RN Leadership Online Practice 2023B Quiz & Flashcards

Questions and Answers

What should the nurse do after providing educational materials to the client about the procedure?

Answer the client's question and have the client sign the consent form.

Which statement indicates understanding of the use of mechanical restraints by a newly licensed nurse?

I should check the client every 30 minutes while in mechanical restraints.

I should request the provider to examine the client within 1 hour of applying mechanical restraints. (correct)

I should document every hour when a client is in mechanical restraints.

I should use mechanical restraints when a client who is manic starts pacing.

Which client should a medical nurse, without orthopedic experience, be assigned to care for?

A client who had a total hip arthroplasty 3 days ago.

A client who is in balanced skeletal traction.

A client who has a fractured femur with a new cast.

A client who had a right above-the-knee amputation 24 hr ago. (correct)

What should the nurse do when a client with renal failure decides to stop hemodialysis treatment?

Support the client's decision regarding treatment. Signup and view all the answers

What action should a charge nurse on the PACU take when an external disaster plan is activated?

Identify stable clients for transfer to a surgical unit. Signup and view all the answers

Which statement by a newly licensed nurse about incident reports indicates understanding?

I should complete an incident report for an unexpected client occurrence. Signup and view all the answers

What should the ethics committee do when confronted with a dilemma regarding continuing nutritional support for a terminally ill client?

Assist in weighing the options involved in the decision. Signup and view all the answers

Which action requires intervention by the charge nurse?

A nurse photocopying their assigned client's diagnostic test results. Signup and view all the answers

Which assessment finding should be reported as the priority?

A client who is 2 days postoperative and has a urine output of 20 mL/hr. Signup and view all the answers

Which action should the nurse manager take during a meeting to achieve a win-win resolution?

Encourage the nurses to collaborate with one another to address the conflict. Signup and view all the answers

Which findings require notification of the provider when planning client care? (Select all that apply)

Prealbumin level Signup and view all the answers

Which findings indicate the client's condition is worsening and the care plan should be updated? (Select all that apply)

Blood pressure Signup and view all the answers

Which findings should the nurse identify as requiring immediate follow-up? (Select 4)

Blood pressure Signup and view all the answers

What should the nurse do first using the nursing process?

Assess the client's feelings and clarify expectations. Signup and view all the answers

After developing the initial plan for client discharge, what is the next action the nurse should take?

Determine goals and objectives. Signup and view all the answers

What position should the client be in for a routine abdominal assessment?

Dorsal recumbent position. Signup and view all the answers

Which finding is a potential environmental hazard for a family with a toddler?

The toilet seat lid is in the raised position. Signup and view all the answers

What task can be delegated to an assistive personnel (AP) in a maternal newborn unit?

Measuring urine output of the client's first voiding. Signup and view all the answers

Which task should not be assigned to a licensed practical nurse (LPN)?

Develop a teaching plan for a client who has a new diagnosis of type 2 diabetes mellitus. Signup and view all the answers

What indicates understanding of 'do-not-resuscitate' (DNR) orders by an AP?

I will call for the client's nurse to come to the room if I cannot detect the client's pulse. Signup and view all the answers

What action should the nurse take to validate the client's understanding of a procedure before it is performed?

Ask the client to verbalize the purpose, risks, and benefits of the procedure. Signup and view all the answers

What is the nurse's first action upon notification of a fire on the unit?

Assist clients who are in immediate danger to a safe location. Signup and view all the answers

What should the nurse do if a client refuses a recommended surgical procedure?

Discuss the client's concerns about having the surgery. Signup and view all the answers

Which behavior could indicate that a staff nurse might be working while impaired?

Frequent use of the restroom. Signup and view all the answers

What should a nurse do after being reprimanded by a provider in front of a client?

Discuss the situation with the provider in private. Signup and view all the answers

Which client should the nurse assess first in triage following a motor vehicle crash?

A client who has arm contusions and manifests asymmetrical thoracic movement. Signup and view all the answers

What should the nurse verify regarding a transfer client's informed consent?

Receiving moderate sedation. Signup and view all the answers

What information should the nurse report in a verbal report for a client post-surgery?

The client's level of consciousness. Signup and view all the answers

What should a nurse manager include in an annual performance review?

Complete a performance checklist. Signup and view all the answers

How should a charge nurse respond to an AP's complaint about unfair workload?

I delegate tasks to personnel based on their job descriptions. Signup and view all the answers

Which client should the nurse assess first during shift report?

A client who had abdominal surgery 6 hours ago and has had a heart rate of 120/min for the last 2 hours. Signup and view all the answers

What demonstrates the nurse's advocacy regarding a client with a mutation of the BRCA2 gene?

Let's review what you understand about this test result. Signup and view all the answers

What should a nurse do if they observe non-compliance with pain assessment protocols?

Report this issue to the nurse manager. Signup and view all the answers

What is the first action when developing a plan to improve hand hygiene adherence?

Set a goal for improvement in adherence. Signup and view all the answers

What action should a nurse take regarding a client with a living will that denies artificial nutrition?

Review the client's request with the family. Signup and view all the answers

How should a charge nurse approach a conflict between two nurses over workload sharing?

Explore alternative solutions to address unit workflow with the nurses. Signup and view all the answers

What action should the nurse take if a client has questions about surgical alternatives?

Review the surgical procedure described on the consent form with the client. Signup and view all the answers

Which of the following findings should the nurse identify require follow-up by the provider? (Select the 6 findings that require immediate follow-up)

Pain level Signup and view all the answers

Which of the following interventions is appropriate for the plan of care for a client who has active herpes simplex lesions?

Wear a gown and gloves when caring for the client. Signup and view all the answers

Which action should the nurse take to maintain client confidentiality?

Tell a client's partner that the client's laboratory tests cannot be disclosed without permission. Signup and view all the answers

Which statement is an example of using the conflict resolution strategy known as smoothing?

You always complete your work on time and do a great job. I believe you can handle the assignment well. Signup and view all the answers

What is the priority action for a nurse manager planning daily work and activities for the unit?

Assign client care to staff. Signup and view all the answers

Informed consent should be given by which of the following people for a school-age client with a laceration?

The client's guardian Signup and view all the answers

What should the nurse do for a client uncertain about undergoing a tubal ligation?

Discuss the client's feelings about the procedure. Signup and view all the answers

Which of the following tasks is appropriate to delegate to a licensed practical nurse (LPN)?

Suction a client who has a chronic tracheostomy. Signup and view all the answers

What should the nurse do first upon seeing staff members looking at the electronic medical record for a celebrity client?

Remind the staff members that this is a breach of confidentiality. Signup and view all the answers

Which instruction reflects effective communication regarding delegation to an assistive personnel (AP)?

Check the urinary output at 1100 for John Doe and report it to me immediately. Signup and view all the answers

Which response should the nurse make to a client who does not want to continue chemotherapy?

I will gather information about palliative care for you. Signup and view all the answers

Which resources should the nurse consult when planning for a policy creation allowing nurses to insert PICC lines?

State Nurse Practice Act (NPA) Signup and view all the answers

What is the first step in addressing an increase in health care-associated UTIs on a medical-surgical unit?

Establish best practice guidelines for reducing the incidence of UTIs. Signup and view all the answers

Which client's finding should receive a class III, or green tag, in a triage situation?

Facial contusions Signup and view all the answers

What was the first action a nurse should take when observing smoke from a wastebasket?

Transported the client to the hallway Signup and view all the answers

What response should the charge nurse make to a staff nurse's concern that a client is seeking drugs?

Clients are the experts on their own pain. Signup and view all the answers

Which statement reflects an intrapersonal conflict?

I'm not sure whether to apply for the unit manager's position or start a family this year. Signup and view all the answers

What action should the case manager perform prior to discharging a client requiring IV antibiotics at home?

Ensure that home infusion therapy has been arranged. Signup and view all the answers

For a client with dementia being admitted for surgery, which action promotes safety?

Place the client in a room near the nurses' station. Signup and view all the answers

Which statement from an assistive personnel (AP) indicates the nurse should assess the client first?

The client who had an indwelling urinary catheter removed 8 hours ago reports an inability to void. Signup and view all the answers

What response should the nurse make when a client claims informed consent was not obtained for an indwelling urinary catheter?

This procedure does not require written informed consent. Signup and view all the answers

What action should the nurse take after receiving a change-of-shift report?

Obtain a capillary blood glucose reading. Signup and view all the answers

Which action should the nurse take to ensure the competency of the AP regarding removal of a client's urinary catheter?

Review the AP's skill competency checklist. Signup and view all the answers

After a client reports staff members are not answering the call light promptly, what should the nurse do first?

Assess the client for any additional needs. Signup and view all the answers

Study Notes

Postoperative Care Observations

Immediate follow-up required for increased heart rate, respiratory rate, and pain level of 8 post-abdominal surgery.
Large amounts of bright red blood at the incision site indicate possible hemorrhage.
Decreased blood pressure and oxygen saturation are critical signs for intervention.

Herpes Simplex Infection Care

Use contact precautions when caring for clients with herpes simplex lesions.
Barriers such as gowns and gloves are essential for prevention of infection spread.

Maintaining Client Confidentiality

Inform partners that laboratory test results cannot be disclosed without client permission.
Verbal permission is necessary for discussing client names in academic settings.

Conflict Resolution Strategy

"You always complete your work on time..." is an example of smoothing, where a compliment is used to minimize conflict emotions.

Nurse Manager's Priorities

Assigning client care to staff is the highest priority for ensuring timely treatments and continuity of care.

The client’s guardian must give informed consent for medical procedures involving minors.

Supporting Client Decision Making

Discussing feelings about a tubal ligation procedure is key to supporting the client's autonomy in decision-making.

Delegation in Nursing

Suctioning a client with a chronic tracheostomy can be appropriately delegated to a licensed practical nurse (LPN).

Breach of Confidentiality

Immediate intervention is required if staff members access confidential records without authorization.

Effective Delegation Communication

Clear instructions should include specific tasks, client information, a timeline, and expectations for reporting back.

Palliative Care Options

Acknowledge the client's right to refuse treatment while offering information about palliative care options as support.

Policy Development in Nursing

Consult the State Nurse Practice Act for regulatory guidelines regarding expanded nursing functions.

Quality Improvement in Healthcare

Establish best practice guidelines as the first step in addressing health care-associated urinary tract infections.

Triage in Emergencies

Class Ill (green tag) should be assigned to clients with less severe injuries, such as facial contusions.

Fire Safety Protocol

According to RACE, transporting the client to safety is the first priority when fire is detected.

Pain Management Acknowledgment

Nurses should affirm that clients are the best indicators of their pain experiences.

Intrapersonal Conflict Examples

Uncertainty about applying for a promotion or starting a family reflects intrapersonal conflict stemming from competing desires.

Case Management Responsibilities

Ensuring home infusion therapy is arranged is crucial for a client transitioning home post-IV antibiotic treatment.

Client Safety for Dementia Patients

Placing clients with dementia near the nurses' station promotes safety and frequent monitoring.

Client Assessment Prioritization

Assess clients who report inability to void post-indwelling urinary catheter removal as this indicates potential urinary retention risks.

Insertion of an indwelling urinary catheter does not require written informed consent; compliance implies consent.

Nursing Shift Responsibilities

Obtaining a capillary blood glucose reading is essential before administering scheduled insulin.

Competency Assurance

Reviewing an assistive personnel's skill competency checklist ensures they are qualified for tasks like catheter removal.

Addressing Client Concerns

Asking the client to express their expectations regarding staff response times is the first step in addressing their concerns.

Policy Revision Processes

Determining goals and objectives is a crucial next step after developing an initial policy revision plan.

Abdominal Assessment Protocol

Place the client in a dorsal recumbent position to facilitate accurate abdominal assessments.

Home Safety Assessments for Toddlers

Conduct comprehensive evaluations of potential safety hazards in homes with toddlers during home health assessments.### Environmental Hazards for Toddlers
Raised toilet seat lid presents a risk of accidental drowning for toddlers.

Delegating Tasks

Assistive personnel (AP) can measure urine output of the client's first voiding.
Licensed practical nurses (LPNs) can provide enteral feeding to clients like those with Crohn's disease.

Understanding DNR Orders

APs should contact the nurse if unable to detect a client's pulse, rather than perform resuscitation.

A client’s understanding of a procedure is confirmed by asking them to verbalize its purpose, risks, and benefits.

Fire Emergency Response

Prioritize assisting clients in immediate danger during a fire incident.

Client Autonomy and Surgery

Discuss a client's concerns about surgery, emphasizing open communication to understand their perspective.

Identifying Impairment in Nurses

Frequent restroom use by a nurse may indicate impairment, alongside errors and mood swings.

Conflict Resolution

Address conflicts between nurses by discussing situations privately to promote understanding and resolve issues.

Triage in Emergency Situations

A client with asymmetrical thoracic movement after a crash may have a tension pneumothorax and must be prioritized for assessment.

Ensure consent is documented prior to procedures involving moderate sedation.

Postoperative Care Reporting

Include the client’s level of consciousness in verbal reports to maintain effective communication.

Annual Performance Evaluations

Include peer evaluations and self-appraisals in performance reviews to reflect a nurse's performance comprehensively.

Delegation and Fair Work Distribution

Charges nurses should be transparent about task delegation based on job responsibilities to address AP concerns.

Client Priority During Shift Changes

Assess clients who show signs of instability, such as elevated heart rate post-surgery, first during shift changes.

Client Advocacy for Genetic Testing Results

Encourage clients to discuss their understanding of test results, respecting their decisions while advocating for their health.

Adherence to Pain Assessment Policies

Report issues of non-compliance with pain assessment policies to management for resolution.

Hand Hygiene Improvement Plans

Establish goals for improving hand hygiene adherence as the first step in addressing adherence rates.

Ethical Considerations and Living Wills

Review client wishes as stated in their living wills with family, especially regarding life-sustaining treatments like tube feeding.

Conflict Management in Nursing Units

Encourage collaboration between conflicting nurses to evaluate workflow and foster resolution.

Direct clients’ questions about alternative treatments to the provider for clarification and transparency.

Regulations on Mechanical Restraints

A provider must evaluate a client within 1 hour of applying mechanical restraints to ensure proper oversight.

Assignment of Nursing Tasks

A medical nurse can care for clients with non-specialized needs, such as recent amputations, due to a lack of immediate specialized care needed.

Supporting Client Decisions

Nurses should support clients' decisions regarding the discontinuation of treatments like hemodialysis, reinforcing their autonomy.

Emergency Preparedness in Disasters

In disasters, charge nurses should assess stable clients for transfer to ensure efficient care delivery during crises.

Understanding Incident Reports

Complete incident reports for unexpected occurrences, but do not place copies in clients' medical records to maintain confidentiality.### Incident Reporting
Completion of incident reports is essential for analyzing unexpected occurrences and deviations from care standards.

Ethics Committee Involvement

Ethics committees aid in resolving dilemmas, such as disagreements over continuing nutritional support for terminally ill clients.
The committee's role includes assisting in weighing options and examining all relevant facts; however, they do not make final decisions or provide legal representation.

Charge Nurse Responsibilities

A charge nurse must intervene if a nurse photocopies a client’s diagnostic test results due to confidentiality and privacy breaches.
Documentation and sharing of client information must adhere strictly to privacy regulations.

Priority Assessment in Nursing

Postoperative clients with urine output below the expected range (e.g., 20 mL/hr) must be reported as they may indicate critical issues like hypovolemia or renal failure.
Other findings, such as mild edema, heart rate changes, or nausea, may warrant monitoring but are less urgent.

Conflict Resolution in Nursing Management

Effective conflict resolution involves collaboration among staff to achieve mutual goals and minimize workplace tension.
Encouraging competitors or avoidance strategies typically do not lead to sustainable solutions.

Monitoring Client Health Indicators

Critical findings warranting notification to healthcare providers include increased heart rate, temperature, WBC count, decreased blood pressure, and lower prealbumin levels indicating possible wound infection and risk for sepsis.

Recognizing Substance Use Disorder in Employees

Warning signs of substance use disorder in nurses may include attendance issues, mood swings, hygiene decline, changes in social habits, and client complaints about pain management.
Immediate action involves removing the nurse from the unit if substance abuse is suspected.

Evaluating Client Care Plans

Indicators that suggest a worsening condition in clients include blood-tinged sputum, elevated temperature, increased heart and respiratory rates, and decreased oxygen saturation levels, particularly in patients with pneumonia.

Follow-Up Requirements for Critical Findings

Immediate follow-up is necessary for clients showing weakness, nausea, diaphoresis, abnormal ECG results, low oxygen saturation, and significant changes in blood pressure and respiratory rate, suggesting potential angina or urgent health issues.

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Description

Test your knowledge with the RN Leadership Online Practice flashcards for 2023B. This quiz focuses on identifying critical findings that require immediate follow-up by the provider in a postoperative patient scenario. Perfect for nursing students and professionals preparing for their evaluations.

RN Leadership Online Practice 2023B