Capstone Leadership Assessment Test
Questions and Answers
Question 1
A nurse is preparing to administer the initial dose of ceftriaxone to a client who
has endometritis. Which of the following statements by the client should cause
the nurse to hold the medication and consult the provider?
"I have a severe allergy to amoxicillin."
"I get sick when I take diuretics."
"I have a history of hearing problems."
"I take prednisone for my asthma."
Correct Answer
"I have a severe allergy to amoxicillin."MY ANSWERCeftriaxone is a third-generation
cephalosporin. Due to the potential for cross-sensitivity reactions, clients who have
serious allergic responses to penicillin should not take cephalosporins.
"I get sick when I take diuretics."Difficulty taking diuretics does not indicate a need
to avoid taking ceftriaxone. Trimethoprim-sulfamethoxazole is contraindicated for
clients who have allergies to sulfonamides.
"I have a history of hearing problems."Gentamicin and other aminoglycosides are
associated with hearing loss and should be used with caution by clients who have
hearing loss. However, hearing loss is not an adverse effect associated with
ceftriaxone.
"I take prednisone for my asthma."Prednisone, a corticosteroid medication, is
associated with an increased risk of tendon rupture if taken concurrently with a
fluoroquinolone antibiotic, such as ciprofloxacin. However, there is no interaction
associated with prednisone and ceftriaxone.
Page 1 of 52
,Question 2
A nurse is planning a staff education program to review nursing interventions
for clients who have kidney failure. Which of the following sources should the
nurse identify as the best resource for obtaining evidence-based information?
The advice of an expert nephrology nurseThe nurse can obtain information from
another nurse who is considered an expert on kidney failure. However, according to
evidence-based practice, another source would provide the best information.
Retrospective chart reviewsThe nurse can obtain information about implemented
interventions from retrospective chart reviews, which provide information on a select
group of clients over time. However, according to evidence-based practice, another
source would provide the best information.
Facility critical pathwayThe nurse can obtain information from facility critical
pathways, since these care plans provide information on the expected course of the
condition and nursing interventions. However, according to evidence-based practice,
another source would provide the best information.
A recent peer-reviewed nursing research articleMY ANSWERCurrent research articles
in peer-reviewed journals constitute the evidence upon which clinical practice
guidelines and decisions about nursing practice should be based. The nurse should
identify this source as the best resource when preparing a staff education program
attributed to evidence-based practice.
Correct Answer
Page 2 of 52
,Question 3
A community health nurse is reviewing primary prevention strategies for West
Nile virus with a group of clients in a rural health clinic. Which of the following
instructions should the nurse include?
void exposure to deer ticks.Avoiding exposure to deer ticks or black-legged ticks
A
decreases the risk for Lyme disease. Ticks can be avoided by staying away from
heavily wooded areas during the spring and summer months, wearing long-sleeve
shirts and pants, and using an insect repellent containing N,N-diethyl-meta-
toluamide (DEET).
Eliminate areas of standing water.MY ANSWERThe West Nile virus is transmitted to
humans by the bite of a mosquito infected with the virus. Eliminating areas of
standing water where mosquitoes breed reduces the risk for infection.
Use a respiratory mask when cleaning bird coops.Wearing a respiratory mask when
working in environments like chicken or pigeon coops is not necessary to prevent
transmission of West Nile virus. While birds are the natural reservoir of the virus, there
is no evidence of transmission from birds to humans. As a safety precaution, the nurse
should recommend that clients wear gloves if handling a dead bird.
Plan outdoor activities after dusk.Mosquitoes, which are carriers of West Nile virus, are
more active between dusk and dawn. Clients who engage in outdoor activities during
these times should be instructed to wear long sleeve shirts and pants and to use an
insect repellent containing N,N-diethyl-meta-toluamide (DEET).
Correct Answer
Page 3 of 52
, Question 4
A charge nurse is discussing HIPAA with a newly licensed nurse. Which of the
following actions should the charge nurse include in the teaching as an example
of a HIPAA violation?
Correct Answer
Posting the name of the nurse providing care on a client's communication boardThe
nurse's name should be posted on the client's communication board, so the client
knows who to ask for when they need assistance.
Discussing the client's new medication with a hospital pharmacistThe hospital
pharmacist is a member of the interprofessional team providing client care. It is
acceptable for the nurse to discuss the client's new medication with the hospital
pharmacist.
Faxing requested medical information for a client who is transferring to another
facilityIt is acceptable for the nurse to fax requested information for a client who is
transferring to another facility with permission from the client and if following
facility policies. One such policy could include using a cover sheet to indicate the
appropriate recipient of the information, confirming the fax numbers, and
encrypting the information so the fax cannot be read without an encryption key.
Emailing the client's positive hepatitis results from an unencrypted serverMY
ANSWERTo prevent unauthorized access to confidential data, the nurse should not
email any client information over an unencrypted server. This action is a breach of
confidentiality and a HIPAA violation.
Page 4 of 52
Questions and Answers
Question 1
A nurse is preparing to administer the initial dose of ceftriaxone to a client who
has endometritis. Which of the following statements by the client should cause
the nurse to hold the medication and consult the provider?
"I have a severe allergy to amoxicillin."
"I get sick when I take diuretics."
"I have a history of hearing problems."
"I take prednisone for my asthma."
Correct Answer
"I have a severe allergy to amoxicillin."MY ANSWERCeftriaxone is a third-generation
cephalosporin. Due to the potential for cross-sensitivity reactions, clients who have
serious allergic responses to penicillin should not take cephalosporins.
"I get sick when I take diuretics."Difficulty taking diuretics does not indicate a need
to avoid taking ceftriaxone. Trimethoprim-sulfamethoxazole is contraindicated for
clients who have allergies to sulfonamides.
"I have a history of hearing problems."Gentamicin and other aminoglycosides are
associated with hearing loss and should be used with caution by clients who have
hearing loss. However, hearing loss is not an adverse effect associated with
ceftriaxone.
"I take prednisone for my asthma."Prednisone, a corticosteroid medication, is
associated with an increased risk of tendon rupture if taken concurrently with a
fluoroquinolone antibiotic, such as ciprofloxacin. However, there is no interaction
associated with prednisone and ceftriaxone.
Page 1 of 52
,Question 2
A nurse is planning a staff education program to review nursing interventions
for clients who have kidney failure. Which of the following sources should the
nurse identify as the best resource for obtaining evidence-based information?
The advice of an expert nephrology nurseThe nurse can obtain information from
another nurse who is considered an expert on kidney failure. However, according to
evidence-based practice, another source would provide the best information.
Retrospective chart reviewsThe nurse can obtain information about implemented
interventions from retrospective chart reviews, which provide information on a select
group of clients over time. However, according to evidence-based practice, another
source would provide the best information.
Facility critical pathwayThe nurse can obtain information from facility critical
pathways, since these care plans provide information on the expected course of the
condition and nursing interventions. However, according to evidence-based practice,
another source would provide the best information.
A recent peer-reviewed nursing research articleMY ANSWERCurrent research articles
in peer-reviewed journals constitute the evidence upon which clinical practice
guidelines and decisions about nursing practice should be based. The nurse should
identify this source as the best resource when preparing a staff education program
attributed to evidence-based practice.
Correct Answer
Page 2 of 52
,Question 3
A community health nurse is reviewing primary prevention strategies for West
Nile virus with a group of clients in a rural health clinic. Which of the following
instructions should the nurse include?
void exposure to deer ticks.Avoiding exposure to deer ticks or black-legged ticks
A
decreases the risk for Lyme disease. Ticks can be avoided by staying away from
heavily wooded areas during the spring and summer months, wearing long-sleeve
shirts and pants, and using an insect repellent containing N,N-diethyl-meta-
toluamide (DEET).
Eliminate areas of standing water.MY ANSWERThe West Nile virus is transmitted to
humans by the bite of a mosquito infected with the virus. Eliminating areas of
standing water where mosquitoes breed reduces the risk for infection.
Use a respiratory mask when cleaning bird coops.Wearing a respiratory mask when
working in environments like chicken or pigeon coops is not necessary to prevent
transmission of West Nile virus. While birds are the natural reservoir of the virus, there
is no evidence of transmission from birds to humans. As a safety precaution, the nurse
should recommend that clients wear gloves if handling a dead bird.
Plan outdoor activities after dusk.Mosquitoes, which are carriers of West Nile virus, are
more active between dusk and dawn. Clients who engage in outdoor activities during
these times should be instructed to wear long sleeve shirts and pants and to use an
insect repellent containing N,N-diethyl-meta-toluamide (DEET).
Correct Answer
Page 3 of 52
, Question 4
A charge nurse is discussing HIPAA with a newly licensed nurse. Which of the
following actions should the charge nurse include in the teaching as an example
of a HIPAA violation?
Correct Answer
Posting the name of the nurse providing care on a client's communication boardThe
nurse's name should be posted on the client's communication board, so the client
knows who to ask for when they need assistance.
Discussing the client's new medication with a hospital pharmacistThe hospital
pharmacist is a member of the interprofessional team providing client care. It is
acceptable for the nurse to discuss the client's new medication with the hospital
pharmacist.
Faxing requested medical information for a client who is transferring to another
facilityIt is acceptable for the nurse to fax requested information for a client who is
transferring to another facility with permission from the client and if following
facility policies. One such policy could include using a cover sheet to indicate the
appropriate recipient of the information, confirming the fax numbers, and
encrypting the information so the fax cannot be read without an encryption key.
Emailing the client's positive hepatitis results from an unencrypted serverMY
ANSWERTo prevent unauthorized access to confidential data, the nurse should not
email any client information over an unencrypted server. This action is a breach of
confidentiality and a HIPAA violation.
Page 4 of 52
