N275 Medical Surgical Nursing Leadership Final Questions
With Complete Solutions
. The client in the operating room states, "I don't think I will
have this surgery after all." Which intervention should the nurse
implement first?
1. Have the surgeon speak with the client.
2. Ask the client to discuss the concerns.
3. Continue to prep the client for surgery.
4. Immediately stop the surgical procedure. Correct Answers 4.
Stopping the surgical procedure is the first intervention for the
nurse to implement.
. The hospital will be implementing a new medication
administration record (MAR) for documenting medication
administration. Which action should the clinical manager take
first when implementing the new MAR?
1. Discuss the new MAR with each nurse individually.
2. Schedule meetings on all shifts to discuss the new MAR.
3. Require the nurse to read a handout explaining the new MAR.
4. Ask the nurses to watch a video explaining the new MAR.
Correct Answers 2. The first intervention should be to arrange
meetings to explain the new MAR and allow nurses to ask
questions to clarify the new policy
A major disaster has been called, and the charge nurse on a
medical unit must recommend to the medical discharge officer
,on rounds which clients to discharge. Which client should not be
discharged?
1. The client diagnosed with chronic angina pectoris who has
been on new medication for 2 days.
2. The client diagnosed with deep vein thrombosis (DVT) who
has had heparin discontinued and has been on warfarin
(Coumadin) for 4 days.
3. The client with an infected leg wound who is receiving
vancomycin IVPB every 24 hours for methicillin-resistant
Staphylococcus aureus (MRSA) infection.
4. The client diagnosed with COPD who has the following
arterial blood gas (ABG) levels: pH, 7.34; PCO2, 55; HCO3, 28;
PaO2, 89. Correct Answers 3. Because resistant infections are
very difficult to treat, this client should remain in the hospital for
the required IVPB medication.
A male HCP frequently tells jokes with sexual overtones at the
nursing station. Which action should the female charge nurse
implement?
1. Tell the HCP that the jokes are inappropriate and offensive.
2. Report the behavior to the medical staff committee.
3. Discuss the problem with the chief nursing officer.
4. Call a Code Purple and have the nurses surround the HCP.
Correct Answers 1. Telling jokes with sexual innuendos creates
a "hostile work environment" and should be addressed with the
HCP. This is a courtesy to the HCP to allow him to correct the
behavior without being embarrassed.
,A terrible storm causes the electricity to go out in the hospital
and the emergency generator lights come on. Which action
should the charge nurse implement?
1. Request all family members to leave the hospital as soon as
possible.
2. Instruct the staff to plug critical electrical equipment into the
red outlets.
3. Have the unlicensed assistive personnel (UAP) place a
portable flashlight on each bedside table.
4. Contact the maintenance department to determine how long
the electricity will be out. Correct Answers 2. During an
electrical failure, the red outlets in the hospital run on the
backup generator, and all IV pumps and necessary equipment
should be plugged into these outlets.
At 0830, the day shift nurse is preparing to administer
medications to the client. Which action should the nurse take
first?
1.Check the client's armband against the medication
administration record (MAR).
2. Assess the client's IV site for redness and patency.
3. Ask for the client's date of birth.
4. Determine the client's last K_ level. Correct Answers 4. The
nurse should assess the client's last potassium (K+) level
because hypokalemia (abnormally low K+ level) is the most
common cause of dysrhythmias in clients receiving digoxin
secondary to clients concurrently taking diuretics. Furosemide
(Lasix) is a loop diuretic. The nurse should check for digoxin
, and K+ levels and apical pulse (AP) prior to administering
digoxin.
The 24-month-old toddler is admitted to the pediatric unit with
vomiting and diarrhea. Which interventions should the nurse
implement? Rank in order of performance.
1. Teach the parent about weighing diapers to determine output
status.
2. Show the parent the call light and explain safety regimens.
3. Assess the toddler's tissue turgor.
4. Place the appropriate size diapers in the room.
5. Take the toddler's vital signs. Correct Answers 5, 3, 2, 4, 1
The 32-year-old male client with a traumatic right above-the-
elbow amputation tells the home health (HH) nurse he is worried
about supporting his family and finding employment since he
can't be a mechanic anymore. Which intervention should the
nurse implement?
1. Contact the HH agency's occupational therapist.
2. Refer the client to the state rehabilitation commission.
3. Ask the HH agency's social worker about disability.
4. Suggest he talk to his wife about his concerns. Correct
Answers 2. The NCLEX-RN® test blueprint lists referrals
under Management of Care. After a client has been injured and
is unable to return to previous employment because of the
injury, the rehabilitation commission of each state will help
evaluate the client and determine whether the client is eligible to
receive training or education for another occupation.
With Complete Solutions
. The client in the operating room states, "I don't think I will
have this surgery after all." Which intervention should the nurse
implement first?
1. Have the surgeon speak with the client.
2. Ask the client to discuss the concerns.
3. Continue to prep the client for surgery.
4. Immediately stop the surgical procedure. Correct Answers 4.
Stopping the surgical procedure is the first intervention for the
nurse to implement.
. The hospital will be implementing a new medication
administration record (MAR) for documenting medication
administration. Which action should the clinical manager take
first when implementing the new MAR?
1. Discuss the new MAR with each nurse individually.
2. Schedule meetings on all shifts to discuss the new MAR.
3. Require the nurse to read a handout explaining the new MAR.
4. Ask the nurses to watch a video explaining the new MAR.
Correct Answers 2. The first intervention should be to arrange
meetings to explain the new MAR and allow nurses to ask
questions to clarify the new policy
A major disaster has been called, and the charge nurse on a
medical unit must recommend to the medical discharge officer
,on rounds which clients to discharge. Which client should not be
discharged?
1. The client diagnosed with chronic angina pectoris who has
been on new medication for 2 days.
2. The client diagnosed with deep vein thrombosis (DVT) who
has had heparin discontinued and has been on warfarin
(Coumadin) for 4 days.
3. The client with an infected leg wound who is receiving
vancomycin IVPB every 24 hours for methicillin-resistant
Staphylococcus aureus (MRSA) infection.
4. The client diagnosed with COPD who has the following
arterial blood gas (ABG) levels: pH, 7.34; PCO2, 55; HCO3, 28;
PaO2, 89. Correct Answers 3. Because resistant infections are
very difficult to treat, this client should remain in the hospital for
the required IVPB medication.
A male HCP frequently tells jokes with sexual overtones at the
nursing station. Which action should the female charge nurse
implement?
1. Tell the HCP that the jokes are inappropriate and offensive.
2. Report the behavior to the medical staff committee.
3. Discuss the problem with the chief nursing officer.
4. Call a Code Purple and have the nurses surround the HCP.
Correct Answers 1. Telling jokes with sexual innuendos creates
a "hostile work environment" and should be addressed with the
HCP. This is a courtesy to the HCP to allow him to correct the
behavior without being embarrassed.
,A terrible storm causes the electricity to go out in the hospital
and the emergency generator lights come on. Which action
should the charge nurse implement?
1. Request all family members to leave the hospital as soon as
possible.
2. Instruct the staff to plug critical electrical equipment into the
red outlets.
3. Have the unlicensed assistive personnel (UAP) place a
portable flashlight on each bedside table.
4. Contact the maintenance department to determine how long
the electricity will be out. Correct Answers 2. During an
electrical failure, the red outlets in the hospital run on the
backup generator, and all IV pumps and necessary equipment
should be plugged into these outlets.
At 0830, the day shift nurse is preparing to administer
medications to the client. Which action should the nurse take
first?
1.Check the client's armband against the medication
administration record (MAR).
2. Assess the client's IV site for redness and patency.
3. Ask for the client's date of birth.
4. Determine the client's last K_ level. Correct Answers 4. The
nurse should assess the client's last potassium (K+) level
because hypokalemia (abnormally low K+ level) is the most
common cause of dysrhythmias in clients receiving digoxin
secondary to clients concurrently taking diuretics. Furosemide
(Lasix) is a loop diuretic. The nurse should check for digoxin
, and K+ levels and apical pulse (AP) prior to administering
digoxin.
The 24-month-old toddler is admitted to the pediatric unit with
vomiting and diarrhea. Which interventions should the nurse
implement? Rank in order of performance.
1. Teach the parent about weighing diapers to determine output
status.
2. Show the parent the call light and explain safety regimens.
3. Assess the toddler's tissue turgor.
4. Place the appropriate size diapers in the room.
5. Take the toddler's vital signs. Correct Answers 5, 3, 2, 4, 1
The 32-year-old male client with a traumatic right above-the-
elbow amputation tells the home health (HH) nurse he is worried
about supporting his family and finding employment since he
can't be a mechanic anymore. Which intervention should the
nurse implement?
1. Contact the HH agency's occupational therapist.
2. Refer the client to the state rehabilitation commission.
3. Ask the HH agency's social worker about disability.
4. Suggest he talk to his wife about his concerns. Correct
Answers 2. The NCLEX-RN® test blueprint lists referrals
under Management of Care. After a client has been injured and
is unable to return to previous employment because of the
injury, the rehabilitation commission of each state will help
evaluate the client and determine whether the client is eligible to
receive training or education for another occupation.
