Hesi Leadership Exit exam Version 2 Correct and Verified Answers Graded A

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Hesi Leadership Exit exam Version 2 Correct and Verified Answers Graded A

NCLEX/Nursing Practice Questions

• The nurse manager conducts regular audits of patient care medication records and

notices that the amount of narcotic pain medications administered during the evening shift on a postsurgical unit.• Correct Answer: Conduct a closer examination of staff nurse's distribution of pain medication from evening shift

• The nursing supervisor sends an unlicensed assistant personnel (UAP) to a medical

unit to replace an absent UAP. When delegating the task of obtaining client's blood sugar levels using a glucometer, which action is most important for the nurse to implement?• Correct Answer: Observe the UAP obtain a fingerstick glucose level using the glucometer.

• The charge nurse notices that a respiratory therapist who has been cross-trained to

work as a phlebotomist and unlicensed assistive personnel (UAP) seems to be avoiding HIV positive clients.

• Correct Answer: Provide the employee with feedback about observed behavior

• The nurse caring for a client with bacterial meningitis is preparing report for the

oncoming nurse. It is most important to include which assessment finding in the report?

• Correct Answer: Increasing Pulse Pressure

• The nurse is observing the staff provide care to a client with acquired immune

deficiency syndrome.• Correct Answer: Unlicensed assistive personnel wearing a mask to take client's blood pressure.

• A healthcare provider notifies the nurse that new prescriptions have been written

for a client. Which is the 1st action the nurse should implement?

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• Correct Answer: Read all of the new prescriptions for the client written by the provider

• A young adult client with a brain tumor refuses further treatment and requests to be

allowed to die a natural death. The healthcare provides does not agree with the client's decision and refuses to write do-not-resuscitate instructions. Which action should the nurse take?

• Correct Answer: Initiate a review of the situation by the hospital's ethics

committee.

• The nurse should assess the client with which problem first?

• Correct Answer: Paresthesia secondary to an arterial occlusion

• The nurse is admitting a woman who has an arteriovenous (AV) fistula in her right

arm that is used for hemodialysis. She missed her last hemodialysis session and is experiencing shortness of breath and an irregular heartbeat. Which action should the nurse assign to the UPA who is working with the nurse?

• Correct Answer: Measure Vital Signs

• A nurse is performing telephone triage at the clinic office. Which client has the

most acute problem and should be scheduled for the first available appointment?• Correct Answer: A 21 year old with a history of a kidney transplant. Today the client reports flu-like symptoms with a fever of 100.4 F (38 C)

• The smell of cigarette smoke is coming from a client's bathroom. Which action

should the nurse take?

• Correct Answer: Educate the client about the hospital smoking policy.

• The practical nurse (PN) reports to the charge nurse that the transparent dressing

covering a single lumen central venous catheter inserted in the subclavian vein of a client has come loose and the insertion site is inflamed. Which action should the charge nurse implement?• Correct Answer: Confirm the findings of the PN while securing the transparent dressing and notify the healthcare provider.

• At 0200 the nurse phones the healthcare provider to request a PRN medication for

a client who is unable to sleep. The healthcare provider is awakened and gives the nurse a prescription for four times the normal dosage. When questioned by the nurse, the healthcare provider responds in a sleepy manner.

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• Correct Answer: Call the healthcare provider back, and report that the dosage prescribed is four times the normal dosage.

• The charge nurse notices that a female practical nurse (PN), who has a long work

history on the unit and is a valued employee, seems tired and slow to respond verbally during the change of shift report. One hour later the charge nurse overhears the PN telling an unlicensed assistive personnel (UAP) that she took a sleeping pill 4 hours ago and she is still feeling its effects. Which action should the charge nurse take?• Correct Answer: Send the PN to the employee health center for a urine drug Screen

• It is most important to assign which client to a registered nurse rather than a

practical nurse?• Correct Answer: After ambulating, a postoperative client grimaces and reports incisional pain at a "9" on a point scale.

• After receiving a change of shift report for clients on a medical surgical unit, which

task should the nurse perform?

• Correct Answer: Apply hydrocolloid dressings to venous ulcer

• The charge nurse observes unlicensed assistive personnel (UAP) and a nurse

arguing at the nurse's station. What action is best for the charge nurse to implement?• Correct Answer: Inform both individuals that their behavior is inappropriate in a work setting

• A male client with metastatic lung cancer has requested that "no heroic measures"

are used to extend his life, so the healthcare provider prescribes transferring the client to the palliative care unit.• Correct Answer: Ensure the prescriptions or transfer include the client's end-of-life choice.

• The charge nurse observes that a client with a nasogastric tube applied to low

intermittent suction is drinking a glass of water immediately after the unlicensed assistive personnel (UAP) left the room. What is the best initial action for the charge nurse to take?

• Correct Answer: Remove the glass of water and speak to the UAP.

• The nurse hears a newly employed unlicensed assistive personnel (UAP) who is

working in a long-term care facility calling the adult residents "honey" and "dearie." What is the best action for the nurse to take?

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• Correct Answer: Meet with the UAP to discuss respectful client care strategies.

• The charge nurse is providing instructions to unlicensed assistive personnel (UAP)

who will be assisting with the care of a client who has a hiatal hernia. Which instruction should the charge provide the UPA?

• Correct Answer: Elevate the head of the bed before the client begins to eat

• A nurse (RN), practical nurse (PN), and unlicensed assistive personnel (UAP) are

working as a team to provide care for an acutely ill client requiring immediate bedside insertion of a chest tube. Which assignment is best use of each persons skills?• Correct Answer: The UAP obtains oxygen saturation level while the RN reports findings to the healthcare provider

• The nurse is caring for a group of clients with the help of an experienced

unlicensed assistive personnel UAP. Several specimens need to be collected and sent to the lab. Which specimen collection can the nurse delegate to the UAP?

• Correct Answer: Urine from indwelling catheter; Fecal drainage sample.

• The nurse observes that a practical nurse (PN) charted that wound care was

performed on a client. However, the nurse's assessment indicates that the date on the dressing is 2 days old, and the dressing does not appear to have been changed since the date noted. Which is the best initial intervention?

• Correct Answer: Consult with the PN about the discrepancy

• After reviewing the morning laboratory findings for four clients, which client should

the nurse follow-up?• Correct Answer: The BNP assay for a client with shortness of breath after a MI increases to 1000 pg/mL.

• After receiving morning report on an acute care unit, which client should the nurse

assess first?

• Correct Answer: A client sitting close to the nurse's station who has been

restrained the past six hours

• An older woman with a long history of hypertension is transferred from a long-term

care facility to the hospital intensive care unit because of an exacerbation of heart failure (HF). She has a signed and witnessed "do not resuscitate" from in her record.Which action should the nurse take?