PN LEADERSHIP EXAM QUESTIONS AND ANSWERS | NGN UPDATE

PN LEADERSHIP EXAM QUESTIONS AND ANSWERS | NGN UPDATEThe nurse who slanders uses the spoken word to harm another professional's reputation Choose matching term Battery Slander Negligence Libel Don't know? 1 of 53 Definition Sanguineous drainage is bright red and indicates active bleeding Choose matching term purulent sanguineous battery serous Don't know? 2 of 53 Definition Monitoring for shortening of the affected leg is a nursing action that identifies dislocation Signs of dislocation include shortening of the extremity pain and external rotation of the extremity These findings should be reported immediately The nurse should check neurovascular status, which includes pain, pallor, pulse, paresthesia, paralysis, and pressure Choose matching term Risk for injury when working with clients who have a history of anger and aggression Serosanguineous Remove an NG tube ( always very order before removal of the NG tube) Monitor for shortening of the affected leg with Hip arthoplasty Don't know? 3 of 53 Definition Example: Nurse Jones is deciding between going to a professional meeting or attending a play Choose matching term The individual nurse is struggling to make a personal or professional decision, which is an example of intrapersonal conflict Battery Five Rights of Delegation The individual nurse is collaborating with a team to plan a community event, which is an example of community engagement Don't know? 4 of 53 Definition It is appropriate to flush the tubing with tap water The stomach is not considered sterile, so tap water is acceptable Typically, the tubing is flushed with 30 to 60 mL of tap water (or as prescribed) following each feeding and after administering medications to prevent clogging When an NG tube is used for decompression, the client is at risk for electrolyte imbalance Irrigation may be necessary if the tip of the tubing rests against the stomach wall or if the tube is blocked with thick secretions Choose matching term Peg Tube Nasogastric Tube NG Tube Chest Tube Don't know? 5 of 53 Definition A first-degree sprain requires rest, ice, compression, and elevation (RICE) -The client should rest the ankle, but immobilization is not necessary for a first-degree sprain Initially, the client may need to avoid weight bearing -Elevate ankle above the level of the heart is correct In order to reduce inflammation as a result of the sprain, the client should elevate the ankle above the level of the heart to promote venous return and decrease edema For example, the nurse should position the client on the bed with the client's foot propped up on one or two pillows to elevate the ankle above the heart Immediately after the injury, the nurse should reinforce to the client to rest, ice, compress, and elevate the ankle Heat may be applied After 48 hr, but the client should not apply heat During the initial 48 hr of injury. Wrap ankle with an elasticized compression bandage Application of an elasticized compression bandage for a few days following the injury is necessary to reduce swelling and provide joint support Compression also can help with pain relief and is facilitated by wrapping an elasticized compression bandage around the injured extremity Choose matching term hip arthroplasty first-degree ankle sprain acute glomerulonephritis predetermined Don't know? 6 of 53 Definition The nurse who uses battery touches a client without permission, which may cause embarrassment or injury Choose matching term Slander Libel Battery Placental Don't know? 7 of 53 Definition Early symptoms of hypoglycemia include sweating, irritability, anxiety, tachycardia, and hunger Late symptoms include weakness, fatigue, confusion, and seizures. TIRED is an acronym for early signs: tachycardia, irritability, restlessness, extreme hunger, and diaphoresis. Choose matching term Maternal complications Five rights of delegation Early symptoms of hypoglycemia A major complication of total hip replacement Don't know? 8 of 53 Definition Acute glomerulonephritis is an inflammation of the glomerular capillaries The expected symptoms include hematuria, decreased urine output, and proteinuria Clients should consume a diet low in sodium and restrict fluid intake Choose matching term Acute tubular necrosis Acute glomerulonephritis Nephrotic syndrome Acute pancreatitis Don't know? 9 of 53 Definition The responsibility for the delivery of quality care rests with the staff member who directly provides the care Individuals have the greatest impact on the perceived quality of care provided to a specific client in any health care organization Choose matching term The nurses conflicting among themselves to make a client care decision is an example of intrapersonal conflict Delegation involves The client is considered to be a primary source of information The responsibility for the delivery of quality care rests with the staff member who directly provides the care Individuals have the greatest impact on the perceived quality of care provided to a specific client in any health care organization Don't know? 10 of 53 Definition Affect is the outward representation of a person's internal state of being and is an objective finding A diminished affect could indicate depression, or be seen in clients who have schizophrenia This should be reported, but it is not the priority Choose matching term Acute glomerulonephritis Decreased energy level Precipitous labor Diminished facial affect Don't know? 11 of 53 Definition Avoid wearing necklaces during client care is correct Know the layout of the facility is Provide immediate verbal feedback for escalating behavior Providing immediate verbal feedback for escalating behavior is an effective de-escalation technique Choose matching term Risk for injury when working with clients who have a history of anger and aggression Remove an NG tube ( always very order before removal of the NG tube) Monitor for shortening of the affected leg with Hip arthoplasty when nurse sees a change in a client's behavior such as Don't know? 12 of 53 Definition The head of the bed should be positioned at a minimum of 30° elevation to prevent aspiration from reflux during feedings The greatest risk to a client receiving enteral feedings is injury from aspiration Therefore, the priority nursing action before initiating an enteral feeding is to determine proper placement of the tube and maintain the client in semi-Fowler's position during the feeding - If aspiration of formula is suspected, the first action the nurse should take is to stop the feeding Other actions should include the following: Turn the client to the side Suction the airway Provide oxygen if indicated Monitor the client's vital signs for elevated temperature Auscultate breath sounds for increased congestion Notify the provider Obtain a chest x-ray Choose matching term First-degree ankle sprain Positioning with Ng feeding Intermittent feeding ng tube feeding Placental Don't know? 13 of 53 Definition The nurse who is libel uses untrue written communication Choose matching term Libel Negligence Battery Slander Don't know? 14 of 53 Definition 1- Note time and call for help: 2- Calling for help will initiate additional team members to assist and is essential for client safety 3- Position client safely 4- Loosen restrictive clothing 5- Reorient and reassure client 6- Determining precipitating trigger Choose matching term client who is experiencing a seizure 1- Note time and call for help: 2- Calling for help will initiate additional team members to assist and is essential for client safety 3- Position client safely: 4- Loosen restrictive clothing 5- Reorient and reassure client 6- Determining precipitating trigger continuous quality improvement (CQI) program client who is experiencing a seizure Treatment for alcohol withdrawal Don't know? 15 of 53 Definition - Meaningless phrases, worry A mixture of words or phrases that lack meaning are characterized by loose association in clients who have schizophrenia It is an indication of disorientation, disorganization, and an alteration in mental cognition This should be the nurse's priority because of the threat to client safety and the safety of others Choose matching term Monitor for shortening of the affected leg with Hip arthoplasty continuous quality improvement (CQI) program Risk for injury when working with clients who have a history of anger and aggression when nurse sees a change in a client's behavior such as Don't know? 16 of 53 Definition Illusions present the greatest safety risk to the client and are therefore the priority finding Findings: - Increased heart rate is a finding that can occur during alcohol withdrawal - Diaphoresis is a finding that can occur during alcohol withdrawal - Vitamin deficiency is a finding that can occur during alcohol withdrawal - Give vitamin B12 Choose matching term client who is experiencing a seizure Intermittent feeding NG Tube feeding continuous quality improvement (CQI) program Treatment for alcohol withdrawal Don't know? 17 of 53 Definition Intermittent feeding may be done by using a large barrel syringe or feeding bag The steps in administering intermittent NG tube feedings include the following: 1- Have the formula and a 60-mL syringe prepared 2- Remove the plunger from the syringe 3- Hold the tubing above the instillation site 3- Open the stopcock on the tubing, and insert the barrel of the syringe with the end up 4- Fill the syringe with 40 to 50 mL of formula 5- If using a feeding bag, fill the bag with the total amount of formula prescribed for one feeding, and hang it to drain via gravity until empty (about 30 min) 6- If using a syringe, hold it high enough for the formula to empty gradually via gravity 7-Continue to refill the syringe until the amount prescribed for the feeding is instilled 8-Flush with tap water after infusion is complete 9-Clamp the NG tube once the feeding and flushing are complete Choose matching term Treatment for alcohol withdrawal client who is experiencing a seizure first-degree ankle sprain Intermittent feeding NG Tube feeding Don't know? 18 of 53 Definition Food sources of iron fall into two categories: 1- heme iron (from lean red meat, poultry, and fish) 2- nonheme iron (from fruit, vegetables, grains, and dried peas and beans) The body more easily absorbs heme iron Choose matching term acute pancreatitis placental Diminished facial affect Iron Don't know? 19 of 53 Definition responsibility: an obligation to accomplish a task accountability: accepting ownership for the results or lack of authority: right to act or empower over others Choose matching term Predetermined The responsibility for the delivery of quality care rests with the staff member who directly provides the care individuals have the greatest impact on the perceived quality of care provided to a specific client in any health care organization Third-degree sprains Delegation involves Don't know? 20 of 53 Definition After addressing the pain the nurse should: rest the pancreas and reduce secretion of pancreatic enzymes, oral fluids and food are withheld during the acute phase of pancreatitis Choose matching term acute cholecystitis acute pancreatitis placental cellulitis Don't know? 21 of 53 Definition - Discontinuing a NG tube requires a provider order Therefore, confirmation of an order would be a priority before removal of the tubeNasogastric tubes can be used to provide enteral nutrition, to administer medication, and to provide gastric decompression - NG tube requires only clean technique - One purpose of NG tubes is to provide gastric decompression -The NG tube is connected to suction, which is connected to a canister to collect gastric drainage Prior to discontinuing the NG tube, the suction should be turned to the off position to prevent damage to the gastric mucosa during removal of the tube It would be important to turn off the suction - Part of the nursing process is to observe and record the color and amount of gastric drainage Choose matching term Intermittent feeding NG Tube feeding The client is considered to be a primary source of information Positioning with Ng feeding Remove an NG tube ( always very order before removal of the NG tube) Don't know? 22 of 53 Definition Prior to administering an intermittent gastric tube feeding, the stomach should be checked for residual volume When gastric residual exceeds 100 mL (10 mL for intestinal placement), the nurse should do the following: - Withhold the feeding - Notify the provider -Maintain semi-Fowler's position -Recheck residual in 1 hr or as prescribed -Before the first feeding, placement should be confirmed with an x-ray Thereafter, placement should be checked by aspirating gastric secretions and checking the pH Aspirate gently to collect gastric contents and observe the color, test pH (4 or less is expected) Note: - Injecting air into the tube and listening over the abdomen is not an acceptable practice. Choose matching term Change Agent Negligence Remove an NG tube ( always very order before removal of the NG tube) NG Tube Don't know? 23 of 53 Definition The nurse should implement foam wedge between legs to prevent dislocation Because the muscle surrounding the hip joint has been cut to expose and replace the diseased joint clients are at risk for hip dislocation Proper body alignment after total hip arthroplasty includes keeping the affected leg slightly abducted A major complication of total hip arthroplasty is subluxation (partial dislocation) or total dislocation In some facilities, abduction devices such as foam wedges and pillows are placed between legs Adduction of the hip should be avoided to prevent dislocation. Choose matching term Ankle fracture Knee arthroplasty Hip arthroplasty Hip replacement Don't know? 24 of 53 Definition Serosanguineous drainage is pink (light red), watery, and a mixture of serum and blood Choose matching term iron serous purulent serosanguineous Don't know? 25 of 53 Definition because they are unlicensed, they have no scope of practice in general, nursing tasks that may be delegated include non-invasive and non-sterile treatments assist in a variety of direct client care activities or tasks, e.g., bathing, transferring, ambulating, feeding, toileting, and obtaining measurements (vital signs, height, weight, intake and output, blood glucose levels) perform indirect activities such as housekeeping, transporting people and stocking supplies Choose matching term Nursing technician (nt) Registered nurse (rn) Preferred Provider Organizations (ppo's) Unlicensed Assistive Personnel (UAP) Don't know? 26 of 53 Definition Example: Nurse Lee is professionally threatened by Nurse Doe Choose matching term The nurse who is threatened by another nurse may be experiencing bullying, this is an example of interpersonal conflict Interpersonal conflict arises from differing goals and value system Battery Slander The individual nurse is struggling to make a personal or professional decision, which is an example of intrapersonal conflict Don't know? 27 of 53 Definition The most effective way to recognize someone's abilities and contributions is through direct, immediate feedback. Direct communication of both positive and negative feedback fosters teamwork Choose matching term Feedback should only be given in written form to avoid misunderstandings Teamwork is best fostered by only highlighting negative aspects of performance Ignoring contributions is the best way to motivate individuals The most effective way to recognize someone's abilities and contributions is through direct, immediate feedback. Direct communication of both positive and negative feedback fosters teamwork Don't know? 28 of 53 Definition assessment of clients evaluation of client data nursing judgment client/family education/counseling and evaluation nursing diagnosis/nursing care planning Choose matching term Rns can delegate medication administration to family members of the client RNs cannot delegate the following activities to unlicensed assistive personnel (UAP) Rns are allowed to share client data with administrative staff for billing purposes Rns can assign tasks to licensed practical nurses (lpns) for patient care Don't know? 29 of 53 Definition The most important intervention is preventing injury to the infant during the delivery Fetal complications from precipitous labor include hypoxia caused by decreased periods of uterine relaxation between contraction A change in pressure from a rapid delivery of the fetal head may cause neurologic damage (increased intracranial pressure and dural/subdural tearing) Rapid birth also may cause maternal injury, such as vaginal or perineal lacerations Choose matching term precipitous labor include ( rapid labor) placental continuous quality improvement (cqi) program maternal complications Don't know? 30 of 53 Definition 1- Note time and call for help: When a client experiences a seizure, noting the time is essential because it allows for accurate documentation that may aid the provider in caring for the client 2- Calling for help will initiate additional team members to assist and is essential for client safety The nurse should remain with the client during this time 3- Position client safely: - If the client is standing or sitting, assist the client to the floor and protect the head - If the client is in the bed, remove pillows and raise side rails Clearing the area promotes client safety Turning the client to the side is essential to allow secretions to drain from the mouth and to prevent aspiration or choking Choose matching term client who is experiencing a seizure 1- Note time and call for help: 2- Calling for help will initiate additional team members to assist and is essential for client safety 3- Position client safely: 4- Loosen restrictive clothing 5- Reorient and reassure client 6- Determining precipitating trigger The responsibility for the delivery of quality care rests with the staff member who directly provides the care Individuals have the greatest impact on the perceived quality of care provided to a specific client in any health care organization The client is considered to be a primary source of information NG Tube Don't know? 31 of 53 Definition to review the events leading up to each medication administration error The purpose of CQI is to evaluate outcomes of care based on standards of practice In CQI, once a problem is identified, data collection and analysis should take place before intervening to fix the problem Evaluation consists of reviewing the events leading up to the errors Choose matching term precipitous labor when nurse sees a change in a client's behavior such as continuous quality improvement (CQI) program placental Don't know? 32 of 53 Definition Provide client privacy during this time 4- Loosen restrictive clothing 5- Reorient and reassure client Continue to monitor the seizure (type of seizure; parts of body affected; loss of consciousness; presence of lip smacking, mastication, or grimacing; rolling of eyes; presence of incontinence; presence of apnea) Some clients may be confused As the client is regaining consciousness, the nurse should reorient the client, explain what happened, and provide reassurance to minimize anxiety 6- Determining precipitating trigger Client safety is the priority when caring for a client during a seizure episode Choose matching term Unlicensed Assistive Personnel (UAP) client who is experiencing a seizure Example: A nurse is teaching a client who is at risk for iron-deficiency anemia about optimizing her dietary intake of iron. The nurse should explain that which of the following sources of iron is easiest for the body to absorb? first-degree ankle sprain Don't know? 33 of 53 Definition Soy milk is the best choice for this client because soy milk is lactose-free. Choose matching term Almond Milk Rice Milk Bean Soup Soy Milk Don't know? 34 of 53 Definition Example: Nurses on the day and night shift are conflicting regarding who should do client daily weights. Choose matching term The nurses conflicting among themselves to make a client care decision is an example of intrapersonal conflict The nurses discussing their shifts and schedules is an example of organizational management The nurses collaborating effectively to enhance patient care is an example of teamwork The nurses agreeing on a common goal for patient outcomes is an example of interprofessional collaboration Don't know? 35 of 53 Definition The nurse's conduct displayed negligence, which is providing client care below the standard of care and placing the client at risk for harm. Choose matching term Slander Libel Negligence Battery Don't know? 36 of 53 Definition Example: Nurses throughout the hospital disagree on having 8-hour shifts or 12-hour shifts Choose matching term The nurses discussing their preferences for breaks is an example of personal negotiation The nurses working together to improve shift efficiency is an example of team building The nurses throughout an organization conflicting about length of shifts is an example of intergroup conflict The nurses agreeing on a standardized shift length is an example of policy implementation Don't know? 37 of 53 Definition A major complication of total hip replacement is subluxation (partial dislocation) or total dislocation In addition to preventing adduction, the client should avoid flexing the hips more than 90°, not 60° The nurse should use diagrams or demonstrate correct positioning to help reinforce this information prior to the surgical procedure Choose matching term A major complication of total hip replacement Maternal complications Monitor for shortening of the affected leg with Hip arthoplasty The most effective way to recognize someone's abilities and contributions is through direct, immediate feedback. direct communication of both positive and negative feedback fosters teamwork Don't know? 38 of 53 Definition Immobilization is indicated for 4 to 6 weeks in or when severe ligament damage occurs As a result of a third-degree sprain, arthroscopic surgery may be necessary Choose matching term Third-degree sprains Predetermined Placental Chronic subluxing peroneal tendons Don't know? 39 of 53 Definition Predetermined is used to distinguish the characteristic for implementing a new standard of care Choose matching term Predefined Structured Predetermined Centralized Don't know? 40 of 53 Definition Cellulitis is a generalized infection in deep connective tissue with staphylococcus or streptococcus It is usually a localized inflammation that may enlarge rapidly if not treated Expected findings include redness, warmth, edema, tenderness, and pain This client will require pain management and antibiotics Choose matching term Psoriasis Folliculitis Dermatitis Cellulitis Don't know? 41 of 53 Definition If the client reports throbbing, discomfort, or the wrap is too tight, the nurse should remove and rewrap the bandage with less stretch The nurse should begin from the distal point of the extremity (toes) and move toward the proximal point (up the leg) in order to promote venous return Apply intermittent cold compress to the ankle for the first 24-48 hr Cold is used for the first 24-48 hr For a client who has a muscle sprain, an ice bag is an ideal nonpharmacological intervention to prevent edema formation as well as to anesthetize the body part Cold provides short-term pain relief and also limits swelling by reducing blood flow to the injured area through vasoconstriction The nurse should reinforce to the client not to apply ice directly to the skin or leave ice on the ankle for more than 20 min at a time Longer exposure can damage the skin and even potentially result in frostbite Choose matching term ng tube predetermined first-degree ankle sprain hip arthroplasty Don't know? 42 of 53 Definition Precipitous labor is defined as labor that lasts less than 3 hr from the onset of contractions to the time of birth Precipitous labor may result from hypertonic uterine contractions, which may increase the risk for placenta abruption Choose matching term Hemorrhage Placental Precipitous labor Uterine hyperstimulation Don't know? 43 of 53 Definition assist in implementing a defined plan of care and to perform procedures according to protocol assessment skills involve collecting data and are directed at differentiating normal from abnormal may reinforce information that has been given to the client by the RN competence to care for physiologically stable clients with predictable conditions the scope of practice for LPN/VNs is not the same in every jurisdiction Choose matching term Continuous quality improvement (cqi) program Positioning with ng feeding client who is experiencing a seizure Licensed Practical or Vocational Nurses (LPN/VN) Don't know? 44 of 53 Definition Right Task Right Circumstances Right Person Right Direction/Communication Right Supervision/Evaluation Choose matching term Appropriate Delegation Five Rights of Delegation Characteristics of Communication Early Symptoms of Hypoglycemia Don't know? 45 of 53 Definition Wearing elastic stockings or a sequential compression device (SCD) will help prevent another complication, venous thromboembolism To prevent venous thromboembolism, the nurse should also teach leg exercises; encourage fluid intake; observe for redness, swelling, pain, or changes in mental status; and administer prescribed anticoagulants Choose matching term Pulmonary embolism Venous thromboembolism Cellulitis Hemorrhage Don't know? 46 of 53 Definition Information obtained directly from the client (client concern) is the most accurate and provides the best information available to the nurse The client is considered to be a primary source of information. Choose matching term Client concerns are often exaggerated and should be disregarded The nurse should rely on secondary sources for accurate information The client is considered to be a primary source of information Information from family members is always more reliable than from the client Don't know? 47 of 53 Definition Seizure precautions include placing the bed in the lowest position, ensuring oxygen and suctioning equipment are available, and placing a saline lock (especially if the client is at risk for a generalized tonic-clonic seizure) The practice of padding the side rails is currently controversial Side rails are rarely the source of significant injury, Padded side rails may embarrass the client and family, and could be considered a restraint Therefore, the agency policy regarding this practice must be followed After reorienting the client and ensuring a return to stable vital signs, the nurse should determine whether the client experienced an aura, which can possibly indicate the origin of the seizure in the brain Determining a trigger that precipitated the seizure will assist the client in preventing recurring episodes and manage the disorder Choose matching term client who is experiencing a seizure client who is experiencing a seizure 1- Note time and call for help: 2- Calling for help will initiate additional team members to assist and is essential for client safety 3- Position client safely: 4- Loosen restrictive clothing 5- Reorient and reassure client 6- Determining precipitating trigger Unlicensed Assistive Personnel (UAP) Example: A nurse is teaching a client who is at risk for iron-deficiency anemia about optimizing her dietary intake of iron. The nurse should explain that which of the following sources of iron is easiest for the body to absorb? Don't know? 48 of 53 Definition Remember the steps in the Nursing Process - A Delicious PIE A = Assessment D = Diagnosis P = Planning I = Implementation E = Evaluation Choose matching term Predetermined The client is considered to be a primary source of information Remember the steps in the Nursing Process - A Delicious PIE when nurse sees a change in a client's behavior such as Don't know? 49 of 53 Definition A change agent organizes and prepare available resources when change is going to occur and informs the staff nurse of the change and education needed, this statement is characteristic of a change agent A change agent plans ahead for education when a major change occurs A change agent is knowledgeable of available resources to meet the needs of change for the staff nurses A change agent is an excellent communicator when change is impending Choose matching term sanguineous placental serosanguineous Change Agent Don't know? 50 of 53 Definition If a precipitous labor results in emergency birth without the provider attending, the placenta can be left in place until the provider arrives The nurse should never tug on the cord Signs of placental separation include a slight gush of dark blood, lengthening of the cord, and change in the shape of the uterus. Choose matching term precipitous labor dilation placental marsupial Don't know? 51 of 53 Definition Maternal complications associated with a precipitous labor can include: uterine rupture, lacerations of the birth canal, and postpartum hemorrhage Applying perineal pressure as the fetal head is crowning may decrease maternal tearing and injury Choose matching term Fetal anomalies Maternal complications Acute pancreatitis Gender Don't know? 52 of 53 Definition Chicken Choose matching term The nurses conflicting among themselves to make a client care decision is an example of intrapersonal conflict client who is experiencing a seizure 1- Note time and call for help: 2- Calling for help will initiate additional team members to assist and is essential for client safety 3- Position client safely: 4- Loosen restrictive clothing 5- Reorient and reassure client 6- Determining precipitating trigger Example: A nurse is teaching a client who is at risk for iron-deficiency anemia about optimizing her dietary intake of iron. The nurse should explain that which of the following sources of iron is easiest for the body to absorb? client who is experiencing a seizure