PRACTICE MIDTERM - HESI Leadership

Arrange the principles of time management in order. 1. Evaluation 2. Priority setting 3. Goal setting 4. Interruption control 5. Time analysis

1. Goal setting 2. Time analysis 3. Priority setting 4. Interruption control 5. Evaluation rationale: The first step of time management is setting goals. The second step is analyzing the time needed to complete the goal. The third step is to set priorities. The fourth step is interruption control. The last step is evaluation.

A nurse works for a facility that does not have a formal mechanism to allow input into organizational decision making. Which statement would a nurse in this setting make? Select all that apply. One, some, or all responses may be correct. a. "My supervisor does not know how things get done." b. "What would they do if I quit my job right now?" c. "My organization does not value me." d. "My organization is providing cultural competency care." e. "My organization also hires unlicensed assistive personnel (UAP)."

a. "My supervisor does not know how things get done." b. "What would they do if I quit my job right now?" c. "My organization does not value me." rationale: A nurse who works in an organization that has no formalized mechanism for nurse input into organizational decision making can find informal avenues for influence. Asking thought-provoking questions such as "What would they will do if I quit my job right now?" and having informal discussions based on the statement. "My supervisor does not know how things get done" are ways to informally create influence. Discussion over the value of employees is often seen in organizations without mechanisms for employee input. The statement "My organization is providing cultural competency care" does not involve informal discussion. The organization can hire UAP; this does not indicate failure in implementing a formalized mechanism for nurse input into organizational decision making.

Which statement made by the nurse indicates understanding of the style of a transactional leader? a. "Team members are penalized for poor performance." b. "Employees are motivated by articulating an inspirational vision." c. "Employees are encouraged to transcend their own self-interests." d. "Team members are challenged to find new solutions to old problems."

a. "Team members are penalized for poor performance." rationale: A transactional leader is responsible for penalizing a nurse for poor performance. This type of leader influences followers to fulfill their contracts or get penalized. Motivating employees by articulating an inspirational vision is the behavior of a transformational leader. Encouraging employees to transcend their own self-interests to increase job satisfaction is the behavior of a transformational leader. Challenging the process that involves new solutions to old problems is the behavior of a transformational leader.

Which example, mentioned by the nurse, belongs to the third level of needs in Maslow's hierarchy of needs? Select all that apply. One, some, or all responses may be correct. a. "The client verbalizes being depressed because their spouse has passed away." b. "A client complains of constipation due to excess loss of fluids from the body." c. "Attempts to reconnect with old friends are made by the client after being diagnosed with cancer." d. "The client is forced to live in a rat-infested apartment due to lack of financial resources." e. "Family gatherings are avoided because the client is not accepted by family members."

a. "The client verbalizes being depressed because their spouse has passed away." c. "Attempts to reconnect with old friends are made by the client after being diagnosed with cancer." e. "Family gatherings are avoided because the client is not accepted by family members." rationale: According to Maslow's hierarchy of needs, the third level of needs is love and belonging. This includes friendship, social relationships, sexual love, and so on. If the client is depressed due to the death of the spouse, this is an example of the third level of needs not being met. If the client feels the urge to reconnect with old friends after being diagnosed with a terminal illness, the client is in need of emotional support and love. If the client refuses to retain social relationships with family members, this is an example of a failure to meet love and belonging needs. If the client is losing body fluids leading to constipation, this indicates a deficit in the first level of needs, which are physiologic. If the client lives in a rat-infested apartment, there is an increased risk for infections and disease, which indicates a lack of physical safety, and this is an example of the second level of needs not being met.

Which statement by a nurse reflects an understanding of advocacy for clients with heart disease? Select all that apply. One, some, or all responses may be correct. a. "There are grassroots networks to provide input on tobacco regulation." b. "Promoting healthier food options in our hospital's cafeteria is a form of advocacy." c. "It is important to advocate for the protection of federal support of heart disease research." d. "To advocate for our clients with heart disease, I am forming a committee to petition for a pedestrian trail." e. "To advocate for the uninsured and underinsured people in our community, I would like us to provide free lipid and glucose screenings twice a year."

a. "There are grassroots networks to provide input on tobacco regulation." b. "Promoting healthier food options in our hospital's cafeteria is a form of advocacy." c. "It is important to advocate for the protection of federal support of heart disease research." d. "To advocate for our clients with heart disease, I am forming a committee to petition for a pedestrian trail." e. "To advocate for the uninsured and underinsured people in our community, I would like us to provide free lipid and glucose screenings twice a year." rationale: All of these plans are advocating for clients with heart disease. Joining grassroots tobacco coalitions, promoting healthier cafeteria choices, advocating for the National Institutes of Health (NIH) and other organizations to maintain and increase research, creating safe places to promote physical activity in the community, and providing free screenings and education are all excellent ways to promote the well-being of the population.

Which statement is accurate regarding the funds allocated to health departments for personal health services provided by local, state, and federal governments? Select all that apply. One, some, or all responses may be correct. a. "They provide care for newborns." b. "The money supports care for clients with pneumonia." c. "The funds provide care for clients with dengue." d. "Money is used to care for clients with tuberculosis." e. "This allocation of funds cares for children with birth defects."

a. "They provide care for newborns." d. "Money is used to care for clients with tuberculosis." e. "This allocation of funds cares for children with birth defects." rationale: The funds provided by local, state, and federal governments for personal health services include care for newborns, care for communicable diseases such as tuberculosis, and care for children with birth defects. Care for pneumonia and dengue are not included in the funds for personal health services.

While providing feedback to staff, the nurse leader warns an employee that he or she needs to improve performance. Which leadership style is the nurse leader using? a. Autocratic b. Situational c. Democratic d. Laissez-faireAutocratic

a. Autocratic rationale: An autocratic leader stresses prompt and orderly performance. This type of leadership puts pressure on employees who fail to adhere to expectations. Situational leadership provides flexibility to the manager in adapting to the needs of the work group. A democratic leader does not pressure employees; instead, he or she allows employees more control and individual participation in decision-making. A laissez-faire leader avoids responsibility and delegates all decision-making to the group.

Which type of leadership is reflected when a nurse delegates tasks to a rescue team caring for a group of clients who survived an earthquake? a. Autocratic b. Situational c. Democratic d. Laissez-faire

a. Autocratic rationale: During autocratic leadership, the leader retains authority and responsibility. An autocratic leader places little trust and confidence in others during a natural disaster. Situational leadership requires flexibility on the part of the manager in adapting to the needs of the work group. Democratic leadership involves treating every staff member equally; this type of leadership is not appropriate in a crisis situation. Laissez-faire leadership involves delegating decision-making to the group.

After a train accident, severely injured clients are sent in large masses to the emergency department. A nurse leader prepares the staff for care of the trauma victims. Which type of leadership would be most beneficial in this situation? a. Autocratic b. Situational c. Permissive d. Democratic

a. Autocratic rationale: In an autocratic leadership, the leader retains all authority and responsibility and is primarily concerned with the tasks and goal accomplishment. This style of leadership is important in emergency situations in which immediate decisions are required and there is not enough time for group decisions. Situational leadership is a comprehensive approach to the issue of management that takes into account the style of the leader, the group being managed, and the situation at hand. In permissive leadership, the leader completely relinquishes control and chooses to avoid responsibility by delegating all decision making to the group. Therefore, it would be inappropriate in managing the care of the clients. Democratic leadership is a people-centered approach that emphasizes team building and collaboration through the joint effort of all team members.

Which leadership approach is most beneficial while managing a cardiac arrest situation? a. Autocratic leadership d. Situational leadership c. Democratic leadership d. Laissez-faire leadership

a. Autocratic leadership rationale: An autocratic leader makes all the decisions without a team discussion. In times of crisis such as a cardiac arrest, autocratic leadership behavior is suitable. The time it takes the leader to make decisions in situational leadership, democratic leadership, and laissez-faire leadership would be too long in these situations.

Which goal would a nurse who is in the role of community opinion leader have? a. Building a society that treats men and women equally b. Following new innovations in the organization effectively c. Providing culturally competent care to clients effectively d. Conducting research on diseases that do not have treatment

a. Building a society that treats men and women equally rationale: The community opinion leaders, in partnership with others, can build a more just society. Therefore, the statement indicating building a society that treats men and women equally makes the nurse a community opinion leader. Following new innovations in the organization, providing culturally competent care, and conducting research on diseases to find treatments indicate the role of a nurse, not a community opinion leader.

Which role can assume responsibility for the nurse when the nurse takes a break? a. Charge nurse b. Chief nursing officer c. Health care provider d. Licensed practical nurse (LPN)

a. Charge nurse rationale: The charge nurses have knowledge and expertise in critical thinking, clinical practice, leadership, and communication; therefore, the charge nurse can assume the duties when the registered nurse (RN) goes for a break. Chief nursing officers are accountable for establishing systems to communicate competency requirements related to delegation. Health care providers may delegate and assign tasks for unlicensed nursing personnel (UNPs). LPN are not eligible for delegation; the LPNs are delegatees.

Which member of the healthcare team is suitable to manage the care of a client who has a brain injury and skull fracture? Select all that apply. One, some, or all responses may be correct. a. Charge nurse b. Chief nursing officer c. Licensed practical nurse d. Newly hired registered nurse e. Unlicensed nursing professional

a. Charge nurse d. Newly hired registered nurse rationale: The education and scope of practice of the charge nurse and the newly hired registered nurse allows them knowledge and skills to manage the nursing care of a critically ill client. The chief nursing officer would not be suitable to take on the task due to other responsibilities within the role. The licensed practical nurse and the unlicensed nursing personnel have not been provided the knowledge and skills to care for a critically ill client.

Which factor would be considered when delegating a task to the licensed practical nurse (LPN)? Select all that apply. One, some, or all responses may be correct. a. Client's condition b. Complexity of the task c. Number of LPNs available d. Predictability of outcomes e. Relationship status between the delegatee and delegator

a. Client's condition b. Complexity of the task d. Predictability of outcomes rationale: The decisions for delegation should be based on multiple factors such as the client's condition, complexity of the task, and predictability of outcomes. The number of LPNs may not be important information while assigning the tasks. Relationship status between the delegatee and the delegator is not an important consideration for delegating a task to the LPN effectively.

Which action of the nurse indicates effective implementation of the rules of leaders in the profession? Select all that apply. One, some, or all responses may be correct. a. Communicating in a simple language with followers b. Giving a chance to the followers to express their views c. Instructing followers to decide the actions to be performed d. Avoiding communicating the clear boundaries with followers e. Ensuring proper eye contact while communicating with followers

a. Communicating in a simple language with followers b. Giving a chance to the followers to express their views e. Ensuring proper eye contact while communicating with followers rationale: An effective leader should use the simplest and fastest method to communicate with followers. An effective leader should give a chance to the followers to express their views, as followers have many questions to ask. Proper eye contact ensures effective communication; therefore, an effective leader should maintain proper eye contact while communicating with followers. An effective leader should use critical thinking to decide the actions to be performed but should not instruct the followers. An effective leader should communicate clear boundaries with followers.

Which skill would be essential for an effective nurse manager to develop and improve collaboration with others? Select all that apply. One, some, or all responses may be correct. a. Flexibility b. Reacting hastily c. Showing frustration d. Ability to listen to others e. Ability to share information and ideas

a. Flexibility d. Ability to listen to others e. Ability to share information and ideas rationale: To collaborate effectively, the nurse should be flexible, must be willing to listen to others, and must share information and ideas with others. The nurse manager should plan a thoughtful response, consider others' perspective first, and not react hastily. The nurse manager should not share his or her anger or frustration with other staff.

Which quality would a nurse who is promoted to leader of a unit possess? Select all that apply. One, some, or all responses may be correct. a. Having adaptability to hospital rules b. Encouraging the newly appointed nurses c. Penalizing the nurses for poor performance d. Doubting the health care staff performance e. Being aware about the events of organization f. Collaborating with the staff for decision making

a. Having adaptability to hospital rules b. Encouraging the newly appointed nurses e. Being aware about the events of organization f. Collaborating with the staff for decision making rationale: As a leader, the nurse would be able to adapt to the rules of the hospital to perform accordingly. A nurse leader would motivate or encourage the newly appointed staff to reach the desired goals. A nurse leader would also be aware of any organization events; this helps in managing the team effectively. Collaboration with the staff and allowing them to participate in decision making helps reduce medical errors and improves job satisfaction. Penalizing the nurses for poor performance is the duty of the nurse manager. Incredulity or doubting the staff performance may reduce job satisfaction instead of motivating nurses to improve their performance.

The managerial team decides to promote a nurse to a managerial position after the nurse performs exceedingly well on a project. Which action by the nurse would justify the decision of the panel? Select all that apply. One, some, or all responses may be correct. a. Inspiring new ideas b. Establishing short-term goals c. Demonstrating positive feelings d. Maximizing results from existing resources e. Showing willingness to both lead and follow peers

a. Inspiring new ideas b. Establishing short-term goals c. Demonstrating positive feelings d. Maximizing results from existing resources rationale: The leader provides new ideas with a long-term effect on the progress of the organization. He or she should also provide a positive atmosphere by giving an equal importance to the followers. Providing short-term goals and maximizing results from existing resources are the job responsibilities of a manager. The willingness to lead and follow peers is the quality of a good follower.

A health care facility expects their nurse leaders to understand and choose the appropriate leadership style that fits situations they will encounter with their staff. Which situation most needs an autocratic leader? a. Managing staff during an emergency procedure b. Discussing unit issues at a monthly staff meeting c. Evaluating staff for proper use of policies and procedures d. Persuading staff to participate in a hospital fundraiser

a. Managing staff during an emergency procedure rationale: Autocratic leadership is best suited for emergency situations where immediate decisions are required and there is not enough time for group decisions. Therefore, this leadership style is best. Autocratic leadership is not appropriate when discussing unit issues because it may alienate the staff. A democratic style would be most appropriate. Autocratic leadership is least appropriate for evaluating the proper use of policies and procedures by staff members. Democratic-style leadership is more appropriate when attempting to persuade.

How would the nurse advocate as a community health leader in helping a city commission decide on whether to convert a community park to a museum site? a. Oppose building the museum. b. Suggest a layout for building a museum. c. Raise funds from community members. d. Contribute to a budget plan for the project.

a. Oppose building the museum. rationale: As a community opinion leader, the nurse would help build a more peaceful and healthful society. Building a museum in the place of a community park may affect public health by reducing green space. The nurse as a community leader would not suggest a layout for building a museum in place of a community park as it affects the health of society. The nurse would not be involved in collecting funds from the community members to build a museum as it does not help maintain a healthful society. The nurse as a community opinion leader would oppose the building of a museum in place of the community park and would not contribute to a budget plan.

Which client care assignment can be delegated to the unlicensed nursing personnel on a medical-surgical unit? Select all that apply. One, some, or all responses may be correct. a. Performing a bed bath for a client on bed rest b. Evaluating the effectiveness of acetaminophen and codeine c. Obtaining an apical pulse rate before oral digoxin is administered d. Assisting a client who has patient-controlled analgesia (PCA) to the bathroom e. Assessing the wound integrity of a client recovering from an abdominal laparotomy

a. Performing a bed bath for a client on bed rest d. Assisting a client who has patient-controlled analgesia (PCA) to the bathroom rationale: Performing a bed bath for a client on bed rest is within the scope of practice of an unlicensed nursing personnel. Assisting a client who has PCA to the bathroom does not require professional nursing judgment and is within the job description of the unlicensed nursing personnel. Evaluating human responses to medications requires the expertise of a licensed professional nurse. Obtaining an apical pulse rate requires a professional nursing judgment to determine whether or not the medication should be administered. Assessing a surgical wound requires the expertise of a licensed professional nurse.

Which responsibility of the nurse manager differs from the responsibilities of a nurse leader? a. Planning the budget b. Motivating the team c. Resolving conflicts d. Penalizing for poor performance

a. Planning the budget rationale: Budgeting is the responsibility of a nurse manager. The role of a nurse leader is to motivate the nursingsubordinates. Resolving conflicts is the responsibility of both the nurse leader and the nurse manager. Penalizing for poor performance is a behavior of transactional leadership.

Which action about documenting and transcribing prescriptions indicates a need for further teaching? a. Processing the stat prescription last to avoid confusion b. Reading through all prescriptions before transcribing them c. Checking computer entry prescriptions with the intended order d. Reading back the verbal prescriptions and then documenting the details

a. Processing the stat prescription last to avoid confusion rationale: A stat prescription usually contains a single dose of medication to be administered immediately. Therefore, the nurse would process a stat prescription first. The nurse would read all prescriptions before transcribing them to avoid confusion. The nurse would check whether the computer entry prescriptions correspond correctly to the intended chart. If the nurse takes a verbal prescription, he or she would write down the prescription on the prescription sheet first. Then the nurse would read the prescription back for confirmation of the details and document the conversation for further verification.

Which nursing intervention would benefit the nurse who is addicted to alcohol? Select all that apply. One, some, or all responses may be correct. a. Referring the nurse to a rehabilitation center b. Suggesting that the nurse look into altruistic egoism and choice c. Encouraging the nurse to actively indulge in job-related responsibilities d. Seeking immediate support from a formal nursing peer assistance program e. Providing the same care and support to the nurse as one would give to clients with substance abuse issues

a. Referring the nurse to a rehabilitation center d. Seeking immediate support from a formal nursing peer assistance program e. Providing the same care and support to the nurse as one would give to clients with substance abuse issues rationale: A nurse who is addicted to alcohol may be chemically impaired. This nurse would be referred to a rehabilitation center for voluntary treatment. To save the career and life of the nurse, a formal nursing peer assistance program would be contacted immediately about the condition. The same care and support that would be provided to clients with substance abuse issues would also be given to the nurse. Altruistic egoism and choice help prevent burnout, but they may not help the nurse to control his or her alcohol abuse. A person with alcohol abuse problems may not be in a condition to deal or cope with job-related responsibilities actively.

Which prescription for a child with a tentative diagnosis of Wilms tumor would the nurse question? a. Renal biopsy b. Abdominal ultrasound c. Computed tomography scan d. Magnetic resonance imaging

a. Renal biopsy rationale: A renal biopsy is an invasive procedure. In the early stages, Wilms tumor is encapsulated. Any disruption of the tumor capsule may precipitate metastasis. Magnetic resonance imaging, computed tomography, and abdominal ultrasound are all helpful in making the diagnosis.

Which action on the part of the nurse constitutes transactional leadership? a. Rewarding the licensed practical nurse for high performance b. Encouraging innovative thinking by the licensed practical nurse c. Encouraging the licensed practical nurse to transcend self-interest d. Motivating the licensed practical nurse by articulating an inspirational vision

a. Rewarding the licensed practical nurse for high performance rationale: Transactional leadership depends on the power of organizational position and formal authority to reward and punish performance. Therefore rewarding the licensed practical nurse for high performance indicates transactional leadership. Encouraging innovative thinking in the licensed practical nurse is transformational leadership. Encouraging the licensed practical nurse to transcend self-interest is also transformational leadership. Motivating the licensed practical nurse by articulating an inspirational vision is transformational leadership as well.

A client reports to the nurse, "I am unable to face my family and friends because of guilt and embarrassment." According to Maslow's hierarchy, which need does the nurse suspect the client has? a. Self-esteem b. Self-actualization c. Safety and security d. Love and belonging

a. Self-esteem rationale: A loss of self-respect, self-confidence, and self-worth indicates low self-esteem. The statement, "I am unable to face my family and friends because of guilt and embarrassment" shows that the client has low self-esteem. Therefore, according to Maslow's hierarchy, the nurse would provide self-esteem support to the client. The self-actualization need includes the full use of individual talents. The safety and security need includes providing the client with stability, protection, security, and freedom from fear and anxiety. The love and belonging need includes affection and acceptance by peers and community.

Which answer would the potential nurse manager give to the interview question, "How will you develop political skills in your team?" Select all that apply. One, some, or all responses may be correct. a. "Teaching them to be honest." b. "Encouraging their participation in Nurse Lobby Day." c. "Assisting them to be comfortable with conflict and ambiguity." d. "Developing their ability to take constructive criticism gracefully." e. "Encouraging their active memberships in the state nurses' association."

b. "Encouraging their participation in Nurse Lobby Day." e. "Encouraging their active memberships in the state nurses' association." rationale: The participation in Nurse Lobby Day to meet the state legislators may help build the team's political skills. The nurses should be encouraged to be active members of the state nurses' association, which also helps develop their political skills. Honesty building may be associated with the development of personal power strategies. The leader might teach the team to be comfortable with conflict and ambiguity, which helps develop the personal power strategies of the team. The ability to take constructive criticism gracefully would be taught for developing a personal power strategy.

Which statement describes the attributes of a transformational leader? Select all that apply. One, some, or all responses may be correct. a. "The nurse leader is punitive." b. "The leader is charismatic." c. "The person is motivational." d. "The transformational leader rewards good work." e. "This person shows individualized consideration."

b. "The leader is charismatic." c. "The person is motivational." e. "This person shows individualized consideration." rationale: A transformational leader has a charismatic behavior, motivates and inspires their team, and shows individualized consideration. A transactional leader has a punitive behavior. The act of rewarding for good performance is the role of a transactional leader.

Which task can the nurse delegate to the unlicensed assistive personnel (UAP) based on their knowledge and qualifications? a. An invasive procedure b. A repetitive, simple skill c. A skill that is used during a crisis d. An intervention that facilitates goal accomplishment

b. A repetitive, simple skill rationale: According to the five rights of delegation, a task that can be delegated to UAP should be a skill that is repetitive and requires little supervision. Noninvasive processes that pose minimal risk to the client can be delegated to UAP. The UAP should not be assigned to perform skills used during a crisis or skills that facilitate goal accomplishment.

Which extra responsibility would the nurse leader need to provide if given an additional duty as a nurse navigator? Select all that apply. One, some, or all responses may be correct. a. Plan care for clients. b. Address barriers to care. c. Provide psychosocial support. d. Communicate effectively to facilitate care. e. Provide health education about the disease.

b. Address barriers to care. c. Provide psychosocial support. e. Provide health education about the disease. rationale: A nurse navigator may help clients with serious chronic diseases by assessing, screening, diagnosing, treating, and providing follow-up care. The responsibilities of a nurse navigator include overcoming health system barriers and providing psychosocial support while treating the client. Providing health education about the disease, from prevention to treatment, is also the responsibility of a nurse navigator. Planning the client's care and communicating effectively are the responsibilities of a nurse leader and not a nurse navigator.

Which client care activity would a nurse safely delegate to an unlicensed health care worker? a. Assessing a client's mastectomy incision for signs of inflammation b. Assisting a client who is recovering from an abdominal hysterectomy to the bathroom c. Providing information about side effects to a client receiving chemotherapy for breast cancer d. Evaluating the effectiveness of an antiemetic that was administered to a client to relieve nausea

b. Assisting a client who is recovering from an abdominal hysterectomy to the bathroom rationale: An unlicensed health care worker is taught how to safely ambulate clients; this activity does not require extensive nursing knowledge or expert clinical judgment. Assessment, teaching, and evaluation of client responses to care all require clinical judgment and a license to practice nursing.

Which statement describes how nurses provide effective nursing care to clients from different cultural backgrounds? a. By advising clients that some cultural practices may be harmful to health b. By providing care that fits clients' cultural beliefs c. By strictly adhering to organization policies regarding nursing care d. By ignoring the cultural aspect and focusing on the medical aspect of care

b. By providing care that fits clients' cultural beliefs rationale: When providing care to clients from different cultural backgrounds, nurses should be careful to provide care that fits clients' cultural beliefs. It helps provide effective nursing care to the satisfaction of the client. Advising clients against their cultural practices may offend them and should be avoided. Organization policies should be made flexible to incorporate cultural aspects of care. Ignoring the cultural aspect of client care may result in ineffective nursing care.

Which quality of a leader indicates a transformational approach to leadership? Select all that apply. One, some, or all responses may be correct. a. Punitive in nature b. Charismatic c. Contingent reward d. Intellectually stimulating e. Inspirational and motivational

b. Charismatic d. Intellectually stimulating e. Inspirational and motivational rationale: The leader who has a transformational approach to leadership possesses charismatic, intellectually stimulating, and inspirational and motivational qualities. The transformational leader follows an inspirational and motivational approach. The leader who uses the transactional leadership approach has a punitive nature and gives rewards to followers contingently.

Which action would a nurse manager do to provide a nonthreatening and positive environment to the group members? Select all that apply. One, some, or all responses may be correct. a. Ask indirect and close-ended questions. b. Encourage group members to actively participate. c. Create an environment conducive to solving problems. d. Protect the members and their suggestions from attack. e. Encourage the attempts of members to monopolize the discussion.

b. Encourage group members to actively participate. c. Create an environment conducive to solving problems. d. Protect the members and their suggestions from attack. rationale: Encouraging group members to actively participate may help elicit different ideas from different members. An environment conducive to solving problems helps keep the group focused on tasks and strategies. Protecting members and their suggestions from attack should be done for a healthy discussion and to create a nonthreatening environment. Asking direct and close-ended questions may not help involve members who are not actively involved in the discussion. Encouraging the attempts of members to monopolize the discussion may not encourage more passive individuals to contribute to the discussion.

Which quality is crucial for the nurse to have in order to accomplish the delegation of care for clients affected by flooding thoroughly and on time? Select all that apply.One, some, or all responses may be correct. a. Treats each staff member as an adult b. Experienced in handling crisis conditions c. Adapts to the needs of the work group d. Quick in making decisions and taking actions e. Firm in assigning the defined tasks to the staff

b. Experienced in handling crisis conditions d. Quick in making decisions and taking actions e. Firm in assigning the defined tasks to the staff rationale: An autocratic leader is an expert in handling crisis conditions such as natural disasters (floods) and is often reputed for being able to skillfully handle difficult assignments. An autocratic leader is firm, insistent, dominating, and quick at making decisions and taking necessary actions. This type of leader clearly assigns defined tasks to the working group to complete the work on time. A democratic leader involves staff members in the decision-making process. A situational leader manages tasks by adapting to the needs of the work group, which enables professional growth.

Which aspect relates to the quality of relationships while assessing the degree of conflict resolution in nursing leadership? Select all that apply. One, some, or all responses may be correct. a. Creativity of the plan b. Generation of empathy c. Practicality of the objectives d. Understanding being created e. Wellness of the intended goals achieved

b. Generation of empathy d. Understanding being created rationale: Quality of relationships includes aspects such as generation of empathy and the understanding being created. The aspects of the creativity of the plan, practicality of the objectives, and wellness of the intended goals achieved relate to the quality of decisions.

Which characteristic is necessary to become an effective transformational leader? Select all that apply. One, some, or all responses may be correct. a. Acquiring a mentor b. Inspiring a shared vision c. Upgrading self-knowledge d. Improving interpersonal skills e. Being able to motivate the nursing staff

b. Inspiring a shared vision d. Improving interpersonal skills e. Being able to motivate the nursing staff rationale: Having a shared vision helps effective transformational leaders and their teams become inspired and committed to a shared goal. Being an effective transformational leader depends on one's interpersonal skills; improving these can help in interactions with the staff. The ability to motivate the nursing staff is also important for a transformational leader because this helps one reach desired goals and improve performance. Acquiring a mentor is not a requirement of transformational leadership. Upgrading one's self-knowledge is beneficial for a nurse leader in decision making.

Which strategy helps combat burnout, feelings of despair, and conforming to the expectations of other people? a. Balance b. Integrity c. Awareness d. Compartmentalizing

b. Integrity rationale: A nurse experiencing burnout may feel despair and may forget his or her needs by trying to conform to the expectations of others. Restoration of personal integrity is an important strategy that helps combat burnout. Balance among work, family, leisure, and lifelong learning enhances personal judgments, satisfaction, and productivity. Awareness helps identify and create boundaries to prevent stress. Compartmentalizing helps the nurse complete as much of a job at hand as possible.

Which statement is true regarding the right supervision aspect of delegation? Select all that apply. One, some, or all responses may be correct. a. It includes limits and expectations. b. It is essential to maintain accountability. c. It is essential to complete the task in time. d. It involves providing assistance and feedback. e. It includes the appropriate client setting and available resources.

b. It is essential to maintain accountability. c. It is essential to complete the task in time. d. It involves providing assistance and feedback. rationale: Right supervision is essential to maintaining accountability of events taking place while delegating a task and completing a task in a timely manner. It is essential for the delegatee to ask questions and seek assistance comfortably and for the delegator to provide appropriate feedback. Right communication involves limits and expectations. Right circumstances include figuring out the appropriate client setting and available resources.

Which action of the nurse exhibits transactional leadership? Select all that apply. One, some, or all responses may be correct. a. Motivating or inspiring the employees b. Meeting the targets within the deadline c. Working according to organizational rules d. Correcting the errors in a reactive manner e. Increasing the employee commitment of an organization

b. Meeting the targets within the deadline c. Working according to organizational rules d. Correcting the errors in a reactive manner rationale: The characteristics of transactional leadership include valuing the orders and structures of an organization. The nurse who exhibits transactional leadership will meet the targets within the deadline given by the organization. The nurse will also follow the rules of an organization and will correct the errors of an employee in a reactive manner. Motivating or inspiring the employees and increasing employee commitment are the characteristics of transformational leadership.

Which action would the registered nurse (RN) supervise when caring for a client who is hospitalized with severe diarrhea? a. Feeding the client b. Monitoring of hemodynamic status c. Assessing gastrointestinal (GI) status d. Ambulating the client with physical therapy

b. Monitoring of hemodynamic status rationale: The RN would supervise monitoring of the hemodynamic status. It is the responsibility of the RN to supervise the delegated task. Feeding the client is usually performed by a licensed practical nurse, unlicensed assistive personnel, or any member of the health care team. Assessment of the client's GI status would be performed by the RN. Ambulation by physical therapy would not need to be supervised by the RN.

Which advice would a nurse give to a newly hired nurse who is not wearing gloves while vaccinating an infant at a well-child clinic? a. Speak with the nurse manager regarding techniques b. Put on gloves because standard precautions are required c. Continue with the immunizations because gloves are not needed d. Evaluate the child's appearance to determine whether gloves are needed

b. Put on gloves because standard precautions are required rationale: The protocol of the Centers for Disease Control and Prevention (CDC) (Canada: Public Health Agency of Canada [PHAC]) for administering parenteral medications requires standard precautions including the use of gloves. It is the nurse's responsibility to maintain standard precautions within the clinic environment. Gloves are needed and must be worn when children are given parenteral medications. The child's appearance is not a factor. The CDC (Canada: PHAC) protocol for administering parenteral medications requires standard precautions.

Which would act as the team leader in a rehabilitation program? a. Unit secretary b. Registered nurse c. Licensed practical nurse d. Unlicensed nursing personnel

b. Registered nurse rationale: The registered nurse has responsibility for a group of individuals that work on a team. The unit secretary is an individual with no medical training and cannot accept any responsibilities of the team. The licensed practical nurse and unlicensed nursing personnel are individuals who work under the directions of a registered nurse.

Which type of treatment would the direct care nurse assist in to provide tertiary care? a. Chronic care b. Rehabilitation c. Health maintenance d. Prevention of disease complications

b. Rehabilitation rationale: Tertiary care includes rehabilitation. Chronic care and health maintenance are considered primary care, and prevention of disease complications is classified as secondary care.

Which right of delegation is implemented when the nurse instructs the unlicensed nursing personnel to help a high-fall-risk client with toileting every 2 hours? a. Right task b. Right direction c. Right supervision d. Right circumstance

b. Right direction rationale: Delegating the right direction or communication between the nurse and the unlicensed nursing personnel is important, especially during a shift of care. The nurse should give a clear, concise description of the task to the unlicensed nursing personnel, such as "Assist the high-fall-risk client with toileting every 2 hours," to coordinate care. The right task is delegated for a specific client within the health care professional's scope of practice. The right supervision is essential to provide appropriate monitoring, evaluation, and intervention as needed. The right circumstance considers the appropriate client setting, available resources, and other relevant factors.

Which right of delegation involves a description of limits and expectations? a. Right task b. Right direction c. Right supervision d. Right circumstances

b. Right direction rationale: Right direction or communication involves giving a clear and concise description of limits and expectations. Right task involves ensuring that the delegated task is within the health care professional's scope of practice. Right supervision involves appropriate monitoring, evaluation, intervention as needed, and feedback of the task. Right circumstances involve a consideration of the appropriate client setting and other factors.

By which delegation right is it essential for the assistive personnel to be comfortable asking questions and seeking assistance? a. Right person b. Right supervision c. Right circumstance d. Right communication

b. Right supervision rationale: The right supervision is essential to allow assistive personnel to ask questions and seek assistance. The right person is essential for delegating the right task. The right circumstance is necessary to determine what to delegate. The right communication is essential to coordinate care.

Which quality is characteristic of an effective team? Select all that apply. One, some, or all responses may be correct. a. Autocratic leadership b. Shared vision and goals c. Objectives include personal agendas d. Vague role definitions e. Ability to handle conflicts by having open discussions

b. Shared vision and goals e. Ability to handle conflicts by having open discussions rationale: An effective team works together with shared vision and goals. An effective team will handle conflict by openly discussing issues. Autocratic leadership does not allow input from team members, which creates ineffective teams. Objectives involving personal agendas do not represent the entire team. Vague role definitions create confusion, which decreases the effectiveness of a team.

Which theory does the nurse leader utilize when addressing work quality that affects the environment and overall productivity? a. Trait theory b. Style theory c. Transformational theory d. Situational-contingency theory

b. Style theory rationale: Style theory measures the achievement of satisfactory performance. It requires supervisors to pursue an effective relationship with their followers. Therefore, leaders need to obtain feedback from their followers, peers, and superiors. Trait theory involves the leader using self-awareness of his or her traits. It is useful in self-development, as well as in seeking employment that matches the traits. Transformational theory includes a process by which the leader attends to the needs of the followers. This interaction raises the followers to higher levels of morality. Situational-contingency theory involves leaders considering the challenge of a situation.

Which explanation is the key idea of "role theory" in nurse leadership? Select all that apply. One, some, or all responses may be correct. a. Allowing a nonlinear change b. Understanding behavior in certain circumstances c. Considering the lower level of basic needs as important d. Clarifying the relationship between the pathway employees e. Collecting concepts that predict the actor's performance in a given role

b. Understanding behavior in certain circumstances e. Collecting concepts that predict the actor's performance in a given role rationale: Role theory involves understanding behavior in certain circumstances. It also includes collecting the concepts that predict the leader's performance in a given role. Diffusion theory focuses on allowing a nonlinear change. The lower levels of the basic needs are considered important according to McGregor's theory. Pathgoal theory focuses on the environment for clarifying the relationship between the pathway employees.

Which task would the nurse delegate to an unlicensed health care worker? a. Evaluation of a postpartum client's lochia b. Vital signs on a client 4 hours after delivery c. Assessment of a postpartum client's episiotomy d. Assisting the postpartum client to breastfeed for the first time

b. Vital signs on a client 4 hours after delivery rationale: Evaluating the client's lochia, assessing the client's episiotomy, and helping the client breastfeed for the first time would involve assessment, teaching, or evaluation and should not be delegated. The only task that does not require any of these is taking vital signs 4 hours after delivery.

Which statement used by the nurse to the client waiting for food appropriately makes his or her positive intent explicit? a. "I will order the food for you." b. "I am sorry for the delay in the food." c. "I want to make you comfortable; here's your food." d. "I really admire your patience for waiting so long for the food."

c. "I want to make you comfortable; here's your food." rationale: The nurse makes the client comfortable by providing the food and verbally makes this known. Therefore, this action is related to the nurse making his or her positive intent explicit. The act of ordering the food for the client clearly shows that the client is the focus for the nurse. However, it may not relate to positive intent explication. The apology for the food delay is an example of a blameless apology. The expression of admiration of the client's patience is a way of expressing appreciation.

Which behavior by a nursing assistant reflects a boundary violation? a. Offering advice to the client b. Providing false reassurance c. Accepting a gift from the client d. Engaging in excessive probing

c. Accepting a gift from the client rationale: A boundary violation occurs when a provider of care goes beyond the established therapeutic relationship standard and enters into a personal or social relationship with a client, such as with accepting a gift from the client. Offering advice to the client is an example not of a boundary violation but rather of inadequate communication skills; advice should not be given because it undermines the client's ability to solve problems and may precipitate dependency and helplessness. False reassurance is an example not of a boundary violation but rather of inadequate communication skills; false reassurance should not be given because it is not based in reality and may close off communication. Engaging in excessive probing is an example not of a boundary violation but rather of inadequate communication skills; inappropriate probing is not therapeutic and may be done by the provider of care to prevent uncomfortable silences or obtain information because of curiosity.

The nurse manager enlists several nurses for a project addressing the needs of the client diagnosed with human immunodeficiency virus (HIV). Which essential factor would be the most important element for the success of the project? a. Offering ideas to the direct care nurses b. Providing training to the direct care nurses c. Allowing the direct care nurses to share ideas d. Promoting discipline among the direct care nurses

c. Allowing the direct care nurses to share ideas rationale: The most important element of success for the nursing manager is to allow the direct care nurses to share their ideas about the project and participate in decision making. This approach will increase their organizational commitment and increase the feeling of self-worth. The nurses will then be more likely to invest extra effort for successful completion of the project. The other factors necessary for successful completion of the project include providing ideas, training the nurses, and promoting discipline.

Which leadership style is reflected when the nurse leader asks the team, "What do you think should be done in this situation?" a. Autocratic b. Situational c. Democratic d. Laissez-faire

c. Democratic rationale: Democratic leadership is a people-centered approach that allows employees and other individuals to be involved in decision making. This leadership is demonstrated by the nurse asking his or her subordinates questions about care implementation. A leader who uses an autocratic leadership style displays little trust and confidence in employees. Situational leadership offers flexibility to the manager. Laissez-faire leadership involves the nurse avoiding responsibility and delegating decision making to the group

While addressing the group, a nurse places an emphasis on team building. The nurse also specifies that the individuals within the team will be credited based on their behavior and performance during the decision-making process. Which type of leadership is displayed when there is an emphasis on team building and individuals are credited for their behavior and performance? a. Situational b. Autocratic c. Democratic d. Free-run style

c. Democratic rationale: In democratic leadership, the lead nurse emphasizes team building and collaboration while delegating care. These team members are credited based on their behavior to promote growth and development of the staff. Situational leadership enables professional growth for both managers and staff by managing tasks based on the situation. In autocratic leadership, the lead nurse makes firm decisions, which are unidirectional. In free-run style leadership, there is no sense of direction unless it is provided by the group or an informal leader.

Which action would the nurse leader perform while preparing to share information with the team? a. Giving complete information at one time b. Avoiding sharing information through mail c. Determining which information is to be shared d. Sending text messages instead of face-to-face communication

c. Determining which information is to be shared rationale: The nurse leader would determine the information that has to be shared with followers but would not give all information at once. The nurse leader would give only limited information; giving too much at once can create disinterest in the listeners. The nurse leader can share information through mail as a primary communication method. The nurse leader would use face-to-face communication over text messages.

Which action of the nurse leader supports implementing Gardner's task of "achieving workable unity" effectively? a. Being honest and keeping promises to clients b. Representing the values of organization to clients c. Developing conflict resolution skills effectively d. Inspiring the team members to achieve their vision

c. Developing conflict resolution skills effectively rationale: Gardner's task of "achieving workable unity" can be implemented by inculcating the unity in the team. This can be achieved by developing conflict resolution skills effectively. The nurse leader implements Gardner's task of "developing trust" by being honest and keeping promises to clients. The nurse leader implements Gardner's task of "affirming values" by representing the value of organization to clients. The nurse leader implements Gardner's task of "motivating" by inspiring the team members to achieve their vision.

Which statement is true regarding autocratic style leadership? a. Autocratic style leadership completely relinquishes control. b. It allows employees to have more control. c. It involves establishing one-way communication with the group. d. It encourages individual participation in the decision-making process.

c. It involves establishing one-way communication with the group. rationale: In autocratic style leadership, the leader retains all authority and responsibility. The leader is primarily concerned with task and goal accomplishment; therefore, he or she establishes one-way communication with the group. In laissez-faire leadership, the leader completely relinquishes control and delegates all decision making to the group. Democratic style leadership is a people-centered approach in which employees are allowed more control and the leader encourages individual participation in the decision-making process.

While auditing unit documents, a nurse finds some omissions. Which term best describes when the nurse meets with the staff to discuss the findings and communicates ways to achieve the desired goals? a. Leadership b. Followership c. Management d. Decision making

c. Management rationale: The process of guiding, planning, and controlling others in a situation where communication is shared to improve clinical processes and outcomes is referred to as management. Leadership can be defined as a process of identifying a goal or target, motivating other people to act, and providing support and motivation to achieve goals. Followership is the process of following the leader or the manager to ensure the best clinical decision making and actions taken to achieve organizational outcomes. Decision making is a process of making crucial decisions.

Which action is the most appropriate for the team leader to approach an ethical situation of a nurse arriving at work after drinking alcohol? a. Counsel the nurse about the problem. b. Ignore the problem until it happens again. c. Notify the nurse manager about the problem. d. Resolve the problem by sending the nurse home.

c. Notify the nurse manager about the problem. rationale: After identifying the problem, the nurse should explore options to address the situation; this is best accomplished in collaboration with the nurse manager. Counseling the nurse about the problem is not the role of a nurse; the nurse who has been drinking needs professional counseling. Ignoring the problem until it happens again is unsafe; clients may be placed in jeopardy. Resolving the problem by sending the nurse home delays addressing the problem.

A lead nurse orders the staff nurse to give reports on time and to complete documentation after attending a client care conference. Which other nursing responsibility would be included while coordinating care during a nursing shift? a. Conduct teaching sessions. b. Plan time to assist colleagues. c. Prepare medications for administration. d. Discuss difficulties with an experienced colleague.

c. Prepare medications for administration. rationale: Attending a client care conference, giving a staff report on time, and preparing medications for administration are essential to setting goals while coordinating care. Scheduling priorities are based on establishing the best time for activities such as conducting teaching sessions and providing times for rest. Interruption control includes planning time to assist colleagues to complement the client care schedule. Evaluation includes discussing difficulties with experienced colleagues.

Which principle of time management is the nurse following when listing activities according to goals for the client's condition? a. Goal setting b. Time analysis c. Priority setting d. Interruption control

c. Priority setting rationale: Scheduling priorities according to the client's needs helps establish goals within a given time frame; therefore, priority setting is important in this situation. Goals are established every day based on the client's condition. Time analysis reflects how well the nurse uses his or her time while delegating client care. Interruption control involves avoiding or limiting prolonged discussions with colleagues to control the interruption of client care activities.

Which action involving client needs would a nurse delegate to an unlicensed health care worker? a. Assessing a newly admitted client's contraction pattern b. Discussing pain management options with a laboring client c. Providing ice chips to a client in early labor per the primary health care provider's prescription d. Obtaining a sterile urine specimen for a suspected urinary tract infection

c. Providing ice chips to a client in early labor per the primary health care provider's prescription rationale: Providing ice chips to a client in early labor per the primary health care provider's prescription does not require clinical knowledge or judgment for safe, effective care. Assessment, discussion of alternative actions, and the use of sterile technique during an invasive procedure all require clinical knowledge and judgment beyond the scope of practice of an unlicensed health care provider.

A nurse leader finds a postoperative client in a semiconscious state with impaired psychomotor functions resulting from the after effects of anesthesia. According to Maslow's hierarchy of human needs, which client need would the nurse leader prioritize? a. Esteem b. Self-actualization c. Safety and security d. Love and belonging

c. Safety and security rationale: The client is suffering from the after effects of anesthesia, which is marked by an altered state of consciousness. Thus the nurse leader's priority is meeting the client's safety and security needs to ensure that the client is not physically harmed. Esteem, self-actualization, and love and belonging needs are not a priority for a client in this situation.

A nurse reviews the preoperative instructions for a child who is to undergo follow-up cleft palate surgery. Which instruction would the nurse question? a. Nothing by mouth (NPO) after midnight. b. Start intravenous (IV) D5% 0.45% NS at 6:00 am. c. Tap water enema until clear this pm. d. Draw blood for hemoglobin and hematocrit this pm.

c. Tap water enema until clear this pm. rationale: The prescription of a tap water enema is unnecessary; the lower gastrointestinal tract is not involved with this procedure. IV fluid is needed because the child is on NPO status. The child is kept NPO to minimize the risk of aspiration associated with anesthesia administration. Obtaining blood for typing and crossmatching is an important routine preoperative instruction in the event that a transfusion might be needed.

Which service would be provided by an organization that provides secondary care for clients with cancer? a. Providing long-term care for fatigue b. Providing treatment for pain management c. Teaching the client about prevention of infection d. Teaching the client about adverse effects of the therapy

c. Teaching the client about prevention of infection rationale: Secondary care involves the prevention of disease complications. Therefore, teaching clients about the prevention of infection would help prevent complications as cancer clients are at high risk for infection. Long-term care for fatigue would be included as primary or tertiary care, not secondary care. Treatment for chronic care, such as pain management in clients diagnosed with cancer, is a type of primary care. Primary care involves health maintenance measures such as teaching the client about adverse effects of the therapy.

Which action of the nurse leader supports implementing the dialogue method while working along with the team? a. Enquiring about personal problems of the team members b. Giving positive or negative feedback to the team members c. Sharing information about new innovations in technology with the team members d. Allowing team members with different perspectives to come together and find common goals

d. Allowing team members with different perspectives to come together and find common goals rationale: Dialogue allows team members with different perspectives to come together and find common goals. Enquiring about personal problems of the team members does not indicate implementing the method of dialogue. Giving positive and negative feedback does not indicate implementing the method of dialogue. Sharing information about new innovations in technology with the team members indicates teaching but does not indicate implementing the method of dialogue.

Which question enables the nurse to evaluate the understanding of leadership skills in those being mentored? Select all that apply. One, some, or all responses may be correct. a. "Are you getting my points?" b. "Would you all like a break?" c. "Can I change the topic in a little while?" d. "How can you solve a conflict at the workplace?" e. "What did you hear in the process of this communication?"

d. "How can you solve a conflict at the workplace?" e. "What did you hear in the process of this communication?" rationale: The question such as "what did you hear in the process of this communication?" cannot be answered by a "yes" or "no" and requires a detailed explanation of the things that are taught. The question starting with "how" are usually open-ended and require the person to answer in detail. Therefore, these questions can help the nurse leader evaluate the understanding level of the followers. Questions such as "Are you getting my points?", "Would you all like a break?", and "Can I change the topic in a little while?" can be answered by a "yes" and "no." Therefore, these questions do not help the nurse leader to evaluate the understanding level of the followers.

Which statement by the nurse indicates an autocratic leadership style? a. "I guide my co-team members simultaneously when required." b. "I treat my team members as equally important while making a decision." c. "I ask my team members to feel free to express their opinion while making decisions." d. "I have the power to intimidate any team members who fail to adhere to expectations."

d. "I have the power to intimidate any team members who fail to adhere to expectations." rationale: An autocratic leader is firm, insistent, and dominating; this leader may intimidate any team members who fail to adhere to expectations. A situational leader guides the co-team members simultaneously when required to enable professional growth. A democratic leader treats other team members as equals and allows them to make decisions while delegating a task. A laissez-faire leader may permit team members to express their opinions freely.

Which statement about the modified patient-focused care model indicates more teaching is needed? a. "It improves client satisfaction." b. "It improves worker job satisfaction." c. "It increases the efficiency of the hospital." d. "It requires a technician to provide client care."

d. "It requires a technician to provide client care." rationale: The original patient-focused model required the use of cross-trained technicians who provided patient-side care. The modified model, however, includes team members providing direct care activities. In this model there is improved client satisfaction and worker job satisfaction. This, in turn, increases the efficiency of the hospital.

Which statement about the situational leadership role is correct? a. "Situational leadership is also called free-run style." b. "This style allows the manager to grow professionally." c. "This style of leadership works well in highly motivated professional groups." d. "The basis of this leadership style is the manager's flexibility in adapting to the needs of the group or individual."

d. "The basis of this leadership style is the manager's flexibility in adapting to the needs of the group or individual." rationale: In situational leadership theory, the manager has flexibility in adapting to the needs of the group or individual. Laissez-faire leadership is called free-run style. This type of leadership style fosters professional growth of the manager and staff, and it does not work well with highly motivated professional groups.

Which statement regarding leadership is true? a. Transactional leadership uses motivation and inspiration strategies. b. Democratic leadership is useful in times of natural disaster. c. Situational leadership is the most commonly used leadership style. d. Autocratic leadership stresses prompt and orderly performance.

d. Autocratic leadership stresses prompt and orderly performance. rationale: An autocratic leader retains all authority and responsibility and stresses prompt and orderly performance of tasks. Successful organizations require both leadership and management. The autocratic leader is useful in times of natural disaster. The most commonly used styles of leadership are autocratic, democratic, and laissez-faire.

Which strategy is first for burnout prevention? a. Focus b. Choice c. Balance d. Awareness

d. Awareness rationale: Awareness is the first strategy of burnout prevention because it deliberately reflects on the stress in one's life. Focusing on the goals to be achieved with full energy and the ability to make choices and prioritize are helpful, but these are not the first strategies. The important step next to awareness is to prevent or deal with burnout for restoring balance in one's life.

Which skill of a nurse leader is most important? a. Priority setting b. Time management c. Clinical decision making d. Clinical care coordination

d. Clinical care coordination rationale: The most important leadership skill for a nurse leader is clinical care coordination. Priority setting, time management, and clinical decision making are secondary components included in clinical care coordination.

While trying to define a problem, the nurse leader determines the external and internal constraints for implementing a solution. Which problem-defining process is the leader nurse performing? a. Justifying the need b. Writing the problem c. Establishing the need d. Contextualizing the problem

d. Contextualizing the problem rationale: As per the problem-definition process, while contextualizing a problem, a nurse leader will determine the external and internal constraints of the problem. This may help in figuring out how to best implement a solution. To justify the need, the nurse leader should decide the desired benefits. Writing the problem includes how to evaluate the solution and measure success. To establish the need, the nurse leader should understand the desired outcomes.

Which element would be considered when selecting the suitable unlicensed nursing personnel for delegation of a task? a. Time b. Safety c. Stability d. Critical thinking

d. Critical thinking rationale: Critical thinking is of utmost importance for selecting a suitable unlicensed nursing personnel for delegation of a task in a situation where a client requires more attention, as the delegatee should be able to perform the task effectively. Time, safety, and stability are also elements for effective delegation, but these are suitable depending on the situation for assigning a delegation task.

Which action is most appropriate for the charge nurse/team leader to take when an unlicensed assistive personnel (UAP) is consistently late to work, which causes delayed nursing care? a. Discuss the issue with a friend from another unit. b. Remind the UAP of the expected start time. c. Report the problem to the Human Resources department. d. Document the information before discussing it with the UAP.

d. Document the information before discussing it with the UAP. rationale: Documentation is the best initial response; documentation should include both the missed time and the effect on client care. Discussing the issue with a friend from another unit is not a professional or appropriate response to the problem. Reminding the UAP of the expected start time may be helpful but will not address the issue if the problem continues. Reporting the event to the Human Resources department may be a later response to the problem.

Which of Gardner's tasks involves anticipating client outcomes for single clients or families and helping them formulate their vision of future well-being? a. Explaining b. Motivating c. Affirming values d. Envisioning goals

d. Envisioning goals rationale: Envisioning goals is one of Gardner's tasks of leading. It involves anticipating client outcomes for single clients/families and helping clients formulate their vision of future well-being. Explaining involves teaching and providing information to promote client/family functioning and well-being. Motivating involves relating to and inspiring clients and their families to achieve their vision. Affirming values involves helping the client/family explain personal values in relation to health problems and their effect on lifestyle.

The licensed practical nurse is assigned to delegate client ambulation to unlicensed assistive personnel (UAP). Which action of the LPN indicates a need for further teaching? a. Describing the delegated task in detail to the nursing staff b. Receiving reports on assigned clients and checking their treatment charts c. Evaluating the knowledge and performance of the member performing the task d. Expecting unlicensed assistive personnel (UAP) to redelegate ambulation for the client

d. Expecting unlicensed assistive personnel (UAP) to redelegate ambulation for the client rationale: Delegation is an important aspect of client care. The LPN should explain to the UAP that redelegation of a task is not appropriate and if the UAP cannot complete the task it must be communicated to the LPN. Delegation mandates clear communication of all aspects of the delegated care to the nursing staff responsible for completion of the task. The LPN must receive a report on all assigned clients and make sure charts are reviewed. The licensed practical nurse (LPN) should consider the job description, educational level, ability, and licensure of other nursing personnel who are responsible for completing the task.

Which statement is true about compartmentalizing? a. Deliberately reflects on the stressor b. Means paying attention to one's own personal needs c. Is closely aligned with focusing, with an emphasis on outcome d. Helps the nurse complete the job at hand as soon as possible

d. Helps the nurse complete the job at hand as soon as possible rationale: Compartmentalizing is a stress management strategy that may enable the nurse to complete a job as soon as possible. It helps to manage stress by establishing boundaries on life tasks. Awareness deliberately reflects on stressors. Altruistic egoism means paying as much attention to one's own personal needs as one would to others. Goals are closely aligned with focusing, with an emphasis on the outcomes.

Which power does the nurse possess that has great skill in teaching clients different self-care activities and is sought out by colleagues to teach their clients? a. Reward b. Position c. Connection d. Information

d. Information rationale: The nurse has skill in teaching clients and is sought out by colleagues to teach their clients. This indicates that the nurse has information power and possesses information that is needed by others. Reward power is based on a person's ability to provide rewards or favors. Position power is possessed by the virtue of the position within an organization. Connection power is gained by the people association that has links to the powerful people.

While communicating with a nursing peer, the nurse leader reports, "I allow my team to work freely and accomplish their own tasks without oversight." Which style of leadership is the nurse following? a. Autocratic style b. Situational style c. Democratic style d. Laissez-faire style

d. Laissez-faire style rationale: A laissez-faire leader chooses to avoid responsibility by delegating all decision-making to the group. This type of leader would want the group members to feel free to accomplish their own tasks. An autocratic leader is firm, insistent, and dominating. A situational leader makes decisions based on the situations to be handled. A democratic leader encourages the participation of workgroups and facilitates goal accomplishment while stressing the self-worth of everyone.

A client learns that he has acquired immune deficiency syndrome (AIDS). The nurse provides support to the client and his family. According to Maslow's hierarchy of needs, which level of need is the nurse addressing? a. Esteem need b. Self-actualization need c. Safety and security need d. Love and belongingness need

d. Love and belongingness need rationale: According to Maslow's hierarchy of needs, the love and belongingness need involves the nurse lending support to a client and his or her loved ones when the client is diagnosed with a life-threatening disease. Self-esteem needs are addressed when dignity and recognition are taken into consideration in health care. Selfactualization needs involve personal growth and maturity. Safety and security needs are associated with protection from physical harm.

When a bedridden client complains that they are thirsty, the nurse says, "I want to make you comfortable. Here is a glass of water, please take it." Which communication skill is the nurse using to make caring visible? a. Listening actively b. Expressing appreciation c. Showing caring nonverbally d. Making their positive intent explicit

d. Making their positive intent explicit rationale: The nurse is making their positive intent explicit by explaining the purpose and demonstrating that what they are doing is in the client's best interest. Listening actively indicates acknowledging and reflecting back the person's feelings in a nonjudgmental way. Expressing appreciation refers to giving the personal gift of positive reward. Showing caring nonverbally can be done by using a facial expression, intonation, posture, eye contact, and body language to mirror the client's feelings.

While having a group discussion in a decision-making process, a nurse leader has asked team members to silently write down their ideas so that the group can discuss them to choose the best decision. Which strategy is the nurse leader using? a. Focus group b. Brainstorming c. Delphi technique d. Nominal group technique

d. Nominal group technique rationale: The nominal group technique has group members silently provide written input into the decision-making process. Choosing the ideas based on highest ranking is done after discussing the merits of the ideas. This technique allows equal participation among members and minimizes the problem of dominance. The focus group strategy is used to identify problems or to evaluate the effects of an intervention during a face-to-face discussion but not through writing the ideas. The brainstorming strategy is applied during a decision-making process to generate innovative ideas in spite of having criticism from team members. The Delphi technique is used to achieve consensus among team members by reconsidering and judging the opinions.

Which model of nursing care would include working "within the walls" as well as "beyond the walls" of the hospital? a. Primary nursing method b. Practice partnership model c. Patient-focused care model d. Nursing case-management model

d. Nursing case-management model rationale: In the nursing case-management model, the nurse needs to provide care for a client in nurse-managed centers, home health agencies, urgent care centers, schools, and rural settings. In the primary nursing method, a single nurse cares for a client while that client is in the hospital. In the practice partnership model, a registered nurse (RN) is paired with an unlicensed nursing personnel. In the patient-focused care model, a RN is paired with a crosstrained technician who provides patient-side care.

Which action would a nurse perform as a community volunteer? a. Recording vaccinations b. Attending a city commission meeting c. Writing letters to the editor of a newspaper d. Organizing individuals in the community to develop health care delivery

d. Organizing individuals in the community to develop health care delivery rationale: Nurses provide unique leadership in community volunteer opportunities. Organizing individuals in the community to develop health care delivery is an example of the nurse's role as community volunteer. Recording vaccinations, attending a city commission meeting, and writing letters to the editor of a newspaper are tasks performed by a nurse as a community opinion leader.

Which behavior from the nurse leader exhibits charismatic leadership qualities? a. Uses a shared vision as a core of leadership b. Encourages innovation and creativity in solving a problem c. Encounters a situation with the transactional leadership style d. Possesses an inspirational quality that makes team members attracted to him or her

d. Possesses an inspirational quality that makes team members attracted to him or her rationale: Charismatic behavior is seen in the transformational leadership style; this inspiring quality attracts team members. By sharing a vision, the leader is not attracting team members; therefore, this may not be a charismatic leadership behavior. Encouraging innovation and creativity in problem solving will exhibit a quality of intellectual stimulation and is a transformational leadership behavior. Charismatic behavior is not seen in the transactional leader.

Which initiative demonstrated by the nurse is an effective art of communication of a leader? a. Keeping the information broad b. Ignoring the loss involved in the change c. Being sensitive to verbal communication d. Reinforcing the values behind the change

d. Reinforcing the values behind the change rationale: To be an effective leader, the nurse should reinforce the values behind the change by explaining why something has changed. To be an effective leader, the nurse should keep the information simple. To be an effective leader, the nurse should acknowledge the loss involved in the process of change. To be an effective leader, the nurse should be sensitive to nonverbal communication.

According to Maslow's hierarchy, which category of human needs would be prioritized while caring for the client experiencing depression caused by professional problems? a. Belonging b. Physiologic c. Self-esteem d. Self-actualization

d. Self-actualization rationale: A client suffering from depression caused by professional problems would be taught about problem-solving abilities. This activity would be included under self- actualization needs according to Maslow's hierarchy. Belonging needs may include actions such as warm communication with the client and showing love and affection. Physiologic needs may include monitoring the client's oxygen, nutrition, and elimination. Self-esteem needs may include instilling self-respect and self-confidence in the client.

Which statement is an example of an intermediate priority need? a. The teachings of home self-care b. A psychological episode of an anxiety attack c. A physiologic episode of an obstructed airway d. The measures required to decrease postoperative complications

d. The measures required to decrease postoperative complications rationale: The nurse leader should have the ability to set the priorities of the client depending on the client's need. Intermediate priority needs include nonemergency, nonlife-threatening needs. An example of this need would be measures that are required to decrease postoperative complications. The teaching of home self-care is a low priority need. High priority needs include addressing a psychological episode of an anxiety attack and addressing a physiologic episode of an obstructed airway.

Which reason explains why quality improvement (QI) processes are important to the nurse leader when executing QI processes in a team? a. They involve chart audits. b. They inspect nursing activities. c. They discover and correct errors. d. They review the nursing activities.

d. They review the nursing activities. rationale: QI processes improve quality by reviewing nursing activities. Quality assurance (QA) processes involve chart audits. QI processes will review nursing activities but will not inspect them. Inspection of nursing activities is done during the QA process. The QA process discovers and corrects errors, whereas the QI process prevents errors