HESI-RN-LEADERSHIP-AND-MANAGEMENT-EXAM-20-Versions-1200-Verified-Q-A-Latest-2022/2023,100% CORRECT

HESI-RN-LEADERSHIP-AND-MANAGEMENT-EXAM-20-Versions-1200-Verified-Q-A-Latest-2022/2023 5. Client satisfactory surveys from a med-surg unit indicate the pain is not being adequately relieved during the first 12 hr post-opt. The unit manager decides to identify post-opt pain as a quality indicator. Which of the following data sources will be helpful in determine the reason why clients are not receiving adequate pain management after surgery? A. Prospective chart audit B. Retrospective chart audit C. Postoperative care policy D. Pain assessment policy 6. A nurse precepting a newly licenced nurse who is caring for a client who is confused and has an IV infusion. The newly licensed nurse has placed the client in wrist restraints to prevent dislodging the IV catheter. Which of the following questions should the precepting nurse ask? A. “Did you secure the restraints to the side rails of the bed?” B. “Are you able to insert two fingers between the restraint and the client‟s skin?” C. “Did you tie the restraints using double knot?” D. “Are you removing the client‟s restraints every 4 hr?” 7. A nurse is caring for an older adult client who has stage III pressure ulcer. The nurse request a consultation with the wound care specialist. Which of the following actions by the nurse is appropriate when working with a consultant? A. Arrange the consultation for time when the nurse is caring for the client is able to be present for consultation B. Provide the consultant with subjective opinions and beliefs about the client‟s wound care C. Request the consultation after several wound care treatment tried D. Arrange for the wound care nurse specialist to see the client daily to provide the recommended treatment 8. A client is admitted wit TB and placed in a negative pressure room. Which of the following actions is appropriate? A. Notify the local health department of the admission B. Place a sign on the client‟s door with the diagnosis C. Ensure that admitting staff undergo PPD skin tests D. Determine who had contact with the client in the last 48 hr 9. A nurse is caring for a client who is unconscious and whose partner is health care proxy. The partner has spoken with the provider and wishes to discontinue the client‟s feeding tube. The provider states the nurse, “I will not discontinue the client‟s treatment. His partner has no right to make decisions regarding the client‟s care. “Which of the following responses by the nurse is appropriate? A. You should consider speaking with the facility‟s ethics committee before making your decision B. You have the right to make decision, even if the partner is the client‟s health care proxy C. The client has designated his partner as health care proxy in his advance directives D. We‟ll need to have the nursing supervisor review the client‟s advance directives 10. A nurse is caring for a client who has increased intracranial pressure and is receiving IV corticosteroids. Which of the following info is most important for the nurse to report at shift change? A. Gasglow Coma scale score B. Most recent blood glucose reading C. Lab test scheduled for next shift D. Reddened area on the coccyx 11. A nurse is assigned the following four clients for the current shift. Which of the following clients should the nurse assess first? A. A client who has a hip fracture and is in Buck‟s traction B. A client who has aspiration pneumonia and a respiratory rate of 28/min C. A client who has diabetes mellitus stage 2 pressure ulcer on his foot D. A client who has a C diff infection and needs a stool specimen collected 12. A nurse is caring for a client who fell and is reporting pain in the left hip with external rotation of the left leg. The nurse has been unable to reach the provider despite several attempts over the past 30 min. Which of the following actions should the nurse take? A. Notify the nursing supervisor about the issues B. Contact the client‟s physical therapist C. Apply a warm compress to the hip D. Reposition the client for comfort 13. The mother of a client with breast cancer states, it‟s been hard for her, especially after losing her hair. And it has been difficult to pay for all the treatments. Which of the following actions is appropriate client advocacy? A. The nurse investigates potential resources to help the client purchase wig B. The nurse explains to the mother that most clients with cancer lose their hair C. The nurse informs the next shift nurse regarding the mother‟s concerns. D. The nurse suggests counseling for the client‟s body image issues 14. Which of the following items must be discarded in a biohazard waste receptacle? A. A urinary catheter drainage bag from a client who is post-opt B. A bed sheet from a client with bacterial pneumonia C. A perineal pad from a client who is 24-hr post-vaginal delivery D. An empty IV bag removed from a client who has HIV 15. A nurse tells the unit manager, “I am tired of all the changes on the unit. If things don‟t get better, I‟m going to quit. “Which of the following responses appropriate? A. “So you are upset about all the changes on the Unit” B. “I think you have a right to be upset, I am tired of the changes too” C. “Just stick with it a little longer. Things will get better soon D. “ You should file complaints with hospital administrator 16. According to the HIPAA regulations, which of the following is a violation of client confidentiality? A. Telephone the pharmacy with a prescription for the spouse to pick up B. Providing a copy of the record to the transporting paramedic C. Reporting a client‟s disposition to the referring provider D. Informing housekeeping staff that the client is in dialysis unit 17. A Nurse preceptor is evaluating a newly licensed nurse‟s competency in assisting with a sterile procedure. Which of the following actions indicates the nurse is maintaining sterile technique? (Select all that apply.) A. Open the sterile pack by first unfolding the flap farthest from her body B. Rests the cap of a solution container upside down on the sterile field C. Removes the outside packaging of a sterile instrument before dropping into the sterile field D. Holds a bottle of a sterile solution 15 cm (6 inches) above the sterile field E. Places sterile items within 1.25 cm (0.5 inch) border around the edge of the sterile field 18. A nurse is providing care for 4 post-opt clients. The nurse should first assess the client A. Whose pulse has been steadily increasing during the past shift B. Who is reporting a pain level of 8 on a scale of 0 to 10. C. Whose urine output averaged 32 ml/hr for the past 24 hr D. Who is reporting nausea after the prescribed antiemetic was administered 19. A nurse is preparing to transcribe a client‟s med prescription in the medical record. Which of the following should the nurse recognize as containing the essential components of a medication order? A. NPH insulin 10 Units before and at bedtime B. Haloperidol (Hadol) 1mg per mouth C. Multivit every morning by mouth D. Aspirin 650 mg by mouth every 4hr 20. A nurse is assisting with orientation of a newly licensed nurse. The newly licensed nurse is having trouble focusing and has difficulty completing care for his assigned clients. Which of the following interventions is appropriate? A. Recommend that he takes time to plan at the beginning of shift B. Advise him to complete less time-consuming tasks first C. Ask other staff members to take over some of his staffs D. Offer to provide care for his clients while he takes a break 21. A nurse in an urgent care clinic is admitting a client who has been exposed to a liquid chemical in an industrial setting, which of the following actions should the nurse take first? A. Remove the client‟s clothing B. Irrigate the exposed area with water C. Report the incident to OSHA Don personal protective equipment. 22. A facility provides annual staff education regarding ethical practice. A charge nurse recognizes a need for further education when which of the following behaviors is observed? A. A nurse refuses to actively participate during an elective abortion procedure scheduled for her client. B. A nurse gives prescribed opioids to a client who has a terminal illness and respirations of 8/min C. A nurse explains to a client‟s family that a DNR order includes withholding comfort measures D. A nurse informs a confused client who wants to go home that he is going to stay at the facility until he is better 23. A nurse is an ambulatory care setting is orienting a newly licensed nurse who is preparing to return a call to a client. The nurse should explain that which of the following is an objective of tele health? A. Assessing client needs B. Providing med reconciliation C. Establishing communication between providers D. Developing client treatment protocols 24. Which of the following put a hospital at the highest risk of infringement of client record confidentiality? A. A nurse clusters documentation of care for multiple clients? B. A provider and nurse access client info using one access code C. Paper-based charts are stored at the nurse‟s station D. A nurse performs electronic documentation outside a client‟s room 25. Which of the following observations requires a charge nurse to intervene and demonstrate safe handling techniques? A. A nurse cleans up blood spill with a 1:10 bleach solution B. A nurse uses googles to perform tracheostomy suctioning C. A nurse disconnects an indwelling urinary catheter from the drainage bag to collect a specimen D. A nurse places a mask on a client with TB before transport to the radiology department 26. Which of the following should lead a nurse to suspect abuse that must be reported? A. A school-age child has several bruises on her lower legs. B. A toddler cries whenever his parents enters the hospitals room. C. An Adolescent admitted to the emergency won‟t speak to his parents D. A preschool child who was previously toilet trained now requires diapers in the hospital 27. A parish nurse is making referral to a community meal delivery program for a member of the congregation. This is an example of which of the following functions of the parish nurse? A. Liaison B. Pastoral care provider C. Health educator D. Personal Health counselor 28. A nurse performing triage during a mass casualty incident should recognize that which of the following clients should be transported to the hospital first? A. A client who reports substernal chest pain radiating to the neck ????? B. A client who has an open fracture of the femur C. A client who has a 4-inch laceration on the forearm D. A client who has a penetrating head injury and fixed dilated pupils 29. A nurse is providing teaching to a client about advance directives. Which of the following statements by the client indicates an understanding of the teaching? a. “Once I sign my living will, a family member must co sign it” b. “I will wait until I have a serious health problems to sign my advance directives” c. “My doctor will need to provide approval for the decisions outlines in my living will d. “My durable power of attorney for health care is part of my advance directives” 30. A nurse manager overhears a provider and a staff nurse talking about a client‟s diagnosis in the cafeteria. Which of the following actions should the nurse take first? A. Provide a staff in-service about client confidentiality B. Report the incident to the nursing supervisor C. Remind them that the client info is confidential ???????? D. Fill out an incident report regarding the situation 31. A client has a substance use disorder is admitted to the mental health Unit and reports that he has been depressed lately. When preparing for discharge the next day, the client states: “It‟s Ok. Soon everything will be just fine.” Which of the following is the nurse‟s primary first action? A. Ask the client if he has considered hurting himself B. Provide the client with info about Alcoholics Anonymous C. Encourage the client to participate in physical activities D. Reinforce the need to follow up with the discharge referral 32. A nurse is caring for a client who reports acute pain but refuses IM medication. The nurse distracts the client and quickly administer the injection. This illustrate which of the following? A. False imprisonment B. Battery C. Assault D. Libel 33. A nurse manager smells alcohol on the breath of a nurse who is starting a shift. Which of the following actions should the nurse manager take first? A. Report the situation to the director of nursing B. Have a blood alcohol level drawn from the nurse C. Document a factual description of the situation D. Remove the nurse from the unit 34. A nurse observes a paper bag at the bedside of a client. This finding suggest that the client is receiving treatment for which of the respiratory disorders A. Asthma B. Hyperventilation C. Stidor D. Atelectasis 35. A nurse is preparing the discharge a client back to a long-term care facility after he was admitted to an acute care facility 2 days ago for pneumonia. Which of the following information should the nurse include in the verbal transfer report? A. Lab results within the expected reference range B. List of regularly prescribed meds C. Date of last bowel movement D. Level of consciousness 36. A nurse who is precepting a newly licensed nurse is discussing the client assignment for the shift. Which of the following actions should the nurse preceptor take first to demonstrate appropriate time management? A. Review the client‟s new lab values B. Document assessment data C. Complete required tasks D. Determine client care goals 37. A nurse manager is reviewing isolation guidelines with a newly licensed nurse. Which of the following statements by the newly licensed indicates understanding of isolation guidelines? A. I will instruct visitors to wear a mask when visiting a client who is on contact precaution B. I will place a client who has compromised immunity in a negative-pressure airflow room C. I will wear N-95respirator mask when caring for a client who is on droplet precaution D. I will have a client who is on airborne precautions wear a mask when out of her room 38. A charge nurse is delegating tasks to the staff on the unit. Which of the following tasks is appropriate to delegate to a licensed practical nurse? A. Changing the dressing on a postoperative wound B. Referring a client to social services for assistance with transportation C. Instructing a client who is obese about a low-fat diet D. Providing the first oral feeding to a client following a stroke 39. A case manager working in a rehabilitation unit is discharging to home a client who a spinal cord injury level C-7. Which of the following is the priority action creating the discharge plan? A. Select strategies for cost-effective home care B. Identify the client‟s ability to perform activities of daily living C. Provide educational handouts related to care requirements. D. Recommend community resources available to assist with client care. 40. A nurse is preparing to complete morning assessments on several assigned clients. Which of the following clients should the nurse plan to assess first? A. A client who has a nasogastric tube to intermittent suction and reports nausea B. A client who has an early morning blood glucose of 220 mg/dl C. A client who had a bladder scan that indicated 250 ml of urine in the bladder D. A client who is 3 days post-opt & whose dressing has serosanguinous drainage 41. A nurse is making shift assignments in a hospital. Which of the following tasks is appropriate to assign to a licensed practical nurse? A. Plan break times for assistive personnel. B. Pick up the meal trays after lunch. C. Administer a nasogastric tube feeding. D. Determine adequacy of ventilator settings 42. An RN is planning client assignments for a licensed practical nurse (LPN) and three assistive personnel. The RN should assign the LPN to the client who requires A. Recording of daily intake and output B. Assistance with meals C. A complete bed bath D. Frequent dressing changes 44. A nurse is caring for 4 clients. Which of the following tasks can be delegated to an assistive personnel? A. Assessing a client who just returned from hemodialysis B. Reviewing dietary instructions for a client with kidney stones C. Obtaining a stool sample from a client with renal failure D. Monitoring a client with a fluid restriction 45. A charge nurse is making rounds observes that an assistive personnel (AP) has applied wrist restraints to a client who is agitated and does not have a prescription for restraints. Which of the following actions should the nurse take first? A. Inform the unit manager of the incident B. Remove the restraints from the client‟s wrists. C. Speak with the AP about the incident D. Review the chart for non-restraint alternatives for agitation. 46. A client is brought to the emergency department (ED) following a motor-vehicle creash. Drug use is suspected in the crash, and a voided urine specimen is ordered. The client repeatedly refuses to provide the specimen. Which of the following is the appropriate action by the nurse? A. Document the client‟s refusal in the chart B. Tell the client that a catheter will be inserted C. Obtain a provider‟s prescription for a blood alcohol level. D. Assess the client for urinary retention. 47. Nurses on an impatient care unit are working to help reduce unit costs. Which of the following is appropriate to include in the cost-containment plan? A. Use clean gloves rather than sterile gloves for colostomy care. B. Wait to dispose of sharps containers until they are completely full. C. Return unused supplies from the bedside to the unit‟s supply stock. D. Store opened bottles of normal saline in a refrigerator for up to 48 hr. 48. An older adult client is awaiting surgery for a fractured right hip. The nurse should recognize that which of the following can be delegated to an assistive personnel? A. Turning the client B. Recording the client‟s vital signs C. Determining the client‟s pain level D. Checking the pulses of the client‟s right foot. 49. To resolve a conflict between staff members regarding potential changes in policy, a nurse manager decides to implement the changes she prefers regardless of the feelings of those who oppose those changes. Which of the following conflict-resolution strategies in the nurse manager using? A. Compromising B. Collaborating C. Cooperating D. Competing 50. A charge nurse on an obstetrical unit is preparing the shift assignment. Which of the following clients should be assigned to an RN who has floated from a med-surg unit? A. A client who has gestational diabetes and is receiving biweekly nonstress tests B. A primigravida client who is 1 day post-opt following a cesarean section and has a PCA pump C. A multigravida client who has preemclampsia and is receiving mistoprostol (Cytotec) for induction of labor. D. A client who is at 32 weeks of gestation and has premature rupture of membranes. 51. A nurse working on a med-surg unit is managing the care of 4 clients. The nurse should schedule an interdisciplinary conference for which of the following clients? A. A client who is at risk for pressure ulcers and has an albumin of 4.2 g/dl B. A client who has type 1 DM and uses insulin pump C. A client who has orthostatic hypotension and is receiving IV fluids. D. A client who is receiving heparin and has an aPTT of 34 seconds 52. A charge nurse is assessing staff knowledge about safety procedures regarding needlestick injuries. Which of the following statements by a nurse indicates appropriate understanding of these safety procedures? A. Prophylatic treatment should be initiated after a needlestick during preparation of an injection B. I should stop the bleeding as soon as possible following a needlestick injury C. An incident report should be completed if a client receives a stick from her own used needle D. The needle should be recapped to prevent injury during transport to the biohazard container. 53. A nurse on a medical surg Unit is caring for a group of clients with the assistance of a licensed practical nurse (LPN) and an assistive personnel. Which of the following taks should the nurse assign to the LPN A. Obtaining a urine specimen from an older adult client B. Providing postmortem care for a client who has just died C. Accompanying a client who just had a wound debridement to physical therapy D. Reinforcing dietary teaching with a client who has heart disease 54. A nurse enters the room of a client who is unconscious and finds that the client‟s son is reading her electronic medical records from a monitor located at the bedside. Which of the following actions should the nurse take first? A. Recommend the son meet with the provider to get info about his mother‟s condition B. Complete an incident report regarding the breach of the client‟s confidentiality C. Log out of the computer so that the client‟s son is unable to view his mother‟s info D. Report the possible violation of client confidentiality to the nurse manager 55. A home health nurse is assessing the home environment of a client who is on continuous oxygen therapy. Which of the following findings requires the nurse to intervene? A. The oxygen machine has a grounded plug ????????? B. The family keeps a spare oxygen tank in the room C. The window of the client‟s room are open D. The client is covered with a woolen blanket Rationale: Oxygen therapy safety precaution: Avoid materials that generate static electricity, such as woolen blankets and synthetic fabrics. Advise clients and caregivers to wear cotton fabrics and use cotton blankets. 56. A nurse is teaching a client how to use a finger stick glucometer at home. Which of the following instruction should the nurse include? A. Elevate the arm for 1 min before taking the blood sample B. Cap the lancet prior to putting it in in the trash C. Obtain the blood sample from the finger pads. D. Warm the hands prior to piercing the skin 57. A nurse in the emergency department is preparing to care for a client who arrived via ambulance. The client is disoriented and has a cardiac arrhythmia. Which of the following actions should the nurse take? A. Contact the client‟s next of kin to obtain consent for treatment. B. Proceed with treatment without obtaining written consent C. Have the client sign a consent for treatment. D. Notify risk management before initiating treatment. 58. A client has a new permanent pacemaker inserted. Which of the following home care instructions should the nurse include? A. The client should avoid using microwave oven to heat food ???????? B. Regular programming evaluations can be conducted by telephones C. The client should avoid using remote control devices to prevent dysrhythmias D. Suctioning could cause the unit to have an electrical shock. 59. While auditing the medical records of clients currently on an oncology unit, the nurse manager finds that 6 of the 15 records lack documentation regarding advance directives. Which of the following is the priority action for the nurse to take? A. Reinforce the potential consequences of not having this info on record to the nursing staff. B. Ask the nurses who are caring for clients without this info in the medical record to obtain it. C. Meet with nursing staff to review the policy regarding advance directives. D. Remind nurses to obtain this info during the admission process. 60. A client is admitted with COPD. Which of the following findings should the nurse report to the provider? A. Oxygen saturation 89% on room air. B. WBC‟s count 9,000/mm C. Report of dyspnea on exertion D. Bilateral crackles on auscultation of lungs. 61. A charge nurse notices 2 staff nurses are not taking meal breaks during 8-hr shifts. Which of the following actions should the nurse take first? A. Provide coverage for the nurse‟s breaks. B. Determine the reasons the nurses are not taking scheduled breaks. C. Discuss tie management strategies with the nurses. D. Review facility policies for taking scheduled breaks. 62. A nurse is caring for a client who has anorexia nervosa. Which of the following interdisciplinary team members should be consulted in regard to this client‟s care? (Select all that apply.) A. Occupational therapist B. Nutritional therapist C. Physical therapist D. Mental Health counselor E. Case manager 63. A nurse manger is reviewing guidelines for informed consent with the nursing staff. Which of the following statements by a staff nurse indicates that the teaching was effective? A. Guardian consent is required for an emancipated minor B. Consent can be given by a durable power of attorney. C. A family member can answer any questions the client has about the procedure. D. The nurse can answer any questions the client has about the procedure 64. A nurse on a medical-surg unit is caring for 4 clients. This nurse should recognize that which of the following clients is the highest priority? A. A client who is newly diagnosed with pancreatic cancer and is scheduled to begin IV chemotherapy. B. A client who has peripheral vascular disease and has absent pedal pulse in right foot. C. A client who is post-opt following a laminectomy 12 hr ago and is unable to void. D. A client who has methicillin-resistant Staphylococcus Aureus (MRSA) and has an axillary temp of 38 degree C ( 101 F) 65. A client scheduled for a tubal ligation procedure starts to cry as she wheeled into the surgical suite. Which of the following nursing statements is an appropriate nursing response? A. It‟s not too late to cancel the surgery if you want to B. This won‟t take long and it will be over before you know it. C. Why did you make the decision to have this procedure D. You shouldn‟t be worried because the procedure is very safe 66. A nurse working in the emergency department is assessing several clients. Which of the following clients is the highest priority? A. A client who has a raised red skin rash on his arms, neck, and face B. A client who reports right-sided flank pain and is diaphoretic C. A client who reports shortness of breath and left neck and shoulder pain D. A client who has active bleeding from a puncture wound of the left groin 67. A nurse is working on a quality improvement team that is assessing an increase in client falls at the facility. After problem identification, which of the following actions should the nurse plan tot ake first of the quality improvement process? A. Review current literature regarding client falls. B. Implement a fall prevention plan C. Notify staff of the increased fall rates D. Identify clients who are at risk for falls 68. A nurse is evaluating a newly licensed nurse who is administering a vitamin K (Aquamephytoin) injection to a newborn. Which of the following actions by the newly licensed nurse indicates understanding of the teaching? (Select all that apply.) A. Selects the dorsogluteal site to administer the injection B. Cleans the injection site with alcohol C. Applies gentle pressure at the site after injection D. Aspirate the syringe for blood return after needle insertion E. Inserts the needle at a 45 degree angle. HESI LEADERSHIP 2 3. A nurse preceptor is evaluating a newly licensed nurse‟s competency in assisting with a sterile procedure. Which of the following actions indicates the newly licensed nurse is maintaining sterile technique? (SATA) a. Places sterile items within a 1.25 cm (0.5 in) border around the edges of the sterile field b. Opens the sterile pack by first unfolding the top flap away from her body c. Prepares a container of sterile solution on the field after putting on sterile gloves d. Removes the outside packaging of a sterile instrument before dropping it onto the sterile field e. Holds the sterile solution bottle with the label facing up 4. A nurse enters a client‟s room and identifies that the client is receiving too much IV fluid because the IV pump is not working properly. Which of the following actions should the nurse take first? a. Auscultate the client‟s lungs. b. Notify the provider. c. Place a faulty equipment tag on the pump. d. Complete an incident report. 5. A nurse is planning care for a group of clients and can delegate care to a licensed practical nurse (LPN) and an assistive personnel. Which of the following tasks should the nurse assign to the LPN? a. Reinforcing teaching with a client who is learning to self-administer insulin b. Ambulating a client who is scheduled for discharge later in the day c. Administering morphine IV bolus to a client who is hr postoperative d. Admitting a new client who has chronic back pain to the unit 6. A nurse is supervising a newly licensed nurse who is performing surgical asepsis. After donning a sterile gown and gloves, which of the following actions by the newly licensed nurse demonstrates correct aseptic technique? a. The nurse applies goggles. b. The nurse turns her back to the sterile field. c. The nurse holds her hands above her waist. d. The nurse puts on a face mask. 7. A nurse who is caring for a group of clients delegates collection of vital signs to an assistive personnel (AP). Which of the following actions should the nurse take to evaluate the delegated task? a. Review vital sign trends at the end of the shift. b. Recheck vital signs that are outside the expected reference range. c. Ask the AP to write a summary of the delegated tasks during the shift. d. Compare the vital signs the AP obtained with those taken by another AP on a previous shift. 8. A nurse is caring for four clients. Which of the following tasks can be delegated to an assistive personnel? a. Obtaining a stool sample from a client who has renal failure b. Monitoring a client who has a fluid restriction c. Assessing a client who just returned from hemodialysis d. Reviewing dietary instructions for a client who has kidney stones 9. A nurse is triaging a group of clients following a disaster. Which of the following clients should the nurse recommend for treatment first? a. A client who has a neck injury and is unable to breathe spontaneously b. A client who has two open chest wounds with a left tracheal deviation c. A client who has major burns over 75% of her body surface area d. A client who has bipolar disorder and is exhibiting signs of hallucination (Class 3) 10. A nurse manager is reviewing guidelines for informed consent with the nursing staff. Which of the following statements by a staff nurse indicates that the teaching was effective? a. “A family member can interpret to obtain informed consent from a client who is deaf.” b. “Consent can be given by a durable power of attorney.” c. “Guardian consent is required for an emancipated minor.” d. “The nurse can answer any questions the client has about the procedure.” 11. A nurse is caring for four clients. For which of the following clients should the nurse collaborate with the facility ethics committee? a. A middle adult client who leaves the facility against medical advice b. An older adult client who has advanced directives on file c. A young adult client who is participating in a medical research study d. An adolescent client whose parents refuse a blood transfusion for religious reasons 12. A nurse in an ambulatory care setting is orient a newly licensed nurse who is preparing to return a call to a client. The nurse should explain that which of the following is an objective of telehealth? a. Assessing client needs b. Developing client treatment protocols c. Providing medication reconciliation d. Establishing communication between providers (Community Health pg. 75) 13. A nurse is providing discharge teaching to a client who has a new diagnosis of diabetes. The client expresses concern about the cost of blood-glucose monitoring supplies. Which of the following actions should the nurse take? a. Refer the client to the social services department. b. Provide the client with a week‟s worth of supplies from the hospital (still needs help paying after) c. Ask the provider about the possibility of less frequent monitoring (pt needs to monitor often) d. Recommend the client reuse the testing lancets (breaks the safety & infection protocol) 14. A charge nurse is receiving change-of-shift report. Which of the following situations should the charge nurse address first? a. A nurse on the previous shift wrote an incident report about a medication error. b. Two staff members have called to say they will be absent. c. Transport assistance is unavailable to take a client to occupational therapy. d. The emergency department nurse is waiting to give report on a new admission. 15. A nurse who is precepting a newly licensed nurse is discussing the client assignment for the shift. Which of the following actions should the nurse preceptor take first to demonstrate appropriate time management? a. Complete required tasks. b. Review the client‟s new laboratory values. c. Determine client care goals (set/plan goals) d. Document assessment data. 16. A charge nurse is reviewing information about HIPAA with a group of staff nurses. Which of the following statements by a staff nurse indicates understanding? a. “Clients who participate in research studies forfeit their HIPAA right to privacy.” b. “HIPAA allows facility-specific coding of client health care information to ensure privacy.” c. “HIPAA prohibits the uploading of photographs of client’s providers to social media sites.” d. “HIPAA allows clients to request a review of their own medical records.” 17. A nurse is caring for a client who has a tumor. The provider recommends surgery. The client refuses, but the client‟s partner wants the surgery performed. Which of the following is the deciding factor in determining if the surgery will be done? a. Whether the client understands the risk of refusing the procedure b. Whether the facility ethics committee reached a consensus on the case c. Whether the partner is the client‟s durable power of attorney for health care d. Whether the client‟s refusal is based on religious belief 18. A charge nurse is planning the care of four newborns. An assistive personnel and licensed practical nurse are available for staffing. Which of the following tasks should the nurse assign to a licensed practical nurse? a. Conduct the newborn hearing screening. (RN assessment) b. Administer a hepatitis B vaccine. c. Perform a New Ballard screening. (RN assessment) d. Obtain vital signs. (CNA) 19. During a staff meeting a unit manager reviews the results for documenting client education and finds that they are below the benchmark. Which of the following strategies should the nurse manager implement first? a. Train LPNs to reinforce teaching with clients using a standardized teaching plan. b. Determine factors that interfere with the documentation of client education. c. Include documentation of client education as part of unit nurses‟ annual performance evaluation. d. Offer incentives for the staff once the unit‟s results are back in adherence with the benchmark. 20. A nurse is explaining ethics and values to a newly licensed nurse. The nurse should explain that preventing client injury by removing a fall hazard demonstrates which of the following ethical principles? a. Utility b. Autonomy c. Nonmaleficence d. Veracity 21. A nurse is caring for a group of clients. Which of the following clients should the nurse plan to assess first? a. A client who has congestive heart failure and has lost 0.9 kg (2 lb) in the past 24 hr (improvement) b. A client who has diabetes mellitus and reports paresthesia in his fingers and toes (ABC--circulation) c. A client who has a nasogastric tube and has crackles in the lungs (ABC-- airway) d. A client who has a new diagnosis of Graves‟ disease and a TSH level of 0.2 microunits/mL 22. A charge nurse is planning to evacuate clients on the unit because there is a fire on another floor. Which of the following clients should the nurse evacuate first? a. A client who is in Buck‟s traction for a left hip fracture (can‟t necessarily move too much) b. A client who is 1 day postoperative following thoracic surgery and has a chest tube (possible physical instability) c. A client who is confused and restrained for safety (still needs continual nursing care/assessment) d. A client who is receiving IV chemotherapy and is ambulatory 23. A nurse enters the room of a client who is unconscious and finds that the client‟s son is reading her electronic medical records from a monitor located at the bedside. Which of the following actions should the nurse take first? a. Recommend the son meet with the provider to get information about his mother‟s condition. b. Report the possible violation of client confidentiality to the nurse manager. c. Complete an incident report regarding the breach of the client‟s confidentiality. d. Log out the computer so that the client‟s son is unable to view his mother‟s information. 24. A nurse is preparing a client for cardiac catheterization. Just before the procedure, the client asks the nurse about the risks of the procedure. Which of the following actions should the nurse take? a. Explain the risks of the procedure to the client. b. Convey the client‟s request to the nurse who witnessed the consent. c. Check to see if the medial record indicates the provider explained the procedure to the client. d. Notify the provider about the client‟s concerns. 25. A nurse is prioritizing care after receiving change-of-shift report on four clients. Which of the following clients should the nurse assess first? a. A client who reports a headache with sensitivity to light b. A client who reports an urge to void but has not urinated during the prior shift c. A client who reports indigestion and pain in her jaw d. A client who reports feeling lightheaded when he stands up from a lying position 26. A charge nurse notices that two staff nurses are not taking meal breaks during their shifts. Which of the following actions should the nurse take first? a. Discuss time management strategies with the nurses. b. Determine the reasons the nurses are not taking scheduled breaks. Assess first c. Provide coverage for the nurses‟ breaks. d. Review facility policies for taking scheduled breaks. 27. A nurse is preparing to delegate bathing and turning of a newly admitted client who has end-stage bone cancer to an experienced assistive personnel (AP). Which of the following assessments should the nurse make before delegating care? a. Has the AP checked the client‟s pain level prior to turning her? (RN only - do not delegate what you can EAT = evaluate, assess, teach) b. Is the client‟s family present so the AP can show them how to turn the client? (this is not necessary) c. Has data been collected about specific client needs related to turning? (Assessment of holistic care r/t pt needs and what the experienced AP can do) d. Does the AP have the time to change the client‟s central IV line dressing after turning her? (AP cannot change dressings) 28. A nurse is preparing to transfer a client from the emergency department to a medical- surgical unit using the SBAR communication tool. Which of the following information should the nurse include in the background portion of the report? a. A prescribed consultation -under situation b. The client‟s vital signs c. The client‟s name -under situation d. The client‟s code status -under situation 29. A nurse is planning discharge for a client who has rheumatoid arthritis. Which of the following statements by the client should the nurse identify as an indication that a referral to an occupation therapist is necessary? a. “I need some help planning my meals to maintain my weight.” b. “I am tired of having pain in my joints all the time.” c. “I‟m having difficulty climbing the stairs at my house.” d. “I will need assistance with bathing.” 30. A nurse in the emergency department is caring for a 16-year-old client who reports abdominal pain and is accompanied by an adult neighbor. The provider diagnoses a ruptured appendix and states that the client requires an emergency appendectomy. Which of the following actions should the nurse? a. Ask the adult neighbor to sign the consent form. b. Obtain consent from the hospital administrator. c. Witness the client signing the consent form. d. Attempt to notify the client‟s guardian to obtain consent. 31. A nurse on a medical-surgical unit is caring for four clients. Which of the following findings is the highest priority? a. A client who had a cardiac catheterization whose capillary refill in the great toe is 4 seconds b. A client who has COPD and has an oxygen saturation of 90% c. A client who had a cholecystectomy 6 hr ago and is requesting pain medication d. A client whose TPN was discontinued 4 hr ago and is requesting clear liquids 32. A charge nurse suspects that a staff nurse is chemically impaired. Which of the following actions should the charge nurse take? a. Assign clients who are not prescribed narcotics to the staff nurse. b. Collect data about the staff nurse to support further action. c. Report the staff nurse to the facility ethics committee. d. Counsel the staff nurse about substance use. 33. A nurse is assessing a client‟s comprehension of a pulmonary function test prior to the procedure. Which of the following client statements indicates to the nurse an understanding of the procedure? a. “I will be given contrast dye during this test.” b. “I might have to wear a nose clip during this test.” c. “I might have a tube inserted into my airway during the test.‟ d. “I will run on a treadmill during this test.” 34. A nurse in the emergency department is triaging four clients. Which of the following clients should the nurse recommend to be examined first? a. A toddler who has a 2 cm (0.79 in) head laceration oozing dark red blood b. An adolescent client who has an injured ankle and reports a pain level of 8 on a scale from 0 to 10 c. An older adult client who has dyspnea and a respiratory rate of 26/min d. An adult client who has large ecchymosis on both legs 35. A home health nurse finds piles of newspapers in the hallway of a client‟s home. The nurse explains the need to discard the newspapers for safety reasons. The client agrees to move the newspapers into the living room. Which of the following conflict resolution strategies has the nurse used? a. Collaborating b. Smoothing c. Accommodating d. Compromising 36. A nurse is planning to delegate client care assignments. Which of the following tasks should the nurse plan to delegate to an assistive personnel? a. Advising a client on self-administration of acetaminophen b. Informing a family of a client‟s progress in physical therapy c. Teaching a client to perform a finger-stick for testing blood glucose levels d. Performing post mortem care prior to transferring the client to the morgue 37. A nurse is providing discharge teaching to a client following a total knee arthroplasty. Which of the following information should the nurse include (SATA) a. Advance directives information b. Contact information for the physical therapist c. Medication guidelines information d. Insurance information e. Information about follow-up care 38. A nurse is planning to discharge a client who has terminal cancer and suggests that the family might benefit from respite services. When the client‟s partner asks how this service can help, which of the following responses by the nurse is appropriate? a. “This service offers psychological interventions during and after your wife‟s illness.” b. “The clinicians help reduce the severity of your wife‟s physical problems.” c. “This service delivers meals and supplies to reduce your errands away from home.” d. “It makes it possible for you to have some time away from caring for your wife.” 39. A nurse is teaching a client how to use a finger-stick glucometer at home. Which of the following instructions should the nurse include? a. Warm the hands prior to piercing the skin. b. Cap the lancet prior to putting it in the trash.- never recap c. Elevate the arm for 1 min before taking the blood sample.- has to be down so gravity can assist to milk the blood out . d. Obtain the blood sample from the finger pads. 40. A nurse is assessing a client who had a recent stroke. Which of the following findings should indicate the need for referral to an occupational therapist? a. Receptive aphasia→ unable to understand language in its written or spoken form b. Facial drooping→ speech therapist c. Memory loss d. Unilateral neglect –is one of the disabling features of stroke, and is defined as a failure to attend to the side opposite a brain lesion. 41. A nurse is participating in the development of a disaster management plan for a hospital. The nurse should recognize that which of the following resources is the highest priority to have available in response to a bioterrorism event? a. A network for communication between staff members and families b. A mental health specialist on the response team c. A sufficient supply of personal protective equipment d. A system for tracking client information 42. A nurse in a clinic is reviewing laboratory reports for a group of clients. Which of the following diseases should the nurse report to the state health department? a. Rotavirus b. Pertussis c. Respiratory syncytial virus d. Group B streptococcal disease 43. A charge nurse is teaching a newly licensed nurse about proper cleaning of equipment used for a client who has Clostridium difficile. Which of the following solutions should the nurse recommend to clean the equipment? a. Chlorine bleach b. Triclosan c. Chlorhexidine d. Isopropyl alcohol 44. A nurse is assessing an older adult client who was brought to the emergency department by his adult son, who reports that the client fell at home. The nurse suspects elder abuse. Which of the following actions should the nurse take? a. Treat and discharge the client. b. Ask the client‟s son to go to the waiting area. c. File an incident report. d. Ask the client about his injuries with the son present 45. A nurse is completing discharge teaching with a client who is being treated for tuberculosis (TB). Which of the following statements by the client indicates an understanding of the teaching? a. “I need to take my prescribed medication for 3 months.” b. “I should have a sputum culture done every 2 to 4 weeks.” c. “I need to have a TB skin test done once per year.” d. “I should wear a mask while around my family.” 46. An older adult client is awaiting surgery for a fractured right hip. The nurse should recognize that which of the following can be delegated to an assistive personnel? a. Checking the pulses of the client‟s right foot b. Recording the client‟s vital signs c. Turning the client d. Determining the client‟s pain level 47. A charge nurse in the newborn nursery is delegating tasks to an assistive personnel (AP). Which of the following is an appropriate task for the AP? a. Inspect the skin of a newborn who is receiving phototherapy. – Assess b. Answer the parents‟ questions about newborn circumcision. - Teaching c. Show a new mother how to change the newborn‟s diaper. - Teaching d. Obtain the weight of a newborn that is receiving formula 48. A nurse is orienting a newly licensed nurse about the use of restraints. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? a. “A provider can write a prescription for restraints „as needed‟.” b. “I need to tie the restraint to the part of the bed frame that moves.” c. “I should tie the restraints using a square knot.” d. “I will remove a client‟s restraints every 4 hours.” 49. An infection control nurse is planning an education program for a group of newly licensed nurses. Which of the following infections should the nurse include when discussing illnesses requiring droplet precautions? a. Mumps b. Rubeola c. Varicella d. Rotavirus 50. A nurse is caring for a client who has cancer. The client and her partner are asking the nurse about hospice are. Which of the following statements by the nurse is appropriate? a. “Hospice care will prolong the life expectancy of clients who are terminally ill.” b. “Hospice care is a multidisciplinary program for clients who are terminally ill.” c. “Hospice care is helpful for clients at various stages of chronic illness.” d. “Hospital access is no longer available for clients who are in hospice care.” 51. A nurse is planning care for a client who has Addison‟s disease. Which of the following tasks should the nurse plan to delegate to an assistive personnel? a. Decide how often to measure vital signs. b. Explain to the client about a 24-hr urine specimen collection. c. Determine the client‟s muscle strength prior to ambulation. d. Remind the client to change positions slowly. 52. A charge nurse discovers that a staff nurse on the unit has made repeated medication errors. Which of the following actions should the charge nurse take first? a. Notify the risk management department of the situation. (4) b. Review with the nurse the principles of medication administration. (2) c. Ask the nurse to describe her medication administration procedure. (1) d. Identify education opportunities for the nurse regarding safe medication administration. (3) 53. A case manager is reviewing documentation on several clients and notes a progress report that falsely identifies a client as HIV-positive due to multiple sexual partners. The nurse manager should identify that which of the following torts has occurred? P. 42 ch 3 a. Libel : talking bad about someone via writing it in notes b. Battery : intentional/wrongful physical contact c. Slander : Defamation with the spoken word d. Negligence 54. A nurse is preparing a client for an elective mastectomy. The client is wearing a plain gold wedding band. Which of the following is an appropriate procedure for taking care of this client‟s ring? a. Place the client‟s ring in the facility safe. b. Tape the ring securely to the client‟s finger. c. Place the ring in the bad with the client‟s clothing. d. Agree to keep the ring for the client until after surgery. 55. A nurse is prioritizing postpartum care for four clients. Which of the following actions should the nurse take first? a. Assist a client who requests help breastfeeding her 4-hr-old newborn. b. Administer RH immune globulin to a client who is Rh-negative and 6 hr postpartum. c. Check uterine tone for a client who received methylergonovine- if the uterine tone is not d. Instruct a client who has an episiotomy about a sitz bath. 56. A hospice nurse is caring for a client who has a terminal illness and reports severe pain. After the nurse administers the prescribed opioid and benzodiazepine, the client becomes somnolent and difficult to arouse. Which of the following actions should the nurse take? a. Withhold the benzodiazepine but continue the opioid. b. Contact the provider about replacing the opioid with an NSAID. c. Administer the benzodiazepine but withhold the opioid. d. Continue the medication dosages that relieve the client‟s pain. 57. A nurse is observing an assistive personnel (AP) administer 0.9% sodium chloride enema to an adult client. For which of the following actions by the AP should the nurse intervene? a. Administers the solution at room temperature b. Points tubing in the direction of the umbilicus during insertion c. Position the client on her left side with knees flexed d. Inserts the tubing 8 cm (3.1 in) into the rectum 58. A nurse is providing information to a client about advance directives. The nurse should explain that advance directives include which of the following? P . 38 ch 3 a. Instructions regarding treatments the client desires or does not desire – (livings wills and durable power of attorney make up AD). b. Information regarding the disposition of the client‟s body upon death c. Information regarding organ donation d. A form with directions for contacting next of kin 59. A nurse on a medical-surgical unit is caring for four clients. The nurse should recognize that which of the following clients is the highest priority? a. A client who has peripheral vascular disease ad has an absent pedal pulse in the right foot b. A client who is newly diagnosed with pancreatic cancer and is scheduled to begin IV chemotherapy. c. A client who has methicillin-resistant Staphylococcus aureus (MRSA) and has an axillary temperature of 38C (101F) d. A client who is postoperative following a laminectomy 12 hr ago and is unable to void 60. A staff development nurse is giving an in-service presentation about advocacy in nursing. Which of the following statements by a nurse indicates an understanding of the role of a client advocate? a. “In the role of client advocate, I should take responsibility for coordinating each client‟s care.” b. “As a client advocate, I will suggest the best course of action for clients who are indecisive.” c. “My role as a client advocate is to empower the clients to make informed healthcare decisions.” d. “As a client advocate, I will adhere to the provider‟s prescribed treatments.” 61. A nurse manager observes an assistive personnel (AP) incorrectly transferring a client to the bedside commode. Which of the following actions should the nurse take first? a. Refer the AP to the facility procedure manual. b. Instruct the AP to request assistance when unsure about a task. c. Help the AP assist the client with the transfer. d. Demonstrate the proper client transfer technique for the AP. 62. A nurse at the local health department is caring for four clients who have communicable diseases. Which of the following infections should the nurse report to the state health department? a. Chlamydia trachomatis b. Pediculosis capitis c. Impetigo contagiosa d. Candida albicans 63. A charge nurse witnesses two nurses having a loud discussion at the nurses‟ station about not wanting to care for a client who has drug-resistant tuberculosis. Which of the following actions should the charge nurse take? a. Escort the nurses to the nurses‟ lounge to continue the discussion. b. Recommend that both nurses be terminated. c. Make arrangements to take over the client‟s care. d. Contact the house supervisor to mediate the conflict. 64. A newly licensed nurse is floating to an unfamiliar unit and determines that he does not have sufficient experiences to safely care for his assigned clients. Which of the following actions should the nurse take? a. Accept the assignment with help from assistive personnel on the unit. b. Request that the charge nurse modify the assignment. c. Document the concern in the nurse‟s notes. d. Notify the risk manager. 65. A nurse is conducting an in-service about the nursing code of ethics with a group of newly licensed nurses. Which of the following information should the nurse include in the teaching as an example of advocacy? a. Recommending a referral for a client who requires physical therapy b. Suggesting a client‟s partner attend a support group for emotional support c. Evaluating a client‟s home for safety hazards d. Completing an incident report following a medication error 66. A charge nurse in the emergency department is supervising a nurse who is floating from the medical-surgical unit. Which of the following assignments is appropriate for the float nurse? a. Administer IV nitroglycerin to a client who is experiencing chest pain. b. Perform a urinary catheterization for a client who has experienced a cerebrovascular accident. c. Set up a trauma room for an incoming client who was in a motor-vehicle crash. d. Complete a SAD PERSONS assessment scale for a client who has attempted suicide. 67. A home health nurse is assessing the home environment during an initial visit to a client who has history of falls. Which of the following findings should the nurse identify as increasing the client‟s risk for falls? (SATA) a. A folding chair without arm rests b. A wheeled office chair at the client‟s computer desk HESI LEADERSHIP 3 4. A nurse is orienting a newly licensed nurse on the neurological unit. Which of the following clients should the nurse assign to the newly licensed nurse? a. A client who has multiple sclerosis and ataxia b. A client who has brain tumor and is admitted for chemotherapy c. A client who has guillain-barre syndrome and a tracheostomy d. A client who sustained a concussion and is being monitored for complication 5. A nurse is providing teaching to a client about advance directives. Which of the following statements by the client indicates an understanding of the teaching? a. “Once I sign my living will, a family member must co sign it” b. “I will wait until I have a serious health problems to sign my advance directives” c. “My doctor will need to provide approval for the decisions outlines in my living will d. “My durable power of attorney for health care is part of my advance directives” 6. A nurse is chairing a committee about preventing infant abduction in a new birth care center. Which of the following quality control tasks should the nurse assign to be completed first? a. Identify the industry standards for infant safety b. Evaluate the selected infant safety system c. Choose an infant safety system d. Establish measurement criteria for infant safety systems 7. A nurse notes that a client is eating about half of the food on his plate and coughs frequently during meals. The nurse plans to perform dysphagia screening to determine the client's need for a referral to which of the following providers? a. Physical therapist b. Respiratory therapist c. Speech therapist d. Occupational therapist 8. A home health nurse is assessing the home environment during an initial visit to a client who has a history of falls. Which of the following findings should the nurse identify as increasing the client's risk for falls (SATA) [repeat] • A wheeled office chair at the client's computer desk • A raised vinyl seat on the toilet in the bathroom • A throw rug covering some cracked floor • A folding chair without arm rests • A two wheeled walker used to assist the client with ambulation 9. A nurse manager is planning to assign care for four clients on a medical surgical unit. Which of the following clients should the nurse assign to a LPN a. An older adult who has lung cancer and has periodic episodes of severe dyspnea b. A middle adult client who has a below the knee amputation and requires a dressing change c. A young adult client who is postoperative, receiving morphine via epidural, and reports pruritus d. An adolescent who requires teaching regarding insulin administration 10.While auditing the medical records of clients currently on an oncology unit, the nurse manager finds that six of the 15 records lack documentation regarding advance directives. Which of the following is the priority for the nurse to take? a. Remind nurses to obtain this information during the admission process b. Reinforce the potential consequences of not having his information on record to the nursing staff c. Meet with nursing staff to review the policy regarding advance directive d. Ask nurse who are caring for client without his information in the medical record to obtain it nurse is caring for a group of clients. Which of the following should the nurse see first? a. A client who is postoperative and has a fever. b. A client whose pressure ulcer has serosanguineous drainage on the dressing c. A client who has diabetes mellitus and is diaphoretic d. A client who has a fractured hip and reports a pain level of 7 on a scale from 0-10 nurse is receiving change-of-shift report for four clients. Which of the following clients should the nurse care for first? a. A client who is 4 hr postoperative following a hernia repair and has pitting edema of the right leg b. A client who is scheduled for an intermittent enteral feeding in 2 hr and reports diarrhea c. A client who has pneumonia and requires a tracheostomy dressing change d. A client who has a new colostomy and requires discharge teaching nurse manager discovers there is a conflict between nurses working the day shift and nurses working on the night shift. Which of the following actions should the nurse manager take first? a. Acknowledge the conflict and encourage the nurses to focus on working as a team b. Gather information regarding the situation c. Encourage the nurses to resolve the conflict autonomously d. Meet with a committee from each shift to discuss issues related to the conflict nurse in an urgent care clinic is admitting a client who has been exposed to a liquid chemical in an industrial setting. Which of the following actions should the nurse take first? a. Don personal protective equipment b. Irrigate the exposed area with water c. Remove the client‟s clothing d. Report the incident to OSHA newly licensed nurse realizes that she administered metoprolol 25 mg PO to the wrong client. Which of the following actions should the nurse perform first? a. Complete an incident report b. Measure the client‟s vital signs c. Inform the nurse manager d. Call the provider nurse is assessing a client who has meningitis. Which of the following findings should the nurse report to the provider immediately? a. Decreased level of consciousness b. Generalized rash over trunk c. Increased temperature d. Report of photophobia client who is febrile is admitted to the hospital for treatment of pneumonia. In accordance with the care pathway, antibiotic therapy is prescribed. Which of the following situations requires the nurse to complete a variance report with regard to the care pathway? a. Antibiotic therapy was initiated 2 hr after implementation of the care pathway. b. A blood culture was obtained after antibiotic therapy had been initiated c. An allergy to penicillin required an alternative antibiotic to be prescribed d. The route of antibiotic therapy on the care pathway was changed from IV to PO nurse manager is making staffing assignments for the maternal newborn unit. Which of the following clients should the nurse manager assign to a float nurse from the medical- surgical unit? a. A client who is postterm and is receiving oxytocin for labor induction b. A client who gave birth to her first child and requires instruction on breastfeeding techniques c. A client who is 2 days post-operative following a caesarean birth and is having difficulty ambulating d. A client who has preeclampsia and is receiving a continuous magnesium sulfate infusion nurse is coordinating an interprofessional team to review proposed standards to reduce the transmission of methicillin-resistant Staphylococcus aureus (MRSA). Which of the following members of the interprofessional team should the nurse consult? a. Risk management coordinator b. Clinical pharmacist c. Nursing supervisor d. Infection control nurse nurse is caring for a client who has uterine prolapse. The provider has recommended a total abdominal hysterectomy, but the client tells the nurse that the surgery is not an option. Which of the following is an appro