RN Leadership Online Practice 2016 B

Teaching new nurse about obtaining telephone prescription from a provider
Repeat prescription to provider for verification
Four clients on Med Surge unit… assess first?
Post op total knee and cap refill of 3 seconds
Notification of Fire on the unit… first action?
Assist
Med Surge nurse is caring for terminally ill patient. Action that demonstrates ethical care
Collaborate with client to establish realistic goals
Case manager is planning a teaching on use of critical pathways
critical pathways prevent unnecessary expense
Nurse manager completing a performance improvement audit and determines documentation of client discharge teaching is below benchmark… action to implement first?
Determine the factors that interfere with the documentation of client education
Older adult client who has renal failure decides to stop hemodialysis.. action?
Support client’s decision
Plan of care for a total hip arthroplasty. Action to take?
Inform AP of client’s weight bearing status
Home health nurse is planning daily visits and receives lab results.. See first?
Platelets 100,00
Education about patient protection and the affordable care act and patient rights
My insurance coverage no longer has lifetime coverage limits
New nurse caring for a patient with pulmonary tuberculosis.
N95 respirator mask when in the client’s room
Public health nurse is developing recommendations for her supervisor on how to implement evidence based practice to improve community outcomes
Phenomenology
Appropriate tasks that a nurse can delegate to an assistive personnel
Record a client’s meal intake
Terminally ill client receiving nutritional support. Adult children disagree and dilemma is referred to ethics committee
assisting in weighing the options involved
Older adult client with dementia and has become aggressive. Client has been prescribed wrist restraints
Apply padded portion of the restraint around the client’s wrist
Developing a plan of care for a school aged whose family is homeless, what is the priority?
Child has inflamed fissures at the corners of her mouth
Nurse is caring for a client who has a mutation of the BRCA2 gene, client states she doesn’t plan to tell her adult daughters. What response displays client advocacy
Let’s review what you understand about this test result
Nurse is reviewing a client’s medication administration record and finds that client has not received prescribed dose of Warfarin for past 2 days.
Check client’s INR
Charge nurse evaluating novice.. client on continuous NG tube feeds.. what should be part of plan of care?
Use 60 mL syringe to flush
Interprofessional conference for client who is 3 days post op.. Priority?
Client refuses to attend PT sessions
Small spark when plugging in an infusion pump.
Tag pump as broken
Client recovering from a Stroke
Discuss patient concerns
Charge notices new nurse does not finish client care tasks
Set aside time to plan at start of shift
Two nurses feel the other is not doing fair share
Explore alternative solutions
Charge Nurse is conducting an in service with staff about infection control.. droplet precautions
Pertussis
Client with back pain presents to the ED and is provided oxycodone. Staff nurse feels client is seeking drugs and not in distress.
Clients are experts on their own pain
Charge nurse observing a new nurse perform an abdominal assessment.
Place the client in dorsal recumbent position for the exam
Show the client where the power button is
Ensure call light is within reach
Admitting clients following an earth quake
Sucking Chest wound
Nurse caring for a client who has a right lower leg DVT and a prescription for application of an aquathermia pad to the right lower leg
Report if the pad is too warm
Admitting a client to a cardiac intensive care unit. When does discharge planning begin?
At the time of admission
Discharge care for an older adult client who has rheumatoid arthritis. Difficulty buttoning her clothing
Occupational therapy
Client is comatose with living will that declines use of artificial enteral feedings but family requests feedings are started
Review clients requests with family
Group of clients.. Which is priority?
2 days post op and 20 mL/hr of urine
Change of shift report, which patient should the nurse assess first
Abdominal surgery 6 hr ago and a HR of 120/min for the last 2 hours
Nurse is serving on a committee that is considering the creation of a policy that will allow nurses to insert PICC in the ICU. Consult in planning for this policy?
State Nurse Practice Act
Massive community disaster and stable clients must be discharged to prepare for new casualties.
Client with Multiple sclerosis
Charge nurse is planning assignments, which should be assigned to the LPN?
Provide enteral feeding to a client who has Crohn’s disease
Information on health care law to a group of newly licensed nurses.
The Patient Self Determination act
Assessing a client who is post op and has a PCA. Client is restless, has an elevated pulse, and decreased BP.
Modified Trendelenburg
New nurse learning about incidence reports
I should complete an incident report for an unexpected client occurrence
Nurse manager is conducting an annual performance review. Best strategies
Include peer evaluations
Self appraisal
Performance checklist
Charge nurse observes that nurse’s behavior has changed over the past few weeks. Which is an indication that the nurse is working while impaired?
Isolates herself
Caring for a client who has a sealed radiation therapy implant. Precaution to take?
When wearing the lead apron, avoid turning her back to the client
Client in the ED reports weakness, vomiting, diarrhea for past 3 days.
Serum potassium level
Which instruction from a nurse reflects effective communication regarding delegation of a task to an assistive personnel
Check the urinary output at 1100 for John Doe and report it to me immediately
Staff nurse detects alcohol on the breath of another nurse, unsteady gait and occasionally slurred speech.
Notify charge nurse
Nurse manager is reviewing stages of conflict resolution with nursing staff
Latent conflict
Perceived conflict
Felt conflict
Manifest Conflict
Conflict aftermath
Assistive Personnel tells the charge nurse that it is unfair she has to take care of all the clients who are incontinent
I delegate tasks to personnel based on their job description
Newly licensed nurse about using electronic medical records.
My access to client records may be tracked by nurse manager
Obtaining a clients informed consent, what is nurse’s role?
Confirm voluntary signature
Client with a terminal illness voices concern about how she will care for herself following discharge
case manager will coordinate
Discharge teaching to a patinet who is scheduled to receive oxygen at home
Verify flow rate on equipment daily
Nurse talking to daughter of Alzheimer’s patient… daughter is crying
Respite Care options
Administering medication to a client with Crohn’s disease. Client is too tired.
Inform client of consequences
Observing new nurse perform a sterile dressing change.. APPROPRIATE action?
Picks up first glove by grasping folded cuff edge
Nurse manager finds an increase in urinary tract infections. action to take first?
Perform a chart review
Planning care for a client without Advanced Directives.. intervention?
Provide client with information about AD
Nurse overhears 2 nurses discussing a client’s care. Intervention to take?
Report to nurse manager
Accommodating new bariatric services
Role Model
Encourage staff
Categories: Leadership