Leadership,
Management,
Delegation, and
Prioritization (Part 2)
### Question 1
The charge nurse is making patient assignments for a medical-surgical unit with a high patient acuity
level. Which patient should the charge nurse assign to the most experienced registered nurse?
A. A patient with diabetes mellitus requiring insulin administration
,B. A patient with a newly placed chest tube after a pneumothorax
C. A patient with a urinary tract infection requiring oral antibiotics
D. A patient with chronic hypertension requiring blood pressure monitoring
💫RATIONALE✔️✔️: The patient with a newly placed chest tube requires the most experienced nurse
due to the complexity of care, need for close monitoring, and potential for rapid deterioration. Chest
tube management requires advanced assessment skills and knowledge of potential complications.
💫ANSWER✔️✔️: B. A patient with a newly placed chest tube after a pneumothorax
---
### Question 2
The nurse manager is implementing a new evidence-based practice protocol for preventing central line-
associated bloodstream infections (CLABSIs). Which approach is most likely to promote successful
adoption of the new protocol?
A. Distributing written copies of the protocol to all staff members
B. Involving staff nurses in the development and implementation process
C. Requiring staff to attend a mandatory training session
D. Posting the protocol on the unit's bulletin board
💫RATIONALE✔️✔️: Involving staff nurses in the development and implementation of evidence-
based practice changes promotes buy-in, ownership, and sustainability. Staff engagement leads to
better understanding, acceptance, and adherence to new protocols.
💫ANSWER✔️✔️: B. Involving staff nurses in the development and implementation process
,---
### Question 3
The RN is delegating tasks to the licensed practical nurse (LPN) and unlicensed assistive personnel (UAP).
Which task should the RN delegate to the UAP?
A. Administering oral medications to stable patients
B. Performing a sterile dressing change
C. Assisting a patient with bathing and hygiene
D. Performing a comprehensive admission assessment
💫RATIONALE✔️✔️: Assisting with bathing and hygiene is within the scope of practice for UAP.
Administering oral medications and performing sterile dressing changes are tasks for licensed nursing
personnel. Comprehensive admission assessments are the responsibility of the RN.
💫ANSWER✔️✔️: C. Assisting a patient with bathing and hygiene
---
### Question 4
The nurse is caring for multiple patients and must prioritize care. Which patient should the nurse assess
first?
A. A patient who is 2 days post-operative and reports pain rated 6 on a 0-10 scale
, B. A patient with a history of chronic obstructive pulmonary disease who has an oxygen saturation of
88%
C. A patient who requests a glass of water
D. A patient who needs assistance with ambulation to the bathroom
💫RATIONALE✔️✔️: The patient with an oxygen saturation of 88% is experiencing hypoxemia and
requires immediate assessment and intervention. This is a priority over pain management, requests for
water, and ambulation assistance.
💫ANSWER✔️✔️: B. A patient with a history of chronic obstructive pulmonary disease who has an
oxygen saturation of 88%
---
### Question 5
A nurse manager is reviewing the occurrence of medication errors on the unit. Which approach is most
effective for reducing medication errors?
A. Disciplining nurses who make medication errors
B. Implementing a "no-interruption" zone during medication administration
C. Requiring nurses to administer medications within 10 minutes of preparation
D. Increasing the number of medication carts on the unit
💫RATIONALE✔️✔️: A "no-interruption" zone during medication administration has been shown to
significantly reduce medication errors by allowing nurses to focus on the medication administration
process without distractions. This is a proactive, systems-based approach.
Management,
Delegation, and
Prioritization (Part 2)
### Question 1
The charge nurse is making patient assignments for a medical-surgical unit with a high patient acuity
level. Which patient should the charge nurse assign to the most experienced registered nurse?
A. A patient with diabetes mellitus requiring insulin administration
,B. A patient with a newly placed chest tube after a pneumothorax
C. A patient with a urinary tract infection requiring oral antibiotics
D. A patient with chronic hypertension requiring blood pressure monitoring
💫RATIONALE✔️✔️: The patient with a newly placed chest tube requires the most experienced nurse
due to the complexity of care, need for close monitoring, and potential for rapid deterioration. Chest
tube management requires advanced assessment skills and knowledge of potential complications.
💫ANSWER✔️✔️: B. A patient with a newly placed chest tube after a pneumothorax
---
### Question 2
The nurse manager is implementing a new evidence-based practice protocol for preventing central line-
associated bloodstream infections (CLABSIs). Which approach is most likely to promote successful
adoption of the new protocol?
A. Distributing written copies of the protocol to all staff members
B. Involving staff nurses in the development and implementation process
C. Requiring staff to attend a mandatory training session
D. Posting the protocol on the unit's bulletin board
💫RATIONALE✔️✔️: Involving staff nurses in the development and implementation of evidence-
based practice changes promotes buy-in, ownership, and sustainability. Staff engagement leads to
better understanding, acceptance, and adherence to new protocols.
💫ANSWER✔️✔️: B. Involving staff nurses in the development and implementation process
,---
### Question 3
The RN is delegating tasks to the licensed practical nurse (LPN) and unlicensed assistive personnel (UAP).
Which task should the RN delegate to the UAP?
A. Administering oral medications to stable patients
B. Performing a sterile dressing change
C. Assisting a patient with bathing and hygiene
D. Performing a comprehensive admission assessment
💫RATIONALE✔️✔️: Assisting with bathing and hygiene is within the scope of practice for UAP.
Administering oral medications and performing sterile dressing changes are tasks for licensed nursing
personnel. Comprehensive admission assessments are the responsibility of the RN.
💫ANSWER✔️✔️: C. Assisting a patient with bathing and hygiene
---
### Question 4
The nurse is caring for multiple patients and must prioritize care. Which patient should the nurse assess
first?
A. A patient who is 2 days post-operative and reports pain rated 6 on a 0-10 scale
, B. A patient with a history of chronic obstructive pulmonary disease who has an oxygen saturation of
88%
C. A patient who requests a glass of water
D. A patient who needs assistance with ambulation to the bathroom
💫RATIONALE✔️✔️: The patient with an oxygen saturation of 88% is experiencing hypoxemia and
requires immediate assessment and intervention. This is a priority over pain management, requests for
water, and ambulation assistance.
💫ANSWER✔️✔️: B. A patient with a history of chronic obstructive pulmonary disease who has an
oxygen saturation of 88%
---
### Question 5
A nurse manager is reviewing the occurrence of medication errors on the unit. Which approach is most
effective for reducing medication errors?
A. Disciplining nurses who make medication errors
B. Implementing a "no-interruption" zone during medication administration
C. Requiring nurses to administer medications within 10 minutes of preparation
D. Increasing the number of medication carts on the unit
💫RATIONALE✔️✔️: A "no-interruption" zone during medication administration has been shown to
significantly reduce medication errors by allowing nurses to focus on the medication administration
process without distractions. This is a proactive, systems-based approach.
