Professional Development 1 & 2
s/s burnout
*physical* fatigue changes in sleeping, eating lack of energy loss of interest in sex *psychological* irritability hypersensitivity frustration negative outlook forgetting *spiritual* loss of commitment loss of meaning loss of integrity FON 1258
know why an impaired nurse would use alcohol or other drugs
-job-related stress -inability to cope with changes in the workplace -overwhelming personal responsibilities -feeling of frustration and helplessness in their personal and professional loves -easy access to drugs FON 1264
what the primary purpose for your nursing license is
-keep an unwavering eye on their principal concern, the human being -stay focused on the patient and the patient's needs FON 1244 licensure permits people to offer special skills to the public, but it also provides legal guidelines for protection of the public FON 1265
know what the fastest growing group age-wise is in population that needs the most treatment medical wise
in the past two decades, the older adult population (ages 65 and older) has grown twice as quickly as the rest of the population FON 1082
different ways you can obtain continuing education as an LVN
seminars workshops orientation to the facility inservice education continuing education classes sharing information FON 1245
as a nurse know what a temporary agency is
staffing agencies -provide nurses to meet the staffing needs in a variety of health care facilities FON 1252
as a nurse know what you are required to report by law
suspected abuse threats to do harm to others or themselves
nurses who work in home settings need a higher level of what
technically proficient self-motivated expert organizational skills innovative independent decision makes respond to problems promptly common sense flexibility compassion empathy patience honesty dependability FON 1182 autonomy
definition of negligence
the commission of an act that a prudent person would not have done or the omission of a duty that a prudent person would have fulfilled, result in in injury or harm to another person; proof is necessary that other prudent members of the same profession would ordinarily have acted differently under the same circumstances FON 1250
as an LVN know what your license permits
to assist individuals, sick or well, in there performance of those activities contributing to health, to their recovery, or to a peaceful death (activities that patients would perform unaided if they had the necessary strength, will, or knowledge) and, if feasible, to do this in such a way as to help patients gain independence as rapidly as possible FON 17
What are duties of a team leader? (Select all that apply.) a. Receiving reports on assigned patients b. Making patient assignments for team members c. Assessing all assigned patients d. Assisting with medication administration e. Conferring with team members
ANS: A, B, C, D, E All options are the duties of a team leader. REF: Page 2064
this act defines title and regulations governing nursing *spelling*
*nurse practice act* is the licensing law -defines the title and regulations governing the practice of nursing FON 1249
*19.* minimum number of questions for you when taking the NCLEX
*85* 60 "real" questions 24 "try-out" questions FON 1248
another term for promotion
*advancement* a rise in rank or importance, a promotion, progress, improvement FON 1243
what setting an LVN can be placed into management or leadership
*assuming the role of team leader* -assisting and guiding the nursing team in providing care for a select group of patients -assigns patients to each team member and takes responsibility for the delivery of care to patients, as well as for supervision of all members of the team *duties* -receiving reports on assigned patents -making assignments for team members -making rounds and assessing all assigned patients -giving team members a report on assigned patients -assisting in administering mediations and treatments -providing time in the early part of the shift to have a conference with team members on priority patients to keep everyone informed of progress in patient care, provide continuity of care, and allow the team member to answer questions and resolve problems FON 1256
know what a letter of application is
*cover letter* *objective* introduce yourself announce your interest in employment briefly state your qualifications express your availability FON 1238
what it's called to have a license from one state to the next
*endorsement* a statement of recognition of the license of a health practitioner in one state by another state; the applicant needs to meet the current state's licensing requirements *reciprocity* mutual agreement to exchange privileges, dependence, or relationships, such as, for example, an agreement between two governing bodies to accept the credentials of caregivers licensed in the other's state FON 1248
laissez-faire
1. a leader or manager assumes a passive, non directive, and inactive approach and relinquishes part or all of the responsibilities to the members of the group 2. decision making is left to the group, with the leader or manager providing little, if any, guidance, support, or feedback NCLEX 62 -*"free-run style"* or *permissive* leadership -leader relinquishes control completely and chooses to avoid responsibility -delegates all decision making to the group -want everyone to feel free to "do their own thing" -no sense of direction unless provided by the group or an informal leader *sometimes works well* -highly motivated profession groups (research staff) -seldom works well in health care settings because of the complexity of the work environment FON 1255
step you would take if co-worker was under the influence
1. if a nurse suspects that a co-worker is abusing chemicals and potentially jeopardizing a client's safety, the nurse must report the individual to the nursing administration in a confidential manner (client safety is always the first priority) 2. nursing administration notifies the board of nursing regarding the nurse's behavior NCLEX 56
situational
1. uses a combination of styles based on the current circumstances and events 2. styles are assumed according to the needs of the group and the tasks to be achieved NCLEX 62 -takes into account the style of the leader, the maturity of the group, and the situation at hand -no single leadership style is best but rather that the best style for the manager to use is contingent on the maturity level of the employees or group and the situation at hand -the more managers adapt their leadership styles to work situations and needs and abilities of staff, the more effective the managers will be -four typical styles for leaders -leader will at times use all four styles all at once -staff empowerment -fosters the growth of others and facilitates their development so that they become progressively less dependent on the leader -*cornerstone* flexibility of the manager in adapting to the needs of the individual or the work group FON 1255
A medication station that dispenses medicine after being accessed from a computer screen is called .
ANS: Pyxis Newer medication dispensing systems, such as computer-assisted or electronic devices, are variations of unit-dose and floor-stock systems. DIF: Cognitive Level: N/AREF: Page 2070 TOP: Computers
Certification in long-term care (CLTC) encompasses pharmacology, aging, pediatrics, and other key topics. To be eligible for certification, a person must hold an LPN/LVN license in the United States and within the last 3 years have practiced long-term care for: a. 1000 hours. b. 1500 hours. c. 1750 hours. d. 2000 hours.
ANS: D To be eligible for CLTC, a person must have practiced long-term care for 2000 hours within the past 3 years. REF: Page 2054 TOP: Certification
consensus decision making
a grow process involving all participants, with the outcome being a decision that all members are able to agree with and support FON 1256
definition of interview
a meeting of people face to face, as for evaluating or questioning a job applicant FON 1240
definition of career
a profession for which one trains and that is undertaken as a permanent calling FON 1237
different styles of leadership, which one is the one that accounts for the maturity and circumstances at hand
*situational leadership* comprehensive approach to the issue of management takes into account the style of the leader, the maturity of the group, and the situation at hand FON 1255
what it's called when a physician orders something and wants immediate intervention done
*stat order* -process state orders first -give a single dose of medicate immediately and only once FON 1261
physician has different ways of communicating orders to nurses, which method is the least subject to error
*written* telephoned verbal FON 1260
The organization that specifically supports and meets the needs of the LVN/LPN is the: a. NAPNES. b. NLN. c. ANA. d. NFLPN.
ANS: A NAPNES is the professional organization that is specifically for LVN/LPNs. REF: Page 2053 TOP: New graduate
s/s of burn out are for a nurse
*physical* fatigue changes in sleeping, eating lack of energy loss of interest in sex *psychological* irritability hypersensitivity frustration negative outlook forgetting *spiritual* loss of commitment loss of meaning loss of integrity FON 1258
what LVN can delegate to a CNA (several questions)
*properly trained nursing assistant will have the capability to perform:* -vital signs FON 1260 *nursing assistant* *noninvasive interventions* -skin care -ROM -ambulation -grooming and hygiene measures *LPN* dressing changes suctioning urinary catheterization medication administration (oral, sc, IM) *RN* responsible for assessment planning care initiating teaching IV medications NCLEX 66
different rights of delegation
*right task* the right task is one you delegate for a specific patient, such as tasks that are repetitive, require little supervision are relatively noninvasive, have results that are predictable, and pose only minimal risk *right circumstances* consider the appropriate patient setting, available resources, and other relevant factors; in an acute care setting, patient's conditions often change quickly; good clinical decision making is necessary to determine what to delegate *right person* the right person is delegating the right tasks to the right person for performance on the right patient *right direction (communication)* give a clear, concise description of the task, including its objective, omits, and expectations; it is essential for communication to be ongoing between the RN and assistive personnel during a shift of care *right supervision* provide appropriate monitoring, evaluation, intervention as needed, and feedback; it is essential that assistive personnel feel comfortable asking questions and seeking assistance FON 1260
what's included in a letter of resignation
-at least a tow-week notice -state your reason for leaving -address the letter to your immediate supervisor or employer -deliver it in a sealed envelope FON 1243
one of the principles of time management is evaluation, know what that means
-at the end of each day, take time to think about how effectively you used your time -if you are having difficulties, discuss them with a more experienced colleague FON 1257
know why LVNs become certified in other areas of nursing
-basis for improved nursing skills and safety in patient care -also the basis for salary increases and advancement FON 1246
function of an LVN
-direct patient caregivers in most institutions -what done on the job is based on the scope of practice FON 13
as an LVN what is required to become certified in long term care
-home study certification program -covers pharmacology, aging, pediatrics, and key topics that enhance nursing competence *eligibility requirements* 2000 hours of long-term care practice within the past 3 years FON 1246
situational: delegating
-leader gives the responsibility for decision making and problem solving to mature staff who have demonstrated their competence -low supportive and low directive behavior -leader recognized there is more than one right way to do things and gives authority to staff that matches their level or responsibility FON 1256
situational: coaching
-monitors the accomplishment tasks while also explaining decisions, asking for feedback or suggestions, and recognizing good performance -high directive and high supportive behavior -typically, leader and staff have jointly developed a work plan FON 1256
emergency plans and supplies
-plan a meeting place for family members -identify where to go if an evacuation is necessary -determine when and how to turn of water, gas, and electricity at main switches -locate the safe spots in the home for each type of disaster -replace water supply every 3 months and food supply every 6 months *supplies* -a 3-day supply of water (1 gallon per person per day) -a 3-day supply of nonperishable food -clothing and blankets -first-aid kit -adequate supply of prescription medication -battery-operated radio -flashlight and batteries -credit card, cash, or traveler's checks -extra set of car keys and a full tank of gas in the care -sanitation supplies for washing, toiling, and disposing of trash -extra pair of eyeglasses -special items for infants, older adults, or disabled individuals -items needed for a pet such as food, water, and leash -important documents in a waterproof case NCLEX 69
know what the function of the LVN state board is
-protect the public by administering the nurse practice act -approving schools of nursing and renewing and issuing licenses FON 1249
prioritize client care based on symptoms (lots of questions)
-schedule the priorities that you have established for patients within set time frames -determine the best time for activities such as conducting teaching sessions, planning ambulation, and providing times for rest FON 1257 *prioritizing id deciding which needs or problems require immediate action and which ones could tolerate a delay in response until a later time because they are not urgent* -the nurse and the client mutually rank the client's needs in order of importance based on the client's preferences and expectations, safety, and physical and psychological needs; what the client sees as his or her priority needs may be different from what the nurse sees as the priority needs -priorities are classified as high, intermediate, or low -client needs that are life-threatening client or that could result in harm to the client if they are left untreated are high priorities -nonemergency and non-lifethreatening client needs are intermediate priorities -client needs that are not related directly to the client's illness or prognosis are low priorities -when providing care, the nurse needs to decide which needs or problems require immediate action and which ones could be delayed until a later time because they are not urgent -the nurse considers client problems that involve actual or life-threatening concerns before potential health threatening concerns -when prioritizing care, the nurse must consider time constraints and available resources -problems identified as important by the client must be given high priority -the nurse can use the ABCs-airway, breathing, and circulation-as a guide when determining priorities; client needs related to maintaining a paten airway are always the priority -the nurse can use Maslow's Hierarchy of Needs theory as a guide to determine priorities and identify the levels of physiological needs, safety, love and belonging, self-esteem, and self-actualization (basic needs are met before moving to other needs in the hierarchy) -the nurse can use the steps of the nursing process as a guide to determine priorities, remembering that data collection is the first step of the nursing process NCLEX 67
situational: supporting
-supports the efforts of others, facilitates their goal accomplishment, and shares responsibility for decision making -high supportive and low directive behavior -leader is willing to try new ideas of staff and uses consensus decision making to choose a course of action -leader values growth and not perfection, collaboration and not competition FON 1256
situational: directing
-the leader provides specific instructions and supervises the accomplishment of tasks -high directive and low supportive behavior -give detailed instruction; state specific expectations; enforce rules and policies; and tell employees what to do, hot to do it, and when to do it -applies with new employees, employees with repeated performance problems, and crisis work situations FON 1255
know what home care nurses responsibilities are
1. *restorative* the return to a previous level of functioning as appropriate and realistic 2. *improvement* achieving better health and a higher level of functioning than at admission 3. *maintenance* preserving functional capacities and independence by maintaining current level of health 4. *promotion* teaching healthy lifestyles that keep the effect of illness or disability to a minimum and prevent the recurrence of illness FON 1182 goal is to assess and evaluate "acute episodes" and prevent hospitalization
why it's important to have your own malpractice insurance, not just that of your employer
1. if you or your employer are codefendants and the court finds you liable and the cost of the settlement exceeds your employer's policy limits, it is possible that you will be required to pay the excess out of your own pocket 2. it is possible for your employer's insurance company to sue you if they believe they incurred a loss because of your actions 3. many employee policies are claim based rater than occurrence based; a claims-based policy covers claims made whir the policy is in effect; if you employer discontinues this policy and a claim is made later (which often happens), you will not have coverage FON 1264
what actions would be appropriate for an LVN in disaster planning
1. make personal and family preparations 2. be aware of the disaster plan at the place of employment and in the community 3. maintain certification in disaster training and in CPR 4. participate in mock disaster drills, including a bomb threat drill 5. prepare professional emergency response items, such as a copy of nursing license, personal health care equipment such as a stethoscope, cash, warm clothing, record-keeping materials, and other nursing care supplies NCLEX 69
liability insurance
1. nurses need their own liability insurance for protection against malpractice lawsuits 2. having their own insurance provides nurses protection as individuals; this allows a nurse to have an attorney present who has only the nurse's interest in mind NCLEX 49
know what needs to be included in your end of shift report
1. state patient's room and bed number, name, age, physician, all diagnoses, and date of surgery if patient is postoperative 2. summarize parent's day (or evening or night) 3. report all pertinent nursing care 4. describe change in patient's condition; usually, mot facilities report only abnormal VS except for first postoperative day, when the last set of VS is given 5. report special medications, IV solutions, infusion rate, and IV credits; state time method, and dosage of analgesics given and the effect 6. report all I&O 7. report status of lungs and bowel sounds 8. report mental status and LOC 9. report circulatory checks, pedal pulses, and skin abnormalities in turgor or color 10. state diagnostic procedure, such as cT scans, X-ray studies, MRI, endoscopy, proctoscopy, thoracentesis, and surgery; report diet changes, special permits, preoperative procedure, daily weights, activity status, accuchecks, hematest for stools, clean-catch urine for analysis or C&S, sputum specimen or C&S, respiratory therapy, and physical therapy orders; report all nursing interventions, such as dressings, packs, ostomy care, and oxygen 11. discuss patient and family education 12. note other services, such as social services, pastoral care, and discharge planning 13. state any pertinent information helpful in patient care 14. report "no code" status 15. present the report inane unbiased, nonjudgmental manner FON 1263
bureaucratic
1. the leader or manager believes that individuals are motivated by external forces 2. the leader/manager relies on organizational policies and procedures for decision making NCLEX 62
autocratic
1. the leader or manager is focused and maintains strong control, makes decisions, and addresses all problems 2. the leader or manager dominates the group and commands rather than seeks suggestions or input NCLEX 62 -leader retinas all authority and responsibility -concerned primarily with task and goal accomplishment -assigns clearly defined tasks -establishes one-way communication with the group -leader is firm, insistent, and dominating -stresses prompt, orderly performance -uses power to intimidate or pressure those who fail to adhere to expectations -displays little trust or confidence in employees -makes all decisions -some stifling of individual initiative and creativity because of fear *sometimes appropriate* -when immediate action is required and there is no time for group decisions -leader is able to take quick action -excel in times of crisis (cardiac arrest) -excel in times of disorder (natural disaster) -often have reputation of getting difficult assignments completed FON 1255
democratic
1. this is also called *participative* 2. it is based on the belief that every group member should have input into the development of goals and problem solving 3. a leader or manager acts primarily as a facilitator and resource person and is concerned for each member of the group 4. this style is a more "talk with the members" style and much less authoritarian than the autocratic style NCLEX 62 -people-centered approach -allows employees more control and individual participation in the decision-making process -emphasis is on team building and spirit of collaboration through the joint effort of all team members -leaders function to facilitate goal accomplishment while stressing the self-worth of each individual -treat each staff member as an adult and expect the same in return -criticism focuses on behaviors, not on personality, and its purpose is to promote growth and development of the staff *works best* -mature employees who work well together as groups -sometimes does not work as well with ancillary staff, who in many cases will need more direction -group decision-making sometimes seems slow and frustrating to those who expect prompt action on an issue -disagreements are more likely and sometimes require more time to resolve -demands more of the leader -valued for the sake of the growth and development of the staff it facilitates *results in health care settings* -shared governance (an organized, systematic approach to decision making that enables nurses at all levels to participate) -self-directed work teams -quality improvement staff committees FON 1255
on average the decision to hire a candidate during an interview is done in what amount of time
30 seconds
maximum amount of time that is allowed for the NCLEX
5 hours FON 1247
what you need to report at the end of your shift
8. know what needs to be included in your end of shift report 1. state patient's room and bed number, name, age, physician, all diagnoses, and date of surgery if patient is postoperative 2. summarize parent's day (or evening or night) 3. report all pertinent nursing care 4. describe change in patient's condition; usually, mot facilities report only abnormal VS except for first postoperative day, when the last set of VS is given 5. report special medications, IV solutions, infusion rate, and IV credits; state time method, and dosage of analgesics given and the effect 6. report all I&O 7. report status of lungs and bowel sounds 8. report mental status and LOC 9. report circulatory checks, pedal pulses, and skin abnormalities in turgor or color 10. state diagnostic procedure, such as cT scans, X-ray studies, MRI, endoscopy, proctoscopy, thoracentesis, and surgery; report diet changes, special permits, preoperative procedure, daily weights, activity status, accuchecks, hematest for stools, clean-catch urine for analysis or C&S, sputum specimen or C&S, respiratory therapy, and physical therapy orders; report all nursing interventions, such as dressings, packs, ostomy care, and oxygen 11. discuss patient and family education 12. note other services, such as social services, pastoral care, and discharge planning 13. state any pertinent information helpful in patient care 14. report "no code" status 15. present the report inane unbiased, nonjudgmental manner FON 1263
After transcribing each order in a list of orders, the nurse should the order.
ANS: check off The nurse should check off each order as it is transcribed to ensure that each order is implemented. REF: Page 2069 TOP: Orders
The experienced nurse who assists a novice to learn the skills of the profession is called a(n) .
ANS: mentor The nurse who guides a novice in the skills of the profession is called a mentor. REF: Page 2058 TOP: Mentoring
An LPN/LVN took the responsibility of working with the equipment company representative to learn about some new equipment coming to the facility. The LPN/LVN then developed and presented in-service teaching to the rest of the staff. This LPN/LVN is managing under management theory _____.
ANS: Y The management Y theory states that a person who knows what is expected can become self-directed to finish the task.
Planning, organizing, directing, and controlling are major functions of _____.
ANS: management The major functions of management are planning, organizing, directing, and controlling.
What characteristic is necessary in both leaders and managers? a. Motivational skills b. Sympathy skills c. Authoritarian style d. Participative style
ANS: A Although leaders and managers use different styles and responsibilities, they both must have motivational skills.
A newly admitted 35-year-old patient rings the call bell. By the time the nurse arrives, he is found unconscious and barely breathing. The charge nurse calls for a "code blue" and directs the staff on what to do without discussion. One staff member calls the physician, and some go to other rooms to comfort patients. What type of leadership style is exemplified? a. Autocratic b. Democratic c. Laissez-faire d. Participative
ANS: A During an emergency such as a "code blue," the person in charge correctly assumes an autocratic leadership role because no time is available for a discussion of choices in activities.
Employment of LPN/LVNs in the hospital setting is at a high level because their salaries are lower than RNs, which helps hospitals to provide cost-effective care. The specialty of the LPN/LVN is: a. excellent bedside care. b. individualized patient care. c. specialized patient care. d. customized patient care.
ANS: A Employment of LPNs/LVNs in hospital settings is at a high level. Because of health care economics, hospitals are responsible for providing quality care as economically as possible. Under the supervision of an RN, the LPN/LVN is legally able to provide most bedside care to patients in the hospital setting. Because the LPN/LVN salary is less than that of the RN, it makes economic sense to employ a number of LPNs/LVNs. It also makes sense because the LPN/LVN is prepared to give excellent bedside care. This is his or her specialty. REF: Pages 2058-2059 TOP: Role of LPN/LVN
A setting in which a new graduate has a very good salary, the opportunity to refuse to take an assignment, and more flexibility in one's personal schedule but with an uncertainty of work availability is a(n): a. temporary agency. b. outpatient surgery. c. outpatient clinic. d. adult day care center.
ANS: A In a temporary agency, the salary is good, and an LPN/LVN has the right to refuse assignments. However, the disadvantage is the uncertainty of work availability. REF: Page 2060 TOP: New graduate
A nurse tells the other staff members that she works only for the money and simply wants to "do the job and go home." With which leadership style would this nurse most likely be comfortable? a. Autocratic b. Democratic c. Laissez-faire d. Participative
ANS: A Individuals who simply want to "do their job" seek a directive style of leadership because it reduces their responsibilities.
What type of leadership is opposite of laissez-faire leadership? a. Authoritarian b. Bureaucratic c. Democratic d. Participative
ANS: A Laissez-faire leadership is a hands-off style; authoritarian leadership is a very directive and controlling style.
An LPN/LVN in charge of two units on the evening shift notices that two of the nursing assistants (NAs) are constantly bickering. This appears to be interfering with patient care time. Both units are extremely busy with care needs. Which solution best reflects the process of accommodation? a. Their issues are trivial and do not affect patient care actions. No time is presently available for extended discussions. Send one of the NAs to another area and allow time for both to defuse. Good patient care in an expedient manner is the priority at this time. b. Call the supervisor to send the arguing dissenters home. c. Call the dissenters into the office. Listen to their concerns and make a decision about the resolution of their trivial matters. d. Allow the NAs to leave the building and settle their differences before they come back. Make no notation of their absence on their timesheets or in the report.
ANS: A Patient care is the main priority. The leader cannot lose two caregivers but may separate them so they can provide needed patient care, accommodating both NAs by separating them.
The process of management for the nurse leader consists of the application of steps similar to those of the nursing process. Which scenario contains all the steps of the management process? a. At the end of the shift report, the team leader tells the staff that charting will be reviewed, medication Kardex checked, and patient rounds made an hour early today to obtain a more detailed patient profile of care provided during that shift. b. The team leader has been unavoidably late, has missed most of the shift report, and grabs the staffing roster to make out patient assignments. The assignments are scheduled by alphabetical order by the geographic areas of the unit. No incidents appear to have occurred on the unit during the shift. c. The nurse is perpetually late for duty and frequently leaves before the end of the shift report, asking others to help in completing the patient assignment. The team leader ignores this as long as patient care is completed. d. The staff member is noted to leave some patients in strange positions on several occasions. On rounds, the team leader notices this and correctly repositions the patients. The team leader thinks that the staff could probably use some in-service training on proper positioning; however, she decides that no time is available to schedule this training.
ANS: A Planning, organizing, and directing must be done for the provision of effective nursing care to meet standards. Evaluation or controlling is the process that checks delivered care for effectiveness.
When expressing interest in a job, the first letter submitted should be customized, brief, neatly typed, correctly spelled, simple, and direct. The purpose is to introduce oneself and state qualifications, interest, and availability. This is called a letter of: a. application. b. intent. c. concern. d. interest.
ANS: A The letter of application should be customized, brief, neatly typed, and correctly spelled. REF: Page 2046 TOP: New graduate
What are principles of time management? (Select all that apply.) a. Goal setting b. Time analysis c. Priority setting d. Interruption control e. Evaluation
ANS: A, B, C, D, E All of the options are part of the time management analysis. REF: Page 2065 TOP: Time management
What should a team leader be able to do to establish an effective team? (Select all that apply.) a. Establish a clear purpose and clarify its significance. b. Be firm to maintain focus on one idea, not sidetracked by the ideas of others. c. Listen to all input in an active manner. d. Demonstrate concern for stress of the team members. e. Be honest concerning own opinions and attitudes.
ANS: A, C, D, E Besides establishing a clear purpose, listening, and being concerned and honest, the team leader should be flexible and consider the ideas of others.
A promotion is usually based on a person's qualifications, behavior, performance, and preparation. Another term for promotion is: a. reward. b. advancement. c. elevation. d. improvement.
ANS: B Advancement may result from additional preparation or additional experience. It may be gained by learning the position more thoroughly and by assuming new and greater responsibilities. REF: Page 2051 TOP: New graduate
A contract can be written or oral, includes a set of promises between two people, and states the obligations both must fulfill. This contract establishes a relationship between the two people that is: a. binding. b. legal. c. cohesive. d. secure.
ANS: B A contract creates a legal relationship between two people. REF: Page 2050 TOP: New graduate
A head nurse puts a blank copy of the shift duty schedule on the table in the break room. The staff is permitted to fill in the shifts that they want to work during the next cycle. What leadership style does this reflect? a. Autocratic b. Democratic c. Laissez-faire d. Participative
ANS: B Democratic leadership focuses on the individual abilities and problem-solving skills of group members to avoid power struggles. Decisions are made through group consensus.
A new graduate attempting to get others to do something believed necessary and influencing them to follow is demonstrating: a. management. b. leadership. c. influence. d. control.
ANS: B Leadership is the art of getting others to want to do something that is perceived as necessary. REF: Page 2062 TOP: New graduate
Physical, emotional, and spiritual exhaustion can occur among caregivers and appears more often in people who have excessive expectations of themselves. This situation is called: a. excessiveness. b. burnout. c. fatigue. d. weariness.
ANS: B Physical, emotional, and spiritual exhaustion among caregivers is sometimes called burnout. REF: Page 2066 TOP: Burnout
The type of leadership that uses four different styles—directing, coaching, supporting, and delegating—is: a. autocratic. b. situational. c. democratic. d. authoritative.
ANS: B Situational leadership identifies four typical styles for leaders. REF: Page 2063 TOP: Leadership
The setting in which a new graduate may learn skills not normally acquired in an LPN/LVN program, will likely have a daytime schedule with weekends off, and will focus on prevention is a(n): a. outpatient clinic. b. physician's office. c. home care setting. d. adult day care.
ANS: B Skills may be taught by the physician, and the schedule of primarily days can be considered an advantage. REF: Page 2060 TOP: New graduate
The recognition and use of the LPN/LVN began because of RN shortages and a reevaluation of LPN/LVNs as team leaders. What is the approximate year of this change in staffing? a. 1940s b. 1950s c. 1960s d. 1970s
ANS: B Team nursing with LPN/LVN leadership was introduced in the 1950s as a result of a shortage of RNs and an abundance of auxiliary nursing personnel, whose skills and leadership potential were reevaluated.
The role of the LPN/LVN as a team leader has been developed to broaden and improve patient care. Which statement best reflects this role implementation? a. As LPN/LVN team leaders, these nurses are totally and only personally responsible, under the terms of licensure, for personal care actions and the nursing actions of the others assigned on their units and shifts. b. As an LPN/LVN team leader, this nurse, under the supervision and guidance of an RN, is responsible for all aspects of patient care that is assigned to this team. c. As an LPN/LVN team leader, this nurse uses skills and judgments learned in school to guide and direct the team members in what the nurse believes is correct patient care. The LPN/LVN is accountable only to patients for the care provided. d. The team leader LPN/LVN decides on patient care assignments, takes care to promote accident prevention and safety, and is accountable only to self-professionalism for the nursing actions of the team.
ANS: B The LPN/LVN practices under the supervision of an RN but is responsible for her or his own performance and of that of the team's.
New graduates should purchase their own malpractice insurance rather than depend on institutional insurance because their own policy will: a. not cover them unless they are on the job. b. carry liability coverage. c. protect them against all lawsuits. d. protect them from losing their license.
ANS: B The new graduate should purchase insurance in addition to that of the institution to ensure that there is personal liability coverage and also coverage should the graduate work in some other setting. REF: Page 2072 TOP: Malpractice insurance
A setting in which the new graduate gives total care to one patient; is totally independent; provides care in the home, hospital, or other facility; is paid directly by the patient; and is legally responsible for his or her own actions is: a. home health nursing. b. private duty nursing. c. patient care nursing. d. agency care nursing.
ANS: B The private duty nurse gives total care to one patient. REF: Page 2061 TOP: New graduate
Technical and scientific changes have resulted in a multiplicity and complexity of functions placed on nurses, and sometimes job descriptions have not been rewritten. The role of the LPN/LVN is constantly: a. enlarging. b. changing. c. improving. d. growing.
ANS: B The role of the LPN/LVN is constantly changing. REF: Page 2051 TOP: New graduate
The commission of an act that a prudent nurse would not have done, or the omission of an act a prudent nurse would have done, that results in injury to a patient is termed: a. malpractice. b. negligence. c. neglect. d. disregard.
ANS: B To qualify as negligence, it must be proved that a prudent member of the profession would have acted differently. REF: Page 2058 TOP: Negligence
A licensed practical/vocational nurse (LPN/LVN), as a regular staff member, knows all the patients and anticipates many of their needs. Other staff members are comfortable asking for advice. The advice is given freely with a clear explanation or demonstration or both. In what role is this nurse acting? a. Self-appointed teacher b. Management-assigned instructor c. Informal leader d. Designated supervisor
ANS: C
A concise, one-page, comprehensive, well-organized, neat, accurate summary of educational and work experience that provides prospective employers with their first impression, is called a(n): a. introduction. b. review. c. resumé. d. composite.
ANS: C A resumé is a one-page written document that contains information about the applicant's education and experience. REF: Pages 2046-2047 TOP: New graduate
When a nurse encounters a problem, it is best to follow the chain of command. Problems can best be resolved by: a. agreement. b. argument. c. communication. d. withdrawing.
ANS: C Any problem can best be resolved by communication at the most basic level. REF: Page 2050 TOP: New graduate
. Leadership is different from management. Which definition best describes this difference? a. The leadership function comes after the manager decides on it. b. Management refers to providing the means to inspire people. c. A leader selects the role, and a manager is appointed. d. A manager selects goals and the means to achieve them.
ANS: C As defined in the text, whereas leaders inspire people to strive to accomplish particular goals, management provides the means to achieve these goals.
On the way to the biohazard disposal closet to dispose intravenous (IV) tubing and a bag used on a patient who is positive for human immunodeficiency virus, the LPN/LVN drops the IV tubing and bag on the floor, causing a spill. What is the team leader's most appropriate action? a. Quickly pick up the dropped supplies and dispose of them in the biohazard bag in the biohazard room. Ask housekeeping to place a small barricade over the spill until it can be mopped up later. b. Find the floor maintenance person to pick up and dispose of the used equipment and to mop the floor, reminding him or her to wash his or her hands with soap and water. Chart that the IV was infused and discontinued appropriately. c. Call and report to designated personnel to come and cordon off the area from staff and patients; have the spill cleaned with approved infection and chemotherapy spill control procedures. d. Chart the spill in the patient's chart, inform the RN when convenient, and have housekeeping mop up the spill.
ANS: C Blood and chemotherapeutic agents are biohazards. Each facility has a policy regarding safety issues, which includes immediate reporting to the designated personnel.
Failure by the nurse or the employer to perform duties listed in the contract results in a: a. lawsuit. b. termination. c. breach of contract. d. reprimand.
ANS: C Failure by the nurse or employer to perform contractual duties is a breach of contract. REF: Page 2050 TOP: New graduate
When a resumé reflects too many job changes, the employer may question it. It is best to remain at the first place of employment for at least: a. 6 months. b. 3 months. c. 1 year. d. 2 years.
ANS: C Resigning from a position properly is another skill that the LPN/LVN will need to have. Employers will sometimes question a resumé that reflects frequent job changes; therefore, it is best to remain at the first place of employment at least 1 year. REF: Page 2051 TOP: New graduate
A director of nursing in a long-term care facility appoints an LPN/LVN to be project head to coordinate a review of end-of-shift reporting times and to develop a new, more timely format for the entire agency to use. What is the role of the LPN/LVN? a. Goal-setting organizer b. Organizing leader c. Assigned manager d. Manager-leader
ANS: C The LPN/LVN has been appointed to manage the implementation of a goal set by the leader.
The setting that provides a relaxed atmosphere, decreased patient load, a primarily daytime schedule, is becoming more common, and is less costly for insurance companies is: a. hospice. b. adult day care. c. home health. d. long-term care.
ANS: C The advantages of home health are a more relaxed atmosphere, decreased patient load, and less cost. REF: Page 2060 TOP: New graduate
The type of leadership in which the leader displays little trust or confidence in employees and therefore makes all decisions is called: a. democratic. b. laissez-faire. c. autocratic. d. authoritative.
ANS: C The autocratic leader displays little trust in employees, and therefore makes all decisions. REF: Page 2063 TOP: Leadership
A team leader nurse is attending college classes for a degree after work and spends much of the day reading and writing. As a result, the staff is given few directions. They make their own patient assignments and time schedules and solve problems among themselves. Significant confusion is evident on the unit. What leadership style is being practiced? a. Autocratic b. Democratic c. Laissez-faire d. Participative
ANS: C The laissez-faire leader gives no direction to the activities of the staff, allowing them to do what they want.
The licensing law that (1) defines the title and regulations governing the practice of nursing and (2) states the requirements for licensure is called the: a. state practice act. b. nurse regulation act. c. nurse practice act. d. legislative act.
ANS: C The nurse practice act defines the title and regulations governing the practice of nursing. REF: Page 2057
A team leader is preparing to type the evening shift report. Which comment should be included in the report? a. Patient A complained of a headache until his wife arrived to visit. She was 20 minutes late because of unavoidable traffic. b. Patient B ate everything on her dinner tray—roast beef, mashed potatoes, and green beans—and the dessert, too, which is her usual pattern. c. Patient C was so restless that the dressing on her sacrum came off and had to be replaced. No change occurred in the assessment of the decubitus. d. Patient D had her usual visitors. She is sleeping after her regular evening medications, which were given as ordered at 2000.
ANS: C The shift report should contain only clear, concise, and thorough information without extra useless comments.
When staff members complain about being pulled to other areas to work without prior notice, the leader agrees with their request to develop a more effective system and does so with assistance and input from the entire staff. Which leadership theory does this exemplify? a. X b. Y c. Z d. T
ANS: C Theory Z involves all workers in every phase of the operation. Theory X assumes that all workers desire direction. Theory Y assumes that all work gives satisfaction.
The graduate may practice in another state if he or she has passed the NCLEX- PN® examination in his or her own state and meets the other state's educational requirements. This licensure from one state to another is called: a. auxiliary. b. co-licensure. c. endorsement. d. qualified licensure.
ANS: C This licensure from one state to another is called endorsement. REF: Page 2056
Which task is most likely to be delegated to a certified nurse's assistant (CNA)? a. Updating a nursing care plan b. Developing a teaching plan c. Weighing a patient d. Evaluating pain medication responses
ANS: C Unlicensed persons may weigh a patient when directed to do so.
From what source does an LPN/LVN receive authority to delegate care to unlicensed personnel? a. Physician or registered nurse (RN) who hired them b. National Nurse Practice Act c. 1994 Entry Level Competencies Report d. Nurse practice act of the individual state
ANS: D Delegation of responsibilities must be in accordance with the state's nurse practice act.
A professional nurse has skills and knowledge to direct the care provided by other staff. What nursing care organization does this indicate? a. Primary nursing b. Functional nursing c. Rehabilitative nursing d. Team nursing
ANS: D In a team nursing situation, the skills of each team member are used to best advantage for efficient nursing care.
A team leader is making out the patient care assignment. A new patient needs several extensive dressing changes for open diabetic wounds, a nasogastric (NG) tube feeding, and irrigation of the Foley catheter as needed. Which member of the care team is best suited for this assignment? a. Nurse aide A, who has had 10 years' experience working at this facility, especially because this room is on the hall area where this NA is usually assigned b. Nurse aide B, who has just been employed but has recently been through the state nurse aide certificate program and needs the experience of these treatment modalities c. Nurse aide C, who is always asking for something new to try out and who is attending LPN/LVN school in off-duty hours d. LPN/LVN C because these treatments are covered under the LPN/LVN state practice act
ANS: D Invasive procedures may not be carried out by unlicensed personnel.
The setting in which an LPN/LVN can advance to charge nurse or staff developer and management and leadership skills can be developed, is a(n): a. acute care hospital. b. rehabilitation hospital. c. trauma center. d. long-term care facility.
ANS: D Management and leadership skills of the LPN/LVN can be developed in long-term care settings with RN supervision. REF: Page 2060 TOP: New graduate
A case conference is called to plan for a patient who has caused stress in the staff with constant calls and trivial requests. The nurse leader expresses personal views when leading the discussion about approaches to the problem and then makes the decision for care based on the discussion. What type of leadership style does this exemplify? a. Autocratic b. Democratic c. Laissez-faire d. Participative
ANS: D Participative leadership encourages group involvement and suggestion, but the decision is made by the leader.
A team leader assigns LPN/LVN A to patient care in rooms 123 and 129 and explains the special higher level care that these patients require. Nurse aides G and F are assigned to the rest of the hall, splitting the numbers of patients needing total care versus partial care. Their care duties are discussed in detail. What does making assignments according to skill level exemplify? a. Planning b. Organizing c. Evaluating d. Directing
ANS: D The management function of directing is evident when the team leader makes assignments according to skill levels and explains what is to be done.
Which leadership style allows leadership flow among members of the team according to the task at hand? a. Democratic b. Laissez-faire c. Multicratic d. Transformational
ANS: D The transformational style allows leadership to flow among the members of the team, based on the task at hand. Such style indicates a well-functioning team.
which organizations are totally committed to LVN
National Association for Practical Nurse Education and Services (NAPNES) National Federation of Licensed Practical Nurses (NFLPN) FON 1245
what organizations are totally committed to vocational nursing and continuing education
National Association for Practical Nurse Education and Services *(NAPNES)* National Federation of Licensed Practical Nurses *(NFLPN)* FON 1245
when you are working as an LVN you are under the direct supervision of whom *select all*
RN medical physician FON 1243 osteopathic physician dentist FON 13
definition of a contract
a promise or a set of promises between two or more people that creates a legal relationship between them and a legal obligation that one or more of them has to fulfill FON 1241
definition of leadership
art of getting others to want to do something you are convinced has to be done FON 1254
different types of leadership styles (lots of questions)
autocratic democratic laissez-faire situational bureaucratic
what makes a contract legal
can be written or oral *nurse* perform nursing functions with the skill and knowledge of an LVN in accordance with standards or profession and any additional qualifications the nurse claimed to possess *employer* responsible for providing a safe working environment, sufficient and competent fellow workers, and safe equipment FON 1242
individual on the floor (found them that way) eyes closed, what is your first action
check for response then airway
definition of negligence
conduct that falls below a standard of care; failure to meet a client's needs either willfully or by omission or failure to act NCLEX 46
what can you delegate to personnel
delegate only tasks for which you are responsible; a nurse who delegates is accountable fore the tax; the person who assumes responsibility for the task is also accountable NCLEX 66
situational: four styles of leadership
directing coaching supporting delegating FON 1255
qualities of an effective leader
effective communicator credible critical thinker initiator of action risk taker is persuasive and influences employees NCLEX 63
when a nurse does not perform their duties listed in their contract, know what this is called
failure not eh part of the nurse or the employer to perform these duties is a *breach of contract* FON 1242
know what a new graduate would include on a resume
information about you your education your experience brief outline of your personal and professional life concrete skills and interests FON 1238
as a nurse your first duty is to client health and safety, what is another essential component to what your duties should include
participates in activities that promote the community's positive attitude toward health care FON 1245
appropriate way to communicate with your personal
provide clear and concise details about the task, including the time frame and the expected outcome, the purpose of the task, and any limitations in responsibility or authority for accomplishing the task FON 1260