HESI Leadership RN Samuel Merit Related

An older client who had a hernia repair 12 hours ago suddenly becomes agitated, pulls out the intravenous (IV) catheter, and staggers out into the corridor, demanding to be set free. The nurse assists the client back to bed and re-establishes the IV access. Which intervention is most important for the nurse to implement prior to leaving the client's room?

• A. Discuss with the family about placing the client in a skilled care facility.
• B. Determine if the client is manifesting other neurologic changes.
• C. Apply a restraining device to prevent the client from self injury.
• D. Request family members report when the client is left alone.

A staff nurse has been tardy for morning shift assignments for the past three days and provides no explanation for arriving late. Which approach is best for the nurse manager to use when addressing this staff member's tardiness?

• A. Offer to switch the nurse's shift assignments to afternoons or evenings.
• B. Stress the expectation that the nurse will arrive on time for all scheduled shifts.
• C. Caution the nurse that one more tardiness will result in probational employment.
• D. Have the nurse sign a copy of the hospital employee attendance policy.

The registered nurse (RN) is gathering supplies to assist a healthcare provider with a bedside thoracentesis when the emergency department (ED) nurse calls to report on a client with unstable angina who must be admitted immediately. A practical nurse (PN) and unlicensed assistive personnel (UAP) are available to the RN. How should the RN assign the necessary nursing actions?

• A. Assign the UAP to prepare the room while the PN obtains report on the new admission and the RN assists with the thoracentesis.
• B. Assign the UAP to assist with the thoracentesis while the PN goes to the ED to transport the client to the unit and the RN obtains report from the ED nurse.
• C. Assign the PN to assist with the thoracentesis while the RN obtains report and the UAP prepares the room for the new admission.
• D. Assign the PN to go to the ED to obtain report and transport the client while the UAP prepares the room and the RN assists with the thoracentesis.

The nurse-manager overhears an older female nurse complaining to a co-worker about the time being used to attend an in-service session for bioterrorism preparedness. How should the nurse-manager respond?

• A. Ask the nurse why she thinks there is no need for an in-service program about these emergencies.
• B. Encourage the nurse to share her concerns and discuss ways to prepare for such emergencies.
• C. Choose to send another nurse who is more receptive because the older nurse is not interested.
• D. Inform the older nurse that in-service is not optional and her scheduled attendance is mandatory.

A male client is admitted with difficulty breathing related to a recent diagnosis of metastatic lung cancer. He tells the nurse that he does not want to be 'hooked up to any machines'. His vital signs are heart rate 120 beats/minute, blood pressure 98/50 mm Hg, respirations 30 breaths/minute, and oxygen saturation rate is 88%. Which action should the nurse take?

• A. Obtain the client's legal records for power of attorney.
• B. Ask the palliative care team to speak with the client.
• C. Give analgesic medications as needed (PRN).
• D. Discontinue the intravenous infusion.