Question 1

What is the first step in the qualitative research process?

Accepted Answer

Answer reason: In qualitative research, the process begins by clarifying the problem and grounding it in what is already known, which is done through a review of the literature. This step helps refine the purpose and research questions and identifies gaps that qualitative inquiry can address. Sampling, study design, and data analysis occur after the topic and context have been established from existing evidence.

Question 2

Which type of research should the OTR review to obtain the strongest level of evidence regarding this intervention?

Accepted Answer

Answer reason: Systematic reviews and meta-analyses synthesize results across multiple high-quality studies, increasing statistical power and reducing the influence of random error compared with individual studies. In evidence hierarchies, they generally provide the strongest level of evidence for intervention effectiveness when based on rigorous methods and appropriate included studies. Case reports/expert opinion and case series are lower-level designs with higher bias and limited generalizability, and non-randomized two-group studies are more prone to confounding than randomized evidence.

Question 3

True or False The primary purpose of a nursing care plan is to ensure documentation accuracy?

Accepted Answer

Answer reason: False A nursing care plan’s primary purpose is to guide individualized, goal-directed nursing care by identifying patient problems, expected outcomes, and specific interventions. While accurate documentation supports communication, continuity, and quality monitoring, it is not the main goal of the care plan itself. The care plan functions as a clinical roadmap to coordinate care among the team and evaluate patient response over time.

Question 4

The first step in curriculum development is?

Accepted Answer

Answer reason: Curriculum development starts by identifying what learners should be able to do at the end of the program, which guides all subsequent decisions. Clear objectives drive the selection of appropriate content, teaching-learning activities, and assessment methods. Evaluation is performed after implementation to judge whether the objectives were achieved and to inform revisions.

Question 5

The nursing instructor is considering becoming a member of the National League for Nursing (NLN). Which primary goal of the NLN will most strongly impact the nurse’s decision to become a member?

Accepted Answer

Answer reason: The NLN is primarily focused on excellence in nursing education, including developing, promoting, and evaluating educational standards and accreditation-related guidance. For a nursing instructor, membership is most directly relevant when the organization’s mission supports curriculum quality, faculty development, and educational outcomes. The other options describe broader nursing or global health missions that are more aligned with different professional organizations rather than the NLN’s core educational role.

Question 6

A nurse has been working as a staff nurse in the surgical intensive care unit for 2 years and is interested in certification. Which credential would be most applicable for her to seek?

Accepted Answer

Answer reason: This scenario tests knowledge of appropriate professional certification for an experienced staff nurse working in an intensive care setting. The CCRN credential is the standard certification for registered nurses providing direct care to acutely/critically ill adult patients, which aligns with a surgical ICU role. The other options correspond to different roles or acuity settings (advanced practice, clinical nurse specialist, or progressive care rather than ICU).

Question 7

The nurse describes to a student nurse how to use evidence-based practice guidelines when caring for patients. Which statement, if made by the nurse, would be the most accurate?

Accepted Answer

Answer reason: Evidence-based practice integrates the best available research evidence with clinician expertise and the patient’s values and preferences to guide decisions. Using only research findings without considering expertise or patient goals is incomplete and may not fit an individual’s situation. Relying on tradition and experience alone is not evidence-based because it can perpetuate ineffective or unsafe practices. Consistently meeting outcomes reflects quality improvement evaluation rather than defining evidence-based guideline use.

Question 8

Expected outcome should be written following which five step guideline?

Accepted Answer

Answer reason: Expected outcomes in nursing care planning should be objective and able to be evaluated, so they must be measurable and time-limited. They also need to be realistic for the patient’s condition and resources, which aligns with achievable and reasonable. Finally, outcomes should be focused and prioritized to what is most relevant to the patient’s needs, reflected by being selective.

Question 9

A nurse manager notices a decrease in patient satisfaction scores. What should the nurse manager do first?

Accepted Answer

Answer reason: The first step in addressing declining satisfaction is to assess and identify contributing factors using available data from clients and staff. This supports a structured performance improvement approach—collecting information before implementing changes or corrective actions. Increasing workload or terminating staff without assessment may worsen care quality and morale and introduces avoidable risk. Waiting to see if scores improve delays necessary evaluation and undermines continuous quality improvement.

Question 10

As a professional, a nurse can do research for varied reason except?

Accepted Answer

Answer reason: Research in nursing is primarily conducted to generate evidence that improves patient outcomes, validates or refines interventions, and strengthens professional practice. Participation can also support professional growth through scholarly engagement and contribution to the discipline. Pursuing research chiefly for personal financial gain conflicts with the ethical and professional purpose of nursing research, which centers on beneficence, integrity, and quality of care.

Question 11

A nurse observes that despite interventions, a patient’s wound is not healing. What is the next step?

Accepted Answer

Answer reason:  Lack of progress indicates the current interventions are not achieving expected outcomes, so the nurse should reassess and revise the plan based on evaluation findings. This includes identifying barriers to healing (e.g., infection, poor perfusion, uncontrolled diabetes, pressure, malnutrition) and updating interventions and goals accordingly. Continuing unchanged care delays improvement, while stopping all interventions or ignoring outcomes is unsafe and inconsistent with the nursing process.

Question 12

According to Henri Fayol, the functions of planning, organizing, coordinating, and controlling are considered which aspect of management?

Accepted Answer

Answer reason: Fayol’s classic management theory defines core managerial functions as planning, organizing, coordinating (often framed as directing/commanding), and controlling. These are what managers do to accomplish organizational goals, distinct from managerial roles (e.g., Mintzberg’s interpersonal/informational/decisional roles). “Process” is broader and can include steps or workflows, but Fayol specifically labeled these as management functions. “Taxonomy” is not a standard descriptor for Fayol’s framework in management.

Question 13

Which of the following is considered a decisional managerial role?

Accepted Answer

Answer reason: This item tests Mintzberg’s managerial roles: decisional roles include entrepreneur, disturbance handler, resource allocator, and negotiator. An entrepreneur initiates change and improvement efforts (e.g., introducing new processes or services) and makes decisions to innovate within an organization. The other options are classified as informational (disseminator) or interpersonal (figurehead, leader) rather than decisional roles.

Question 14

Which of the following is formal continuing education?

Accepted Answer

Answer reason: Formal continuing education refers to structured, accredited learning activities that lead to recognized academic credit or credentials and support professional competence. Graduate school enrollment is a formal, institutionally regulated educational pathway with defined curricula, evaluation, and awarded credits/degrees. Conferences and seminars are commonly classified as informal or non-degree continuing education unless specifically credit-bearing, and a refresher course is typically a short update course rather than a formal academic program. Therefore, the option that best fits the definition of formal continuing education is graduate school enrollment.

Question 15

You have noticed that the last several patients you have cared for have had questionable blood pressure readings from their arterial lines. When checked against cuff pressures, a discrepancy has been noted, and further investigation has revealed faulty transducers. This is not the first product issue with this company. What positive step could you take to help resolve this situation?

Accepted Answer

Answer reason: Establishing a peer workgroup supports structured evaluation, standard-setting, and selection of safer devices before widespread use, addressing the root cause rather than adding workarounds. Hourly cuff checks may temporarily detect discrepancies but does not prevent recurrence and increases workload while leaving the defective product in circulation. Notifying the risk manager is appropriate for reporting, but it is less proactive than engaging frontline clinicians in product evaluation and process improvement to prevent future failures.

Question 16

Which method best describes the use of evidence-based practice?

Accepted Answer

Answer reason: Evidence-based practice is the integration of the best current evidence with clinical expertise and patient values to make care decisions. The correct choice captures the central principle of using current, relevant evidence to guide nursing care and improve client outcomes. Reading and analyzing research is only one step in EBP and does not fully describe the application of evidence at the point of care. Monitoring Joint Commission compliance and collecting efficiency data are quality improvement and regulatory activities, which are related but not the defining method of EBP.

Question 17

Which action represents the evaluation stage of the plan of care?

Accepted Answer

Answer reason: When outcomes are not met, the nurse must modify the plan of care by revising interventions, timelines, or expected outcomes based on the reassessment data. This option directly describes outcome comparison followed by plan revision, which is the defining action of evaluation. By contrast, assigning a nursing diagnosis reflects the diagnosing step, and taking vital signs/health history are assessment activities rather than evaluation.

Question 18

The nurse has been monitoring the patient's progress on a new drug regimen since the first dose and documenting the patient's therapeutic response to the medication. Which phase of the nursing process do these actions illustrate?

Accepted Answer

Answer reason: Monitoring the patient after medication initiation and documenting the therapeutic response are direct measures of outcome achievement and treatment effectiveness. Implementation would be the act of administering the medication and carrying out related interventions, not judging the results. Planning involves setting goals and selecting interventions before they are carried out and assessed.

Question 19

When the nurse determines whether resources were maximized in implementing Ligtas Tigdas, she is evaluating?

Accepted Answer

Answer reason:  Efficiency evaluates how well resources (time, staff, supplies, and funds) are used to achieve program outputs with minimal waste. The phrase “whether resources were maximized” specifically targets the input-to-output relationship, which is the core concept of efficiency. Effectiveness instead focuses on whether the intended health outcomes (e.g., reduced measles cases) were achieved, regardless of resource use. Adequacy and appropriateness relate more to sufficiency and fit of services to client needs, not optimization of resource utilization.

Question 20

Which of these statements best describes the characteristic of an effective reward-feedback system?

Accepted Answer

Answer reason: Providing feedback close to the event improves accuracy of recall and reinforces desired behaviors, which is essential in a reward-feedback system aimed at improving performance. Equal amounts of feedback over time is not a quality criterion and can ignore differences in performance and learning needs. Inflating goals beyond attainability undermines motivation and credibility, increasing frustration rather than improvement.

Question 21

During the evaluation phase for a client, the nurse should focus on?

Accepted Answer

Answer reason: This phase emphasizes judging response to interventions, identifying what worked or did not work, and deciding whether to continue, modify, or terminate the plan of care. Ongoing re-evaluation is essential because client status can change and requires updating outcomes and interventions accordingly. Options describing data collection of stressors align with assessment, while setting goals and selecting interventions align with planning.

Question 22

The nurse manager has a nurse employee who is suspected of a problem with chemical dependency. Which intervention would be the best approach by the nurse manager?

Accepted Answer

Answer reason: Involving HR ensures the manager uses the correct chain of command, aligns actions with labor law and facility procedures, and initiates appropriate fitness-for-duty evaluation and employee assistance processes. Direct confrontation without policy guidance can lead to inconsistent handling, inadequate documentation, or escalation that jeopardizes safety and fairness. Holding a staff conference without the nurse present increases gossip and violates confidentiality. Advising resignation is inappropriate because it bypasses investigation, reporting obligations, and structured support/monitoring programs.

Question 23

The hospital is planning to downsize and eliminate a number of staff positions as a cost-saving measure. To assist staff in this change process, the nurse manager is preparing for the "unfreezing" phase of change. With this approach and phase the nurse manager should?

Accepted Answer

Answer reason: Providing a clear rationale helps staff understand the problem the change addresses and begins shifting attitudes from the status quo. Options focused on acceptance of changes align more with the moving/changing and refreezing phases rather than initial readiness. Anticipating defensive responses can be helpful, but without establishing the compelling need for change, resistance is less likely to decrease effectively.

Question 24

A new nurse manager is responsible for interviewing applicants for a staff nurse position. Which interview strategy would be the best approach?

Accepted Answer

Answer reason: Structured interviewing aligns questions with job-related competencies and organizational policy, which is central to quality processes in staffing. Varying the interview style between candidates undermines comparability and increases subjective decision-making. Yes/no questions often fail to assess clinical judgment and communication skills, and asking personal information risks illegal or discriminatory inquiries that violate employment standards.

Question 25

A nurse manager considers changing staff assignments from 8 hour shifts to 12 hour shifts. A staff-selected planning committee has approved the change, yet the staff are complaining. As a change agent, the nurse manager should first?

Accepted Answer

Answer reason: When staff are complaining despite committee approval, the nurse manager should first evaluate whether the planning process adequately assessed concerns such as fatigue, safety, coverage patterns, and work-life impact. This step supports evidence-based implementation and helps tailor communication, education, and mitigation strategies to improve buy-in and outcomes. Moving directly to implementation prioritizes authority over engagement and increases the likelihood of resistance and unintended safety or staffing problems. A time delay without evaluation does not address root causes and can erode trust in the change process.

Question 26

The nurse educator is responsible for teaching staff members about a change in a central line dressing change procedure. Which method of education would best enhance the staff's retention of this information?

Accepted Answer

Answer reason: An in-service can be tailored to the exact updated central-line dressing protocol, include demonstration/return-demonstration, and allow questions and feedback, all of which improve memory and skill transfer. Specialty certification is broad and not designed to rapidly disseminate a single procedural change to an entire unit. Contact hours mainly document continuing education credit and do not, by themselves, ensure effective teaching methods or skills validation.

Question 27

A new nurse is not performing dressing changes satisfactorily. What is the best approach for the nurse-manager to use first?

Accepted Answer

Answer reason: Effective performance management starts with assessment and therapeutic, nonpunitive communication to identify the cause of the problem (knowledge gap, skill deficit, resource issue, or misunderstanding of policy). Inviting self-assessment builds rapport, encourages accountability, and provides the manager with specific information to tailor coaching and remediation. Jumping immediately to deadlines or formal documentation is premature without first clarifying expectations and barriers, and may escalate defensiveness rather than improve practice. Unit-wide education may be appropriate later if a broader trend exists, but the immediate issue is an individual performance concern requiring direct feedback and assessment first.

Question 28

A nurse-manager has identified several interpersonal problems with a staff member. Which approach is best for the nurse-manager to take?

Accepted Answer

Answer reason: Effective management of performance and interpersonal issues relies on collaborative problem-solving, shared prioritization, and staff engagement to promote accountability and sustainable behavior change. Working together to rank issues focuses effort on the highest-impact concerns and reduces overwhelm, which improves the likelihood of measurable improvement. This approach also supports a fair, supportive process consistent with coaching and performance improvement rather than a punitive or unilateral plan. By contrast, independently mapping solutions or simply working down a list can ignore the staff member’s perspective and readiness to change, undermining buy-in and follow-through.

Question 29

The nurse-manager meets with a staff nurse to evaluate performance after the 6-month probationary period. As part of the evaluation process, the nurse manager would ask the staff nurse to?

Accepted Answer

Answer reason: Effective performance appraisal is a structured, collaborative process that includes the employee’s reflective input to identify strengths, gaps, and an actionable development plan. A self-assessment supports professional accountability and helps align goals with unit standards and competency expectations. Signing an evaluation does not require agreement and should not be framed as acceptance of the manager’s judgment. Peer input and upward feedback can be useful in some systems, but they are not the core expectation of a probationary performance review meeting.

Question 30

A new graduate nurse has almost completed orientation on the assigned nursing unit; however, a skills checklist and performance test identify deficient skills. What is the most appropriate action for the nurse-manager to take?

Accepted Answer

Answer reason: Performance deficits during orientation should trigger a supportive remediation plan that protects patient safety while developing competence. Partnering with the preceptor allows targeted coaching, additional supervised practice, and objective re-evaluation against the checklist criteria. Immediate termination or threatening termination is premature and can undermine learning without first providing structured assistance and documentation of improvement efforts. A transfer does not address the underlying skill gaps and may simply shift risk to another unit rather than correcting the problem.

Question 31

A new graduate nurse is assigned to a nursing unit. The nurse-manager notes that the graduate’s skills are deficient. Which action is most appropriate for the nurse-manager to take?

Accepted Answer

Answer reason: The appropriate management principle is to address performance gaps through supportive supervision, education, and a structured remediation process to protect patient safety while fostering staff development. A targeted improvement plan can include competency validation, mentoring/preceptorship, and measurable goals with timelines, allowing the manager to evaluate progress objectively. Immediate transfer or termination is premature without first attempting corrective action and providing resources and feedback. A threat of termination may be part of progressive discipline later, but it is not the most appropriate initial response when deficits are first identified.

Question 32

The nurse is leading a team to develop an evidence-based practice guideline for preventing skin breakdown in the hospitalized client. To fully use the databases available to the nurse, which should be the nurse’s first step in the process for developing the guidelines?

Accepted Answer

Answer reason: A well-built question defines the population, intervention, comparison, and outcomes, which directly determines search terms, inclusion criteria, and the type of evidence needed. Appraisal of individual studies and synthesis come after the relevant literature has been retrieved. Choosing an EBP model/strategy may guide workflow, but it does not replace the foundational need for a searchable, answerable question to fully leverage databases.

Question 33

The nurse notices a posting on a bulletin board for a continuing education (CE) offering on the prevention of pressure ulcers. Which is the most compelling reason for the nurse to attend?

Accepted Answer

Answer reason: Quality and performance improvement activities are driven by identified care problems and outcome trends, prioritizing education that targets a demonstrated patient-safety gap. An increase in pressure ulcers signals a systems-level issue in prevention practices, risk assessment, turning schedules, support surfaces, or skin care that requires immediate action to reduce harm. Attending education focused on prevention directly addresses the unit’s adverse outcome and supports implementing evidence-based interventions. In contrast, personal convenience or licensure requirements are individual motivations and do not carry the same urgency as responding to a rising complication rate affecting multiple patients.

Question 34

The nurse confides to a coworker that when reporting a change in the client’s condition to the HCP, the HC P stated, “It seems that every time you work, there is some catastrophe. Can’t you problem- solve earlier so this doesn’t happen!” What is the coworker’s best response?

Accepted Answer

Answer reason:  Professional communication that intimidates or shames staff is a safety and quality concern because it can suppress timely reporting of patient changes and increase risk of harm. The best immediate support is to encourage use of the facility’s established reporting pathway so the behavior is documented and addressed through the proper chain of command and performance improvement processes. This response is actionable and policy-based, which protects both staff and patients and promotes a just culture. Options that normalize the behavior or rely on hearsay about what the manager is already doing fail to ensure appropriate documentation and follow-through.

Question 35

At 1000, the client states, “I can’t get enough air,” and the nurse assesses fine crackles in the client’s bilateral lung bases. At 1010 the nurse increases the client’s oxygen from 2 liters per nasal cannula (NC) to 4 liters per protocol. Which is the most appropriate nursing documentation?

Accepted Answer

Answer reason:  Nursing documentation should be objective, time-stamped, and include the assessment findings, the intervention performed, and the clinical rationale/authorization (e.g., per protocol). This entry records the client’s respiratory complaint and auscultated crackles and clearly documents the oxygen titration that occurred at 1010, aligning with the scenario. Option A is incomplete because it documents only the intervention without the assessment context that prompted it. Option C reflects inappropriate delay in acting despite a protocol and fails to document the actual intervention taken. Option D includes unclear/incorrect terminology (“rnask”) and adds outcome claims without clearly capturing the assessment-to-intervention sequence at the correct time.

Question 36

The family complains to the oncoming shift nurse about the poor care provided by the previous nurse. They state that discharge instructions including how to perform dressing changes and the client’s activity level were confusing and incorrect. After meeting the client and family needs, which action should the oncoming nurse take to prevent this situation from happening again?

Accepted Answer

Answer reason: The nurse manager is the appropriate leader to assess competence issues, review the event, and implement corrective actions such as remediation, policy reinforcement, or education to prevent recurrence. Informal fact-finding with peers risks gossip and breaches professionalism without creating a formal corrective pathway. Notifying risk management is typically reserved for significant adverse events or liability exposure, whereas this scenario centers on staff performance and discharge-teaching quality needing managerial follow-up.

Question 37

Prior to medication administration, a hospital policy requires a double-check of two unique client identifiers against the MAR. The nurse manager forms a performance improvement team with the goal of improving nursing compliance with this important safety check. Which activity, related to checking two unique identifiers, should be the responsibility of the performance-improvement team?

Accepted Answer

Answer reason: Direct observation and reporting (audit/monitoring) provide objective baseline data on whether two identifiers are being checked against the MAR and where breakdowns occur (process, workflow, environment). Accountability and discipline are managerial/HR actions and can suppress reporting, undermining a safety culture needed for sustained improvement. Changing the identifier standard itself is inappropriate because the policy reflects an evidence-based patient safety requirement; the PI team should instead evaluate adherence and barriers to compliance.

Question 38

The nurse manager is teaching nursing staff about the use of an evidence-based practice (EBP) framework for performance improvement. Which description should the nurse manager include?

Accepted Answer

Answer reason: An EBP framework is a structured process for improving care by turning a practice problem into a focused clinical question, then systematically appraising and integrating the best available evidence with clinical expertise and context. This option describes the core EBP steps (identify problem, ask a focused question, gather/appraise evidence, and translate findings into practice implications). The other options describe tools or resources that may support EBP (e.g., databases or guidelines) rather than the framework/process itself. A common pitfall is confusing the nursing process or auditing guideline adherence with EBP, but those do not capture evidence searching and appraisal.

Question 39

A group of nurses is discussing the benefits of specialized certifications in specific areas of nursing. One of the nurses states, “I believe that the additional knowledge that I acquired by studying for my specialty certification was worth the time and money that I spent. It enhances my client care and benefits my clients every day.” Several nurses in the group decide to study for their certifications based on the certified nurse’s positive experience. This is an example of which type of staff education and development?

Accepted Answer

Answer reason: Informal staff development occurs through peer-to-peer interaction, role modeling, and day-to-day sharing of experiences rather than an organized, scheduled program. Here, a nurse’s personal testimony about certification motivates colleagues to pursue learning based on observed benefit and discussion within the group. Formal education would involve structured classes or planned in-services with defined objectives and evaluation. Mandatory education/compliance training are required by the employer or regulation (e.g., annual competencies), which is not described in this voluntary, influence-based scenario.

Question 40

The nurse manager plans to establish quality metrics for the nursing unit based on national metrics and compare them to other healthcare organizations. This process is identified as?

Accepted Answer

Answer reason: Benchmarking is the quality method of comparing an organization’s processes and outcomes against external standards or peer organizations to identify gaps and best practices. The stem specifically describes using national metrics and comparing the unit’s results with other healthcare organizations, which is an external comparison. Continuous quality improvement and performance improvement are broader ongoing frameworks for improving processes, but they do not inherently mean comparing to outside organizations. Quality management is an umbrella term for organizing and overseeing quality activities rather than the specific act of external metric comparison.

Question 41

A nurse manager works on a unit where the nursing staff members are uncomfortable taking care of clients from cultures that are different from their own. How should the nurse manager address this situation?

Accepted Answer

Answer reason: Cultural competence is best improved through structured education that allows reflection, discussion, and skills practice to reduce bias and improve communication. A workshop can address attitudes, provide evidence-based cultural care principles, and create a safe environment for staff to ask questions and identify learning needs. Simply assigning readings is passive and may not change behaviors or comfort level in real interactions. Relocating staff avoids the professional responsibility to provide equitable care and is impractical because diverse clients present in all settings.

Question 42

The nurse manager regularly performs chart audits and room inspections in the unit. They tell the staff to address the unit’s deficiencies during a meeting. Which concept of management is the nurse manager displaying?

Accepted Answer

Answer reason: Quality management is the ongoing, organized oversight of care processes to identify gaps and ensure standards are met. Regular chart audits and environmental inspections are classic monitoring activities used to detect deficiencies in practice and the care environment. Calling staff together to address identified deficits reflects managing quality by closing the loop between measurement and corrective action. Benchmarking would emphasize comparison to external best performers, which is not described here. Continuous quality improvement is a broader philosophy, but the stem most directly highlights the managerial function of monitoring and correcting unit-level quality issues.

Question 43

The nurse caring for a client reports a critical laboratory value of 120,000/mm3 (120 x 10^9/L) platelets, decreased from 300,000/mm3 (300 x 10^9/L) on admission. The health care provider says this is normal. The client is receiving heparin injections. Which nursing action would be the most appropriate?

Accepted Answer

Answer reason: Thorough charting establishes the clinical timeline and supports follow-up actions (e.g., notifying the charge nurse, requesting re-evaluation, and implementing facility chain-of-command) while maintaining legal and clinical accountability. Reporting directly to licensing/medical boards or the legal team is not the first step and is typically reserved for confirmed misconduct, impairment, or unresolved unsafe practice after internal processes. The safest “most appropriate” action among the listed choices is to document the interaction clearly and factually while continuing appropriate escalation through institutional channels.

Question 44

A nursing manager is reviewing new evidence-based practice articles regarding an infection prevention protocol. Which of the following actions should be performed by the nurse manager first, prior to implementation on the unit?

Accepted Answer

Answer reason: Determining whether the study participants and clinical context match the manager’s unit establishes external validity and prevents adopting a protocol that is ineffective or unsafe for a different risk profile. Staff willingness, cost analysis, and assigning leaders are important implementation steps, but they come after confirming the evidence is relevant to the intended patients. If the population or setting does not align, further planning wastes resources and may introduce preventable infection-control risks.

Question 45

Which of the following statements about a client being admitted with diabetes and hypertension displays correct understanding of the medication reconciliation process by the nurse?

Accepted Answer

Answer reason: Medication reconciliation is a safety process to compare the patient’s complete home regimen against inpatient orders to identify omissions, duplications, dosing errors, and inappropriate substitutions. A change from one beta-blocker to another is exactly the type of discrepancy that must be identified, clarified, and documented to prevent duplicate therapy or unintended gaps in blood pressure/heart rate control. Bringing medications from home does not eliminate the need for reconciliation because the nurse must still verify what is actually taken and ensure orders match clinical intent. Complementary/OTC therapies and all prescribed medications should be included because they can interact with antihypertensives and antidiabetic agents and affect patient outcomes.

Question 46

The nursing supervisor has implemented a new assignment system for nursing staff. In order to reduce resistance to this new system, the nurse manager should?

Accepted Answer

Answer reason: Resistance to change is best reduced by involving staff in the process and allowing open discussion of concerns. This promotes engagement, trust, and acceptance. Incentives, data, and presentations may support change, but they are less effective without active staff participation and communication.

Question 47

One leadership theory states that “leaders are born and not made,” which refers to which of the following theories?

Accepted Answer

Answer reason: This aligns with the Great Man theory, which argues that certain individuals are naturally destined to lead due to inherent attributes. In contrast, situational leadership emphasizes adapting style to context and follower readiness, not being born with leadership. Trait theory focuses on identifying characteristics common to leaders, but the classic “born, not made” phrasing most directly points to the Great Man concept. Charismatic leadership centers on influence through personal charm and inspiration, which can be cultivated and is not strictly an inborn-destiny claim.

Question 48

Ms. Caputo is newly promoted to a patient care manager position. She updates her knowledge on the theories in management and leadership in order to become effective in her new role. She learns that some managers have low concern for services and high concern for staff. Which style of management refers to this?

Accepted Answer

Answer reason: The leader prioritizes staff comfort, morale, and relationships, often avoiding conflict and minimizing performance demands. As a result, unit output and service quality can suffer despite a generally pleasant work climate. By contrast, team management would reflect high concern for both staff and services, aiming for high performance with strong collaboration.

Question 49

Situation 5- Rosie, a new staff nurse, was assigned to the psychiatric unit. A depressed patient assigned to her fell from her bed. Her head nurse asked her to submit an incident report (IR) 91. The purpose why the head nurse asked Nurse Rosie to submit an IR is to ________?

Accepted Answer

Answer reason: Prompt documentation supports timely investigation, corrective actions, and system changes to prevent recurrence. It is not placed in the employee’s personnel file and is not primarily used to evaluate staff performance. Tracking patterns may be a later use of aggregated reports, but the immediate purpose is accurate contemporaneous documentation of the event.

Question 50

When administering Propranolol through an IV, what should be done before?

Accepted Answer

Answer reason: Independent double-checks of the provider order, dose calculations, and pump programming are a key medication-safety strategy to prevent preventable harm before administration. Eating or drinking water does not mitigate the primary risks associated with IV beta-blocker administration and can be irrelevant or unsafe depending on the patient’s status. A “nothing needed” approach ignores standard high-risk medication administration safeguards and increases the chance of wrong-dose/wrong-rate errors.

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