NSG 4800 NURSING LEADERSHIP & MANAGEMENT EXAM
STUDY GUIDE – KEY CONCEPTS, EXAM QUESTIONS &
RATIONALES| GURANTEED COMPLETE EXAM PREP A+
The Nurse Is Monitoring A Client In The Immediate Postpartum Period For Signs Of Hemorrhage.
Which Sign, If Noted, Would Be An Early Sign Of Excessive Blood Loss?
A .Temperature Of 100.4°F (38°C)
B. An Increase In The Pulse Rate From 88 To 102 Beats/Minute
C. A Blood Pressure Change From 130/88 To 124/80 Mm Hg
D. An Increase In The Respiratory Rate From 18 To 22 Breaths/Minute
ANS: B
Rationale: During The Fourth Stage Of Labor, The Maternal Blood Pressure, Pulse, And
Respiration Should Be Checked Every 15 Minutes During The First Hour. An Increasing Pulse Is
An Early Sign Of Excessive Blood Loss Because The Heart Pumps Faster To Compensate For
Reduced Blood Volume. A Slight Increase In Temperature Is Normal. The Blood Pressure
Decreases As The Blood Volume Diminishes, But A Decreased Blood Pressure Would Not Be The
Earliest Sign Of Hemorrhage. The Respiratory Rate Is Slightly Increased From Normal.
The Nurse In The Ambulatory Care Unit Is Providing Home Care Instructions To A Client After
Cryotherapy For The Treatment Of Malignant Skin Lesions. Which Statement Would Be Most
Appropriate For The Nurse To Include In The Home Care Instructions For This Client?
1. "Apply Ice To The Site To Prevent Swelling."
2. "Clean The Site With Alcohol 3 Times Daily."
3. "Apply A Warm, Damp Washcloth If Discomfort Occurs."
4. "Avoid Showering Or Taking Baths Until Seen By The Health Care Provider In 1 Week."
ANS: 3
Rationale: Cryotherapy Involves The Local Application Of Liquid Nitrogen To The Lesion; This
Causes Cell Death And Tissue Destruction. Tissue Freezing Is Followed In 1 To 2 Days By
Hemorrhagic Blister Formation; Therefore, Ice Is Not Applied To The Site. The Application Of A
Warm, Damp Washcloth Intermittently To The Site Will Provide Relief Of Any Discomfort. The
, Nurse Instructs The Client To Clean The Site With The Prescribed Solution To Prevent Secondary
Infection. A Topical Antibiotic Also May Be Prescribed. Alcohol Would Cause Irritation To The
Skin. There Is No Reason For The Client To Avoid Showering Or Bathing.
The Registered Nurse Is Caring For The Following Clients. It Would Be A Priority For The Nurse To
Initiate A Multidisciplinary Conference For The Client Who Is
A.12 Years Old With Autism Who Is Starting A New School And Recently Had A Uri (Upper
Respiratory Tract Infection)
B.39 Years Old, Has Type 2 Diabetes Mellitus, Is Homeless And Had A Recent Hemoglobin A1c Of
13%
C.52 Years Old, With Myasthenia Gravis, Recently Prescribed Mestinon (Pyridostigmine) And Is
Employed As A Mail Carrier
D.79 Years Old, Has Bipolar And Schizophrenia, Lives Alone And Reports Hearing Non
Threatening Voices.
ANS: B
Rationale: A Client With Uncontrolled Diabetes Mellitus Would Require The Greatest Number Of
Disciplines (Multidisciplinary) To Manage Their Care I.E. Medicine, Nursing, Social Work,
Nutritionist; The Other Choices Do Not Require As Many Providers Of Care To Meet Their Needs.
A Client Is Scheduled To Begin Therapy With Carbamazepine. The Nurse Should Assess The
Results Of Which Test(S) Before Administering The First Dose Of This Medication To The Client?
A. Liver Function Tests
B. Renal Function Tests
C. Pancreatic Enzyme Studies
D. Complete Blood Cell Count
ANS: D.
Rationale: Carbamazepine May Be Used To Treat A Seizure Disorder. It Can Cause Leukopenia,
Anemia, Thrombocytopenia, And, Very Rarely, Fatal Aplastic Anemia. To Reduce The Risk Of
Serious Hematological Effects, A Complete Blood Cell Count Should Be Done Before Treatment
STUDY GUIDE – KEY CONCEPTS, EXAM QUESTIONS &
RATIONALES| GURANTEED COMPLETE EXAM PREP A+
The Nurse Is Monitoring A Client In The Immediate Postpartum Period For Signs Of Hemorrhage.
Which Sign, If Noted, Would Be An Early Sign Of Excessive Blood Loss?
A .Temperature Of 100.4°F (38°C)
B. An Increase In The Pulse Rate From 88 To 102 Beats/Minute
C. A Blood Pressure Change From 130/88 To 124/80 Mm Hg
D. An Increase In The Respiratory Rate From 18 To 22 Breaths/Minute
ANS: B
Rationale: During The Fourth Stage Of Labor, The Maternal Blood Pressure, Pulse, And
Respiration Should Be Checked Every 15 Minutes During The First Hour. An Increasing Pulse Is
An Early Sign Of Excessive Blood Loss Because The Heart Pumps Faster To Compensate For
Reduced Blood Volume. A Slight Increase In Temperature Is Normal. The Blood Pressure
Decreases As The Blood Volume Diminishes, But A Decreased Blood Pressure Would Not Be The
Earliest Sign Of Hemorrhage. The Respiratory Rate Is Slightly Increased From Normal.
The Nurse In The Ambulatory Care Unit Is Providing Home Care Instructions To A Client After
Cryotherapy For The Treatment Of Malignant Skin Lesions. Which Statement Would Be Most
Appropriate For The Nurse To Include In The Home Care Instructions For This Client?
1. "Apply Ice To The Site To Prevent Swelling."
2. "Clean The Site With Alcohol 3 Times Daily."
3. "Apply A Warm, Damp Washcloth If Discomfort Occurs."
4. "Avoid Showering Or Taking Baths Until Seen By The Health Care Provider In 1 Week."
ANS: 3
Rationale: Cryotherapy Involves The Local Application Of Liquid Nitrogen To The Lesion; This
Causes Cell Death And Tissue Destruction. Tissue Freezing Is Followed In 1 To 2 Days By
Hemorrhagic Blister Formation; Therefore, Ice Is Not Applied To The Site. The Application Of A
Warm, Damp Washcloth Intermittently To The Site Will Provide Relief Of Any Discomfort. The
, Nurse Instructs The Client To Clean The Site With The Prescribed Solution To Prevent Secondary
Infection. A Topical Antibiotic Also May Be Prescribed. Alcohol Would Cause Irritation To The
Skin. There Is No Reason For The Client To Avoid Showering Or Bathing.
The Registered Nurse Is Caring For The Following Clients. It Would Be A Priority For The Nurse To
Initiate A Multidisciplinary Conference For The Client Who Is
A.12 Years Old With Autism Who Is Starting A New School And Recently Had A Uri (Upper
Respiratory Tract Infection)
B.39 Years Old, Has Type 2 Diabetes Mellitus, Is Homeless And Had A Recent Hemoglobin A1c Of
13%
C.52 Years Old, With Myasthenia Gravis, Recently Prescribed Mestinon (Pyridostigmine) And Is
Employed As A Mail Carrier
D.79 Years Old, Has Bipolar And Schizophrenia, Lives Alone And Reports Hearing Non
Threatening Voices.
ANS: B
Rationale: A Client With Uncontrolled Diabetes Mellitus Would Require The Greatest Number Of
Disciplines (Multidisciplinary) To Manage Their Care I.E. Medicine, Nursing, Social Work,
Nutritionist; The Other Choices Do Not Require As Many Providers Of Care To Meet Their Needs.
A Client Is Scheduled To Begin Therapy With Carbamazepine. The Nurse Should Assess The
Results Of Which Test(S) Before Administering The First Dose Of This Medication To The Client?
A. Liver Function Tests
B. Renal Function Tests
C. Pancreatic Enzyme Studies
D. Complete Blood Cell Count
ANS: D.
Rationale: Carbamazepine May Be Used To Treat A Seizure Disorder. It Can Cause Leukopenia,
Anemia, Thrombocytopenia, And, Very Rarely, Fatal Aplastic Anemia. To Reduce The Risk Of
Serious Hematological Effects, A Complete Blood Cell Count Should Be Done Before Treatment
