Leadership

A nurse is helping an NAP provide a bed bath to a comatose patient who is incontinent. Which of the following actions requires the nurse to intervene?

• The nursing assistant answers the phone while wearing gloves.

• The nursing assistant log‐rolls the client to provide back care.

• The nursing assistant places an incontinent diaper under the client.

• The nursing assistant positions the client on the left side, head elevated.

A nurse is caring for a patient who has chronic obstructive pulmonary disease (COPD) and is 2 days postoperative after a laparoscopic cholecystectomy. Which intervention for airway management should the nurse delegate to the NAP?

• Assisting the patient to sit up on the side of the bed

• Instructing the patient to cough effectively

• Teaching the patient to use incentive spirometry

• Auscultating breath sounds every 4 hours

A nurse is assigned to care for the following patients. Which patient should the nurse assess first?

• A 60‐year‐old patient on a ventilator for whom a sterile sputum specimen must be sent to the

  laboratory

• A 55‐year‐old with COPD and a pulse oximetry reading from the previous shift of 90% saturation

• A 70‐year‐old with pneumonia who needs to be started on intravenous (IV) antibiotics

• A 50‐year‐old with asthma who complains of shortness of breath after using a bronchodilator.

Jane is a new nurse manager who will be holding her first staff meeting tomorrow. She has learned that the staff have not been following important patient care policies. What is the most important communication skill that she should use at the meeting?

• Talking to the staff

• Laughing with the staff

• Listening

• Crying

As Jane speaks with the team, she learns why the staff have had difficulty following policies. Which of these would be considered barriers to effective communication?

• The charge nurse is unavailable to help the nurses when they have questions about policies.

• Some staff are afraid to ask particular charge nurses for help for fear of retribution.

• The use of acronyms is confusing to staff who are new to the unit.

• All of the above.

Bedside shift report is one of the things that Jane reviews at the staff meeting. She stresses the way she would prefer the report to start. Which of these would be the least important to share with the oncoming nurse?

• Telling the oncoming nurse what happened on the unit during the shift

• Introducing the client and his diagnosis to the oncoming nurse

• Sharing the nurse’s personal opinion of the client

• Reviewing new medication orders and the medication administration record (MAR)

The Joint Commission attributes 80% of all medical errors to:

• Poor hygiene and handwashing

• Poor handoff communication

• Poor work environment

• Lack of care

The patient with COPD has a nursing diagnosis of Ineffective Breathing Pattern. Which is an appropriate action to delegate to the experienced LPN under your supervision?

• Observe how well the patient performs pursed‐lip breathing

• Plan a nursing care regimen that gradually increases activity intolerance

• Assist the patient with basic activities of daily living

• Consult with the physical therapy department about reconditioning exercises

An RN is supervising a team consisting of an LPN and a NAP. Which of the following patients should the RN see first?

• A patient on an insulin drip requiring hourly blood glucose checks

• A terminally ill cancer patient complaining of pain radiating throughout the abdomen

• A patient diagnosed with chronic obstructive pulmonary disease (COPD) who has become confused

• A patient with a serum potassium of 4.0

A nurse is caring for a patient diagnosed with acute exacerbation of COPD. Which of the following is the RN’s priority assessment?

• Breath sounds

• Pedal pulses

• Location and intensity of pain

• Cardiac rate and rhythm