Leadership and Management NCLEX Questions
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Question 1 of 5.
The nurse in the emergency department (ED) is caring for a client and establishes continuous cardiac monitoring. Which initial action should the nurse take based on the electrocardiogram tracing? See the exhibit for additional client information.
A. Establish vascular access and request a prescription for atropine
B. Assess the client's blood pressure and level of consciousness
C. Obtain and review the client's current medications
D. Document the findings and reassess the client in one hour
Explanation: Sinus bradycardia can be benign or symptomatic. The priority is to determine whether the client is hemodynamically stable by assessing blood pressure (BP) and level of consciousness (LOC). If the client is symptomatic (e.g., hypotension, dizziness, altered mental status), further interventions such as atropine administration may be required.
Question 2 of 5.
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
Explanation: 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
Question 3 of 5.
The nurse is caring for a client taking prescribed captopril. Which abnormal laboratory value should the nurse prioritize when notifying the healthcare provider?
A. Serum creatinine 1.3 mg/dL (114.92 μmol/L) [Male: 0.6-1.2 mg/dL, Female: 0.5-1.1 mg/dL, Male 49-93 μmol/L, Female 22-75 μmol/L]
B. Serum potassium 5.2 mEq/L (mmol/L) [3.5-5 mEq/L (mmol/L)]
C. Serum phosphorus 4.6 (1.48 mmol/L) [2.5-4.5 mg/dL, 0.81-1.58 mmol/L]
D. Blood glucose 135 mg/dL (7.5 mmol/L) [70-110 mg/dL, 4-6 mmol/L]
Explanation: Hyperkalemia (potassium 5.2 mEq/L, B) is a priority with captopril, an ACE inhibitor, as it can cause life-threatening arrhythmias. Creatinine (A) and phosphorus (C) are slightly elevated but less urgent. Glucose (D) is elevated but not critical in this context.
Question 4 of 5.
The charge nurse is orientating a newly hired nurse to the charge nurse role. Which observation by the charge nurse requires follow-up? The newly hired nurse Select all that apply.
A. requests the unlicensed assistive personnel (UAP) transport a client with respiratory distress to radiology.
B. asks the licensed practical/vocational nurse (LPN/VN) to witness informed consent for a client scheduled for surgery.
C. instructs the licensed practical/vocational nurse (LPN/VN) to review orders just written by the physician.
D. assks the unlicensed assistive personnel (UAP) to transport blood specimens to the lab.
E. assigns a client immediately postoperative from cardiac catheterization to a licensed practical/vocational nurse (LPN/VN).
Explanation: Transporting a client with respiratory distress (A) by a UAP is unsafe, as they require monitoring. An LPN witnessing consent (B) is outside their scope; RNs or providers typically do this. Reviewing orders (C), transporting specimens (D), and assigning a stable post-catheterization client (E) are appropriate.
Question 5 of 5.
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
Explanation: 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.