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WorksheetsSOAL TRY OUT QUIZZES — Nursing Practice and Management
Total questions: 60
Worksheet time: 45mins
A post-operative patient who underwent an abdominal procedure requests a pain medication from the nurse and rates the pain at level nine. There is a standing order for narcotic administration. When the nurse opens the narcotic box and performs a count, the number of pills remaining in the box is different than the number of pills recorded on the sheet. What is the most appropriate initial nursing action?
Notify the nursing supervisor
Write the finding on the narcotic sheet
Administer the patient's requested medication
Identify the last nurse who used the narcotic box
An 81-year-old bedridden patient in the Geriatric Ward was receiving medication through his nasogastric tube. After an hour, the patient fell into deep sleep, his breathing pattern changed, and he did not respond when his name was called. Which of the following should be the immediate nursing intervention?
Call the physician to examine the patient
Check for the correct dosage given
Check vitals and inform the physician
Try to wake up the patient
The nurses in the Male Medical Unit took a signature from a patient who needs an abdominal CT with contrast. What is the best nursing practice?
Consent should be taken after the procedure
Verbal consent is acceptable for this procedure
Consent should be taken from the patient's relatives
Consent should be taken according to the organization's policy
In the hospital digital dashboard, what types of data are typically displayed?
Staffing
Financial
Performance
Knowledge-based
A newly assigned nursing director arrives at a hospital. What is the first thing he should do?
Evaluate the staff
Change the head nurses
Change the roles
Do nothing
A surgeon instructs a nurse to serve as a witness to an elderly patient’s informed consent for surgery. During the explanations, it becomes clear that the patient is confused and does not understand the procedure, but reluctantly signs the consent form. What should the nurse do?
Sign the form as a witness, making a note that the patient did not appear to understand
Not sign the form as a witness and notify the nurse supervisor
Not sign the form and answer the patient’s questions after the surgeon leaves the room
Sign the form and proceed with the scheduled surgery
During a home health visit, a nurse administered a prescribed intramuscular medication to a patient. How should the nurse dispose of the used needle and syringe?
Recap the needle, then place the needle and syringe into a waterproof container until safe disposal can be made
Bend the needle back towards the barrel of the syringe before discarding
Place the needle and syringe in a metal trash container
Wrap the needle and syringe in disposable paper before putting them into the dirty section of the nurse’s equipment bag
Put the needle and syringe directly into a puncture-resistant plastic container that has a lid
A community nurse assigned to work in Makkah, one of the most multicultural cities in Saudi Arabia, has to interact with multicultural populations every day. What is the most important step the nurse should do before meeting with clients?
Ask the client about his/her cultural background
Conduct an appropriate culturological assessment
Ensure that the client has privacy
Look at the client's file to take history
The head nurse meets with staff nurses to discuss ways to improve communication among shifts. Which of the following statements best exemplifies the final stage of conflict management?
We need to clearly define the nature of the conflict
I will evaluate the outcomes of the strategies used monthly
Let us create a timeline for the implementation of our strategies
I have to force you to follow the rules to resolve the issue
The head nurse of a Coronary Care Unit delegated a task to a senior nurse in that unit. What initial step must the head nurse implement before delegating?
Check the hospital policies for delegating tasks
Explain the task to the senior nurse
Negotiate with the senior nurse
Take the signature of the senior nurse
What must be known regarding the legal points of delegation when assigning a process to a new nurse?
Evaluation of delegate performance by clients
Actual time it takes to complete the task by the delegate
Institution’s definition of the job description
Number of times the delegate has previously performed the task
The nursing director wants to evaluate the quality of nursing care in inpatient areas. The management team will evaluate, on a quarterly basis, the documentation and the relationship between the patient's length of stay and the quality of care. Which of the following is the most important data source to identify the quality of care?
Patient’s complaints and time taken to resolve them
Patient’s satisfaction level at the time of discharge
Details of nursing notes for patient’s progress
The disease is divided according to three factors: host, environment, and agent. The patient completed an antibiotics course, then the disease returns again. What is the causative factor?
Agent
Environment
Host
Reaction between host and environment
A nurse witnesses another nurse entering an isolated patient’s room with airborne precautions while wearing only a gown and gloves. What is the appropriate action for the witnessing nurse to take?
Talk with the nurse about wearing a mask
Talk with the education nurse to introduce a lecture for staff about PPE
Inform the head of department about the nurse
Ignore the nurse’s action
A nurse is putting together a presentation on meningitis. Which of the following has not been linked to meningitis?
S. pneumoniae
H. influenzae
N. meningitidis
C. difficile
A patient in isolation needs temperature measurements taken several times a day. Where is the appropriate place for the thermometer to be kept?
At the nurses’ station
On the isolation cart outside the patient’s room
In the dirty utility room
In the patient’s room
A patient presents with fever and coughing blood. The nurse calls the infection center to provide precautions for the patient. Which precaution should the nurse apply?
Airborne
Droplet
Contact
Precautions until confirmation of diagnosis
The relation between organism and environment is:
Ecology
Pathology
Bacteriology
Parasitology
For smallpox isolation, what should the nurse wear?
Gloves and mask
Gloves and gown
Gloves and eye protector
Gloves, gown, and N95 mask
A patient with smallpox becomes fine and has no symptoms but is still isolated for 12–14 days. What is the type of the period?
Incubation period
Infective period
Latency period
Communicable period
Henry is a Unit Manager I the Medical Unit. He is not satisfied with the way things are going in his unit. The patient satisfaction rate is 60% for two consecutive months and staff morale is at its lowest. He decides to plan and initiate changes that will push for a turnaround in the condition of the unit. Which of the following actions is a priority for Henry?
Call for a staff meeting and take this up in the agenda.
Seek help from her manager.
Develop a strategic action on how to deal with these concerns.
Ignore the issues since these will be resolved naturally.
After discussing the possible effects of the low patient satisfaction rate, the staff started to list down possible strategies to solve the problems head-on. Should they decide to vote on the best change strategy, which of the following strategies is referred to by this?
Collaboration
Majority rule
Dominance
Compromise
She surfs the internet for more information about leadership styles. She reads about shared leadership as a practice in some magnet hospitals. Which of the following describes this style of leadership?
Leadership behavior is generally determined by the relationship between the leader’s personality and the specific situation.
Leaders believe that people are basically good and need not be closely controlled.
Leaders rely heavily on visioning and inspire members to achieve results.
Leadership is shared at the point of care.
One staff suggests that they review the pattern of nursing care that they are using, which is described as a:
Job description
System used to deliver care
Manual of procedure
Rules to be followed
Which of the following is true about functional nursing?
Concentrates on tasks and activities.
Emphasizes the use of group collaboration.
One-to-one nurse–patient ratio.
Provides continuous, coordinated, and comprehensive nursing services.
Functional nursing has some advantages, which one is an exception?
Psychological and sociological needs are emphasized.
Great control of work activities.
Most economical way of delivering nursing services.
Workers feel secure in a dependent role.
He raised the issue of giving priority to patient needs. Which of the following offers the best way for setting priority?
Assessing nursing needs and problems.
Giving instructions on how nursing care needs are to be met.
Controlling and evaluating the delivery of nursing care.
Assigning a safe nurse: patient ratio.
Which of the following is the best guarantee that the patient’s priority needs are met?
Checking with the relative of the patient.
Preparing a nursing care plan in collaboration with the patient.
Consulting with the physician.
Coordinating with other members of the team.
When Henry uses team nursing as a care delivery system, he and his team need to assess the priority of care for a group of patients, which of the following should be a priority?
Each patient is listed on the worksheet.
Patients who need the least care.
Medications and treatments required for all patients.
Patients who need the most care.
He is hopeful that his unit will make a big turnaround in the succeeding months. Which of the following actions of Henry demonstrates that he has reached the third stage of change?
Wonders why things are not what they used to be.
Finds solutions to the problems.
Integrate the solutions to his day-to-day activities.
Selects the best change strategy.
The statement, “The Holy Spirit Medical Center aims to provide patient-centered care in a total healing environment” refers to which of the following?
Vision
Goal
Philosophy
Mission
Joey is a newly-appointed nurse manager of The Holy Spirit Medical Center, a tertiary hospital located within the heart of the metropolis. He thinks of scheduling a planning workshop with his staff in order to ensure effective and efficient management of the department. Should he decide to conduct a strategic planning workshop, which of the following is not a characteristic of this activity?
Long-term goal-setting.
Extends to 3–5 years in the future.
Focuses on routine tasks.
Determines directions of the organization.
Which of the following statements refer to the vision of the hospital?
The Holy Spirit Medical Center is a trendsetter in tertiary health care in the next five years.
The officers and staff of The Holy Spirit Medical Center believe in the unique nature of the human person.
All the nurses shall undergo a continuing competency training program.
The Holy Spirit Medical Center aims to provide patient-centered care in a total healing environment.
Joey plans to revisit the organizational chart of the department. He plans to create a new position of a Patient Educator who has a coordinating relationship with the head nurse in the unit. Which of the following will likely depict this organizational relationship?
Box
Solid line
Broken line
Dotted line
He likewise stresses the need for all the employees to follow orders and instructions from him and not from anyone else. Which of the following principles does he refer to?
Scalar chain
Discipline
Unity of command
Order
Joey orients his staff on the patterns of reporting relationships throughout the organization. Which of the following principles refer to this?
Span of control
Hierarchy
Esprit de' corps
Unity of direction
He emphasizes to the team that they need to put their efforts together towards the attainment of the goals of the program. Which of the following principles refers to this?
Span of control
Unity of direction
Unity of command
Command responsibility
Joey stresses the importance of promoting ‘esprit d corps’ among the members of the unit. Which of the following remarks of the staff indicates that they understand what he pointed out?
“Let’s work together in harmony; we need to be supportive of one another”
“In order that we achieve the same results; we must all follow the directives of Julius and not from other managers.”
“We will ensure that all the resources we need are available when needed.”
“We need to put our efforts together in order to raise the bar of excellence in the care we provide to all our patients.”
He discusses the goal of the department. Which of the following statements is a goal?
Increase the patient satisfaction rate.
Eliminate the incidence of delayed administration of medications.
Establish rapport with patients.
Reduce response time to two minutes.
He wants to influence the customary way of thinking and behaving that is shared by the members of the department. Which of the following terms refer to this?
Organizational chart
Cultural network
Organizational structure
Organizational culture
A 16-year-old patient with cystic fibrosis is admitted with increased shortness of breath and possible pneumonia. Which nursing activity is most important to include in the patient’s care?
Perform postural drainage and chest physiotherapy every 4 hours.
Allow the patient to decide whether she needs aerosolized medications.
Place the patient in a private room to decrease the risk of further infection.
Plan activities to allow at least 8 hours of uninterrupted sleep.
A patient with acute respiratory distress syndrome (ARDS) is receiving oxygen by a non-rebreather mask, but arterial blood gas measurements still show poor oxygenation. As the nurse responsible for this patient’s care, you would anticipate a physician order for what action?
Perform endotracheal intubation and initiate mechanical ventilation.
Immediately begin continuous positive airway pressure (CPAP) via the patient’s nose and mouth.
Administer furosemide (Lasix) 100 mg IV push stat.
Call a code for respiratory arrest.
A patient with chronic obstructive pulmonary disease (COPD). Which intervention for airway management should you delegate to a nursing assistant?
Assisting the patient to sit up on the side of the bed.
Instructing the patient to cough effectively.
Teaching the patient to use incentive spirometry.
Auscultation of breath sounds every 4 hours.
A patient with sleep apnea has a nursing diagnosis of Sleep Deprivation related to disrupted sleep cycle. Which action should you delegate to the nursing assistant?
Discuss weight-loss strategies such as diet and exercise with the patient.
Teach the patient how to set up the BiPAP machine before sleeping.
Remind the patient to sleep on his side instead of his back.
Administer modafinil (Provigil) to promote daytime wakefulness.
After a change of shift, you are assigned to care for the following patients. Which patient should you assess first?
A 60-year-old patient on a ventilator for whom a sterile sputum specimen must be sent to the lab.
A 55-year-old patient with COPD and a pulse oximetry reading from the previous shift of 90% saturation.
A 70-year-old patient with pneumonia who needs to be started on intravenous (IV) antibiotics.
A 50-year-old with asthma who complains of shortness of breath after using a bronchodilator.
After the respiratory therapist performs suctioning on a patient who is intubated, the nursing assistant measures vital signs for the patient. Which vital sign value should the nursing assistant report to the registered nurse immediately?
Heart rate of 98 beats/min
Respiratory rate of 24 breaths/min
Blood pressure of 168/90 mm Hg
Tympanic temperature of 101.4°F (38.6°C)
The charge nurse is making assignments for the next shift. Which patient should be assigned to the fairly new nurse (6 months experience) pulled from the surgical unit to the medical unit?
A 58-year-old on airborne precautions for tuberculosis (TB).
A 68-year-old just returned from bronchoscopy and biopsy.
A 72-year-old who needs teaching about the use of incentive spirometry.
A 69-year-old with COPD who is ventilator dependent.
The high-pressure alarm on a patient’s ventilator goes off. When you enter the room to assess the patient, who has ARDS, the oxygen saturation monitor reads 87% and the patient is struggling to sit up. Which action should you take next?
Reassure the patient that the ventilator will do the work of breathing for him.
Manually ventilate the patient while assessing possible reasons for the high-pressure alarm.
Increase the fraction of inspired oxygen on the ventilator to 100% in preparation for endotracheal suctioning.
Insert an oral airway to prevent the patient from biting on the endotracheal tube.
When a patient with TB is being prepared for discharge, which statement by the patient indicates the need for further teaching?
"Everyone in my family needs to go and see the doctor for TB testing."
"I will continue to take my isoniazid until I am feeling completely well."
"I will cover my mouth and nose when I sneeze or cough and put my used tissues in a plastic bag."
"I will change my diet to include more foods rich in iron, protein, and vitamin C."
The nursing assistant tells you that a patient who is receiving oxygen at a flow rate of 6 L/min by nasal cannula is complaining of nasal passage discomfort. What intervention should you suggest to improve the patient’s comfort for this problem?
Suggest that the patient’s oxygen be humidified.
Suggest that a simple face mask be used instead of a nasal cannula.
Suggest that the patient be provided with an extra pillow.
Suggest that the patient sit up in a chair at the bedside.
To improve respiratory status, which medication should you be prepared to administer to the newborn infant with respiratory distress syndrome (RDS)?
Theophylline (TheoAir, TheoChron)
Surfactant (Exosurf)
Dexamethasone (Decadron)
Albuterol (Proventil)
The clinical instructor directed the student nurse to care for a client whose potassium is 6.7 mEq/L. Which intervention is delegated correctly to the student nurse?
Give potassium 10 mEq orally.
Give sodium polystyrene sulfonate (Kayexalate) 15 g orally.
Give spironolactone (Aldactone) 25 mg orally.
Assess the electrocardiogram (ECG) strip for tall T waves.
The patient with COPD has a nursing diagnosis of Ineffective Breathing Pattern. Which is an appropriate action to delegate to the experienced LPN under your supervision?
Observe how well the patient performs pursed-lip breathing.
Plan a nursing care regimen that gradually increases activity intolerance.
Assist the patient with basic activities of daily living.
Consult with the physical therapy department about reconditioning exercises.
Which of these medication orders for a patient with a pulmonary embolism is more important to clarify with the prescribing physician before administration?
Warfarin (Coumadin) 1.0 mg by mouth (PO)
Morphine sulfate 2 to 4 mg IV
Cephalexin (Keflex) 250 mg PO
Heparin infusion at 900 units/hr
When assessing a 22-year-old patient who required emergency surgery and multiple transfusion 3 days ago, you find that the patient looks anxious and has labored respirations at the rate of 38 breaths/min. The oxygen saturation is 90% with the oxygen delivery at 6 L/min via nasal cannula. Which action is most appropriate?
Increase the flow rate on the oxygen to 10 L/min and reassess the patient after about 10 minutes.
Assist the patient in using the incentive spirometer and splint his chest with a pillow while he coughs.
Administer the ordered morphine sulfate to the patient to decrease his anxiety and reduce the hyperventilation.
Switch the patient to a nonrebreather mask at 95% to 100% oxygen and call the physician to discuss the patient’s status.
Jenna is a nurse from the medical-surgical unit of a tertiary hospital. She was asked to float on the orthopedic unit in which she has no prior experience working. Which client should be assigned to her?
A client with a cast for a fractured femur and who has numbness and discoloration of the toes.
A client with balanced skeletal traction and needs assistance with morning care.
A client who had an above-the-knee amputation yesterday and currently has a temperature of 101.4°F.
A client who had a total hip replacement two days ago and needs blood glucose monitoring.
Which intervention for a patient with a pulmonary embolus could be delegated to the LPN on your patient care team?
Evaluating the patient’s complaint of chest pain.
Monitoring laboratory values for changes in oxygenation.
Assessing for symptoms of respiratory failure.
Auscultating the lungs for crackles.
Which of the following should the nurse assess first?
Respiratory status
Level of consciousness
Level of pain
Reflexes and movement of extremities
Nurse Jenny of Nurseslabs Medical Center is planning care for a client who had undergone colposcopy. Which of the following actions should the RN take first?
Discuss the client's fear regarding potential cervical cancer.
Assist with silver nitrate application to the cervix to control bleeding.
Give instructions regarding douching and sexual relations.
Administer pain medications.
Sally is a nurse working in an emergency department and receives a client after a radiological accident. Which task is the utmost priority for the nurse to do first?
Decontaminate the client's clothing.
Decontaminate the open wound on the client's thigh.
Decontaminate the examination room the client is placed in.
Save the client's vomitus for analysis by the radiation safety staff.
