NR446 Exam 4 Actual Exam Style V1 | NR
446 Collaborative Healthcare |
Chamberlain
1. A nurse is delegating tasks to an Unlicensed Assistive Personnel (UAP). Which task is most
appropriate for the nurse to delegate?
A. Evaluating a patient’s response to pain medication.
B. Providing discharge instructions to a patient and family.
C. Assessing the lung sounds of a patient with pneumonia.
D. Assisting a stable patient with a bed bath and oral care.
Answer: D
Rationale: Delegation to UAPs should focus on routine tasks that do not require clinical
judgment or nursing assessment. Assisting with a bed bath and oral care is a standard task
within the UAP’s scope of practice for stable patients. The RN remains responsible for
assessment, teaching, and evaluation tasks as these require professional nursing
knowledge.
2. A charge nurse is managing a conflict between two staff nurses regarding the holiday
schedule. The charge nurse suggests that both nurses work a portion of the holiday to reach a
middle ground. Which conflict management strategy is being used?
A. Competing
,B. Compromising
C. Avoiding
D. Smoothing
Answer: B
Rationale: Compromising involves each party giving up something to reach a mutually
acceptable middle ground. This strategy is often used when both sides have equal power
and goals are moderately important. It helps resolve conflicts quickly though it may not
address the underlying issues as thoroughly as collaboration.
3. A nurse is prioritizing care for four patients. Which patient should the nurse assess first?
A. A patient with a history of heart failure reporting 2+ pitting edema.
B. A patient who had a cholecystectomy 4 hours ago and reports pain as 6/10.
C. A patient who is 1 hour postoperative and has a sudden decrease in blood pressure.
D. A patient with chronic obstructive pulmonary disease (COPD) and an oxygen saturation
of 91%.
Answer: C
Rationale: The nurse must prioritize patients using the ABC (Airway, Breathing,
Circulation) framework or those showing signs of acute instability. A sudden drop in blood
pressure in a postoperative patient suggests potential hemorrhage or shock, which is a
circulation emergency. Other patients in the scenario are currently stable or reporting
symptoms consistent with their chronic or expected postoperative status.
, 4. In the event of a mass casualty incident, which patient would be assigned a ‘red’ tag using
the START triage system?
A. A patient who is walking and has minor lacerations.
B. A patient with a respiratory rate of 35 breaths per minute.
C. A patient with no respirations even after airway repositioning.
D. A patient who is conscious and follows commands but has a broken arm.
Answer: B
Rationale: A ‘red’ tag indicates the need for immediate intervention to survive. Under the
START triage system, a respiratory rate over 30 breaths per minute is a primary indicator
for immediate priority. Patients who are walking are tagged green, those not breathing
after repositioning are black, and those who are stable but injured are yellow.
5. A nurse is acting as a patient advocate for a client who refuses a life-saving blood
transfusion due to religious beliefs. What is the nurse’s primary responsibility?
A. Persuade the patient to accept the treatment for their own good.
B. Consult the hospital’s ethics committee to override the patient’s refusal.
C. Ensure the patient understands the consequences and support their decision.
D. Notify the patient’s family so they can convince the patient.
Answer: C
446 Collaborative Healthcare |
Chamberlain
1. A nurse is delegating tasks to an Unlicensed Assistive Personnel (UAP). Which task is most
appropriate for the nurse to delegate?
A. Evaluating a patient’s response to pain medication.
B. Providing discharge instructions to a patient and family.
C. Assessing the lung sounds of a patient with pneumonia.
D. Assisting a stable patient with a bed bath and oral care.
Answer: D
Rationale: Delegation to UAPs should focus on routine tasks that do not require clinical
judgment or nursing assessment. Assisting with a bed bath and oral care is a standard task
within the UAP’s scope of practice for stable patients. The RN remains responsible for
assessment, teaching, and evaluation tasks as these require professional nursing
knowledge.
2. A charge nurse is managing a conflict between two staff nurses regarding the holiday
schedule. The charge nurse suggests that both nurses work a portion of the holiday to reach a
middle ground. Which conflict management strategy is being used?
A. Competing
,B. Compromising
C. Avoiding
D. Smoothing
Answer: B
Rationale: Compromising involves each party giving up something to reach a mutually
acceptable middle ground. This strategy is often used when both sides have equal power
and goals are moderately important. It helps resolve conflicts quickly though it may not
address the underlying issues as thoroughly as collaboration.
3. A nurse is prioritizing care for four patients. Which patient should the nurse assess first?
A. A patient with a history of heart failure reporting 2+ pitting edema.
B. A patient who had a cholecystectomy 4 hours ago and reports pain as 6/10.
C. A patient who is 1 hour postoperative and has a sudden decrease in blood pressure.
D. A patient with chronic obstructive pulmonary disease (COPD) and an oxygen saturation
of 91%.
Answer: C
Rationale: The nurse must prioritize patients using the ABC (Airway, Breathing,
Circulation) framework or those showing signs of acute instability. A sudden drop in blood
pressure in a postoperative patient suggests potential hemorrhage or shock, which is a
circulation emergency. Other patients in the scenario are currently stable or reporting
symptoms consistent with their chronic or expected postoperative status.
, 4. In the event of a mass casualty incident, which patient would be assigned a ‘red’ tag using
the START triage system?
A. A patient who is walking and has minor lacerations.
B. A patient with a respiratory rate of 35 breaths per minute.
C. A patient with no respirations even after airway repositioning.
D. A patient who is conscious and follows commands but has a broken arm.
Answer: B
Rationale: A ‘red’ tag indicates the need for immediate intervention to survive. Under the
START triage system, a respiratory rate over 30 breaths per minute is a primary indicator
for immediate priority. Patients who are walking are tagged green, those not breathing
after repositioning are black, and those who are stable but injured are yellow.
5. A nurse is acting as a patient advocate for a client who refuses a life-saving blood
transfusion due to religious beliefs. What is the nurse’s primary responsibility?
A. Persuade the patient to accept the treatment for their own good.
B. Consult the hospital’s ethics committee to override the patient’s refusal.
C. Ensure the patient understands the consequences and support their decision.
D. Notify the patient’s family so they can convince the patient.
Answer: C
