Leadership
The nurse is getting accustomed to the role of nurse manager. What are requirements for this nursing role? Select all that apply. Creating schedules for the unit Setting goals for individual clients Managing the unit's operational budget Introducing methods to improve staff efficiency Evaluating the success of the unit policies Regulating the amount of teamwork used by staff
Creating schedules for the unit Managing the unit's operational budget Introducing methods to improve staff efficiency Evaluating the success of the unit policies The nurse manager is responsible for managing the unit's operational budget, improving staff efficiency, creating the schedule, and evaluating the effectiveness of unit policies. Staff nurses, not the nurse manager, are responsible for setting goals for individual clients in collaboration with the clients. The nurse manager should encourage teamwork by the staff at all times, not regulate how much of it the staff use.
The nurse has delegated several parts of basic care for a client who is a fall risk to an unlicensed assistive personnel (UAP) member. Which UAP action requires nursing intervention? placing the bed into the lowest setting assisting the client to put on slippers prior to ambulation assuring that there is a clear path between the bathroom and bed reminding the client to sit on the bed for a few moments before standing
assisting the client to put on slippers prior to ambulation Slippers do not offer much support or traction. The nurse should intervene to remind the UAP that better footwear should be utilized. Other actions are appropriate and do not require further nursing intervention, other than regular supervision during delegated activities.
A nurse leader is working with a client with hypertension who needs to learn about a low-sodium diet. The nurse recognizes that the client is in the unfreezing stage of Lewin's Change theory with which client statement? "I don't see a problem with what I normally eat." "I am developing a daily meal plan for a low-sodium diet." "I have selected my daily menu with low-sodium foods." "I understand why I need to eat a low-sodium diet."
"I understand why I need to eat a low-sodium diet." Lewin's Change theory involves three phases, which include unfreezing, moving, and freezing. With the unfreezing stage, the person recognizes the need for change. The client who understands why a low-sodium diet is needed with hypertension recognizes that this is a necessary change for the client's health status. If the client does not recognize a problem that needs to be changed, as in the client who wants to continue with a normal diet, the person is not ready for change. The person who is planning a meal is in the moving phase, which is the initiation of change after planning. The person who has already made the change with the daily menu is in the refreezing stage, where change has been effectively made.
The chief nursing officer (CNO) wants to encourage nurses in the hospital to become clinical nurse leaders (CNL) and is reviewing a roster of nurses working on the medical-surgical unit. Which nurse should the CNO recognize as being qualified to take the CNL examination?' An RN who attended a diploma program, has 20 years of nursing experience, is a bedside nurse, is reliable, and provides quality client care An with a BSN who is a case manager; has 16 years of nursing experience, is trustworthy, and provides compassionate client care An RN with an MSN who is a nurse manager, has 7 years of nursing experience, is supportive, and is engaged in community service activities An RN with an ADN who is a charge nurse, has 5 years of nursing experience, is honest, and is enrolled in BSN courses
An RN with an MSN who is a nurse manager, has 7 years of nursing experience, is supportive, and is engaged in community service activities The RN with an MSN who is a nurse manager, has 7 years of nursing experience, is supportive, and is engaged in communitiy service activities is the only nurse qualified to become a CNL. The American Association of Colleges of Nursing requires an RN to have at least a master's degree to be eligible to become a CNL
A client with obsessive compulsive disorder reports to the nurse that the routine of having the the night-light on was not followed on the night shift. What would be the nurse's best course of action? Document the situation and make an incident report in accordance with hospital protocol. Instruct the night nurse to follow the care plan more carefully in the future. Place a sign at the end of the bed stating that the client needs a night-light. Ask the night nurse about the experience of caring for the client the previous night.
Ask the night nurse about the experience of caring for the client the previous night. Asking the night nurse about the experience is the preferred approach to handling this situation; it creates a collaborative dialogue and is an effective strategy to gather information while creating a healthier working relationship. Instructing the night nurse to follow the care plan more carefully isn't the best course of action because the nurse may become defensive before considering all the facts. Placing a sign at the end of the client's bed might help ensure continuity of care during future assignment changes, but it's far better for the nurse to develop a cooperative relationship with the staff member. Making an incident report would be a presumptive overreaction. Gathering data and developing a positive relationship to solve the problem in a peer-oriented and collaborative manner is more appropriate than formally documenting the incident.
A nurse is in charge of a large group of employees on a busy surgical floor. Today's care must be completed early due to a special event involving most of the employees. Which management style would work best in this situation? Authoritarian Coercive Democratic Laissez-faire
Authoritarian With authoritarian, or autocratic, leadership, the leader determines, dictates, and directs the activities of the group, with no input from the followers on decisions. It is particularly effective when decisions for a large group need to be made quickly and efficiently, as in this scenario. Coercion--involving forcing actions upon the staff--is not a recognized leadership style and, in any case, would not be an advisable approach as it would likely trigger resistance in the group and be counterproductive. Democratic leadership is appropriate when the task, or decision at hand, is not one that requires urgent action, when subordinates can be expected to make meaningful contributions, and when their input can be taken into account. Laissez-faire management provides little or no direction; coworkers develop their own goals, make their own decisions, and take responsibility for their own management.
A registered nurse serves as the chair of the Nursing Practice Committee for the hospital. The meetings of this committee do not have a planned agenda; members of the committee who are interested in a particular topic feel free to suggest it and then to lead the subsequent discussion. This chair's leadership style could be most accurately termed what? Laissez-faire Decentralization Democratic Autocratic
Laissez-faire Little or no direction is provided in laissez-faire management: coworkers develop their own goals, make their own decisions, and take responsibility for their own management. Democratic leadership, also known as participative or shared leadership, involves members of the group taking a more participative role in the decision-making process. Autocratic leadership, also known as authoritarian leadership, is characterized by the leader's individual control over all decisions and little input from group members. Decentralized decision-making is any process in which the decision-making authority is distributed throughout a larger group.
A registered nurse (RN) and a licensed practical nurse (LPN) are caring for a client who has been admitted with an acute exacerbation of chronic obstructive pulmonary disease (COPD). Which nursing actions can the RN delegate to the LPN? Select all that apply. Obtaining pulse oximetry Auscultating breath sounds Performing an admission assessment Developing a nursing care plan Administering an oral antibiotic
Obtaining pulse oximetry Auscultating breath sounds Administering an oral antibiotic It is within the scope of practice for a licensed practical nurse (LPN) to obtain pulse oximetry, auscultate breath sounds, and administer oral antibiotics. A registered nurse (RN) must perform the admission assessment and develop the nursing care plan. These are tasks that cannot be delegated because these are not in the scope of the LPN.
A nurse in the community has been asked to join an organization based on the leadership abilities demonstrated both in the facility of employment and community-based activities. Which organization is most likely being described? American Nurses Association (ANA) American Association of Colleges of Nursing (AACN) Sigma Theta Tau International National Council of State Boards of Nursing (NCSBN)
Sigma Theta Tau International Sigma Theta Tau, the nursing honor society, extends membership invitations to students who demonstrate excellence in scholarship and nurses in the community who demonstrate excellence in leadership. The ANA is open to all licensed registered professional nurses. The AACN sets standards and publishes essential components of baccalaureate, master's and doctoral education in nursing. The NCSBN is responsible for NCLEX testing standards.
Which action by the nurse is an example of peer review? The nurse seeks feedback from the nurse manager regarding job performance for the previous year. The nurse seeks information from the unlicensed assistive personnel (UAP) regarding the family's response to the nurse's education. The new graduate nurse consults the policies and procedures of the institution prior to skill implementation. The nurse preceptor provides feedback to the new graduate nurse after 6 weeks of orientation.
The nurse preceptor provides feedback to the new graduate nurse after 6 weeks of orientation. Peer review involves the evaluation of one staff member by another staff member on the same level in the hierarchy of the organization for the purpose of professional performance improvement. The nurse preceptor providing feedback to the new graduate nurse after 6 weeks of orientation is an example of peer review. The nurse manager and the UAP are not on the same level in the organization as the nurse. Consulting policies and procedures is not peer review.
The nurse-manager of a 20-bed coronary care unit is not on duty when a staff nurse makes a serious medication error that results in a client's overdose. The client nearly dies. Which statement accurately reflects the accountability of the nurse-manager? The nurse-manager would receive a call at home from the on-duty nursing supervisor, apprising the nurse-manager of the problem as soon as possible. Because the nurse-manager is off duty and not accountable for incidents that occur in their absence, the nurse-manager need not be notified. The nurse-manager only needs to be informed of the incident when the nurse-manager reports to work on the next scheduled day. Although the nurse-manager is off duty and not responsible for what happened, the nursing supervisor would call the nurse-manager only if time permits.
The nurse-manager would receive a call at home from the on-duty nursing supervisor, apprising the nurse-manager of the problem as soon as possible. The nurse-manager is accountable for what happens on the unit 24 hours per day, 7 days per week. If a serious problem occurs, the nurse-manager should be notified as soon as possible. None of the other choices accurately reflect the nurse--manager's accountability in this situation.
The registered nurse (RN) wants to delegate measuring a client's urinary output to an unlicensed assistive personnel (UAP). Which factors should the nurse consider before delegating the task? The complexity of the activity, age of the UAP, and predictability of the outcome Predictability of the UAP, the amount of time required for the task, and RN's skill level The stability of the patient's condition, potential for harm, and complexity of the activity The context of the other patient needs, the desired outcome, and autonomy of the patient
The stability of the patient's condition, potential for harm, and complexity of the activity RNs should consider the following when delegating tasks to UAPs: qualifications and capabilities of the UAP (not the age of the UAP or the RN's skill level), stability of the patient's condition (not the autonomy of the patient), complexity of the activity to be delegated (not the time required to complete the activitiy), potential for harm, predictability of the outcome (not the predictability of the UAP or the desired outcome), and overall context of other patient needs.
Which client's care may a registered nurse (RN) safely delegate to the nursing assistant? a client who requires continuous pulse oximetry monitoring admitted with bronchitis a client requiring assistance ambulating, who was admitted with a history of seizures a client with a trach that requires intermittent suctioning a client with end-stage chronic obstructive pulmonary disease receiving patient-controlled analgesia.
a client requiring assistance ambulating, who was admitted with a history of seizures The RN may safely delegate assistance ambulating for the client with a history of seizures to a nursing assistant. The RN should provide direct care to the client who requires continuous pulse oximetry monitoring because pulse oximetry interpretation requires assessment skills. Care of the clients requiring suctioning and patient-controlled analgesia can be safely delegated to a licensed practical nurse.
When providing education to a teenage prenatal class, the nurse states that infants born to teenage mothers are more likely to have which outcome? genetic problems postdate birth low-birth weight lower mortality rates
low-birth weight Infants born to adolescent mothers are more likely to have a low birth weight and poor outcomes and higher mortality rates when compared to infants of older mothers. Infants born to teenage mothers are not more likely to have genetic problems; they are more likely to be born preterm rather than postdate.
The nursing supervisor is evaluating how many clients each of the department nurses has been assigned for the shift. This type of evaluation would be considered: process. outcome. goal. subjective. structure.
structure. Availability of equipment, layout of physical facilities, nurse-client ratios, administrative support, and maintenance of nursing staff competence are some areas of concern for structure evaluation. Process, outcome, goal, and subjective evaluation address those respective categories.