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Community Final Practice Questions RN VATI Leadership/Community 2019 1. A nurse at a long-term care facility discovers flames coming from a trash can in the day room. Which of the following actions should the nurse take first? a. Close the doors leading to the area of the fire. b. Activate the fire alarm to alert the fire department. c. Move the clients to an area of safety. d. Use a fire extinguisher to put out the fire. 2. A nurse is receiving change of shift report for a group of clients. Which of the following clients should the nurse assess first? a. A client who requests sumatriptan for a migraine b. A client who is postoperative and has respiratory rate of 10/min c. A client who is immobile and has a reddened coccyx d. A client who is scheduled for a sterile dressing change 3. A nurse is caring for a client who was involved in a motor vehicle crash with his partner. The client asks the nurse about his partner’s condition. Which of the following actions should the nurse take? a. Access the electronic health record (EHR) of his partner to get a status update for the client. b. Ask the nurse caring for the partner to come and speak with the client. c. Tell the client a staff member will check on the partner. d. Let the client know that he will be updated as soon as possible. 4. A nurse manager is evaluating staffing needs for a unit, including the need for overtime hours. Which of the following actions should the nurse implement first? a. Develop a written defense of the need for overtime hours to present to the administration. b. Remind staff members of the importance of avoiding overtime hours. c. Access computerized data correlating client acuity, staffing, and scheduling. d. Graph the number of overtime hours in relation to staff to support the need for more staff. 5. A nurse is assessing a client who is 4 hours postoperative following an open appendectomy. Which of the following manifestations should indicate to the nurse that the client requires a nasogastric tube with low intermittent suction? a. Decreased oxygen saturation b. Abdominal distention c. Decreased bowel sounds d. Incisional pain 6. A charge nurse is following up on a task delegated to another nurse and discovers an error that could harm the client. Which of the following actions should the charge nurse take? a. Take accountability for the nurse's mistake. b. Create an incident report and document it in the client's medical record. c. Delegate the task to another nurse. d. Implement interventions to ensure the client's safety. 7. A nurse manager suspects that a staff nurse on the night shift has a substance use disorder. Which of the following actions should the nurse manager make? a. Discuss the situation with the facility administrator. b. Document thoroughly any unusual behavior by the nurse. c. Impose a 2-week suspension with a strong recommendation for rehabilitation. d. Counsel the nurse before referring the nurse for help.

8. A nurse manager is implementing a plan to motivate unit personnel to provide quality care to clients on the unit. Which of the following leadership strategies should the nurse implement to improve client care? a. Democratic leadership b. Transactional leadership c. Laissez-faire leadership d. Authoritarian leadership 9. A charge nurse is teaching a newly licensed nurse about providing written discharge instructions for a client who is postoperative following an arthroplasty. The change nurse should identify that which of the following discharge instructions written by the newly licensed nurse indicates an understanding of the teaching? a. Take oxycodone 10 mg, q6h, PRN, for pain. b. Report pus-like drainage from the wound. c. Resume Na-restricted diet. d. Perform quadriceps setting exercises when supine. 10. A nurse manager on a maternal newborn unit is completing a chart audit on discharge clients to evaluate the success of breastfeeding education by a lactation consultant. Which of the following type of audits is the nurse manager utilizing? a. Structure audit b. Outcome audit c. Concurrent audit d. Prospective audit 11. A nurse is developing a plan of care for a client who has chronic kidney disease. The client gives the nurse copies of his advance directives which state that he does not want to begin dialysis. Which of the following actions should the nurse include in the plan? a. Document within the medical record that the client has advance directives in place. b. Place a do-not-resuscitate (DNR) bracelet on the client. c. Ask the client to sign an Against Medical Advice form. d. Ensure the client's family is aware of the treatment decisions within the advance directives. 12. A nurse manager is providing disciplinary action for a staff nurse who is claiming 1 hour of overtime every day for the past month to complete documentation. Which of the following actions should the nurse manager take first? a. Suspend the nurse. b. Prepare a written reprimand of the nurse. c. Terminate the nurse's employment. d. Speak with the nurse regarding the incident. 13. A nurse in an acute care facility is caring for a client who is leaving against medical advice (AMA). Which of the following actions should the nurse take? (Select all that apply.) a. Attempt to detain the client. b. Request the client sign an AMA form. c. Notify the provider of client's intent. d. Sedate the client while waiting for the provider to arrive. e. Advise the client about the dangers of leaving. 14. A nurse manager is planning the staff’s annual performance appraisals. Which of the following locations should the nurse manager choose to conduct the appraisals? a. A private office with the door closed

b. Near the nurses' station to be accessible to staff c. A quiet location with a witness present d. In a conference room sitting behind a large desk 15. A nurse is planning care after receiving report for four clients. Which of the following clients should the nurse plan to assess first? a. A client who has a BP of 118/74 mm Hg and is receiving treatment for hypertension b. A client who has diabetes mellitus and a fasting blood glucose of 96 mg/dL c. A client who is 2 days postoperative and has a urinary output of 500 mL/24 hr d. A client who has a heart rate of 68/min and is receiving IV fluids 16. A charge nurse in an acute care facility is teaching a newly licensed nurse about caring for an adult client who is cognitively impaired. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? a. "I will let the client sit at the nurses' station during the day." b. "I will assign the client to a room close to the nurses' station." c. "I will elevate full-length bed rails while the client is in bed." d. "I will place a red wrist band on the client to indicate fall risk." 17. A nurse is developing a plan of care for a client who is immobile and at risk for developing a pressure injury. Which of the following interventions should the nurse include in the plan?

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a. Apply moisturizing lotion to the client's skin after bathing. b. Massage the client's bony prominences twice per shift. c. Maintain the head of the client's bed at a 45° angle. d. Place the client in contact isolation. A nurse manager is considering changing the policy for administering medications to the clients on a unit. Which of the following actions should the nurse manager take first? a. Recognize individual efforts during the change process. b. Develop strategies to enhance acceptance of changes. c. Create a task force to implement needed changes. d. Determine the unit staff's perception of the need for change. A nurse is planning care for a client who has hemiparesis and dysphagia following a stroke. The nurse should collaborate with which of the following members of the interprofessional team to assist the client with managing ADLs? (Select all that apply.) a. Occupational therapist b. Physical therapist c. Audiologist d. Respiratory therapist e. Speech-language pathologist A nurse is planning interdisciplinary care for a client experiencing an exacerbation of myasthenia gravis. Which of the following information should the nurse plan to communicate to the occupational therapist? a. The client requests help finding a support group. b. The client has difficulty grasping eating utensils. c. The client is experiencing dysarthria. d. The client has been too weak to ambulate since admission. A nurse manager is anticipating a period when staffing will be especially short. The nurse manager decides to reorganize the delivery of care on the unit until staffing improves by appointing a charge nurse, a medication nurse, and a treatment nurse. Which of the following delivery systems is the nurse manager using?

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a. Primary nursing b. Team nursing c. Functional nursing d. Modular nursing A nurse manager is meeting with a staff nurse who is consistently late for work. Which of the following statements by the nurse manager demonstrates an assertive communication style? a. "When you come to work late, I am concerned that client care will be jeopardized." b. "If you're late one more time I'm going to fire you." c. "No one here likes it when you are late for work and it makes the other staff unhappy. Try to get here on time." d. "You disappoint me when you come in late." A nurse in an ED is assessing an adult client from a long-term care facility who has a developmental disability. The nurse observes bruising in various stages of healing. The client denies any abuse and tells the nurse not to report the findings. Which of the following actions should the nurse take? a. Respect the client's wishes. b. Document the findings for the provider. c. Share the findings with a close family member of the client. d. Report the suspected abuse to the client's long-term care facility. A nurse is caring for a client who received pain medication 1 hour ago. The client tells the nurse the medication is not working because they are still experiencing pain. Which of the following actions by the nurse demonstrates client advocacy? a. Provide the client with a back massage to help ease their pain. b. Recommend the client watch television as a distraction from the pain. c. Attempt to obtain a prescription for a different analgesic medication. d. Inform the client that they can receive their next dose in 3 hr. A nurse in a long-term care facility is caring for a group of clients. The nurse should prioritize which of the following clients for an interdisciplinary care conference? a. A client admitted 48 hr ago who has anorexia and a BMI of 23 b. A client who has COPD and an oxygen saturation of 92% c. A client who is 1 week postoperative following a hip fracture d. A client who has decreased mobility and reports constipation A nurse is performing morning rounds for a client and finds the client’s bedtime medications at the bedside in a medication cup. Which of the following actions should the nurse take? a. Contact the charge nurse to complete an incident report. b. Document the missed medication administration in the client's medical record. c. Request that the nurse who prepared the bedtime medications complete a report. d. Place a copy of an incident report in the client's medical record. A nurse is prioritizing care for four clients. Which of the following clients is the nurse’s priority? a. A client who is postoperative following a thyroidectomy and reports tingling around their mouth. b. A client who is postoperative following a total hip arthroplasty and reports a pain level of 6 on a pain scale of 0 to 10. c. A client who is postoperative following a stapedectomy and reports vertigo. d. A client who is postoperative following esophageal dilation and has green drainage from a nasogastric tube.

28. A nurse is providing teaching for a client about advance directives. Which of the following client statements indicates an understanding of the teaching? a. "I need to choose a family member to be my health care proxy." b. "My family member or a friend will use my living will for health care decisions when I am ill." c. "I am unable to change my living will after I have signed it." d. "My health care proxy will make my health care decisions when I am no longer able." 29. A nurse manager is scheduling a meeting to address a conflict between staff members and a client’s family. In the meeting, staff and family members will identify common goals and express their concerns. Which of the following conflict resolution strategies is the nurse manager implementing? a. Competition b. Collaboration c. Accommodation d. Smoothing 30. A nurse supervisor in an acute care facility has to recommend a client for discharge to make room for a client who was injured during an explosion. Which of the following clients should the nurse recommend for discharge? a. A young adult client who has a new diagnosis of diabetes insipidus b. An adult client who is on telemetry for dysrhythmias c. An older adult client who had a total knee arthroplasty 1 week ago d. An adult client who had a bowel resection 1 day ago 31. A nurse is providing care to a group of clients. Which of the following steps should the nurse plan to take to manage time effectively? (Select all that apply.) a. Document completed nursing interventions at the end of the day. b. Complete small tasks first that require the least amount of time and energy. c. Organize tasks around the priority needs of the clients. d. Create a list of all planned activities. e. Delegate tasks to assistive personnel. 32. A nurse is providing discharge teaching to a client’s adult child regarding the client’s discharge to home with hospice care. Which of the following statements by the client’s adult child indicates an understanding of the teaching? a. "Once my father is home with hospice, he can no longer be admitted to the hospital." b. "I understand that hospice services are out-of-pocket expenses for the family." c. "Participating in a hospice program should enable my father to live longer." d. "The hospice team will provide services for the entire family, not just my father." 33. A nurse is delegating client care on a labor and delivery unit. Which of the following tasks should the nurse delegate to assistive personnel (AP)? a. Instruct a client about breathing techniques. b. Complete I&O on clients who are in active labor. c. Obtain a fetal heart rate from a client who is a primipara and is in early labor. d. Obtain consent from a client for cesarean birth. 34. A nurse is preparing a client for a surgical procedure to continue the revision of a large burn scar on the left arm. The client tells the nurse that they want to cancel the procedure. Which of the following responses should the nurse take? a. "This procedure will improve the appearance of your arm." b. "Why have you changed your mind about this procedure?" c. "I will inform the provider of your decision."

d. "Don't worry, this is a routine procedure." 35. A nurse in an ED is admitting a 15-year-old client who is accompanied by her grandparent. The client requires an open reduction and internal fixation of several fractures. The nurse confirms that the client’s parents are out of the country. Which of the following actions should the nurse take? a. Inform the provider to ask the grandparent to provide consent. b. Obtain consent from the client. c. Find out whether the client has a health care proxy. d. Proceed with the surgery via implied consent. 36. A nurse manager is preparing a nurse’s performance appraisal. Which of the following actions should the nurse manager take? a. Avoid using specific examples of client care to maintain confidentiality. b. Focus on the nurse's most recent performance just before the evaluation. c. Present goals to the nurse at the initial meeting. d. Use a formalized system to discuss important issues. 37. A nurse is teaching a newly licensed nurse about do-not-resuscitate (DNR) orders. Which of the following information should the nurse include in the teaching? a. The provider decides whether a client should have a DNR order. b. The provider will discontinue the client's medications after writing a DNR order. c. The client will need to sign an informed consent form for CPR if they do not have a DNR order. d. The provider should periodically evaluate the DNR order. 38. A nurse manager calls a staff nurse to come in and work due to staffing shortages on several units. The staff nurse is at home and has influenza. Which of the following actions by the staff nurse demonstrates the ethical principle of nonmaleficence? a. Report to work as requested. b. Agree to work only until the supervisor can find a replacement. c. State that staff nurses do not have an obligation to work on days off. d. Decline because nurses should not work when ill. 39. A nurse is using the SBAR communication tool for reporting a client’s condition to the provider. Which of the following information should the nurse include in the “S” portion of the tool? a. The client was medicated with morphine 2 mg IV 1 hr ago. b. The client needs a change in pain medication prescription. c. The client is reporting a pain level of 8 on a scale from 0 to 10. d. The client has a heart rate of 110/min and a BP of 148/88 mm Hg. 40. A nurse manager is changing the ratio of registered nurses (RNs) to licensed practical nurses (LPNs) on a unit to decrease costs. Which of the following strategies should the nurse implement to reduce resistance from the staff? a. Send a memo to each staff member announcing the new RN/LPN ratio. b. Assign the staff to read research articles about the process of change. c. Formulate a sample staffing schedule covering 1 month. d. Discuss the planned change with other nurse managers. 41. A nurse is teaching a group of newly licensed nurses about caring for a client who has Clostridium difficile. Which of the following instructions should the nurse include in the teaching? a. Wear a surgical mask when caring for the client. b. Use chlorhexidine for hand hygiene after providing care for the client.

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c. Assign the client to a positive airflow room. d. Put on a gown when caring for the client. A nurse is admitting a client who has heart failure and speaks a different language than the nurse. Which of the following actions should the nurse take when communicating with the client using an interpreter a. Enhance understanding by using metaphors. b. Observe the client's nonverbal expressions. c. Address the interpreter when asking questions. d. Speak words clearly by increasing vocal volume. A charge nurse is walking outside on the facility’s grounds during break time and overhears two nurses discussing the biopsy results of a client who is on the unit. Which of the following actions should the nurse take? (Select all that apply.) a. Tell the nurses to lower their voices when discussing a client. b. Plan an in-service program for the nurses about HIPAA privacy rules. c. Ask the nurses to stop discussing the client's protected health information. d. Inform the nurse manager about the confidentiality breach. e. Complete an incident report about the nurses' breach of confidentiality. A nurse suspects a client is developing opioid use disorder and reduces the client’s dosage of pain medication by 50% without a prescription from a provider. The nurse checks on the client 1 hour later and sees the client sitting up in a chair. The client tells the nurse, “I am in so much pain to reach the nurse call button.” The nurse is liable for which of the following legal violations? a. Gross negligence b. Libel c. Battery d. False imprisonment A nurse from an acute pediatric unit who has not cared for adult clients in more than 5 years is assigned to float to a medical-surgical unit. Which of the following actions should the nurse take? a. Attend a formal orientation training program before reassignment. b. Negotiate specific tasks to perform with the nursing supervisor. c. Ask a coworker to take their place. d. Refuse to accept the assignment to float. A nurse is caring for a client when they erroneously administer a medication dosage...