Fundamentals of Nursing Ch. 28

The nurse is reviewing feedback from other staff members on leadership behaviors. Which characteristics are consistent with being an effective leader? Standard Text: Select all that apply. 1. Energetic 2. Creative 3. Optimistic 4. Open 5. Risk taking

Correct Answer: 1, 2, 3, 4 Rationale 1: Being energetic is a characteristic of an effective leader. Rationale 2: Creativity is a characteristic of an effective leader. Rationale 3: Optimism is a characteristic of an effective leader. Rationale 4: Being open is a characteristic of an effective leader. Rationale 5: Risk taking is a characteristic of a transformational leader.

A nurse is identified as being an effective leader. With this designation, the nurse will most likely demonstrate which characteristics? Standard Text: Select all that apply. 1. Self-aware 2. Focus on people 3. Excellent communicator 4. Mentor to others 5. Focus on systems

Correct Answer: 1, 2, 3, 4 Rationale 1: The nurse as leader is self-aware. Rationale 2: The nurse as leader is focused on people. Rationale 3: The nurse as leader is an excellent communicator. Rationale 4: The nurse as leader mentors others. Rationale 5: The nurse as manager is focused on systems.

The nurse is determining whether an activity can be delegated to a UAP. What will the nurse use to make this determination? Standard Text: Select all that apply. 1. Determine whether it is the right task. 2. Determine whether it is under the right circumstances. 3. Determine whether it is to the right person. 4. Determine the type of communication. 5. Determine whether there is enough time.

Correct Answer: 1, 2, 3, 4 Rationale 1: The right task is one of the five rights of delegation. Rationale 2: The right circumstance is one of the five rights of delegation. Rationale 3: The right person is one of the five rights of delegation. Rationale 4: The right communication is one of the five rights of delegation. Rationale 5: Enough time is not one of the five rights of delegation.

The manager identifies a staff nurse to serve as a change agent for the implementation of a computerized documentation system. What attributes did the manager observe to designate the staff nurse to have this role? Standard Text: Select all that apply. 1. Self-confident 2. Skilled in teaching 3. Hesitant with decision making 4. Excellent communication skills 5. Effective utilization of resources

Correct Answer: 1, 2, 4, 5 Rationale 1: Change agents are self-confident and are able to take risks and inspire trust in themselves and others. Rationale 2: Change agents are skilled in teaching. Rationale 3: Change agents are able to make decisions. Hesitancy is not a characteristic of a change agent. Rationale 4: Change agents have excellent communication skills with all levels and types of individuals. Rationale 5: Change agents have knowledge of available resources and know how to use them wisely.

Prior to delegating a task, the nurse reviews the rights of delegation; these include which rights? Standard Text: Select all that apply. 1. Supervision 2. Evaluation 3. Client 4. Time 5. Task

Correct Answer: 1, 2, 5 Rationale 1: According to the National Council of State Boards of Nursing (NCSBN), right supervision is one of the rights of delegation. Rationale 2: According to the National Council of State Boards of Nursing (NCSBN), right evaluation is one of the rights of delegation. Rationale 3: The right client is not one of the rights of delegation. Rationale 4: The right time is not one of the rights of delegation. Rationale 5: According to the National Council of State Boards of Nursing (NCSBN), right task is one of the rights of delegation.

The nursing staff is informed that the current system of record keeping is going to be changed to make it more efficient. In which stage of change is the nursing staff? 1. Refreezing 2. Unfreezing 3. Moving 4. Drift

Correct Answer: 2 Rationale 1: Refreezing is when the change is integrated and stabilized. Rationale 2: During the unfreezing stage, the need for change is recognized, driving and restraining forces are identified, alternative solutions are generated, and participants are motivated to change. Rationale 3: During the second stage, moving, participants agree that the status quo is undesirable and the actual change is planned in detail and implemented. Rationale 4: Drift is a type of unplanned change in which change occurs without effort on anyones part.

During a particularly heated staff meeting regarding staff assignments, the nurse manager makes this comment: When you all can come to a decision, let me know and well move on from there. This leader is best identified as which of the following? 1. Democratic leader 2. Permissive leader 3. Bureaucratic leader 4. Situational leader

Correct Answer: 2 Rationale 1: The democratic leader encourages group discussion and decision making, provides constructive criticism, offers information, makes suggestions, and asks questions. Rationale 2: The permissive leader recognizes the groups need for autonomy and self-regulation by assuming a hands-off approach. Allowing the group to come to its own decision and then accepting that decision reflects the style of a permissive leader. Rationale 3: The bureaucratic leader relies on the organizations rules, policies, and procedures to direct the groups work efforts. Rationale 4: A situational leader is one who adapts his or her leadership style to the situation.

A charge nurses responsibilities include the day-to-day management and coordination of therapies for the clients, client assignments, and scheduling. Which type of management is the charge nurse performing? 1. Top level 2. Middle level 3. First level 4. Upper level

Correct Answer: 3 Rationale 1: Upper-level (same as top-level) managers are organizational executives who are primarily responsible for establishing goals and developing strategic plans. Rationale 2: Middle-level managers supervise a number of first-level managers and are responsible for the activities in the departments they supervise. Rationale 3: First-level managers are responsible for managing the work of nonmanagerial personnel and the day-to-day activities of a specific work group (rehabilitation unit in this case). Rationale 4: Upper-level (same as top-level) managers are organizational executives who are primarily responsible for establishing goals and developing strategic plans.

An unlicensed assistive person (UAP) is working on a rehabilitation unit. Which task would be appropriate for this person to delegate? 1. Taking and recording vital signs 2. Assisting with bathing 3. Making a bed 4. An unlicensed assistive person may not delegate tasks.

Correct Answer: 4 Rationale 1: Taking and recording vital signs is an appropriate task for the registered nurse to delegate to the UAP. Rationale 2: Assisting with bathing is an appropriate task for the registered nurse to delegate to the UAP. Rationale 3: Making a bed is an appropriate task for the registered nurse to delegate to the UAP. Rationale 4: The unlicensed person may not delegate tasks to another person. Delegation is part of the registered nurses role.

A hospital is implementing a computerized charting system, and all nursing staff is required to be oriented to the system by a specific deadline. Which type of change is occurring with the staff? 1. Overt change 2. Covert change 3. Unplanned change 4. Drift

Correct Answer: 1 Rationale 1: An overt change is one that is planned and that people are aware of. Implementing a new computer system is certainly a planned, purposeful event. Rationale 2: Covert change is hidden or occurs without the individuals awarenessit may be gradual, subtle, and unplanned. Rationale 3: An unplanned change is an alteration imposed by external events or persons and occurs when unexpected events force a reaction. Rationale 4: Drift is a type of unplanned change in which change occurs without effort on anyones part.

The nurse practices responsibility when functioning in the role of manager of a care area. What will the nurse manager demonstrate as evidence of responsibility? Standard Text: Select all that apply. 1. Effective utilization of resources 2. Communication to subordinates 3. Implementation of organizational goals and objectives 4. Problem solving 5. Managing the work team

Correct Answer: 1, 2, 3 Rationale 1: Managers are responsible for effective utilization of resources. Rationale 2: Managers are responsible for communication to subordinates. Rationale 3: Managers are responsible for the implementation of organizational goals and objectives. Rationale 4: Problem solving is a skill associated with critical thinking. Rationale 5: Managing the work team is a skill associated with building and managing teams.

The nurse has been promoted to a position that includes the supervision of first-level management and responsibility for activities in a specific department. This nurse will most likely have which title? Standard Text: Select all that apply. 1. Supervisor 2. Nurse manager 3. Head nurse 4. Primary care nurse 5. Vice president

Correct Answer: 1, 2, 3 Rationale 1: Middle-level managers may be called supervisors. Rationale 2: Middle-level managers may be called nurse managers. Rationale 3: Middle-level managers may be called head nurses. Rationale 4: First-level managers may be called primary care nurses. Rationale 5: Upper-level managers may be called vice presidents.

A staff nurse has been identified by others as being an effective leader. With this designation, the nurse implements which principles? Standard Text: Select all that apply. 1. Vision 2. Influence 3. Serve as a role model 4. Planning 5. Organizing

Correct Answer: 1, 2, 3 Rationale 1: Principles of effective leadership include vision, which is a mental image of a possible and desirable future state. Rationale 2: Principles of effective leadership include influence, which is an informal strategy used to gain the cooperation of others without exercising formal authority. Rationale 3: Principles of effective leadership include role modeling, an example of which is demonstrating caring toward coworkers and clients. Rationale 4: Planning is a function of management. Rationale 5: Organizing is a function of management.

The nurse has been promoted to the role of manager for a client care area. What responsibilities of the nurse will this new role include? Standard Text: Select all that apply. 1. Accomplish the goals of the organization. 2. Use the organizations resources efficiently. 3. Ensure effective client care. 4. Ensure compliance with regulatory standards. 5. Manage relationships.

Correct Answer: 1, 2, 3, 4 Rationale 1: The nurse manager is responsible for efficiently accomplishing the goals of the organization. Rationale 2: The nurse manager is responsible for efficiently using the organizations resources. Rationale 3: The nurse manager is responsible for ensuring effective client care. Rationale 4: The nurse manager is responsible for ensuring compliance with regulatory standards. Rationale 5: The nurse leader manages relationships.

According to the National Council of State Boards of Nursing (NCSBN), which rights of delegation should the nurse follow? Standard Text: Select all that apply. 1. Supervision 2. Evaluation 3. Client 4. Time 5. Task

Correct Answer: 1, 2, 5 Rationale 1: According to the NCSBN, the nurse delegates the right task under the right circumstances to the right person with the right direction and communication and the right supervision and evaluation. Rationale 2: According to the NCSBN, the nurse delegates the right task under the right circumstances to the right person with the right direction and communication and the right supervision and evaluation. Rationale 3: The right client is a part of the rights of medication administration. Rationale 4: The right time is a part of the rights of medication administration. Rationale 5: According to the NCSBN, the nurse delegates the right task under the right circumstances to the right person with the right direction and communication and the right supervision and evaluation.

A group of community health nurses work together in the same office. They are each responsible for their own caseloads and scheduling of appointments. Their major leadership directives come from the state health office, several hundred miles away. This group of nurses is functioning under what type of leadership? 1. Charismatic 2. Shared 3. Transformational 4. Transactional

Correct Answer: 2 Rationale 1: A charismatic leader is characterized by an emotional relationship between the leader and group members. Rationale 2: Shared leadership recognizes that a professional workforce is made up of many leaders. No one person is considered to have knowledge or ability beyond that of other members of the work group, as in this situation. Rationale 3: A transformational leader fosters creativity, risk taking, commitment, and collaboration by empowering the group to share in the organizations vision. Rationale 4: A transactional leader has a relationship with followers based on an exchange for some resource valued by the followers.

A nurse manager has had to handle a particularly difficult physician who is demanding as well as demeaning. Through this situation, the nurse manager has learned that accuracy and honesty are attributes of which skill necessary for managers? 1. Critical thinking 2. Communication 3. Networking 4. Responsibility

Correct Answer: 2 Rationale 1: Critical thinking is a creative process that includes problem solving and decision making. Rationale 2: Good communication skills are essential to managers and include assertiveness, clear expression of ideas, accuracy, and honesty. Rationale 3: Networking is a process whereby professional links are established through which people can share ideas, knowledge, and information; offer support and direction to each other; and facilitate accomplishment of professional goals. Rationale 4: Responsibility is one of the principles of management, not a management skill.

A nurse manager is working on new job descriptions for all nursing units of the hospital. Which management function is this nurse conducting? 1. Planning 2. Organizing 3. Directing 4. Coordinating

Correct Answer: 2 Rationale 1: Planning involves assessing a situation, establishing goals and objectives that identify priorities, delineating who is responsible, determining deadlines, and describing how the intended outcome is to be achieved and evaluated. Rationale 2: Organizing is an ongoing process of management that involves determining responsibilities, communicating expectations (which job descriptions would fall under), and establishing the chain of command for authority and communication. Rationale 3: Directing is the process of getting the organizations work accomplished. Coordinating is the process of ensuring that plans are carried out and evaluating outcomes. Rationale 4: Coordinating is the process of ensuring that plans are carried out and evaluating outcomes

A nurse manager allows the staff members to make their own schedules and do their own client assignments on their shifts. However, during a code situation, the nurse manager will make decisions for the staff by instructing which nurse to assume which responsibility. This manager is exemplifying which style of leadership? 1. Permissive 2. Democratic 3. Situational 4. Bureaucratic

Correct Answer: 3 Rationale 1: Permissive leaders assume a hands-off approach. Rationale 2: The democratic leader encourages group discussion and decision making. Rationale 3: According to contingency theorists, effective leaders adapt their leadership style to the situation. Unlike the singular style of authoritarian, democratic, and permissive leaders, the situational leader adapts his or her leadership to the readiness and willingness of the group to perform the assigned task. Rationale 4: A bureaucratic leader relies on the organizations rules, policies, and procedures to direct the groups work efforts

A nurse manager has the reputation of being an autocratic leader. Which of the following statements by this manager would support that reputation? 1. Id like to hear from you (addressing the staff) what your ideas are for promoting better morale in this unit. 2. Im putting a suggestion box in the break room if anyone has ideas that would be helpful to the unit. 3. The new work schedule is posted for the next 6 weeks. 4. I put the new procedure manual out. Please add your comments to the blank sheet of paper attached to the front.

Correct Answer: 3 Rationale 1: This option is more reflective of a democraticstyle leader. Rationale 2: This option is more reflective of a democraticstyle leader. Rationale 3: An autocratic leader makes decisions for the group. This style is likened to a dictator in that the autocratic leader gives orders and directions to the group, determines policies, and solves problems without input from the group. Rationale 4: This option is more reflective of a democraticstyle leader.

The nurse manager is implementing risk management for a client-care issue. In what order will the manager implement risk management? Standard Text: Click and drag the options below to move them up or down. Choice 1. Analyzing, classifying, and prioritizing risks Choice 2. Evaluating and modifying risk reduction programs Choice 3. Anticipating and seeking sources of risk Choice 4. Developing a plan to avoid and manage risk Choice 5. Gathering data that indicate success at avoiding or minimizing risk

Correct Answer: 3, 1, 4, 5, 2 Rationale 1: Analyzing, classifying, and prioritizing risks is the second step of the risk management process. Rationale 2: Evaluating and modifying risk reduction programs is the fifth step of the risk management process. Rationale 3: Anticipating and seeking sources of risk is the first step of the risk management process. Rationale 4: Developing a plan to avoid and manage risk is the third step in the risk management process. Rationale 5: Gathering data that indicate success at avoiding or minimizing risk is the fourth step of the risk management process.

The manager determines that a new graduate nurse needs additional training on the principles of delegation. What delegation to unlicensed assistive personnel did the manager observe to make this decision? Standard Text: Select all that apply. 1. Bathing a patient recovering from surgery 2. Weighing a patient who is prescribed diuretics 3. Discharge instruction teaching 4. Transferring and ambulating a client after hip replacement surgery 5. The care of an intravenous access device

Correct Answer: 3, 5 Rationale 1: Bathing can safely be delegated to unlicensed assistive personnel. Rationale 2: Weights can safely be delegated to unlicensed assistive personnel. Rationale 3: Client education may not be delegated to unlicensed assistive personnel. Rationale 4: Transferring and ambulation can be safely delegated to unlicensed assistive personnel. Rationale 5: The care of invasive lines may not be delegated to unlicensed assistive personnel.

A nursing student would like to do an observation on one of the inpatient units at a hospital. In assisting the student to meet this desire, the educator would look for which type of nurse? 1. Mentor 2. Manager 3. Team leader 4. Preceptor

Correct Answer: 4 Rationale 1: A mentor acts in a more nurturing role, perhaps for a longer period of time, and provides support, guidance, assistance, advice, and inspiration to a younger nurse. Rationale 2: A manager is a different type of management role. Rationale 3: A team leader is a different type of management role. Rationale 4: The preceptor is a person of experience who assists a new nurse in improving clinical skills and nursing judgment.

A hospital was named in a lawsuit after a client had to undergo a second surgical procedure because an arthroscopy was performed on the wrong knee during surgery. The hospital settled out of court with the client for damages. This is an example of which principle of management? 1. Authority 2. Responsibility 3. Coordination 4. Accountability

Correct Answer: 4 Rationale 1: Authority is defined as the right to direct the work of others. Rationale 2: Responsibility is an obligation to perform a task. Rationale 3: Coordination is a function of management, not one of the principles. Rationale 4: Accountability is the ability and willingness to assume responsibility for ones actions and to accept the consequences of ones behavior. The hospital had a responsibility to the client for quality care and service. That was not provided; therefore, the hospital was willing to accept the consequences of the injury experienced by the client.

An RN delegates the task of taking a newly admitted clients vital signs to a nurses aide. The clients blood pressure was 182/98, but did not get reported to the physician for several hours. Who is responsible for the lapse in time between discovery and action? 1. Nurse manager 2. Aide 3. Client 4. RN

Correct Answer: 4 Rationale 1: The nurse manager did not delegate the task of vital signs and therefore is not responsible for the time lapse between discovery and action. Rationale 2: The aide did not delegate the task of vital signs and therefore is not responsible for the time lapse between discovery and action. Rationale 3: The client did not delegate the task of vital signs and therefore is not responsible for the time lapse between discovery and action. Rationale 4: The RN is ultimately responsible for the action, for reporting it, and for following through on any action. Part of delegation is supervision and evaluationultimate responsibilities that belong to the RN.