leadership final question

A nurse is teaching a group of newly hired nurses about the requirements for disaster planning. Which of the following statements by one of the newly hired nurses indicates an understanding of the teaching?

"Disaster drills should be held on a regular basis."

The nurse leader has assembled a team to develop a plan to decrease the number of patient falls on the unit. Which statement by a team member is the best example of an exemplary follower?

"I have noticed that the last few patients who fell were experiencing dementia. What if we focused on those patients first?"

A charge nurse notes that a staff nurse delegates an unfair share of tasks to the assistive personnel (AP) and the nurses on next shift report the staff nurse frequently leaves tasks uncompleted. Which of the following statements should the charge nurse make to resolve this conflict?

"I need to talk to you about unit expectations regarding delegating and completing tasks

A nursing unit is being educated on methods to prevent workplace violence from occurring on the nursing unit. Which statement by a nursing staff member indicates that adequate instruction has been provided?

"I will remain accountable for all of my behaviors and actions while working on the nursing unit."

A nurse manager is reviewing the Good Samaritan law with a group of newly licensed nurses. Which of the following statements by the nurses manager is appropriate?

"If you render aid in an accident, do not leave the scene until another competent person can take over."

In a job interview for a staff position, which of the following indicates your knowledge of patient safety?

"Is there a strategy in place to reduce the number of overtime hours on the unit?"

In delegating to a CNA in a home health setting, which of the following represents the most appropriate delegation communication?

"Mrs. S needs help getting into and out of her bathtub. Her bath will need to be completed by 10:00 When you are helping her to dry, please check between her toes and toenails, and phone me by 10:30 if you notice nail discoloration or redness

A nursing filling out an incident report after finding a client lying on the floor. Which of the following information should the nurse include?

"The client was lying on the floor next to his bed."

The RN is assessing the client's daily schedule and habits. Which question is most appropriate for the RN to ask the client?

"What time do you prefer bathing and do you take a tub bath or shower?"

A nurse is reviewing the medication administration records from the previous shift. Which of the following findings should indicate to the nurse a need for an incident report?

A client received a crushed bupropion XL tablet mixed with applesauce

A nurse has received morning report on the following four clients. Which of the following clients should the nurse assess first?

A client who was administered glipizide for type 2 diabetes mellitus and has a blood glucose of 68 mg/dL

The RN must delegate care of an assigned client to a CNA for the shift. Which client would be best to delegate to the CNA?

A client who was transferred from the ccu 3 days ago and is ambulatory.

A nurse manager is reviewing the admission history of four adults who were admitted to the medical-surgical unit during the shift. Which of the following situations is the nurse required to disclose information to an outside agency about the client or the client's circumstances?

A dependent adult admitted for the treatment of a spiral fracture

A nurse is triaging clients in an urgent care clinic. Which of the following clients should the nurse have the provider care for immediately?

A middle adult male who is diaphoretic and reports epigastric pain

Who is a key stakeholder that is a critical part of the informatics team when attempting to implement an electronic documentation system?

A super user who is a shift expert

Which of the following indicates safe delegation?

A unit manager agrees to release a staff her unit to Unit B.The staff member she agrees to release is experienced on Unit B and is agreeable to the change. The unit manager's unit is fully staffed and patients are stable.

The unit is shifting from primary nursing to a team model in an effort to contain costs. Staff members are angry and ask for a meeting to discuss the change. After hearing their concerns related to reduction in professional autonomy and care quality, yo

Acknowledge the loss

Team members are becoming disillusioned with the group performance. The team leader is seeking a method to get members engaged.Which option would help to promote engagement among team members?

Agenda should be sent out to team members prior to the meeting of the team

In the past year, you have noticed an increase in patient falls on your unit. In reading studies related to staffing and patient outcomes, you realized that you will need to plan for:

An increased number of RN positions

The RN is caring for a client diagnosed with full thickness burn over the right lower extremity. Which task should the RN delegate to the UAP?

Ask the UAP to cleanse the client's dentures and place in a container.

A charge nurse is delegating tasks to nursing personnel on a 10-bed medical-surgical nursing unit. Which of the following assignments is an example of over-delegation?

Assigning the most efficient AP to perform glucometer monitoring for each client

A nurse requests a schedule change due to a family issue. The nurse manager states, "You cannot change the schedule without going through the staffing office" The NM is demonstrating what type of leadership style?

Autocratic

Nursing management observes team members picking up assignments from others in order to complete the designated task. How would the nurse manager categorize this action?

Backup behavior

A nurse is teaching a class on torts. The nurse should instruct the class that administering an antibiotic medication to a competent client after the client has refused it is an example of which of the following torts?

Battery

The nurse is caring for a patient that has limited vision. Which ethical principle is the nurse upholding by ensuring that there are no obstacles present between the patient's bed and the bathroom?

Beneficence

A new nurse witnesses an experienced nurse documenting an assessment on a patient-controlled analgesia (PCA) pump incorrectly on the computerized flow sheet. Which of the following should the new nurse do?

Bring to the nurse's attention that she is charting incorrectly and offer to demonstrate proper charting on the flow sheet

The most appropriate person to ask to place the leads back on the patient in 6D who is being monitored is:

CNA

The RN is utilizing the QSEN competencies to ensure quality of care for patients on a busy surgical unit. Which elements of the QSEN competency of teamwork and collaboration is essential to ensure implementation?

Care coordination

In which of the following situations would you, as the head nurse, be concerned about potential safety issues?

Carla, RN, has just ended a relationship with Jake, RN, and he will not leave her alone. You are meeting with Jake today because colleagues on nights have reported that Jake seems to have been intoxicated last night and the previous night.

. A unit manager watches a new RN graduate interacting with a patient. When the RN comes out of the room, the unit manager says, "I don't know what they taught you in your nursing program, but if I see you do that again, I will write you up." This example demonstrates:

Coercive use of power

The unit manager on the vascular unit is planning a change in the way post mortem care is provided. Which is the first step in the change of process?

Collect data

A nurse is caring for a client that is preoperative. The nurse signs as a witness on the client's consent form. The nurse's signature on the consent form indicates which of the following?

Confirms the client appears competent to provide consent

A holistic nursing leader has multiple responsibilities on any given day. To prepare for delivering quality patient care, the nurse must first:

Consider self care needs.

A nurse is admitting a client who has a wound infected with vancomycin-resistant enterococci (VRE). Which of the following types of precautions should the nurse plan to initiate?

Contact

A nurse is having difficulty reading the provider's writing when transcribing a prescription for a client's medication. Which of the following actions should the nurse take?

Contact the provider to clarify the prescription

A charge nurse allows two nurses who are arguing about who gets to go to lunch first to go together. The charge nurse agrees to take care of both of the nurses' clients while they are at lunch. The charge nurse is demonstrating which of the following types of conflict management?

Cooperating

. A nursing instructor is teaching a class on conflict resolution. She relates to the class that conflict in an organization is important, and that an optimal level of conflict will do the following: Generate:

Creativity, a problem-solving atmosphere, a strong team spirit, and motivation for its workers

At the beginning of the shift, an RN is preparing assignments for a licensed practical nurse (LPN) and an assistive personnel (AP). Which of the following tasks should the nurse assign to the LPN?

D. Inserting a nasogastric tube for a client

. A nurse requests a schedule change due to a family issue. The nurse manager states, "If you cannot come in, we will figure it out." The NM is demonstrating what type of leadership style?

Democratic

The nurse is aware that what leadership responsibilities are important to all nurses? **Select all that apply.

Developing delegation skills Maintaining effective working relationships

A nurse is participating in a biological disaster simulation where citizens are exposed to pneumonic plague. Which of the following isolation precautions should the nurse plan to use while caring for these clients?

Droplet

Which rules should be incorporated by nurse managers and leaders in order to maintain synergy when working with team development? (select all that apply)

Each member of the team should be able to state the intended purpose of the team , Team members should share objective feedback,Team members are encouraged by leadership to share ideas

Which task should the RN delegate to the UAP

Empty the Jackson Pratt Drain and record the amount

A new graduate RN joins your unit. After a few weeks, she complains about some of her peers on the unit and compares their practices negatively to what she learned in her nursing program. She also is vocal about how she has learned so much here that she did not in her program. She is best described as:

Experiencing cultural marginality

A nurse is caring for a client who is scheduled to have surgery. In preparing the client for surgery, which of the following actions is considered outside the nurse's responsibilites?

Explaining the operative procedure, risks, and benefits

During orientation of new nurse managers, the chief nursing officer stresses strategies that help nurse managers to achieve a powerful image. Which groups of behaviors best contribute to a powerful image for the nurse manager?

Greeting patients, families, and colleagues with a handshake and a smile; listening carefully when problems arise

The nurse leader is referencing the American Nurses Association nursing-sensitive quality indicators and knows that structure indicators include which element?

Hours of nursing care per patient

A nurse manager has recently become aware of a conflict between the pharmacy and the staff nurses regarding sending and receiving medications. Which of the following actions should the nurse take first to resolve the conflict?

Identify the problem

As the unit manager on the unit that is leading changes in heparin locks, you find that Elizabeth is very valuable in terms of her observation about other units and her knowledge of organization processes, and now in discussing the new procedure with others. Elizabeth might be considered an:

Informal change agent

The client is admitted to the ER with a third degree burn over the front legs. Which priority intervention should the RN implement?

Insert two large bore IV access routes.

The client is admitted to the ED with a third degree burn over the front of both legs, which is priority intervention should the nurse implement 1st?

Insert two large-bore IV access routes

The RN and the UAP enter the client's room and discover the client is unresponsive. Which action, according to the AHA guidelines, should the RN assign to the UAP first?

Instruct the UAP to get the crash cart

In a hospital setting, there appears to be conflict between two nurses, one who works in the emergency department and the other who works in the operating room. What type of conflict could be applied to this situation?

Interpersonal

Clinical incompetence is one of the more serious problems facing a nurse manager. Joyce, the nurse manager, is not aware of the problems of Sarah, a novice nurse. After she investigates, it is obvious that Sarah's peers are covering for her. Which of the following might Joyce include in her meeting with the nurses? (select all that apply)

Is is a nurses professional responsibility to maintain quality control , All instances of clinical incompetence are to be reported, It is not considered being disloyal when one nurse reports another for poor care, Patient care is the number one concern. Meeting standards is mandatory and necessary.

Nurses at all levels of an acute care facility are preparing for a Joint Commission accreditation is necessary for what reason?

It guarantees that the organization has met Medicare certification standards

Clinical incompetence is one of the more serious problems facing a nurse manager. Joyce, the nurse manager, is not aware of the problems of Sarah, a novice nurse. After she investigates, it is obvious that Sarah's peers are covering for her. Which of the following might Joyce include in her meeting with the nurses? (select all that apply)

It is a nurse's professional responsibility to maintain quality control All instances of clinical incompetence are to be reported It is not considered being disloyal when one nurse reports another for poor care Patient care is the number one concern. Meeting standards is mandatory and necessary.

All nurses are leaders in patient health care primarily because they:

Know the patient the best

A nurse requests a schedule change due to a family issue. The nurse manager states, "Find someone to switch with you." The NM is demonstrating what type of leadership style?

Laissez-faire

The nurse administrator is aware that the 1984 death of a college student from a drug-drug interaction resulted in what standard of medical care?

Limitation to the number of hours a resident in training may work

Which action by a nurse manager would be viewed as a barrier to change in the clinical setting?

Limiting communication among members of staff

10. The nurse manager knows that what is the most important focus of a culture of safety?

Looking at the reason for an error

As a new leader in a 40-bed step down unit, Jane desires to make an impact on the nurses, patients and families. In order to survive and thrive as a leader, she knows that she must do which of the following? (Select all)

Maintain a positive attitude, Listen to constituents, Maintain balance, Generate self-motivation, Build self-confidence

Which statement is inaccurate with regard to leading and managing teams?

Management personnel must assume team leadership positions

What theme do most definitions of critical thinking have in common?

Most critical thinking methods are both systematic and logical in nature

A client smoking in his bathroom has dropped a cigarette butt into a wastepaper basket, which begins to smolder. Which of the following actions is the nurse's priority?

Move any clients in the immediate vicinity

A nurse enters a client's room and finds a fire has started. Number the following actions in the appropriate sequence that the nurse should follow.

Move the patient away from the fire, Activate the fire alarm, Shut the doors on the unit, and Extinguish the fire

The nurse manager is working to establish a culture of safety and knows that which element is the most important factor to its establishment?

No punishment is involved for reporting.

The nurse manager observes that the nursing staff on the unit who had previously undertaken the task of reviewing electronic documentation is not actively engaged in the process. Which part of the team development process is represented by the observations?

Norming

The female client diagnosed with pancreatic cancer has an advanced directive (AD) stipulating no CPR. Which intervention should Ms. Kathy implement first?

Notify the HCP about the AD

Which action would contribute to nurse fatigue in a staff nurse who is working a 12-hour shift on a medical unit and who has been assigned to take care of the five patients based on a primary care model?

Nurse eats lunch meal at the nurse's station while answering unit phone

According to the Institute of Medicine, which health care profession has been directly linked to patient safety?

Nurses

A group of nurses are working on an obstetrical unit and are discussing how the Nurses' Bill of Rights can be incorporated into the day-to-day operations of the nursing unit. Which suggestion could be implemented that would reflect compliance?

Nurses act as patient advocates

A nurse on a medical-surgical unit is planning to delegate tasks to an adult volunteer. Which of the following tasks should the charge nurse avoid assigning to the volunteer

Observing a postoperative client who is confused.

The primary nurse in the critical care respiratory unit is very busy. Which nursing task should be the nurse's priority?

Obtain a tracheostomy tray for a client exhibiting air hunger

A nurse is working with an interdisciplinary disaster committee to develop a community-wide emergency response plan in the event of a non-biological or chemical incident. The nurse should include which of the following agencies to be notified immediately after calling 911?

Office of Emergency Management (OEM)

A nurse manager notices that Nathan, an RN who has been on the unit for approximately 3 years, has a particular interest in technology and seems to be very enthusiastic about working with software and hardware at home. She speaks with Nathan and asks him if he would lead investigation of software applications on the unit. This is an example of:

Opportunity

The 8 year old client diagnosed with vaso-occlusive sickle cell crisis is complaining of a severe headache. Which intervention should the RN implement first?

Orient the parents and child to the room

Which of the following outlines the rights of individuals in health care settings?

Patient Care Partnership

Upon admission, a patient is given a copy of the rights of all patients and that health-care facility's policy and procedures to protect these rights. When asked by the patient the reason for this paperwork, the nurse replies that it is required by what governmental legislation?

Patient Self-Determination Act

A group of staff nurses are dissatisfied with the new ideas presented by the newly hired nurse manager. The staff wants to keep their old procedures, and they resist the changes. Conflict arises from:

Perceptions of incompatibility

The culture of blame and punishment or errors tends to encourage a culture of:

Perfectionism

A medical-surgical unit has added three new RN's to their night shift. Based on Brenner's novice to expert model and observations from the National Council of State Board of Nursing (NCSBN), what would the nurse manager expect to see from these new graduates nurses as they begin their orientation on the nursing unit?

Performance at a novice and/or advanced beginner level

A nurse is caring for a client who has an infection. The nurse should use which of the following strategies to prevent the transmission of the client's infection?

Performing hand hygiene before, during, and after direct contact with the client

The matriarch of a family died on the vascular unit. The family tells the nurse the daughter is coming from a nearby city to see the body. Which intervention should the nurse implement?

Plan to allow the daughter to see the client in the room

The RN is preparing to ambulate the client with full-thickness burns on the lower extremities down the hall. Which priority intervention should the RN implement?

Put a gait belt around the client's waist.

A nurse is planning care for a 4-year old child who requires airborne precautions. Which of the following activities should the nurse plan for the child?

Putting a large puzzle together

A nurse in an emergency department receives report from an emergency responder who states a client is being transported following exposure to a "dirty bomb." The nurse should prepare to care for a client that has been exposed to which of the following types of agent?

Radiologic

A home health nurse is assessing the safety of a client's home. Which of the following factors may increase the client's risk for falls? (Select all that apply).

Reduced vision- Impaired memory- House slippers- Kyphosis- HX of Falls

The RN is caring for clients on a vascular unit. Which nursing task is most appropriate to delegate to the UAP?

Request the UAP to elevate the feet of the client who has chronic venous insufficiency

The RN is preparing for an initial visit to a client diagnosed with CHF. Which intervention should the RN implement first?

Review the client's referral form/pertinent data.

You are part of a multidisciplinary team that is charged with designing a workplace safety plan for your healthcare organization. This team has been established in response to increases in reports of violence and aggression. You begin by:

Surveying staff about levels of satisfaction with the workplace and management, collegial, and patient relations

A nurse has several tasks to delegate to an assistive personnel (AP). Which of the following tasks should the nurse ask the AP to perform first?

Take an arterial blood gas (ABG) specimen to the laboratory.

The RN is caring for a client 1 day post op sigmoid resection. There is a large amount of bright red blood on the dressing. Which intervention should the RN implement first?

Take no action because this is an appropriate delegation

An example of a care activity that would likely not be delegated by an RN to a UNP is (select all that apply)

Teaching self-catheterization to a patient with paraplegia who has limited English, Basic care for a patient with a head injury who is rapidly deteriorating ,Assessment of patients being admitted through the emergency department

A nurse manager is known to use an autocratic style of management. The nurses who work for this nurse manager know that this style of management leads to what possible result?

Team members may become demoralized because of the management style.

A key advantage that a nurse has in terms of delegating is that:

Team skills can be used more effectively

A key advantage that a nurse manager has in terms of delegating is that:

Team skills can be used more effectively

When planning delegation of tasks to assistive personnel (AP), a nurse considers the five rights of delegation. Which of the following should the nurse consider when using one of the five rights of delegation

The AP has the knowledge and skill to perform the task

Which situation would constitute an example of "bullying", in the nursing environment?

The UAP on the unit continues to make jokes about another staff member in the presence of others as well as when alone in the staff member's presence

A nurse is planning to use the SBAR communication tool when calling a provider. Which of the following statements should the nurse include in the B step?

The client was found unconscious on the floor in her home

Which client requires the immediate attention of the intensive care nurse

The client with acute respiratory distress syndrome (ARDS) who is having difficulty breathing

The RN and LPN are caring or a group of clients. Which information provided by the LPN warrants immediate attention by the RN

The client with biological response modifier who has a T: 99.2 P 68 RR 24 BP 176/96

Ms. Bonner is caring for clients on the burn unit. After the shift report which client should Ms. Bonner assess first?

The client with full thickness burns on the chest who is having trouble breathing

The clinic nurse is reviewing lab results for clients seen in the clinic. Which client requires additional assessment by the RN?

The client with hemoglobin of 9 g/dL and hematocrit of 29%

A nurse finds that a client did not receive a scheduled dose of Furosemide (Lasix). Which of the following should the nurse include in the incident/variance report? (Select all that apply)

The client's vital signs- The time the client was to receive the medication- The date of the incident

The nurse is sharing information received during a patient interview with different health-care providers. In which of these interactions does the nurse breach the patient's confidentiality?

The nurse discusses the patient's marital difficulties with nurse's from another unit

5. The nurse manager is aware that which incident would be classified as a sentinel event?

The patient receives a second-degree burn from a malfunction in a hypothermia blanket

A group of nursing students are discussing how staffing affects patient safety. Which nursing student comment if observed by the nursing instructor would warrant intervention?

There is little evidence to support that adequate staffing leads to improved patient outcomes.

Which action supported by current research contributes to the existence of workplace violence in the clinical setting?

There is no support from administration

A nurse requests a schedule change due to a family issue. The nurse manager states, "Let's develop a system to be proactive for all the staff when things like this happen." The NM is demonstrating what type of leadership style?

Transformational

In 2003, the IOM published a report emphasizing competencies of health care professionals. Which of the following is (are) integral to promoting a safe health care environment? (select all that apply) :

Utilize informatics, Provide patient-centered care, Work in interdisciplinary teams, Employ evidence-based practices, Apply quality improvement

During staff meetings, you make it a regular practice to encourage shared problem solving and to recognize those who go to beyond basic roles and responsibilities to contribute to a positive team environment and to quality patient care. This practice exemplifies:

Values-based management

While caring for a client, the nurse experiences a needle stick injury. Which of the following actions should the nurse take first?

Wash the site of injury with soap and water

A nurse is admitting a client who requires droplet precautions due to influenza. Which of the following actions should the nurse take?

Wear a mask when providing care to the client

A unit manager of a 25-bed medical/surgical area receives a phone call from a nurse who has called in sick five times in the past month. He tells the manager that he very much wants to come to work when scheduled but must often care for his wife, who is undergoing treatment for breast cancer. According to Maslow's need hierarchy theory, what would be the best approach to satisfying the needs of this nurse, other staff, and patients?

Work with the nurse, staffing office, and other nurses to arrange his scheduled days off around his wife's treatments.

You overhear a newly graduated RN telling one of your colleagues that leadership and management belong to the unit manager and not to her. As a nursing colleague, you respond by demonstrating understanding that the perception of the new graduate:

Would benefit from further understanding of her role as a professional, whose influence may affect the decision making of patients, colleagues, and other professionals.

A nurse is reviewing information about the Health Insurance Portability and Accountability Act (HIPAA) with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates a need for further teaching?

a. "Information about a client can be disclosed to family members at any time."

What task should be delegated to the CNA?

b. Clean up the patient (ESRD) in 6G who was incontinent

Which task should Beyonce NOT delegate to the CNA?

b. Explain the side effects of gentamycin to the patient in 6A

Which task should the RN assign to the CNA during a code?

cardiac compressions