Leadership and Management NCLEX Questions

Leadership and Management NCLEX Questions Related

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The charge nurse is reviewing assignments on the nursing unit for the upcoming shift. Which room assignment should be changed based on the nurse assigned? See the exhibit. Select all that apply.

  • A. Room 1
  • B. Room 2
  • C. Room 3
  • D. Room 4
  • E. Room 5
  • F. Room 6
  • G. Room 7
Correct Answer: B,E,F

Rationale: the client with angina and ST-segment changes should be assigned to the RN because of this client's clinical unpredictability. Angina accompanied by ST-segment changes is a worrisome sign of acute coronary syndrome. This assignment needs to be modified so it is assigned to an RN.

Choice E is correct. The client with ARDS requires a high level of care. ARDS is a potentially fatal condition that may require mechanical ventilation. This assignment needs to be modified so it is assigned to an RN.

Choice F is correct. The client with a pulmonary embolism receiving a continuous infusion of heparin should be assigned to the RN. A pulmonary embolism has a degree of unpredictability in its course, and a continuous infusion of heparin will be titrated based on the client's activated partial thromboplastin time (aPTT). Titration of infusions is within the scope of an RN. This assignment needs to be modified so it is assigned to an RN.t

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The nurse is developing a staff in-service on negligence. A participant demonstrates correct understanding by identifying which elements must be met in a negligence lawsuit? Select all that apply.

  • A. Duty owed
  • B. Breach of duty owed
  • C. Causation
  • D. Harm or damages
  • E. Beneficence
Correct Answer: A, B, C, D

Rationale: Negligence requires duty owed (A), breach of duty (B), causation (C), and harm or damages (D). Beneficence (E) is an ethical principle, not a legal element of negligence.

The nurse is triaging phone calls at the mental health clinic. Which client situation requires immediate follow-up? A client prescribed

  • A. olanzapine reporting muscle stiffness and feeling hot.
  • B. haloperidol reporting blurred vision and constipation.
  • C. clozapine reporting occasional twitches of the mouth.
  • D. aripiprazole reporting feeling very restless.
Correct Answer: A

Rationale: Muscle stiffness and feeling hot with olanzapine (A) suggest neuroleptic malignant syndrome, a life-threatening emergency requiring immediate follow-up. Blurred vision/constipation (B), mouth twitches (C), and restlessness (D) are less urgent side effects.

The nurse is performing an assessment on a client with pneumonia. The nurse should prioritize assessing the client's

  • A. temperature.
  • B. oral intake.
  • C. lung sounds.
  • D. white blood cell count.
Correct Answer: C

Rationale: Lung sounds (C) are the priority in pneumonia to assess for consolidation or respiratory compromise, guiding immediate interventions. Temperature (A), intake (B), and WBC count (D) are important but secondary, as they inform longer-term management.

The nurse is caring for a client with congestive heart failure. Using the ISBAR format, Select the text that expresses the nurses' recommendation to the physician.

  • A. Client reported a cough and shortness of breath while resting.
  • B. The onset of symptoms was sudden and not relieved, with the client being positioned with the head of the bed at 90 degrees.
  • C. Vital signs were obtained: 156/98; P 108; RR 26/minute; Oxygen saturation 91% on room air.
  • D. Lung sounds had crackles in all fields.
  • E. A rapid response was called because of the unstable vital signs.
  • F. Dr. Thomas Smith was notified to obtain diuretics and critical care monitoring orders.
Correct Answer: B,F

Rationale: Notifying Dr. Smith for diuretics and critical care monitoring (F) is the recommendation in the ISBAR format, proposing specific actions for the physician to address the client’s worsening heart failure. Other options provide situation (A, B), background (C, D), or assessment (E) details.

The nurse is caring for assigned clients. The nurse should initially follow up on the client who

  • A. has a basilar skull fracture and has bruises under their eyes.
  • B. had a craniotomy and has a change in the Glasgow coma scale (GCS) from 13 to 11 in the last hour.
  • C. has amyotrophic lateral sclerosis (ALS) and is requesting to have resuscitation efforts withheld.
  • D. has Guillain-Barré syndrome (GBS) and is reporting lower extremity muscle weakness.
Correct Answer: B

Rationale: A GCS drop from 13 to 11 post-craniotomy (B) indicates neurological deterioration, possibly from hematoma, requiring immediate follow-up. Bruises with skull fracture (A), ALS DNR request (C), and GBS weakness (D) are less urgent, though GBS needs monitoring.

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