NR446 Exam 3 Actual Exam Style V3 | NR
446 Collaborative Healthcare |
Chamberlain
1. A nurse is prioritizing care for four clients. Which client should the nurse assess first?
A. A client who is post-operative and requests pain medication.
B. A client who has a chest tube and reports a new onset of dyspnea.
C. A client with a fever of 101.2 F following surgery.
D. A client who needs a dressing change for a stage III pressure injury.
Answer: B
Rationale: The client with new-onset dyspnea takes priority according to the ABC (Airway,
Breathing, Circulation) framework. New respiratory distress in a client with a chest tube
could indicate a tension pneumothorax or tube displacement. The other clients are stable
or have needs that can be addressed after the emergency is managed.
2. An RN is delegating tasks to a Licensed Practical Nurse (LPN). Which task is most
appropriate for the LPN?
A. Developing the initial teaching plan for a client with newly diagnosed diabetes.
B. Administering an intravenous bolus of a high-alert medication.
C. Performing an admission assessment on a client transferred from the ICU.
D. Administering a scheduled subcutaneous insulin injection.
,Answer: D
Rationale: LPNs are trained to administer medications through various routes, including
subcutaneous injections. Developing teaching plans and performing initial or complex
assessments are responsibilities reserved for the RN. Administering high-alert IV bolus
medications is typically outside the scope of practice for an LPN in many jurisdictions.
3. A nurse manager is resolving a conflict between two staff nurses using the ‘win-win’
approach. Which strategy is being used?
A. Compromising
B. Competing
C. Avoiding
D. Collaborating
Answer: D
Rationale: Collaboration is considered a win-win strategy because both parties work
together to find a mutually satisfying solution. This process requires open communication
and a focus on shared goals rather than individual winning. It is the most effective way to
ensure long-term resolution and team cohesion.
4. Which action by the nurse demonstrates the ethical principle of beneficence?
A. Providing a client with accurate information about their diagnosis.
B. Spending extra time to sit and talk with a lonely client.
, C. Fostering the client’s right to make their own healthcare decisions.
D. Ensuring that the same quality of care is given to all clients.
Answer: B
Rationale: Beneficence refers to the duty to do good and promote the well-being of others.
Spending extra time with a lonely client directly benefits the client’s emotional health and
demonstrates this principle. Other principles like autonomy, veracity, and justice address
different ethical obligations.
5. A mass casualty event has occurred, and the nurse is triaging victims. Which client should
receive a ‘red’ tag?
A. A client with a sucking chest wound and significant respiratory distress.
B. A client with a large head wound who is unresponsive and has agonal gasps.
C. A client with a compound fracture of the femur and a pedal pulse.
D. A client with minor abrasions and a small laceration on the arm.
Answer: A
Rationale: The red tag is assigned to clients who have life-threatening injuries but a high
chance of survival if treated immediately. A sucking chest wound is an immediate threat to
the airway and breathing that can be corrected. In contrast, agonal gasps in a mass casualty
usually result in a black tag for expectant death due to low survival probability.
446 Collaborative Healthcare |
Chamberlain
1. A nurse is prioritizing care for four clients. Which client should the nurse assess first?
A. A client who is post-operative and requests pain medication.
B. A client who has a chest tube and reports a new onset of dyspnea.
C. A client with a fever of 101.2 F following surgery.
D. A client who needs a dressing change for a stage III pressure injury.
Answer: B
Rationale: The client with new-onset dyspnea takes priority according to the ABC (Airway,
Breathing, Circulation) framework. New respiratory distress in a client with a chest tube
could indicate a tension pneumothorax or tube displacement. The other clients are stable
or have needs that can be addressed after the emergency is managed.
2. An RN is delegating tasks to a Licensed Practical Nurse (LPN). Which task is most
appropriate for the LPN?
A. Developing the initial teaching plan for a client with newly diagnosed diabetes.
B. Administering an intravenous bolus of a high-alert medication.
C. Performing an admission assessment on a client transferred from the ICU.
D. Administering a scheduled subcutaneous insulin injection.
,Answer: D
Rationale: LPNs are trained to administer medications through various routes, including
subcutaneous injections. Developing teaching plans and performing initial or complex
assessments are responsibilities reserved for the RN. Administering high-alert IV bolus
medications is typically outside the scope of practice for an LPN in many jurisdictions.
3. A nurse manager is resolving a conflict between two staff nurses using the ‘win-win’
approach. Which strategy is being used?
A. Compromising
B. Competing
C. Avoiding
D. Collaborating
Answer: D
Rationale: Collaboration is considered a win-win strategy because both parties work
together to find a mutually satisfying solution. This process requires open communication
and a focus on shared goals rather than individual winning. It is the most effective way to
ensure long-term resolution and team cohesion.
4. Which action by the nurse demonstrates the ethical principle of beneficence?
A. Providing a client with accurate information about their diagnosis.
B. Spending extra time to sit and talk with a lonely client.
, C. Fostering the client’s right to make their own healthcare decisions.
D. Ensuring that the same quality of care is given to all clients.
Answer: B
Rationale: Beneficence refers to the duty to do good and promote the well-being of others.
Spending extra time with a lonely client directly benefits the client’s emotional health and
demonstrates this principle. Other principles like autonomy, veracity, and justice address
different ethical obligations.
5. A mass casualty event has occurred, and the nurse is triaging victims. Which client should
receive a ‘red’ tag?
A. A client with a sucking chest wound and significant respiratory distress.
B. A client with a large head wound who is unresponsive and has agonal gasps.
C. A client with a compound fracture of the femur and a pedal pulse.
D. A client with minor abrasions and a small laceration on the arm.
Answer: A
Rationale: The red tag is assigned to clients who have life-threatening injuries but a high
chance of survival if treated immediately. A sucking chest wound is an immediate threat to
the airway and breathing that can be corrected. In contrast, agonal gasps in a mass casualty
usually result in a black tag for expectant death due to low survival probability.
