402 coursepoints

What best describes someone who is an informal nursing leader?

A well-respected nurse with years of experience on the unit becomes a team leader.

A nurse explains the informed consent form to a patient who is scheduled for heart bypass surgery. Which elements are considered essential to the effective establishment of informed consent?

-Competence of the patient must be determined prior to consent -Comprehension of the information by the patient or guardian -Full disclosure of information regarding the procedure

What information is accurate when describing the Nurse Practice Acts?

-They need to be consistent with applicable federal statures -They identify actions that fall outside of the nurse's scope of practice -When considering the law, they are an example of a statute -They focus on the practice of the professional nurse

Which document addresses the role of the nurse in taking appropriate action regarding instances of illegal, unethical, and/or inappropriate behavior when caring for a patient population of any age?

American Nurses Association (ANA) Scope and Standards of Practice

A nurse manager is considering how to gain more staff involvement in meeting budgetary goals. Which activity is most likely to result in staff understanding and participating in budgetary goals?

Communicating budgetary planning goals to staff

Samantha has approached Dr. Gonzalez in an effort to discuss Mary's care, and it is clear that they disagree about the necessary approach. What should Samantha do in order to promote a collaborative approach to conflict management?

Discuss Mary's situation with Dr. Gonzalez and try to agree on a common goal for her care.

Which response by the nurse manager is most appropriate when overhearing staff complaints about a new hospital-wide process to improve patient ID band identification?

Let's start today with addressing these new patient ID bands in every huddle, and then I'll send a memo before calling a special meeting to discuss this by the end of the week

The pediatric nurse is admitting an 8-year-old child with cellulitis of both hands and arms from multiple infected bug bites in various stages of healing. The child has not received care for these infected bug bites. The nurse is upset and angry when she becomes aware that other unit staff have previously made several referrals to the local CPS agency about this family for issues related to neglect of care. Which ethical issue may be used to describe this situation?

Moral outrage

When making a decision about using a prn pool for added staffing, what can the nurse manager do to make the best decision?

Make a decision with all of the facts.

A nurse manager is reviewing the budget for the nursing unit. Which budget covers the expenditures for the unit's workforce?

personnel

Which of the following are steps included in the flexible budgeting process?

- Separate the costs into fixed, variable, or mixed categories -Forecast the cost for each of these categories of activities -Analyze the cost patterns over that period of time

A nurse manager is using a budgeting approach that requires justification for each budgetary need. What approach is being used?

zero based

The nurse manager has an obligation to act as advocate for which entities?

- The staff -The patient -The profession -Themselves

Leadership succession planning is defined as:

The organization has ensured that there are competent, qualified, well-prepared people available for future positions

A nurse has a difficult decision to make regarding patient care. What should the nurse due to influence a positive outcome?

- Slow down the thinking process -Identify a number of different options. -Understand the repercussions of each option. -Gather data and input from a variety of sources.

What rights do patients have?

- The right to protection of their privacy -The right to end treatment without physician consent -The right to informed consent -The right to respectful care free of discrimination

When the care required of a patient comes into conflict with the nurse's personal beliefs, what situation exists?

ethical dilemma

Why should nurses be aware of the rights and duties of legal matters?

they are better able to protect themselves

Which situations are necessary components for malpractice to occur?

- A direct connection between care given and injury must be present. -A standard of care must be in place whereby the provider has accepted duty for the patient. - The practitioner has failed to meet a standard of care, also called a "breach of duty." -Foreseeability of harm must exist.

Which statement is true about an incident report?

- A disclosed incidence report can be subpoenaed in court. -The document is generally considered confidential. -The chart should contain all the variables related to the incident.

A few months ago, a new nurse leader at a hospital discovered via evidence-based practice that tablet computers improved accuracy of documentation and decreased patient wait time. The leader noted that these outcomes are beneficial to the facility, staff, and patients, as tablets provide portable access to patient electronic medical records. The nurse leader is currently in the planning stage. Which activities are part of planning stage?

- Anticipating resistance to the change by less tech-savvy staff -Determining the scope of the change project, a schedule for its implementation, and a budget to submit to administration for approval.

According to Marquis and Huston (2021), there are other critical elements that nurse managers/leaders use to complete the decision-making process. From the following choices, select those that are considered crucial to problem solving and decision making.

- Develop realistic timeline -Carefully gather pertinent data -Think logically -Objectives clearly define

What must a person giving informed consent for surgery or a procedure fully comprehend in order to give informed consent?

- Expected complications or potential side effects that may occur as a result of the treatment. -The risks involved -Expected or desired outcomes -The procedure to be performed

The Health Insurance Portability and Accountability Act ensures strong privacy protections for the patient without threatening access to which areas of care?

- Health care plans - Health care clearinghouses -Exchange of patient information among appropriate health care providers

After attending a health care research seminar, a registered nurse who works in the transplant unit became very interested in the ability of 3D printing to help save lives. The nurse would really like to raise awareness and see the hospital invest in a 3D printer. What are the different technical reasons for resistance that the nurse may encounter?

- Unqualified personnel - Lack of resources - budget issues

As the nursing manager of a unit, which key steps should be performed before implementing a change effort?

- Use a roadmap as a guide to complete the change. -Encourage input from team members who would be impacted by the change. - Investigate the magnitude and complexity of the intended change

Which of the following competencies are important for the nurse leader to develop?

Ability to diagnose a situation, adapt, and communicate

The nurse manager is aware that there will be critical changes made to staffing due to low census in an acute care facility, and staff is already lacking trust in administration. What would be the best way for the nurse manager to handle the situation?

Be truthful regarding the situation about staffing and census.

How can the nurse manager best minimize the personal risk for legal liability?

Creating a work environment that prioritizes patient needs

The nurse manager on the unit where Mary is receiving care is applying Crisham's (1985) MORAL decision-making model to Mary's care planning. What is the nurse manager's best initial action?

Gather as much specific information about Mary's status and circumstances as possible.

What area do consumers value the most when seeking health care?

High quality, low cost, and ability to meet patient outcomes

The new nurse manager identifies what reason for the need to thoughtfully use a change management process?

If all critical human and organizational elements are addressed in a structured manner, it increases the likelihood of sustainable change.

A nurse manager is evaluating the current fiscal year budget. Which statement regarding the evaluation stage of the budgetary process is most accurate?

Large variations from the projected budget must be examined.

Operational budgets are financial plans for the entire organization day-to-day operations. This type of budget includes which of the following?

Payroll, supplies, and expenses

A nurse manager is considering revising the budget cycle for the nursing unit. Which budget cycle has the greatest probability for error?

Planning for the distant future

Which of the following are behaviors associated with effective leaders?

Priority setting, critical thinking, skillful communication

When discussing the role of mandated reporting for suspected child abuse, the student nurse understands that not reporting suspected abuse could result in which legal action?

Professional negligence

Samantha is applying the American Nurses Association Code of Ethics for Nurses when planning the next steps of Mary's care. When applying the principles of the Code, Samantha should prioritize what factor?

Protecting and promoting Mary's rights, dignity, and well-being

Which of the following delineates the set of values and beliefs of an organization's goals and guides the development of the philosophy statement?

Purpose or mission statement

What is the most significant negative impact of implementing mandatory overtime to cover staffing shortages?

Risk to patient safety and health

A nursing staff member in the ED has noted where improvement of a procedure would bring about more efficiency. The staff member wants to share their idea with their supervisor. What would be the best option to facilitate the possibility of change?

Schedule a meeting with your supervisor and submit a concise plan related to your idea for consideration

A new nurse manager on a med-surg unit is not satisfied with the consistently low scores on patient-satisfaction surveys in the area of staff responsiveness. The manager has also noticed that staff morale is quite low compared to other units. Which strategy is a priority for this new nurse manager?

Schedule a special staff meeting to address the survey results and add "patient survey results" as a standing agenda item for each monthly staff meeting

What is the role of the change agent?

Seeks to lead or create change

Which of the following strategies should nurse leaders use to promote evidence-based practice?

Staying current with professional issues

According to the ANA Code of Ethics for Nurses, what is the nurse's primary commitment?

The application of ethical standards to the delivery of patient care

A nursing manager is considering the budget for a nursing unit as compared with the overall institutional budget. Which is the most negative outcome of multiple nursing units "padding" or inflating their department budgets to cushion against administrative cuts?

The entire institution's budget may be ineffective.

A nurse manager is preparing a presentation to be delivered to a group of nurses in a nursing unit about the current U.S. health care system. Which statement about resource utilization is most accurate?

The health care resources that are available in the United States are not used cost-effectively.

What is the primary purpose of law and legislation governing nursing practice?

To protect the patient and the nurse

A nurse manager is holding a meeting to discuss a sensitive issue with the staff. A previous meeting was held regarding the same issue and it ended in a negative manner. What action can the manager take in order to minimize the impact of leader/group style mismatch?

appoint a leader as a participant

A nurse educator in a college setting has developed leadership skills as a result of attaining further education and sharing positive change within the department. What transformational leadership characteristic is this nurse educator demonstrating?

empowering others

Which budgeting approach can foster overspending?

incremental

The manager of several related departments brings the team together to inform them that they will all be cross training to other units for the purpose of increasing productivity. What form of leadership does this manager demonstrate?

transactional

A nurse in a leadership role is committed to a vision for retention in the medical-surgical unit and is able to empower others with this vision. What form of leadership is this nurse demonstrating?

transformational

A nurse makes a decision using intuitive judgment regarding a patient's rapid change in condition. What action should the nurse take after the decision?

use evidence based data to validate decision

A nurse manager is having a difficult time in making a decision about reprimanding a staff nurse who has exceeded the absentee policy. Why would the manager's values cause personal conflict in making this decision?

values often collide with one another

The nurse must get a consent signed by the patient regarding their upcoming surgery. She notes in the chart that the patient was medicated for pain one hour ago with hydromorphone. Ethically, what should the nurse do?

withhold the consent until another time

A nurse manager wants to improve the efficiency and effectiveness of budgetary expenditures. Which budgeting approach would be the best to use in this situation?

performance

A nurse leader recently transferred to a different hospital that is much older than the hospital at which the nurse was previously employed. After working in the new hospital for a month, the nurse leader believes it would be a great idea to brighten the rooms with a lighter paint job, obtain newer hospital beds and curtains, and hang some fun artwork. However, the nurse leader doesn't want to be perceived as a threat to the team. How could these ideas be presented to minimize resistance?

- Engage other nurses in a discussion about the benefits of exam room aesthetics, then solicit their ideas to improve aesthetics. - Engage other nurses in a discussion about the benefits of exam room aesthetics, then present the idea. - Make over one of the exam rooms and use it as a test case to collect data on patient satisfaction, then present the data along with the idea to the team if the experiment was successful.

A nurse manager is considering the reasons for the current problems with the health care system. Which are negative consequences of higher spending in health care

- Higher spending may result in overuse of technology. - Higher spending may result in overutilization of services. - Higher spending may result in duplication of services.

A new nurse manager is learning about fiscal planning. Which are barriers for nurse managers' participation in fiscal planning?

- Nursing education lacks preparation in fiscal planning. -Many nurses perceive that fiscal planning is difficult.

Which statement is true regarding the Good Samaritan law?

- Protection provided is generally limited to emergency situations. -The provider may not exceed scope of practice limits.

A nurse educator determines that the present classroom environment is ineffective in promoting critical thinking. What methods could the educator employ in the classroom to improve critical thinking?

- Simulation -Case studies - Problem-based learning exercises

The charge nurse of a step-down unit is implementing a new procedure for charting, which will impact all of the nursing staff. According to Lewin's Model of Change, the "Movement stage" can be more successful if certain things are considered by the change agent

- set target dates - include all stakeholders - implement the change

In a leadership class discussing the role of advocacy in nursing, the student nurse learns that these are patient advocacy nursing values when caring for a pediatric patient who may be a victim of child abuse?

-Respect -Empowerment -Autonomy -Caring

The nurse is a member of the nursing staff at a hospital that is undergoing significant organizational change. Which factor is the greatest contributor to the resistance encountered with organizational change?

Employee mistrust of management

A nurse leader is considering using transformational leadership. What information would the nurse leader need to keep in mind?

Empowerment of both the leader and follower occurs.

A new nurse manager is interested in a transformational leadership style. Which statement best describes this type of leadership?

Seeks input from all staff for joint problem solving with a focus on team building

The nurse is admitting a new patient and is collecting data through obtaining a health history and physical assessment. What phase of the problem-solving process is the nurse focusing on with the patient?

assessing

The nurse engages in actions to promote the good of the patient. The nurse is engaging in fulfillment of which ethical principle?

beneficence

Choose the method of reimbursement that includes the cost of providing the service plus a markup for profit.

charge

Which type of law regulates the practice of nursing?

civil law

A nurse manager informs the staff that if they do not increase productivity by 15%, there will be people losing their jobs. What form of power is the nurse manager displaying with the staff members?

coercive power

The nurse manager for a medical-surgical unit is implementing a change in unit procedures as it relates to patient discharge. During the fourth phase of change known as "action," the manager should incorporate the major component known as:

communication

A nurse is arrested for possession of illegal drugs. What kind of law governs this type of activity?

criminal

A nurse does not assist with ambulation for a postoperative patient on the first day after surgery. The patient falls and fractures a hip. What charge might be brought against the nurse?

negligence

What is the term used to identify the omission of doing something that a reasonable person would do, guided by the considerations that ordinarily regulate human affairs?

negligence

Which legal act gives patients the right to determine their desired end-of-life care?

patient self determination act

A nurse manager is preparing the annual budget for the coming fiscal year, and is considering what the goal is of using the allocated funds. What stage of the budgetary process is this?

diagnosis

A nurse is travelling to work on the highway. The nurse sees a car get hit from the rear. The car spins out of control and hits the median. The nurse stops to help at the scene. Legally, the nurse may do this based on the Good Samaritan Law. What ethical framework is the Good Samaritan Law based upon?

duty based

Samantha recognizes the need to adhere to the ethical principle of beneficence when addressing this challenge in Mary's care. Samantha can best promote beneficence in Mary's care by:

ensuring that Mary's best interests inform any decisions that are made

A nurse is determining whether the outcomes were met for a patient preparing for discharge with an open abdominal wound and reassessing if not met. What phase of the nursing process is the nurse performing?

evaluating

Which step in the problem-solving process assists the nurse leader to prioritize the problem or issue?

identifying the problem

A nurse determines that action is justified for a patient with limited mobility after an injury. After a plan for a solution has been identified, what is the next step in the problem-solving process?

implementation

A nurse is educating a patient who is scheduled to undergo an open cholecystectomy how to turn, cough, and deep breathe in order to prevent complications after the procedure. What phase of the nursing process is the nurse providing?

implementation

new nurse manager with limited budgeting expertise is considering what approach to use to determine the budget of the nursing unit for the upcoming fiscal year. Which approach would be the easiest to implement?

incremental

Last month, two nursing units were merged to save on staffing costs. The nursing manager is now inquiring among the staff about how the change is working and if any barriers remain. What stage of change is this?

integrate

A nurse is caring for a patient that suddenly becomes short of breath and has a decrease in oxygen saturation to 86%. The nurse places the patient on 4 L of oxygen via nasal cannula and elevates the head of the bed. What decision tree would the nurse have used in this situation?

intuitive judgement

A nursing instructor is discussing ways to improve critical thinking during a clinical rotation with a student. The student asks the nurse what critical thinking is. What is the best response by the nursing instructor?

it requires reasoning and creative analysis

A nurse manager is assigned to a new unit due to issues of administrative mismanagement, which had resulted in staff becoming disillusioned as to the mission of the unit. As the unit manager, you are expected to develop new policies for the staff to follow. What is one of the greatest factors that may contribute to resistance of change on this unit?

lack of trust

A nurse leader is working in the ER when a patient presents with a deep head laceration requiring immediate suturing. The nurse leader went to the medical supply area for antibacterial ointments, gloves, and bandages. However, the nurse noticed that the medical supply cabinet was extremely disorganized, so it took much longer than it should have to find the necessary supplies. The next morning, the nurse leader began to ask team members if they had any input regarding the organization of the medical supplies, and then began to brainstorm a few different ideas, such as rearranging the supplies and relabeling items. What is the next stage of change the nurse leader should address?

plan

Identifying alternatives in the decision-making process would compare to what step in the nursing process?

plan

A nurse leader is thinking about approaching their manager with a new idea. To be properly prepared, the nurse leader should recognize this as a natural and expected response to change:

resistance

he nurse is caring for a patient whose vital signs are not stable and who seems to be nearing the end of life. The provider orders the patient to be placed on life-sustaining treatments, but the nurse questions this order. The nurse is operating within which type of ethical framework?

right based