Leadership & Management Exam 3 Final Evolve Mod 10-14

A PN ending their shift reports to the RN that a newly hired AP has not calculated the intake and output for several clients. Which of the following actions should the RN take? A. Complete an incident report. B. Delegate this task to the PN. C. Ask the AP if they need assistance. D. Notify the nurse manager.

A. A n incident report is indicated when a critical incident has occurred. It is not necessary to complete an incident report in this situation. B. Do not redelegate this task. C. CORRECT: Find out what the AP knows about performing the task and provide education for the AP if indicated. D. T he RN is capable of handling the situation. It is not necessary to notify the nurse manager.

A newly licensed nurse is preparing to insert an IV catheter in a client. Which of the following sources should the nurse use to review the procedure and the standard at which it should be performed? A. Website B. Institutional policy and procedure manual C. More experienced nurse D. State nurse practice act

A. A website might not provide information that is consistent with institutional policy. B. CORRECT: The institutional policy and procedure manual will provide instructions on how to perform the procedure that is consistent with established standards. This is the resource that should be used. C. A more experienced nurse on the unit might not perform the procedure according to the policy and procedure manual. D. The nurse practice act identifies scope of practice and other aspects of the law, but it does not set standards for performance of a procedure.

A nurse manager is providing information about the audit process to members of the nursing team. Which of the following information should the nurse manager include? (Select all that apply.) A. A structure audit evaluates the setting and resources available to provide care. B. An outcome audit evaluates the results of the nursing care provided. C. A root cause analysis is indicated when a sentinel event occurs. D. Retrospective audits are conducted while the client is receiving care. E. After data collection is completed, it is compared to a benchmark.

A. CORRECT: A structure audit evaluates the setting in which care is provided and includes resources (equipment and staffing levels). B. CORRECT: An outcome audit evaluates the effectiveness of nursing care. It should include observable data (infection rates among clients). C. CORRECT: A root cause analysis is indicated when a sentinel event occurs. A sentinel event is a serious problem (injury to or death of a client). Immediate investigation of the problem is indicated. The health care team can use root cause analysis to study the problem and take measures to prevent recurrence. D. R etrospective audits are conducted when the client is no longer receiving care. E. CORRECT: The benchmark is set at the beginning of the process and then it is compared to the data after collection is completed.

supervising reprimanding a client for not using the urinal properly. The AP threatens to put a diaper on the client if the urinal is not used more carefully next time. Which of the following torts is the AP committing? A. Assault B. Battery C. False imprisonment D. Invasion of privacy

A. CORRECT: Assault is conduct that makes a person fear they will be harmed. B. Battery is physical contact without a person's consent. C. False imprisonment is restraining a person against their will. It includes the use of physical or chemical restraints, and refusing to allow a client to leave a facility. D. Invasion of privacy is the unauthorized release of a client's private information.

A nurse is serving as a preceptor to a newly licensed nurse and is explaining the role of the nurse as advocate. Which of the following situations illustrates the advocacy role? (Select all that apply.) A. Verifying that a client understands what is done during a cardiac catheterization B. Discussing treatment options for a terminal diagnosis C. Informing members of the health care team that a client has do‑not‑resuscitate status D. Reporting that a health team member on the previous shift did not provide care as prescribed E. Assisting a client to make a decision about their care based on the nurse's recommendations

A. CORRECT: Ensuring that the client has given informed consent illustrates nurse advocacy. B. Discussing treatment options is not within the scope of practice of the nurse. C. CORRECT: Ensuring that the client's care is consistent with their DNR status illustrates nurse advocacy. D. CORRECT: Ensuring that all clients receive proper care illustrates nurse advocacy. E. Assisting a client to make decisions about their care based on nurse recommendations is inappropriate. The nurse should support the client in making their own decisions.

An RN on a medical‑surgical unit is making assignments at the beginning of the shift. Which of the following tasks should the nurse delegate to the PN? A. Obtain vital signs for a client who is 2 hr postprocedure following a cardiac catheterization. B. Administer a unit of packed red blood cells (RBCs) to a client who has cancer. C. Instruct a client who is scheduled for discharge in the performance of wound care. D. Develop a plan of care for a newly admitted client who has pneumonia.

A. CORRECT: It is within the scope of practice of the PN to monitor a client who is 2 hr postprocedure for a cardiac catheterization, because this client is considered stable. B. T he RN is responsible for administering blood components, including packed RBCs, because this outside of the scope of practice for the PN. C. T he RN is responsible for client education. It is within the scope of practice of the PN to reinforce but not provide initial client education. D. T he RN is responsible for developing a plan of care for a client. It is within the scope of practice for the PN to suggest additions to but not develop the plan of care.

A nurse is hired to replace a staff member who has resigned. After working on the unit for several weeks, the nurse notices that the unit manager does not intervene when there is conflict between team members, even when it escalates. Which of the following conflict resolution strategies is the unit manager demonstrating? A. Avoidance B. Smoothing C. Cooperating D. Negotiating

A. CORRECT: The goal in resolving conflict is a win‑win situation. The unit manager is using an ineffective strategy, avoidance, to deal with this conflict. Although the unit manager is aware of the conflict, they are not attempting to resolve it. B. T he goal in resolving conflict is a win‑win solution. When smoothing is used, one person attempts to "smooth" the other party and/or point out areas in which the parties agree. This is typically a lose‑lose solution. C. T he goal in resolving a conflict is a win‑win solution. When cooperating is used, one party allows the other party to win. This is a lose‑win solution. D. T he goal in resolving a conflict is a win‑win solution. When negotiating is used, each party gives up something. If one party gives up more than the other, this can become a win‑lose solution.

A nurse manager is developing an orientation plan for newly licensed nurses. Which of the following information should the manager include in the plan? (Select all that apply.) A. Skill proficiency B. Assignment to a preceptor C. Budgetary principles D. Computerized charting E. Socialization into unit culture F. Facility policies and procedures

A. CORRECT: The purpose of orientation is to assist the newly licensed nurse to transition from the role of student to the role of employee and licensed nurse. Include evaluation of skill proficiency and provide additional instruction as indicated. B. CORRECT: The purpose of orientation is to assist the newly licensed nurse to transition from the role of student to the role of employee and licensed nurse. Include assignment of a preceptor to ease the transition of the newly licensed nurse. C. Budgetary principles are an administrative skill that is usually the responsibility of the unit manager. D. CORRECT: The purpose of orientation is to assist the newly licensed nurse to transition from the role of student to the role of employee and licensed nurse. Include computerized charting, which is an essential skill for the newly licensed nurse. E. CORRECT: The purpose of orientation is to assist the newly licensed nurse to transition from the role of student to the role of employee and licensed nurse. Include socialization to the unit as a way to ease the transition of the newly licensed nurse. F. CORRECT: The purpose of orientation is to assist the newly licensed nurse to transition from the role of student to the role of employee and licensed nurse. Include information about facility policies and procedures, which is essential information for the newly licensed nurse.

A nurse manager is observing the actions of a nurse they are supervising. Which of the following actions by the nurse requires the nurse manager to intervene? (Select all that apply.) A. Reviewing the health care record of a client assigned to another nurse B. Making a copy of a client's most current laboratory results for the provider during rounds C. Providing information about a client's condition to hospital clergy D. Discussing a client's condition over the phone with an individual who has provided the client's information code E. Participating in walking rounds that involve the exchange of client‑related information outside clients' rooms

A. CORRECT: To maintain confidentiality, client information is disseminated on a need‑to‑know basis only. A nurse who is not assigned to care for a client should not access the client's information. B. CORRECT: Paper copies of confidential information create a risk for breach of confidentiality. C. CORRECT: Information about a client's condition is disseminated on a need‑to‑know basis. It is inappropriate to share this information with the hospital clergy. D. The nurse can share information with an individual who has been provided the information code. E. CORRECT: Sharing information in the hallway where it can be overheard by others can result in a breach of confidentiality.

A nurse is caring for a child who is being treated in the emergency department following a head contusion from a fall. History reveals the child lives at home with one parent. The provider's discharge instructions include waking the child every hour to assess for indications of a possible head injury. In which of the following situations should the nurse intervene and attempt to prevent discharge? A. The parent states they do not have insurance or money for a follow‑up visit. B. The child states, "My head hurts and I want to go home." C. The nurse smells alcohol on the parent's breath. D. The parent verbalizes fear about taking the child home and requests they be kept overnight.

A. Lack of insurance does not warrant a delay in discharge, but it can indicate the need for referral for social services to assist with client needs. B. The child's report of pain is an expected finding. C. CORRECT: It would be unsafe to discharge a child who requires hourly monitoring with a parent who might be chemically impaired. D. Fear verbalized by the parent does not warrant denial in discharge. The nurse should alleviate the parent's fears by providing education about how to monitor the child and provide phone numbers for use.

ATI... A nurse enters the room of a client and finds the client lying on the floor. Which of the following actions should the nurse take first? A. Call the provider. B. Ask a staff member for assistance getting the client back in bed. C. Inspect the client for injuries. D. Instruct the client to ask for help if they need to get out of bed.

A. Notify the provider to determine whether the client needs further examination and treatment, but there is another action to take first. B. Seek assistance in returning the client to bed to prevent further harm to the client, but there is another action to take first. C. CORRECT: The first action to take using the nursing process is to assess the client in order to determine which interventions the client will need. D. Instruct the client to ask for help before getting out of bed to help prevent future falls, but there is another action to take first.

A nurse is participating in a quality improvement study of a procedure frequently performed on the unit. Which of the following information will provide data regarding the efficacy of the procedure? A. Frequency with which procedure is performed B. Client satisfaction with performance of procedure C. Incidence of complications related to procedure D. Accurate documentation of how procedure was performed

A. T he frequency with which the procedure is performed is important. The team can take the frequency in which the procedure is performed under consideration in the planning process, but this information does not address the efficacy of the procedure. B. T he team should take client satisfaction under consideration in the planning process, but this information does not address the efficacy of the procedure. C. CORRECT: The incidence of complications related to the procedure is an outcome measure directly related to the efficacy of the procedure. D. T he team can take accuracy of documentation under consideration in the planning process, but this information does not address the efficacy of the procedure.

A nurse manager is providing information to the nurses on the unit about ensuring client rights. Which of the following regulations outlines the rights of individuals in health care settings? A. American Nurses Association Code of Ethics B. HIPAA C. Patient Self‑Determination Act D. Patient Care Partnership

A. The American Nurses Association Code of Ethics provides nurses with a set of standards for nursing practice. B. The Privacy Rule of HIPAA ensures client privacy and confidentiality. C. The Patient Self‑Determination Act is federal legislation that requires that all clients admitted to a health care facility be asked whether they have advance directives. D. CORRECT: The Patient Care Partnership is a document that addresses clients' rights when receiving care.

A nurse is caring for a client who is scheduled for surgery. The client hands the nurse information about advance directives and states, "Here, I don't need this. I am too young to worry about life‑sustaining measures and what I want done for me." Which of the following actions should the nurse take? A. Return the papers to the admitting department with a note stating that the client does not wish to address the issue at this time. B. Explain to the client that you never know what can happen during surgery and to fill the papers out just in case. C. Contact a client representative to talk with the client and offer additional information about the purpose of advance directives. D. Inform the client that surgery cannot be conducted unless the advance directives forms are completed.

A. The nurse should advocate for the client by ensuring that the client understands the purpose of advance directives. B. This response is nontherapeutic and can cause the client to be anxious about the surgery. C. CORRECT: The nurse should advocate for the client by ensuring that the client understands the purpose of advance directives. Seeking the assistance of a client representative to provide information to the client is an appropriate action. D. This statement is untrue and is a barrier to therapeutic communication

A nurse is caring for a client who is medically unstable. The client's adult child informs the nurse that the client has a DNR prescription with their primary care provider. Which of the following actions should the nurse take? A. Assume that the client does not want to be resuscitated, and take no action if they experience cardiac arrest. B. Write a note on the front of the provider prescription sheet asking that the DNR be represcribed. C. Write a DNR prescription in the client's medical record. D. Call the provider to verify the existence of an active DNR prescription.

A. Without a current DNR prescription, the nurse must initiate emergency resuscitation, which most likely is not consistent with the client's wishes. B. Without a current DNR prescription, the nurse must initiate emergency resuscitation, which most likely is not consistent with the client's wishes. Writing a note on the prescription sheet likely will result in a delay in resolving the problem. C. The nurse cannot write a DNR prescription for the client without instruction to do so by the primary provider. D. CORRECT: The nurse should immediately call the primary provider to validate whether the client has a current DNR order in place

A new nurse wants to be a change agent on the unit. What action listed would be the MOST appropriate for the nurse to take? a. Become an early adopter. b. Wait until a more experienced nurse vocalizes support. c. Seek help from her nurse manager. d. Talk to a peer on another unit about the problems with more experienced nurses.

a. Become an early adopter.

What type of performance appraisal is based on the employee and manager jointly setting goals? a. Management by objective b. Behaviorally anchored rating scales c. Critical incidents d. Narrative method

a. Management by objective

The nurse manager for an ICU develops a plan to implement the new sepsis management protocol. The plan includes education, focused sessions to discuss concerns with the staff, and sepsis warning signs in various places on the unit. What does this demonstrate by the manager? a. Planned change b. Complexity management c. Unplanned change d. Open systems

a. Planned change

A new graduate nurse is preparing to interview for a position in a clinic. The graduate nurse has limited experience or exposure to the role of a nurse in a clinic setting. What would the new nurse review prior to applying for the position? a. Position description b. Salary ranges for position c. Corrective action processes d. Relocation expenses

a. Position description

The staff nurse discovers that the one of the CNAs refused to help a co-worker ambulate a very obese, high-risk pregnant patient to the bathroom. What is the appropriate response by the nurse? a. Give them a lecture on working together as a team. b. Ask questions about the safety of the patient related to the behavior. c. Describe the anger and upset as inappropriate behavior. d. Assist the CNA to ambulate the patient and ignore the CNS issues.

b. Ask questions about the safety of the patient related to the behavior.

The charge nurse observes a specific employee has a significant increase in errors and may have some emotional problems from personal issues at home. What is the appropriate response by the charge nurse? a. Schedule a series of meetings with the employee to support and assist the employee in addressing the problem. b. Ask the employee some questions ending with a suggestion that Employee Assistance might be an option. c. Put the employee on the first steps of disciplinary action. d. Send the employee to the mental health center and ask for documentation before returning to work.

b. Ask the employee some questions ending with a suggestion that Employee Assistance might be an option

The charge nurse is question in if the staffing ratios demand the use of high-level delegation strategies. What "delegation right" is she assessing in this thought process? a. Task b. Circumstances c. Person d. Communication or direction

b. Circumstances

Delegation, a multifaceted decision-making process, what is NOT a reason to implement delegation? a. Improve the work performance of staff. b. Decrease the registered nurse's accountability. c. Achieve nursing goals. d. Improve patient care outcomes.

b. Decrease the registered nurse's accountability.

Role theory provides one framework for development and evaluation of staff. What term describes when employees are unwilling or unable to meet requirements? a. Role ambiguity b. Role conflict c. Role acquisition d. Role clarity

b. Role conflict

Nurses were long viewed by physicians, legislators, the media, and others as powerless because nurses a. declined to participate in political activities in the earliest years of the profession in the United States. b. as women were subject to control by medicine and other paternalistic groups; women had limited legal rights in late 19th-century America. c. and nursing leaders in the mid-20th century did not wish to be viewed by those outside of nursing as pushy or demanding. d. were subject to nursing practice acts that limited their ability to take political action.

b. as women were subject to control by medicine and other paternalistic groups; women had limited legal rights in late 19th-century America.

How can a leader deal fairly with employees who fail to meet established standards of care? a. . Determine if the employee issue is a will or skill issue. b. Conduct a chart review that reflects the care issue. c. . Ask questions of the employee that can reflect the employee's knowledge base. d. Ask other staff to document concerns to use for discharging.

c. . Ask questions of the employee that can reflect the employee's knowledge base.

What observation by the charge nurse indicates a new nurse needs additional education regarding the safe use of the electronic medical record? a. The nurse logs off the computer before walking away. b. The nurse using a computer outside of the patient room minimizes the screen when a family member approaches. c. Before leaving the patient's room, the nurse minimizes her documentation on the computer screen. d. The care assistant needs to document and asks to use the nurse's computer; before the care assistant begins documentation, the nurse logs out of the system.

c. Before leaving the patient's room, the nurse minimizes her documentation on the computer screen.

What is the benefit of strategic planning for a healthcare organization? (Select all that apply.) a. It allows an organization to set its vision and goals. b. It allows an organization to assess its strengths, weaknesses, opportunities, and threats. c. It defines the driving forces in the environment.Incorrect Answer d. All of the above

d. All of the above

When administering medications to a patient utilizing bar-code technology, what is the most important first step? a. Scan patient's identification band. b. Scan medication. c. Administer medication. d. Check the five rights.

d. Check the five rights.

A new staff nurse discovers two of the certified nursing assistants (CNAs) in the utility room speaking loudly and pointing at each other. What is the MOST appropriate action by the nurse? a. Continue walking down the hall, believing they will work it out. b. Walk into the utility room and tell them to stop or they will be reported to HR. c. Make an observation about their behavior and ask them what's going on. d. Get the nurse manager and take her to the utility room.

d. Get the nurse manager and take her to the utility room.

What is the appropriate term for the ability to transfer selected nursing activities in a given situation to a competent individual? a. Supervision b. Accountability c. Responsibility d. Legal authority

d. Legal authority

"Power in nursing" refers to the nurse's ability to a. protest unfair working conditions through walkouts and strikes. b. demonstrate knowledge about organizational behavior. c. act on issues that influence nursing licensure but not patient care. d. use one's influence to create change in pursuit of goals.

d. use one's influence to create change in pursuit of goals.