Leadership Final
A young male is visiting his mother in the Intensive Care unit. He is muttering and complaining about the facility. Which is the most appropriate response by the nurse?
Ask the visitor what he needs This response could potentially deescalate the situation by addressing his concerns.
The Emergency Department nurse manager asked the team leader to pull a list of all the patients last month who had a diagnosis of diabetes mellitus. Which is the best category description of this data?
A group of people A group refers to individuals that share commonalities, such as a diagnosis.
Senior nurses are becoming frustrated with a new nurse who they say is telling them how to do their jobs. Which communication pitfall might the nurse be exhibiting?
Giving advice Giving advice when it is not requested is a communication pitfall.
A nurse is caring for a young patient who is struggling emotionally after being diagnosed with a terminal illness. Who should the nurse consider adding to the health care team caring for this patient?
Chaplain The chaplain provides ministry and additional support to the patient and family, and would be a great addition to the health care team caring for this patient.
A nurse manager is setting goals for the unit, which includes working towards interdependency and power-sharing. The nurse knows that these are characteristics of which type of environment?
Collaboration Collaboration is a complex process that builds on communication, mutual respect and trust. The characteristics of true collaboration include interdependency, complementary roles among providers, mutual respect and power-sharing.
A nurse is preparing a patient for discharge and is looking to make community referrals to better support the patient's recovery. What should the nurse do as the first step of this process?
Determine the patient's existing home and community resources The first step in making community referrals is to assess the patient's existing home and community resources, and determine how best to use what is already available to the patient.
A nurse is developing a set of policies to determine which medical transport company should be used when making a referral to another health care facility. The nurse knows that this is an example of which component of referrals?
Health system The health system component is where each facility develops policies and procedures that simplify the referral process. Developing a policy about which medical transport company to use is an example of the health system component of the referral process.
The nurse manager of a busy medical/surgical unit is concerned because patient satisfaction on the unit has decreased from 90% to 65%, incident reports for falls on the unit have doubled in the past 30 days, and staff morale is low. How can the manager help improve patient outcomes and raise staff morale?
Implement a team nursing strategy for performing patient care on the unit Both team collaboration and improved workflow have been shown in studies to increase staff morale. The nurse manager should be mindful of staff morale and find ways to improve efficiency and staff collegiality. Schedule a staff meeting to start a dialogue with the nursing staff on the unit about these concerns Communication with the staff members would be an important step for the unit manager to take. Increased communication lends itself to improved empowerment of staff and increased staff morale, which will result in better patient outcomes and higher patient satisfaction rates on the unit. Check patterns of nurse-patient ratio to ensure adequate number of staff members have been scheduled during the past 30 days This is a very important step for the unit manager to take, as research indicates the number of RN's on the unit correlates to positive benefits for patients and nurse sensitive outcomes (such as falls) and decreased nurse burnout rates (raising staff morale).
A nurse is cleaning out her locker after being terminated. She slams the locker door shut and yells, "What am I going to do? I have three kids!" Which principles of cognitive rehearsal should the nurse manager choose for this situation?
Listen to what the nurse is saying Listening is a principle of cognitive rehearsal and is most appropriate during this time of frustration. Stop and process what the nurse is saying before responding Processing information before responding is appropriate as it allows for a thoughtful and appropriate answer, rather than a quick reactionary reply.
An older adult patient who is known to have a hot temper is very upset because the dinner tray has meat on it, and he is a vegetarian. The nurse recognizes the violence cycle and best responds with which actions?
Listens to the patient respectfully Listening can defuse the violence cycle by showing empathy. Obtains a meat-free tray for the patient Obtaining a meat-free tray could defuse the violence cycle by fixing the issue.
The nurse working in the Maternity unit was denied a request for her fourth overtime shift. When she questions her nurse manager's decision, the manager responds, "Appropriate staffing and scheduling is just as important to the unit as it is to my nurses." The nurse manager is likely identifying with which AORN healthy working environment concept?
Promoting a positive work-life balance AORN recommends scheduling to provide and promote positive work-life balance as part of a healthy work environment. Several overtime shifts per week could place added strain on the nurse, creating work-life imbalance.
A patient's son threatens to hit the nurse if she does not leave his mother's room immediately. The charge nurse approaches the man to understand what the problem is. The man is so angry he cannot speak clearly. The charge nurse has the man sit down and she offers him some water. She states that she will have someone else care for his mother and will return in 15 minutes to see if he is feeling any better. Which principle of conflict resolution does this nurse demonstrate?
Providing a cooling off period to allow the son to calm down The nurse is allowing for a "cooling-off" period before reconvening to come to a resolution.
The Medical-Surgical nurse manager has adopted guidelines introduced by national nursing organizations to establish a healthy work environment in her unit. When evaluating the results of this implementation, what encompassing concept of these guidelines should be evident?
The best outcomes are achieved by the sum of individual small acts of many people. This is the overall concept of all the guidelines set forth by organizations such as AONE, AACN, and AORN.
The nurse observes that a visitor in the waiting room appears very agitated. He knocks a chair over and yells at the nurse, "I'm tired of waiting here! I demand to see the manager right now!" The nurse should use which communication technique?
Use a mild, but firm tone to retain authority over the situation. Even if the nurse is not feeling in control of the situation, the nurse's response should be calm and confident, allowing him/her to have control over the escalated scenario.
Which finding demonstrates that a nursing team has successfully adopted the recommendations for teamwork and collaboration from the Quality and Safety Education for Nurses (QSEN) model?
Work cohesively with health care professionals The QSEN model includes functioning effectively within nursing and interprofessional teams.
A nurse manager is looking to hire a nurse facilitator to promote the collaborative process on the stroke unit. All candidates have similar years of experience in the field. Which candidate should the nurse consider?
A nurse who has excellent communication skills Excellent communication skills along with a willingness to learn and respect for other collaborators are key components for a successful interprofessional collaboration. This nurse would make an excellent choice for the nurse facilitator position.
How can a nurse manager prevent horizontal violence?
Advocate for safe-staffing ratios and workloads Advocating for safe-staffing ratios and workloads prevents horizontal violence by decreasing overwhelming workloads. Provide multiple avenues for staff to share concerns Providing avenues for staff to share concerns prevents horizontal violence by providing a safe environment for communication. Assign experienced staff to mentor newly hired nurses Mentoring by an experienced nurse can prevent horizontal violence by providing a model of professional behavior and promoting civility. Provide educational opportunities to increase self-awareness Providing educational opportunities prevents horizontal violence by allowing the staff an opportunity for intrapersonal exploration.
A nurse is developing a continuing education course for nurses about the importance of collaboration. Which benefits of collaboration should the nurse include in the curriculum?
Better health outcomes Better health outcomes for the patient have been associated with collaboration among the health care team. Improved patient-centered care Patient-centered care is one of the hallmark characteristics of collaboration among the health care team. Long-term sustainability of the health care organization Collaboration in the health care team has been associated with overall sustainability of the health care organization. Leaders must be able to balance the needs of the organization with the clinical needs of the patient.
A nurse manager is evaluating new marketing strategies to attract new nurses. How can the nurse manager most effectively find quality applicants to fill staff nursing positions?
Collaborate with the hospital marketing department Hospital marketing departments usually have large budgets and can collaborate on marketing strategies to attract quality nurses for recruiting efforts, while leveraging advertising costs. Include virtual tours and testimonials on the hospital web page Stepping out of the box and avoiding routine information on web pages can help nurse managers excel in attracting more talented new staff. Develop a web page with job openings, relocation benefits, and other useful information Developing a web page in collaboration with the hospital marketing department is an effective strategy for attracting quality nurses.
A nurse is reviewing the established referral policy. The other staff nurses are complaining about repeated phone calls from patients asking for phone numbers of their other providers. What is one action that the nurse can consider to help alleviate this concern?
Develop a written provider resource list, and follow up with patients about their experiences. Developing a written provider resource list to be handed out to patients can be helpful in minimizing repeat phone calls for contact information. It is extremely important to follow up with these patients about their experiences with the referrals and change the resource list as needed.
Which is the least effective strategy for the nurse leader to implement when addressing horizontal violence in the nursing department?
Encourage staff to work out their conflicts independently This strategy does not reduce the incidence of horizontal violence and may increase the likelihood of conflict.
It is the holiday season and the nurse leader of a busy psychiatric unit notices that many staff members seem to be experiencing nursing burnout. Which action should the nurse manager take to address this issue?
Ensure an adequate nurse-patient ratio on the unit throughout the holiday season Paying close attention to nurse-patient ratios and making sure there is enough staff to meet the patients' needs, particularly during the busy season, will lend itself to lowering the nurse burnout level.
When establishing strategies for healthy work environments, the nurse leader must know how to deal with conflict. The first step includes understanding the principles of conflict resolution. Which examples best represent these principles?
Exploring the feelings of the individuals involved Exploring the feelings of the individuals involved will examine the real issues of all parties involved. This is the beginning of conflict resolution. Meeting with the parties afterward to provide additional support Working with staff and/or patients after the conflict shows that the leader is invested in the resolution and in a healthy work environment. Reminding those involved of the implications of unresolved conflict Reviewing with all parties the likely consequences of unresolved conflict could entail disciplinary action.
A nurse manager is introducing an initiative to improve interprofessional collaboration on the patient care unit. One of the staff nurses asks how improving collaboration will improve staff satisfaction. How does the manager reply?
Improves communication Improved communication and clarity on roles of each health care provider is a direct benefit to the staff with improved collaboration. Reduces burnout among staff Collaboration has been shown to reduce burnout because of the increase in staff satisfaction with the employer. Helps to build cohesion among the team members Studies have shown that collaboration and teamwork improves cohesion among members of the health care team. This is a direct benefit to the nursing staff.
The nurse manager is having problems recruiting and hiring an adequate number of qualified nurses on the unit. Which actions indicate the nurse manager has a good grasp on various factors that can have an adverse effect on recruiting efforts?
Quickly addressing any concerns or complaints among staff members The experience of staff nurses speaks loudly of the reputation of an organization. The reputation of the unit or facility can be adversely affected when dissatisfied nurses talk to other nurses about negative experiences. Maintaining good communication with subordinates is imperative for effective nurse leaders. Fostering a relationship of mutual respect and trust with employees Nurses who have a high level of respect for their managers and feel they are empowered readily spread this information when networking with other employable nurses. Interacting closely with employees to build a good reputation in the community Nurses interact frequently in the community via continuing education seminars, personal contacts, and more. This is an important factor when it comes to setting the tone for satisfied employees who can speak well of the institution.
The nurse leader has weekly staff meetings with the nurses on the unit and asks for input on major decisions affecting staff; some of the input has led to the creation of a task force team, and the nurse leader has asked a staff nurse to join the team. Which strategies are being used to help retain employees?
Respect Incorporating respect into staff-manager relationships can be done by involving staff in decisions that affect them. This is an example of a strategy that can be used to help retain nurses. Empowerment Leaders can unite and help retain nurses through the use of empowerment. The strategy of empowerment provides nurses with a united vision and creates a sense of community. Shared governance Shared governance, when organizations encourage professional autonomy, such as in providing opportunities for staff to engage in unit decisions, is an example of a strategy that can be used to help retain nurses.
Which statement indicates that the nurse leader understands the significance of implementing successful recruitment strategies?
Successfully recruiting qualified nurses who plan to stay on the job long-term will save money. Successful recruiting involves hiring nurses who plan to stay in their jobs long-term. This saves money in terms of not having to pay temporary staff or overtime pay.
A nurse is developing an interprofessional collaborative team for the health care unit. It is important for the nurse to provide which information to the other team members?
The goals of the team and criteria for success The team should understand the goals of the team and how success or failure of those goals will be measured. This information helps the team focus their collaborative efforts. Potential barriers to the creation of the collaborative team Understanding the barriers to the creation and working of the collaborative team is important because it gives the team an opportunity to respond to and address those barriers upfront. The process of the task and the most responsible person to perform it The process for approaching each task, as well as who will be responsible for that task is crucial information that must be provided to the team. Without clear direction, the team may find it difficult to meet their goals. Information about the professional expertise of the other members of the team Understanding and respecting the knowledge, expertise, and professional role of other members of the team is one of the most important components of collaboration. This information should be provided to other members of the health care team.