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    Exam Review

    1. A charge nurse is working on a medical-surgical unit. For which of the following nurses' actions should the charge nurse recognize the need to intervene for breach of confidentiality? Select all that apply.
      (SATA)
      A)
      Nurse 3
      B)
      Nurse 2
      C)
      Nurse 1
      D)
      Nurse 5
      E)
      Nurse 4
    2. A nurse manager discovers there is a conflict between nurses working the day shift and nurses working the night shift. Which of the following actions should the nurse manager take first?
      A)
      Meet with a committee of nurses from each shift to discuss issues related to the conflict.
      B)
      Gather information regarding the situation.
      C)
      Acknowledge the conflict and encourage the nurses to focus on working as a team.
      D)
      Encourage the nurses to resolve the conflict autonomously.
    3. A nurse is teaching an in-service about the safe use of equipment to a newly licensed nurse. Which of the following statements made by the newly licensed nurse indicates an understanding of the teaching?
      A)
      "I should grasp the cord when unplugging equipment."
      B)
      "I should make sure oxygen cylinders are placed in an upright position.
      C)
      "it is ok to clean equipment while it is plugged into the wall.
      D)
      "When using a fire extinguisher, squeeze the handle and pull the pin."
    4. A nurse enters a client's room and notices a small fire in the client's garbage can. After removing the client from the room, which of the following actions should the nurse take next?
      A)
      Use a fire extinguisher to put out the fire.
      B)
      Close the door to the client's room.
      C)
      Pull the fire alarm in the hallway.
      D)
      Ensure all of the windows are closed.
    Page 1 of 18

    Exam Review

    1. A nurse manager is developing a quality improvement project. The nurse manager should recognize that which of the following tools should be used to measure outcomes?
      A)
      Clinical indicators
      B)
      Cause-and-effect diagrams
      C)
      SBAR Communication tool
      D)
      Flowcharts
    2. A nurse overhears two staff members talking in the cafeteria about a client's scheduled surgery. Which of the following actions should the nurse take?
      A)
      Discuss the incident with another staff nurse.
      B)
      Report the staff members' actions to the state board of nursing
      C)
      Counsel the staff members about the breach of confidentiality.
      D)
      File a grievance report about the breach of confidentiality.
    3. A staff development nurse is giving an in-service presentation about advocacy in nursing. Which of the following statements by a nurse indicates an understanding of the role of a client advocate?
      A)
      "In the role of client advocate, I should take responsibility for coordinating each client's care."
      B)
      "My role as a client advocate is to empower the clients to make informed health care decisions."
      C)
      "As a client advocate, I will suggest the best course of action for clients who are indecisive.
      D)
      "As a client advocate, I will adhere to the provider's prescribed treatments.
    4. A nurse is teaching a newly licensed nurse about implementing droplet precautions for a client who has influenza. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?
      A)
      "I will assign the client to a room with positive airflow."
      B)
      "I will wear a surgical mask within 3 feet of the client."
      C)
      "I will wear an N95 respirator when providing care for the client."
      D)
      "I will check that the room has a high-efficiency particulate air filtration system."
    Page 2 of 18

    Exam Review

    1. A charge nurse is evaluating a newly licensed nurse's understanding of infection control procedures. Which of the following actions demonstrates that the nurse is following the appropriate protocol for a client who has streptococcal pharyngitis?
      A)
      Explaining to the client that he cannot have visitors until his manifestations resolve
      B)
      Wearing a mask when within 1 m (3.3 ft) of the client
      C)
      Donning sterile gloves when performing routine oral care
      D)
      Placing the client in a positive airflow room with 12 air exchanges per hour
    2. A nurse on a medical-surgical unit is making staff assignments. Which of the following tasks should the nurse delegate to an assistive personnel?
      A)
      Pouching a client's established ostomy
      B)
      Demonstrating the use of an incentive spirometer to a client
      C)
      Reinforcing teaching with a client about a low-sodium diet
      D)
      Updating a family member about a client's condition
    3. A charge nurse is planning to evacuate clients on the unit because there is a fire on another floor. Which of the following clients should the nurse evacuate first?
      A)
      A client who is receiving IV chemotherapy and is ambulatory
      B)
      A client who is in Buck's traction for a left hip fracture
      C)
      A client who is 1 day postoperative following thoracic surgery and has a chest tube
      D)
      A client who is confused and restrained for safety
    4. A nurse is speaking with a client about client confidentiality. Which of the following statements about HIPAA should the nurse include in the teaching?
      A)
      "it ensures that clients are fully informed about treatment options."
      B)
      "it allows client information to be shared with their loved ones."
      C)
      "HIPAA rules and penalties vary from state to state."
      D)
      "HIPAA allows consulting providers to share confidential client information."
    Page 3 of 18

    Exam Review

    1. A charge nurse is assessing the room of a newly admitted client who has dysphagia. Which of the following pieces of equipment should the nurse ensure is available in the client's room?
      A)
      Large-handled utensils
      B)
      Bite block
      C)
      Yankauer suction device
      D)
      Nasal cannula and oxygen
    2. A nurse is caring for a client who has early-stage Alzheimer's disease. In which of the following actions is the nurse acting as a client advocate?
      A)
      Reorienting the client several times throughout the day
      B)
      Performing an updated cognitive assessment on the client
      C)
      Requesting a referral for the client to attend reminiscent therapy sessions
      D)
      Providing assistance for the client when ambulating down the hall
    3. A nurse is caring for a client who is scheduled for a hysterectomy and has signed the informed consent form. The client tells the nurse she is unsure about having the procedure. Which of the following responses should the nurse make?
      A)
      "Let me provide you with resources you can read about the surgery."
      B)
      "You should not have signed the consent form if you have reservations about the surgery."
      C)
      "I will contact the provider and request medication to help you relax."
      D)
      "If you have any concerns about the procedure, the surgery can be canceled."
    4. A nurse is caring for a client who has a prescription for intravenous therapy. The nurse has not performed venipuncture before. Which of the following actions should the nurse take?
      A)
      Attempt the venipuncture up to the
      B)
      Ask the charge nurse to assist with the procedure.
      C)
      Notify the provider about their inability to complete the task.
      D)
      Obtain written consent to attempt the venipuncture.
    Page 4 of 18

    Exam Review

    1. A nurse is performing triage at the site of a mass casualty. For which of the following clients should the nurse assign a yellow tag?
      A)
      The client who is experiencing chest pain with radiation to the arm
      B)
      The client who has a deep laceration to the leg
      C)
      The client who has a large bruise to the shoulder
      D)
      The client who is unable to breathe without manual ventilation
    2. A nurse is assessing a client who has heart failure two months after the implementation of a quality improvement initiative to reduce the hospital readmission rate. Which of the following findings should the nurse identify as an indication the quality improvement initiative is successful?
      A)
      Presence of jugular vein distention
      B)
      Development of 53 heart sounds
      C)
      Decreased brain natriuretic peptide levels
      D)
      Increased weight of 2.27 kg (5 lb) in one week
    3. A nurse manager is attending a meeting about the cost of health care. Which of the following measures should the nurse implement to reduce the cost of treatment in the acute care setting?
      A)
      Reserve budgetary planning for senior management.
      B)
      Encourage staff to participate in quality improvement projects.
      C)
      Staff an additional assistive personnel each shift.
      D)
      Plan budget needs based on average client stay over 6 months.
    4. A nurse is preparing to discharge a client who requires home oxygen. The equipment company has not yet delivered the oxygen tank. Which of the following actions should the nurse take?
      A)
      Instruct the client’s family to contact the insurance provider about the oxygen equipment
      B)
      Send an oxygen tank from the facility home with the client
      C)
      Contact social services about the delivery of the oxygen equipment
      D)
      Notify the provider about the delayed oxygen tank delivery
    Page 5 of 18

    Exam Review

    1. A nurse has received change-of-shift report for a group of clients. Which of the following clients should the nurse see first?
      A)
      A client who is scheduled for surgery and is having second thoughts after signing an informed consent
      B)
      A newly admitted client who has type 2 diabetes mellitus and is refusing to eat their dinner
      C)
      A client who is 1 day postoperative and has an increasing amount of serosanguineous drainage on the dressing
      D)
      A client who has pneumonia, reports shortness of breath, and has an oxygen saturation of 88%
    2. A nurse is caring for a client who has just returned to the unit from the PACU, Which of the following tasks should the nurse assign to the assistive personnel?
      A)
      Assist the nurse to transfer the client to the bed.
      B)
      Check the client's dressing for bleeding.
      C)
      Obtain the client's vital signs.
      D)
      Ask the client if he requires pain medication.
    3. A nurse on a medical-surgical unit is observing an assistive personnel (AP) provide care for a group of clients. Which of the following actions by the rag AP requires intervention by the nurse?
      A)
      Ambulates a client who is 2 days postoperative following a total hip arthroplasty
      B)
      Performs a simple dressing change on a client's foot wound
      C)
      Measures the urinary output of a client who has an indwelling urinary catheter
      D)
      Evaluates the effectiveness of the client's pain medication
    4. A charge nurse is discussing incident reports with a newly licensed nurse. Which of the following situations should the nurse identify as requiring an incident report?
      A)
      A client throws a box of tissues at a nurse.
      B)
      A visitor pinches his finger in the client's bed frame.
      C)
      A nurse administers a medication 30 min after the scheduled time.
      D)
      A client refuses to attend physical therapy.
    Page 6 of 18