Leadership Exam #2

What is brainwriting? A. A strategy to encourage free flow of ideas B. A mutually beneficial negotiation result C. A winning approach to formal negotiation D. A devaluation reaction to negotiation

A. A strategy to encourage free flow of ideas

There are numerous sources of power in an organization. Several are available to nurses. Which one is not? A. Authority B. Reward C. Control of information D. Coercion

A. Authority

A nurse on a telemetry unit is caring for a client who was admitted 2 hr ago and has chest pain. The client becomes angry and tells the nurse that there is nothing wrong with him and that he is going home immediately. Which of the following actions should the nurse take? SATA A. Notify the client's family of his intent to leave the facility B. Document that the client left the facility AMA C. Explain to the client the risks involved if he chooses to leave D. Ask the client to sign a form relinquishing responsibility of the facility E. Prevent the client from leaving the facility until the provider arrives

B. Document that the client left the facility AMA C. Explain to the client the risks involved if he chooses to leave D. Ask the client to sign a form relinquishing responsibility of the facility

Florence has two team members who continually criticize each other despite being told to stop. Which approach is the most appropriate for this situation? A. Refer each of them for employee counseling B. Engage in problem resolution C. Bring in a union representative D. Engage in a formal negotiation process

B. Engage in problem resolution

If you are employed at a hospital owned by a corporation listed on the stock market, in which category does your facility belong? A. Publicly supported B. Voluntary, not-for-profit C. For-profit D. All of the above

C. For-profit

A nurse manager is working with a committee of nurses to update policies for new employee orientation. The nurse manager directs the team to collect as much data as possible and recommend several options. Which of the following decision-making styles is the nurse manager demonstrating? A. Decisive B. Flexible C. Hierarchal D. Integrative

D integrative

A nurse is assigned to care for the following patients. Which patient should the nurse assess first? A. A 60 year old patient on a ventilator for whom a sterile sputum specimen must be sent to the lab B. A 55 year old with COPD and a pulse ox reading from the previous shift of 90% saturation C. A 70 year old with pneumonia who needs to be started on IV antibiotics D. A 50 year old with asthma who complains of shortness of breath after using a bronchodilator

D. A 50 year old with asthma who complains of shortness of breath after using a bronchodilator

An assistant nurse manager is making assignments for the next shift. Which patient should the assistant nurse manager assign to a nurse with 6 months of experience and who has been floated from the surgical unit to the medical unit? A. A 58 year old on airborne precautions for TB B. A 68 year old who just returned form bronchoscopy and biopsy C. A 69 year old with COPD who is ventilator dependent D. A 72 year old who needs teaching about the use of incentive spirometry

D. A 72 year old who needs teaching about the use of incentive spirometry

Which of the following issues may be addressed in a collective bargaining agreement? A. Shift differentials B. Safe working environment C. Grievance procedures D. All of the above

D. All of the above

ISBARR provides a framework for communicating critical patient information. It stands for:

Introduce, situation, background, assess, recommend, readback

A PN ending her shift reports to the RN that a newly hired AP has not calculated the intake and output for several clients. Which of the following actions should the RN take? a. complete an incident report b. delegate this task to the PN c. ask the AP if she needs assistance d. notify the nurse manager

c. ask the AP if she needs assistance

A nurse is helping an NAP provide a bed bath to a comatose patient who is incontinent. Which of the following actions requires the nurse to intervene? A. The nursing assistant answers the phone while wearing gloves B. The nursing assistant log-rolls the client to provide back care C. The nursing assistant places an incontinence diaper under the client D. The nursing assistant positions the client on the left side, head elevated

A. The nursing assistant answers the phone while wearing gloves

Differences in status and authority within the health-care team can generate conflict. What is the most common cause of conflict? A. Disrespect and incivility B. Inappropriate language and sarcasm C. Blaming and finger pointing D. Physical violence

A. Disrespect and incivility

The purpose of learning how to negotiate conflict is to: A. Eliminate conflict entirely B. Resolve conflicts more effectively C. Win D. Reduce stress

B. Resolve conflicts more effectively

What is the most desirable result of a problem-resolution A. Win-lose B. Lose-lose C. Win-win D. none of the above

C. win-win

The hospital has recently reorganized; therefore, several departments were closed. The patient census on the unit has increased. The staff have always had a strong team spirit, but the nurse manager knows that workflow changes can cause conflict. What can the nurse manager do to reduce the possibility of conflict among her team? A. Monitor the quality of patient care B. Ensure that supplies and equipment are readily available C. Assess the equity of nursing assignments D. All of the above

D. All of the above

Organizational culture is best defined as A. The stated vision and mission of an organization B. Policies and procedures C. The type of decor that was chosen for the facility D. An enduring set of shared values and beliefs

D. An enduring set of shared values and beliefs

A respiratory therapist performs suctioning on a patient with a closed head injury who has a tracheostomy. Afterward, the NAP obtains vital signs. The nurse should communicate that the NAP needs to report which VS value or values immediately? SATA A. HR = 96 B. RR= 24 C. O2 of 95% D. Temp of 101.4

D. Temp of 101.4

A nurse manager is providing information about the audit process to members of the nursing team. Which of the following information should the nurse manager Include? SATA A. A structure audit evaluates the setting and resources available to provide care B. An outcome audit evaluates the results of the nursing care provided C. A root cause analysis is indicated when a sentinel event occurs D. Retrospective audits are conducted while the client is receiving care E. After data collection is completed, it is compared to a benchmark

A. A structure audit evaluates the setting and resources available to provide care B. An outcome audit evaluates the results of the nursing care provided C. A root cause analysis is indicated when a sentinel event occurs

A nurse is participating in an inter-professional conference for a client who has a recent C6 spinal cord injury. The client worked as a construction worker prior to his injury. Which of the following members of the inter-professional team should participate in planning care for the client? SATA A. PT B. speech therapist C. OT D. psychologist E. Vocational counselor

A. PT C. OT D. psychologist E. Vocational counselor

Bedside shift report is one of the things that Jane reviews at the staff meeting. She stresses the way she would prefer the report to start. Which of these would be the least important to share with the oncoming nurse? A. Telling the oncoming nurse what happened on the unit during the shift B. Introducing the client and his or her diagnosis C. Sharing the nurse's personal opinion of the client D. Reviewing new medication orders and the MAR

B. Introducing the client and his or her diagnosis

Nurses who feel empowered can make significant contributions to a health-care organization. Feeling empowered includes feelings as if you make a difference, that colleagues value your opinion, and that your voice is important. What is essential to nurse empowerment? A. Belonging to a professional organization B. Participating in a unit practice council C. Reasonable work assignments D. A rewards and recognition program

B. Participating in a unit practice council

TJC attributes 80% of all medical errors to A. Poor hygiene and hand washing B. Poor hand-off communication C. Poor work environment D. Lack of care

B. Poor hand-off communication

Creating a culture of safety requires organizational commitment to preventing harm. Which of the following is not a key feature of a culture of safety? A. Provision of adequate resources to provide care and service B. Use of interprofessional collaboration to solve problems and assess risk C. Adherence to staffing ratios D. Encourages the reporting of errors and near misses

C. Adherence to staffing ratios

If an informal negotiation session becomes too highly emotional, what should the nurse manager do? A. Let the feelings flow B. Cancel the negotiation C. Deal with the feelings first D. Tell them to ignore the feelings and deal with the issues

C. Deal with the feelings first

Communities and regulatory agencies continually challenge hospitals, skills nursing facilities, and home health companies to enhance, improve, or change care delivery and the care environment to ensure safe, high-quality care. Which factors are important in improving a hospital's care environment? A. Adequate staffing B. Collegial relationships among staff C. Emphasis on staff development D. All of the above

D. All of the above

Implicit bias affects our understanding in an unconscious manner. A person's ability to recognize these biases can improve communication with patients and colleagues alike. Which of the following statement is true about implicit bias? A. Forms during a lifetime B. Can influence clinical decision making and treatment C. Contributes to an individual's social behavior D. All of the above

D. All of the above

Nursing management and the nursing union are having differences on several issues. There may be a need for negotiation. Which of the following is a serious disadvantage to using collective bargaining to resolve this conflict? A. Protecting the right to fair treatment B. Creating an adversarial relationship between staff and management C. Lacking professionalism on the part of the collective bargaining unit members D. Failing to uphold important standards of care

B. Creating an adversarial relationship between staff and management

A nurse enters the room of a client who is on contact precautions and finds the client lying on the floor. Which of the following actions should the nurse take first? A. Call the provider B. Ask a staff member for assistance getting the client back in bed C. inspect the client for injuries D. Instruct the client to ask for help if he needs to get out of bed

C. inspect the client for injuries

As jane speaks with the team, she learned why the staff members have had difficulty following policies. Which of these would be considered barriers to effective communication> A. The charge nurse is unavailable to help the nurses when they have questions about policies B. Some staff are afraid to ask particular charge nurses for help for fear of retribution. C. The use of acronyms is confusing to staff members who are new to the unit D. All of the above

D. All of the above

You are working on the trauma unit today, and your new patient with a femur fracture complains of leg pain and seems a little diaphoretic and SOB. You assess the patient and prepare to contact the surgeon. In preparation for contacting the physician, you: A. Immediately page the MD; it could be a PE and time is of the essence. You will give particulars when he arrives B. Wait for the MD to round on his patient because it should be within the next hour C. Medicate the patient for patient and plan to contact the MD when he rounds D. Jot down notes about the situation as it is presented to you, review the patient's history, focus your assessment, and determine what you need for the patient

D. Jot down notes about the situation as it is presented to you, review the patient's history, focus your assessment, and determine what you need for the patient

Jane is a new nurse manager who will be holding her first staff meeting tomorrow. she has learned that the staff members have not been following important patient care policies. What is the most important communication skill that she should use at the meeting? A. Talking to the staff B. Laughing with them C. Listening D. Crying

C Listening

A nurse is participating in a quality improvement study of a procedure frequently performed on the unit. Which of the following information will provide data regarding the efficacy of the procedure? A. Frequency with which procedure is performed B. Client satisfaction with performance of procedure C. Incidence of complications related to procedure D. Accurate documentation of how procedure was performed

C. Incidence of complications related to procedure

Which of the following is a characteristic of a bureaucratic organization? A. Organic structure B. Flexible teams C. Rigid unit structures D. Self-correction and self-control

C. Rigid unit structures

An experienced LPN is working under the supervision of the RN> The LPN is providing nursing care for a patient who has a respiratory problem. Which activities should the RN delegate to the experienced LPN? SATA A. Auscultate breath sounds B. Administer medications via metered-dose inhaler C. Complete in-depth admission assessment D. Initiate the nursing care plan E. Evaluate the patient's technique for using MDIs

A. Auscultate breath sounds B. Administer medications via metered-dose inhaler

A nurse is hired to replace a staff member who has resigned. After working on the unit for several weeks, the nurse notices that the unit manager does not intervene when there is conflict between team members, even when it escalates. Which of the following conflict resolution strategies is the unit manager demonstrating? A. Avoidance B. Smoothing C. Cooperating D. Negotiating

A. Avoidance

What is the best explanation of authority? A. It is position dependent B. It is based upon the ability to lead others C. It is expertise-driven D. It resides primarily in the clients served

A. It is position dependent

Social media is commonly used to update friends and groups on things we have going on in our lives. Health-care organizations routinely use social media to promote medical facts, services, and recognitions. What is important for nurses to remember when deciding to post something work related on a social media site? A. Nurses should never post protected health info B. Stories with good outcomes can be posted to your media page C. Stories and photos can always be shared if the patient's name or face is not visible D. Posting stories on personal time is OK because the nurse is not working

A. Nurses should never post protected health info

The patient with COPD has a nursing diagnosis of Ineffective Breathing Pattern. Which is an appropriate action to delegate to the experienced LPN under your supervision? A. Observe how well the patient performs pursed-lip breathing B. Plan a nursing care regimen that gradually increases activity intolerance C. Assist the patient with basic activities of daily living D. Consult with the physical therapy department about reconditioning exercises.

A. Observe how well the patient performs pursed-lip breathing

An RN on a medical surgical unit is making assignments at the beginning of the shift. Which of the following tasks should the nurse delegate to the PN? A. Obtain vital signs for a client who is 2 hr postprocedure following a cardiac catheterization B. Administer a unit of packed RBCs to a client who has cancer C. Instruct a client who is scheduled for discharge in the performance of wound care D. Develop a plan of care for a newly admitted client who has pneumonia

A. Obtain vital signs for a client who is 2 hr postprocedure following a cardiac catheterization

A nurse manager is developing an orientation plan for newly licensed nurses. Which of the following information should the manager include in the plan? SATA A. Skill proficiency B. Assignment to a preceptor C. Budgetary principles D. Computerized charting E. Socialization into unit culture F. Facility policies and procedures

A. Skill proficiency B. Assignment to a preceptor D. Computerized charting E. Socialization into unit culture F. Facility policies and procedures

The nursing assistant tells a nurse that patient who is receiving oxygen at a flow rate of 6L by NC is complaining of nasal passage discomfort. What intervention should the nurse suggest to improve the patient's comfort for this problem? A. Suggest that the patient's oxygen be humidified B. Suggest that a simple face mask be used instead of a nasal cannula C. Suggest tat the patient be provided with an extra pillow D. Suggest that the patient sit up in a chair at the bedside

A. Suggest that the patient's oxygen be humidified

Several of your colleagues are going to join the American Nurses Association. You know the annual dues are a little more than you can afford right now, but you want to learn more. Your friends think that joining will help empower them. How do professional organizations empower nurses? A. They represent nurses in the political arena B. They equalize power between employees and staff C. They provide opportunities for promotion D. They provide health insurance

A. They represent nurses in the political arena

A nurse is caring for a patient who has a pulmonary embolus. The patient is receiving anticoagulation with IV heparin. What instructions should the nurse give the NAP who will help the client with ADLs? SATA A. Use a lift sheet when moving and positioning the client in bed B. Use an electric razor when shaving the patient each day C. Use a soft bristled toothbrush or tooth sponge for oral care D. Use a rectal thermometer to obtain a more accurate body temperature E. Be sure the patient's footwear has a non-slip sole when the patient ambulates

A. Use a lift sheet when moving and positioning the client in bed B. Use an electric razor when shaving the patient each day C. Use a soft bristled toothbrush or tooth sponge for oral care E. Be sure the patient's footwear has a non-slip sole when the patient ambulates

A nurse is caring for a patient who has COPD and is 2 days postoperative after a laparoscopic cholecystectomy. Which intervention for airway management should the nurse delegate to the NAP? A. assisting the patient to sit up on the side of the bed B. Instructing the patient to cough effectively C. Teaching the patient to use incentive spirometry D. Auscultating breath sounds every 4 hours

A. assisting the patient to sit up on the side of the bed

A nurse is preparing to transfer an older adult client who is 72 hr postoperative to a long-term care facility. Which of the following information should the nurse include in transfer report? SATA A. Type of anesthesia used B. Advance directive status C. Vital signs on day of admission D. Medical diagnosis E. Need for specific equipment

B. Advance directive status D. Medical diagnosis E. Need for specific equipment

The EMR has many advantages compared with paper charting. It helps track data through time and can help monitor tings such as preventative care in primary care practices. Jane is the office nurse in a local practice. She is meeting a new patient for the first time who informs her that she was recently hospitalized. Jane pulls up the EMR and sees no information regarding his recent hospital stay. How could this have happened? A. The patient's discharge was so recent that it is not available yet B. EMRs are usually practice or hospital specific, so the patient's information would not be accessible to Jane C. The patient was hospitalized out of state D. The patient has not signed the necessary consents to give Jane access

B. EMRs are usually practice or hospital specific, so the patient's information would not be accessible to Jane

A nurse who has just assumed the role of unit manager is examining her skills in inter-professional collaboration. Which of the following actions support the nurse's inter-professional collaboration? SATA A. Use aggressive communication when addressing the team B. Recognize the knowledge and skills of each member of the team C. Ensure that a nurse is assigned to serve as the group facilitator for all interprofessional meetings D. Encourage the client and family to participate in the team meeting E. Support team member requests for referral

B. Recognize the knowledge and skills of each member of the team D. Encourage the client and family to participate in the team meeting E. Support team member requests for referral

You have been asked to serve on your unit practice council. This is an important role and one that you are excited to perform. What should you know about professional governance so that you are prepared for this work. Professional governance in nursing involves: A. Working longer hours B. Attending a lot of meetings C. Nurses setting nursing standards for daily practice D. Changing the organization's culture

C. Nurses setting nursing standards for daily practice

Who is responsible for accepting, transcribing, and implementing physician orders? A. unit clerk 2. Medical intern or resident C. Professional nurse D. Medical assistant

C. Professional nurse

A nurse is caring for a patient who is diagnosed with CAD and sleep apnea. Which action should the nurse delegate to the NAP? A. Discuss weight-loss strategies such as diet and exercise with the patient B. Teach the patient how to set up the CPAP machine before sleeping C. Remind the patient to sleep on his side instead of his back D. administer Provigil to promote daytime wakefulness

C. Remind the patient to sleep on his side instead of his back

Nursing and respiratory departments both experienced job cuts. The nurse manager notices that members of his staff are having more trouble getting a fast response from a respiratory therapist. What source of conflict is probably operating here? A. Union-management conflict B. Interpersonal problem C. Cultural differences D. Work intensification

D. Work intensification