Nursing Management and Leadership — SNLE practice questions

Question 1

In the emergency department, four patients arrive simultaneously. Applying the ABC (airway, breathing, circulation) priority framework, which patient should the nurse assess first?

Accepted Answer

A 45-year-old with an audible stridor and increasing facial swelling after eating shellfish

Answer

A 30-year-old with a closed forearm fracture and intact distal pulses

Answer

A 68-year-old with a two-day history of dysuria and low-grade fever

Answer

A 22-year-old with a 4 cm superficial laceration and controlled bleeding

Question 2

A nurse is about to administer an intravenous medication. The patient's identification band lists a name and medical record number. Which patient identification practice meets safety standards?

Accepted Answer

Verify the full name and medical record number against the medication record

Answer

Confirm the patient's room number and bed number match the assignment sheet

Answer

Ask the patient "Are you Mr. Ahmed?" and proceed if he nods yes

Answer

Rely on visual recognition since the nurse has cared for the patient all week

Question 3

A charge nurse on a medical-surgical unit is planning assignments for the next shift. The team consists of one registered nurse (RN), one licensed practical nurse (LPN), and one unlicensed assistive personnel (UAP). Which of the following patients is most appropriate to assign to the LPN?

Accepted Answer

A patient with a stage 2 pressure injury who requires a dressing change and oral antibiotic administration.

Answer

A patient who was admitted 2 hours ago with acute chest pain and is awaiting cardiac enzyme results.

Answer

A patient with newly diagnosed diabetes who needs comprehensive education on insulin self-injection.

Answer

A patient who is 2 days post-operative after a hip replacement and needs assistance with bathing and ambulation.

Question 4

A nurse manager on a medical-surgical unit is reviewing current evidence to update the unit's protocol for preventing catheter-associated urinary tract infections (CAUTI). The manager wants to base the new protocol on the strongest available evidence. Which type of research evidence should the manager prioritize?

Accepted Answer

A systematic review of multiple randomized controlled trials

Answer

A single randomized controlled trial with a large sample size

Answer

A quasi-experimental study with a control group

Answer

A qualitative study exploring nurses' perceptions of CAUTI prevention

Question 5

A nurse documents a patient's pain assessment in the electronic health record (EHR) but later realizes that the pain score was entered as 8/10 instead of the actual 3/10 reported by the patient. What is the most appropriate action to correct this error?

Accepted Answer

Create an addendum noting the error, the correct pain score, and the date and time of the correction.

Answer

Delete the incorrect entry and create a new note with the correct pain score.

Answer

Ask the information technology (IT) department to delete the erroneous entry from the system permanently.

Answer

Leave the incorrect entry unchanged and document the correct pain score in a new progress note without referencing the error.

Question 6

A nurse is preparing to administer a medication and notices that the tablet in the package appears different from the usual form. Upon checking, the nurse finds that the pharmacy dispensed a higher-dose tablet. The nurse returns the medication and obtains the correct dose. The patient receives the correct medication without harm. How should this event be classified in the facility's safety reporting system?

Accepted Answer

Near miss

Answer

Sentinel event

Answer

Adverse event

Answer

No harm event

Question 7

A charge nurse on a medical-surgical unit is planning care for the day shift. The team includes one registered nurse (RN), one licensed practical nurse (LPN), and one unlicensed assistive personnel (UAP). Which of the following patient care activities should the charge nurse delegate to the UAP?

Accepted Answer

A patient 2 days after total hip replacement who is stable and needs assistance ambulating to the bathroom.

Answer

A patient newly diagnosed with diabetes who needs instruction on self-injection of insulin.

Answer

A patient with a chest tube who requires assessment of the insertion site and drainage system.

Answer

A patient receiving total parenteral nutrition (TPN) who needs a new intravenous tubing set-up.

Question 8

A staff nurse notices that an intravenous (IV) bag prepared by pharmacy is labeled for a different patient. The nurse immediately stops the administration and reports the near miss to the charge nurse. According to a just culture approach, what is the most appropriate next step?

Accepted Answer

File an incident report detailing the near-miss event.

Answer

Document the near miss in the patient's medical record.

Answer

Notify the pharmacy manager to discipline the staff involved.

Answer

No further action is needed because the patient was not harmed.

Question 9

A staff nurse reports to the nurse manager that a physician frequently yells at her in front of patients and other team members, causing her significant distress. What is the nurse manager's best initial action?

Accepted Answer

Acknowledge the nurse's concerns and initiate the facility's process for addressing disruptive behavior.

Answer

Advise the nurse to avoid the physician whenever possible to minimize further distress.

Answer

Encourage the nurse to directly confront the physician about the impact of the yelling.

Answer

Schedule a private meeting with the physician to discuss the reported behavior immediately.

Question 10

A nurse realizes that she inadvertently documented a pain assessment under the wrong patient's electronic health record. Which of the following actions should the nurse take?

Accepted Answer

Mark the erroneous entry as 'entered in error,' document the assessment in the correct chart, and notify the supervisor.

Answer

Delete the erroneous entry, document the assessment in the correct chart, and notify the supervisor.

Answer

Leave the erroneous entry unchanged, document the assessment in the correct chart, and notify the supervisor.

Answer

Request that health information management delete the erroneous entry, document the assessment in the correct chart, and notify the supervisor.

Question 11

A nurse observes a colleague using another staff member's login credentials to access a patient's electronic health record (EHR) because the colleague forgot their own password. Which action should the nurse take first?

Accepted Answer

Tell the colleague to log out immediately and stop using the credentials.

Answer

Report the incident to the nurse manager or supervisor right away.

Answer

Ask the colleague to change the password after finishing the task.

Answer

Offer to look up the information for the colleague using your own login.

Question 12

A nurse is planning discharge for a patient who had a colostomy created 2 days ago. The patient states, "I don't think I can manage this at home." Which resource should the nurse coordinate to best support the patient's transition?

Accepted Answer

Wound, ostomy, and continence (WOC) nurse for specialized education

Answer

Home health aide to assist with daily ostomy care

Answer

Social worker to arrange long-term care placement

Answer

Physical therapist to improve mobility for ostomy care

Question 13

A nurse is planning care for a patient newly diagnosed with type 2 diabetes. The patient is uninsured and expresses concern about the cost of insulin and testing supplies. Which team member should the nurse consult to address the patient's financial barriers?

Accepted Answer

Social worker

Answer

Clinical nurse specialist

Answer

Pharmacist

Answer

Registered dietitian

Question 14

A nurse on a medical-surgical unit is concerned about the high rate of catheter-associated urinary tract infections (CAUTIs). The nurse decides to search for evidence and formulates the following clinical question: "In adult hospitalized patients with indwelling urinary catheters, does the use of a silver alloy-coated catheter compared to a standard latex catheter reduce the incidence of CAUTIs within 30 days?" Which component of the PICOT format does "silver alloy-coated catheter" represent?

Accepted Answer

Intervention

Answer

Population

Answer

Comparison

Answer

Outcome

Question 15

A nurse researcher is evaluating a study that examined the effect of a new patient education program on medication adherence. The study assigned participants to the intervention or control group based on the day of the week they attended the clinic. Which type of research design does this study use?

Accepted Answer

Quasi-experimental design

Answer

Randomized controlled trial

Answer

Correlational design

Answer

Descriptive design

Question 16

A charge nurse on a medical-surgical unit overhears two staff nurses arguing loudly in the hallway. The argument is disrupting the unit and drawing attention from patients and visitors. Which of the following actions should the charge nurse take first?

Accepted Answer

Direct the nurses to stop the argument immediately.

Answer

Allow the nurses to resolve the conflict on their own.

Answer

Report the incident to the nurse manager immediately.

Answer

Reassign one of the nurses to another unit for the shift.

Question 17

A nurse on a medical-surgical unit wants to implement an evidence-based practice change to reduce hospital-acquired pressure injuries. The nurse formulates the following clinical question: "In bedridden adult patients, does the use of a prophylactic silicone foam dressing in addition to standard repositioning compared to standard repositioning alone reduce the incidence of sacral pressure injuries over a 4-week period?" Which part of the PICOT question represents the "Outcome"?

Accepted Answer

Incidence of sacral pressure injuries

Answer

Bedridden adult patients

Answer

Prophylactic silicone foam dressing plus standard repositioning

Answer

Standard repositioning alone

Question 18

A nurse is using the electronic medication administration record (eMAR) to administer a prescribed antibiotic. When scanning the patient's wristband, the system displays an alert: 'Allergy Warning – Documented allergy to this medication class.' The patient's allergy band is not present, and the patient states, 'I've never had an allergic reaction to any antibiotic.' What should the nurse do first?

Accepted Answer

Hold the medication and contact the prescriber to clarify the allergy status.

Answer

Hold the medication and document the patient's denial in the EHR.

Answer

Administer the medication after asking the patient to sign a waiver form.

Answer

Override the alert after confirming the patient's identity with a second identifier.