NR446 Exam 2 Actual Exam Style V3 | NR
446 Collaborative Healthcare |
Chamberlain
1. A nurse manager is evaluating the unit’s budget and notices a significant increase in the
use of agency nurses. Which type of budget is primarily affected by this cost?
A. Capital budget
B. Strategic budget
C. Operating budget
D. Project budget
Answer: C
Rationale: The operating budget includes day-to-day expenses such as supplies and
personnel costs, including agency nurse fees. Personnel costs often represent the largest
portion of a healthcare facility’s operating expenses. Monitoring this budget allows
managers to identify trends and adjust staffing levels appropriately to maintain financial
stability.
2. A charge nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which of the
following instructions provides the most appropriate level of direction?
A. ‘Please take the vital signs for all patients in rooms 401 through 410.’
B. ‘Check the blood pressure of the patient in room 405 every 15 minutes.’
,C. ‘Take the blood pressure of the client in room 402 and report if it is above 140/90 mmHg
immediately.’
D. ‘Monitor the client in room 408 for any changes in their clinical status.’
Answer: C
Rationale: This instruction follows the five rights of delegation by being specific, including
the task, the timeframe, and the specific parameters for reporting. Providing clear
expectations and limits is essential for safe delegation to UAPs. Vague instructions like
monitoring for ‘any changes’ involve clinical judgment, which is outside the UAP’s scope of
practice.
3. A nurse is caring for a client who is post-operative and requesting pain medication. Which
action by the nurse demonstrates the ethical principle of nonmaleficence?
A. Providing the medication exactly as prescribed to manage pain.
B. Checking the client’s allergies before administering the medication.
C. Allowing the client to choose between oral or intravenous medication.
D. Ensuring the client understands the risks and benefits of the medication.
Answer: B
Rationale: Nonmaleficence is the duty to ‘do no harm,’ and checking allergies directly
prevents a potentially harmful adverse reaction. While providing medication (beneficence)
and offering choices (autonomy) are important, preventing harm is the core of
, nonmaleficence. This step is a critical safety measure in the medication administration
process.
4. A nurse manager is implementing a new electronic health record system. According to
Lewin’s Change Theory, which action occurs during the ‘unfreezing’ stage?
A. Identifying the need for change and creating awareness of the necessity for a new
system.
B. Providing training sessions for all staff on the new system.
C. Integrating the new system into the daily workflow of the nursing unit.
D. Evaluating the effectiveness of the new system three months after implementation.
Answer: A
Rationale: The unfreezing stage involves preparing the organization for change by
identifying problems and increasing awareness of the need for a solution. This stage
focuses on overcoming resistance and motivating staff to accept the change. It is the initial
phase where the ‘status quo’ is challenged to allow for movement toward a new state.
5. Which of the following tasks is most appropriate for a Registered Nurse (RN) to delegate to
a Licensed Practical Nurse (LPN)?
A. Performing a sterile dressing change on a stable surgical wound.
B. Administering an initial dose of an intravenous antibiotic.
C. Developing a plan of care for a client with complex needs.
446 Collaborative Healthcare |
Chamberlain
1. A nurse manager is evaluating the unit’s budget and notices a significant increase in the
use of agency nurses. Which type of budget is primarily affected by this cost?
A. Capital budget
B. Strategic budget
C. Operating budget
D. Project budget
Answer: C
Rationale: The operating budget includes day-to-day expenses such as supplies and
personnel costs, including agency nurse fees. Personnel costs often represent the largest
portion of a healthcare facility’s operating expenses. Monitoring this budget allows
managers to identify trends and adjust staffing levels appropriately to maintain financial
stability.
2. A charge nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which of the
following instructions provides the most appropriate level of direction?
A. ‘Please take the vital signs for all patients in rooms 401 through 410.’
B. ‘Check the blood pressure of the patient in room 405 every 15 minutes.’
,C. ‘Take the blood pressure of the client in room 402 and report if it is above 140/90 mmHg
immediately.’
D. ‘Monitor the client in room 408 for any changes in their clinical status.’
Answer: C
Rationale: This instruction follows the five rights of delegation by being specific, including
the task, the timeframe, and the specific parameters for reporting. Providing clear
expectations and limits is essential for safe delegation to UAPs. Vague instructions like
monitoring for ‘any changes’ involve clinical judgment, which is outside the UAP’s scope of
practice.
3. A nurse is caring for a client who is post-operative and requesting pain medication. Which
action by the nurse demonstrates the ethical principle of nonmaleficence?
A. Providing the medication exactly as prescribed to manage pain.
B. Checking the client’s allergies before administering the medication.
C. Allowing the client to choose between oral or intravenous medication.
D. Ensuring the client understands the risks and benefits of the medication.
Answer: B
Rationale: Nonmaleficence is the duty to ‘do no harm,’ and checking allergies directly
prevents a potentially harmful adverse reaction. While providing medication (beneficence)
and offering choices (autonomy) are important, preventing harm is the core of
, nonmaleficence. This step is a critical safety measure in the medication administration
process.
4. A nurse manager is implementing a new electronic health record system. According to
Lewin’s Change Theory, which action occurs during the ‘unfreezing’ stage?
A. Identifying the need for change and creating awareness of the necessity for a new
system.
B. Providing training sessions for all staff on the new system.
C. Integrating the new system into the daily workflow of the nursing unit.
D. Evaluating the effectiveness of the new system three months after implementation.
Answer: A
Rationale: The unfreezing stage involves preparing the organization for change by
identifying problems and increasing awareness of the need for a solution. This stage
focuses on overcoming resistance and motivating staff to accept the change. It is the initial
phase where the ‘status quo’ is challenged to allow for movement toward a new state.
5. Which of the following tasks is most appropriate for a Registered Nurse (RN) to delegate to
a Licensed Practical Nurse (LPN)?
A. Performing a sterile dressing change on a stable surgical wound.
B. Administering an initial dose of an intravenous antibiotic.
C. Developing a plan of care for a client with complex needs.
