pg. 1 Evolve HESI Leadership and Management 2024 Exam/ Complete 300 Actual Exam Questions with Correct Detailed Answers (Verified Answers) Graded A+
A client's serum potassium level has increased to 5.8 mEq/L (5.8 mmol/L). What action should the nurse implement first?
- Call the laboratory to repeat the test.
- Take vital signs and notify the healthcare provider.
- Inform the cardiac arrest team to place them on alert.
- Take an electrocardiogram and have lidocaine available. - Correct Answer - 2
Vital signs monitor cardiorespiratory status; hyperkalemia causes cardiac dysrhythmias.The healthcare provider should be notified because medical intervention may be necessary.A repeat laboratory test will take time and probably reaffirm the original results; the client needs immediate attention. The cardiac arrest team is always on alert and will respond when called for a cardiac arrest. Taking an electrocardiogram and having lidocaine available are insufficient interventions.
The nurse has accepted a position as a navigator. What should the nurse expect to learn during training for this role? Select all that apply.
- Approaches to reduce the cost of health care
- Learning ways to work through the health systems
- Strategies to teach clients about disease, including prevention and treatment
- Assessing barriers that clients have encountered while attempting to receive care
- Helping clients cope with delays in receiving treatment until barriers are overcome -
Correct Answer - 2, 3, 4, 5 1 / 4
pg. 2 Navigators are responsible for overcoming health system barriers, providing health education about diseases from prevention to treatment, addressing barriers to care, and providing psychosocial support. These are the areas the nurse should expect to focus on when being trained in the role.Learning approaches to reduce the cost of health care would be appropriate for a case manager to learn.
What aspect of total client care needs to be taken into consideration if used on a 24-bed care area?
- Cost of nurses
- Training needs
- Documentation
- Time commitment - Correct Answer - 1 Cost of nurses
Since total client care is provided by a registered nurse (RN) it can be very expensive and not realistic to use a highly skilled and extremely knowledgeable professional nurse to provide all the care required in a unit of 24 clients.There are no particular issues with training, documentation, or time commitment with total client care.
For which situations would total client care be an appropriate delivery system? Select all that apply.
- Client scheduled for lithotripsy for renal calculi
- Client with an endotracheal tube for pulmonary sepsis
- Client recovering from cardiovascular bypass graft surgery
- Client recovering from the placement of a cerebrospinal fluid shunt
- Client transferring to a rehabilitation unit after total hip replacement surgery - Correct
Answer - 2, 3, 4 Total client care is used in critical care settings where one nurse provides total care to one or two critically ill clients. The client with an endotracheal tube for pulmonary sepsis and the client recovering from cardiovascular bypass graft surgery are considered acutely ill and will be receiving care in a critical care area. The client recovering from 2 / 4
pg. 3 cranial surgery to place a cerebrospinal fluid shunt would be appropriate for total client care.Total client care would not be an ideal care approach for the client scheduled for lithotripsy or the client being transferred to a rehabilitation unit.
Which intervention should the charge nurse perform to manage a task when the unlicensed nursing personal (UNP) is lacking competence?
- Provide constructive feedback and assign another task.
- Provide open vocal feedback and withdraw the UNP from task.
- Provide additional support and temporarily lower expectations.
- Provide accountability to the organization and undergo training again. - Correct
Answer - 3 The charge nurse should manage a task by temporarily lowering expectations and providing additional support to an unlicensed nursing personal (UNP) who is lacking competence. This strategy allows the UNP to build on strengths, minimize weaknesses, and gain confidence.Providing constructive feedback and assigning another task may not improve the strategy of the UNP and may affect the productivity of the new task. Withdrawing the UNP from the task and providing open vocal feedback may weaken the working relationship and the UNP may lose confidence or become frustrated. The charge nurse should be aware of accountability to the organization in case of a failure of the delegation, but assigning the UNP for further training may lead to high risk for legal liability.
The healthcare team is caring for a client with neutropenia. Which task is delegated to unlicensed assistive personnel?
- Administering antibiotics
- Assisting with personal hygiene
- Monitoring for signs and symptoms of infection
- Teaching the client and caregivers about how to avoid infection - Correct Answer - 2
The licensed practical nurse administers antibiotics. Monitoring for signs and symptoms is performed by the licensed practical nurse. The registered nurse teaches the client and caregivers how to avoid infection. 3 / 4
pg. 4 A client's chest tube has accidentally dislodged. What is the nursing action of highest priority?
- Place the client in a left side-lying position.
- Apply oxygen via nonrebreather mask.
- Apply a petroleum gauze dressing over the site.
- Prepare to reinsert a new chest tube. - Correct Answer – 3.
A petroleum gauze dressing will prevent air from being sucked into the pleural space, causing a pneumothorax. The petroleum gauze dressing should be taped only on three sides to allow for excessive air to escape, preventing a tension pneumothorax. The physician should immediately be notified and the client assessed for signs of respiratory distress. Positioning the client on the left side will not make a difference in outcome.There is no indication that the client is experiencing respiratory distress. Preparing to reinsert a new chest tube is not a priority of the nurse at this moment.
A nurse in the postanesthesia care unit (PACU) is providing care to a client who had an abdominal cholecystectomy and observes serosanguineous drainage on the abdominal dressing. What is the next nursing action?
- Change the dressing.
- Reinforce the dressing.
- Replace the tape with Montgomery ties.
- Support the incision with an abdominal binder. - Correct Answer - 2
The nurse should anticipate drainage and reinforce the surgical dressing as needed.Changing a dressing at this time is unnecessary and increases the risk for infection.Montgomery ties are used when frequent dressing changes are anticipated; they are not appropriate at this time. An abdominal binder rarely is prescribed, and it will interfere with assessment of the dressing at this time.
Which are considered as nurse competencies within the synergy model of care delivery? Select all that apply.
- Collaboration
- Care planning
- Communication
- / 4