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The nurse is discussing management styles with a colleague. Which of the following nursing leadership and management-related statements is accurate?
- A. Nurse managers possess personal accountability for not only their specific acts but also acts of delegation and supervision.
- B. Nurses and nurse managers are accountable for supervising others, except for unlicensed assistive personnel (UAP).
- C. When delegated to the appropriate person, the delegating nurse is no longer responsible for ensuring the task is performed correctly.
- D. Managing care entails micromanagement of the unit's staff.
Correct Answer: A
Rationale: Nurse managers are accountable for their actions and delegated tasks, including supervision (A), per nursing standards. UAPs are included in supervision (B), delegators remain responsible (C), and micromanagement (D) is ineffective, not a management goal.
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The nurse is discussing advance care planning with a client and emphasizes the importance of a Medical Power of Attorney (POA). The nurse explains that a Medical POA allows the client to do which of the following?
- A. Designate a family member to make financial decisions on their behalf.
- B. Specify funeral arrangements and preferences for end-of-life care.
- C. Appoint a trusted individual to make healthcare decisions in case of incapacity.
- D. Choose the primary physician for ongoing medical care.
Correct Answer: C
Rationale: A Medical Power of Attorney (C) allows the client to appoint someone to make healthcare decisions if incapacitated. Financial decisions (A), funeral arrangements (B), and physician selection (D) are not covered by a medical POA.
The registered nurse (RN) is observing licensed practical/vocational nurses (LPN/VN) care for assigned clients. Which of the following actions by the LPN would require the RN to intervene? Select all that apply.
- A. Positions an unconscious client semi-Fowlers for oral care
- B. Administers a bronchodilator to a client with chronic asthma
- C. Irrigates an indwelling urinary catheter with 30 ml of sterile saline
- D. Removes and reapplies weight to a client's skin traction every two hours
- E. Administers intramuscular (IM) ketorolac to a client with osteoarthritis
Correct Answer: A
Rationale: Positioning an unconscious client in semi-Fowler’s for oral care (A) risks aspiration, requiring intervention. Bronchodilator (B), catheter irrigation (C), traction adjustment (D), and ketorolac administration (E) are within LPN scope if per protocol.
The nurse cares for an infant undergoing a surgical repair of a total anomalous pulmonary venous return tomorrow. The doctor has talked to the parents and obtained consent. The mother tells the nurse, 'I'm not so sure about this. What if my baby dies?' The nurse's most appropriate response is:
- A. Explain the procedure to the mother.
- B. Notify the surgical team and have them come back to speak with the mother again.
- C. Reassure the mother that everything will go as planned.
- D. Tell the mother that because she has already signed the consent, she cannot change her mind now.
Correct Answer: B
Rationale: Notifying the surgical team (B) ensures the mother’s concerns are addressed by the provider, respecting her need for clarification. Explaining the procedure (A) is the physician’s role, false reassurance (C) is inappropriate, and stating consent is irrevocable (D) is incorrect and dismissive.
The nurse has received the following prescriptions for newly admitted clients. Which prescription should the nurse administer first?
- A. Aspirin to a client experiencing an acute myocardial infarction
- B. Lisinopril to a client with essential hypertension
- C. Risperidone to a client with schizophrenia
- D. Levodopa-carbidopa to a client with Parkinson's disease
Correct Answer: A
Rationale: Aspirin for acute myocardial infarction (A) is the priority to reduce thrombus formation and mortality, per ACS guidelines. Lisinopril (B), risperidone (C), and levodopa-carbidopa (D) address chronic conditions and are less urgent.
The nurse manager is completing an annual performance evaluation of a staff nurse. Which elements should the nurse manager include when completing the evaluation? Select all that apply.
- A. The nurses’ bar-code medication administration scan rate
- B. The number of times the nurse has been absent or tardy
- C. The nurse achieving a national certification
- D. The nurses’ performance compared to other staff nurses
- E. The number of medication errors the nurse has self-reported.
Correct Answer: A, B, C, E
Rationale: Bar-code scan rate (A), absences/tardiness (B), national certification (C), and self-reported errors (E) are objective metrics for evaluation. Comparing to other nurses (D) is subjective and biased, inappropriate for inclusion.