Management of Care

Question 1

A charge nurse has a unit with four clients needing care. Which client should be assessed first?

Accepted Answer

A client with chest pain radiating to the left arm who is diaphoretic

Answer

A client with stable COPD requesting assistance to ambulate to the bathroom

Answer

A postoperative client who reports incisional pain of 4 out of 10

Answer

A client awaiting discharge instructions after an appendectomy yesterday

Question 2

A registered nurse (RN) is delegating tasks to a licensed practical nurse (LPN) and an unlicensed assistive personnel (UAP). Which task is most appropriate to delegate to the UAP?

Accepted Answer

Measure and record vital signs for a client 4 hours post-surgery

Answer

Administer oral medications to a stable post-surgical client

Answer

Perform a focused assessment on a newly admitted client

Answer

Teach a diabetic client about insulin self-injection technique

Question 3

A nurse suspects that a colleague is diverting controlled substances. The nurse's most appropriate first action is to:

Accepted Answer

Report the suspicion to the nurse manager or through the facility's chain of command

Answer

Confront the colleague directly and ask for an explanation

Answer

Monitor the situation for several more weeks before taking action

Answer

Ask other staff members if they have noticed anything unusual

Question 4

A client with terminal cancer has a valid do-not-resuscitate (DNR) order. The client's adult child insists the nurse 'do everything possible' if the client stops breathing. The nurse should:

Accepted Answer

Honor the client's DNR order and explain it reflects the client's own wishes

Answer

Follow the family's wishes, as they are the client's next of kin

Answer

Initiate CPR to avoid conflict with the family

Answer

Contact the physician to rescind the DNR order based on family request

Question 5

A nurse is completing an incident report after a client received the wrong dose of a medication. The report should include:

Accepted Answer

Objective facts: what happened, when, who was involved, and what actions were taken

Answer

The nurse's personal opinion about why the error occurred

Answer

Speculation about which staff member was primarily responsible

Answer

The incident report number documented in the client's medical record

Question 6

A nurse manager notices that several nurses on the unit consistently bypass the two-patient identifier protocol before administering medications. The most effective management intervention is to:

Accepted Answer

Conduct a staff education session and implement unit-level audits to monitor compliance

Answer

Write up each nurse individually and place the documentation in their personnel files

Answer

Post a reminder memo on the medication room door

Answer

Assign the charge nurse to watch every medication administration on the floor