leadership exam

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benefits of membership in the ANA include all but which of the following?

provision of lower health care cost

Factors found to increase nurses' joy at work include: Select all that apply. 1. Ability to provide quality care 2. Consistently high workload 3. A pattern of continuous conflict and disagreement 4. Civility and respect

1. Ability to provide quality care 4. Civility and respect

Which of the following is a current concern related to the nursing profession? 1. Aging of the nursing workforce 2. Oversupply of nurses versus decreasing demand for nursing care 3. Emphasis on evidence-based practices 4. Expansion of EHR use into the community

1. Aging of the nursing workforce

Which of the following events should be reported? Select all that apply. 1. A patient is placed in a broken wheelchair that tips over. 2. A staff member tells a neighbor about a famous athlete who is a patient. 3. An employee reports to work under the influence of alcohol. 4. A patient spills her supplemental protein drink on the floor; the certified nursing assistant (CNA; aide) mops it up.

1. A patient is placed in a broken wheelchair that tips over. 2. A staff member tells a neighbor about a famous athlete who is a patient. 3. An employee reports to work under the influence of alcohol.

What is brainwriting? 1. A strategy to encourage the free flow of ideas 2. A mutually beneficial negotiation result 3. A winning approach to formal negotiation 4. A devaluation reaction to negotiation

1. A strategy to encourage the free flow of ideas

A suburban hospital recently announced that staff nurses could no longer choose their shifts. Instead, they would be assigned to either a 12-hour day shift or a 12-hour night shift on an as-needed basis. An informal group of staff nurses met to discuss this new policy. They came up with several arguments against it. Which of the following suggestions would help to alleviate the deleterious effects of this new policy? 1. Allow self-scheduling by staff nurses in each unit. 2. Provide free dinner for nursing staff at the end of the night shift. 3. Allow staff members to request consistent days off. 4. End visiting hours before the day shift ends so that the night shift nurses do not have to deal with visitors.

1. Allow self-scheduling by staff nurses in each unit. 3. Allow staff members to request consistent days off.

Effective nurse leaders: Select all that apply. 1. Are also good followers 2. Effectively work together with shared goals 3. Never act on their ideas 4. Have master's degrees

1. Are also good followers 2. Effectively work together with shared goals

nurse is caring for a patient who has chronic obstructive pulmonary disease (COPD) and is 2 days postoperative after laparoscopic cholecystectomy. Which intervention for airway management should the nurse delegate to a NAP? 1. Assisting the patient to sit up on the side of the bed 2. Instructing the patient to cough effectively 3. Teaching the patient to use incentive spirometry 4. Auscultating breath sounds every 4 hours

1. Assisting the patient to sit up on the side of the bed

An experienced LPN is working under the supervision of the RN. The LPN is providing nursing care for a patient who has a respiratory problem. Which activities should the RN delegate to the experienced LPN? Select all that apply. 1. Auscultate breath sounds. 2. Administer medications via metered-dose inhaler (MDI). 3. Complete an in-depth admission assessment. 4. Initiate the nursing care plan. 5. Evaluate the patient's technique for using MDIs.

1. Auscultate breath sounds. 2. Administer medications via metered-dose inhaler (MDI).

The Situational Leadership Model focuses on: 1. Both followers and the task 2. The task 3. The follower 4. The behavior of others

1. Both followers and the task

An effective leader will have: Select all that apply 1. Courage and integrity 2. A critical mindset 3. The ability to set priorities 4. The ability to provide feedback

1. Courage and integrity 2. A critical mindset 3. The ability to set priorities 4. The ability to provide feedback

If an informal negotiation session becomes too highly emotional, what should the nurse manager do? 1. Let the feelings flow. 2. Cancel the negotiation. 3. Deal with the feelings first. 4. Tell them to ignore the feelings and deal with the issues.

3. Deal with the feelings first.

A patient tells a nurse that he has an advance directive from 6 years ago. The nurse looks at the medical record for the advance directive. What content should the nurse expect to find in the advance directive? Select all that apply. 1. Decisions regarding treatments 2. When to take the patient to the hospital 3. Do not resuscitate orders 4. Who should be notified in the case of illness, injury, or death 5. Durable power of attorney for health care 6. HIPAA protocols

1. Decisions regarding treatments 2. When to take the patient to the hospital 3. Do not resuscitate orders 5. Durable power of attorney for health care

Differences in status and authority within the healthcare team can generate conflict. What is the most common cause of conflict? 1. Disrespect and incivility 2. Inappropriate language and sarcasm 3. Blaming and finger pointing 4. Physical violence

1. Disrespect and incivility

1Which common practice puts the nurse at liability for invasion of patient privacy? 1. During care, the nurse reveals information about the patient to those in the room. 2. The nurse releases information about the patient to nursing students who will be caring for the patient the next day. 3. The nurse conducts a patient care session about a patient whose care is difficult and challenging. 4. Confidential information regarding an admitted patient is released to third-party payers.

1. During care, the nurse reveals information about the patient to those in the room.

Enhancing the quality of work life can be achieved by: 1. Encouraging critical thinking and new ideas 2. Discouraging a working relationship with one's peers 3. Being negative 4. Endangering a client's health or safety

1. Encouraging critical thinking and new ideas

Burnout at work can be identified best by: 1. Expressions of frustration and powerlessness 2. Fatigue and refusal to work double shifts 3. Allergic reactions 4. A preference for efficiency

1. Expressions of frustration and powerlessness

Theory Y emphasizes: 1. Guidance, development, and reward 2. Leadership, not management 3. Control, close monitoring, and reprimanded 4. Evaluation, budgeting, and time studies

1. Guidance, development, and reward

Actions to address violence in the healthcare workplace include: Select all that apply. 1. Identifying the factors that contribute to violence and controlling as many as possible 2. Allowing the violence to escalate 3. Assessing staff attitudes and knowledge regarding responses to violence 4. Providing weapons training to those identified as having a potential for physical violence

1. Identifying the factors that contribute to violence and controlling as many as possible 3. Assessing staff attitudes and knowledge regarding responses to violence

A nurse is providing care to a patient whose family has previously brought suit against another hospital and two physicians. Under which ethical principle should the nurse practice? 1. Justice 2. Veracity 3. Autonomy 4. Nonmaleficence

1. Justice

Effective nurse managers have: Select all that apply. 1. Leadership capabilities 2. Clinical expertise 3. Business sense 4. Budgeting savvy

1. Leadership capabilities 2. Clinical expertise 3. Business sense 4. Budgeting savvy

A patient is transported to the emergency department by rescue after being involved in a motor vehicle accident. The patient is alert and oriented but keeps stating he is having trouble breathing. Oxygen is started, but the patient is still showing signs of dyspnea. The patient suddenly develops respiratory arrest and dies. During the resuscitation process, it is discovered that the nurse failed to open the correct oxygen valve. The family sues the hospital and the nurse for: 1. Malpractice 2. Negligence 3. Nonmaleficence 4. Equipment failure

1. Malpractice

Mara Z. wants to become a nurse manager. She has been offered an opportunity to take a nursing management course. Which topic is most important for her to learn? 1. Managing people 2. Managing the unit's budget 3. Planning for the future 4. Redesigning the unit's workflow

1. Managing people

Which of the following are considered reasonable accommodations for an employee with a disability? Select all that apply. 1. Modification of the work schedule 2. Salary reduction to reflect the lower output 3. Additional days off and extended vacations 4. Adjustment of work procedures

1. Modification of the work schedule 4. Adjustment of work procedures

Social media is commonly used to update friends and groups on things we have going on in our lives. Healthcare organizations routinely use social media to promote medical facts, services, and recognitions. What is important for nurses to remember when deciding to post something work related on a social media site? 1. Nurses should never post protected health information on a social media site. 2. Stories with good outcomes can be posted to your media page. 3. Stories and photos can always be shared if the patient's name or face is not visible. 4. Posting stories on personal time is OK because the nurse is not working.

1. Nurses should never post protected health information on a social media site.

The patient with COPD has a nursing diagnosis of an Ineffective Breathing Pattern. Which is an appropriate action to delegate to the experienced LPN under your supervision? 1. Observe how well the patient performs pursed-lip breathing. 2. Plan a nursing care regimen that gradually increases activity intolerance. 3. Assist the patient with basic activities of daily living. 4. Consult with the physical therapy department about reconditioning exercises.

1. Observe how well the patient performs pursed-lip breathing.

HHS is charged with protecting the health of all Americans and providing essential health services. Which of the following HHS quality initiatives is currently underway? 1. Post-acute care reform initiative 2. National healthcare research and quality indicators aimed at helping improve access to care 3. NDNQI 4. Health IT

1. Post-acute care reform initiative

An effective way to help diverse staff work together is to: 1. Provide equal opportunities for advancement 2. Pretend there are no cultural differences 3. Promote uniformity in communication styles 4. Establish an English-only policy institution-wide

1. Provide equal opportunities for advancement

Healthcare reform encompasses many issues and concerns. Which of the following is probably the most controversial goal? 1. Requiring everyone to have some form of health insurance 2. Developing school-based healthcare centers 3. Eliminating preexisting condition rules in insurance coverage 4. Eliminating lifetime limits to insurance coverage

1. Requiring everyone to have some form of health insurance

The ANA Code of Ethics with Interpretive Statements guides nurses in ethical behaviors. Provision 3 of the ANA Code of Ethics says: "The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient." Which of the following best describes an example of this provision? 1. Respecting the patient's privacy and confidentiality when caring for him 2. Serving on a committee that will improve the environment of patient care 3. Maintaining professional boundaries when working with a patient 4. Caring for oneself before trying to care for another person

1. Respecting the patient's privacy and confidentiality when caring for him

Medical errors account for 250,000 deaths per year. It is estimated that as many as 50% of these errors may be preventable. What steps would you take to avoid a medication error? 1. Review the patient's medication administration record during a bedside shift report. 2. Ask your colleagues to get your medication so that you can give it on time. 3. Call the pharmacist. 4. Review the medication administration policy.

1. Review the patient's medication administration record during a bedside shift report.

Which of the following is a macro-level change? 1. Shift in Medicare payment policies 2. Change in shift differentials 3. Opening a new unit 4. Changing visiting hours

1. Shift in Medicare payment policies

The nursing assistant tells a nurse that a patient who is receiving oxygen at a flow rate of 6 L/min by nasal cannula is complaining of nasal passage discomfort. What intervention should the nurse suggest improving the patient's comfort with this problem? 1. Suggest that the patient's oxygen be humidified. 2. Suggest that a simple face mask be used instead of a nasal cannula. 3. Suggest that the patient be provided with an extra pillow. 4. Suggest that the patient sit up in a chair at the bedside.

1. Suggest that the patient's oxygen be humidified.

An incident of sexual harassment as identified by the EEOC is: Select all that apply. 1. Telling jokes about sexual identity issues 2. Separate restrooms 3. Providing coffee and doughnuts to the nursing staff 4. Demanding a daily kiss for writing a favorable evaluation

1. Telling jokes about sexual identity issues 4. Demanding a daily kiss for writing a favorable evaluation

An RN is obtaining a signature on a surgical informed consent document. Before obtaining the signature, the RN must ensure which of the following? Select all that apply. 1. The client is not sedated. 2. The doctor is present. 3. A family member is a witness. 4. The signature is in ink. 5. The patient understands the procedure.

1. The client is not sedated 5. the patient understands the procedure

You are a new nurse. The hospital where you work is committed to providing safe, high-quality care. Which of the following activities would let you know that your organization is committed to improving patient safety? 1. The hospital has a good catch program for staff who recognize errors and near misses. 2. The hospital subscribes to TJC safety publications. 3. The hospital measures performance every month, monitors quality indicators, and regularly reports on quality .4. All of the above

1. The hospital has a good catch program for staff who recognize errors and near misses.

After 3 years of uneventful employment, the nurse made a medication error that resulted in patient injury. What hospital response to this event is ethical? 1. The hospital was supportive and assistive as the nurse coped with this event. 2. The nurse was dismissed for incompetence. 3. The hospital quality department advised the nurse not to tell the patient about the error. 4. The nurse was reassigned to an area in which there is no direct patient care responsibility.

1. The hospital was supportive and assistive as the nurse coped with this event.

The healthcare facility has sponsored a continuing education offering on emergency management of pandemic influenza. At lunch, a nurse is overheard saying, "I' m not going to take care of anyone who might have that flu. I have kids to think about." What is true of this statement? Select all that apply. 1. The nurse has a greater obligation than a layperson to care for the sick or injured in an emergency. 2. This statement reflects defamation and may result in legal action against the nurse. 3. This statement is a breach of the Code of Ethics for Nurses. 4. The nurse has this right as no nurse-patient contract has been established.

1. The nurse has a greater obligation than a layperson to care for the sick or injured in an emergency. 3. This statement is a breach of the Code of Ethics for Nurses.

A nurse is helping a NAP provide a bed bath to a comatose patient who is incontinent. Which of the following actions requires the nurse to intervene? 1. The nursing assistant answers the phone while wearing gloves. 2. The nursing assistant log-rolls the client to provide back care. 3. The nursing assistant places an incontinence diaper under the client. 4. The nursing assistant positions the client on the left side, head elevated.

1. The nursing assistant answers the phone while wearing gloves.

To achieve safe patient care, a culture of safety must exist. What are the characteristics of an organization with a culture of safety? 1. Transparency, openness, and reporting of errors is rewarded, blame-free environment 2. Honesty, studying serious events 3. Privacy and reporting of errors appreciated 4. Blame-free environment, openness and, error reporting are encouraged

1. Transparency, openness, and reporting of errors is rewarded, blame-free environment

A nurse is caring for a patient who has a pulmonary embolus. The patient is receiving anticoagulation with IV heparin. What instructions should the nurse give the NAP who will help the patient with activities of daily living? Select all that apply. 1. Use a lift sheet when moving and positioning the patient in bed. 2. Use an electric razor when shaving the patient each day. 3. Use a soft-bristled toothbrush or tooth sponge for oral care. 4. Use a rectal thermometer to obtain a more accurate body temperature. 5. Be sure the patient's footwear has a non-slip sole when the patient ambulates.

1. Use a lift sheet when moving and positioning the patient in bed. 2. Use an electric razor when shaving the patient each day. 3. Use a soft-bristled toothbrush or tooth sponge for oral care. 5. Be sure the patient's footwear has a non-slip sole when the patient ambulates.

Which of the following is the best indication that a change has been integrated? 1. When no one talks about it anymore 2. If adoption occurred rapidly 3. When resistance turns from active to passive 4. When a full year has passed since the change was introduced

1. When no one talks about it anymore

A nurse's significant other undergoes exploratory surgery at the hospital where the nurse is an employee. Which practice is most appropriate? 1. The nurse is an employee; therefore, access to the chart is permissible. 2. Access to the chart requires a signed release form. 3. The relationship with the client provides the nurse special access to the chart. 4. The nurse can ask the surgeon to discuss the outcome of the surgery.

2. Access to the chart requires a signed release form.

When should a new graduate consider taking on management responsibilities? 1. As soon as they are offered 2. After developing clinical expertise 3. After 15 years on the job 4. Before developing leadership expertise

2. After developing clinical expertise

According to NIOSH, a common reaction to latex allergy is: 1. Increased appetite 2. Allergic contact dermatitis 3. Increased falls 4. An increase in violent outbursts

2. Allergic contact dermatitis

Nursing management and the nursing union are having differences on several issues. There may be a need for negotiation. Which of the following is a serious disadvantage to using collective bargaining to resolve this conflict? 1. Protecting the right to fair treatment 2. Creating an adversarial relationship between staff and management 3. Lacking professionalism on the part of the collective bargaining unit members 4. Failing to uphold important standards of care

2. Creating an adversarial relationship between staff and management

Which best describes the difference between patient privacy and patient confidentiality? 1. Confidentiality occurs between persons who are close, whereas privacy can affect anyone. 2. Privacy is the right to be free from intrusion into personal matters, whereas confidentiality is protection from sharing a person's information. 3. Confidentiality involves the use of technology for protection, whereas privacy uses physical components of protection. 4. Privacy involves protection from being watched, whereas confidentiality involves protection from verbal exchanges.

2. Privacy is the right to be free from intrusion into personal matters, whereas confidentiality is protection from sharing a person's information.

The EMR has many advantages compared with paper charting. It helps track data through time and can help monitor things such as preventative care in primary care practices. Jane is the office nurse in a local practice. She is meeting a new patient for the very first time who informs her that he was recently hospitalized. Jane pulls up the patient's EMR and sees no information regarding his recent hospital stay. How could this have happened? 1. The patient's discharge was so recent that it is not available yet. 2. EMRs are usually practice or hospital-specific, so the patient's information would not be accessible to Jane. 3. The patient was hospitalized out of state. 4. The patient has not signed the necessary consent to give Jane access.

2. EMRs are usually practice or hospital-specific, so the patient's information would not be accessible to Jane.

Florence has two team members who continually criticize each other despite being told to stop. Which approach is the most appropriate for this situation? 1. Refer each of them for employee counseling. 2. Engage in problem resolution. 3. Bring in a union representative. 4. Engage in a formal negotiation process.

2. Engage in problem resolution.

In which of the following situations would a personal change probably be the hardest to make? 1. When the need is immediate 2. If the benefits will be realized years from now 3. When the reward is immediate 4. If it is change that keeps you in your comfort zone

2. If the benefits will be realized years from now

When is it most appropriate to dictate (order) change? 1. When the change is very complicated 2. In an emergency 3. When resistance is very high 4. If the change is unimportant

2. In an emergency

The purpose of QI is to continuously improve the capability of everyone involved to provide safe, high-quality patient care. What is important to know about the QI process? 1. It is independent of teamwork. 2. It is a data-driven approach to improving processes. 3. Common safety indicators are not used to evaluate the quality of care. 4. Opportunities for QI are selected by organization leadership.

2. It is a data-driven approach to improving processes.

A unit team leader who fails to provide direction to his or her nursing care team is a(n): 1. Democratic leader 2. Laissez-faire leader 3. Autocratic leader 4. Situational leader

2. Laissez-faire leader

Which of the following are the primary current problems with the U.S. healthcare system? Select all that apply. 1. Increased use of EHRs 2. Less-than-optimum outcomes (quality issues) 3. Number of people who are uninsured 4. High cost of care

2. Less-than-optimum outcomes (quality issues) 3. Number of people who are uninsured 4. High cost of care

What is the difference between management and leadership? 1. Management focuses on budget. 2. Management is an assigned position. 3. Leadership is not concerned with getting work done. 4. Leadership is more focused on people.

2. Management is an assigned position.

Which of the following best describes the nurse of today? 1. Assistant to the physician 2. Member of the largest healthcare profession 3. Member of the most powerful lobby group in healthcare 4. Woman in white

2. Member of the largest healthcare profession

Which of the following procedures and modifications contributes to reducing indoor air pollution? 1. Windows that may be opened by staff as needed 2. More powerful ventilation systems and air filtration 3. Selection of products with more polyvinyl chloride (PVC) 4. Increased use of medical waste incinerators

2. More powerful ventilation systems and air filtration

TJC attributes 80% of all medical errors to: 1. Poor hygiene and hand washing 2. Poor hand-off communication 3. Poor work environment 4. Lack of care

2. Poor hand-off communication

When evaluating the quality of care, healthcare organizations must consider structures, processes, and outcomes of care delivery. Which of the following is a good example of an organizational process? 1. Budgeting adequate money for nursing salaries 2. Preparing a patient for discharge 3. Monitoring for infections 4. Increasing time between clinic visits

2. Preparing a patient for discharge

Structured care methodologies (SCM) are: 1. Nursing tools designed to identify best practices and facilitate standards of care 2. Used to create a stable set of performance indicators to measure outcomes 3. Used to assist employees with wellness and injury prevention 4. Helpful when making staffing assignments

2. Used to create a stable set of performance indicators to measure outcomes

The purpose of learning how to negotiate conflict is to: 1. Eliminate conflict entirely 2. Resolve conflicts more effectively 3. Win 4. Reduce stress

2. Resolve conflicts more effectively

A new nurse manager plans to implement a new scheduling process. This was met with resistance from the staff who were very happy with the current scheduling process. How can the nurse manager lower their resistance to this change? 1. Tell the staff that their concerns about the new schedule are unfounded and plan to post the new schedule. 2. Share information about the new schedule and discuss its impact on the unit. 3. Post the schedule and deal with staff on an individual basis. 4. Ask the staff to come up with an alternative for the nurse manager's consideration.

2. Share information about the new schedule and discuss its impact on the unit.

Effective followers are those who are: 1. Passive employees 2. Skilled and self-directed employees 3. Less valuable employees 4. Employees who are never supportive of new ideas

2. Skilled and self-directed employees

What does "be visible and vocal" mean? Select all that apply. 1. Take a course on healthcare policy. 2. Speak out on issues important to nursing. 3. Write letters to the editor and e-mail your state and federal representatives. 4. Look for opportunities to appear on radio or television.

2. Speak out on issues important to nursing. 3. Write letters to the editor and e-mail your state and federal representatives. 4. Look for opportunities to appear on radio or television.

Which of the following health and safety concerns is NOT one of our greatest concerns currently? 1. "Escape" of health-care-acquired infections into the community 2. Spread of poliomyelitis and smallpox 3. Increase in opioid-related deaths 4. Health disparities (poorer health and treatment outcomes in minorities, limited income, and other groups)

2. Spread of poliomyelitis and smallpox

Which of the following best describes what is most likely to be within a nurse's comfort zone? 1. A new assignment 2. Tasks she's done many times 3. Change to a different shift 4. Addition of several new tasks

2. Tasks she's done many times

George S. has just become a nurse manager in a long-term care facility. He knows he has a lot to learn—what should he tell his staff? 1. Nothing; he should pretend he has experience 2. That he is still learning, too, and values their input 3. That the staff needs to manage themselves 4. How little he knows about management

2. That he is still learning, too, and values their input

A nurse is working on an ethics committee to determine the best course of action for a patient who is dying. The nurse considers the positive and negative outcomes of the decision to assist with choices. Which best describes the distinction of using a list when making an ethical decision? 1. The nurse can back up her reasons for why she has decided to provide a certain type of care. 2. The nurse can compare the benefits of one choice over another. 3. The nurse can communicate the best choice of action to the interdisciplinary team. 4. The nurse can provide care based on developed policies and standards.

2. The nurse can compare the benefits of one choice over another.

Health Insurance Portability and Accountability Act (HIPAA) regulations guard confidentiality. In several situations, confidentiality can be breached, and information can be reported to other entities. Which of the following meets these criteria? Select all that apply. 1. The patient is from a correctional institution. 2. The situation involves child abuse. 3. An injury occurred from a firearm. 4. The patient is a physician. 5. The breach of information was unintentional.

2. The situation involves child abuse. 3. An injury occurred from a firearm.

A patient asks a nurse if he has to agree to the health provider's treatment plan. The nurse asks the patient about his concerns. Which ethical principle is the nurse applying in this situation? Select all that apply. 1. Beneficence 2. Autonomy 3. Veracity 4. Justice

2. autonomy

A colleague tells you, "I'm so burned out, I think it's time for me to resign." What can you tell your colleague? 1. "You probably need a break from work. Why don't you ask for a 6-month leave of absence?" 2. "Why don't you apply for a position at our rival hospital?" 3. "Tell me how you take care of yourself and what you like about your work." 4. "We're all burned out. Welcome to the club."

3. "Tell me how you take care of yourself and what you like about your work."

An important competency that nurse leaders need to develop in order to lead effectively is the: 1. Ability to be firm and inflexible 2. Ability to be close-minded and to ignore negative feedback 3. Ability to communicate effectively with others 4. Ability to follow orders without questioning them

3. Ability to communicate effectively with others

Theory X emphasizes: 1. Guidance, development, and reward 2. Leadership, not management 3. Control, close monitoring, and reprimanded 4. Evaluation, budgeting, and time studies

3. Control, close monitoring, and reprimanded

Servant leadership focuses on: 1. Helping patients care for themselves 2. Removing incompetent managers 3. Creating a supportive work environment 4. Resolving conflicts quickly

3. Creating a supportive work environment

An RN new to the emergency department documented that "the patient was intoxicated and acted in a crazy manner." The team leader told the RN that this type of documentation can lead to: 1. Assault 2. Wrongful publication 3. Defamation of character 4. Slander

3. Defamation of character

Transformational nursing leaders have the ability to: 1. Increase the negativity of the team 2. Work best alone 3. Define the group's mission and communicate that mission to others 4. Pay close attention to the weaknesses and shortcomings of others

3. Define the group's mission and communicate that mission to others

The occurrence of sexual harassment may be reported to: 1. IHI 2. ANA 3. EEOC 4. CDC

3. EEOC

Autocratic leaders: 1. Postpone decision-making as long as possible 2. Share leadership with members of the team 3. Give orders and make decisions without consulting the team 4. Encourage creativity when problem-solving

3. Give orders and make decisions without consulting the team

An RN sees an older woman fall in the mall. The RN helps the woman. The woman later complains that she twisted and sprained her ankle. The RN is protected from litigation under: 1. Hospital malpractice insurance 2. Good faith agreement 3. Good Samaritan law 4. Personal professional insurance

3. Good Samaritan law

In the U.S. healthcare system, who is the real "customer"? That is, who actually pays most of the healthcare bill? 1. The U.S. government 2. The head of the household 3. Government entities and employers 4. Employees and their families

3. Government entities and employers

A surprisingly dangerous job in the United States is working: 1. In a coal mine 2. As a window cleaner in New York City 3. In a healthcare facility 4. As a police officer

3. In a healthcare facility

ISBARR provides a framework for communicating critical client information. ISBARR is an acronym for: 1. Identify, Study, Background, Assess, Recognize, Readback 2. Issue, Situation, Better, Advise, Refer with Recommendations 3. Introduce, Situation, Background, Assess, Recommend, Readback 4. None of the above

3. Introduce, Situation, Background, Assess, Recommend, Readback

Jane is a new nurse manager who will be holding her first staff meeting tomorrow. She has learned that the staff members have not been following important patient care policies. What is the most important communication skill that she should use at the meeting? 1. Talking to the staff 2. Laughing with them 3. Listening 4. Crying

3. Listening

Studying errors and identifying how they occur helps organizations improve patient safety. Which category of errors is the most useful in identifying and remedying vulnerabilities in the organization? 1. Sentinel event 2. Adverse event 3. Near-miss event 4. Wrong procedure event

3. Near-miss event

A good description of the present U.S. healthcare system would be: 1. The best in the world 2. Efficient and effective 3. Needs improvement 4. Meets everyone's needs

3. Needs improvement

A nurse is caring for a patient who feels that life should not be prolonged when hope is gone. She has decided that she does not want extraordinary measures taken when her life is at its end. She has discussed her feelings with her family and healthcare provider. The nurse realizes that this is an example of: 1. Affirming a value 2. Choosing a value 3. Prizing a value 4. Reflecting a value

3. Prizing a value

Who is responsible for accepting, transcribing, and implementing physician orders? 1. Unit clerk 2. Medical intern or resident 3. Professional nurse 4. Medical assistant

3. Professional nurse

A nurse is caring for a patient who is diagnosed with coronary artery disease and sleep apnea. Which action should the nurse delegate to the NAP? 1. Discuss weight-loss strategies such as diet and exercise with the patient. 2. Teach the patient how to set up the CPAP machine before sleeping. 3. Remind the patient to sleep on his side instead of his back. 4. Administer modafinil (Provigil) to promote daytime wakefulness.

3. Remind the patient to sleep on his side instead of his back.

A democratic nurse leader consistently works to: 1. Move the group toward the leader's goals 2. Make little or no attempt to move the group 3. Share leadership with the group 4. Dampen creativity

3. Share leadership with the group

Bedside shift report is one of the things that Jane reviews at the staff meeting. She stresses the way she would prefer the report to start. Which of these would be the least important to share with the oncoming nurse? 1. Telling the oncoming nurse what happened on the unit during the shift 2. Introducing the client and his or her diagnosis to the oncoming nurse 3. Sharing the nurse's personal opinion of the client 4. Reviewing new medication orders and the medication administration record (MAR)

3. Sharing the nurse's personal opinion of the client

Janice Mendoza is settled in her nursing position and wants to devote some time to one of the issues facing the nursing profession. Which of the following activities would probably have the LEAST impact on advocating for the nursing profession? 1. Contribute to the ANA's PAC 2. Visit the representatives when the state legislature is in session 3. Talk with her friends, explaining her concerns 4. Speak on radio and television programs

3. Talk with her friends, explaining her concerns

There has been a sudden increase in catheter-associated urinary tract infections that must be addressed on Jane's unit. What is the best way for Jane to persuade the staff to implement a new Foley catheter care protocol? 1. Tell them the change has been ordered by the administration. 2. Present statistics proving the need to change. 3. Tell a compelling story about why change is needed. 4. Explain the importance of the change in simple terms.

3. Tell a compelling story about why change is needed.

10. Which of the following is a major reason why newly licensed nurses resign? 1. Poor pay scales 2. Needlestick injuries 3. Unsupportive management 4. Lack of advancement opportunities

3. Unsupportive management

What is the most desirable result of a problem resolution? 1. Win-lose 2. Lose-lose 3. Win-win 4. None of the above

3. Win-win

A nurse is assigned to care for the following patients. Which patient should the nurse assess first? 1. A 60-year-old patient on a ventilator for whom a sterile sputum specimen must be sent to the laboratory 2. A 55-year-old with COPD and pulse oximetry reading from the previous shift of 90% saturation 3. A 70-year-old with pneumonia who needs to be started on IV antibiotics 4. A 50-year-old with asthma who complains of shortness of breath after using a bronchodilator

4. A 50-year-old with asthma who complains of shortness of breath after using a bronchodilator

An assistant nurse manager is making assignments for the next shift. Which patient should the assistant nurse manager assign to a nurse with 6 months of experience and who has been floated from the surgical unit to the medical unit? 1. A 58-year-old on airborne precautions for tuberculosis (TB) 2. A 68-year-old who just returned from bronchoscopy and biopsy 3. A 69-year-old with COPD who is ventilator dependent 4. A 72-year-old who needs teaching about the use of incentive spirometry

4. A 72-year-old who needs teaching about the use of incentive spirometry

Nursing standards of care and the organization's policies and procedures greatly decrease the risk to patient safety. Which of the following steps can a nurse take to further reduce risk? 1. Submit event or incident reports for near misses. 2. Follow medication administration policies and procedures. 3. Always report significant data on care to patients and providers in a timely manner. 4. All of the above

4. All of the above

The hospital has recently reorganized; therefore, several departments were closed. The patient census on the unit has increased. The staff has always had a strong team spirit, but the nurse manager knows that workflow changes can cause conflict. What can the nurse manager do to reduce the possibility of conflict among her team? 1. Monitor the quality of patient care. 2. Ensure that supplies and equipment are readily available. 3. Assess the equity of nursing assignments. 4. All of the above

4. All of the above

Which of the following issues may be addressed in a collective bargaining agreement? 1. Shift differentials 2. Safe working environment 3. Grievance procedures 4. All of the above

4. All of the above

Your new organization is committed to quality patient care. Which of these is considered characteristic of quality health care? 1. The nurses use evidence-based research to guide care delivery. 2. The nurses are respectful and responsive to their clients' individual preferences. 3. The nurses perform an independent double-check when administering chemotherapy medication. 4. All of the above

4. All of the above

As Jane speaks with the team, she learns why the staff members have had difficulty following policies. Which of these would be considered barriers to effective communication? 1. The charge nurse is unavailable to help the nurses when they have questions about policies. 2. Some staff is afraid to ask particular charge nurses for help for fear of retribution. 3. The use of acronyms is confusing to staff members who are new to the unit. 4. All the above

4. All the above

Implicit bias affects our understanding in an unconscious manner. A person's ability to recognize these biases can improve communication with patients and colleagues alike. Which of the following statements is true about implicit bias? 1. Implicit bias forms during a lifetime. 2. Implicit bias can influence clinical decision-making and treatment. 3. Implicit bias contributes to an individual's social behavior. 4. All the above

4. All the above

When designing a technical change, which of the following should be considered? 1. Will it work better than the old way? 2. Is this change needed? 3. Is there a simple way to do this? 4. All the above

4. All the above

A common ergonomic occupational-related risk in the healthcare environment is: 1. Indoor air pollution 2. Active shooters 3. Nosocomial infection 4. Back injuries

4. Back injuries

Informational aspects of a nurse manager's job include: 1. Evaluation 2. Resource allocation 3. Being a coach 4. Being a spokesperson

4. Being a spokesperson

A federal agency that partners with other agencies throughout the nation to investigate health problems, conduct research, implement prevention strategies, and promote safe and healthy environments is known as the: 1. FDA 2. IOM 3. ANA 4. CDC

4. CDC

A new nurse manager has observed several instances of horizontal violence between staff members on her unit, primarily verbal abuse, and malicious gossip. What should she do? 1. Ignore it because it is not physical violence and will not hurt anyone. 2. Model this bullying behavior so that staff can see how it affects people. 3. Keep a log of observed bullying behavior to discuss during the employees' annual evaluation. 4. Confront the bullying behavior and discuss strategies for responding to it.

4. Confront the bullying behavior and discuss strategies for responding to it.

OSHA, a federal government agency, is responsible for: 1. Providing training to handle difficult clients and their families 2. Providing research and education training 3. Upholding the standards of nursing practice 4. Developing and enforcing workplace safety and health regulations

4. Developing and enforcing workplace safety and health regulations

Scientific management focuses on: 1. Interpersonal relations 2. Servant leadership 3. Staff development 4. Efficiency

4. Efficiency

New graduates usually experience a "honeymoon" period at their first job, which is characterized by: 1. Extreme criticism from colleagues 2. Long hours and low pay 3. Feeling undervalued 4. Excitement about the new position

4. Excitement about the new position

In the United States, healthcare insurance can best be described as 1. Universal 2. Available to all 3. Free 4. Expensive

4. Expensive

How can you increase your staff's receptivity to an important change in procedures? 1. Assign the new procedure to the newest staff member. 2. Apologies for making their work more complicated. 3. Provide them with a booklet on preparing for change. 4. Give them time to learn the new procedure.

4. Give them time to learn the new procedure.

You are working on the trauma unit today, and your new patient with a femur fracture complains of leg pain and seems a little diaphoretic and short of breath. You assess the patient and prepare to contact the surgeon. In preparation for contacting the physician, you: 1. Immediately page the MD; it could be a pulmonary embolism, and time is of the essence. You will give him the particulars when the MD arrives. 2. Wait for the MD to round on his patient because it should be within the next hour or so. 3. Medicate the patient for pain and plan to contact the MD when he rounds. 4. Jot down notes about the situation as it is presented to you, review the patient's history, focus your assessment, and determine what you need for the patient.

4. Jot down notes about the situation as it is presented to you, review the patient's history, focus your assessment, and determine what you need for the patient.

An RN has asked a licensed practical nurse (LPN) to trim the toenails of a diabetic patient. The LPN trims them too short, which results in a toe amputation from infection. The patient files a lawsuit against the hospital, the RN, and the LPN. What might all three be found guilty of? 1. Unintentional tort 2. Intentional tort 3. Negligence 4. Malpractice

4. Malpractice

Stephanie Beals was a little nervous during her first week of work as a licensed nurse. Distracted by a lead nurse behind her, her hand slipped, and she was stuck by the needle she had just used. What is most important for Stephanie to do? 1. Disinfect the site of the needlestick. 2. Apologies to the patient, clean the site, and properly dispose of the needle. 3. Update her hepatitis B immunization. 4. Report the incident and obtain post-exposure prophylaxis (PEP) within 2 hours.

4. Report the incident and obtain post-exposure prophylaxis (PEP) within 2 hours.

What type of resistance to a change is the hardest to overcome? 1. The resistance that comes from inertia: "We always do it this way." 2. Active resistance to changing a preferred procedure 3. Passive resistance to an unpopular change 4. Resistance based upon fear of losing one's job

4. Resistance based upon fear of losing one's job

A respiratory therapist performs suctioning on a patient with a closed head injury who has a tracheostomy. Afterward, the NAP obtains vital signs. The nurse should communicate that the NAP needs to report which vital sign value or values immediately. Select all that apply. 1. Heart rate of 96 beats/min 2. Respiratory rate of 24 breaths/min 3. Pulse oximetry of 95% 4. Tympanic temperature of 101.4°F (38.6°C)

4. Tympanic temperature of 101.4°F (38.6°C)

An emotionally intelligent nurse leader: 1. Seeks the emotional support of others 2. Cannot juggle multiple demands 3. Works alone without help 4. Welcomes constructive criticism

4. Welcomes constructive criticism

Nursing and respiratory departments both experienced job cuts. The nurse manager notices that members of his staff are having more trouble getting a fast response from a respiratory therapist. What source of conflict is probably operating here? 1. Union-management conflict 2. Interpersonal problem 3. Cultural differences 4. Work intensification

4. Work intensification

An RN calls a healthcare provider to report that a patient's condition is deteriorating. The physician gives orders on the telephone to draw arterial blood gases. What should the nurse do next when receiving telephone orders from a healthcare provider? 1. Call the respiratory therapist to obtain the blood gases. 2. Give the order to the unit secretary to ensure it is entered quickly. 3. Enter the order directly into the system as it was given to the RN. 4. Write the order down and read it back to the provider.

4. Write the order down and read it back to the provider

Which of the following demonstrates a nurse as advocating for a patient? The nurse 1. calls a nursing supervisor in conflicting situations. 2. reviews and understands the law as it applies to the client's clinical condition. 3. Document all clinical changes in the medical record in a timely manner. 4. assesses the client's point of view and prepare to articulate this point of view.

4. assesses the client's point of view and prepare to articulate this point of view.

Several studies have shown that although care planning and advance directives are available to clients, only a minority actually complete them. which of the following has been shown to be related to complete an advance directive? SATA 1. African American race 2. younger age 3. hx of chronic illness 4. lower socioeconomic status 5. higher education

5. higher education

Ethics refers to ____, whereas morals usually refers to ____. A. a standardized code to guide behaviors; an individual's personal code for acceptable behavior B. an individual's personal code for acceptable behavior; a standardized code to guide behaviors C. rules for the duties that individuals owe each other; rules for behaviors considering the consequences of an action

A. a standardized code to guide behaviors; an individual's personal code for acceptable behavior

Nursing practice in the 21st century is an art and science that focuses on 1. The client 2. The nursing process 3. Cultural diversity 4. The health-care facility

Answer: 1 Rationales: 1. Health-care reform and nursing practice focus on client- or patient-centered care. 2. The nursing process is a scientific method used by nurses to ensure the quality of patient care 3. Cultural diversity is the existence and understanding that various cultures exist within populations 4. The health-care facility is the physical place where care occurs

Which of the following is unique to a professional standard of decision making? Select all that apply. 1. Weighs benefits and risks when making a decision 2. Analyze and examines choices more independently 3. Concentrate thinking 4. Anticipate when to make choices without others' assistance

Answer: 1, 2 Rationales: Professional behaviours include accountability and sound decision-making abilities 1. Professionals look at risks and benefits before making a decision 2. They analyze choices in order to make sound decisions 3. Concrete thinking is literal and focuses on the physical world. 4. Professional decision making occurs independently

Which of the following represent the knowledge and skills expected of the professional nurse? Select all that apply. 1. Accountability 2. Advocacy 3. Autonomy 4. Social netowrking 5. Participation in nursing blogs

Answer: 1, 2, 3 Rationales: Professional behaviours include: 1. Accountability for one's work and responsibilities 2. Advocating for patients and families 3. Autonomy in making decisions within the scope of practice 4. Social networking is not considered a knowledge or skill unique to professional nursing 5. Participation in nursing blogs is not considered a knowledge or skill unique to professional nursing

Professional accountability serves the following purpose: Select all that apply. 1. To provide a basis for ethical decision making 2. To respect the decision of the client 3. To maintain standards of health 4. To evaluate new professional practices and reassess existing ones 5. To belong to a professional organization

Answer: 1, 2, 3, 4 Rationales: 1. To provide a basis for ethical decison making is a characteristic of professional accountability 2. To respect the decision of the client is a characteristic of professional accountability 3. To maintain standards of health is a characteristic of professional accountability 4. To evaluate new professional practices and reassess existing ones in a characteristic of professional accountability 5. Belonging to a professional organization demonstrates commitment to the profession, not necessarily accountability

Advanced Practiced Registered Nurse (APRN) generally: Select all that apply. 1. Function independently 2. Function as unit directors 3. Work in acute care settings 4. Work in the university setting 5. Hold advanced degrees

Answer: 1, 5 Rationales: Although advanced practice nurses (APNs) work in a variety of settings, they all: 1. Function independently as guided by the nurse practice acts of the individual states 2. Are educated to provide higher level patient care 3. May work in acute care settings 4. May work in university settings 5. Are educated at the master's level or higher

Nurses at a community hospital are in an 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? 1. Continuing education 2. Graduate education 3. In-service education 4. Professional registered nurse education

Answer: 3 Rationales: 1. Continuing education furthers knowledge and skills within the professional domain 2. Graduate education leads to a higher level degree such as a master's or doctorate 3. In-service education takes place within an institution or agency. It is usually directed at teaching nurses who work in the institution about a new policy, standard, or type of equipment 4. Professional registered nurse education is the basic nursing education to sit for licensure

Nursing has it's origins with 1. Florence Nightingale 2. The Knights of Columbus 3. Religous orders 4. Wars and battles

Answer: 3 Rationales: 1. Florence Nightingale formalized nursing practice 2. The Knights of Columbus was an organization but not a religious order 3. Religious orders such as the Sisters of Mercy assumed the role of "nursing" the sick and infirm 4. Wars and battles required nurses

The NCLEX for nurses is exactly the same in every state in the United States. The examination: 1. Guarantees safe nursing care for all patients 2. Ensures standard nursing care for all patines 3. Ensures that honest and ethical care is provided 4. Provides a minimal standard or knowledge for a registered nurse in practice

Answer: 4 Rationales: 1. The exam ensures minimally safe practice 2. Standards of care are designated by evidence-based practice 3. Honest and ethical care is expected and guided by the Code of Ethics 4. The NCLEX exam ensures that the registered nurse has achieved the minimum knowledge and skills necessary to enter practice

You are participating in a clinical care coordination conference for a patient with terminal cancer. You talk with your colleagues about using the nursing code of ethics for professional registered nurses to guide care decisions. A non-nursing colleague asks about this code. Which of the following statements best describes this code? 1. Improves communication between the nurse and the patient 2. Protects the patient's right of autonomy 3. ensures identical care to all patients 4. Acts as a guide for professional behaviours in giving patient care

Answer: 4 Rationales: 1. Although good communication is expected, it is not considered an "ethical code." 2. Protecting autonomy is part of the ethical code. 3. All individuals are entitled to equitable care; however, nursing care is patient-centered, so care, although equitable, may not be identical 4. Codes of ethics provide guidelines for appropriate professional behaviours and guide practice

Who stated that the "function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death)"? 1. Henderson 2. Rogers 3. Robb 4. Nightingale

Answer: 4 Rationales: 1. Henderson built on Nightingale's theory 2. Rogers developed a theory of nursing known as the Science of Unitary Human Beings 3. Robb was the first superintendent of nurses at Johns Hopkins School of Nursing 4. Florence Nightingale defined nursing function in both the sick and the well state.

partners with other national agencies to investigate problems, implement prevention and promote safety and health

CDC

which of the following organizations supports nursing education

NLN

there are numerous sources of power in an organization. several are viable to nurses. which are not

authority

what does the NSNA provide to its members

career development information

what type of resume helps show stable employment without gaps or many job changes?

chronological

what is the STAR method of interviewing

emphasizes behaviors

which of the following is representative of the S in SWOT analysis?

flexibilty

a hospital owned by a corporation listed on the stock market belongs in which of the following categories?

for-profit

professional careers go through several phases. which of the following would be the final phase of a successful career?

harvest phase

what is the purpose of a cover letter when applying for a position

introduces the applicant

what is the best explanation of authority?

it is position dependent

organizational culture is best defined as

policies and procedures

a nurse is caring for a patient with CAD and sleep apnea. which action should the nurse delegate to the NAP?

remind the patient to sleep on their side instead of their back

which of the following is characteristic of a bureaucratic organization?

rigid unit structures

what is an important contribution of nursing speciality organizations?

setting standards for specialty practice

when conduction a SWOT analysis, the T represents

threats to obtaining a position


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