Leadership Exam !
The nurse came across a theory which states that the leadership style is effective dependent on the situation. Which of the following styles best fits a situation when the followers are self-directed, experts and are matured individuals? The leader can take a permissive attitude. A. Democratic B. Authoritarian C. Laissez faire D. Bureaucratic
C Laissez faire leadership is preferred when the followers know what to do and are experts in the field. This leadership style is permissive.
A client recently admitted for abdominal pain states pain is an 10/10. The nurse believes the client is displaying drug seeking behavior. She withholds ordered pain medication, causing the patient to remain in pain. This is an example of: A. Tort B. Negligence C. Malpractice D. Liability
C. Malpractice is defined as the failure of a professional to act in a reasonable manner causing harm to the patient. Malpractice is correct because the nurse intentionally withheld ordered pain medication resulting in harm to the client. The other choices are incorrect because negligence is defined as omission of a reasonable act that is unintentional, a tort is a general civil wrong, and liability is the person responsible.
A family wants to perform CPR on their mother who has a DNR and has just coded. They are begging to override the DNR and begin CPR. Which ethical principle would the nurse be adhering to by not performing CPR? A. Autonomy This answer is correct because the nurse is supporting the patient's wishes as a DNR code. B. Utility This answer is incorrect because utility means good for the many people. C. Confidentiality Confidentiality is related to respecting privileged information and doesn't pertain to this question. D. Veracity Veracity is truth telling and nobody lied in this scenario.
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Nurse Sarah's patient is Spanish speaking and having surgery in the morning. The patient is about to sign the informed consent, what is Sarah's role as a nurse? A. Educate the patient about the procedure they are having and ask if they have any further questions before signing. Nurses are not responsible for educating the patient about the procedure, only witnessing the signature. B. Have a family member translate the form and witness the signature of the patient. Family members are not allowed to translate for the patient. C. Explain the procedure to the patient in English and have a translator repeat. Nurses are not responsible for explaining the procedure, the surgeon or physician is responsible. D. Call the surgeon and a translator to explain the procedure to the patient and witness the signature of the informed consent. This is the correct answer because the surgeon and translator are appropriately educating and the nurse is witnessing the signature.
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Which is not true about being a good nurse leader... A. A leader uses interpersonal skills to influence others to accomplish a goal This is what a good leader is responsible for B. Someone who has control over everyone in the unit A good leader does not take control over other people in the unit. C. Leaders can be informal as well as formal This is true about leaders, they do not have to have a specified management title to lead. D. They achieve consensus within a group about its goals, and facilitate accomplishment of goals Leaders often help accomplish goals by achieving a consensus within a group.
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1. A nurse is caring for a diabetic patient with ARDS. Which action related to the patient's care can the nurse delegate to unlicensed assistive personnel? a. Check capillary blood glucose b. Evaluate response to medication therapy c. Teach the patient about the importance of smoking cessation and diet modification d. Assess the patient's skin integrity on the feet and sacrum
A
1. A nursing student is shadowing a unit manager for the first time and recognizes that they rely heavily on their unit based council when making important decisions about the unit. Which of the following leadership styles does this action most adhere to? a. Democratic b. Authoritarian c. Laissez faire d. Bureaucratic
A
2. A nurse ignores a client's right to refuse a procedure and continues to hold down a patient to insert a catheter. The client decides to file a lawsuit because the nurse is likely to be found guilty of: a. Battery b. Assault c. Unintentional tort d. Violation of privacy
A
2. Many of the staff have expressed concerns that the Unit manager makes all the decisions and doesn't give anyone else the chance to voice their opinions. After bringing it up with more staff on the unit they concur that they don't feel comfortable sharing ideas. What type of leadership is the unit manager implementing? A. Autocratic. B. Bureaucratic. C. Laissez-faire. D. Democratic
A
3. A nurse manager is explaining the hospital's organizational structure to a newly licensed nurse and states, "The structure is low in complexity. It allows the staff nurses to have a lot of power because they have a direct line to their managers who have a direct line to the vice nursing president." The newly licensed nurse correctly identifies this type of organizational structure as: a. Flat b. Matrix c. Bureaucratic d. Centralized
A
3. A nurse respects their patient's wishes to end chemotherapy treatment. This nurse demonstrates proficiency in which of the following ethical principles? a. Respecting the patient's autonomy b. Demonstrating beneficence c. Adhering to the principle of justice d. Exemplifying fidelity to the patient
A
A nurse on a telemetry unit is caring for 4 patients who all are asking for assistance by the nurse. One is complaining of chest pain, one needs to use the restroom, one needs help getting into the chair, and one is confused on how to use the Incentive Spirometer after initial education. Which patient can the nurse NOT delegate to a PCT. a. The patient with chest pain b. The patient needing to use the restroom c. The patient needing help getting to the chair d. The patient needing help regarding the incentive spirometer
A
The Nurse Manager on the Trauma ICU is reviewing the unit-based budget. The Nurse Manager knows that all of the following are examples of direct costs except: a. The cable bill for TVs in each patient room. b. The salaries and wages of the RN's on the unit. c. The cost of drugs in the Pyxis and med room. d. The amount spent on supplies such as linens, band-aids, urinals, etc.
A
The nurse is witnessing their patient signing an informed consent document for open-knee surgery. For which patient can the nurse legally verify signing the informed consent document? A. 40 year old Spanish-speaking male who had the procedure explained by a medical interpreter in Spanish and was given the informed consent document in their native language. B. 80 year old female with dementia. C. 16 year old female who is alone at the time of the signature. D. 30 year old male who was just given 2 mg Morphine IV for pain 10 minutes ago.
A
Which of the generations is challenged by sharing leadership with other generations? (powerpoint) A. Baby Boomers B. Generation Y C. Generation X D. Generation Z
A
2) A new nurse overhears a another nurse tell a patient " If you don't take this medication, then your toes will fall off." The new nurse know that this is a violation of which ethics principle? a. Autonomy b. Nonmaleficence c. Veracity d. Fidelity
A and B are incorrect because she is not allowing the patient his autonomy to choose and her comment can cause harm. The true ethics principle broken is the principle of veracity (C). The nurse lied to her patient and gave him false information. D is not the answer because she did not make or break any promises. This information comes from the Ethics in Nursing Powerpoint.
A new nurse has a concern about a hospital policy regarding insulin administration. She asks her nurse manager who says she will report it directly to the vice president of the hospital. The new nurse knows that her hospital has a ________ organizational structure a) Flat b) Bureaucratic c) Matrix d) Direct
A is correct because Flat organizations structures allow staff direct access to hospital administration through their managers. B is incorrect because there is not a multistep hierarchy for the new nurse to go through. C is incorrect because there are no extra positions parallel to her nurse manager. D is incorrect because there is no such thing as a direct organizational structure. This came from the Healthcare organizations & structure PowerPoint.
3) A nurse who administers regular insulin without checking the latest blood sugar result is demonstrating: a. Negligence b. Malpractice c. Slander d. Assault
A is incorrect because she is a registered nurse and it is her professional responsibility to safely administer medications to patients. B is correct because she is a medical professional and she is not acting in a reasonable manor to provide correct patient care. C is incorrect because she is not talking inappropriately about the patient. D is incorrect because the nurse is not threatening the patient. This information came from the Law and Policy PowerPoint.
Linda is creating a budget for the fiscal year for her medical-surgical unit. When considering what might influence the budget, she should keep in mind which of the following: (select all that apply). a. Census of the unit b. Population the unit serves c. Manager's experience d. Equipment needed e. Visitation policy
A, B, D
Linda is creating a budget for the fiscal year for her medical-surgical unit. When considering what might influence the budget, she should keep in mind which of the following: (select all that apply). a. Census of the unit b. Population the unit serves c. Manager's experience d. Equipment needed e. Visitation policy
A, B, and D are correct. The average census of the unit will determine how profitable the unit will be, but also how many supplies and nurses will be needed. The population the unit serves is important to consider because it will influence what special equipment might be required. The manager's experience is important for her ability to create a budget and lead a unit, but does not affect the cost. Visitation policy does not affect cost.
A charge nurse on an ICU floor decides on her own which patients should be seen first by the staff nurses and then directly tells them what to do. What kind of leadership style is she utilizing? A. Autocratic B. Democratic C. Laissez-faire D. Bureaucratic
A. An autocratic leader is concerned with task accomplishments, makes decisions alone and exercises her power through coercion.
1) A Nurse manager is teaching a new nurse about delegation. Which statement correctly indicates understanding of the teaching a. I can send a UAP to listen to lung sounds on a patient with pneumonia. b. I can ask an UAP to take vital signs every 15 minutes on a patient receiving a blood transfusion. c. I do not need to follow up with an UAP about blood glucose as long as they chart the patient. d. I can ask the UAP to ambulate a third day postoperative bowel resection.
According to the five rights of delegation, A is incorrect because UAP cannot perform assessments. B is incorrect because a nurse cannot delegate vital signs in the circumstance of a blood transfusion. C is incorrect because there needs to be closed loop communication and the nurse is responsible for closing that loop. D is correct because ambulation of a stable patient is within the UAPs scope of practice. This question came from the daily unit management PowerPoint.
1. A Nurse Manager on a medical-surgical unit is speaking to the nursing staff about implementing a new quiet-time policy on the floor. Which of the following examples shows a democratic leadership style? a. "I have decided we are implementing a new quiet-time policy on the floor, trainings will begin this week and the policy will be enforced starting Monday." b. "I have noticed various staff concerns about the new quiet-time policy on the floor. I would like to hold a meeting to discuss opinions and suggestions regarding the new policy." c. "Try to follow the new quiet-time policy if you can, I will not be following up with you on this." d. "The hospital has implemented a new quiet-time policy and our unit will start using it on Monday." Correct answer:
B
1. Nurses on your unit have voiced a need for more chucks as they are continually running out of them. As the nurse manager, you are looking into purchasing more chucks each month to accommodate your patients better. Which area of the budget will these purchases come out of? a. HC budget b. Non-salary c. Personnel d. Capital
B
2) A nurse is caring for four patients when she is contacted via Vocera about another patient concern. Which task is most appropriate to delegate to an LVN? a) assessment of a newly admitted patient complaining of being nauseous. b) reinforcing the importance of using an incentive spirometer to a patient who is two days post-op. c) administering IV Morphine after the RN has scanned and educated the patient on the purpose of this medication. d) performing wound care on a patient that has just arrived on the floor for a snake bite, after completing training with wound team nurses.
B
3) There was a fall yesterday on a med-surg unit and the nurse on the floor reported it per hospital protocol. At the staff meeting today, the manger on the floor asks for input about what happened to cause the fall. Instead of putting the blame on one nurse, she asked the staff as a whole about what could be done to prevent falls in the future and together, the nurses discussed what they could do differently. The manger on this floor is practicing what type of leadership style? a) Autocratic: INCORRECT. an autocratic leader exercises power with coercion and makes decisions alone. The manager on this floor allowed for collaboration and teamwork. b) Democratic: CORRECT. The nurse manager is concerned about human relations and fosters communication and collaboration among the team to work together to prevent falls in the future. c) Laissez-faire: INCORRECT. With a laissez-faire leadership style, there would have been no meeting or communication to review what happened after the fall. d) Bureucratic: INCORRECT. This is not bureaucratic leadership because the manager isn't only going off rules and policies, but instead is relating personally with the team to figure out what they can do better.
B
3. A medical-surgical nurse is caring for a patient who is being treated after a traumatic car accident. A physical therapist who is a friend of the patient calls the nurse and asks how the patient is doing. The nurse states, "I'm sorry I cannot give out that information. You will have to ask the patient directly." Which principle of ethics is the nurse demonstrating? a. Fidelity b. Confidentiality c. Beneficence d. Veracity
B
4) A nurse working on a med-surg floor happens to witness a middle aged man, who is not her patient, fall to the floor and go unconscious. She is late on giving her patients' medications and thus does not stop at the scene but says she will call the charge nurse. However, moments later she receives a phone call which distracts her and she never manages to call. This would be an example of? a) Negligence: INCORRECT. This is negligent care but because she is a nurse she is held to a higher standard. b) Malpractice: CORRECT. This is a failure of a person with professional training to act in a reasonable manner. c) Violation of Common Law: INCORRECT. This would be a violation of the state law, specifically the nurse practice act which defines the scope and standards of practice. d) None of the above: INCORRECT. This would be outside her scope and standard. The nurse's scope and standard requires her to provide care and act in a reasonable manner.
B
A nurse manager calls a staff meeting to discuss cost-containment. The manager asks the staff for input regarding strategies that might help reduce cost. Which type of leadership is the nurse manager using? a. Autocratic b. Democratic c. Laissez-faire d. Moral
B
A nurse manager is observing the actions of a nurse she is supervising. Which of the following actions by the nurse requires the manager to intervene? a. Reviewing the health care record of a client assigned to the nurse. b. Making a copy of a clients most current lab results for the doctor during rounds. c. Providing information about a client's condition to hospital clergy after request and permission by the client. d. Participating in walking rounds that involve the exchange of client-related information inside the client's room
B
A nurse working in an Urgent Care facility is working at which level of service? (Textbook and Healthcare structure powerpoint) A. Primary care B. Secondary care C. Organizational care D. Tertiary care
B
The manager on the unit goes around telling others what to do, does not consult other team members on the unit before making a decision, and their main concern is task accomplishment. This is an example of which type of Leadership style? (LSP and management powerpoint) A. Democratic B. Autocratic C. Laissez-Faire D. Bureaucratic
B
When preparing an annual performance report, the nurse manager rates one of the staff nurses on her unit as "outstanding" with providing high-quality cost-effective care. What did the manager observe the nurse perform to provide this level of rating? A. The nurse spends most of her time in patient rooms rather than charting during her shift. B. Before leaving at the end of each shift, the nurse ensures she empties her pockets of all extra supplies she picked up throughout the day, such as alcohol swabs and saline flushes. C. The nurse continually replaces her patient's IV fluid bags that are running low before they run out, regardless of the patient's orders. D. The nurse brings in extra linens with every new patient, so she can be prepared in case of a needed bed change during a busy shift.
B
A registered nurse on an inpatient oncology unit receives news that a patient she has worked with for several months has decided to discontinue treatment. Although the nurse would like the patient to continue treatment, she supports the patient's decision by using what ethical principle? A. Beneficence B. Autonomy C. Justice D. Non-maleficence
B. Beneficence is the desire to good and taking positive action to help others. This is not the primary ethical principle the nurse is using. Autonomy is the agreement to respect another's right to self-determine a course of action; support of independent decision making. By supporting the the patient's decision to discontinue treatment, the nurse is using the ethical principle. Justice refers to an equal and fair distribution of resources. This is not the primary ethical principle the nurse is using. Non-maleficence is the avoidance of harm or hurt. This is not the primary ethical principle the nurse is using.
1) A public health nurse hosts an annual flu clinic at TCU for students and faculty members. The nurse's initiative to provide immunizations best represents which of the following principals of ethics? a) Paternalism b) Justice c) Utility d) Nonmaleficence
C
1. A staff nurse is interested in becoming a nurse manager. After discussing the roles and responsibilities of a nurse manager with the current nurse manager on her unit, the staff nurse understands that a nurse manager: a. Is anyone who uses interpersonal skills to influence others to accomplish a specific goal b. Achieves consensus within a group about its goals and facilitates accomplishment of goals c. Is directly responsible for maintaining standards of care, managing fiscal resources, and developing staff d. Must be a natural manager of task
C
2. A nurse receives the lab results about a patient and recognizes that their Potassium levels are low. Knowing that the value is critical and having this problem with a patient before, the nurse administers the amount of potassium that she believes is appropriate without consulting the physician. The patient goes into cardiac arrest. What legal/ ethical standard did the nurse violate? a. Negligence b. Assault c. Malpractice d. Professional Misconduct
C
3. A patient on the unit has a diagnosis of chronic obstructive pulmonary disease (COPD). Which of the following actions can be delegated to a nursing assistant (PCT)? A. Educating the patient about incentive spirometry B. Auscultating breath sounds every 4 hours C. Assisting the patient to ambulate to a chair D. Administering a new bronchodilator medication
C
4. A unit manager in the NICU is analyzing variances in the unit's operating budget. She notices that the unit has spent too much money on direct expenses in relation to the amount budgeted. What can the nurse manager do to lower the amount of money the unit spends on direct expenses? a. Decrease administrative salaries b. No longer provide cable television in patient rooms c. Observe the nurse's use of medical and surgical supplies and analyze potential waste. d. Fire the security guard stationed outside of the unit and put in place a buzzer system connected to the secretary to allow visitors to buzz in.
C
4. An Alzheimer's patient comes to the hospital alone, confused, and unable to make decisions. When the healthcare professionals are trying to determine how to proceed with his treatment of care what legal document would give them the information to proceed with the care the patient wants? A. Informed consent B. Informed Assent C. Advance Directives D. Healthcare power of attorney
C
There have been several patient complaints that the staff members of the unit are disorganized and that "no one seems to know what to do or when to do it." The staff members concur that they don't have a real sense of direction and guidance from their leader. Which type of leadership is this unit experiencing? (powerpoint) A) Autocratic. B) Bureaucratic. C) Laissez-faire. D) Authoritarian.
C
There is a male passenger on a plane who begins to have a heart attack. Other passengers look at him frantically but no other passenger or crewmember proceeds in helping the man or even calling out for a doctor or nurse on the plane. What civil wrong is being done, if any? A. Malpractice B. Abuse C. Negligence D. Failure to warn
C
2. A nurse is witnessing the informed consent of a patient before a hysterectomy. The nurse wants to verify that the patient fully understands the risks and benefits of the procedure. What is the nurse's correct response? a. Do nothing; it is the physician's responsibility to give the patient the necessary information to make an informed consent b. Ask the patient's husband if the patient understood the physician's explanation c. Fill any gaps in the patient's knowledge by re-explaining the physician's explanation so that the patient can make an informed consent d. Assess the patient's understanding of the procedure and ask if she would like the physician to clarify any gaps in knowledge
D
A nurse collaborates with a social worker on a unit to set up a Meals on Wheels delivery service for a patient who is in need of that resource prior to discharge. Which ethical principle does this most closely represent? (Ethics powerpoint) A. Autonomy B. Veracity C. Justice D. Beneficence
D
A nurse is overwhelmed in caring for a difficult patient and decides to delegate a task to an Unlicensed Assistant (UA). Which of the following is an appropriate task for the nurse to delegate? a. Perform an assessment on a newly admitted patient. b. Administer a rectal suppository c. Provide discharge education to a diabetic patient d. Perform a routine blood glucose check
D
A nurse is reviewing a client's health care record and discovers that the client's do-not-resuscitate prescription has expired. The client's condition is not stable. Which of the following actions should the nurse take? a. Assume that the client does not want to be resuscitated and take no action. b. Write a note on the front of the provider prescription sheet asking that the DNR be represcribed. c. Anticipate that CPR will be instituted if the client goes into cardiac arrest. d. Call the provider to determine whether the prescription should be immediately reinstated.
D
A nurse is working with an assistive personnel. According to the 5 rights of delegation, what should the nurse determine prior to assigning tasks? a. Whether the AP consents to the delegated tasks b. The client's willingness to consent to the AP performing the task c. Whether the task can be done more efficiently by the nurse d. The degree of supervision the AP will require to complete the task
D
A nurse on an ICU unit is swamped with 3 high acuity patients, which of these tasks can the nurse delegate to the unit technician? A. Assess the patient's abdomen for swelling because of the patient's complaints. B. Educate the patient's family about what to expect after discharge C. Change the patient's dirty dressing using sterile technique D. Collect urine from the patient to monitor I&Os
D
What is appropriate for the RN delegate to the UAP? A. Insulin injection of 4 units of Insulin Lispro. B. Receiving medication orders from the physician via phone. C. Dosage calculation before giving the medication. D. Assisting the client in ambulating after RN's initial assessment.
D
Which of the following is an example of negligence performed by the nurse? a. The nurse delegates to a PCT to assess the dressing and chart his findings on a patient who is 1 hour post-op, the PCT does not notice the patient bleeding more than expected which results in the patient becoming hypovolemic. b. A difficult patient on the unit continuously presses the call light, because she is busy with other patients, the nurse does not respond or call for a PCT assistance, which results in the patient falling out of bed. c. The nurse administered a subcutaneous injection of insulin without verifying the patients blood glucose level, which resulted in the patient becoming critically hypoglycemic d. All of these scenarios above are examples of negligence.
D
Which statement related to delegation is correct? (powerpoint) A. The practice of nursing assistive personnel (NAP) is defined in the nurse practice act. B. Nursing practice can be delegated only when the LPN/LVN and/or NAP have received adequate training. C. Supervision is not required when routine tasks are delegated to a competent individual. D. The RN must be knowledgeable about the laws and regulations that govern nursing practice, as well as those that have no clearly defined parameters, such as for NAP.
D
An ICU nurse is floated to a medical surgical unit in a hospital. When he looked in the patient's chart there were no standing orders i for chest pain. His patient complained of chest pain so the nurse implemented the chest pain protocol he used in the ICU. He got an ECG within five minutes of the complaint, drew up a cardiac panel, hooked the patient up to oxygen, and took nitroglycerine, aspirin, and morphine out of the Pyxis and prepared to administer the medications. What will most likely happen to this nurse? A. The patient's doctor will thank him for being proactive. B. The patient will sue the nurse for malpractice. C. The patient's doctor will file a complaint in human resources about the nurse practicing beyond his scope of profession. D. The nurse will lose his license at the state-level because of his professional misconduct.
D The nurse will lose his license at the state-level because of his professional misconduct. In the "Class 3 Part 1" power point on healthcare law and policy. Professional misconduct can be practicing without a license or beyond the scope of the profession. The nurse went beyond his scope of practice by ordering labs and tests and drawing up medications that he did not have an order for when the urgency of the situation was not established
The unit started using a new IV catheter brand because it was more cost effective. At first many nurses were reluctant to this and said it "didn't advance well" now the nurses say that the catheters are actually better than the other brand they used to use. This shows that the unit is moving more towards which stage of change? (Change powerpoint) A. Freezing B. Unfrosting C. Experiencing the change D. Refreezing
D is the correct answer, which is Refreezing. Freezing is when others are resistant to change this is seen in the first part of the question. Unfrosting is not a real stage of change. Experiencing the change is moving toward the change. Refreezing is stabilizing the change and it is moving towards the new norm. In the question the nurses are now recognizing the new change and acknowledging its benefits
To improve the health of the people in the communities we serve" is a __________statement? A. Vision B. Goal C. Philosophy D. Mission
D. A mission statement is short and memorable. Here and now. A vision statement is where we want to be.
