REVISION QUESTIONS AND

NCLEX Practice - Safe & Effective Care Environment COMPLETE

REVISION QUESTIONS AND

CORRECT DETAILED ANSWERS

(VERIFIED ANSWERS) ALREADY

GRADED A+

The nurse notices a unlicensed assistive personnel (UAP) passing by several call lights during the shift.What is the nurse's best initial action?

• Confront the UAP about the behavior.
• Report unsafe behavior to the charge nurse.
• File an incident report due to safety risk.
• Ask another UAP to help cover this UAP's client load. - Answer: Choice A is correct. Ignoring call lights

(or not responding in a timely manner) puts clients at increased risk of falls and injury. The chain of command says the nurse should address issues/conflicts with the peer (if another nurse) or subordinate (UAP), as long as the situation is not illegal or dangerous. This nurse should first address issues with the UAP to determine the reason for this behavior (i.e. negligence versus work overload) and collaborate to find a solution. If the interaction is not effective, the nurse would then bring the issue up the chain of command (charge nurse) to determine the next steps.You are educating a new nurse regarding sentinel events. Which of the following are examples of sentinel events? Select all that apply.

• An untimely assessment of the client
• An incomplete assessment of the client
• A client falls from the chair to the floor and sustains a humerus fracture
• The wrong client is almost sent to the operating room
• A client undergoes colectomy instead of appendectomy - Answer: Choices C and E are correct. A

sentinel event is defined as an event that has reached the client and caused harm (death, permanent harm, or severe, temporary harm). A sentinel event is unrelated to the client's illness or underlying condition. Such events are called "sentinel" because they signal a need for immediate investigation and response. All sentinel events must be reviewed by the hospital and are subject to review by the Joint Commission. A sentinel event may occur due to medical errors like wrong-site, wrong-procedure, wrong- 1 / 2

client surgery. Please note that the terms "sentinel event" and "medical error" are not synonymous; not all sentinel events occur because of an error, and not all errors result in sentinel events.The nurse is providing care in a unit that uses the total client care model for delivering nursing care. The nurse recognizes which of the following as an aspect of this nursing care delivery model?

• The RN assumes responsibility for a caseload of clients
• The RN supervises team members providing direct client care
• The RN provides care for the same clients during their hospital stay
• The RN is responsible for all aspects of care during a shift of care - Answer: Choice D is correct.

Characteristics of the total client care model include: the RN being responsible for all aspects of care during a shift of care, care can be delegated, and the RN works directly with the client, family, and health care team members.The nurse manager is completing an annual performance appraisal/evaluation on a staff nurse. Which elements should the nurse manager include when completing the evaluation? Select all that apply.

• The nurse's barcode medication administration scan rate
• The number of times the nurse has been absent or tardy
• The nurse achieving a national certification
• The nurse's performance compared to other staff nurses
• The number of medication errors the nurse has self-reported - Answer: Choices A, B, and C are

correct. The performance appraisal/evaluation goal is to provide a broad review of the employee's performance with minimal evaluator bias. The more objective the evaluation, the less the bias. Objective metrics such as bar-code medication administration rate, attendance, and national certifications are logical elements to include in the appraisal.A nurse working in a busy long-term care facility needs to delegate to the unlicensed assistive personnel she is working with. Which of the following tasks would be appropriate to delegate? Select all that apply.

• Performing an initial assessment
• Checking vital signs
• Setting up oxygen
• Listen to the client's lung sounds
• Administering acetaminophen for pain score of 3 - Answer: B is correct. Checking vital signs is an

appropriate task to delegate.

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