NR446 Exam 4 Actual Exam Style V3 | NR
446 Collaborative Healthcare |
Chamberlain
1. A nurse manager is evaluating a new nurse’s understanding of the prioritization of care.
Which patient should the nurse assess first?
A. A patient with a suspected femoral artery bleed following a cardiac catheterization
B. A patient who is 12 hours post-operative and reporting a pain level of 6 out of 10
C. A patient with a chronic history of COPD who has an oxygen saturation of 91%
D. A patient scheduled for discharge who needs education on their new medication
regimen
Answer: A
Rationale: The nurse should prioritize the patient with the femoral artery bleed because
this represents a life-threatening circulatory emergency. According to the ABC (Airway,
Breathing, Circulation) framework, active bleeding takes precedence over chronic
conditions or expected post-operative pain. Timely intervention is required to prevent
hypovolemic shock and ensure patient stability.
2. A registered nurse (RN) is delegating tasks to a licensed practical nurse (LPN). Which task is
most appropriate for the LPN to perform?
A. Performing the initial assessment of a patient newly admitted for heart failure
,B. Administering an intravenous bolus of a high-alert medication
C. Developing a nursing care plan for a patient with complex multi-system failure
D. Providing sterile dressing changes to a stable patient with a stage III pressure ulcer
Answer: D
Rationale: LPNs are trained to perform sterile procedures and care for stable patients with
predictable outcomes. Assessment, care planning, and administering high-alert IV
medications are typically reserved for the RN scope of practice. This delegation follows the
principle of matching the right task with the right person based on their training and
licensure.
3. The nurse manager is using Lewin’s Change Theory to implement a new electronic health
record system. Which action occurs during the ‘Unfreezing’ stage?
A. Providing training sessions and hands-on practice for all staff members
B. Rewarding staff who successfully transition to the new system without errors
C. Gathering data to demonstrate that the current charting system is inefficient
D. Updating the facility policy manuals to reflect the new electronic workflow
Answer: C
Rationale: The ‘Unfreezing’ stage involves creating the motivation for change by
highlighting the flaws in the current status quo. By gathering data on inefficiencies, the
, manager helps staff realize that a change is necessary for improvement. This step is crucial
for overcoming resistance before the actual transition takes place.
4. A nurse is caring for a patient who refuses a blood transfusion due to religious beliefs,
despite having life-threatening anemia. Which ethical principle is the nurse upholding by
respecting this decision?
A. Beneficence
B. Autonomy
C. Nonmaleficence
D. Justice
Answer: B
Rationale: Autonomy refers to the right of a patient to make their own decisions regarding
their healthcare, even if the nurse disagrees. By respecting the refusal of the transfusion,
the nurse acknowledges the patient’s right to self-determination. This principle is a
cornerstone of patient-centered care and legal medical practice.
5. During a staff meeting, two nurses disagree on the new scheduling protocol. One nurse
says, ‘I’ll just work whatever days you want so we can stop talking about it.’ Which conflict
resolution style is being used?
A. Accommodating
B. Competing
C. Collaborating
446 Collaborative Healthcare |
Chamberlain
1. A nurse manager is evaluating a new nurse’s understanding of the prioritization of care.
Which patient should the nurse assess first?
A. A patient with a suspected femoral artery bleed following a cardiac catheterization
B. A patient who is 12 hours post-operative and reporting a pain level of 6 out of 10
C. A patient with a chronic history of COPD who has an oxygen saturation of 91%
D. A patient scheduled for discharge who needs education on their new medication
regimen
Answer: A
Rationale: The nurse should prioritize the patient with the femoral artery bleed because
this represents a life-threatening circulatory emergency. According to the ABC (Airway,
Breathing, Circulation) framework, active bleeding takes precedence over chronic
conditions or expected post-operative pain. Timely intervention is required to prevent
hypovolemic shock and ensure patient stability.
2. A registered nurse (RN) is delegating tasks to a licensed practical nurse (LPN). Which task is
most appropriate for the LPN to perform?
A. Performing the initial assessment of a patient newly admitted for heart failure
,B. Administering an intravenous bolus of a high-alert medication
C. Developing a nursing care plan for a patient with complex multi-system failure
D. Providing sterile dressing changes to a stable patient with a stage III pressure ulcer
Answer: D
Rationale: LPNs are trained to perform sterile procedures and care for stable patients with
predictable outcomes. Assessment, care planning, and administering high-alert IV
medications are typically reserved for the RN scope of practice. This delegation follows the
principle of matching the right task with the right person based on their training and
licensure.
3. The nurse manager is using Lewin’s Change Theory to implement a new electronic health
record system. Which action occurs during the ‘Unfreezing’ stage?
A. Providing training sessions and hands-on practice for all staff members
B. Rewarding staff who successfully transition to the new system without errors
C. Gathering data to demonstrate that the current charting system is inefficient
D. Updating the facility policy manuals to reflect the new electronic workflow
Answer: C
Rationale: The ‘Unfreezing’ stage involves creating the motivation for change by
highlighting the flaws in the current status quo. By gathering data on inefficiencies, the
, manager helps staff realize that a change is necessary for improvement. This step is crucial
for overcoming resistance before the actual transition takes place.
4. A nurse is caring for a patient who refuses a blood transfusion due to religious beliefs,
despite having life-threatening anemia. Which ethical principle is the nurse upholding by
respecting this decision?
A. Beneficence
B. Autonomy
C. Nonmaleficence
D. Justice
Answer: B
Rationale: Autonomy refers to the right of a patient to make their own decisions regarding
their healthcare, even if the nurse disagrees. By respecting the refusal of the transfusion,
the nurse acknowledges the patient’s right to self-determination. This principle is a
cornerstone of patient-centered care and legal medical practice.
5. During a staff meeting, two nurses disagree on the new scheduling protocol. One nurse
says, ‘I’ll just work whatever days you want so we can stop talking about it.’ Which conflict
resolution style is being used?
A. Accommodating
B. Competing
C. Collaborating
