin pump c. c. a client who is receiving heparin and has an aPTT of 34 seconds d. d. a client who has orthostatic hypotension and is receiving IV fluids. 47. A nurse manager is reviewing isolation guidelines with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicated understanding of isolation guidelines? a. A. “I will have a client who is on airborne precautions wear a mask when out of her room.” b. B. “I will wear an N95 respirator mask for a client who is on droplet precautions.” c. C. “I will place a client who has compromised immunity in a negative-pressure airflow room.” d. d. “I will instruct visitors to wear a mask when visiting a client who is on contact precautions.” 48. A charge nurse witnesses an AP failing to follow the facility protocol when discarding contaminated linens. Which of the following actions should the nurse take first? a. A. discuss the issue with the AP b. B. reinforce facility protocols at the next staff meeting c. c. notify the unit manager about the incident d. d. alert the infection control department. 49. A nurse on a med-surg unit is caring for a group of clients with the assistance of an LPN and an AP. Which of the following tasks should the nurse assign to the LPN? a. A. Reinforce dietary teaching with a client who has heart disease. b. B. Obtaining a urine specimen from an older adult client c. c. providing postmortem care for a client who has just died. d. d. accompanying a client who just had a wound debridement to PT. 50. A nurse in a long-term care facility is caring for a client who reports the AP repositioned him in bed using excessive force. Which of the following actions should the nurse take? a. A. Document in the client’s chart that an incident report has been filed. b. B. Contact the nurse manager. c. C. Reassure the client that the staff is well trained. d. D. Call risk management to interview the client. 51. 51. A nurse working in the emergency department is assessing several clients. Which of the following clients is the highest priority? a. a. A client who reports right-sided flank pain and is diaphoretic b. b. A client who has active bleeding from a puncture would of the left groin area c. c. A client who has a raised red skin rash on his arms, neck, and face d. d. A client who reports shortness of breath and left neck and shoulder pain 52. A nurse is caring for a client who has been admitted and diagnosed with type 1 diabetes mellitus. The client tells the nurse she has decided to go home. Which of the following actions should the nurse take? a. a. inform the client that she cannot leave without a discharge prescription from the provider b. b. Ask the client if she would like a sedative to help her relax c. c. assign a security officer to the client’s room until the provider can speak to the client d. d. have the client sign the Against Medical Advice form 53. A nurse in a clinic is reviewing laboratory reports for a group of clients. Which of the following diseases should the nurse report to the state health department? a. a. pertussis b. b. Group B streptococcal disease c. c. Respiratory syncytial virus d. d. rotavirus 54. A nurse is preparing to delegate bathing and turning of a newly admitted client who has end- stage cancer to an experienced assistive personnel (AP). Which of the following assessments should the nurse make before delegating care? a. a. is the client’s family present so the AP can show them how to turn the client? b. b. Has data been collected about specific client needs related to turning? c. c. Does the AP have time to change the client’s central IV line dressing after turning her? d. d. Has the AP checked the client’s pain level prior to turning her? 55. 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. a. withhold the benzodiazepine but continue the opioid b. b. contact the provider about replacing the opioid with an NSAID c. c. administer the benzodiazepine but withhold the opioid d. d. Continue the medication dosages that relieve the client’s pain 56. A nurse is teaching newly licensed nurses about client confidentiality. The nurse should include that which of the following examples represents a violation of client confidentiality? a. a. informing housekeeping staff that the client is in the dialysis unit b. b. reporting a client’s disposition to the referring provider c. c. calling the pharmacy with a prescription for the client’s partner to pick up d. d. providing a copy of the client’s medical record to the transporting paramedic 57. A nurse is caring for a client who has a new diagnosis of chlamydia. Which of the following actions should the nurse take? a. a. report the infection to the local health department b. b. apply an antiviral cream to lesions c. c. instruct the client to use condoms until the treatment is completed d. d. initiate contact precautions 58. A nurse is caring for four clients. Which of the following clients should the nurse assess first? a. a. a client who is newly admitted with diabetes mellitus and whose fasting blood glucose level is 200 mg/dL b. b. a client who is 3 days postoperative following abdominal surgery and is ready for discharge c. c. a client who has Alzheimer’s disease and bacterial pneumonia with newly onset restlessness d. d. a client who is 24 hours postoperative following surgical reduction of a hip fracture and reports a pain level of 7 on a scale from 0 to 10 59. A nurse in an ambulatory care setting is orienting a newly licensed nurse who is preparing to return a call to a client. The nurse should explain that which of the following is an objective of telehealth? a. a. assessing client needs b. b. providing medication reconciliation c. c. establishing communication between providers d. d. developing client treatment protocols 60. A nurse is caring for a client who is unconscious and whose partner is their health care surrogate. The partner wishes to discontinue client’s feeding tube, but another family member tells the nurse that they want the client to continue receiving treatment. Which of the following responses should the nurse make? a. a. “You should contact the provider about your wishes for your family member.” b. b. “We’ll need to have the nursing supervisor review the client’s advance directives.” c. c. “You should speak with the facility’s ethics committee about your concerns.” d. d. “As the health care surrogate, the client’s partner can make this decision.” 61.) Nurses on an inpatient care unit are working to help reduce unit costs. Which of the following actions is appropriate to include in the cost-containment plan? a) Store opened bottles of normal saline in a refrigerator for up to 48 hr. b) Return unused supplies from the bedside to the unit’s supply stock c) What to dispose of sharps containers until they are completely full d) Use clean gloves rather than sterile gloves for colostomy care 62.) A nurse is working on a quality improvement team that is assessing an increase in client falls at the facility. After problem identification, which of the following actions should the nurse plan to take first as part of the quality improvement process? a) Implement a fall prevention plan b) Notify staff of the increased fall rate c) Review document literature regarding client falls d) Identify clients who are at risks for falls 63.) A nurse is providing discharge teaching to the parent of a toddler who has a new diagnosis of asthma. The parent states she is unable to afford the nebulizer prescribed for the child. Which of the following referrals should the nurse recommend? a) Social worker b) Pharmacist c) Respiratory therapist d) Child protective services 64.) A nurse is preparing a client for an elective mastectomy. The client is wearing a plain gold wedding band. Which of the following is an appropriate procedure for taking care of this client’s ring? a) Agree to keep the ring for the client untul after surgery b) Place the ring in the bag with the clients clothing c) Tape the ring securely to the client’s finger d) Place the clients ring in the facility safe. 65.) A nurse is preparing to complete an incident report regarding a medication error. Which of the following actions should the nurse plan to take? (Select all that apply) a) Make a copy of the incident report for personal keeping b) Identify the medication name and dosage administered to the client in the report c) Obtain an order from the client’s provider to complete the report d) Include the time the medication error occurred in the report e) Place a copy of the completed report in the client’s medical record 66.) A nurse had just completed assessment charting on the electronic record for an assigned client. An assistive personnel (AP) who just measured the client’s vital signs asks to chart them while the nurse is still logged into the record. Which of the following actions should the nurse take? a) Offer to chart the vital signs for the AP b) Recommend the AP come back later when the record is available c) Allow the AP to document the vital signs prior to logging out d) Log out so the AP can log in to document the vital signs 67.) A nurse is preparing a client for surgery. The client has signed the consent form but tells the nurse that she has reconsidered because she is worried about the pain. Which of the following responses by the nurse is appropriate? a) If you have the procedure now, you wont have to deal with pain and disability later. b) You’ll be fine. You’ll receive a prescription for pain medication. c) Why didn’t you discuss your concerns with your provider? d) I understand and it’s not too late to change your mind. 68.) A nurse is conducting a disaster preparedness drill with a group of nurses who are orienting to the facility. Which of the following triage colors should the nurse instruct the group to apply to a client who has full-thickness burns on 72% of his body? a) Black b) Red c) Green d) Yellow 69.) A nurse is comparing the rate of medication errors on the medical unit to the rate from a medical unit in a magnet hospital. Which of the following quality improvement methods is the nurse using? a) Structure audit b) Benchmarking c) Risk benefit analysis d) Root cause analysis 70.) A nurse at a long term care facility is planning a fall prevention program for the residents. Which of the following interventions should the nurse include? a) Apply vest restraints on residents who are confused b) Keep the four side rails up on beds at night c) Accompany residents older than 85 years of age during ambulation d) Institute rounds every 2 hr during the day to offer toileting.