Contemp II
A nurse realizes that much time is wasted during shift report when coworkers discuss personal items such as recent movies or department store sales. Which statement would help with time management during this critical interaction?
"I have the list of patients; let's start with revisions to the plan of care and scheduled activities for the next shift."
A hospital standard states, "All intravenous (IV) sites must be rotated every 72 hours." The nurse who assesses and records variations from this standard is fulfilling which role of nursing? a. Infection control b. Quality management c. Coordinator position d. Counselor
A
A novice nurse is assigned a patient who has an order to draw blood for culture and sensitivity from a central line before antibiotic therapy is started. The novice reads and rereads the procedure manual. An hour later he stands at the bedside of the patient and stares at the central line, without knowing how to proceed. This phase of reality shock is termed: a. honeymoon. b. shock or rejection. c. recovery. d. resolution.
A
A nurse manager is preparing a budget that does not base annual budgets on the revenue and expenditures of the prior year and has the advantage that outdated information is not integrated into the budget. The manager is using which budget method? a. Zero-based b. Incremental c. Labor d. Operational
A
A patient is admitted with hypotension, shortness of breath, flushing, and hives. All levels of staff have been trained to assess vital signs. Given budget restrictions and proper delegation rules, to which care provider would the RN delegate the task of obtaining the initial blood pressure reading? a. RN b. LPN/LVN c. Nursing assistive personnel (NAP) d. Use the blood pressure obtained in the ambulance, because it was assessed via electronic monitoring.
A
A team of experienced nurses work together to develop algorithms that are converted into checklists to ensure standardization of commonly performed procedures. The focus of this team is primarily on which Institute of Medicine (IOM) competency? a. Safety b. Timely c. Equitable d. Patient-centered care.
A
After keeping a log of activities designed to improve time management, the nurse divides the distractions into internal and external sources. The nurse would classify which distraction as internal? a. Responding to recurring crises at work or in one's personal life b. Unsuccessful attempts to communicate with the unit manager c. Talking with potential faculty candidates d. Being given unclear job responsibilities
A
An RN is consistently late to work, causing reassignment of patient care and the need for repeated shift reports. The nurse, who receives a warning for repeated tardiness, states, "My husband left me, I have no car, no family close by, and the bus is always late, which makes me late. The nurse manager doesn't care how hard I try to get here, and I am raising a child by myself." The nurse is using which type of logical fallacy? a. Appeal to emotion b. Appeal to tradition c. Hasty generalization d. Confusing cause and effect
A
Cover letters: a. should signify an interest in the employer and let the employer know that you took time to research the organization. b. must be handwritten so the employer can determine whether charting will be legible. c. should be limited to one paragraph because time is of the essence. d. let the employer know your desired salary, shift, and area of practice.
A
During orientation a novice nurse sits and "virtually spends" the first few paychecks, envisioning the money going into a personal bank account. In the dream state, the nurse smiles and knows that the pain of nursing school was worth it. Which phase of reality shock is the nurse experiencing? a. Honeymoon b. Shock or rejection c. Recovery d. Resolution
A
Graduates from approved schools of nursing cannot begin their careers and practice as registered nurses until they: a. pass the National Council Licensure Examination for Registered Nurses (NCLEX- RN). b. provide evidence of mental competency. c. supply written proof of physical fitness. d. have signed an employment contract with a health care facility.
A
In a large health care facility, the executive administrative leaders set the budget goals to decrease full-time equivalents by 3%, eliminate the cost of agency nurses, reduce lost revenue from lost supplies by 1%, and provide a 0.5% hourly salary incentive for working on a float unit when the assigned unit has a low census. Nurse managers meet with nursing administrators to design their unit budgets to meet these established goals. The budget approach that is being used is the: a. top-down approach. b. participatory approach. c. iterative approach. d. incremental approach.
A
In deciding whether to say no to a request that involves a time commitment, the professional nurse must consider: a. the cost/benefit ratio. b. the time commitment of coworkers. c. ways to buffer saying no. d. personal preference.
A
In the NCLEX-RN exam test plan, client needs forms the organizing framework of the exam with questions in four categories: safe and effective care environment, health promotion and maintenance, psychosocial integrity, and physiologic integrity. Certain processes are then integrated throughout the categories of client needs. Which process is integrated into all client need categories? a. Teaching/learning b. Health promotion c. Infection control d. Pharmacology
A
Nurses on a unit provide personal hygiene, administer medications, educate the patient and family about treatments, and provide emotional support. These nurses provide patient care based on which nursing delivery system? a. Total patient care b. Partnership nursing c. Team nursing d. Functional nursing
A
The nurse manager is planning staffing levels and realizes that the first step is to: a. know the intensity of care needed by patients according to physical and psychosocial factors. b. examine the educational level of the staff. c. assess the skill level of caregivers. d. review the budget to determine the financial consequences of past staffing patterns.
A
The nurse prepares to apply sterile gloves needed for a procedure. After introducing self and verifying patient information, the nurse performs hand hygiene. The nurse should open the outer package and then perform the following steps in order (items on left will be moved in correct order on the right): Place in correct order. Open inner package, taking care not to touch inner surface. Put the glove on the nondominant hand using the sterile gloved hand. Put glove on dominant hand by grasping folded cuff edge, touching only inside of cuff. Adjust each glove carefully by sliding finders under the cuffs. The above question represents which type of alternate-format question written at which level of Bloom's taxonomy? a. Drag-and-drop item, comprehension b. Chart exhibit item, analysis c. Multiple-response, application d. Hot-spot item, knowledge
A
The nurse prepares to apply sterile gloves needed for a procedure. After introducing self and verifying patient information, the nurse performs hand hygiene. The nurse should open the outer package and then perform steps in which order: 1. Open inner package, taking care not to touch inner surface 2. Put the glove on the nondominant hand using the sterile gloved hand 3. Put glove on dominant hand by grasping folded cuff edge, touching only inside of cuff 4. Adjust each glove carefully by sliding finders under the cuff.
A
The primary focus of the care provider role for the nurse involves: a. using the nursing process to provide guidance to the patient in recovery. b. encouraging consumer self-responsibility and emphasizing health promotion/maintenance. c. focusing on increasing satisfaction among professional nurses. d. advancing nursing practice through research.
A
The primary purpose of the NCLEX-RN exam is to: a. ensure that practitioners have the minimum skills and knowledge needed to provide care that will produce the best patient care outcomes. b. regulate nursing education. c. determine the mandatory educational level required for nurses to practice. d. accredit schools of nursing.
A
The task of completing and signing the initial assessment on a newly admitted patient who is about to undergo minimally invasive procedures on an outpatient basis can be delegated to: a. the registered nurse (RN). b. the licensed practical/vocational nurse (LPN/LVN). c. nursing assistive personnel (NAP). d. all levels of staff, because the information is about the past and cannot change.
A
Time can be maximized to produce the best outcomes by: a. making the first hour of each workday productive. b. completing trivial tasks before performing important tasks. c. eliminating all recreational activities. d. omitting breaks until the entire task has been completed.
A
Time is becoming crucial for the nurse to address issues related to sponsoring programs to include hearing aid costs as part of Medicare coverage. The nurse involved in grassroots political actions realizes that the least timely mode by which to reach elected officials would be via: a. letter. b. telephone. c. e-mail. d. facsimile (fax).
A
When choosing to delegate, the nurse should delegate the task to the most qualified person or to the person he or she wishes to: a. develop. b. promote. c. punish. d. reward.
A
When delegating care, the RN assigns one nurse to care for a patient with shingles and a different nurse to care for a patient with human immunodeficiency virus/acquired immunodeficiency disease syndrome (HIV/AIDS). This represents which category of nursing care? a. Safe and effective care environment b. Health promotion and maintenance c. Psychosocial integrity d. Teaching/learning
A
Which statement concerning the NCLEX-RN exam is correct? a. Graduates from all three types of nursing programs (diploma, associate degree, and baccalaureate degree) take the same examination. b. The examination is scored on an interval scale rather than on a pass-fail basis. c. The examination is offered twice a year in major urban areas. d. The candidate has the option of choosing a pencil-and-paper format.
A
Which task is most likely to be considered in a state's practice act as appropriate to delegate to a LPN/LVN if the patient's condition is stable and competence in the task has been established? a. Administer an enema for an elective surgery patient. b. Administer an antiarrhythmic medication IV while interpreting the patient's rhythm on the cardiac monitor. c. Develop a plan of care for a stable patient admitted for observation after a head injury. d. Teach a patient how to instill eye drops for glaucoma.
A
Which of the following occurrences would be classified as a sentinel event?
A nurse assisting with the delivery of twins places the "Twin 1" name tag on the second-born twin, causing the first-born twin to undergo surgery that was scheduled for the other twin.
Which statement made by an RN regarding delegation indicates the need for additional teaching? (Select all that apply.) a. Nursing assistive personnel (NAPs) can assess vital signs during the first 5 minutes for a patient who is receiving a blood transfusion because a reaction at this time is unlikely. b. An LPN/LVN can administer a PPD (tuberculin skin test) if there is no history of a positive PPD. c. When dopamine is ordered continuously, the LPN/LVN can administer dopamine at a low dose for the purpose of increasing renal perfusion. d. NAPs can transfer a patient who is being discharged home from the wheelchair to the bed if they have received training and demonstrated competency. e. Responsibility can be delegated to the NAP, but the delegator retains accountability.
ABC
When preparing a portfolio, the nurse should include: (Select all that apply.) a. copies of diplomas awarded by colleges/universities. b. copies of college transcripts. c. a personal photograph, if not included with the application. d. letters of recognition for scoring high on national achievement tests while in nursing school. e. a copy of the voter's registration card.
ABD
Which factors would be considered in the first steps of developing an effective patient classification system? (Select all that apply.) a. Planned procedures b. Ethnic diversity of patients c. Clinical competency of staff d. Educational level of nurses e. Age of patients
ABE
A nurse wants to become an advanced practice nurse and investigates the requirements for a: (Select all that apply.) a. nurse practitioner. b. nurse executive. c. certified nurse-midwife. d. certified registered nurse anesthetist.
ACD
A nurse has recently been appointed to the position of nurse manager. To become successful in managing the unit's budget, the new nurse manager should: (Select all that apply.) a. read the financial policy manual to learn more about the organization's budgeting process. b. allow the nursing administration office to manage the unit's budget until he or she is able to complete an online financial management course. c. communicate regularly with a person in the hospital's finance office about interpreting budget reports. d. pay attention to only the bottom line numbers in budget reports rather than trying to understand each line in these reports. e. discuss the process of developing budgets with other members of the management team.
ACE
While participating in a task force to proactively plan for nursing care delivery over the next 20 years, dramatic changes will occur as a result of: (Select all that apply.) a. the increase in the number of minimally invasive procedures being performed for disease treatment. b. care provided for patients over an extended period in acute care settings. c. the reduction in the number of nurses and other health care professionals who are available to provide care. d. the widespread illiteracy and decreased self-efficacy of the aging patient population. e. the need to focus on social and environmental influences, educational level, and individual characteristics and values of the patient. f. the devaluing of nursing as a means of improving patient outcomes.
ACE
A nurse on the unit is heard saying, "I am not going to document that I used four catheters to start that IV; it doesn't matter anyway." What action can help the staff nurse understand the financial budget goals of the unit?
Ask the nurse to represent the unit on the budget planning committe
"Ninety-five percent of all patients presenting to the emergency department with chest pain will receive aspirin 80 mg within 15 minutes of arrival unless contraindicated." Top hospital emergency departments use this standard to eliminated sudden death related to chest pain. Hospitals desiring to replicate these results establish compliance rates known as: a. competencies. b. benchmarks. c. driving force. d. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS).
B
.A nurse manager is mentoring an inexperienced manager in determining staffing needs. The mentor explains, "We must determine the acuity level of the patient by: a. assessing patient satisfaction with nursing care." b. quantifying the amount and intensity of care required." c. examining the skill mix and educational preparation of the staff." d. determining the number of hospital days required by the patients."
B
A bill is pending in the state legislature that will mandate teaching health promotion related to smoking cessation. Which action by the nurse should have the greatest impact on passage of the bill? a. Explain the rationale for the bill to the school board. b. Contact the elected representative's office by phone to request support for the bill. c. Support a health advocate to run for election as state representative. d. Tell all students about the bill.
B
A candidate who is taking the NCLEX-RN exam received only 75 questions before the test was stopped. She called her professor and stated, "I passed. I had to answer only 75 questions." The professor correctly responds by saying: a. "You are now officially licensed; you answered the more difficult questions correctly." b. "It is possible to receive only 75 questions and not be successful; however, we will keep a positive attitude." c. "If you were given only 75 questions, you will have to retest because this is not enough to determine competency." d. "You must have been extremely close to the passing standard because the computer shut off."
B
A concerned nursing student calls the office of an elected official to voice support for the bill to ban smoking in all public places. The secretary asks, "Are you a constituent?" What does the term constituent mean? a. A member of a professional organization who supports the organization's political issue b. A citizen who is registered and is eligible to vote for a representative c. An elected official who proposes legislation to be considered as a potential law d. A member of the House of Representatives who is seeking support for a particular bill
B
A hospital converts to a system of care delivery in which RNs, LPNs, and nursing assistive personnel (NAP) are responsible for implementing a specific task, such as medication administration or personal hygiene, for the entire nursing unit. This type of delivery system is: a. total patient care. b. functional nursing. c. team nursing. d. primary nursing.
B
A hospital standard states, "All intravenous (IV) sites must be rotated every 72 hours." The nurse who assesses and records variations from this standard is fulfilling which role of nursing? a. Infection control b. Quality management c. Coordinator position d. Counselor
B
A male nurse hired to work in the emergency department is observed throwing a contaminated needle into the trash can. The team leader reprimands the nurse for not appropriately disposing of sharps. The nurse states, "You don't care that I threw the needle in the trash. You just want an all-female staff," putting the team leader in a defensive position. This communication technique is known as: a. straw man. b. red herring. c. slippery slope. d. confusing cause and effect.
B
A new mother is experiencing pain after delivering an infant with Down syndrome. The staff nurse states, "I don't think she is really hurting. Let the next shift give the pain medication." The team leader notices the staff nurse looks agitated and anxious and asks about any concerns in providing care to this new mom. The staff nurse admits having a stillborn infant with Down syndrome. This is an example of which component of communication? a. Personal perception b. Past experiences c. Filtration d. Preconceived idea
B
A novice nurse is assigned a patient who has an order to draw blood for culture and sensitivity from a central line before antibiotic therapy is started. The novice reads and rereads the procedure manual. An hour later he stands at the bedside of the patient and stares at the central line, without knowing how to proceed. This phase of reality shock is termed: a. honeymoon. b. shock or rejection. c. recovery. d. resolution.
B
A nurse gives Dilantin intravenously with lactated Ringer's solution containing multivitamins. The drug precipitates and obstructs the only existing line. When the team leader informs the nurse that these drugs cannot be mixed, the nurse states, "Everyone just pushes the medicine slowly. No one checks for compatibility. There isn't even a compatibility chart on the unit." Which type of logical fallacy has influenced the nurse? a. Ad hominem abusive b. Appeal to common practice c. Appeal to emotion d. Appeal to tradition
B
A nurse manager is mentoring an inexperienced manager in determining staffing needs. The mentor explains, "We must determine the acuity level of the patient by: a. assessing patient satisfaction with nursing care." b. quantifying the amount and intensity of care required." c. examining the skill mix and educational preparation of the staff." d. determining the number of hospital days required by the patients."
B
A nurse manager is working with the financial officer to develop the budget of the nursing unit for the next fiscal year. The nurse manager tells the financial officer that which of the following information will affect budget assumptions? a. The capital budget request for new emergency department equipment has been turned in for consideration by the hospital's administrative team. b. The patient census likely will increase during the next fiscal year because two large physician groups have transferred their admission privileges to this hospital. c. The participatory budgeting approach instituted last year has been helpful in controlling supply costs. d. Zero-based budgeting will help the managers to be more efficient in establishing next year's budget.
B
A nurse manager plans the fiscal budget to include salaries for two RNs for two 12-hour shifts with a patient census of 6 in the short-stay observation room. The nurse manager reviews the budget report 3 months later and notes that the salary expenses are higher than was budgeted because of higher than planned RN staff salaries. This additional RN staff is necessary to meet patient care needs because the census has remained constant at 10 patients rather than the 6 projected when the budget was developed. The difference between the planned budget and the actual cost is known as: a. revenue. b. variance. c. monitoring. d. capital expenditures.
B
A nurse researcher is attempting to describe the demographics of today's RNs and reports that: a. less than 50% hold active licenses. b. most continue to work full time. c. younger nurses are rapidly entering the workforce. d. most nurses are initially graduating with a bachelor's degree.
B
A nurse would like to obtain background information and learn the political platform of a candidate who is running for national office. The nurse should contact the: a. National Registry for Candidates. b. American Nurses Association Nurses Strategic Action Team (N-STAT). c. National League of Nurses. d. National Council of State Boards of Nursing.
B
A nursing unit is comparing team nursing to the partnership model and found: a. with the partnership model, an RN does not have to be part of the mix. b. leadership abilities of the RN is a major determinant of effectiveness of care for both models. c. the RN teaches the LPN/LVN or nursing assistive personnel (NAP) how to apply the nursing process in team nursing. d. with team nursing the RN cares for the patient while the team members work with the family or significant others.
B
A patient is admitted for a hysterectomy, and the RN develops and implements the plan of care but also delegates to the LPN/LVN the responsibility of administering oral medications. While off duty, this RN receives a call requesting a change in the plan of care because the patient has developed deep vein thrombosis. The nurse who originally planned the care is practicing which type of nursing care delivery? a. Modular b. Primary c. Team d. Functional
B
A patient is admitted with coronary artery disease and is scheduled for coronary artery bypass grafting (CABG), and according to the clinical pathway should be extubated and discharged from critical care the day after surgery. During surgery the patient's oxygen saturation decreased drastically as a result of chronic tobacco abuse. Subsequently, the patient remained on the ventilator an additional 2 days postoperatively. According to the clinical practice guideline for CABG, this situation represents a: a. patient outcome. b. variance. c. goal. d. standard.
B
A patient is admitted with pneumonia. The case manager refers to a plan of care that specifically identifies dates when supplemental oxygen should be discontinued, positive-pressure ventilation with bronchodilators should be changed to self-administered inhalers, and antibiotics should be changed from intravenous to oral treatment, on the basis of assessment findings. This plan of care is referred to as a: a. patient classification system. b. clinical pathway. c. patient-centered plan of care. d. diagnosis-related group (DRG).
B
A patient presents with chest pain that increases when lying flat and low-grade fever. Assessment reveals muffled heart sounds, tachycardia and 3+ edema in the lower extremities. The nurse asks the patient to learn forward, which eases respiratory efforts. The nurse then places the stethoscope at which area to facilitate auscultation? The above question represents which type of alternate-format question written at which level of Bloom's taxonomy? A. Multiple-response item, comprehension level B. Hot-spot item, analysis level C. Chart exhibit item, application level D. Drag-and-drop item, knowledge level
B
A patient's spouse was just diagnosed with lung cancer although there was no history of tobacco use. The spouse states, "I am so mad, how can you get cancer without smoking?" Which statement by the nurse represents empathy? a. "Research is identifying many risk factors for cancer besides smoking." b. "I understand how you could feel angry about the diagnosis." c. "He is still a good husband." d. "Why do you think he got cancer?"
B
A primary function of the budgeting process is to provide managers with an opportunity to: a. insist that salary increases for all nurses are included in the annual budget. b. discuss concerns about resource allocation with leaders of the organization who are capable of resolving issues. c. develop a mechanism for changing from zero-based budgeting to incremental budgeting. d. develop for all staff an educational program related to supply usage.
B
A student nurse is concerned about delegation practices and wonders why hospitals employ nursing assistive personnel (NAP) and LPN/LVNs. The student nurse refers to the National Council of State Boards of Nursing and learns that the role of these personnel is to: a. supplement the staffing pattern when an RN is not available. b. aid the RN by performing simple, routine patient care tasks. c. replace the RN when the health care facility provides long-term care. d. provide patient teaching, allowing more direct care to be provided by the RN.
B
A task force is considering factors that contribute to high-quality safe staffing. Which statement reflects an understanding of the American Nurses Association's (ANA) Safe Staffing Saves Lives recommendations? a. Because patient needs remain constant on a daily shift, staffing needs at the beginning of the shift should be sufficient to provide safe quality care. b. Staffing should allow time for the RN to apply the nursing process so decisions result in quality safe patient outcomes. c. Patient acuity levels affect staffing by increasing the need for unlicensed personnel to provide routine basic care rather than increasing RNs in staff mix. d. RN staffing is not cost effective, thus is it important for staffing models to limit the number of RNs assigned per shift.
B
A team of experienced nurses work together to develop algorithms that are converted into checklists to ensure standardization of commonly performed procedures. The focus of this team is primarily on which Institute of Medicine (IOM) competency? a. Safety b. Timely c. Equitable d. Patient-centered care.
B
A teenage patient is using earphones to listen to hard rock music and is making gestures in rhythm to the music. The nurse assesses the amount of urine output in the Foley catheter and leaves the room. What communication technique is demonstrated in both of these situations? a. Blocking b. Filtration c. Empathy d. False assurance
B
A valuable tool for determining whether a potential employer is suitable for your career goals is to: a. call The Joint Commission (TJC) to ask whether the organization meets required standards. b. assess the work climate by walking through the facility. c. review financial statements of the institution. d. ask what they can do for you rather than what you can do for them.
B
Although the NCLEX-RN exam has new formats for questions, the most common format is the: a. fill-in-the-blank item, because candidates are not provided with clues from distracters. b. multiple-choice question item, which allows candidates to select the one correct answer. c. multiple-response item, because these questions require a higher level of critical thinking. d. hot-spot item, because these questions are written at the application level of Bloom's analysis.
B
An RN delegates to NAP the task of performing blood pressure checks for a group of patients on a nursing unit. The NAP accepts the task and is responsible for: a. delegating the task to another NAP if he or she does not have the time or skill to complete the task. b. keeping the RN informed of any abnormal blood pressure readings. c. calling the physician when the patient's vital signs are not within established parameters. d. informing the dietary department to initiate a low-sodium diet for patients who are hypertensive.
B
An RN delegates to an experienced LPN/LVN the task of administering oral medications to a group of patients. The LPN/LVN accepts the assignment, and the RN knows that the LPN/LVN has had the training and has acquired the skills needed to complete the task. The RN then observes the LPN/LVN recording a patient's medication administration just before entering the patient's room. The priority intervention by the RN is to: a. check the patient's drug packages to ensure that the correct drugs were given. b. stop the LPN/LVN immediately and discuss the possible consequences of his actions in a nonjudgmental manner. c. contact the nurse manager and ask that the LPN/LVN's license be suspended. d. call the pharmacy and ask for replacement medications for the patients.
B
An experienced nurse volunteers to serve on a task force intended to improve the quality of care because she possesses excellent patient care skills and has selected a career goal of working in quality management. However, the nurse is unable to concentrate on any one task or issue and is unable to view the health care milieu sensibly. Which source of energy is missing in this nurse? a. Physical b. Mental c. Spiritual d. Emotional
B
An inexperienced nurse has heard of other novice nurses who take shortcuts in providing patient care. This nurse feels that this is unacceptable and that all tasks must be performed faultlessly, which leads to her inability to complete all assigned tasks. This nurse would benefit from the seminar "Obstacles to Time Management: How to Deal With: a. Creativity." b. Perfectionism." c. Failure." d. Downtime."
B
Computerized adaptive testing implies that: a. the candidate must be computer literate. b. competency is determined on the basis of difficulty of questions, knowledge of the nursing process, and the number of questions answered correctly. c. testing facilities have been adapted for the physically challenged candidate. d. questions cannot be adapted to the needs of the student.
B
During a health history interview, the nurse listens to a patient relating the precipitating events that led to the onset of chest pain. She focuses her attention on the patient, makes eye contact, and acknowledges what the patient has to say. The nurse is exhibiting: a. assertive communication. b. active listening. c. empathy. d. passive communication.
B
During height and weight assessments at a school's health fair, a child admits to drinking a cup of coffee with his mother every morning, and another child reports enjoying a morning cup of coffee on the commute to school. These two children are both below average on the height chart, and the nurse states, "Drinking coffee stunts a child's growth." This logical fallacy is referred to as: a. appeal to common practice. b. confusing cause and effect. c. ad hominem abusive. d. red herring.
B
During resuscitation efforts, a provider states, "I need to give a 1.5 mg/kg bolus of lidocaine because the patient is in ventricular tachycardia." The nurse responds, "I have a lidocaine bolus equal to 1.5 mg/kg." This communication model is known as: a. situation background assessment recommendation (SBAR). b. check-back. c. hand-off check. d. critical-language.
B
Following a complicated surgery, a patient who was received in the recovery room suddenly loses consciousness and become unstable. The nurse that arrives at the scene performs assessments and makes the following comments, "The patient is nonresponsive to verbal stimuli," "The patient is not initiating any spontaneous respiration," and "I am unable to palpate a femoral pulse," and other members of the health care team react to the comments. The team is using the mental model for communication known as: a. critical language. b. call-out. c. check-back. d. hand-off.
B
In today's world of fast, effective communication, what is the most commonly used means of societal communication? a. Facial expression b. Spoken word c. Written messages d. Electronic messaging
B
It is important for nurses to know the functions of the branches of the federal government. At a local meeting of the state nurses' association, an officer reminds members that the branch that is capable of originating major policy initiatives is the: a. executive branch. b. legislative branch. c. judicial branch. d. administrative branch.
B
Many nursing professionals have portfolios that include: a. family pictures. b. letters of commendation. c. articles that describe lack of quality in health care. d. high school achievements.
B
Members of a state's constituent member association meet at a local restaurant to plan a Nurse Walk to support the local food bank. When entering the restaurant, the nurses note the environmental inspection report shows deficiencies because food handlers were not wearing hairnets and rodents were spotted, resulting in a score of 60 out of 100. This certificate of inspection is health policy enforced at which level of government? a. Local b. State c. Federal d. International
B
Nurses in a nonunionized health care facility are concerned about patient safety because of the requirement for nurses to work overtime. Which organization can address the needs of these nurses? a. United American Nurses b. Center for American Nurses c. Occupational Safety and Health Administration (OSHA) d. American Association for Mandatory Overtime
B
Nurses working on an orthopedic unit use personal digital assistants (PDAs) to review medications prior to administration to reduce potential drug interactions. Software is also installed that provides video clips of common procedures performed by nurses. Nurses on this unit are best demonstrating which QSEN competencies? a. Patient-centered care b. Informatics c. Teamwork d. Quality improvement
B
On the NCLEX-RN exam, when the candidate is asked to set goals in collaboration with other members of the health care team, the nurse is being tested in the area of: a. assessment. b. planning. c. analysis. d. implementation.
B
Political action committees (PACs) are established for the purpose of: a. financially supporting candidates. b. persuading policymakers to support certain policies. c. lobbying legislators. d. recommending health care policy.
B
The National Council of State Boards of Nursing determines acceptable NCLEX-RN exam questions on the basis of: a. the geographic location of the candidate. b. research that indicates needed skills for positions in which most entry level nurses are employed. c. surveys conducted by employers to determine the weaknesses of entry level nurses. d. surveys of physicians performed to determine what nurses must know to provide safe care.
B
The new director of nurses has instituted "walking rounds" on all nursing units, rather than the usual taped shift reports. A veteran nurse exclaims, "She doesn't know how we do things here!" The nurse is demonstrating: a. appeal to emotion. b. appeal to tradition. c. red herring. d. straw man.
B
The nurse manager determines that four RNs, five LPN/LVNs, and two nursing assistive personnel (NAP) are required per shift to meet the needs of the patient population on the unit, according to acuity and census. The nurse manager is concerned with: a. assignments. b. staffing. c. output. d. productivity.
B
Throughout the history of health care in our nation, one particular piece of federal legislation provided funds for hospital construction. As the number of hospitals rapidly increased, the need for nurses to staff hospitals also increased, and the shift from community-based nursing care to hospital-based nursing care began. This fundamental piece of legislation was the: a. Sheppard-Towner Act. b. Hill-Burton Act. c. Veterans Bill. d. Access to Health Care Bill.
B
When the policy process is compared with the nursing process, identifying the issue is consistent with which step of the nursing process? a. Assessment b. Diagnosis c. Planning d. Implementation
B
When using the ABC system of managing time, those items coded A include: a. calling the pharmacy to see whether a drug insert is available for a patient. b. checking to see why a ventilator is alarming. c. organizing the medication cart. d. writing memos to remind everyone to contribute to the boss's birthday gift.
B
Which component of budgeting might normally be addressed in the annual performance evaluation for a nurse manager? a. Including in the labor budget costs for overtime and benefits b. Managing variances in nursing overtime costs and supply usage c. Accurately predicting revenues on the basis of unit of service d. Providing qualitative analysis for variances in the capital budget
B
While performing a job search, a nurse reviews the list of Magnet hospitals of the American Nurses Credentialing Center because: a. these hospitals are able to hold on to revenue gained from patient care. b. nursing longevity, autonomy, and self-governance are important features of these institutions. c. all RNs have a minimum of a master's degree and are credentialed in the area in which they provide care. d. these hospitals have the most up-to-date diagnostic equipment such as magnetic resonance imagery.
B
A nurse manager has calculated that providing 75 hours of direct nursing care per day requires that 120 hours must actually be worked by nursing staff. The manager is involved in: (Select all that apply.) a. developing the capital budget. b. applying a productivity metric. c. monitoring the labor budget. d. incremental budgeting processes. e. addressing budget assumptions.
BC
A nurse is having difficulty managing assignments at work, which results in a feeling of "failure" and tasks that are not completed or that are not completed satisfactorily. The mentor suggests some tips for time management; these include: (Select all that apply.) a. focusing on activities to be completed, rather than on objectives. b. planning for tomorrow today. c. making certain that the last hours are the most productive in tying up loose ends. d. maintaining a log of how the nurse spends time (no need to worry about using complete sentences). e. picking five major objectives for the day and not stopping until they are achieved.
BD
A team of experienced nurses work together to develop algorithms that are converted into checklists to ensure standardization of commonly performed procedures. The focus of this team is primarily on which Institute of Medicine (IOM) competency? a. Safety b. Timely c. Equitable d. Patient-centered care.
BDE
A hospital is concerned with nurse retention and realizes that job satisfaction is a major influence. To enhance employee satisfaction related to staffing, the management team: a. negotiates for additional agency nurses. b. hires more part-time employees. c. prioritizes participatory management into staffing decisions. d. uses "float" nurses to cover vacancies.
C
A hospital standard states, "All intravenous (IV) sites must be rotated every 72 hours." The nurse who assesses and records variations from this standard is fulfilling which role of nursing? a. Infection control b. Quality management c. Coordinator position d. Counselor
C
A novice nurse is assigned a patient who has an order to draw blood for culture and sensitivity from a central line before antibiotic therapy is started. The novice reads and rereads the procedure manual. An hour later he stands at the bedside of the patient and stares at the central line, without knowing how to proceed. This phase of reality shock is termed: a. honeymoon. b. shock or rejection. c. recovery. d. resolution.
C
A novice nurse is unsure of his ability to insert a nasogastric tube for one of the assigned patients who is vomiting coffee ground emesis. The novice nurse waits, hoping that someone with more experience will volunteer to do the job, or he just waits until the end of the shift. This nurse is practicing: a. energy management. b. priority setting. c. procrastination. d. introspection.
C
A nurse is listening to a patient's apical heart rate. The patient asks, "Is everything okay?" The nurse says nothing and shrugs her shoulders. The nurse is demonstrating: a. open communication. b. filtration. c. blocking. d. false assurance.
C
A nurse moves from California to Arkansas and due to having 20 years of experience as a registered nurse is immediately placed in charge of the telemetry unit. The staffing consists of LPNs and two unlicensed assistive personnel. The RN is unsure of the scope of practice of the LPNs and reviews the nurse practice act for Arkansas, which lacks clarity on some tasks. The RN should: a. query the state nursing association to determine their stance on the role of LPNs. b. ask the LPNs on the unit to list what tasks they routinely performed. c. contact the state board of nursing to determine legal scope of practice for LPNs. d. Refer to California's nurse practice act because the scope of LPNs/LVNs is consistent across the United States.
C
A nurse on the unit is heard saying, "I am not going to document that I used four catheters to start that IV; it doesn't matter anyway." What action can help the staff nurse understand the financial budget goals of the unit? a. Have the nurse work in payroll for a week. b. Enroll the staff in continuing education units (CEU) for personal finance. c. Ask the nurse to represent the unit on the budget planning committee. d. Make the nurse responsible for monitoring all disposable equipment and supplies.
C
A nurse wants to apply open communication to obtain a thorough history and to determine cognitive function. Which question represents the use of open communication? a. Is today Wednesday? b. Do you know what day it is? c. Tell me what day of the week today is. d. Do you know what is the first day of the week?
C
A patient is ordered a low-protein, low-calorie diet but the patient's family brings fish, lentils, and unleavened bread for a meal to observe a cultural practice. The nurse works with the dietitian to adjust the next few meals to accommodate for this variance. This situation would represent: a. a sentinel event. b. an adverse event. c. patient-centered care. d. the communication technique of "call-out."
C
A potential applicant reviews the application process and learns that preemployment physicals often include the following: a. cholesterol screening. b. pregnancy testing. c. urine drug screening. d. vision and hearing tests.
C
A student nurse who is preparing to graduate and take the licensure examination asks, "What is compulsory licensure?" The appropriate response of the nursing advisor is as follows: a. All candidates wishing to take the licensure examination must pass a drug screen. b. Candidates must not have a felony conviction. c. To practice as an RN, the nurse must be licensed as an RN. d. An impaired nurse must sign a legal document to acknowledge limitations on his or her practice.
C
According to the Hallmarks of the Professional Nursing Environment, a nurse should ask a potential employer: a. how salaries compare with those of larger facilities. b. what benefits are provided to RNs that are not available to other health care providers. c. what role nurses have in determining the quality of care. d. how the employer plans to provide long-term economic security to RNs.
C
An LPN/LVN has transferred to a nursing unit and arrives for the first day. The RN checks with the LPN/LVN often throughout the shift to provide support and determine if assistance is needed. The RN is providing which level of supervision? a. There is no supervision, because at times the LPN/LVN is not with the RN. b. Periodic inspection is being used. Because the LPN/LVN is licensed, the RN is relieved of the need to evaluate care. c. Continual supervision is being provided until the RN determines competency. d. Initial supervision is being provided because this is the LPN/LVN's first day on the unit.
C
An RN is counseled by the nurse manager regarding inappropriate delegation when the: a. RN instructs the nursing assistant to greet ambulatory surgery patients and show them to their rooms. b. nursing assistant informs the RN that she has not been trained to collect a sputum specimen, and the RN states, "I will show you this time and you can show me the next time." c. RN assigns the float LPN/LVN the task of completing a plan of care for a stable patient who was admitted for routine replacement of a feeding tube. d. LPN/LVN who has demonstrated competence is asked to perform a dressing change for a patient before she is discharged home.
C
An RN makes the following assignments at the beginning of the shift. Which assignment would be considered high risk delegation? a. A novice RN is assigned a patient with diabetes mellitus requiring mixing of regular and NPH insulin. b. An LPN is assigned an older adult with pneumonia and who requires dressing changes on a foot wound. c. An unlicensed assistive person is assigned the task of assisting a patient with late stages of Huntington's disease to ambulate a short distance in the hallway. d. A float RN from the oncology unit is assigned a patient with a white blood cell count of 4000 mm3
C
An RN recently relocated to another region of the country and immediately assumed the role of charge nurse. When determining the appropriate person to whom to delegate, the RN knows that: a. the role of the LPN/LVN is the same from state to state. b. the LPN/LVN can be taught to perform all the duties of an RN if approved by the employer and if additional on-the-job training is provided. c. he or she must review the state's nurse practice act for LPN/LVNs, because each state defines the role and scope of practice of the LPN/LVN. d. The Joint Commission has certified and established roles for the LPN/LVN.
C
An older adult is unable to reach the phone and is found dead at home several hours later. The son of the deceased person arrives at the hospital and asks, "Can I just please stay and hold my dad's hand? He was so afraid of dying alone." Which response by the nurse shows empathy? a. "You are just too late for that. Where were you when he needed you?" b. "Did you ever consider purchasing a cell phone for your dad to prevent this from happening?" c. "I'll close the door so you can spend time with your dad. I will check back in a few minutes." d. "I lost my dad last year. He died alone. He was a policeman. I am just like you. Let me stay here and console you."
C
Customer satisfaction is primarily based on: a. access to modern, up-to-date facilities. b. availability of an extensive menu selection. c. personal interactions with employees. d. having to undergo fewer invasive procedures.
C
Nurses, physicians, and social workers finalize the plan of care and coordinate discharge for a homeless person who will need wound care and follow up over the next 4 weeks. Each member contributes based on their area of expertise but also recognize other members' strengths. Which of the QSEN competencies are being demonstrated? a. Quality improvement b. Evidence-based practice c. Teamwork and collaboration d. Patient-centered care
C
On the basis of changes effective with the April 2010 test plan, candidates who take the NCLEX-RN exam: a. will have to answer more than 75 questions to be 95% certain that they are above the passing standard. b. will be required to submit a 100-word essay on an important nursing topic to evaluate safe nursing practice. c. should study and take practice examinations written at the application and analysis level to ensure that they can meet the higher standards of nursing care and health care delivery. d. will have additional time to complete the examination because most questions will be prepared in the alternate format, thereby requiring critical thinking.
C
The appropriate procedure for addressing a cover letter when the applicant is unsure of the name and title of the person to whom the letter should be addressed is to: a. address the letter to "To Whom It May Concern." b. address the letter to "Nurse Recruiter." c. call the facility to inquire about the name and title of the person. d. leave the salutation blank if the name and the title are unknown.
C
To conduct a productive meeting, the nurse should: a. provide each person all the time needed to discuss desired topics. b. cover all emotional topics first. c. create an agenda with specific times allotted for each agenda item. d. wait for latecomers and ask for their excuse for being late.
C
To determine basic competency, the interview for a nursing position may include a test in: a. pathophysiology. b. correctly writing nursing diagnoses. c. pharmacology. d. computer skills.
C
To ensure that new laws are implemented as proposed, nurses must realize that: a. regulations must be enacted exactly as intended by the U.S. Department of Health and Human Services (DHHS). b. hearings to discuss the new laws and regulations are closed to the public, and only lobbyists are invited to attend. c. proposed regulations are published and are open to public comment for a time before they are formally adopted. d. final published regulations only suggest how the law will be implemented.
C
When a bill is presented to Congress, the subcommittee may choose to "mark up" the bill, meaning to: a. obtain oral testimony about the bill from the executive branch. b. conduct additional hearings about the bill. c. amend the bill before recommending it to the full committee. d. have the full committee vote on recommendations.
C
When deciding whether and when a task should be completed, a nurse must: a. complete all tasks as they are thought of to prevent having to take time to consider which is most important. b. procrastinate and hope that someone will volunteer to do it. c. ask, "What will happen if I don't complete the task now?" d. view large projects holistically and not as many small pieces.
C
When deciding which staffing option to use on a nursing unit that will open soon, the manager realizes that: a. continuity of care is enhanced and errors are reduced when nurses provide care over longer shifts and consecutive workdays, such as 12-hour shifts on 3 consecutive days per week. b. the use of part-time nurses provides the variability needed to meet diverse patient needs. c. satisfaction of the staff equates to satisfaction of patients. d. nurses provide the same level of care, regardless of the work environment.
C
When should a follow-up letter be written to a recruiter? a. Before the interview to thank him/her for granting you the interview b. Approximately 2 weeks after you did not get the job to inquire why c. A few days after the interview d. When you are sure you got the position
C
When the job applicant is asked to identify weaknesses, one appropriate reply for the novice nurse might be: a. "I have no weaknesses." b. "Are you trying to set me up?" c. "Delegating to peers." d. "Caring requires weakness."
C
Which of the following occurrences would be classified as a sentinel event? a. A postpartum patient who elects to breastfeed only twice daily develops mastitis. b. A newly diagnosed diabetic patient self-injects insulin in the abdominal area rather than the upper thigh as instructed by the patient educator. c. A nurse assisting with the delivery of twins places the "Twin 1" name tag on the second-born twin, causing the first-born twin to undergo surgery that was scheduled for the other twin. d. A nurse administers 3 units of regular insulin rather than 3 units of NPH insulin subcutaneously that resulted in a drop in the patient's serum glucose from 160 to 100 mg while retaining stable vital signs.
C
A nursing administrator who is considering the feasibility of an all-RN staff reviews the report, Keeping Patients Safe: Transforming the Work Environment of Nurses (2003), and determines that RNs: (Select all that apply.) a. are more costly and less efficient than LPNs. b. have little or no effect by being proactive but instead are reactive to patient care errors. c. have a positive effect on patient outcomes when managing patient care. d. are effective overseers of patients' overall health condition e. lack the training to be effective delegators.
CD
A new graduate nurse is preparing for an interview for her first position and knows that: (Select all that apply.) a. the primary goal for the first job is to complete orientation and should be considered as an extension of nursing school. b. appointments for interviews should be scheduled immediately after graduation to avoid rushing into a position. c. self-confidence can be improved with self-talk, which reminds the graduate that peers from her school are effective practitioners. d. work history of even nonmedical positions can demonstrate commitment and reliability so letters from these employers should be in portfolio. e. it is best to arrive 10 to 15 minutes before the scheduled interview dressed for success.
CDE
A nurse is having difficulty keeping up with the six assigned patients and serving on the ethics committee. In order to take charge of both personal and work life, the nurse focuses on improving physical energy by: (Select all that apply.) a. telling herself, "I provide safe quality care and will provide this level of care to all my patients." b. taking a deep breath and remaining calm to develop patience. c. keeping a bottle of water available to consume a minimum of 24 ounces each shift. d. going into the nurse's break room every 1 1/2 hours to eat a healthy snack and prioritize remaining care. e. enrolling in the hospital's fitness program, Nurses Need Nurturing.
CDE
A team of experienced nurses work together to develop algorithms that are converted into checklists to ensure standardization of commonly performed procedures. The focus of this team is primarily on which Institute of Medicine (IOM) competency? a. Safety b. Timely c. Equitable d. Patient-centered care.
CE
The ability to clearly demonstrate the knowledge, skills, attitudes, and professional judgment required to practice safely and ethically in a designated role and setting is termed:
Competency
During height and weight assessments at a school's health fair, a child admits to drinking a cup of coffee with his mother every morning, and another child reports enjoying a morning cup of coffee on the commute to school. These two children are both below average on the height chart, and the nurse states, "Drinking coffee stunts a child's growth." This logical fallacy is referred to as:
Confusing Cause and Effect
A hospital standard states, "All intravenous (IV) sites must be rotated every 72 hours." The nurse who assesses and records variations from this standard is fulfilling which role of nursing? a. Infection control b. Quality management c. Coordinator position d. Counselor
D
A licensed practical nurse (LPN) has been practicing for 25 years on a unit where a newly graduated RN with a bachelor's degree is hired. Before the RN arrives on the unit, the LPN is heard saying, "She'll try to tell everyone what to do because she makes more money. She'll sit at the desk and let us do all the work." This is an example of a(n): a. interpretation. b. context. c. precipitating event. d. preconceived idea.
D
A new graduate arrives for the first interview feeling prepared and excited about beginning a nursing career but quickly becomes concerned when the recruiter asks which illegal question? a. "Have you been convicted of a crime other than a minor traffic violation?" b. "We are very interested in hiring you but you do understand the position is contingent on the results of the preemployment physical and background check?" c. "What do you consider to be your major weaknesses for this particular position?" d. "Because you are applying for a position in the operating room, you must be able to be on call. How many children do you have responsibility for at home?"
D
A novice nurse is assigned a patient who has an order to draw blood for culture and sensitivity from a central line before antibiotic therapy is started. The novice reads and rereads the procedure manual. An hour later he stands at the bedside of the patient and stares at the central line, without knowing how to proceed. This phase of reality shock is termed: a. honeymoon. b. shock or rejection. c. recovery. d. resolution.
D
A nurse is delegating to the newly hired nursing assistive personnel (NAP) the task of assisting with oral hygiene, knowing that this assignment "does not require decisions based on the nursing process." The nurse is correctly using which of the five rights of delegation? a. Supervision b. Communication c. Person d. Circumstance
D
A nurse is preparing an exercise program as part of a health promotion program for older adults with osteoporosis. Which question would retrieve the most valuable information about health practices? a. "Do you exercise?" b. "Do you like to exercise?" c. "When do you exercise?" d. "Can you tell me about your exercise practices?"
D
A nurse realizes that much time is wasted during shift report when coworkers discuss personal items such as recent movies or department store sales. Which statement would help with time management during this critical interaction? a. "Let's only talk about one movie you recently watched." b. "I like to know about department store sales but we need to get through this report, so let's talk about sales as we walk between patient rooms." c. "I know your shift has been busy. What went wrong?" d. "I have the list of patients; let's start with revisions to the plan of care and scheduled activities for the next shift."
D
A nurse who is applying for a position contacts an expert on writing resumes and cover letters and is told: a. to use correction fluid sparingly. b. that when an error is made, a single line should be used to cross through the mistake, and initials should be inserted above the error. c. to limit margins to one half inch so that the page appears full of information. d. to be concise, limit the resume to a single page.
D
A nurse would like to advocate for increased protective services and reporting mechanisms for elder abuse and attends the "meet the candidate" session at the town hall meeting. This is an important time for the nurse to: a. educate the public about the nurse's political platform. b. be spontaneous and not deliver a rehearsed speech. c. address the person as "candidate" rather than using a first name that implies a working relationship. d. learn what the key issues are in the candidate's platform.
D
A nursing unit's census consists primarily of long-term residents with a high risk for falls. To meet new safety regulations, the nurse manager must plan to replace all 50 patient beds with new beds equipped with Fall Watch electronic sensors that will detect when patients get out of bed. The manager will be involved in which type of budgeting to replace the beds? a. Fiscal b. Labor c. Operational d. Capital
D
A patient is brought to the unit with mediastinal chest tubes with no fluctuation in the water seal chamber; arterial blood gas results reveal pH, 7.55; CO2 , 55; HCO, 28 mEq/L, and O2 , 98%. Carotid artery pulsation is visible with the head of the bed elevated and the use of tangential lighting. The first action of the nurse is to _____. The above question represents which level of Bloom's taxonomy? a. Knowledge b. Comprehension c. Application d. Analysis
D
A person who is covered by Medicaid moves from one state to another and asks the nurse at the health department why the benefits changed. The correct response by the nurse is: a. "Local government controls which benefits each county can provide to Medicaid recipients." b. "The federal government does not fund any part of Medicaid, so each state must find ways to pay for benefits." c. "Each state determines benefits on the basis of the present economy." d. "Medicaid is funded by both state and federal governments, but benefits vary from state to state."
D
A student nurse assigned to work with the charge nurse is given the opportunity to help revise the nursing assessment form. She receives several compliments from management and her nursing instructor for her creative suggestions. The student nurse enjoys the project and attention she is receiving and begins to prolong the conclusion of the project. Although she constantly adds new information, she filters this out slowly to others. The student nurse is subject to the time management obstacle of: a. need for perfection. b. fear of losing creativity. c. unclear goals. d. fear of completion.
D
A team of experienced nurses work together to develop algorithms that are converted into checklists to ensure standardization of commonly performed procedures. The focus of this team is primarily on which Institute of Medicine (IOM) competency? a. Safety b. Timely c. Equitable d. Patient-centered care.
D
Accrediting and licensure agencies such as The Joint Commission address staffing by: a. imposing maximum staffing levels. b. requiring a specific staff mix. c. stipulating nurse/patient ratios. d. looking for evidence that patients receive satisfactory care.
D
During orientation, an RN learns that LPN/LVNs in the facility receive additional training to perform some tasks such as hanging continuously infusing intravenous fluids that have no additives. It is important for the RN to understand that: a. the health care facility can override the state practice act by having all LPN/LVNs and nursing assistive personnel (NAPs) participate in on-site training. b. LPN/LVNs are licensed, and accountability for their own practice rests with each LPN/LVN. c. NAPs cannot be held responsible for their own actions or inactions. d. the nurse practice act and state regulations related to delegation override the organization's policies.
D
Nurses, physicians, and social workers finalize the plan of care and coordinate discharge for a homeless person who will need wound care and follow up over the next 4 weeks. Each member contributes based on their area of expertise but also recognize other members' strengths. Which of the QSEN competencies are being demonstrated? a. Quality improvement b. Evidence-based practice c. Teamwork and collaboration d. Patient-centered care
D
Organizations measure the effectiveness of their budgets by examining actual revenues and expenditures versus: a. planned variances. b. incremental budgets. c. productivity metrics. d. expected performance.
D
Positive time management skills include: a. maintaining an open-door policy. b. retaining all paperwork. c. returning all phone calls immediately. d. scheduling daily activities.
D
The length of the NCLEX-RN exam is based on the: a. last four numbers of the candidate's social security number. b. location of testing. c. candidate's educational preparation. d. performance of the candidate.
D
When planning a program to reduce the number of sentinel events in an organization, the program planner should focus on the leading cause of sentinel events, which is related to a problem with: a. leadership or management. b. staffing patterns. c. environmental safety. d. communication.
D
When planning, a nurse should: a. delay planning until the "first task of the morning" has been completed. b. recognize that rewarding oneself has a negative consequence. c. rotate between several tasks to stimulate creativity. d. remember that most tasks take longer than anticipated to complete.
D
When preparing the education section of a resume: a. list high school, followed by the first college attended. b. include all colleges attended, even if a degree was not awarded. c. omit the address of the university unless requested by the potential employer. d. list in reverse chronologic order the names, dates, and addresses of universities that awarded degrees.
D
When the nurse manager conducts a qualitative analysis of budget variances, he or she is: a. determining the percentage increase of supply usage from the last quarter to the current quarter. b. identifying the overall increase in the dollar amount of salaries paid for overtime. c. comparing productivity metrics across all nursing units in the facility. d. reconciling with current conditions the underlying assumptions on which the budget was based.
D
Which action would help a student successfully prepare for the NCLEX-RN examination? a. Make note cards that can easily be retrieved to list only facts. b. Avoid timing oneself while studying and when in the actual testing mode to decrease anxiety. c. Ask peers for help because they had the same resources; especially seek their help for difficult concepts requiring critical thinking. d. Practice taking NCLEX-RN exam-type questions and reviewing rationales for correct and incorrect answers.
D
Which statement accurately describes communication? a. The components of communication are mutually exclusive. b. Communication is linear. c. Communication involves only the sender and the receiver; everything else is superficial. d. When the receiver becomes the sender, the subcomponent of communication that is in use is feedback.
D
Which statement related to delegation is correct? a. The practice of nursing assistive personnel (NAP) is defined in the nurse practice act. b. Nursing practice can be delegated only when the LPN/LVN and/or NAP have received adequate training. c. Supervision is not required when routine tasks are delegated to a competent individual. d. The RN must be knowledgeable about the laws and regulations that govern nursing practice, as well as those that have no clearly defined parameters, such as for NAP.
D
Which task is appropriate for the RN to delegate to the nursing assistive personnel (NAP), provided the delegatee has had experience and training? a. Evaluate the ability of a patient to swallow ice after a gastroscopy. b. Assist a patient who is postoperative hip replacement to ambulate with a walker for the first time. c. Change the disposable tracheotomy cannula for a new postoperative tracheotomy patient if secretions are thick and tenacious. d. Obtain a sterile urine sample from a patient with a Foley catheter that is connected to a closed drainage system.
D
A nurse is reading about positive reinforcement with the goal of increasing staff motivation. Which action would demonstrate positive reinforcement?
Give spur-of-the-moment recognition to an employee who has accomplished a goal
In differentiating between a leader and a manager?
Manager focuses on coordinating resources
A patient is admitted with hypotension, shortness of breath, flushing, and hives. All levels of staff have been trained to assess vital signs. Given budget restrictions and proper delegation rules, to which care provider would the RN delegate the task of obtaining the initial blood pressure reading?
RN
In an attempt to persuade employees to bargain for another type of health insurance, a handout is circulated that describes the present employees' health care insurance as being insensitive, limiting choices of care providers, and providing inferior care. This reflects which aspect of Lewin's planned change?
Unfreeze
Which task is most likely to be considered in a state's practice act as appropriate to delegate to a LPN/LVN if the patient's condition is stable and competence in the task has been established?
administer an enema for an elective surgery patient
A nurse gives Dilantin intravenously with lactated Ringer's solution containing multivitamins. The drug precipitates and obstructs the only existing line. When the team leader informs the nurse that these drugs cannot be mixed, the nurse states, "Everyone just pushes the medicine slowly. No one checks for compatibility. There isn't even a compatibility chart on the unit." Which type of logical fallacy has influenced the nurse?
appeal to common practice
An RN is consistently late to work, causing reassignment of patient care and the need for repeated shift reports. The nurse, who receives a warning for repeated tardiness, states, "My husband left me, I have no car, no family close by, and the bus is always late, which makes me late. The nurse manager doesn't care how hard I try to get here, and I am raising a child by myself." The nurse is using which type of logical fallacy?
appeal to emotion
The new director of nurses has instituted "walking rounds" on all nursing units, rather than the usual taped shift reports. A veteran nurse exclaims, "She doesn't know how we do things here!" The nurse is demonstrating:
appeal to tradition
When deciding whether and when a task should be completed, a nurse must:
ask, "what will happen if I dont complete the task now?"
A nurse is listening to a patient's apical heart rate. The patient asks, "Is everything okay?" The nurse says nothing and shrugs her shoulders. The nurse is demonstrating
blocking
A nursing unit's census consists primarily of long-term residents with a high risk for falls. To meet new safety regulations, the nurse manager must plan to replace all 50 patient beds with new beds equipped with Fall Watch electronic sensors that will detect when patients get out of bed. The manager will be involved in which type of budgeting to replace the beds?
capital
The RN who identifies the best resources at the lowest cost to achieve optimal health outcomes for the client is fulfilling the role of:
case manager
The nurse who is responsible for following the patient from admission through discharge or resolution of illness while working with a broad range of health care providers is called a:
case manager
An RN testifies at a trial where domestic violence is being investigated. She had previously assisted with specimen collection and had assessed the victim. The nurse is involved in:
forensic nursing
The first step in the nursing process and in the problem-solving process is to:
gather information
A nonprofit organization that distributes to governmental agencies, the public, business, and health care professionals knowledge related to health care for the purpose of improving health is the:
institute of medicine
An RN delegates to NAP the task of performing blood pressure checks for a group of patients on a nursing unit. The NAP accepts the task and is responsible for:
keeping the RN informed of any abnormal blood pressure readings
Accrediting and licensure agencies such as The Joint Commission address staffing by:
looking for evidence that patients receive satisfactory care
Time can be maximized to produce the best outcomes by:
making the first hour of each workday productive
A group of nurses is presenting the importance of quality care during a system-wide meeting of medical-surgical nurses. They point out a finding of the Quality Chasm that:
medication related errors place a tremendous financial burden on the US healthcare system
Which task is appropriate for the RN to delegate to the nursing assistive personnel (NAP), provided the delegatee has had experience and training?
obtain a sterile urine sample from a patient with a Foley cath that is connected to a closed drainage system
The nurse who organizes screenings for employees, assesses the work environment for hazards, and teaches health-promoting activities is employed in the field of:
occupational health
A new mother is experiencing pain after delivering an infant with Down syndrome. The staff nurse states, "I don't think she is really hurting. Let the next shift give the pain medication." The team leader notices the staff nurse looks agitated and anxious and asks about any concerns in providing care to this new mom. The staff nurse admits having a stillborn infant with Down syndrome. This is an example of which component of communication?
past experiences
To determine basic competency, the interview for a nursing position may include a test in:
pharmacology
A hospital is concerned with nurse retention and realizes that job satisfaction is a major influence. To enhance employee satisfaction related to staffing, the management team:
prioritizes participatory management into staffing decisions
A novice nurse is unsure of his ability to insert a nasogastric tube for one of the assigned patients who is vomiting coffee ground emesis. The novice nurse waits, hoping that someone with more experience will volunteer to do the job, or he just waits until the end of the shift. This nurse is practicing:
procrastination
When planning, a nurse should:
remember that most tasks take longer than anticipated to complete.
Positive time management skills include:
scheduling daily activities
In today's world of fast, effective communication, what is the most commonly used means of societal communication?
spoken word
20. An RN delegates to an experienced LPN/LVN the task of administering oral medications to a group of patients. The LPN/LVN accepts the assignment, and the RN knows that the LPN/LVN has had the training and has acquired the skills needed to complete the task. The RN then observes the LPN/LVN recording a patient's medication administration just before entering the patient's room. The priority intervention by the RN is to:
stop the LPN/LVN immediately and discuss the possible consequences of his actions in a nonjudgmental manner
The task of completing and signing the initial assessment on a newly admitted patient who is about to undergo minimally invasive procedures on an outpatient basis can be delegated to:
the RN
A potential applicant reviews the application process and learns that preemployment physicals often include the following:
urine drug screening
A nurse manager plans the fiscal budget to include salaries for two RNs for two 12-hour shifts with a patient census of 6 in the short-stay observation room. The nurse manager reviews the budget report 3 months later and notes that the salary expenses are higher than was budgeted because of higher than planned RN staff salaries. This additional RN staff is necessary to meet patient care needs because the census has remained constant at 10 patients rather than the 6 projected when the budget was developed. The difference between the planned budget and the actual cost is known as:
variance
