RN Leadership 2022 B. Best For Revision Exam. Questions and Answers.

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RN Leadership 2019 B 1. A nurse is teaching a newly licensed nurse about an incident report. Which of the following statement by the newly licensed nurse indicates an understanding of the teaching. ... "I should place a copy of an incident report in the client's medical record." The nurse should not place a copy of the incident report in the client’s medical record, as it is confidential communication that belongs to the health care facility. "I should document the completion of an incident report in the client's medical record."* Incident reports are confidential facility documents that are used to assist with preventing further occurrence of an incident, or to defend the facility in the event of a lawsuit. If it is documented that an incident report was completed, the document is no longer confidential and the client can request copies for use in a lawsuit. "I should complete an incident report for an unexpected client occurrence." The nurse should complete an incident report for unexpected occurrences to assist in determining causes of deviations from standards of care. "I should ask the risk manager to complete the incident reports." The nurse is responsible for completing incident reports and should do so as soon as possible after the incident. 2. A public health nurse is developing a list of recommendations for her supervisor on how to use evidence based practice to improve community outcomes. Which of the following should the nurse recommend as a qualitative research method? Meta-analysis Meta-analysis is a quantitative research method that provides a statistical analysis of multiple studies conducted on the same topic. Experimental study* Experimental study is a quantitative research method that uses control and treatment groups to test at least one independent variable. Phenomenology Phenomenology is a qualitative research method that provides additional understanding of participants' experiences with emotional variances, such as grief and hope. Secondary analysis Secondary analysis is a quantitative research method that uses previously collected data to answer newly formed hypotheses. 3. A client with an altered mental status and a right lower leg deep vein thrombosis has a prescription for application of an aquathermia pad to the right lower leg. Which of the following actions should the nurse take. Ask the client to report if the aquathermia pad gets too warm is . The nurse should instruct the client and family to report if the aquathermia pad gets too warm to prevent client injury. Check the client's leg 30 min after applying the aquathermia pad is . The nurse should check the client's right lower leg within 15 to 20 min of applying the aquathermia pad to ensure there is no evidence of complications.* Show the client where the power button is located is . The nurse should show the client where the power button is located so that he can control the equipment himself. Ensure that the client's call light is within reach is . The nurse should ensure that the client's call light is within reach as part of basic safety instructions. Decrease the temperature by 5° if the client's skin becomes reddened is . The nurse should monitor the client's skin for increased redness and should discontinue the aquathermia pad if it is noted. The nurse should report the findings to the provider. 4. A nurse is assessing a client who is postoperative and has a PCA. The client exhibits restlessness, an elevated pulse, and decreased blood pressure. Which of the following actions should the nurse take? Assign an assistive personnel to monitor the client's vital signs. The client's condition is unstable and warrants assessment by an RN. Encourage increased use of the PCA for comfort. The use of the PCA will not treat the cause of the client's rapid pulse and decreased blood pressure. Have the client's provider prescribe a sedative. A sedative will not treat the cause of the client's rapid pulse and decreased blood pressure. Place the client in a modified Trendelenburg position. The client's restlessness and change in vital signs indicates a change in the client’s status, possibly caused by hemorrhage or hypovolemic shock. Placing the client in a modified Trendelenburg position increases venous circulation. 5. A nurse is preparing to administer medication to a client who has Crohn’s disease. The client states, “I want to skip this dose of my medication. I am too tired to take it.” Which of the following actions should the nurse take? Leave the medication on the client's bedside table to take later. The nurse should not leave the medication on the client's bedside table because it is a safety risk to the client and others. If a client refuses medication, the nurse should discard the medication according to facility protocol. Return in 1 hr to administer the medication. The client has refused the medication; therefore, the nurse should not return 1 hr later to make another attempt to administer the medication. Mix the medication in applesauce to administer to the client. The nurse should not administer medication to the client without the client's consent, as this disregards the client's right to self-determination. Inform the client of the consequences of refusing the medication The nurse should inform the client of the consequences of refusing the medication. It is the client's right to decide whether to take the medication. If the client still refuses after receiving further information, the nurse should waste the medication and document the occurrence in the client's medical record. 6. A nurse is caring for a group of clients on a unit. Which of the following assessment findings should the nurse recognize as the priority to report to the charge nurse? A client who has heart failure and 2+ edema of her lower extremities Edema rated as 2+ of the lower extremities is non urgent because it is an expected finding for a client who has heart failure; therefore, there is another finding that is the nurse's priority. A client who is 2 days postoperative and has a urine output of 20 mL/hr When using the urgent vs non urgent approach to client care, the nurse should determine that the priority finding is a urine output of 20 mL/hr, which is below the expected reference range and might indicate that the client is hypovolemic or experiencing renal failure complications. A client who started taking verapamil and has a heart rate of 75/min A heart rate of 75/min is a non urgent finding for a client who is taking verapamil because this is within the expected reference range; therefore, there is another finding that is the nurse's priority. The nurse should report a heart rate below 60/min for a client who is taking verapamil. A client who is receiving morphine and reports nausea Nausea is a non urgent finding for a client who is taking morphine because it is a common adverse effect of the medication; therefore, there is another finding that is the nurse's priority. 7. The charge nurse on a medical-surgical unit is making shift assignments for the next shift. A licensed practical nurse (LPN) and assistive personnel (AP) are members of the team. Which of the following client care assignments should the nurse assign to the LPN? Determine the swallowing ability of a client who has had a stroke. The nurse should plan to initiate a referral to a speech-language pathologist to determine the client's swallowing ability following a stroke, and keep the client NPO to prevent aspiration. Provide an enteral feeding to a client who has Crohn's disease. Administration of enteral feeding is within the scope of practice of an LPN; therefore, it is appropriate for the charge nurse to assign this task to an LPN. Develop a teaching plan for a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should have an RN develop a teaching plan for a client. An LPN can reinforce teaching from pre-developed materials. Weigh a client who is 3 days postoperative following coronary artery bypass grafting. The nurse should plan to have an assistive personnel (AP) obtain a weight on a client who is stable. This improves care efficiency by allowing licensed personnel more time to focus on specialized tasks that an AP cannot perform. 8. A nurse is reviewing a client's medication administration record and finds that the client has not received a prescribed dose of warfarin for 2 days. Which of the following action sholld the nurse take first Check the client's last INR. The first action the nurse should take using the nursing process is to assess the client. A client prescribed an anticoagulant who has missed several doses is at risk for thrombosis; therefore, the nurse should check the client’s last INR to determine the client's coagulation status. Notify the client's provider. The nurse should notify the client's provider that the medication was not administered in case the provider needs to revise the treatment plan; however, there is another action the nurse should take first. Notify the risk manager. The nurse should notify the risk management of the omitted medication to facilitate quality improvement; however, there is another action the nurse should take first. Complete an incident report. The nurse should complete an incident report when a medication error occurs; however, there is another action the nurse should take first. 9. A nurse is caring for a client who is terminally ill and is receiving nutritional support. The client's adult children disagree about continuing nutritional support. The dilemma is referred to the ethics committee. The nurse should expect which of the following actions from the committee? Assisting in weighing the options involved in the decision Ethics committees are members of the interprofessional team who assist with problem solving related to ethical dilemmas. The ethics committee examines all of the facts and provides support for clients and caregivers. Providing a legal representative for the family Although legal experts might participate in ethics committees, it is not the role of the ethics committee to offer legal support. Recommending the best course of action for the client The ethics committee highlights important considerations for each case and provides support for the client and caregivers, but it does not recommend a best course of action. Deciding how the nursing team should resolve the dilemma Ethics committees do not impose a specific decision. The decision maker in this case, and in many ethical dilemmas, is the client or the family. 10. A charge nurse is preparing to observe a newly licensed nurse perform a routine abdominal assessment. Which of the following actions should the charge nurse expect the newly licensed nurse to take Place the client in a dorsal recumbent position for the examination. To prepare the client for a routine abdominal assessment, the nurse should place the client in a dorsal recumbent or supine position and ensure that the client relaxes her abdominal muscles. Auscultate for vascular bruits with the diaphragm of the stethoscope. The charge nurse should expect the newly licensed nurse to use the bell of the stethoscope to auscultate for vascular bruits. Begin the assessment by using light palpation over the abdomen. The charge nurse should expect the newly licensed nurse to begin the assessment by inspecting the client's abdomen for changes in color, contour, and symmetry. Ensure that the client has a full bladder before beginning the procedure. The charge nurse should expect the newly licensed nurse to have the client empty her bladder before beginning the procedure for optimal examination of the abdomen. [Show More]

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