2873 Leadership - Managing Pt Care
A patient asks a nurse what the patient-centered care model for the hospital means. What is the nurse's best answer? "This model ensures that all patients have private rooms when they are admitted to the hospital." "In this model you and the health care team are full partners in decisions related to your health care." "This model focuses on making the patient experience a good one by providing amenities such as restaurant-style food service." "Patients and families sign a document providing them full access to their medical charts."
"In this model you and the health care team are full partners in decisions related to your health care."
The nurse is teaching nursing students about the characteristics of an effective leader. Which statements by the nursing students indicate effective learning? Select all that apply. 1 "A leader is a role model for the staff." 2 "A leader is an effective communicator." 3 "A leader is consistent in managing conflict." 4 "A leader avoids a participatory approach to decision making." 5 "A leader may not be competent in all aspects of delivery of care."
1, 2, 3 An effective leader has some specialized characteristics. The effective leader is a role model for the staff, an effective communicator, and is consistent in managing conflict. An effective leader takes a participatory approach to decision making, because it is helpful for making the right decisions. It is necessary for a leader to be knowledgeable and competent in all aspects of delivery of care.
The head nurse is delegating responsibilities to her staff. What orders should be given to the nurse manager? Select all that apply. 1 "Conduct regular staff meetings." 2 "Make rounds with healthcare providers." 3 "Submit staffing schedules for the unit." 4 "Provide care to the patients using a holistic approach." 5 "Participate in the development of nursing policies and procedures."
1, 2, 3 The nurse manager is responsible for conducting regular staff meetings, making rounds with healthcare providers, and submitting staff schedules for the unit. The nurse manager is not responsible for providing direct care to patients and participating in developing nursing policies and procedures. The nurse practitioner provides holistic care to the patient. The nurse educator participates in the development of nursing policies and procedures.
A recently approved antibiotic has been incorporated for use by the hospital. What steps should the nurse manager take to ensure that the staff members are updated? Select all that apply. 1 Plan an in-service educational program. 2 Send the staff to professional conferences. 3 Send the staff to continuing education classes. 4 Ask the staff members to collect information from the Internet. 5 Instruct the staff members to read books related to the new antibiotic.
1, 2, 3 The nurse manager should ensure that the staff members remain competent in their practice. Competency can be maintained by keeping the staff members updated with the latest research findings and practice guidelines. This can be achieved by planning in-service training programs and encouraging participation in continuing education classes and professional conferences. Asking the staff members to collect information from the Internet is not appropriate as not all sources are reliable and not all the staff members may make an extra effort to read about the antibiotic. Books are a good source of information; however, reading them requires personal motivation of the staff members.
Time management skills are helpful in managing stress. Which principles are included in time management? Select all that apply. 1 Goal setting 2 Time analysis 3 Priority setting 4 Interruption control 5 Clinical decision making
1, 2, 3, 4 There are various principles of time management. Goal setting, time analysis, priority setting, and interruption control are principles of time management. Clinical decision making is part of clinical care coordination.
Which strategies focus on improving the nurse-physician collaborative practice? Select all that apply. 1 Inviting the physician to attend the practice council meeting 2 Participating in physician morning rounds 3 Placing physician photos and names in the unit newsletter 4 Contacting the physician promptly to discuss patient problems 5 Providing a list of physician contact numbers to all staff nurses
1, 2, 4 Inviting the physician to the practice council meeting, participating in physician rounds, and contacting the physician promptly to discuss patient problems improve the nurse-physician collaboration by focusing on strategies that are related to professional practice. Collaboration is a process whereby different perspectives are synthesized to better understand complex problems and an outcome is reached that is a shared solution that could not have been accomplished by a single person or organization. Physician photos and contact numbers provide information to the nursing staff and help them identify and contact providers but are not focused specifically on nurses working with physicians to provide patient care.
Which factors are important during clinical care coordination? Select all that apply. 1 Evaluation 2 Use of resources 3 Interruption control 4 Time management 5 Organizational skills
1, 2, 4, 5 Clinical care coordination is essential to delivering patient care in a timely and effective manner. Clinical care coordination includes factors such as evaluation, use of resources, time management, and organizational skills. It also includes setting priorities and clinical decision making. Interruption control is a principle of time management.
A registered nurse (RN) is delegating patient care to nursing assistive personnel (NAP). Which tips would help the RN appropriately delegate patient care? Select all that apply. 1 Listen attentively to the NAP. 2 Communicate clearly with the NAP. 3 Let the NAP perform tasks independently. 4 Assign tasks a little higher than the NAP's skills. 5 Assess the knowledge and skills of the NAP
1, 2, 5 Delegation is the act of transferring responsibility for the performance of an activity or task while retaining accountability for the outcome. There are certain guidelines for appropriate delegation. Listening attentively helps to sort out priorities. Clear communication is helpful to effective delegation, because it prevents miscommunication. Lack of communication may lead to ineffective delegation and omissions of nursing care. Assessment of the knowledge and skills of the NAP helps the RN assign the tasks accordingly. The RN should supervise the task performed by the NAP. The assigned tasks should match the NAP's skills; assigning a higher level task can lead to poor performance.
What improves staff communication in a healthcare team? Select all that apply. 1 Staff meetings 2 Newsletters 3 Standing orders 4 Protocol 5 Minutes of meetings
1, 2, 5 Staff communication is an important component of any healthcare team. It can be improved through staff meetings to discuss major issues. Newsletters are helpful in updating staff members about activities in the unit. Minutes of meetings help update the team members on staff meetings. Standing orders and protocols are issued by healthcare facilities to guide actions in particular situations.
The senior nurse has been appointed as nurse executive for managing patient care. Which characteristics should the nurse possess to be an effective leader? Select all that apply. 1 The nurse should set objectives and guide the staff. 2 The nurse should maintain a neutral approach in decision making. 3 The nurse should be consistent in managing conflict. 4 The nurse should delegate work appropriately. 5 The nurse should display impassivity towards others to avoid discrimination.
1, 3, 4 An effective leader should set the objectives and guide the staff in achieving the objectives. The nurse should be consistent in managing conflicts and be able to delegate work appropriately. The nurse should actively participate in decision making and displaying care. The nurse should also build a strong team by showing understanding and empathy towards others.
A group of registered nurses in a 75-bed, pediatric healthcare facility are planning to apply for Magnet status for the hospital. The nurses plan to change the nursing management system of the facility. They have to appoint a nurse manager who can carry out the responsibilities successfully. What are the responsibilities of a nurse manager? Select all that apply. 1 Conduct routine nursing staff evaluations. 2 Prepare the care plan for the patients. 3 Interview and hire new nursing employees. 4 Conduct rounds to solve patient and caregiver complaints. 5 Provide psychological support to patients and family members.
1, 3, 4 An effective nurse manager is responsible for conducting routine staff evaluations, recruiting new nursing employees, and solving patients' problems related to nursing care delivery. The nurse managers are not always involved in direct patient care. They are not responsible for preparing nursing care plans or providing psychological support to the patients and caregivers.
The nurse is teaching nursing students about entry-level nurse competencies. Which qualities are desired in an entry-level nurse? Select all that apply. 1 An understanding of the environment of care 2 The ability to provide care single-handedly 3 Respect for the rights, beliefs, and values of patients 4 Knowledge of the roles and responsibilities of a nurse 5 The ability to lead managing patient care as needed
1, 3, 4 Entry-level nurses should be able to understand the environment of care, because that helps them provide effective care. Respecting the rights, beliefs, wishes, and values of the patients helps the nurse provide client-centered care. The nurse should have proper knowledge of the roles, responsibilities, and functions of a nurse to perform all the roles effectively. The entry-level nurse should have the ability to work in a team; the ability to provide care singlehandedly is not expected in an entry-level nurse.
The nurse is learning about a decentralized nursing unit that supports decision making. Which elements of decision making should the nurse practice? Select all that apply. 1 Authority 2 Autonomy 3 Negligence 4 Dependence 5 Responsibility
1, 4, 5 Authority is the legitimate power to give commands while making decisions. Autonomy is the freedom and responsibility of choices, and it is important in decision making. Responsibility is the duties and activities performed in decision making. Negligence is not accepted in decision making or nursing care. Dependence can cause decision making difficult but autonomy gives the freedom to makes choices.
The nurse has been assigned a new patient. Arrange the steps involved in the nursing process in the correct sequence. 1. Identify patient diagnosis. 2. Develop a plan of care. 3. Evaluate patient outcomes. 4. Assess patient problems. 5. Implement nursing intervention
1. Assess patient problems. 2. Identify patient diagnosis. 3. Develop a plan of care. 4. Implement nursing intervention. 5. Evaluate patient outcomes. The nurse begins the patient assignment by assessing the patient's condition. Based on the assessment, the nurse makes an accurate judgment about the diagnoses and collaborative health problems. This helps in developing a caring relationship with a patient, which is very important. Based on the diagnoses, the nurse develops a plan of care, implements nursing interventions, and evaluates patient outcomes. Throughout the nursing process, the nurse applies clinical decision making and a critical-thinking approach.
The nurse works in a medical unit. Which patients should the nurse consider at a high-priority level for nursing care? Select all that apply. 1 A patient who has a fractured bone in his leg 2 A patient who lost consciousness 3 A patient who has impaired oxygenation 4 A patient whose cardiac output is decreased 5 A patient who has pressure ulcers
2, 3, 4 A high-priority level problem poses an immediate threat to a patient's survival. It is considered an emergency and is a life-threatening condition. If left untreated, it can have fatal consequences. Loss of consciousness, impaired oxygenation and decreased cardiac output are high-priority problems. These conditions may be life-threatening if not treated in a timely manner. A fracture of the leg or presence of pressure ulcers does not pose immediate danger to life. Therefore, these are intermediate-priority problems.
The nurse is reviewing the work of nursing assistive personnel (NAP) and notices that one of them is consistently delivering a dissatisfactory performance. What should the nurse do? Select all that apply. 1 Assign another task. 2 Give constructive and appropriate feedback. 3 Schedule additional training with the educational department. 4 Focus on things that can be changed and give specific detail. 5 Involve other colleagues while giving the feedback to the person so that others do not make the same mistake.
2, 3, 4 When a nursing assistant does not perform the given tasks appropriately, the nurse should give appropriate feedback in a constructive way. The alternate ways to handle the situation and a better way to perform the task should be explained. If there is any deficiency in training and education, additional training sessions should be arranged with educational departments. One issue should be discussed at a time, and specific details should be given. If the performance is not satisfactory, it indicates that either the training is inadequate or the assistant has been assigned too many tasks. Assigning the assistant another task may not solve the issue. The feedback should be provided in private to maintain the assistant's self-esteem. Involving others in the feedback process may embarrass the him or her.
What are the characteristics of an effective team? Select all that apply. 1 Different purposes 2 Effective communication 3 Trust 4 The ability to keep feedback to oneself 5 Effective conflict management
2, 3, 5 A good team is important to effective nursing care. The team should be able to communicate properly and avoid miscommunication. The team members should be able to trust each other. Conflicts may arise among team members; the team should be able to manage them amicably. All the team members should have a common purpose so that their efforts are focused. Providing feedback to each other helps improve patient care.
A nursing director has planned to change the nursing care delivery model of the hospital from a team nursing model to a total patient care model because of the increase in the number of registered nurses (RNs) working at the hospital. What orders should be given to incorporate the new model? Select all that apply. 1 The RN leads the team of other RNs. 2 The RNs should plan care. 3 RNs can delegate care to subordinates. 4 One primary RN should assume responsibility of the caseload of patients. 5 The RN works directly with patients, families, and healthcare team members
2, 3, 5 In the total patient care model of nursing, the RNs plan the care and they work directly with patients, families, and healthcare team members. The care can also be delegated to subordinates. In the team nursing model, one RN leads the team of other RNs, and in the primary nursing model, one primary RN assumes responsibility of the caseload of patients.
The nurse is explaining the case management model to a group of nursing students. Which characteristics best describe the model? Select all that apply. 1 Case managers provide all patient care. 2 Multidisciplinary care plans are used. 3 Case managers coordinate discharge planning. 4 Staffing is expensive and may not decrease care costs. 5 Communication with healthcare team members is important. 6 The model serves to promote patient safety and quality.
2, 3, 5, 6 Case management is a care management approach that coordinates and links health care services to patients and their families while streamlining costs and maintaining quality. Multidisciplinary care plans, case managers who coordinate discharge planning, communication, and patient safety and quality are characteristics of the case management model or responsibilities of the case manager. Case managers who provide all patient care and high staffing costs are not characteristics of the case management model. They are typically seen with the primary care model.
The nurse has just given a patient a narcotic for pain relief and must now leave the unit. To whom should the nurse delegate the task of evaluating the client's response to the pain medication? 1 A unit clerk 2 A student nurse 3 Another registered nurse (RN) 4 A patient care aide
3 Assessment and management of pain belongs only to the RN's scope of practice The unit clerk is not responsible for the patient's care. The student nurse may participate in the patient's care but the accountability remains with the RN. The patient care aide is not accountable for the patient's assessment and management of pain
The nurse works in a 32-bed, cardiac step-down unit. The nurse delegates some work to a nursing assistant to manage time. Which nursing interventions delegated by the nurse to the nursing assistant are inappropriate? 1 "Could you please help me position the patient as I insert a catheter for this patient?" 2 "Could you please help the patient walk along the hallway, back and forth? I will check with you in 10 minutes." 3 "Could you please help me to find out the problem with this patient? He is developing severe chest pain." 4 "Could you please help the respiratory therapist position the patient while he gives chest physiotherapy?"
3 The nurse is responsible for delegating tasks to a nursing assistant based on her assessment and priorities. However, activities that involve assessment; diagnosis, planning, and evaluation are not delegated. These activities require critical thinking and decision-making skills. Evaluating a patient based on the development of new symptoms is beyond the scope of work of a nursing assistant. The nurse should ask a senior nurse for help in such a case. Ambulation of the patient and positioning of the patient are tasks the nursing assistant can help with.
You are the charge nurse on a surgical unit. You are doing staff assignments for the 3:00 PM to 11:00 PM shift. Which patient do you assign to the licensed practical nurse (LPN)? 1 The patient who transferred out of intensive care an hour ago 2 The patient who requires teaching on new medications before discharge 3 The patient who had a vaginal hysterectomy 2 days ago and is being discharged tomorrow 4 The patient who is experiencing some bleeding problems following surgery earlier today
3 The patient with the vaginal hysterectomy is stable and requires care that is within the scope of the LPN. The other three patients need a higher level of care requiring assessment, support, and teaching that are the responsibilities of the registered nurse.
A registered nurse performs the following four steps in delegating a task to a nursing assistant. Place the steps in the order of appropriate delegation. 1. Do you have any questions about walking Mr. Malone? 2. Before you take him for his walk to the end of the hallway and back, please take and record his pulse rate. 3. In the next 30 minutes please assist Mr. Malone in room 418 with her afternoon walk. 4. I will make sure that I check with you in about 40 minutes to see how the patient did. 3, 2, 4, 1 2, 3, 4, 1 3, 4, 2, 1 3, 2, 1, 4
3, 2, 4, 1 This is the sequence for effective delegation. The nurse delegated the task of walking a patient to the nursing assistant, which is in the scope of the nursing assistant's duties and responsibilities and matched to his skill level. The nurse provided clear directions by describing the task (the walk, taking and recording the pulse), the desired outcome (walk to the end of the hallway and back), and the time period (within the next 30 minutes). The nurse then told the nursing assistant that she would follow up with him to check how the patient did. By asking the nursing assistant if he had any questions, the nurse provided him an opportunity to ask questions for clarification.
A philosophy of care includes the professional nursing staff's values. Which factors are essential to a philosophy of care? Select all that apply. 1 Management of patient care 2 Selection of proper interventions 3 Selection of the management structure 4 Selection of a nursing care delivery model 5 Knowledge of roles and responsibilities of a nurse
3, 4 A philosophy of care helps support professional nursing care. Selection of the management structure and selection of a nursing care delivery model are essential to the philosophy of care. These factors help provide quality nursing care. Management of patient care is a skill required in an entry-level nurse; it is not related to the philosophy of care. Selection of proper interventions is essential for delivering patient care; it is not a factor in a philosophy of care. The knowledge of roles, responsibilities, and functions of a nurse is something nurses should possess.
A nursing student is learning about the different nursing care delivery models. What characteristics of team nursing hold true? Select all that apply. 1 The registered nurse works directly with the patient and the family. 2 The registered nurse assumes responsibility for the caseload of patients. 3 The registered nurse leads the team of other nurses and nursing assistants. 4 The team leader develops patient care plans and coordinates with team members. 5 The team members provide direct patient care under supervision of the registered nurse.
3, 4, 5 In the team nursing model, the registered nurse leads the team of other nurses and nursing assistants. The team leader develops patient care plans and coordinates accordingly. The team members provide patient care while the registered nurse supervises. The registered nurse works directly with the patient and the family in the total patient care model. The registered nurse assumes responsibility for the caseload of patients in the primary nursing model.
Which task is appropriate for a registered nurse (RN) to delegate to the nursing assistant? 1 Explaining to the patient the preoperative preparation before the surgery in the morning 2 Administering the ordered antibiotic to the patient before surgery 3 Obtaining the patient's signature on the surgical informed consent 4 Assisting the patient to the bathroom before leaving for the operating room
4 Assisting the patient to the bathroom is a skill and task within the knowledge level and tasks appropriate for a nursing assistant. The other tasks are the responsibility of the RN. The RN is responsible for patient teaching, medication administration, and surgical consents.
A registered nurse (RN) is delegating a task to one of the the nursing assistive personnel (NAP). The RN tells her to measure the blood pressure of room 32. Which statement is true about the nurse's delegation skill? 1 The nurse has not provided the right supervision. 2 The nurse has not delegated the task to the right person. 3 The nurse has not delegated the right task to the person. 4 The nurse has violated the principle of right communication.
4 The RN has violated the principle of right communication. The nurse should not address the patient by disease condition or by room number. This can create confusion. The other principles of delegation include right supervision, right person, and right task.
Building an empowered nursing team starts with the nurse executive. What is the responsibility of the nurse executive in this process? 1 Provide training to the nursing staff. 2 Maintain the patient's record in a systematic way. 3 Teach the patients about health and well-being. 4 Establish a philosophy for nursing staff to provide quality nursing care.
4 The executive's position is critical in uniting the strategic direction of an organization with the philosophical values and goals of nursing. The main responsibility of the nurse executive is to establish a philosophy for the nursing staff to provide quality nursing care. The nurse executive is not responsible for providing training to the nursing staff or maintaining the patient's record in a systematic way. Teaching the patients about health and well-being is not the responsibility of the nurse executive. This is done by the nursing staff.
Which task could a staff nurse delegate to a certified nursing assistant? 1 Making rounds with a healthcare provider 2 Evaluating a patient's response to pain 3 Assessing a patient's central venous line site 4 Feeding a stroke patient who has minimal dysphagia
4 The majority of state boards have addressed the issue of delegation and have developed rules that offer specific guidelines regarding who can do what tasks. The scope of practice for the providers at each level of care usually includes a description of the tasks that may be performed at that level. Feeding a stroke patient who has minimal dysphagia can be delegated to a certified nursing assistant. Making rounds with a healthcare provider, evaluating a patient's response to pain, and assessing a patient's central venous line require knowledge and expertise. These activities should be carried out by a registered nurse.
Which duties can the shift nurse on the medical-surgical unit delegate to nursing assistive personnel (NAP)? Select all that apply. 1 Perform a pain assessment. 2 Document the completion of a task. 3 Prepare a plan of care. 4 Give a bedpan to a patient. 5 Monitor vital signs of a stable patient
4, 5 The professional nurse in charge of patient care can decide which activities a nursing assistant performs independently and which activities to perform in partnership. A nursing assistant can be delegated the task of providing bedpans to patients when needed. Although the responsibility of assessment is with the nurse, if the patient is stable, the responsibility of monitoring vital signs can be delegated to the nursing assistant. The nurse is responsible for and should perform the assessment of a patient's ongoing status. For example, the nurse should perform a patient's pain assessment to determine if further intervention is required. The documentation of the completed tasks should be done by the nurse and not delegated to the nursing assistant. Preparing a care plan requires critical thinking skills and should be done by the nurse.
As a nurse, you are assigned to four patients. Which patient do you need to see first? The patient who had abdominal surgery 2 days ago who is requesting pain medication A patient admitted yesterday with atrial fibrillation with decreased level of consciousness A patient with a wound drain who needs teaching before discharge in the early afternoon A patient going to surgery for a mastectomy in 3 hours who has a question about the surgery
A patient admitted yesterday with atrial fibrillation with decreased level of consciousness
While administering medications, a nurse realizes that a prescribed dose of a medication was not given. The nurse acts by completing an incident report and notifying the patient's health care provider. The nurse is exercising: Authority. Responsibility. Accountability. Decision making.
Accountability.
Which example demonstrates a nurse performing the skill of evaluation? The nurse explains the side effects of the new blood pressure medication ordered for the patient. The nurse asks a patient to rate pain on a scale of 0 to 10 before administering the pain medication. After completing the teaching, the nurse observes a patient draw up and administer an insulin injection. The nurse changes a patient's leg ulcer dressing using aseptic technique.
After completing the teaching, the nurse observes a patient draw up and administer an insulin injection.
Which example demonstrates the nurse performing the skill of evaluation? 1 The nurse explains the side effects of the new blood pressure medication ordered for the patient. 2 The nurse asks the patient to rate pain on a scale of 0 to 10 before administering the pain medication. 3 After completing the teaching, the nurse observes the patient draw up and administer an insulin injection. 4 The nurse changes the patient's leg ulcer dressing using the aseptic technique.
After completing the teaching, the nurse observes the patient draw up and administer an insulin injection. Evaluation is one of the most important aspects of clinical care coordination; it involves the determination of patient outcomes. Observing a patient demonstrate teaching is evaluation to ensure that he or she has understood teaching. Asking the patient to rate pain is not an evaluation because it occurs before administering a pain medication. The other options are interventions.
The staff on the nursing unit are discussing implementing interprofessional rounding. Which of the following statements correctly describe interprofessional rounding? Select all that apply. Allows team members to share information about patients to improve care Provides an opportunity for early patient discharge planning Improves communication among health care team members Allows each of the health care team members to identify separate patient goals Allows each health care provider an opportunity to delegate a task.
Allows team members to share information about patients to improve care Provides an opportunity for early patient discharge planning Improves communication among health care team members
A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with them. The nurse is acting as the patient's: Educator Advocate Caregiver Case manager
An advocate protects the patient's human and legal right to make choices about his or her care. An advocate may also provide additional information to help a patient decide whether or not to accept a treatment or find an interpreter to help family members communicate their concerns.
An 18-year-old woman is in the emergency department with fever and cough. The nurse obtains her vital signs, listens to her lung and heart sounds, determines her level of comfort, and collects blood and sputum samples for analysis. Which standard of practice is performed? Diagnosis Evaluation Assessment Implementation
Assessment is the collection of comprehensive data pertinent to the patient's health and/or the situation.
Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples? Select all that apply. Caregiver Autonomy and accountability Patient advocate Health promotion Lobbyist
Caregiver Autonomy and accountability Patient advocate Health promotion
A nurse assesses patients and uses assessment findings to identify patient problems and develop an individualized plan of care. The nurse is displaying: Organizational skills. Use of resources. Priority setting. Clinical decision making
Clinical decision making
The nurse spends time with the patient and family reviewing the dressing change procedure for the patient's wound. The patient's spouse demonstrates how to change the dressing. The nurse is acting in which professional role? Educator Advocate Caregiver Case manager
The nurse is demonstrating the role of educator. An educator explains concepts and facts about health, describes the reason for routine care activities, demonstrates procedures such as home care activities, reinforces learning or patient behavior, and evaluates the patient's progress in learning through return demonstration.
After a nurse receives a change-of-shift report on his assigned patients, he prioritizes the tasks that need to be completed. This is an example of a nurse displaying which practice? Organizational skills Use of resources Time management Evaluation
Time management Completing a priority to-do list is a useful time-management skill. Change-of-shift report can help you sequence activities on the basis of what you learn about the patients' conditions and the care the patient has received.
You are preparing a presentation for your classmates regarding the clinical care coordination conference for a patient with terminal cancer. As part of the preparation you have your classmates read the Nursing Code of Ethics for Professional Registered Nurses. Your instructor asks the class why this document is important. Which of the following statements best describes this code? Improves self-health care Protects the patient's confidentiality Ensures identical care to all patients Defines the principles of right and wrong to provide patient care
Defines the principles of right and wrong to provide patient care When giving care, it is essential to provide a specified service according to standards of practice and to follow a code of ethics. The code of ethics is the philosophical ideals of right and wrong that define the principles you will use to provide care to your patients. It serves as a guide for carrying out nursing responsibilities to provide quality nursing care and the ethical obligations of the profession.
At 1200 the registered nurse (RN) says to the nursing assistive personnel (NAP), "You did a good job walking Mrs. Taylor by 0930. I saw that you recorded her pulse before and after the walk. I saw that Mrs. Taylor walked in the hallway barefoot. For safety, the next time you walk a patient, you need to make sure that the patient wears slippers or shoes. Please walk Mrs. Taylor again by 1500." Which characteristics of positive feedback did the RN use when talking to the nursing assistant? Select all that apply. Feedback is given immediately. Feedback focuses on one issue. Feedback offers concrete details. Feedback identifies ways to improve. Feedback focuses on changeable things. Feedback is specific about what is done incorrectly only.
Feedback focuses on one issue. Feedback offers concrete details. Feedback identifies ways to improve. Feedback focuses on changeable things.
Health care reform will bring changes in the emphasis of care. Which of the following models is expected from health care reform? Moving from an acute illness to a health promotion, illness prevention model Moving from illness prevention to a health promotion model Moving from an acute illness to a disease management model Moving from a chronic care to an illness prevention model
Health care reform also affects how health care is delivered. There is greater emphasis on health promotion, disease prevention, and management of illness.
A registered nurse (RN) is providing care to a patient who had abdominal surgery 2 days ago. Which task is appropriate to delegate to the nursing assistant? Helping the patient ambulate in the hall Changing surgical wound dressing Irrigating the nasogastric tube Providing brochures to the patient on health diet
Helping the patient ambulate in the hall
Which task is appropriate for a registered nurse (RN) to delegate to a nursing assistant? Explaining to the patient the preoperative preparation before the surgery in the morning Administering the ordered antibiotic to the patient before surgery Obtaining the patient's signature on the surgical informed consent Helping the patient to the bathroom before leaving for the operating room
Helping the patient to the bathroom before leaving for the operating room
Which of the following Internet resources available can assist consumers when comparing quality care measures? Select all that apply. WebMD Hospital Compare Magnet Recognition Program Hospital Consumer Assessment of Healthcare The American Hospital Association's webpage.
Hospital Compare Hospital Consumer Assessment of Healthcare
A patient in the emergency department has developed wheezing and shortness of breath. The nurse gives the ordered medicated nebulizer treatment now and in 4 hours. Which standard of practice is performed? Planning Evaluation Assessment Implementation
Implementation is completing coordinating care and the prescribed plan of care.
Nurses in an acute care hospital are attending a unit based education program to learn how to use a new pressure-relieving device for patients at risk for pressure ulcers. This is which type of education? Continuing education Graduate education In-service education Professional Registered Nurse Education
In-service education programs are instruction or training provided by a health care agency or institution. An in-service program is held in the institution and is designed to increase the knowledge, skills, and competencies of nurses and other health care professionals employed by the institution.
A nurse is teaching a patient about wound care that will need to be done daily at home after the patient is discharged. This is which priority nursing need for this patient? Low priority High priority Intermediate priority Nonemergency priority
Intermediate priority Teaching patients wound care for discharge is an intermediate priority. Intermediate priorities are nonemergency, nonlife-threatening, actual or potential needs that the patient and family members are experiencing.
Which of the following are components of interprofessional collaboration? Select all that apply. Interprofessional education does not impact the collaboration among interprofessional team members. Nurses are often viewed as the team leader because of their coordination of patient care. Effective interprofessional collaboration requires mutual respect and trust from all team members. Open communication improves the collaboration among the interprofessional team members. The goal of interprofessional collaboration is to improve the quality of patient care.
Nurses are often viewed as the team leader because of their coordination of patient care. Effective interprofessional collaboration requires mutual respect and trust from all team members. Open communication improves the collaboration among the interprofessional team members. The goal of interprofessional collaboration is to improve the quality of patient care.
The examination for registered nurse (RN) licensure is exactly the same in every state in the United States. This examination: Guarantees safe nursing care for all patients Ensures standard nursing care for all patients Ensures that honest and ethical care is provided Provides a minimal standard of knowledge for an RN in practice
RN candidates must pass the NCLEX-RN® to attain licensure. Regardless of educational preparation, the examination for RN licensure is exactly the same in every state in the United States.
A nurse asks a nursing assistive personnel (NAP) to help the patient in room 418 walk to the bathroom right now. The nurse tells the NAP that the patient needs the assistance of one person and the use of a walker. The nurse also tells the NAP that the patient's oxygen can be removed while he goes to the bathroom but to make sure that it is put back on at 2 L. The nurse also instructs the NAP to make sure the side rails are up and the bed alarm is reset after the patient gets back in bed. Which of the following components of the "Five Rights of Delegation" were used by the nurse? Select all that apply. Right task Right circumstances Right person Right direction/communication Right supervision/evaluation
Right task Right circumstances Right person Right direction/communication
There are three models of nursing care delivery. Which statement is true about the primary nursing model? 1 The model has no hierarchy of communication. 2 The model allows lateral communication from nurse to nurse. 3 The model allows a mix of communication channels. 4 The model allows every staff member to communicate with everyone else.
The model allows lateral communication from nurse to nurse. The primary nursing model of care delivery was developed to place registered nurses (RNs) at the bedside and improve the accountability of nursing for patient outcomes. This model involves lateral communication from nurse to nurse. The model has a hierarchy, but the nurse can communicate with other nurses, and the caregiver can communicate with other caregivers. The model does not allow a mix of communication channels. If every team member communicated with everyone else, there would likely be miscommunication.
A critical care nurse is using a computerized decision support system to correctly position her ventilated patients to reduce pneumonia caused by accumulated respiratory secretions. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? Patient-centered care Safety Teamwork and collaboration Informatics
Using decision support systems is one example of using informatics and gaining competency in informatics.
The nurse manager from the surgical unit was awarded the nursing leadership award for practice of transformational leadership. Which of the following are characteristics or traits of transformational leadership displayed by award winner? Select all that apply. The nurse manager regularly rounds on staff to gather input on unit decisions. The nurse manager sends thank-you notes to staff in recognition of a job well done. The nurse manager sends memos to staff about decisions that the manager has made regarding unit policies. The nurse manager has an "innovation idea box" to which staff are encouraged to submit ideas for unit improvements. The nurse develops a philosophy of care for the staff.
The nurse manager regularly rounds on staff to gather input on unit decisions. The nurse manager sends thank-you notes to staff in recognition of a job well done. The nurse manager has an "innovation idea box" to which staff are encouraged to submit ideas for unit improvements.
The nurses on an acute care medical floor notice an increase in pressure ulcer formation in their patients. A nurse consultant decides to compare two types of treatment. The first is the procedure currently used to assess for pressure ulcer risk. The second uses a new assessment instrument to identify at-risk patients. Given this information, the nurse consultant exemplifies which career? Clinical nurse specialist Nurse administrator Nurse educator Nurse researcher
The nurse researcher investigates problems by applying evidence-based practice or by conducting research to improve nursing care and further define and expand the scope of nursing practice. He or she often works in an academic setting, hospital, or independent professional or community service agency.
A nurse meets with the registered dietician and physical therapist to develop a plan of care that focuses on improving nutrition and mobility for a patient. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? Patient-centered care Safety Teamwork and collaboration Informatics
This is an example of the competency of teamwork and collaboration. This competency focuses on the nurse functioning effectively within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision making to achieve quality patient care.
