LEADERSHIP PROCTORED NEWEST VERSION ACTUAL QUESTIONS & CORRECT, DETAILED AND VERIFIED ANSWERS

LEADERSHIP PROCTORED NEWEST VERSION ACTUAL QUESTIONS & CORRECT DETAILED VERIFIED ANSWERS Professional Responsibilities: Adhering to Ethical Principles - ANSWER Justice (fair treatment), beneficence (doing good), nonmaleficence (doing no harm), fidelity (faithfulness), autonomy (independence), veracity (truthfulness). Professional Responsibilities: Obtaining Informed Consent in an Emergency - ANSWER Informed consent is not needed if the pt is unconscious and surgery is immediately required to save their life. Information Technology: Receiving a Telephone prescription - ANSWER First, write down the prescription. Next, repeat the prescription back to the provider. Document phone conversation in client chart. Professional Responsibilities: Identifying a Tort - ANSWER A wrongful act or an infringement of a right A nurse manager is about to write a 2 month performance appraisal for a newly graduated nurse. Which of the following factors should the nurse manager take into consideration when planning a performance appraisal interview for this nurse? A. The written appraisal & interview should sound friendly & be informal B. No one except the nurse manager should have input regarding the nurses's appraisal C. A nursing administrator who does not know the nurse should conduct the interview to promote fairness D. The nurse should have a copy of performance standards before the appraisal interview - ANSWER D A nurse working at a rehab facility attends an interdisciplinary team meeting for a client who has had a left hemispheric stroke. Which of the following members of the interdisciplinary team should the nurse expect to contribute to the plan of care? Select all that apply. A. Nurse B. Occupational therapist C. Speech therapist D. Physical therapist E. Respiratory therapist - ANSWER A, B, C, D A nurse is writing a goal for a client's reaction following the admin of a med. Which of the following phases of the nursing process should the nurse modify? A. Planning B. Evaluation C. Analyzing D. Assessment - ANSWER A The actual writing of an expected outcome is done in the planning phase of the nursing care plan. A charge nurse on a med surg unit is assigning client care to an RN and an LPN. Which of the following tasks should the nurse assign to the RN? Select all that apply. A. Performing colostomy care B. Administering blood to a client C. Developing a plan of care for a client D. Calculating a TPN flow rate E. Checking nasogastric tube patency - ANSWER B, C, D A nurse manager is providing info about the audit process to members of the nursing team. Which of the following statements should the nurse manager include? Select all that apply. A. A structure audit evaluates the setting & resources available to provide care B. An outcome audit evaluates the results of the nursing care provided C. A root cause analysis is indicated when a sentinel event occurs D. Retrospective audits are conducted while the client is receiving care E. After data collection is completed, it is compared to a benchmark - ANSWER A, B, C, E A nurse is participating in a quality improvement study of a procedure frequently performed on the unit. Which of the following will provide the most relevant info regarding the efficacy of the procedure? A. Frequency w/which the procedure is performed B. Client satisfaction w/performance of procedure C. Incidence of complications r/t procedure D. Accurate documentation of how the procedure was performed - ANSWER C A nurse manager has received a performance appraisal from the unit manager. Which of the following actions by the unit manager requires intervention? A. The evaluation was conducted in the unit manager's office B. Data that was collected for the previous 12 months was presented C. Verbal concerns provided by a staff member were incorporated into the data D. The nurse was asked to review the performance appraisal & complete a self-evaluation - ANSWER C A nurse is preparing to transfer an older adult client who is 72 hr postop from a surgical procedure to a long term care facility. Which of the following should the nurse include in the transfer report? Select all that apply. A. Type of anesthesia used B. The client's advance directives status C. The client's vital signs on day of admission D. The client's medical diagnosis E. Need for special equipment - ANSWER B, D, E A nurse is participating in an interprofessional conference for a client who has a recent C6 spinal cord injury. The client worked as a construction worker prior to his injury. Which of the following members of the interprofessional team should also participate in planning care for this client? Select all that apply. A. Physical therapist B. Speech therapist C. Occupational therapist D. Psychologist E. Vocational counselor - ANSWER A, C, D, E A nurse manager is working with a committee of nurses whose task is to update the policies for new employee orientation. The nurse manager directs the team to collect as much data as possible & recommend several options. Which of the following decision-making styles is being demonstrated by the nurse manager? A. Decisive B. Flexible C. Hierarchical D. Integrative - ANSWER D. A nurse who has just assumed the role of unit manager is examining her skills in interprofressional collaboration. Which of the following actions support interprofessional collaboration? Select all that apply. A. Use aggressive communication when addressing the team B. Recognize the knowledge & skills of each member of the team C. Ensure that a nurse is assigned to serve as the group facilitator for all interdisciplinary meetings D. Encourage the client & family to participate in the team meeting E. Support team member requests for referral - ANSWER B, D, E A nurse is caring for a client who is being prepared for surgery. The client hands the nurse info about advance directives & states, "Here, I don't need this. I am too young to worry about life-sustaining measures & what I want done for me." Which of the following actions should the nurse take? A. Return the papers to the admitting dept w/a note stating that the client doesn't wish to address the issue at this time. B. Explain to the client that you never know what can happen during surgery & that he should fill the paper's out "just in case." C. Contact a client representative to talk w/the client & offer additional info about the purpose of advance directives D. Inform the client that the surgery cannot be conducted unless he completes his advance directives forms - ANSWER C A nurse is serving as a preceptor to a newly licensed nurse & is explaining the role of the nurse as advocate. Which of the following situations illustrates the advocacy role? Select all that apply. A. Verifying that a client understands what is done during a cardiac catheterization B. Discussing treatment options for a terminal diagnosis C. Informing members of the health care team that a client has DNR status D. Reporting that a health team member on the previous shift did not provide care as prescribed E. Assisting a client to make a decision about his care based on the nurse's recommendations - ANSWER A, C, D A nurse manager is providing info to the nurses on the unit about ensuring client rights. Which of the following outlines the rights of individuals in health care settings? A. American Nurses Association Code of Ethics B. HIPAA C. Patient Self-Determination Act D. Patient Care Partnership - ANSWER D A nurse is reviewing a client's health care record & discovers that the client's DNR order has expired. The client's condition is not stable. Which of the following actions should the nurse take? A. Assume that the client does not want be resuscitated, & take no action if she experiences cardiac arrest B. Write a note on the front of the provider order sheet asking that the DNR order be reordered C. Anticipate that CPR will be instituted if the client goes into cardiopulmonary arrest D. Call the provider to determine whether the order should be immediately reinstated - ANSWER D A home health nurse is assessing the safety of a client's home. Which of the following factors may increase the client's risk for falls? Select all that apply. A. History of a previous fall B. Reduced vision C. Impaired memory D. Takes rosuvastatin (Crestor) E. Wears house slippers F. Kyphosis - ANSWER A, B, C, E, F A client is brought back to the unit after a total hip arthroplasty. The client is confused, is moving his leg into positions that could dislocate the new hip joint, & repeatedly attempts to get out of bed. Which of the following actions should the nurse take? Select all that apply. A. Apply arm & leg restraints immediately B. Get an order from the provider C. Have a family member sign the consent for restraints D. Use a square knot to secure the restraints to the bed frame E. Ensure that only one finger can be inserted between the restraint and the client - ANSWER A, B, C A nurse is observing a newly licensed nurse & an AP pull a client up in bed using a drawsheet. Which of the following actions by the newly licensed nurse indicates a need for further education? A. The nurse spreads his legs apart B. The nurse uses his body weight to counter the client's weight C. The nurse's feet are facing inward, toward the center of the bed D. The nurse uses the muscles in his arms to lift the client off the bed using the drawsheet - ANSWER C An AP reports that a client's finger-stick blood glucose reading 30 min before lunch is 58 mg/dL. The client's morning finger-stick blood glucose was 285 mg/dL. The client is asymptomatic for hypoglycemia, & his next dose of insulin is scheduled to be administered at this time. Which of the following actions should the nurse take first? A. Recalibrate the glucometer, & recheck the client's blood glucose B. Have the lab draw a stat serum glucose C. Inform the AP to give the client 120 mL of orange juice D. Administer insulin as prescribed - ANSWER A A nurse discovers that a client was administered an antihypertensive med in error. Number the following actions in the appropriate sequence that the nurse should follow. ___A. Call the client's provider ___B. Monitor the client's vitals ___C. Notify the risk manager ___D. Complete an incident report ___E. Instruct the client to remain in bed until further notice - ANSWER 1. B 2. E 3. A 4. D 5. C A nurse manager is explaining the use of incident reports to a group of nurses in an orientation program. Which of the following statements should the nurse manager include? Select all that apply. A. A description of the incident should be documented in the client's health care record B. Incident reports should not be shared w/the client C. Incident reports include a description of the incident & actions taken D. A copy of the incident report should be placed in the client's health care record E. The risk management dept. investigates the incident - ANSWER A, B, C, E Managing Client Care: Appropriate Assignment During Orientation - ANSWER New RNs should be assigned a patient that they are competent caring for, and only after their skills have been observed and approved by an experienced RN. Airway Management: Discharge planning for a Client Who Has a Tracheostomy - ANSWER Always have two extra trach tubes (one your size and one size smaller). Keep an obturator for each trach tube and trach ties. Keep sterile saline and lubricant with you at all times. Professional Responsibilities: Responding to a Visitor's Question About Status of a Client - ANSWER Information cannot be shared with unauthorized individuals, including family members, unless they provide the code. Professional Responsibilities: Teaching About Confidentiality - ANSWER Client medical records must be kept in secure area. No information can be written on public display boards. EMR should be password protected, and nurses must only use their own log-in information. No part of the medical record can be copied, except for authorized exchange of documents between health care institutions. Preoperative Nursing Care: Securing Client Belongings - ANSWER Give all pt belongings to family member to safely stored. Managing Client Care: Prioritizing Client Care - ANSWER Systemic before local. Acute before chronic. Actual problems before potential problems. Listen carefully to clients and don't assume. Recognize and response to trends vs. transit findings. Recognize indications of medical emergencies & complications vs expected findings. Apply clinical knowledge to procedural standards to determine the priority action. Professional Responsibilities: Adhering to Ethical Principles - ANSWER Justice (fair treatment), beneficence (doing good), nonmaleficence (doing no harm), fidelity (faithfulness), autonomy (independence), veracity (truthfulness). Professional Responsibilities: Obtaining Informed Consent in an Emergency - ANSWER Informed consent is not needed if the pt is unconscious and surgery is immediately required to save their life. Information Technology: Receiving a Telephone prescription - ANSWER First, write down the prescription. Next, repeat the prescription back to the provider. Document phone conversation in client chart. Professional Responsibilities: Identifying a Tort - ANSWER A wrongful act or an infringement of a right Managing Client Care: Performance Improvement Process - ANSWER Standards are made available to employees by way of polices and procedures. Quality issues are identified by staff, management, or risk management department. an inter professional team is developed to review the issue. The current state of structure and process related to the issue is analyzed. Data is collected. If benchmark is not met, possible influencing factors are determined. Maintaining a Safe Environment: Assessing a Client's Home for Safety Hazards - ANSWER Remove items that could cause client to trip. Place electrical cords against the wall. Make sure steps and sidewalks are in good repair. Place grab bars near the toilet and the tub. Use nonskid mat in the tub or shower. Ensure lighting is adequate. Pressure Ulcers, Wounds, and Wound Management: Assessing for Evidence of Healing - ANSWER Inflammation means that the body's immune system is working to heal the wound. Coordinating Client Care: Need for Variance Report - ANSWER A variance report compares the planned budget and the actual financial outcome. Facility Protocols: Caring for a Client Who Has Been Exposed to Anthrax - ANSWER Treat with antibiotics. Managing Client Care: Appropriate Assignment During Orientation - ANSWER New RNs should be assigned a patient that they are competent caring for, and only after their skills have been observed and approved by an experienced RN. Airway Management: Discharge planning for a Client Who Has a Tracheostomy - ANSWER Always have two extra trach tubes (one your size and one size smaller). Keep an obturator for each trach tube and trach ties. Keep sterile saline and lubricant with you at all times. Professional Responsibilities: Responding to a Visitor's Question About Status of a Client - ANSWER Information cannot be shared with unauthorized individuals, including family members, unless they provide the code. Professional Responsibilities: Teaching About Confidentiality - ANSWER Client medical records must be kept in secure area. No information can be written on public display boards. EMR should be password protected, and nurses must only use their own log-in information. No part of the medical record can be copied, except for authorized exchange of documents between health care institutions. Preoperative Nursing Care: Securing Client Belongings - ANSWER Give all pt belongings to family member to safely stored. Managing Client Care: Prioritizing Client Care - ANSWER Systemic before local. Acute before chronic. Actual problems before potential problems. Listen carefully to clients and don't assume. Recognize and response to trends vs. transit findings. Recognize indications of medical emergencies & complications vs expected findings. Apply clinical knowledge to procedural standards to determine the priority action.