NR446 Exam 3 Actual Exam Style V1 | NR
446 Collaborative Healthcare |
Chamberlain
1. A nurse is caring for a client who is post-operative and reports a sudden onset of chest pain
and dyspnea. Which action should the nurse take first?
A. Obtain an electrocardiogram (ECG)
B. Apply supplemental oxygen
C. Administer morphine intravenously
D. Auscultate the client’s lung sounds
Answer: B
Rationale: The nurse should follow the ABC (Airway, Breathing, Circulation) priority
framework. Applying oxygen is the immediate priority for a client experiencing dyspnea
and potential respiratory distress. Once oxygenation is supported, further assessments and
interventions like an ECG can be performed.
2. Which task is most appropriate for a nurse to delegate to an unlicensed assistive personnel
(UAP)?
A. Collecting a midstream urine specimen from a stable client
B. Feeding a client who has a high risk for aspiration
C. Performing a sterile dressing change on a pressure injury
,D. Providing discharge instructions to a client
Answer: A
Rationale: UAPs can perform routine tasks on stable patients that do not require clinical
judgment. Collecting a urine specimen from a stable client is a non-invasive, technical task
within their scope. Tasks involving aspiration risk, sterile procedures, or education require
the expertise of a licensed nurse.
3. A nurse manager is utilizing a democratic leadership style. Which action is consistent with
this style?
A. Making decisions independently without staff input
B. Allowing staff to make all decisions without guidance
C. Using rewards and punishments to motivate staff
D. Seeking consensus from the team before implementing a new policy
Answer: D
Rationale: Democratic leadership involves shared decision-making and collaboration
between the leader and the staff. By seeking consensus, the manager encourages staff
participation and values their professional input. This style contrasts with autocratic
leadership, where the manager retains all decision-making power.
4. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client who is 2 hours post-op with a heart rate of 124/min
, B. A client with a blood glucose of 140 mg/dL
C. A client with a hip fracture requesting pain medication
D. A client receiving IV antibiotics for a urinary tract infection
Answer: A
Rationale: The nurse must prioritize the client who is most hemodynamically unstable. A
heart rate of 124/min in a post-operative client may indicate hemorrhage or shock,
requiring immediate evaluation. The other clients are relatively stable or have non-life-
threatening needs at this moment.
5. An RN is planning care for a client. Which activity must the RN perform and cannot be
delegated to an LPN?
A. Administering a subcutaneous insulin injection
B. Updating the plan of care based on a change in patient status
C. Reinforcing teaching about a low-sodium diet
D. Performing a routine tracheostomy care
Answer: B
Rationale: The development and updating of the nursing care plan require the assessment
and analysis skills of an RN. While LPNs can contribute to the plan and perform many
clinical tasks, the ultimate responsibility for the care plan lies with the RN. Delegation rules
specify that assessment, planning, and evaluation are RN-level responsibilities.
446 Collaborative Healthcare |
Chamberlain
1. A nurse is caring for a client who is post-operative and reports a sudden onset of chest pain
and dyspnea. Which action should the nurse take first?
A. Obtain an electrocardiogram (ECG)
B. Apply supplemental oxygen
C. Administer morphine intravenously
D. Auscultate the client’s lung sounds
Answer: B
Rationale: The nurse should follow the ABC (Airway, Breathing, Circulation) priority
framework. Applying oxygen is the immediate priority for a client experiencing dyspnea
and potential respiratory distress. Once oxygenation is supported, further assessments and
interventions like an ECG can be performed.
2. Which task is most appropriate for a nurse to delegate to an unlicensed assistive personnel
(UAP)?
A. Collecting a midstream urine specimen from a stable client
B. Feeding a client who has a high risk for aspiration
C. Performing a sterile dressing change on a pressure injury
,D. Providing discharge instructions to a client
Answer: A
Rationale: UAPs can perform routine tasks on stable patients that do not require clinical
judgment. Collecting a urine specimen from a stable client is a non-invasive, technical task
within their scope. Tasks involving aspiration risk, sterile procedures, or education require
the expertise of a licensed nurse.
3. A nurse manager is utilizing a democratic leadership style. Which action is consistent with
this style?
A. Making decisions independently without staff input
B. Allowing staff to make all decisions without guidance
C. Using rewards and punishments to motivate staff
D. Seeking consensus from the team before implementing a new policy
Answer: D
Rationale: Democratic leadership involves shared decision-making and collaboration
between the leader and the staff. By seeking consensus, the manager encourages staff
participation and values their professional input. This style contrasts with autocratic
leadership, where the manager retains all decision-making power.
4. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client who is 2 hours post-op with a heart rate of 124/min
, B. A client with a blood glucose of 140 mg/dL
C. A client with a hip fracture requesting pain medication
D. A client receiving IV antibiotics for a urinary tract infection
Answer: A
Rationale: The nurse must prioritize the client who is most hemodynamically unstable. A
heart rate of 124/min in a post-operative client may indicate hemorrhage or shock,
requiring immediate evaluation. The other clients are relatively stable or have non-life-
threatening needs at this moment.
5. An RN is planning care for a client. Which activity must the RN perform and cannot be
delegated to an LPN?
A. Administering a subcutaneous insulin injection
B. Updating the plan of care based on a change in patient status
C. Reinforcing teaching about a low-sodium diet
D. Performing a routine tracheostomy care
Answer: B
Rationale: The development and updating of the nursing care plan require the assessment
and analysis skills of an RN. While LPNs can contribute to the plan and perform many
clinical tasks, the ultimate responsibility for the care plan lies with the RN. Delegation rules
specify that assessment, planning, and evaluation are RN-level responsibilities.
