Leadership Exam 3

A 72 year old man who had a stroke is being transferred from a medical unit to a rehabilitation center. The nurse case manager is assisting in the process. The nurse knows that the goals of case management include which of the following. Select all that apply. A) Improving the coordination of care. B) Increasing referrals to local organizations. C) Reducing the fragmentation of care. D) Discharging clients quickly.

A & C

Quality Improvement (QI)

A management philosophy to improve the organizational structure and the level of performance of key processes in the organization to achieve high-quality outcomes.

The physician orders an MRI of the brain for an adult male client. Which of the following findings in the client's history should the nurse report to the physician? A) Allergy to contrast dye. B) Implanted cardiac pacemaker. C) Chronic obstructive pulmonary disease (COPD) D) Hernia repair

B

State Board of Nursing

Enforces Nurse Practice Act

Mission Statement

Formal expression of the purpose or reason for the existence of the organization

Vision Statement

Identifies how the people of the organization plan to actualize the mission

Good Samaritan Laws

Laws that have been enacted to protect the health care professional from legal liability

Joint Commission

Major accreditation organization that accredits hospitals and health care agencies to ensure that they meet specific standards (last 3 years).

Shared Governance

Organizational framework grounded in philosophy of decentralized leadership that fosters autonomous decision making and professional nursing practice

Doing Phase

Phase of PDSA Cycle that involves collecting data

Acting Phase

Phase of PDSA Cycle that involves implemented changes

Studying Phase

Phase of PDSA Cycle that involves reviewing data

Planning Phase

Phase of PDSA Cycle that uses improvement questions to help identify what needs to be improved

What does PDSA stand for?

Plan Do Study Act

What is the difference between QI and QA?

QI tries to prevent errors while QA looks back at past errors (not proactive).

Flowchart

diagram that represents a process using arrows to show direction of flow

Autonomy

respect for a person's right to self-determination

A 58 year old man with head and neck cancer is admitted to the hospital and tells the nurse he does not want parenteral nutritional therapy as his cancer progresses. The nurse explains he can specify his wishes by creating an advance directive. The nurse knows that the requirement to provide clients with this type of information can be found in which of the following? A) The Patient Self-Determination Act B) Nursing Scope and Standards of Practice C) The Patient Protection and Affordable Care Act D) The Patient's Bill of Rights

A

A client with acne has been using isotretinoin(Accutane). She tells the nurse that she recently learned she is pregnant. She asks "Will my pregnancy interfere with the medication's effectiveness?" Which of the following is the appropriate response by the nurse? A) "The medication is contraindicated for pregnant women." B) "You will have to change the route of administration, because your are pregnant." C) "There is no reason you can't continue taking it." D) "If the medication helps you look better, that will help you feel better about yourself.

A

The nurse is reviewing the chart of an older adult male client after surgery for removal of the parathyroid glands. The client complains of difficulty swallowing and a feeling of "pins and needles." The nurse expects which of the following laboratory values to be abnormal. A) Calcium. B) Lipase. C) Potassium. D) Sodium

A

The nurse is taking care of an adult male with bilateral leg fractures. He has a long leg cast on his right leg as well as traction applied to the left femur. Which of the following is the MAIN purpose served by the cast for this client? A) Immobilizes the tibia and fibula and corrects deformities. B) Keeps the client, who is in traction, more comfortable. C) Immobilizes the pelvic bones for better healing D) Encircles the trunk and stabilizes the spine

A

The pediatric nurse is providing discharge instructions to the parents of a newborn. In which of the following situations would the nurse advise the parents to call a physician? Select all that apply. A) The infant has a temperature higher than 100.4°F. B) The infant vomits more than once in 24 hours. C) The infant's respirations are even and unlabored. D) The infant is unable to deep down food or water. E) The infant has sunken or swollen soft spots on the head.

A, B, D, & E

What does ARKO mean?

A: Take action or no action? R: Reword the question. K: Identify key words in the question stem. O: Review and eliminate options.

NCLEX

Administered by National Council of State Boards of Nursing (NCSBN) to determine if you are safe to practice

The nurse is caring for a child burned over 20% of her body assists the physician in performing dressing changes on day 5 after the initial injury. The child appears disoriented, has a fever of 101°F, and is crying in pain. Which of the following nursing interventions would be MOST appropriate in caring for this client? A) Gather equipment for the dressing change and explain the procedure to the child. B) Do a complete physical assessment and notify the physician of the findings. C) Administer appropriate analgesics and gather equipment for the dressing change. D) Offer the child an enticing distraction from pain, such as a video, music, or toy

B

The nurse is working on a busy locked psychiatric unit. The alarm gets tripped when somebody tries to go through the locked doors without permission from the front desk. Which of the following actions should the nurse take after the alarm is tripped? A) Reset the alarm from the front desk after verifying that everybody is safe and nobody has escaped from the unit. B) Reset the alarm from the location where the alarm was tripped after verifying that everybody is safe and nobody has escaped from the unit. C) Reset the alarm from a client's room after doing a quick scan of the hallway. D) Reset the alarm from the front desk once the receptionist says everybody is accounted for.

B

The nurse is conducting a home visit with a client who has a history of angina. Which of the following BEST demonstrates that further teaching about nitroglycerin therapy is required? A) "I take a tablet about 10 minutes before I walk up the stairs." B) "I take no more than 3 doses in a 15 minute period of time." C) "I keep the tablets in a glass dish on the windowsill so they are readily available." D) "I will call my doctor immediately if I experience blurred vision."

C

The nurse is developing a care plan for a client with hepatitis C. The nurse knows that the primary route of transmission of this hepatitis virus is which of the following? A) Contaminated food. B) Feces. C) Blood. D) Sputum.

C

The nurse is preparing to discharge a 72 year old man on warfarin (Coumadin) therapy for a pulmonary embolism. The nurse's discharge teaching should include which of the following instructions? A) Follow a healthy diet by increasing ingestion of green, leafy vegetables. B) Take herbal remedies to manage cold symptoms. C) Avoid alcohol due to enhanced anticoagulant effect. D) Take Coumadin only on an empty stomach

C

The nurse cares for an elderly client who appears fully alert and oriented. As it gets later in the day, the nurse notices the client becoming increasingly confused and agitated. It would be MOST appropriate for the nurse to take which of the following actions? A) Reorient the client, and then turn on the lights and television to distract the client from his confusion. B) Encourage the client's alert roommate to talk with the client. C) Tell the client he is at home in his own bed to get him to settle down and go to sleep. D) Reorient the client, pull the shades down, shut the lights and television off, and promote a quiet environment.

D

The nurse is assessing a young adult pregnant client with no allergies who as tested postive for gonorrhea. Which of the following medication should the nurse expect to be part of the treatment plan? A) Tetracycline (Declomycin) B) Ciproflozacin(Cipro) C) Azithromycin(Zithromax) D) Cefriaxone(Rocephin)

D

The nurse is cleansing a simple surgical wound. The client is two days postoperative, and the incision has well-approximated edges with no sign of infection. A Jackson-Pratt drain is adjacent to the incision site. Which of the following should the nurse do? A) Cleanse the incision and drain sites while wearing standard clean gloves. B) Cleanse in a back and forth motion across the incision line and in a circular motion around the drain site. C) Cleanse the incision site and drain site together. D) Cleanse the incision and drain sties using a sterile saline solution and sterile gloves

D

The nurse is preparing to discharge a client with rheumatic heart disease who is recovering from endocarditis. Which of the following statements from the client indicates that the client understands the teaching? A) "I'm so glad I don't need any more antibiotics now that I'm feeling better." B) "I can restart my exercise program in a day or two." C) "I will watch for signs of relapse the first few days after discharge." D) "I will inform my dentist should I ever need any dental work."

D

Responsible Person Standard

Doing what a responsible person would do in the same situation; what an expert nurse would do

What are the two ways to improve quality?

Eliminate defects in process OR Increase or meet the needs of the customer

Quality Assurance (QA)

Inspection approach to quality used to ensure that health care institutions maintained minimum standards of care

Nurse Practice Act

Single most important legislation for nursing

Histogram

a graphical representation of the distribution of numerical data

Tort

a negligent or intentional civil wrong not arising out of a contract or statute that injures someone in some way, and in which the injured person may sue the wrongdoer for damages

Assault

a threat to touch another person in an offensive manner w/o that person's permission

Pie Chart

a type of graph in which a circle is divided into sectors that each represent a proportion of the whole

What does the C in FOCUS stand for?

clarify what is happening

Pareto Chart

contains both bars and a line graph where individual values are represented in descending order by bars, and the cumulative total is represented by the line

Negligence

failure to provide the care a reasonable person would ordinarily provide in a similar situation

What does the F in FOCUS stand for?

focus on improvement idea

Time Series Chart

illustration of data points at successive time intervals

Misdemeanor

lesser crime punishable by fine and/or time in county jail

Felony

most serious class of crimes being either violent or nonviolent that can be punished by state prison time

What does the O in FOCUS stand for?

organize team

What does the S in FOCUS stand for?

select solution for improvement

Ishikawa Fish-bone Diagram

shows causes of a specific event grouped into different categories

Benchmarking

the continuous process of measuring products, service, and practices against the toughest competitors or those customers recognized as industry leaders

Beneficence

the duty to go good and to maintain a balance between benefits and harms

Veracity

the obligation to tell the truth

Justice

the principle of fairness

Fidelity

the principle of promise keeping

Nonmaleficence

the principles of doing no harm

Respect for Others

the right of people to make their own decisions

Battery

touching another person without that person's consent

What does the U in FOCUS stand for?

understand degree of change needed

Sentinel Event

unexpected occurrence involving a death or serious physical or psychological injury to a pt

Check Sheet

uses tallies in different sections to record data

Statutory Law

written law usually enacted by a legislative body