Hesi Leadership Exit Exam Version 2

1.A nurse is performing telephone triage at the clinic office. Which client has the most acute problem and should be scheduled for the first available appointment?: A 21 year old with a history of a kidney transplant. Today the client reports flu-like symptoms with a fever of 100.4 F (38 C) 2. 2.The nurse is admitting a woman who has an arteriovenous (AV) fistula in her right arm that is used for hemodialysis. She missed her last hemodialysis session and is experiencing shortness of breath and an irregular heartbeat. Which action should the nurse assign to the UPA who is working with the nurse?: Measure Vital Signs 3. 3.The nurse should assess the client with which problem first?: Paresthesia secondary to an arterial occlusion 4. 4.A young adult client with a brain tumor refuses further treatment and requests to be allowed to die a natural death. The healthcare provides does not agree with the client's decision and refuses to write do-not-resuscitate instructions. Which action should the nurse take?: Initiate a review of the situation by the hospital's ethics committee. 5. 5.A healthcare provider notifies the nurse that new prescriptions have been written for a client. Which is the 1st action the nurse should implement?: Read all of the new prescriptions for the client written by the provider 6. 6.The nurse is observing the staff provide care to a client with acquired immune deficiency syndrome: Unlicensed assistive personnel wearing a mask to take client's blood pressure. 7. 7.The nurse caring for a client with bacterial meningitis is preparing report for the oncoming nurse. It is most important to include which assessment finding in the report?: Increasing Pulse Pressure 8. 8.The charge nurse notices that a respiratory therapist who has been cross-trained to work as a phlebotomist and unlicensed assistive personnel (UAP) seems to be avoiding HIV positive clients: Provide the employee with feedback about observed behavior 9. 9.The nursing supervisor sends an unlicensed assistant personnel ( UAP) to a medical unit to replace an absent UAP. When delegating the task of obtaining client's blood sugar levels using a glucometer, which action is most important for the nurse to implement?: Observe the UAP obtain a fingerstick glucose level using the glucometer. 10. 10.The nurse manager conducts regular audits of patient care medication records and notices that the amount of narcotic pain medications administered during the evening shift on a postsurgical unit: Conduct a closer examination of staff nurse's distribution of pain medication from evening shift 11. 11.The smell of cigarette smoke is coming from a client's bathroom. Which action should the nurse: Educate the client about the hospital smoking policy. 12. 12.The practical nurse (PN) reports to the charge nurse that the transparent dressing covering a single lumen central venous catheter inserted in the subclavian vein of a client has come loose and the insertion site is inflamed. Which action should the charge nurse implement?: Confirm the findings of the PN while securing the transparent dressing and notify the healthcare provider. 13. 13.At 0200 the nurse phones the healthcare provider to request a PRN medication for a client who is unable to sleep. The healthcare provider is awakened and gives the nurse a prescription for four times the normal dosage. When questioned by the nurse, the healthcare provider responds in a sleepy: Call the healthcare or back, and report that the dosage prescribed is our times the normal dosage. 14. 14.The charge nurse notices that a female practical nurse (PN), who has a long work history on the unit and is a valued employee, seems tired and slow to respond verbally during the change of shift report. One hour later the charge nurse overhears the PN telling an unlicensed assistive personnel (UAP) that she took a sleeping pill 4 hours ago and she is still feeling its effects. Which action should the charge nurse take?: Send the PN to the employee health center for a urine drug Screen 15. 15.It is most important to assign which client to a registered nurse rather than a practical nurse?: After ambulating, a postoperative client grimaces and reports incisional pain at a "9" on a point scale. 16. 16.After receiving a change of shift report for clients on a medical surgical unit, which task should the nurse: Apply hydrocolloid dressings to venous 17. 17.The charge nurse observes unlicensed assistive personnel (UAP) and a nurse arguing at the nurse's station. What action is best for the charge nurse to implement?: Inform both individuals that their behavior is inappropriate in a work setting 18. 18.A male client with metastatic lung cancer has requested that "no heroic measures" are used to extend his life, so the healthcare provider prescribes transferring the client to the palliative care: Ensure the prescriptions or transfer include the client's end-of-life choice. 19. 19.The charge nurse observes that a client with a nasogastric tube applied to low intermittent suction is drinking a glass of water immediately after the unlicensed assistive personnel (UAP) left the room. What is the best initial action for the charge nurse to take.: Remove the glass of water and speak to the UAP. 20. 20.The nurse hears a newly employed unlicensed assistive personnel (UAP) who is working in a long-term care facility calling the adult residents "honey" and "dearie." What is the best action for the nurse to take?: Meet with the UAP to discuss respectful client care strategies. 21. 21.The charge nurse is providing instructions to unlicensed assistive personnel (UAP) who will be assisting with the care of a client who has a hiatal hernia. Which instruction should the charge provide the UPA?: Elevate the head of the bed before the client begins to eat 22. 22.A nurse (RN), practical nurse (PN), and unlicensed assistive personnel (UAP) are working as a team to provide care for an acutely ill client requiring immediate bedside insertion of a chest tube. Which assignment is best use of each persons skills?: The UAP obtains oxygen saturation level while the RN reports findings to the healthcare provider 23. 23.The nurse is caring for a group of clients with the help of an experienced unlicensed assistive personnel UAP . Several specimens need to be collected and sent to the lab. Wich specimen collection can the nurse delegate to the UAP?: Urine from indwelling catheter. Fecal drainage sample.