NCLEX Practice Leadership Exam Questions and Correct Answers (Graded A+)
In what order should the nurse assess assigned clients following shift report? Place in priority order.
1. Client admitted with chemotherapy-induced neutropenia with a temperature of 100.8 F (38.2 C).
2. Client one day post splenectomy.
3. Client diagnosed with cancer who is crying and states, "I am not ready to die".
4. Client diagnosed with aplastic anemia needing education regarding ways to decrease infection risk.
5. Client with non-Hodgkin's lymphoma who is refusing prescribed chemotherapy regimen. - Answers
Correct Order: 1, 2, 3, 5, 4
Client admitted with chemotherapy-induced neutropenia with a temperature of 100.8 F (38.2 C).
Client one day post splenectomy.
Client diagnosed with cancer who is crying and states, "I am not ready to die".
Client with non-Hodgkin's lymphoma who is refusing prescribed chemotherapy regimen.
Client diagnosed with aplastic anemia needing education regarding ways to decrease infection risk.
Unlicensed Assistive Personnel (UAP)
What to delegate? - Answers Transport patients, remind patient to put on CPAP at bedtime, empty
catheter, measure intake & output, ambulate stable patient, encourage patient to follow prescription,
re-apply compression devices, set up suction equipment, reposition patients, passive ROM, encourage
patient to vent, maintain HOB position, assist w/feeding, remind about teaching, Oral care, gather
supplies, vital signs (not first post-op), prepare a sitz bath, report pain (do not monitor or Gag relflex),
disconnect NG tube for ambulation, (do not empty),feeding, assist w/walker, hodl chest tube drainage at
level of chest, anti-embolism stockings, drain colostomy bag, bathe patient, listen to patient, take weight
& height, re-orient patient, clip nails, assist with menu, replace heel protectors, clean NG tube nares,
prep patient room
Licensed Personnel Nurse (LPN)
What to delegate? - Answers Stable patients. Give enemas, antibiotics, anti-emetics, sub q meds, (no
pain meds), monitor fluid status, sterile dressing change, wound care, monitor behavior changes, check
environment for hazards, reinforce teaching, gather data, ambulate, nebulizer treatments, insert &
monitor NG tubes, bolus feeding gastro tube, change colostomy bag, Call provider about lab results
The nurse manager is developing a new yearly evaluation form for the staff. What statement(s) by the
nurse manager would most likely improve staff outcomes?
1. "How often do you need help to finish assignments?"
,2. "Are there any new skills you feel capable to learn?"
3. "Describe how you organize your daily assignments."
4. "Which tasks are most difficult for you to complete?"
5. "Explain any new goals you would like to achieve." - Answers 3 & 5. Correct: "Describe how you
organize your daily assignments & Explain any new goals you would like to achieve."Positive outcomes
are more likely when staff feels appreciated, receiving constructive and encouraging feedback on a
regular basis. Evaluations can be very stressful when staff are uncertain of expectations or are perceived
in a negative framework. Seeking clarification on how staff organize assignments indicates awareness
and may help in developing new protocols. Also, showing interest in individual goals will help develop
learning opportunities for all staff.
1. Incorrect The tone of this question is derogatory, implying the individual is not able to complete daily
assignments in a timely manner without assistance.
2. Incorrect: This inquiry is worded in a negative manner, implying the individual may not have the
ability to learn new skills.
4. Incorrect: Although this might present information the nurse manager might use to develop more
learning opportunities, the negative approach may intimidate staff, preventing complete honesty.
In which situation should the nurse consult the client's advanced directive?
1. Client scheduled for breast reconstruction after mastectomy.
2. Client with a T-5 spinal cord injury beginning rehabilitation therapy.
3. Client diagnosed with Guillain-Barre' who is receiving ventilator support.
4. Comatose client with end stage chronic obstructive pulmonary disease.
5. Client diagnosed with inoperative brain tumor who is confused. - Answers 4., & 5. Correct: "Comatose
client with end stage chronic obstructive pulmonary disease. & Client diagnosed with inoperative brain
tumor who is confused." The client must have lost decision-making capacity because of a condition that
is not reversible or must be in a condition that is specified under state law, such as a terminal, persistent
vegetative state, irreversible coma, or as specified in the Advanced Directive. Both of these clients are
terminal.
1. Incorrect: A client scheduled for surgery after a mastectomy is still able to make decisions. The option
does not say the client is terminal, in a vegetative state, or in a coma.
2. Incorrect: A client who has a spinal cord injury and is in rehabilitation is still alert and able to make
decisions
,3. Incorrect: A client diagnosed with Guillain-Barre' is mentally competent and being on a ventilator
does not indicate that the client has lost decision-making capacity.
A nurse manager has several issues regarding staff maintaining proper infection control while caring for
clients. What actions should the manager take regarding this issue?
1. Place colorful posters regarding infection control in conspicuous places on unit.
2. Monitor staff providing client care for the use of appropriate infection control.
3. Give staff a written test on proper infection control.
4. Have all staff read agency policy and procedures regarding infection control.
5. Dock pay of staff who do not maintain proper infection control.
6. Provide mandatory in-service sessions on infection control for every shift. - Answers 1., 2., 3., 4., & 6.
Correct. Each of these actions can be taken by the nurse manager. The staff needs further education,
reminders, and follow-up observation. Posters are great reminders of concepts. All nurses need to
supervise those under their direction. Testing can be done as pretest or post test along with in service
education. Staff development or in service sessions are required by Joint Commission on Accreditation
of Healthcare Organizations (JCHO) on infection control.
5. Incorrect. This is not the best solution, because most people want to do what is right. Education
should be tried first, then documentation of the infractions. You must support, supervise and educate!
The nurse is assigned to care for 4 adult clients. In what order should the nurse care for these clients?
1. The client with facial burns 3 days ago who has been crying since recent visitors left.
2. The client reporting pain 7/10 after returning from debridement surgery 1 hours ago.
3. The client with partial thickness leg burns who has a temperature of 102°F (38.8°C) and a blood
pressure of 88/46.
4. The client admitted with electrical burns 12 hours ago and has a serum potassium level of 5.2 mEq/L. -
Answers Correct Order:
3, 4, 2, 1
The client with partial thickness leg burns who has a temperature of 102°F (38.8°C) and a blood pressure
of 88/46.
The client with facial burns 3 days ago who has been crying since recent visitors left.
The client admitted with electrical burns 12 hours ago and has a serum potassium level of 5.2 mEq/L.
, The client reporting pain 7/10 after returning from debridement surgery 1 hours ago.
"Who could die if I do not see them first?"
The nurse should first see is the client with partial thickness leg burns who has a temperature of 102°F
(38.8°C) and a blood pressure of 88/46. This client has a fever and hypotension, indicative of life
threatening complications of shock. In this case, septic shock.
The client admitted with electrical burns 12 hours ago and has a serum potassium level of 5.2 mEq/L
should be seen second. This client is at risk for heart problems (dysrhythmias) with the electrical burn
and the elevated potassium level.
The third client the nurse should see is the client reporting pain 7/10. The nurse needs to administer
pain medication. However, remember that pain never killed anyone. Take care of the other two client
first. This are at risk for death.
The fourth client the nurse should see is the client who has been crying. Don't let facial burns throw you.
This burn is 3 days old and swelling would be decreasing at this point. Physical problems take priority
over psychological problems. This client is the most stable.
What action should the nurse take after mistakenly administering the wrong medication?
1. Notify the nursing supervisor.
2. Inform the primary healthcare provider.
3. Complete an incident (variance) report.
4. Document client assessment and response to medication.
5. Document medication error and incident (variance) report in nurse's notes. - Answers 1., 2., 3., & 4.
Correct: Nurses must immediately report all client care issues, concerns or problems to the supervising
nurse, the primary healthcare provider and/or the performance improvement or risk management
department. A written report of the incident is completed by the nurse and turned into the appropriate
person (generally the performance improvement department). Documentation of what occurred, and
the client's assessment is required in the nurse's notes.
5. Incorrect: Do not document that an error was made or that an incident (variance) report was
completed. Document what medication was given, the client's assessment, the notification of the
nursing supervisor, and primary healthcare provider, and any prescriptions received.
The nurse inadvertently administered the wrong medication to a client. Place the tasks to be completed
in order of priority.
1. Alert the Unit Manager.
