NR446 Final Exam Actual Exam Style V1 |
NR 446 Collaborative Healthcare |
Chamberlain
1. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with pneumonia who has a new onset of confusion and an oxygen saturation of
88%.
B. A client who is 2 days postoperative following a total hip arthroplasty and reports pain
as 7 out of 10.
C. A client with a history of heart failure who has 2+ pitting edema in the lower extremities.
D. A client who has a scheduled dose of an antibiotic due in 30 minutes for a urinary tract
infection.
Answer: A
Rationale: The client with pneumonia and a new onset of confusion likely has hypoxia,
which is an immediate threat to the airway and breathing according to the ABC framework.
Confusion is often the first sign of declining respiratory status in the elderly or those with
lung infections. This client requires urgent intervention compared to the others who are
relatively stable or have non-life-threatening issues.
2. A charge nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is
appropriate for the nurse to delegate?
A. Evaluating a client’s response to a new pain medication.
,B. Assisting a client with a stable gait to ambulate in the hallway.
C. Performing a sterile dressing change on a postoperative wound.
D. Providing discharge instructions to a client going home.
Answer: B
Rationale: Assisting a stable client with ambulation is a standard task that falls within the
UAP’s scope of practice. Evaluation, teaching, and complex procedures requiring sterile
technique are the responsibility of the registered nurse. The nurse must ensure the client is
stable before delegating mobility tasks to unlicensed staff.
3. A nurse manager is discussing the PDSA cycle during a quality improvement meeting.
Which of the following actions represents the ‘Plan’ phase?
A. Analyzing the data collected to see if the changes made a difference.
B. Implementing the new safety protocol on a small scale in one unit.
C. Identifying a problem and defining the objectives for a new safety protocol.
D. Adopting the changes across the entire hospital system based on successful results.
Answer: C
Rationale: The ‘Plan’ phase involves identifying the problem, setting goals, and deciding
how to measure success. It is the initial stage where the groundwork for improvement is
laid out. Implementing the protocol is part of the ‘Do’ phase, while analyzing results is
‘Study’.
, 4. A nurse is using the SBAR communication tool to report a change in a client’s condition to a
provider. Which statement should the nurse include in the ‘Assessment’ portion?
A. ‘I believe the client is experiencing acute pulmonary edema.’
B. ‘The client was admitted yesterday with a diagnosis of heart failure.’
C. ‘I recommend that we start the client on a high-flow oxygen mask.’
D. ‘The client’s blood pressure is 160/94 and heart rate is 110 beats per minute.’
Answer: A
Rationale: In the SBAR tool, the ‘Assessment’ portion is where the nurse provides their
professional conclusion or what they think the problem is. Vital signs and physical findings
belong in ‘Situation’ or ‘Background’ depending on context. Recommendations involve
suggesting specific interventions to the provider.
5. A nurse manager is using a transformational leadership style. Which action by the nurse
manager best demonstrates this style?
A. Offering a financial bonus to nurses who work extra shifts during the holidays.
B. Focusing on the day-to-day operations and ensuring all tasks are completed on time.
C. Maintaining a hands-off approach and letting the staff solve their own problems.
D. Empowering staff to participate in decision-making and sharing a long-term vision.
Answer: D
NR 446 Collaborative Healthcare |
Chamberlain
1. A nurse is caring for four clients. Which client should the nurse assess first?
A. A client with pneumonia who has a new onset of confusion and an oxygen saturation of
88%.
B. A client who is 2 days postoperative following a total hip arthroplasty and reports pain
as 7 out of 10.
C. A client with a history of heart failure who has 2+ pitting edema in the lower extremities.
D. A client who has a scheduled dose of an antibiotic due in 30 minutes for a urinary tract
infection.
Answer: A
Rationale: The client with pneumonia and a new onset of confusion likely has hypoxia,
which is an immediate threat to the airway and breathing according to the ABC framework.
Confusion is often the first sign of declining respiratory status in the elderly or those with
lung infections. This client requires urgent intervention compared to the others who are
relatively stable or have non-life-threatening issues.
2. A charge nurse is delegating tasks to an unlicensed assistive personnel (UAP). Which task is
appropriate for the nurse to delegate?
A. Evaluating a client’s response to a new pain medication.
,B. Assisting a client with a stable gait to ambulate in the hallway.
C. Performing a sterile dressing change on a postoperative wound.
D. Providing discharge instructions to a client going home.
Answer: B
Rationale: Assisting a stable client with ambulation is a standard task that falls within the
UAP’s scope of practice. Evaluation, teaching, and complex procedures requiring sterile
technique are the responsibility of the registered nurse. The nurse must ensure the client is
stable before delegating mobility tasks to unlicensed staff.
3. A nurse manager is discussing the PDSA cycle during a quality improvement meeting.
Which of the following actions represents the ‘Plan’ phase?
A. Analyzing the data collected to see if the changes made a difference.
B. Implementing the new safety protocol on a small scale in one unit.
C. Identifying a problem and defining the objectives for a new safety protocol.
D. Adopting the changes across the entire hospital system based on successful results.
Answer: C
Rationale: The ‘Plan’ phase involves identifying the problem, setting goals, and deciding
how to measure success. It is the initial stage where the groundwork for improvement is
laid out. Implementing the protocol is part of the ‘Do’ phase, while analyzing results is
‘Study’.
, 4. A nurse is using the SBAR communication tool to report a change in a client’s condition to a
provider. Which statement should the nurse include in the ‘Assessment’ portion?
A. ‘I believe the client is experiencing acute pulmonary edema.’
B. ‘The client was admitted yesterday with a diagnosis of heart failure.’
C. ‘I recommend that we start the client on a high-flow oxygen mask.’
D. ‘The client’s blood pressure is 160/94 and heart rate is 110 beats per minute.’
Answer: A
Rationale: In the SBAR tool, the ‘Assessment’ portion is where the nurse provides their
professional conclusion or what they think the problem is. Vital signs and physical findings
belong in ‘Situation’ or ‘Background’ depending on context. Recommendations involve
suggesting specific interventions to the provider.
5. A nurse manager is using a transformational leadership style. Which action by the nurse
manager best demonstrates this style?
A. Offering a financial bonus to nurses who work extra shifts during the holidays.
B. Focusing on the day-to-day operations and ensuring all tasks are completed on time.
C. Maintaining a hands-off approach and letting the staff solve their own problems.
D. Empowering staff to participate in decision-making and sharing a long-term vision.
Answer: D
