Leadership and management

The area of nursing in which churches employ their own nurse to take care of basic health needs of the congregation is called _____________ nursing.

ANS: parish Parish nurses are employed by the church to keep their groups happy and healthy by treating the whole person—body, mind, and spirit.

How can the LPN/LVN charge nurse meet needs for affiliation among staff on their shift? a. Reorient all staff to policies and shift routine. b. Encourage attendance at continuing education seminars. c. Arrange a social gathering for the staff on the shift. d. Offer training in violence prevention.

.ANS: C Affiliation needs are met by providing for good interpersonal relationships among staff. Planning a social gathering is a way of meeting affiliation needs. Reorienting all staff to policies and shift routine is probably unnecessary and would not address affiliation needs. Encouraging attendance at continuing education seminars addresses level 4 needs for recognition, growth, and responsibility. Offering training in violence prevention addresses level 2 safety needs.

The NCLEX-PN examination measures the _____________ competencies needed to practice practical/vocational nursing.

ANS: minimum The NCLEX-PN examination measures the minimum competencies required to safely and effectively practice as a newly licensed practical/vocational nurse.

A purely task-centered leadership style that thrives on power and involves telling someone what to do, with little regard for the employee as a person, is the ____________________ style.

ANS: autocratic A purely task-centered leadership style (autocratic style) thrives on power. It involves telling someone what to do, with little regard for the employee as a person who may have ideas about how to improve patient care or reach the goals of the employer.

During a staff meeting, the charge nurse encourages feedback from staff nurses about improving patient safety. The charge nurse is displaying the _______________ leadership style.

ANS: democratic

During an emergency, the charge nurse tells the LPN/LVN, "I need you to place the patient on a non-rebreather mask now." The charge nurse has little regard for the LPN/LVN's input at this time. The charge nurse is displaying what leadership style? a. Autocratic b. Situational c. Democratic d. Laissez-faire

ANS: A A purely task-centered leadership style (autocratic style) thrives on power. It involves telling someone what to do, with little regard for the employee as a person who may have ideas about how to improve patient care or reach the goals of the employer. Situational leadership involves varying leadership style to meet the demands of the situation in the work environment. Focusing on both the task and the employee is characteristic of the democratic style of leadership. A purely people-oriented style (laissez-faire) focuses on people's feelings but ignores the task at hand. It allows employees to act without any direction.

The LPN/LVN reads this statement, "Stress is the body's reaction to the mind's analysis of a situation." The LPN/LVN concludes that the critical factor to teach nursing assistants to help them control their stress levels is to a. manage how they think about a situation. b. consider the stressful situation as subjectively as possible. c. focus on developing good clinical skills. d. apply time management principles.

ANS: A According to Ellis, managing one's thinking by replacing irrational thinking with rational thinking reduces stress. The key is to think objectively. Focusing on developing good clinical skills and applying time management principles are not relevant to the scenario

The new nursing assistant arrived 1 hour late for duty on the second day of employment, giving the excuse of car trouble. The LPN/LVN charge nurse should a. note the incident of tardiness in the charge nurse's personal file. b. send a letter of reprimand to the nursing assistant. c. give an oral reprimand to the nursing assistant. d. arrange to terminate the nursing assistant before a pattern develops.

ANS: A Documenting the incident in the charge nurse's personal file will allow the charge nurse to later determine whether a pattern develops. If no pattern develops, no harm has been done to the employee's work record. A first instance of tardiness does not require reprimand or termination but rather an explanation that the expectation for all employees is to be at work on time.

The quality that is the greatest asset for the LPN/LVN working in home health care is a. flexibility. b. judgmental attitude. c. sympathetic approach. d. preference for working alone.

ANS: A Flexibility is necessary because the LPN/LVN often has to improvise while still practicing sound nursing principles. A nonjudgmental attitude is desirable. Empathy, rather than sympathy, is needed. The home health LPN/LVN works with a health care team and the family.

Which area of health care delivery services is the largest employer of LPN/LVNs? a. Long-term care facilities b. Hospitals c. Home health d. Military services

ANS: A Long-term care facility employment is expected to grow faster than other area of employment in response to the needs of the growing number of older adults and disabled people and the use of nursing homes for recuperation after hospitalization.

Which is a basic rule when writing a letter of resignation? a. Avoid venting negative feelings. b. Honesty is the best policy; say how it is. c. List suggestions for agency improvement. d. Prior notice is highly overrated; just don't show up any more.

ANS: A Never mention negative feelings about the agency or its personnel in a letter of resignation. A positive work reference may be needed at a later time. Reread the previous two sentences. It is not a wise idea to list suggestions for agency improvement. This suggests negative feelings about the agency. Proper notice is an important courtesy. Abrupt departure may mean the individual is not eligible to be rehired at a future time.

In which situation would the LPN/LVN charge nurse be in violation of OBRA provisions? a. Letting the unit secretary, who has completed 30 hours of instruction in a CNA program, bathe and ambulate a resident b. Allowing a son to feed his father, who is a resident on the unit c. Scheduling a nursing assistant to attend a 2-hour in-service training session d. Notifying the RN supervisor that a nursing assistant needs additional training in administration of tap water enemas

ANS: A OBRA regulations call for all nursing assistants to be certified. Permitting an uncertified employee to perform the duties of a CNA violates OBRA regulations. Allowing a son to feed his father is permissible. Scheduling a nursing assistant to attend a 2-hour in-service training session and notifying the RN supervisor that a nursing assistant needs additional training are appropriate.

When an SP/VN asks for advice about how to "reduce anxiety before the NCLEX-PN examination," the LPN/LVN should respond, "An effective strategy for reducing test anxiety prior to the NCLEX-PN examination is to a. maintain a confident, positive attitude about your abilities and the outcome." b. drink 3 ounces of an alcoholic beverage 30 minutes before the test." c. prepare yourself for the worst by picturing yourself having to reapply." d. use scrap paper to keep track of the number of questions you think you answered correctly and incorrectly."

ANS: A Positive thinking reduces anxiety. Testing with mild anxiety is more productive than testing with moderate to high anxiety. Drinking alcohol will interfere with critical thinking. Preparing yourself for the worst by picturing yourself having to reply is negative thinking and raises anxiety. Using scrap paper to keep track of the number of questions you think you answered correctly and incorrectly takes the focus away from thinking critically about the questions and wastes time that could better be used to consider question options

When an SP/VN or LPN/LVN is seeking a new position, which pre-interview preparatory action would most likely contribute to a successful interview? a. Practice responding to sample interview questions. b. Focus on spontaneity as the key to answering questions. c. Choose casual clothing, because it denotes self-esteem. d. Remind oneself to address the interviewer by her or his first name.

ANS: A Practice ensures that the interviewee has thought through what responses would be best and will be able to respond in an articulate, sincere fashion. Spontaneity does not always work well; it may not provide appropriate information. Conservative business attire is best. Use the individual's surname unless invited to do otherwise.

Which information can be omitted when the LPN/LVN charge nurse gives the change-of-shift report? a. Routine care for each resident b. New problems for any resident c. Prn medication administered d. New medical orders

ANS: A Routine care should not be included in the change-of-shift report. It is recorded on the resident's Kardex and care plan and documented in the medical record and flow sheets. The change-of-shift report should focus on new information about residents

The American Nurses Association (ANA) a. represents only registered nurses. b. represents only licensed practical nurses. c. represents both registered nurses and licensed practical nurses. d. has attempted to expand licensed practical nurses' scope of practice.

ANS: A The ANA represents only registered nurses. State affiliates of the ANA are altering bylaws to allow LPN/LVNs to join the association at the state level and pay dues but not to have a voice or vote in the organization. The ANA does not represent licensed practical/vocational nurses and has attempted to limit their scope of practice. In 1965 the ANA set a policy to eliminate LPN/LVNs and attempted to do so again in the 1980s.

The most fundamental requirement for assuming the practice role of LPN/LVN charge nurse is a. licensure in the state of practice. b. experience with resident assignment. c. the ability to coordinate patient care services. d. a knowledge of the principles of delegation.

ANS: A The LPN/LVN practice role requires that the individual be licensed as an LPN/LVN in the state in which he or she is practicing. The other qualifications are important but are not the most basic.

To discover the expanded role of the practical nurse, the LPN/LVN should investigate a. the state's Nurse Practice Act. b. job descriptions for the practical nurse in local health care agencies. c. information gained from practical nurses working in various clinical settings. d. the opinions of physicians who service area nursing homes and extended care facilities.

ANS: A The Nurse Practice Act of the state determines the parameters of LPN/LVN practice. The other options may be less detailed than the Nurse Practice Act, so they are not the best resources

The plan of care for a resident in the rehabilitation unit requires the resident to receive teaching about how to monitor blood glucose as part of discharge teaching. The RN is working with a resident whose condition is deteriorating. The LPN/LVN charge nurse has performed blood glucose monitoring many times but is new and has not received facility certification. The nursing assistant assigned to the patient is a diabetic and monitors blood glucose several times a day. Who should perform the teaching? a. RN b. LPN/LVN charge nurse c. Nursing assistant d. Physician

ANS: A The RN is required to initiate teaching. The LPN/LVN can follow up, review, and reinforce

The LPN/LVN nursing home charge nurse usually tells nursing assistants what to do and offers little opportunity for input or suggestions for how to improve care. This leadership style is called a. autocratic. b. democratic. c. situational. d. laissez-faire.

ANS: A The charge nurse is task oriented and seeks no input from staff. This is consistent with autocratic leadership. The other options are not possibilities based on the description given in the scenario

To which goal should the LPN/LVN give priority? a. Resident X, who has been experiencing a medication reaction, will have no rash and uncompromised respirations. b. Resident Y, who is obese and has had a recent knee replacement, will ambulate using a walker with the assistance of a staff member. c. Resident Z will receive blood glucose monitoring and insulin as ordered. d. All residents will be weighed before breakfast.

ANS: A The goal for the resident who has been experiencing a medication reaction that states he will have no rash and uncompromised respirations reflects a level 1 priority, a life-threatening situation. The goal for an obese resident who has had a recent knee replacement that states she will ambulate using a walker with the assistance of a staff member is level 2, essential to safety. The remaining options are level 3 priorities, essential to the medical/nursing plan of care.

The LPN/LVN charge nurse asks the nurse manager, "How can I motivate the nursing assistants on my shift?" The best answer would be: a. "Motivation is an inner force. You can't motivate someone else, but understanding the things that are important to workers can be helpful." b. "Encouragement is the only way. If you praise and encourage the workers, you will have them eating out of your hand and doing their best." c. "Money is the only thing that motivates workers. Since you can't set a higher salary, you can't change their motivation." d. "Communicate! Communicate! Communicate! Be clear and specific. Spell things out. Give the impression that you know what you're talking about at all times."

ANS: A The idea that motivation is an inner force most accurately explains motivation. Encouragement and money are motivators but do not provide accurate information. Referencing communication does not provide information on motivation.

Which of the following individuals is most likely to provide the most authoritative, positive reference for a student nurse who is beginning to search for postgraduation employment? a. Instructor A, who has provided positive feedback during clinical labs b. Program director B, who is familiar with the student nurse's academic record c. Nurse C, who is the student nurse's acquaintance at the health club d. Student nurse D, who is a peer enrolled in the same nursing program

ANS: A This individual would know both the academic record and clinical performance strengths of the student nurse. Because the instructor has given positive feedback, this person should be able to provide a positive reference. The program director may not have first-hand knowledge of clinical performance and might be less able to emphasize clinical performance strengths. The nurse who is the student nurse's acquaintance at the health club would be unable to provide first-hand information about academic and clinical performance. A fellow student cannot provide a reference that would have the same weight as an instructor or a nurse with whom the student has worked in a health care agency.

Which of the following is an example of objective, rational thinking rather than subjective, irrational thinking about nursing assistants whom the LPN/LVN charge nurse supervises? a. "I want nursing assistants to be on time for report." b. "Neat appearance means good clinical skills." c. "Nursing assistants who are late intend to take advantage of coworkers." d. "Beware of nursing assistants who smile a lot. They're manipulative."

ANS: A This is an objective, rational thought that reflects a reasonable expectation for nursing assistants. The other options exemplify subjective, irrational thinking.

An LPN/LVN is working in a health care facility that allows delegation of nursing duties to nursing assistants by the LPN/LVN. Which of the following duties could be delegated to the nursing assistant? a. Weighing a patient b. Initial patient education c. Assessing a patient's pain d. Changing a sterile dressing

ANS: A Weighing a patient is within a nursing assistant's scope of practice. The remaining options are not within a nursing assistant's scope of practice. Examples of duties not to delegate to a nursing assistant include sterile technique procedures, crisis situations, initial patient education, and interpretation of data.

Which principles of delegation should the LPN/LVN charge nurse follow when delegating a duty to a nursing assistant? (Select all that apply.) a. Choose a nursing assistant who is competent to perform the delegated duty. b. Determine the nursing assistant's willingness to accept the delegated duty. c. Transfer responsibility for the duty to the nursing assistant accepting the delegation. d. Permit the nursing assistant to perform the duty without guidance or monitoring. e. Plan to delegate duties the LPN/LVN charge nurse enjoys least.

ANS: A, B Choosing a nursing assistant who is competent to perform the delegated duty fulfills the Right Person criteria. Delegation is complete only when the nursing assistant accepts the delegated duty. Responsibility for a delegated duty cannot be transferred. The LPN/LVN charge nurse is responsible for supervision and evaluation. Delegated duties should not necessarily be those that the nurse does not enjoy.

Which phrases accurately describe computerized adaptive testing (CAT) as used in the NCLEX-PN examination? (Select all that apply.) a. Selects questions of varying difficulty, depending on previous responses b. Provides an individualized examination for each tester c. Requires the tester to answer a minimum of 85 questions d. Selects an equal number of questions from the four categories of patient need e. Ends testing when 50% of the questions have been answered correctly

ANS: A, B, C CAT varies the question difficulty based on previous responses, provides an individualized exam, and requires the tester to answer a minimum of 85 questions. Patient needs are not tested equally. The test plan calls for physiological integrity to be weighted more heavily than the other categories. Testing ends when a minimum of 85 questions have been answered and when 50% of the more difficult questions have been answered correctly.

Which of the following are needed by the candidate to arrange for and take the NCLEX-PN examination? (Select all that apply.) a. An authorization-to-test letter b. An appointment at a testing center c. A picture identification and one other acceptable form of identification d. A copy of one's fingerprint card

ANS: A, B, C The authorization-to-test letter comes from the state board of nursing. An appointment for testing at the testing center is necessary. Walk-in testing is not available. Appropriate identification is necessary to satisfy security requirements. Fingerprinting is done at the time of testing.

Select the various continuing education opportunities that are usually available to an LPN/LVN who accepts employment at a long-term care facility in a metropolitan area having a collegiate nursing program. (Select all that apply.) a. A competency-based orientation b. In-service programs c. Workshops d. CEUs through nursing publications e. Certifications through nursing organizations

ANS: A, B, C, D, E All of these forms of continuing education would be available in such a setting

In which of the following areas may LPN/LVNs obtain certification? (Select all that apply.) a. Managed care b. Pharmacology c. Long-term care d. Mental health care e. IV therapy f. Wound care g. Neonatal care

ANS: A, B, C, E, F Mental health nursing and neonatal nursing are certifications available at this time only to RNs.

Which questions should the nurse identify as illegal for the interviewer to ask and therefore the nurse need not feel obligated to answer directly? (Select all that apply.) a. "Have you been hospitalized within the past year?" b. "What are two important things about yourself that you would like me to know?" c. "Do you have a criminal record?" d. "What would you say is your greatest weakness in the clinical area?"

ANS: A, C These questions have been determined to be illegal for the interviewer to ask. They do not relate to the interviewee's ability to meet the criteria set forth in the job description. The remaining options may be somewhat difficult to answer but are not illegal.

Examples of tasks the LPN/LVN charge nurse of the extended care unit might assign to a nursing assistant (NA) include which of the following? (Select all that apply.) a. Bathing a resident who is in stable condition b. Administering a nasogastric tube feeding c. Assisting a resident with Parkinson disease to ambulate d. Transferring a resident from bed to chair with the assistance of another NA

ANS: A, C, D These tasks have predictable outcomes. Additionally, the NA has been taught to safely perform these tasks. Administering a nasogastric tube feeding is an invasive procedure, beyond the scope of the NA because it requires nursing judgment.

Helpful qualities for home health nurses include which of the following? (Select all that apply.) a. Flexibility b. Judgmental attitude c. Self-confidence d. Ability to deal with emergencies e. Communication skills

ANS: A, C, D, E These are all helpful qualities for home health nurses. A nonjudgmental attitude is a must for the home health nurse, because he or she works in the patient's home. If the nurse is comfortable with his or her own values, different values should not be personally threatening.

Which phrases identify differences between taking the NCLEX-PN examination and a "regular" test in a nursing program? (Select all that apply.) a. One can skip questions and return to them in a program exam. b. One will be penalized for guessing on the NCLEX-PN examination. c. There are a variety of question formats on the NCLEX-PN examination. d. One should stop reading possible answers on the NCLEX-PN examination as soon as selecting the correct answer. e. The NCLEX-PN examination is individualized; program examinations are identical for all testers.

ANS: A, E Most program examinations allow the tester to skip a question and return to it at a later time. The NCLEX-PN examination, as a computerized adaptive examination, individualizes testing, whereas program examinations are identical for all students taking a specific test. There is no penalty for guessing on the NCLEX-PN. Alternate formats can be used in program examinations and the NCLEX-PN examination. One should read all possible answers for both program examinations and the NCLEX examination. Early selection may lead to missing an answer that is better.

The LPN/LVN interviewee determines from personal appearance that the interviewer is from a different cultural background. What action should the interviewee take to minimize the impact of cultural difference during the interview? a. Answer questions in a straightforward manner. b. Use the same gestures the interviewer uses. c. Avert the eyes when responding to questions. d. Be prepared to tolerate decreased personal space.

ANS: AANS: A Even if the interviewer is of a different cultural background, he or she may be fully comfortable interviewing applicants of another culture. One should be more interested in communicating interest in the job and qualifications than in mimicking the interviewer. The interviewer should be given the opportunity to establish norms concerning how to communicate. One cannot anticipate using any of these options, initially. Even if the interviewer is of a different cultural background, he or she may be fully comfortable interviewing applicants of another culture. One should be more interested in communicating interest in the job and qualifications than in mimicking the interviewer. The interviewer should be given the opportunity to establish norms concerning how to communicate. One cannot anticipate using any of these options, initially.

Which services does membership in the National Federation of Practical Nurses (NFPN) provide? (Select all that apply.) a. Subscription to the American Journal of Nursing b. Insurance discounts c. Continuing education articles for CEUs d. Certification programs in IV therapy and gerontology e. Current standards of practice

ANS: B, C, D, E All options but subscription to the American Journal of Nursing are services provided by NFPN. Membership includes a subscription to the Practical Nursing Journal rather than the American Journal of Nursing.

One practical/vocational nursing student tells another student, "I'm computer phobic! I never understand what keys I'm supposed to use to get the thing to work." The reply that shows the best understanding about NCLEX-PN examination testing is: a. "No problem! The question comes up on the screen, and you speak the letter of the correct answer aloud to the voice-activated computer." b. "You answer practice questions before the examination begins to get you used to using the computer." c. "You'll be able to ask the test proctor for help if you get mixed up." d. "If you can't get the hang of the computer, they'll let you use paper and pencil."

ANS: B Answering the practice questions provides orientation to the tester. Voice-activated computers are not used. Asking the test proctor for help if you get mixed up and using paper and pencil are not permitted.

Which quality is rarely found in democratic leaders? a. Assertiveness b. Arrogance c. Desire for new learning d. Effective communication

ANS: B Arrogance is an undesirable quality. The other options are desirable qualities consistent with the democratic leadership style.

For an LPN/LVN to motivate staff members to meet the goals of the organization, it is helpful if the nurse a. practices intimidation. b. understands work motivators. c. offers laissez-faire leadership. d. emphasizes policies rather than people.

ANS: B By understanding what motivates an employee, the nurse is better able to select appropriate motivational strategies. Intimidation is not an effective motivator. Laissez-faire leadership does not focus on motivating staff. People-oriented leaders are better at motivating workers

The priority step the LPN/LVN charge nurse should take before delegating one of the charges to another LPN/LVN on staff is to a. determine whether the other LPN/LVN is competent to perform the task to be delegated. b. check the Nurse Practice Act of the state to learn whether an LPN/LVN charge nurse is allowed to delegate duties. c. delegate both the task and the responsibility that goes with the task. d. determine the directions that will be provided to the person to whom the task is delegated.

ANS: B Charge nurse duties are part of an expanded LPN/LVN role. The charge nurse can delegate duties that are part of the ordinary role of the LPN/LVN to another LPN/LVN but may not be able to delegate duties that are part of the expanded role unless specifically permitted to do so by the Nurse Practice Act of the state. Determining whether the other LPN/LVN is competent to perform the task to be delegated is relevant but not the priority step to take. Delegating both the task and the responsibility that goes with the task is not the priority step to take. Determining the directions that will be provided to the person to whom the task is delegated is relevant but not the priority step to take.

Dressing for success at an interview means an applicant should a. select clothing that could be worn at a cocktail party and a formal hair style. b. wear well-fitting, businesslike clothes and a neat hairstyle. c. wear only new, very conservative dark clothing and have a new haircut and/or style. d. wear an outfit that reflects one's "off-duty" personality or hobbies and a casual hairstyle.

ANS: B Conservative, business-appropriate clothing should be the first choice. Clothing should fit well so that it is comfortable to wear. Wearing conservative, tailored clothing will help the employer see an interviewee as one who will dress appropriately at work. One should try not to wear an outfit for the first time at the interview; having worn it before will give confidence that it fits well. The employer is interested in what appearance one will present at work and would not be able to extrapolate that from the applicant wearing an outfit that reflects "off-duty" personality or hobbies and a casual hairstyle

What action should the nurse take if the employer begins to ask interview questions about work experience on the phone when the nurse calls to set up an interview? a. Answer all questions asked by the employer pleasantly, accurately, and completely. b. Express willingness to discuss qualifications in detail during a scheduled interview. c. Mention being in a hurry now but give permission to receive a call back in an hour. d. Report the phone call to the civil liberties commission.

ANS: B Deflecting employer questions until the actual interview is a good strategy. It prevents the employer from making a snap decision about the individual without seeing the applicant and exploring his or her qualifications in greater detail. Answering all questions asked by the employers pleasantly, accurately, and completely allows the employer to substitute a phone call for a personal interview. Mentioning that you are in a hurry now but giving permission to receive a call back in an hour would be perceived as impolite. Reporting the phone call to the civil liberties commission is unnecessary and inappropriate.

The LPN/LVN nursing home charge nurse encourages nursing assistants to make suggestions regarding improvement of nursing care and shows concern for the staff. This leadership style is called a. laissez-faire. b. democratic. c. autocratic. d. situational.

ANS: B Democratic leadership style is demonstrated when the nurse is concerned about the work to be done and is also concerned about the team performing the work. The team is encouraged to participate in decision making about resident care. The other options are not possibilities based on the scenario description.

The content of the NCLEX-PN examination is divided into four Patient Needs categories. The Health Promotion and Maintenance category includes a. ethical practice. b. family planning. c. crisis intervention. d. basic pathophysiology.

ANS: B Family planning is included in the Patient Needs category Health Promotion and Maintenance. Ethical practice is included in the Patient Needs category Safe, Effective Care Environment. Crisis intervention is included in the Patient Needs category Psychosocial Integrity. Basic pathophysiology is included in the Patient Needs category Physiological Integrity.

What advantage does a nurse have in locating a job he or she likes? a. Nursing school encourages one to decide on a career area prior to graduation and allows for extra experiences. b. Clinical assignments include practical nursing experience in a variety of clinical settings. c. For nursing students in a community college or vocational/technical setting, the school guarantees a job on graduation. d. Because of the rapid turnover of nurses in health care facilities, locating a choice job is easy.

ANS: B Having experience in a variety of clinical settings makes it easier to determine which types of units one would find to be a good match for skills and personality traits. Nursing school does not encourage one to decide on a career area prior to graduation, nor does it allow for extra experiences. Community colleges and vocational/technical settings do not guarantee a job upon graduation. It is not necessarily true that because of rapid turnover of nurses in health care facilities, locating a choice of job is easy. There may be no openings on units the nurse would prefer.

The long-term care agency has recently announced that it will soon lay off six LPN/LVNs and hire eight nursing assistants. Today, the RN charge nurse presents the LPN/LVN charge nurse with a certificate recognizing her ability to manage effectively despite short staffing. The LPN/LVN responds somewhat politely but seems more angry than pleased. In terms of the Howlett hierarchy of needs, which of the following is the best explanation for the employee's reaction? a. The LPN/LVN is probably responding to the poor working conditions. b. When job security is threatened, recognition needs assume lesser importance. c. Achievement and advancement needs are more fundamental than recognition needs. d. The adequacy of benefits is more basic to job satisfaction than affiliation needs.

ANS: B Job security is a level 2 need, whereas recognition is a level 4 need. The level 2 need is threatened; therefore, the level 4 need seems less important. Data are not present to support that the LPN/LVN is responding to poor working conditions. The remaining options are either not accurate or not relevant to the scenario

Endorsement for an LPN/LVN taking the NCLEX-PN examination means that a. the LPN/LVN will never risk losing his or her license. b. the LPN/LVN may apply for licensure in a different state or territory without retesting. c. the LPN/LVN is entitled only to practice in the state in which he or she took the NCLEX-PN examination. d. the LPN/LVN must retake the NCLEX-PN examination if wishing to practice nursing in another state or territory.

ANS: B The NCLEX-PN examination is given in the United States, American Samoa, the District of Columbia, Guam, the Northern Mariana Islands, Puerto Rico, and the Virgin Islands. This makes it possible to provide licensure by endorsement from one board of nursing to another. Endorsement means that an LPN/LVN may apply for licensure in a different state or territory without retesting. Taking the same examination in the United States and its territories facilitates endorsement from one nursing board to another

A new LPN/LVN asks the LPN/LVN charge nurse what continuous quality improvement (CQI) is all about. The charge nurse should explain that the focus of CQI in a health care agency is a. saving time. b. better patient care outcomes. c. making money for the health care agency. d. reducing stress for employees.

ANS: B The focus of CQI is quality of care, as indicated by patient outcomes. CQI does not focus on saving time, agency profit, or stress reduction

Assuming all the following are staff members on the unit, to whom should the LPN/LVN charge nurse assign a newly admitted 65-year-old resident with left hemiplegia and a large sacral decubitus requiring a sterile dressing change? a. LPN/LVN orientee with 1 week of experience b. LPN/LVN with 2 years of experience c. Nursing assistant with 3 years of experience d. Nursing assistant who is a nursing student at a local college

ANS: B The resident will require data collection by an experienced person to assist the RN with care planning. The assigned care giver will need to be able to implement relatively complex care, including use of surgical aseptic technique and nursing judgment. The care required might be more than the orientee can provide. A nursing assistant should not be assigned to care for a new resident requiring careful data collection and use of nursing judgment

During an employment interview, the interviewee asks what additional educational experiences the LPN/LVN can count on receiving when employed at the facility. Which continuing education opportunity is the interviewer most likely to say the agency offers? a. Annual off-site paid workshops b. Orientation and in-service classes c. Paid courses at a local 2-year college d. Correspondence courses funded by NAPNES

ANS: B These educational experiences are considered standard benefits at most agencies. The other options are benefits that may or may not be available at a given agency.

Which statement is true with regard to making a follow-up call after submitting a résumé and cover letter for a position? a. Do not call; the employer will call the applicant if interested. b. Call on the date and at the time mentioned in the cover letter. c. Call on a Monday before 8 AM if possible. d. Call on a Friday between 2 PM and 4 PM if possible.

ANS: B This action shows dependability. Employers expect applicants to follow up if they are truly interested in the position. Monday mornings are poor times to call. People are trying to get organized for the week to follow. Calling on Friday is also a poor time to call. People are finishing last-minute details before leaving for the weekend.

The LPN/LVN charge nurse notices that a nursing assistant has not weighed her assigned residents. The best statement by the nurse is: a. "You didn't weigh your assigned residents this morning. Let's get with the program." b. "I need to have you weigh your assigned residents and report to me by 10 AM." c. "Would you mind explaining why you didn't weigh your residents today?" d. "You've been goofing off lately. Not weighing your assigned residents is a good example of this."

ANS: B This is straightforward and assertive and resolves a clinical problem. The other options fail to provide a solution to the clinical problem created by the nursing assistant's failure to obtain the weights.

The nurse asks for advice about sending a cover letter and résumé electronically to a local health care agency. The best advice would be: a. "Send the cover letter with the résumé as an attachment." b. "Paste the résumé to the end of the cover letter." c. "It is inappropriate to use electronic transmission in this instance." d. "Phone first to find out whether the person hiring is computer literate."

ANS: B This method will ensure that the person receiving the cover letter has ready access to the résumé. Not all systems can open attachments. It is not inappropriate to use electronic transmission in this instance. Many employers prefer e-inquiries. It is not necessary to phone first to find out whether the person hiring is computer literate.

As the interview at the long-term care facility is coming to a close, the interviewer asks the applicant, "What questions may I answer for you?" Which question would be most likely to create a favorable impression? a. "After completing the orientation, when will the first pay raise be given?" b. "Will it be possible to tour a unit such as the one to which I would be assigned?" c. "What will happen if I can't meet the outcomes for the competency-based orientation?" d. "Do you have tuition reimbursement for courses toward my next degree?"

ANS: B This request shows genuine interest in the facility. Asking when the first pay raise will be given indicates you are most interested in salary. Asking what will happen if orientation outcomes cannot be met creates a negative impression. Asking if tuition reimbursement is provided is not as negative as asking when the first pay raise will be given but should be deferred to a later time.

LPN/LVN licensure by endorsement in the United States and its territories is possible because a. English is the spoken language of each locale. b. the NCLEX-PN examination is used by the board of nursing of each locale. c. computer-adaptive testing maximizes testing efficiency. d. the NCLEX-PN examination test plan reflects current practice.

ANS: B When the same examination is used, the boards of nursing can be assured that those who pass have the knowledge to practice practical/vocational nursing at a minimally safe and effective level.

Which statements provide accurate information about determination of pass/fail by NCLEX-PN computerized adaptive testing? (Select all that apply.) a. Only questions testing the application or analysis level of cognition are scored. b. Each question that appears on the screen must be answered; none can be skipped. c. Of the more difficult questions asked, 50% must be answered correctly to pass. d. One's score must be at least 75% of the 205 total questions asked.

ANS: B, C Each question that appears on the screen must be answered in order for the examination to continue. The basis for this is that question selection is based on the correctness of the answer given for the previous question. The computer determines that the candidate has passed when he or she has completed at least 85 questions and it can be determined that the person has correctly answered 50% of the questions with a high index of difficulty. All questions are scored. Not all testers answer the maximum number of questions (205). Seventy-five percent is not used to determine passing.

Which phrases describe the format of the NCLEX-PN examination? (Select all that apply.) a. Uses multiple choice questions exclusively b. Includes questions of varying levels of difficulty c. May have fill-in-the-blank questions d. Uses charts, tables, and graphics as parts of questions e. Requires tester to select a single best answer for every question f. Tests the cognitive levels of knowledge, comprehension, application, and analysis g. Integrates three of the four steps of the nursing process used by LPN/LVNs

ANS: B, C, D, F The NCLEX PN examination includes questions of varying levels of difficulty; it may have fill-in-the-blank questions, charts, tables, and graphics; and it tests the cognitive levels of knowledge, comprehension, application, and analysis. Using multiple choice questions exclusively is incorrect because alternate types of questions are used in the examination. Requiring the tester to select a single best answer for each question is inaccurate because multiple answers may be correct for some questions. Integrating three of the four steps of the nursing process used by LPN/LVNs is incorrect because all four steps of the LPN/LVN nursing process are integrated into the examination.

Nurse T has decided to seek certification in an area that will enhance employability in a nursing home. Which certifications would be of greatest value to the LPN/LVN working in a nursing home? (Select all that apply.) a. IV therapy b. Wound care c. Long-term care d. Managed care e. Pharmacology f. Gerontology

ANS: B, C, E, F The majority of nursing home residents are older adults and receive long-term care. Most receive medications. Those who develop pressure sores require wound care. IV therapy is used less in nursing homes than in hospital settings. Managed care is used less in nursing homes than in hospital and community health settings.

Which phrases would be helpful to remember when filling out a job application? (Select all that apply.) a. Never provide information regarding having held three or more jobs in the past year. b. Explain employment gaps by responses such as laid off, job hunting, family responsibilities. c. Answer questions about wage requirements by inflating current salary by 20%. d. Respond to questions about age, religion, number of children, even though it is not required by law. e. Do not leave questions unanswered or blank spaces on the application.

ANS: B, E Employers look for unexplained gaps in employment, so providing information regarding why gaps exist will prevent discarding of the application. Many employers will not interview applicants unless all questions on the application have been answered. Writing in "Will explain" is preferable to leaving a blank. Never falsify an application. Be honest with the number of jobs held in the past year and give reasons for leaving. It is unwise to answer questions about wage requirements by inflating current salary by 20%. Place wage requirements at a realistic level for the job or write "Open." It is not necessary to respond to questions about age, religion, number of children. One does not have to answer illegal questions.

14. The content of the NCLEX-PN examination is divided into four Patient Needs categories. The Safe, Effective Care Environment category includes a. the aging process. b. abuse and neglect. c. advance directives. d. medication administration.

ANS: C Advance directives are included in the Patient Needs category Safe, Effective Care Environment. The aging process is included in the Patient Needs category Health Promotion and Maintenance. Abuse and neglect are included in the Patient Needs category Psychosocial Integrity. Medication administration is included in the Patient Needs category Physiological Integrity.

Prior to taking the NCLEX-PN examination, candidates sign a confidentiality clause. A candidate would be in violation of "terms of confidentiality" when doing which of the following? a. The candidate asks the examination proctor a question. b. The candidate informs others that she has taken the exam. c. The candidate discusses the examination with his instructor. d. The candidate refrains from discussing the examination with others.

ANS: C Candidates sign an NCLEX-PN examination confidentiality clause prior to testing. Dr. Tom O'Neill, associate director, NCLEX-PN examination, states that, "technically if students were to discuss the examination with an instructor, they would be in violation of the 'terms of confidentiality' they must agree to before they take the exam. These terms include not disclosing the content of the examination items before, during, or after the examination. Legal action could be taken against candidates that break the NCLEX-PN confidentiality clause, including criminal prosecution and civil litigation as well as other administrative disciplinary action."

When a resident's family complains that their mother is receiving inferior care in the extended care facility, which action should the LPN/LVN charge nurse initially take? a. Gently explain that Continuous Quality Improvement (CQI) would not permit giving inferior care. b. Mention that the staff is overworked and would be glad for the family's assistance. c. Ask the family to be specific and give examples of "inferior care" the mother has received. d. Tell the family that their reaction is based on guilt because of their need to place their mother in an extended care facility.

ANS: C Data collection is necessary to clarify the problem needing to be resolved. The other options display various levels of defensiveness

The LPN/LVN tells a peer, "I want to be endorsed in state X. What step do you think I should take first?" The best response would be: a. "Ask our state board to send you a copy of your NCLEX-PN examination score." b. "Photocopy your license and current registration." c. "Write to the board of nursing in state X and ask for instructions." d. "Request our state board to inactivate your license."

ANS: C Endorsement to practice in another state begins by contacting the state board of nursing in that state and asking for instructions about how to proceed. The board will send an application, instructions, fee schedules, and other materials. Asking the state board to send a copy of you NCLEX-PN examination score and photocopying your license and current registration are neither necessary nor priorities. Requesting the state board to inactivate your license is premature. Current licensure and registration are necessary to continue to work in your state while awaiting endorsement for state X.

The first college in the United States to have a distance-learning nursing program (online) is: a. University of Phoenix. b. Minneapolis Community Technical College. c. Excelsior College. d. Lackawanna College.

ANS: C Excelsior College (previously known as Regents College, in Albany, NY) is the first college in the United States to have a distance-learning (online) nursing program. Minneapolis Community and Technical College has one of the oldest nursing programs in the country, but it was not the first distance-learning college. The University of Phoenix offers distance learning but was not the first. Lackawanna College does not offer a distance-learning nursing program at this time.

A leadership style that focuses on both the task and the employee is the a. autocratic style. b. situational style. c. democratic style. d. laissez-faire style.

ANS: C Focusing on both the task and the employee is characteristic of the democratic style of leadership. A purely task-centered leadership style (autocratic style) thrives on power. It involves telling someone what to do, with little regard for the employee as a person who may have ideas about how to improve patient care or reach the goals of the employer. Situational leadership involves varying leadership style to meet the demands of the situation in the work environment. A purely people-oriented style (laissez-faire) focuses on people's feelings but ignores the task at hand. It allows employees to act without any direction.

The content of the NCLEX-PN examination is divided into four Patient Needs categories. The Physiological Integrity category includes a. newborn care. b. stress management. c. medical emergencies. d. accident/error prevention.

ANS: C Medical emergencies are included in the Patient Needs category Physiological Integrity. Newborn care is included in the Patient Needs category Health Promotion and Maintenance. Stress management is included in the Patient Needs category Psychosocial Integrity. Accident/error prevention is included in the Patient Needs category Safe, Effective Care Environment.

The LPN/LVN day shift charge nurse in a nursing home usually reports to the a. owner of the nursing home. b. administrator of the nursing home. c. RN manager of the unit. d. board of directors of the nursing home.

ANS: C Most organizational charts call for the LPN/LVN charge nurse to report to the RN manager of the unit. The other options are not logical

The practical/vocational nursing student tells a colleague, "I know I'm going to fail the NCLEX-PN examination. I've heard that a huge amount of the examination is psychology related, and I hated psychology!" The reply that shows the best understanding of the NCLEX-PN examination is a. "You'd better retake the psychology course." b. "There are equal numbers of questions related to each aspect of patient needs." c. "Psychosocial integrity is the basis for 8% to 14% of the questions." d. "I've heard there's more emphasis on care planning than anything else."

ANS: C Psychosocial integrity is the basis for 8% to 14% of the questions of the NCLEX-PN examination test plan. The other options do not show understanding of the current test plan

A student nurse is interested in working shortly after graduation. What action would have the greatest potential for achieving the goal of securing employment? a. Limit job applications to positions listed in the Help Wanted section of the newspaper. b. Obtain lists of job offerings posted in health care agencies. c. Research agencies of interest and write brief letters expressing an interest in employment. d. Depend on the school of nursing and school placement service to find employment.

ANS: C Researching agencies of interest and writing brief letters expressing an interest in employment follows through on a broad strategy for obtaining employment. Limiting job applications to positions listed in the Help Wanted section of the newspaper makes use of only limited resources. Obtaining lists of job offerings posted in health care agencies suggests obtaining lists but does not suggest taking further action. Depending on the school of nursing and school placement service to find employment is both passive and unrealistic

What advice should the testing candidate consider the best method for preparing to take the NCLEX-PN examination? a. "Participate in an all-night cram session the night before the test." b. "Rely on your intuition to answer questions when you do not know the answer." c. "Study throughout the year and review systematically before the exam." d. "Quiz previous graduates about test content and study what they mention."

ANS: C Studying for each nursing examination and passing it provide a firm foundation for the NCLEX-PN examination. Systematic review over a number of weeks prior to the NCLEX-PN examination will refresh one's knowledge. Cramming is usually counterproductive because it results in fatigue and lowers the ability to think clearly during the examination. Better advice is to rule out wrong answers and consider clues and key words found in the stem of the question. With CAT, the topics covered in the questions answered by one person may be quite different from those selected for another person.

The LPN/LVN spends time exploring the agency mission statement with the nursing assistants who work that shift. They create a list of ways they can contribute to achieving the agency goals. This process is called a. stress management. b. problem solving. c. team building. d. conflict resolution.

ANS: C Team building is a process by which employees become committed to management goals. The scenario does not describe any of the other options

The LPN/LVN tells a mentor, "I want to join the nursing organization that gives me the greatest voice in making policy for LPN/LVN nursing." The mentor can correctly suggest that the LPN/LVN will wish to join the a. National League for Nursing (NLN). b. National Association for Practical Nurse Education and Services (NAPNES). c. National Federation of Practical Nurses (NFPN). d. American Nurses Association (ANA).

ANS: C The NFPN speaks on behalf of LPN/LVNs. It is governed entirely by LPN/LVNs and is the policy-making body and voice of LPN/LVNs. The NLN provides services for LPN/LVN schools of nursing, and NAPNES provides services for individual LPN/LVNs; however, these are not considered policy-making bodies for LPN/LVNs. The ANA is concerned with professional nursing.

8. Assuming all are true, which information about a new graduate should be included in a résumé to highlight abilities that would be valuable to an employer? a. Prefers annual salary of $50,000 to $52,000 b. President of sky diving club c. Fluent in American sign language d. Plans to move to a nearby state after 1 year

ANS: C The ability to communicate with hearing-impaired patients who use sign language would be an asset. It is better not to include salary expectations. Leisure time activities are not relevant. A résumé indicating plans to move to a nearby state after 1 year may prejudice the employer against hiring because it costs money to orient new employees.

A nursing assistant states, "I have never learned how to transfer a resident with end-stage Parkinson's disease from the bed to the chair." The nursing assistant refuses to transfer the resident at this time. Select the appropriate approach for the LPN/LVN charge nurse to take. a. Reprimand the nursing assistant for not performing the job. b. Encourage the nursing assistant to carry through with the transfer. c. Arrange to teach the nursing assistant how to transfer the resident. d. Mention that nursing assistants can be charged with insubordination if they do not perform their jobs.

ANS: C The nursing assistant should not perform tasks for which he or she has not been trained. The nurse should arrange to teach the nursing assistant so that he or she can safely perform the duty. Reprimanding the nursing assistant for not performing the job is unnecessary. Encouraging the nursing assistant to carry through with the transfer is unwise and unsafe. Mentioning that nursing assistants can be charged with insubordination if they do not perform their jobs is threatening.

What is the first step that should be taken by a student nurse who wants to use a particular instructor's name as a reference? a. Look in the catalog to make sure the name is spelled correctly. b. Pass the course taught by the instructor, which permits listing the name. c. Ask the instructor whether her or his name may be used as a positive reference. d. Check with recent graduates to see which instructor writes the best letters of reference.

ANS: C The student should make sure the individual is willing to be a reference and, moreover, is willing to write a positive letter. Looking in the catalog to make sure the name is spelled correctly is relevant but not the first step. Passing a course does not confer the right to use the instructor as a reference. Checking with recent graduates to see which instructor writes the best letters of reference is not an appropriate action.

The content of the NCLEX-PN examination is divided into four Patient Needs categories. The Psychosocial Integrity category includes a. surgical asepsis. b. human sexuality. c. therapeutic communication. d. nutrition and oral hydration.

ANS: C Therapeutic communication is included in the Patient Needs category Psychosocial Integrity. Surgical asepsis is included in the Patient Needs category Safe, Effective Care Environment. Human sexuality is included in the Patient Needs category Health Promotion and Maintenance. Nutrition and oral hydration are included in the Patient Needs category Physiological Integrity.

Desirable qualities and skills for the LPN/LVN working in mental health nursing include a. a judgmental attitude and sympathetic approach. b. preference for working alone and sticking to a routine. c. empathy, good communication, and the ability to work on a team. d. inflexibility, the ability to jump to conclusions, and sensitivity to change.

ANS: C These qualities are desirable for working in the mental health setting; empathy and good communication contribute to development of a therapeutic relationship. The ability to work on a team is essential, because this is the structure adopted by mental health agencies. Nonjudgmental attitudes and empathy are necessary. Mental health nursing requires working with other team members and flexibility. Flexibility, critical thinking, and good mental health are required.

Which behavior should the LPN/LVN charge nurse identify as dysfunctional behavior that violates OBRA regulations by threatening resident quality of life, health, or safety? a. The nursing assistant praises a resident who is having poststroke speech therapy for attempts to communicate verbally. b. The nursing assistant asks to talk to the LPN/LVN charge nurse about changes the nursing assistant would like to make in a resident's plan of care. c. The nursing assistant uses a sharp tone of voice and body posture, suggesting impatience when feeding a resident. d. The nursing assistant offers to help coworkers after finishing his resident care assignment.

ANS: C This behavior negatively affects the quality of life and safety of a resident. The other options do not negatively affect the resident's quality of life.

When the Nurse Practice Act of the state permits delegation as part of the LPN/LVN charge nurse duties, which task could be delegated to experienced, unlicensed assistive personnel who have been trained to perform the task? a. Calling the physician when a resident's condition deteriorates b. Providing a performance evaluation for another nursing assistant c. Taking the vital signs of a resident whose condition is not critical d. Handling a grievance brought by a nursing assistant

ANS: C This duty is one that can be safely and appropriately delegated. The other options are duties that are reserved for charge nurses or higher level management. Duties that may be delegated to nursing assistants usually involve identified resident goals rather than goals relating to personnel management.

The action the LPN/LVN charge nurse takes independently that would most likely require conflict resolution at the unit level is a. organizing shift activities before morning report. b. making sure the necessary equipment and supplies are available. c. eliminating morning breaks and adding 10 minutes to the lunch hour. d. creating a calm, supportive environment.

ANS: C Unilaterally changing working conditions will create stress and conflict and require conflict resolution. The other options are desirable actions.

Which statement indicates that a nurse is knowledgeable about good résumé preparation? a. "My résumé is comprised of nearly three and a half pages." b. "It was difficult to write a good objective statement, but I finally managed." c. "I used a bulleted style to call attention to my list of job skills." d. "To make sure my résumé catches the eye, I used bright pink paper."

ANS: C Using bullets to draw the eye to job skills and make them easily readable helps the person reading the résumé match skills to the requirements of the job. Ideally a résumé should be one page. Use of objective statements is outdated. Paper color should be conservative.

What advice should an LPN/LVN use to adequately follow up an employment interview? (Select all that apply.) a. Write a letter to the editor of the local newspaper praising the facility. b. Offer a written critique of the interview sent to the interviewer. c. Call the interviewer to inquire how the process is proceeding. d. Write a thank you letter for granting the interview.

ANS: C, D It is appropriate for the interviewee to write a thank you letter following the interview and to call to inquire whether he or she has been hired. The remaining options are inappropriate to the situation

Which of the following trends should guide the LPN/LVN in planning for employment over the next 5 years? (Select all that apply.) a. Little change in numbers needed or in potential work sites is projected. b. The number of LPN/LVN positions available in hospitals will nearly double. c. Employment opportunities for LPN/LVNs will increase in long-term care settings due to the care needs of older adults. d. More LPN/LVNs will be needed to work in community-based settings. e. LPN/LVNs will provide care for larger numbers of terminally ill and acutely ill patients.

ANS: C, D, E Nursing home employment of LPN/LVNs is expected to grow in response to the long-term care needs of the growing number of older adults and disabled individuals. The trend to move health care from inpatient to outpatient suggests that more LPN/LVNs will work in community-based agencies. The RN shortage, if unabated, will likely see more LPN/LVNs caring for acutely ill patients, and the LPN/LVN skill set is well matched with the care needs of many terminally ill patients in hospice care. Numbers are expected to increase about as fast as the average for all occupations, whereas work sites are likely to become increasingly diverse. The number of LPN/LVN positions available in hospitals are expected to nearly double according to employment projections.

Identify information that should be included in a résumé. (Select all that apply.) a. State of health b. Salary requirements c. Education d. Marital status e. Work experience f. Licenses/professional memberships g. Military experience

ANS: C, E, F, G This information will help the employer match the applicant's qualifications and the job requirements. The other options supply nonessential information.

A people-oriented leadership style that focuses on people's feelings but ignores the task at hand and allows people to act without any direction is the a. autocratic style. b. situational style. c. democratic style. d. laissez-faire style.

ANS: D A purely task-centered leadership style (autocratic style) thrives on power. It involves telling someone what to do, with little regard for the employee as a person who may have ideas about how to improve patient care or reach the goals of the employer. Situational leadership involves varying leadership style to meet the demands of the situation in the work environment. Focusing on both the task and the employee is characteristic of the democratic style of leadership. A purely people-oriented style (laissez-faire) focuses on people's feelings but ignores the task at hand. It allows employees to act without any direction.

The fundamental difference between holding licensure as an LPN/LVN and having a temporary permit is that a temporary permit a. is surrendered after 2 years; a license is never surrendered. b. requires close RN supervision; a license gives permission to practice without RN supervision. c. certifies minimal competency in LPN/LVN skills; a license guarantees safe practice. d. provides permission to work as a GP/VN; a license certifies minimal competence in LPN/LVN skills.

ANS: D A temporary permit allows a graduate practical or vocational nurse to work until the results of the NCLEX-PN examination are in. The temporary permit is automatically revoked once these results are available. Passing the NCLEX-PN examination allows employment as a fully licensed practical or vocational nurse (LPN or LVN). If the examination is failed, the temporary permit is surrendered.

The LPN/LVN notices that the nursing assistants are taking longer breaks than agency policy permits and wishes to change this behavior as quickly as possible. The LPN/LVN's initial actions should be to a. verbally confront the employees with their behavior. b. write reprimands to be placed in each employee's file. c. ask for in-service classes on time management. d. determine the reason staff members are taking longer breaks.

ANS: D Before attempting to solve any problem, the LPN/LVN must clearly identify the real problem. In this case, longer breaks may be the staff's reaction to a more fundamental workplace problem. Verbal confrontation should not be the initial action. Written reprimands should not be the initial action. In-service classes on time management would be an inappropriate initial action.

When conducting an employee performance evaluation conference, the LPN/LVN charge nurse should understand that a. giving measurable feedback such as "You're doing fine" promotes personal growth. b. positive feedback should be given at the beginning of the interview to set the tone. c. the employee should develop a plan for improvement without input from the charge nurse. d. the employee should be encouraged to identify strengths and ask questions for clarification.

ANS: D Evaluation should be a joint interactive process rather than a one-way communication. Dialogue can clarify and enhance the process. Evaluation should focus on identification of strengths as well as behaviors to be modified. The statement "You're doing fine" does not exemplify measurable feedback. The tone should be nonthreatening and objective but does not require the evaluation to begin with positive feedback. An employee may develop his or her own plan, but the individual needs to include problem areas identified by the charge nurse as well as the employee's own goals.

Preparation for the NCLEX-PN examination should include a. cramming difficult concepts the night before the examination. b. rereading each textbook used in the program of study. c. going to a party the evening before the test. d. reviewing content summaries and focusing on identified areas of weakness.

ANS: D Identifying areas of weakness and undertaking a systematic study program is a good strategy for preparing for the NCLEX-PN examination. Cramming is rarely effective. Rereading all texts is time-consuming and lacks focus. Relaxing is a good idea, but partying may lead to fatigue and lack of clarity in thinking the next day.

Which would be most valuable to include on a list of references? a. People who have worked in the agency to which one is applying b. Personal friends who can be trusted to provide a positive reference c. Influential people in the community d. Health care workers who have supervised one's work and are willing to provide a reference

ANS: D Individuals who can comment authoritatively and positively on work skills are more valuable as references than individuals who are employed at the agency to which one is applying but who have no frame of reference for commenting on one's work skills or those who know one socially or are influential in the community.

During an employment interview, the interviewee is asked, "What do you believe are your greatest weaknesses?" The best reply would be: a. "I'm not aware of any weaknesses." b. "My instructors told me I was disorganized." c. "My biggest problem is lack of clinical experience." d. "I work hard to do my job and meet expectations for my work."

ANS: D It is preferable not to respond directly to a question requiring negatives for an answer. It is better to refocus the question so that one may sincerely say positive things about oneself without sounding boastful. It is probably not true that an interviewee would be unaware of any weaknesses. A prospective employer wants to hire people who are organized. Replying that the biggest problem is the lack of clinical experience has the wrong focus. Having clinical experience in a nursing program is a positive.

LPN/LVNs functioning in an expanded role are most often employed in a. critical care units. b. pediatric clinics. c. home health care. d. long-term care.

ANS: D Long-term care lends itself to the use of LPN/LVNs functioning in the expanded role. The other practice environments involve patients who are less stable and therefore require greater direct supervision by the RN

The requirement for taking the NCLEX-PN examination that is universal to every U.S. state and territory is a. the ability to pay fees using a major credit card. b. holding a valid temporary work permit. c. a conviction-free legal record. d. completion of a PN/VN program.

ANS: D One cannot apply to any state board of nursing and receive permission to take the NCLEX-PN until program completion has been certified by the school of nursing. Taking the NCLEX-PN examination is not contingent on any of the other options.

Which statement pertains to a temporary work permit? a. It is issued automatically upon completion of the LPN/LVN program. b. It permits one to work as an LPN/LVN. c. It is required to take the NCLEX-PN examination. d. It is revoked once the NCLEX-PN examination result is reported. e. It allows one to assume LPN/LVN charge nurse duties.

ANS: D One must apply for the permit on program completion if wishing to work. One works as a GP/VN, not as a fully licensed LPN/LVN. The temporary work permit and the application to take the examination are not dependent on one another. The temporary permit is revoked once the NCLEX-PN examination is reported. If the examination is passed, the individual works as a fully licensed LPN/LVN. If the examination is failed, the individual must surrender the permit and work as a nursing assistant.

A nursing assistant (NA) did an exceptionally good job by encouraging a resident to leave his room and go to an activity. Select the response by the LPN/LVN charge nurse that would best encourage the employee to continue this effort. a. Write a note for the NA's file explaining that she did not leave the resident in his room. b. Tell the NA she is a great nursing assistant and that the charge nurse wished all assistants were like her. c. Report the NA's good efforts to the nursing home's administrator and board of directors. d. Tell the NA that the charge nurse knows how hard she worked to get the resident out of his room and how pleased the nurse is that the NA is concerned with the resident's need for socialization.

ANS: D Providing positive reinforcement for the specific behaviors used makes it more likely that the NA will use these strategies in the future. The LPN/LVN's communication is straightforward and assertive. Writing a note for the NA's file explaining that she did not leave the resident in his room would not be effective as a motivator. Telling the NA she is a great nursing assistant and the charge nurse wished all assistants were like her is not specific enough. Reporting the NA's good efforts to the nursing home administrator and board of directors is not necessary at this point

The LPN/LVN charge nurse has assigned tasks to the nursing assistant staff and the LPN/LVN orienting to the unit. On which statement about responsibility for outcomes should the LPN/LVN charge nurse base her or his actions? a. The LPN/LVN charge nurse has no further responsibility, because the staff members have accepted the assignments and are responsible for completing all tasks. b. The LPN/LVN charge nurse is responsible for checking the outcomes of care of the LPN/LVN orientee only because he is not an official member of the staff. c. The LPN/LVN charge nurse is responsible for checking the outcomes of care of the nursing assistants only, because the nursing assistants are unlicensed, whereas the LPN/LVN orientee is a licensed employee. d. The LPN/LVN charge nurse is legally responsible for checking the outcomes of all assignments made.

ANS: D The LPN/LVN charge nurse is responsible for ensuring that all assigned tasks and delegated duties have been performed and for noting the outcomes.

The 3 to 11 shift LPN/LVN charge nurse on a 20-bed nursing home unit is asked by the only other staff member on duty, a nursing assistant, "Will it be all right if I go home tonight while you are giving report to the night shift? My husband needs the car so he can go to work." The best response by the charge nurse is: a. "It's all right tonight, but don't make a habit of it." b. "Sure, our residents will be sound asleep by 11 PM." c. "Have you lost your mind? What would happen if the owner dropped in for a surprise visit?" d. "That won't be possible. You must be here to answer lights while I give report to the night staff."

ANS: D The LPN/LVN is not responsible for the problems the nursing assistant (NA) has at home and must uphold institutional policies. This response sets limits and explains the reason the NA is needed on the unit. Responding not to make a habit of it and stating that it is permissible because the residents will be sound asleep by 11 PM create an unsafe environment for residents. The remaining option does not explain the major reason the NA is needed on the unit.

An LPN/LVN applicant wishes to use knowledge of interpersonal styles to his benefit during a job interview. He assesses the interviewer to be a "results-focused" person. Which behavior should he adopt? a. Answer the interviewer's questions in detail. b. Try to interject information about himself as a person (e.g., his hobbies). c. Look for ways to interject humor into the interview. d. Keep answers to the point and relatively brief.

ANS: D The LPN/LVN will supply answers without belaboring the point. Moving things along appeals to results-oriented people. Answering the interviewer's questions in detail and trying to interject personal information are not the best ideas. Results-oriented people like shorter, well-organized answers that do not deviate from the topic. Results-oriented people may have a sense of humor, but it's better not to risk being seen as not serious.

The National League for Nursing (NLN) membership a. is open only to registered nurses. b. is open only to licensed practical nurses. c. is open only to advanced practice nurses. d. is open to anyone interested in nursing issues.

ANS: D The NLN membership is open to all levels of nurses and anyone interested in nursing. issues.

What LPN/LVN charge nurse behavior will best accomplish the goal of promoting team building? a. Using "I" statements exclusively when talking about the unit's mission and goals b. Never using rewards to change nursing assistant behaviors because this strategy is manipulative c. Assuming each nursing assistant is fully informed about the unit's mission and goals d. Encouraging politeness, cooperation, respect, and trust

ANS: D The charge nurse is a role model for the attitude and behavior expected of nursing assistants. Team building requires an environment in which employees feel valued. Politeness, cooperation, respect, and trust provide the foundation on which further team building proceeds

Which understanding about leadership would help the LPN/LVN become a more skillful leader? a. Leaders in nursing are appointed by management to accomplish organizational goals. b. Leaders rarely take risks and virtually never make mistakes. c. Leaders have little confidence in themselves until they develop a power base. d. Leaders see change as challenging and providing opportunities for improving quality of care.

ANS: D The only accurate statement is that leaders see change as challenging and providing opportunities for improving quality of care.

The SP/VN reviewing for the NCLEX-PN examination should study based on an understanding that the category of patient need that is most heavily tested is a. the clinical problem-solving process. b. safe, effective care environment. c. health promotion and maintenance. d. physiologic integrity.

ANS: D The physiological integrity category of patient needs includes basic care and comfort, pharmacological therapies, reduction of risk potential, and physiological adaptation. It comprises 35% to 59% of the questions. Questions from the other three categories make up the remainder of the test. The clinical problem-solving process is not a category of patient needs.

The LPN/LVN charge nurse notices that a new nursing assistant has offensive body odor. The LPN/LVN charge nurse should a. report this finding to the RN supervisor. b. send the person to the locker room to shower and put on clean clothes. c. terminate the nursing assistant. d. meet with the person to inform her of the problem and reinforce agency expectations.

ANS: D This action encourages the nursing assistant to take personal responsibility for her hygiene and appearance. The other actions do not permit the nursing assistant the opportunity to take personal responsibility.

The LPN/LVN charge nurse at the long-term care facility has assigned a newly licensed LPN/LVN to care for a resident needing a colostomy irrigation. The new LPN/LVN voices concern, because he has never performed a colostomy irrigation. What would be the best course of action for the LPN/LVN charge nurse? a. State, "A colostomy irrigation is just like giving an enema. You'll be fine." b. Tell the new LPN/LVN, "I'll do the irrigation while you care for your other assigned residents." c. Delegate the procedure to a willing nursing assistant. d. Arrange to supervise the new LPN/LVN as he performs the irrigation.

ANS: D This action provides the supervision the new employee needs, and the new LPN/LVN probably will be capable of performing the task independently in the future. Stating, "A colostomy irrigation is just like giving an enema. You'll be fine" does not recognize the need for supervision. Telling the new employee that the charge nurse will do the irrigation while the LPN/LVN cares for other assigned residents increases the workload of the charge nurse with no change in the employee's capabilities. Delegating the procedure to a willing nursing assistant would be inappropriate. The delegate should be competent, and the delegation should be acceptable according to state and agency policy.

A resident has not voided in 6 hours. Which instruction to a nursing assistant would likely ensure getting the information needed by the LPN/LVN charge nurse? a. "Watch the resident's output closely today." b. "I need to know if the resident is voiding sufficiently." c. "The resident should void at least twice during the shift in quantities of 200 mL or more." d. "Report to me immediately if the resident voids between now and 10 AM, and tell me the amount he voids. If he has not voided by 10 AM, please report this to me."

ANS: D This is an example of specific, complete communication. It should be followed by giving the nursing assistant an opportunity to repeat what is expected. The other instructions are vague and could leave the nursing assistant wondering what to do.