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 actions should the nurse take
first? Correct
...
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 actions should the nurse take
first? Correct Answer- Check the client's INR.
A nurse manager is presenting an in-service about preventing readmission of clients dues to
complications following joint arthroplasty. Which of the following leadership tasks is the nurse
performing? Correct Answer- Advocay
a nurse is teaching an AP about caring for a client who has a DNR order. Which of the following
statements by the AP indicates an understanding of the teaching? Correct Answer- "I will call for the
client's nurse to come to the room if I cannot detect the client's pulse."
The AP should contact the nurse for further assessment whenever a client's condition does not meet
expected findings. The client who has a DNR order in place does not require resuscitation.
A nurse is caring for four clients. Which of the following tasks can the nurse assign to an AP? Correct
Answer- Perform chest compressions on a client who is in cardiac arrest.
The nurse should assign an AP to perform chest compressions on a client who is in cardiac arrest.
Performing basic CPR is within an AP's range of function.
A Nurse is teaching a newly licensed nurse about using electronic medical records. which of the
following statements by the newly licensed nurse indicated an understanding of the teaching? Correct
Answer- "My access to client electronic medical records may be tracked by my nurse manager."
The nurse should keep her password private and not share it with anyone else to decrease the risk for a
breach of client confidentiality.The nurse should expect her employer to track access of client records to
ensure client confidentiality.While a client has the right to read his medical record, and the nurse can
allow him to do so by following facility protocol, a client's partner does not have that right unless
granted by the client.The nurse should log out of the electronic medical record when not actively using
it. Failure to log out increases the risk for breach of client confidentiality.a nurse is receiving change-of-shift report. which of the following clients should the nurse assess first?
Correct Answer- A client who had abdominal surgery 6 hours ago and had a heart rate of 120/min for
the last 2 hours.
A RN delegates the task of obtaining the bp of a client who is 2hr post-op following a cholecystectomy to
a LPN. The LPN reports a BP that is significantly higher than the clients previous reading. which of the
following actions should the RN take first? Correct Answer- Recheck client's BP
A public health nurse is developing a list of recommendations for her supervisior on how to use EBP to
improve community outcomes. Which of the following should the nurse recommend as a qualitative
research method? Correct Answer- Phenomenology
Meta-analysis is a quantitative research method that provides a statistical analysis of multiple studies
conducted on the same topic.Experimental study is a quantitative research method that uses control
and treatment groups to test at least one independent variable.Phenomenology is a qualitative research
method that provides additional understanding of participants' experiences with emotional variances,
such as grief and hope.Secondary analysis is a quantitative research method that uses previously
collected data to answer newly formed hypotheses.
A nurse at a urgent care clinic notices that a pain assessment is not being performed for all clients as
required by policy. Which of the following actions should the nurse take to ensure care is provided
according to policy? Correct Answer- Report this issue to the nurse manager.
The nurse should report this issue to the nurse manager because it is the manager's responsibility to
ensure that standards are met and that care is provided according to policy.
A nurse is teaching a client about advance directives. Which of the following statements by the client
indicates an understanding of the teaching? Correct Answer- "These will outline my wishes for
medication treatment."
The purpose of advance directives is to outline the client's wishes if they become unresponsive
A nurse is caring for a client who recently learned he has a mutation of the BRCA2 gene. The client states
that he does not plan to tell his adult children about the dx. Which of the following responses displays
clients advocacy by the nurse? Correct Answer- "Let's review what you understand about this test
result."The nurse should use therapeutic communication techniques to encourage the client to share his point
of view and to convey respect for the client's decisions. By seeking to understand the client's
perceptions in a nonjudgmental manner, the nurse is displaying client advocacy.
A nurse is caring for a client who has breast cancer and is deciding on a plan of treatment. which of the
following statements should the nurse make? Correct Answer- "Let's talk about the benefits of each
treatment."
Talking about the benefits of each treatment option supports the right of the client to make decisions
regarding treatment and encourages comparison of the treatments.
A nurse in a community health clinic is caring for four clients who each have a communicable disease.
Which of the following conditions is considered a nationally notifiable infectious disease? Correct
Answer- Chlamydia trachomatis
According to the Centers for Disease Control and Prevention, Chlamydia trachomatis is a nationally
notifiable infectious disease in all 51 jurisdictions. The nurse should notify the state health department,
which monitors and controls communicable diseases.
A staff nurse detects alcohol on the breath of another nurse working on the unit. The staff nurse
observes that the nurse's speech is slurred and their gait is unsteady. Which of the following actions
should the nurse take? Correct Answer- Notify the charge nurse of the nurse's behavior.
The charge nurse is responsible for the performance of the nurses on the shift; therefore, the staff nurse
should follow the chain of command and notify the charge nurse about the nurse's behavior.
A nurse overhears two staff members in the facility elevator discussing a clients care. which of the
following actions should the nurse take? Correct Answer- Report the incident to the nurse manager.
A Nurse manager is reviewing the stages of conflict resolutions with the nursing staff. The nurse
manager should instruct the staff to expect the stages of conflict to occur in what order? STEPs: Correct
Answer- 1. Latent Conflict.
2. Perceived Conflict3. Felt Conflict
4. Manifest Conflict.
5. Conflict Aftermath
A nurse is planning discharge care for a client who has rheumatoid arthritis and has difficulty buttoning
clothing. Which of the following referrals should the nurse recommend for the client? Correct AnswerOccupational Therapy
A nurse has just received report on four clients on a med-surg unit. which of the following clients should
the nurse plan to assess first? Correct Answer- A client who is post-op following a total knee arthroplasty
and has a cap. refill of 4 secs.
A nurse is caring for several clients. which of the following actions should the nurse take to maintain
client confidentiality Correct Answer- Tell a client's partner that the clients lab test cannot be disclosed
without permission.
A Charge Nurse is delegating tasks on a nursing unit that is short staffed. A client has a prescription for a
wound irrigation twice per day. Which of the following actions should the CN take? Correct AnswerAssign the procedure to a LPN
A nurse on a med-surg unit is terminally ill. which of the follwoing actions demonstrates that the nurse is
practicing in an ethical manner when caring for the client? Correct Answer- Discuss end-of-life goals with
the client.
A nurse is teaching about the patient protection and affordable care act and their rights regarding
insurance coverage. which of the following statements by the client indicates an understanding of the
teaching? Correct Answer- "My insurance coverage no longer has lifetime coverage limits."
A nurse is delegating tasks for a group of clients to an AP. Which of the following statements by the
nurse provides the right direction of communication with the AP? Correct Answer- "Tell me what time
the client in room 205 voids for the first time after catheter is removed."
A nurse is caring for a client who has acute diverticulitis and is scheduled for surgery within the next 2hr.
The client tells the nurse that she has called a taxicab and is leaving the hospital. After notifying thesurgeon, which of the following actions should the nurse take next? Correct Answer- Inform the client
about the risks she may encounter by leaving the facility.
A Charge Nurse is evaluating a plan of care that a newly licensed nurse developed for a client who us to
received a continuous NG tube feeding. Which of the following interventions should the CN ensure is
part of the plan of care? Correct Answer- Use a 60ML syringe to flush out a clogged tube.
A CN is planning assignments for the upcoming shift. Which of the following tasks should the CN
delegate to an AP? Correct Answer- Assisting a client who had a hip arthroplasty to a chair.
A Nurse manager is conducting an annual performance review for a staff nurse. Which of the following
strategies should the nurse use in the review process? Select all that apply Correct Answer- Include peer
evals completed by other staff nurses
Have the nurse conduct a self-appraisal prior to review
Complete a performance checklist
A nurse manager is reviewing the actions a staff nurse took when they observed smoke coming from the
wastebasket in a client's room. The nurse manager should verify that the nurse acted appropriately
when they performed which of the following actions first? Correct Answer- Transported the client to the
hallway.
A nurse is caring for a client who is experiencing adverse effects after receiving a new medication. Which
of the following communication tools should the nurse use for management of this complication?
Correct Answer- SBAR Framework.
A CN on a medical unit hears the fire alarm announcement that a fire is occurring on the unit. which of
the following is priority action by the CN? Correct Answer- Instruct ambulatory clients to go to a safe
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