Leadership, Leadership: Q5, Leadership: Q1, Delegation EAQs, Leadership/Management EAQ's, Leadership EAQ's, Leadership EAQs, Leadership EAQs, Leadership: Q2
Which action of the clinical nurse is consistent with Gardner's task of "achieving work unity"?
Helping clients accomplish optimal functioning
The RN is delegating tasks for the care of a vulnerable population. Which healthcare team would be appropriate for the delegation of tasks?
RN, LPN and UNP
the RN is caring for a client with severe diarrhea. Which task of the client care plan can be safely delegated to the UAP by the RN?
administration of oral replacement fluids
The registered nurse, as a leader, is teaching about leadership roles to a group of nurse practitioners. Which statement made by a nurse practitioner indicates effective learning?
"I should use experience and knowledge to judge reasonable risks."
The nursing leader stated, "The reimbursed cost is less than the full charge for a service in the hospital." Which type of health reimbursement does the nurse leader describe?
Contractual allowance
The nurse leader suffers from headaches, hypertension, and gastrointestinal problems. Which affirmative statement by the leader reflects an appropriate way to manage the stress?
"I will get enough sleep."
Which of these clients can be provided care safely by unlicensed nursing personnel? select all that apply
1 a client who is stable 2 a client who is recovering
Which task can be delegate to the LVN? Select all that apply
1 Administering oral hypoglycemic agents 2 administering intramuscular medications
A client with hypoglycemia is admitted to the hospital. Which duties can the RN safely delegate to the LPN? select all that apply
1 Administering oral medications 2 administering intramuscular medications
which characteristics of a LPN should be considered before delegation of tasks? select all that apply.
1 critical thinking 2 diagnostic reasoning 3 synthesizing information
Which employee should be competent in critical thinking, leadership, communication, and time management skills? select all that apply.
1. charge nurse 2. registered nurse
The nurse leader noticed that the staff nurse recently promoted to the surgical unit is lacking confidence at work and is worried about a pending review by the nursing director. Which source of power is applicable in this situation?
Coercive power
Who is responsible for client outcomes in the functional model of care?
nurse manager
Who is the designated delegator?
nurse manager
The nurse leader working in a 50-bed surgical unit accrued 765 client days in November and 189 of the clients were discharged during the month. What is the average length of stay for November? Record your answer using a whole number. _____ days
4
Influenza epidemic take orders from
state officials
The nurse leader is teaching about the role of followers to the nursing staff. Which statement made by the nursing staff is true regarding the followers' traits? Select all that apply.
A follower demonstrates collaborative behavior in daily practice. A follower cooperates with the leader and peers to reach the team goal.
Taking an active role in the work of change Bringing everyone together to move toward a goal Encouraging people by giving attention to personal things that are important
According to Kouzes and Posner, what key practices in transformational leadership would a nurse teach? Select all that apply.
the RN is assigning work to four delegatees. Which delegatee most likely has a limited relationship with the delegator?
B, check the client's blood pressure every morning
According to the Model for Differentiated Nursing Practice, which entry-level nurse is most prepared for prioritization of client care?
Bachelor's degree registered nurse
Which system thinking theory principle is involved when the nurse considers the decision of a client to terminate clinical treatment?
Balancing short-term and long-term objectives
Which behavior on the part of the nurse helps develop trust among subordinates?
Behaving with consistency
Which performance appraisal method is used by nurse managers to measure the performance of the nurse both qualitatively and quantitatively?
Behaviorally anchored rating scales
What is the most important skill of the nurse leader?
Clinical care coordination
Which nursing model includes a registered nurse (RN) paired with technical assistance?
Co-primary nursing model
Who is responsible for establishing systems to monitor and verify the competency requirements related to delegation in an organization?
CNOs
A nurse manager in a surgical unit finds that many clients are developing urinary tract infections post-operatively and wants to discuss the measures to prevent it with the team. Which action of the nurse manager reflects good communication practice?
Calling the team for a brief meeting
Type of care for a nurse providing care to one patient the entire shift
Case management
During the delegation process, which healthcare professional acts as a liaison between the team leader and healthcare provider?
Charge nurse
Which description of accountability is correct?
Determination of appropriate actions and provide detailed explanations of the actions
The nursing team is providing care for a client. The team leader develops client care plans and coordinates care among the team members. Which member of the team acts as a team leader?
RN
Which healthcare professional does the nurse know is authorized to delegate work to other healthcare members?
RN
Which healthcare professional would the nurse know is held accountable for the tasks performed by the patient care associate?
RN
The RN assigns a task to a LPN to check the blood pressure and temperature of a client. Which factor is transferred to the LPN for the performance of the task?
Resposibility
A client arrives in the emergency department in cardiac arrest. Which priority action indicates that the nurse is acting as a leader?
Resuscitating the client using clinical protocols
During the delegation process, which healthcare professional acts as a liaison between the team leader and healthcare provider?
charge nurse
The registered nurse assigned a task to UNP. The UNP observed a change when measuring a client's blood pressure. What is the responsibility of the UNP in this situation?
inform the registered nurse immediately
During a status meeting for a research project, the project leader asks the team members for feedback. What leadership theory is represented by the action of the leader?
style theory
What is the ultimate goal of delegation?
to maximize patient care outcomes
Which type of behavior by the registered nurse results in a low-to-stable level of commitment?
punitive
Who is accountable for the ongoing evaluation of a client's care?
Registered Nurse (RN)
Which qualities of a nurse leader can move the organization in a forward direction to continue delivering the best possible care? Select all that apply.
Supporting the followers effectively Nurturing the followers with right knowledge and direction
A client with asthma and depression is admitted to the hospital. Which tasks delegated by the delegator would indicate the task is applicable for the registered nurse?
Teach the client how to use a metered-dose inhaler
What is the ultimate goal of delegation?
To maximize patient care outcomes
The leader teaches the student nurse about STAMP (staring, tone and volume of voice, anxiety, mumbling, pacing) assessment. During the session, the leader mentions rapid speech and dilated pupils. What component is responsible for these two conditions?
anxiety
The nurse leader asks, "Do I avoid taking a stand so that I can escape risk?" Which behavior is the nurse most likely practicing?
rarely using competing
What motivation factors would the nurse describe as forming a part of two-factor theory of leadership? Select all that apply.
recognition achievement
Which among the five rights of delegation is the cornerstone of delegation?
right communication and direction
Which right of delegation would the nurse describe as most instrumental in shaping quality and safety outcomes according to anthony and vidal?
right communication and direction
The nurse leader teaches about attributes that all change agents possess. Which attribute of a change agent is the key to self-support through challenges?
sense of humor
After observing a client waiting for food, the nurse leader instructs the nurse to make arrangements for food. Which statement used by the nurse to the client appropriately makes his or her positive intent explicit?
"I want to make you comfortable, here's your food."
The nurse as a leader teaches staff about organizational disciplines to support change and evolution. Which statement of the nurse is relevant in the context of maintaining self-awareness and using reflection?
"Personal mastery fosters openness in the face of change."
The nurse manager is delegating tasks to the healthcare team to care for a client who underwent brain surgery. Which individuals on the team share accountability during delegation?
1 Nurse manager 2 healthcare provider
According to the Institute of Medicine, which health care profession has been directly linked to patient safety? a. Nurses b. Physicians c. Social workers d. physical therapists
A
the registered nurse (RN) is assessing the conditions of four different clients. which client care should be delegated by the RN to unlicensed nursing personnel (UNP)?
17 year old, diarrhea (viral), subacute
Under a leader, a team of followers has failed to achieve success in conducting research. What does an effective leader do in this situation?
Accepts failure and gains experience from it
What are the desired attributes of the nurse as a leader? Select all that apply.
identify the needs of followers Motivating others assertively towards the objective Using a critical thinking approach while making a decision
Which nursing process includes tasks that can be delegated?
implementation
Which organizational outcomes are expected in followers under transformational leadership? Select all that apply.
increased morale increased performance
Which factors are associated with transformational leadership? Select all that apply.
A shared vision Increased self worth of followers Coaching and mentoring by the leader
Which component is the ability to perform duties in a specific role?
Authority
Which theory of nursing leadership involves the traditional organizational hierarchy playing a less significant role as the "keeper of high-level knowledge?"
Complexity theory
"In today`s workplace, female-male collaboration should provide efficacious models for the future." Which statements support this saying? Select all that apply.
Men and women must learn to work together. Women and men bring separate perspectives to resolving problems.
the registered nurse considers the qualification of the unlicensed nursing personnel before delegating a task. Which right of delegation is followed by the nurse?
Person
the registered nurse is evaluating the statements made by a student nurse after teaching ways to make appropriate delegation decisions. Which statement made by the student nurse indicates a need for correction?
The delegator should recheck and redo the work of the delegatee
The registered nurse assigned a task to a licensed practical nurse. The task was not successfully completed by the deadline. Which action by the registered nurse would be characteristic of a transactional leader?
Punishes the nurse
Which type of behavior by the registered nurse results in a low-to-stable level of commitment?
Punitive
The registered nurse is teaching a group of nursing students about leadership principles. Which statement made by a nursing student indicates the need for further teaching?
"A leader has a formal position." Leader does not necessarily have a formal position to indicate that he or she is a leader; rather, leadership refers to the performance. Leaders are those medical professionals who can intervene with courage when needed. Leaders are also able to organize a group of colleagues to solve an organizational problem. A nursing medical professional becomes a leader after promotion.
The nurse manager shares experiences faced during the journey to leadership with other staff members. Which statement made by the nurse appropriately describes the barriers faced during the leadership journey? Select all that apply.
"It requires time commitment." "The title doesn't guarantee good leadership
22 The formula is client days for a given time period divided by the number of days in the time-period. There are 31 days in July, so 679/31 = 21.9. Therefore, the ADC is 21.9, rounded to 22.
The leader nurse is calculating the average daily census (ADC) in a 40-bed medical surgical unit, which accrued 679 client days in the month of July. What is the ADC on this unit? Record your answer using a whole number. ____________
A medical care facility is seeking to establish an orthopedic center of excellence. The nurse manager teaches direct care nurses about opportunities available to them in the process. Which task would a direct care nurse be eligible for?
Conducting a literature review
A manager is planning to implement Gardner's Managing task of leadership. Which leadership and management behaviors would the leader display? Select all that apply.
Ensuring that organizational systems work on the client's behalf Assisting the client and client's family with planning, priority setting, and decision making
Which behavioral manifestations in the nursing staff should alert the nurse manager of moral distress? Select all that apply.
Failing to act as a client advocate Withdrawing from client care situations
What skills are essential for an effective nurse leader to develop collaboration with others? Select all that apply.
Flexibility ability to share ideas ability to listen to others possession of a string self-concept
Which behavior of the nurse as a leader would be considered a smart trust action according to Covey?
Focusing first on developing character
A nurse leader changes the work schedule after a team member asks for more flexibility in the schedule. Which theory outlines this nurse leader's approach?
Herzberg's theory
A RN is sent to a rehabilitation center because of chemical impairment issues. Which member of the healthcare team will be asked to provide feedback about the RN's progress?
Nurse manager
The registered nurse instructs a student nurse to perform an action as a community volunteer. Which action should the student nurse perform as a community volunteer?
Organizing individuals in the community to develop healthcare delivery
After oral surgery the dentist writes a prescription for pain medication for an 18-month-old child. Which medication does the nurse question?
Oxycodone/aspirin
The nursing manager wants to implement transformational leadership qualities. Which actions best describe this style of leadership? Select all that apply.
Providing intellectual stimulation Performing experiments with system redesign Using motivator factors to inspire work performance
Which behavior of the nurse as a leader indicates Gardner's task of renewing at an executive level?
Providing self-care to enhance the ability to care for clients, families, staff, and the organization
After orthopedic surgery a 15-year-old adolescent reports pain and rates it a 5 on a scale of 0 to 10. A nurse administers the prescribed 5 mg of oxycodone every 3 hours as needed. Two hours after having been given this medication, the adolescent reports pain and rates it a 10 of 10. What action should the nurse take next?
Request that the primary healthcare provider evaluate the need for additional medication.
Which action of the registered nurse (RN) represents his or her leadership ability?
Supervising the tasks assigned to unlicensed nursing personnel
Which work is automatically increased for the delegator when there is a decrease in direct client care?
Supervision
A nurse leader is promoted as nurse manager of a critical care unit. Which action would demonstrate the effectiveness of the nurse leader role as a manager?
Establishing the goals considering the staff expertise
The nurse manager enlists 10 direct care nurses for a project addressing the needs of the human immunodeficiency virus (HIV). The project successfully completes within the timeline. What would be the most essential factor for the success of the nursing manager?
Allowing the direct care nurse to share ideas
The registered nurse is teaching a group of nursing students about leadership principles. Which statement made by a nursing student indicates the need for further teaching?
"A leader has a formal position."
The nurse leader is teaching the nursing staff about conflicts in an organization. Which statement is inaccurate regarding conflict in an organization?
Conflict can be constructive if the conflict is excessive.
The nurse manager is implementing a change in evening care for clients to include back rubs to promote sleep. The nurse manager convinces the managers of various nursing units and also supports nursing staff who are willing to implement the change. Which component of Kotter's eight step model is involved in this scenario?
Forming a powerful coalition
Which aspect relates to the quality of relationships while assessing the degree of conflict resolution in nursing leadership? Select all that apply.
Generation of empathy Understanding being created
The nurse manager evaluates the performance of a group of nurse leaders on a project. One nurse leader performs exceedingly well by assuring that change happens and is promoted as the leader. Which quality attributes would have been shown by the nurse? Select all that apply.
Taking initiative Going beyond the role Thinking outside the box
The nurse observes a dispute between staff members due to differences in perspective concerning nursing practices. Which approaches of the nurse as a leader would be appropriate in building up negotiation "loop-backs" to resolve the conflict? Select all that apply.
Allowing a cooling-off period if the resolution fails Informing of the full consequences of failing to resolve the issues
The nurse manager knows that what is the most important focus of a culture of safety? a. Improving efficiency of patient care b. Increasing training of staff regarding basic elements of safety c. Looking at the reason for an error d. Praising staff when no errors are committed
C
Who is accountable for the ongoing evaluation of a client's care?
RN
a group of individuals is working as a team in a rehabilitation program. Which nursing team member has the responsibility of acting as the team leader?
RN
to improve client care, the RN has delegated tasks involved in assisting the client with activities of daily life to a certified nursing aide, and the administration of oral medications to the licensed piratical nurse. Which member of the health care team would be accountable for the final client care?
RN
the nurse is caring for four different clients with different health conditions. Which client care task delegated to the LVN would be appropriate to develop a suitable care outcome?
condition: hysterectomy; task: providing oral medication BID
Which action would a nurse leader specifically take to promote a health care climate where curiosity, reflection, and change are embraced?
Empowering staff to be life-long learners and risk takers A nurse leader who empowers staff to be life-long learners and risk takers is promoting a health care environment where questioning the status quo, reflecting on processes and advocating for change when appropriate is welcome and encouraged. The nurse leader should serve as coach, maintain a good relationship with the team, and collaborate with the team to problem solve, but these actions are not specific to creating a culture of curiosity, reflection and change.
A client requires emergency cardiac surgery. The leader nurse wants to make the client aware of the situation and wants the client to decide what should be done. Which ethical model does the leader nurse follow here?
Patient-benefit model
Which application would the registered nurse state is related to the trait theory in practice?
To develop assertiveness
the RN delegates a task to the UNP. Which client care is suitable for UNP?
condition: undergone ileostomy; task: monitor wound discharge
The registered nurse is evaluating the statements made by a student nurse after teaching ways to make appropriate delegation decisions. Which statement made by the student nurse indicates a need for correction?
"The delegator should recheck and redo the work of the delegatee."
The nurse manager reviews the performance report of a direct care nurse and asks the nurse to focus on "emotional intelligence" in order to be promoted as the nurse leader. Which statement would the nurse leader most likely use while advising the nurse on areas for improvement?
"Try to be more sensitive to the experiences of others."
The nursing manager is preparing a schedule for delegating appropriate tasks to different health care team members. Which health care team member can be delegated the task of administering oral medications? select all that apply
1 LVN 2 LPN
A healthcare team is caring for a client with dental pain. Which task is most suitable to be delegated to unlicensed assistive personnel to provide effective client care?
Administering mouth was for oral hygiene
The chief operating officer (COO) discusses the performance of a newly appointed leader with the nursing staff. The team communicates that the practical approach of the leader fulfills the quantum theory. What type of work environment does the COO understand that the leader creates at the workplace?
An environment that is rapidly changing and dynamic
The registered nurse finds that two nursing students are arguing with each other. Which action by the registered nurse best represents a leadership quality?
Assessing the condition and strategizing to resolve the matter by reducing the difference
A nurse manager transfers the task of caring for a client who has undergone appendectomy to a registered nurse (RN). Which element of the healthcare system is the RN practicing?
Assignment
Which characteristic of the nurse as a delegator is relfected in the statement, "let me show you how this procedure is done; then you can do it yourself'?
Doing
The nurse manager asks the staff nurse to participate in creating new guidelines for providing services to the client. Which management strategy is utilized by the nurse manager?
Empowerment of staff
In an organization, the leader is providing specific feedback regarding positive performance to his or her subordinate. Which leadership theory behavior is being displayed by the leader?
Expectancy theory
Which Institute of Medicine Report attempted to help interprofessional teams work more effectively together?
Health Professions Education: A Bridge to Quality
What is the key element of success for a nurse manager as a leader?
Including the direct care nurses in decision making
Which characteristics should a nurse focus on to become an effective transformational leader? Select all that apply.
Inspiring a shared vision Improving interpersonal skills Being able to motivate the nursing staff
The nurse is teaching breathing exercises to a client who underwent surgery. Which member of the healthcare team is most suitable for reinforcement of teaching in the client?
LVN
At a staff meeting, the question of a staff nurse's returning to work after completing a drug rehabilitation program is discussed. What is the most therapeutic way for the staff to handle the nurse's return?
Offering the nurse support in a straightforward manner
A client with dehydration is prescribed an intravenous fluid infusion. Which healthcare professional would the nurse expect to be delegated this task?
RN
The student nurse is performing a rapid baseline assessment using a disability mnemonic (AVPU) in a client with drug abuse. Which parameters should the student nurse consider for proper assessment? Select all that apply.
Reaction to pain Response to voice
What is the emergency care for a drowning client?
Safely rescuing the patient
Which theory emphasizes that leadership effectiveness depends on the executive nurse's interpersonal skills?
Situational-contingency theories
Why does the leader ask the direct care nurse, "Do you block cooperative efforts to resolve issues?"
The direct care nurse uses avoidance often.
The nurse as a leader is using a transactional leadership style. Which effect on followers often results from this style of leadership?
The followers will correct errors in a reactive manner.
Which of Gardner's tasks involves anticipating client outcomes for single clients or families and helping them formulate their vision of future well-being?
envisioning goals
During the process of delegation, the delegator's behavior is noted to be observing and monitoring. How is the relationship between the delegator and the delagatee in this situation?
established
which primary task is achieved by a delegator when delegating a task to a delegatee for an effective outcome?
motivating
The nurse is scheduled to be the co-leader of a therapy group being formed in the mental health clinic. When planning for the first meeting, it is of primary importance that the nurse consider what?
needs of the client being included
Which internal factors should be considered while implementing any change in an organization? Select all that apply.
number of staff leader competency nurse education level
Which member of the healthcare team would the nurse claim performs functions through passive delegation?
pharmacist
In order to minimize the likelihood for error during intravenous administration of antibiotics, the legal authority advised the delegatee to wear a colored vest that says. "Do not disturb! medication administration in process." which delegatee is appropriate to follow the advice of legal authority?
registered nurse
A nurse manager regularly analyzes herself and her performance, focusing on developing leadership qualities such as assertiveness, confidence, and task knowledge. Which leadership theory does the manager most likely subscribe to?
trait theory
the RN is caring for an older client who has been admitted to the hospital. The RN allocates several tasks to the UNP. In order to evaluate the understanding of the UNP, the RN asks the UNP to describe which tasks have been allocated. Which responses given by the UNP indicate effective understanding of the tasks? select all that apply
1 I must assist the client with oral care 2 I must give a sponge bath to the client every morning 3 I must record the blood pressure of the client at regular intervals
A hospital wants to implement the primary nursing model on the premises. Which challenges are likely to be faced by the management? Select all that apply.
Lack of nurse availability Lack of experienced nurse
Which leadership theory focuses on the role of leaders in relational and contextual terms?
Style theory
the direct care nurse is delegated the task of reviewing the informed consent form after being completed by the client. Who should the direct care nurse consult regarding queries related to client rights?
nurse manager
when delegating a task, the delegator says, "please tell me how you are going to perform this procedure, and I will share my expectations regarding how we need to communicate with each other." What can be inferred about the delegatee?
the delegatee has willingness and ability, but the relationship is new.
During a vaccination drive at a well-child clinic, a nurse notes that a recently hired nurse is not wearing gloves while vaccinating an infant. What should the nurse advise the newly hired nurse to do?
Put on gloves, because standard precautions are required.
Which objective is associated with creating urgency in Kotter's eight-step model?
To generate open dialogue about external and internal realities
The nurse leader working in a 50-bed surgical unit accrued 765 client days in November and 189 of the clients were discharged during the month. What is the average length of stay for November? Record your answer using a whole number. _____ days
4 The formula for average length of stay is number of client days divided by the number of discharges. 765/189 = 4 days.
What is the status of the unit secretary as a member of the healthcare team, which is in the span of control of a registered nurse (RN)?
Devoid of legal authority
A nurse leader wants to implement the principle of non-maleficence while evaluating the staff. What is an effective way to perform this action?
Emphasizing the good qualities of the staff and giving positive direction for growth
What are the attributes of a nurse leader? Select all that apply.
Identifying the needs of others Using critical-thinking skills in making decisions Using focused energy and stamina to accomplish a vision A nurse leader should possess attributes such as identifying the needs of others. A nurse leader should also use critical-thinking skills in making decisions and focused energy and stamina to accomplish a vision. Accepting responsibility willingly and performing follow up on the consequences of actions taken are the responsibilities of a follower.
Which are the organizational outcomes of transformational leadership? Select all that apply.
Increased loyalty Increased commitment Increased performance
Which behavior from the nurse leader exhibits charismatic leadership qualities?
Possesses an inspirational quality that makes team members attracted to him or her
What tasks should the nurse perform as a leader to increase productivity? Select all that apply.
Provide coaching and mentoring to the staff. Provide information and direction related to meeting unit productivity goals. Prepare a staffing plan that balances the organizational directives with unit needs.
who is most accountable for an initial assessment and the ongoing evaluation of client care?
RN
Which professionals in a healthcare organization can be delegators?
RNs
The nurse manager is in charge of a relatively inexperienced nursing staff. The manager inspires followers through displayed optimism, by providing intellectual stimulation, and by encouraging follower creativity. Which leadership theory is most closely aligned with the manager's approach?
Transformational theory
A healthcare team is caring for a client with diabetes insipidus. According to the functional model, which healthcare personnel would the nurse state is qualified to perform all hygienic tasks?
UAP
Empowerment The role of the nurse executive as the leader is to empower followers or to share the authority with the followers by asking them to actively participate in the given task. Orientation of the employee, employee selection, and financial accountability indicates the role of a nurse manager as leader.
What is the role of the nurse executive as a leader?
A team member has asked the nurse leader about changes in the work schedule. What is the accurate action to be taken by the nurse leader in this situation?
Explaining the reason for the change to the team member clearly
The nurse is managing a client who underwent cardiac bypass surgery. Which healthcare member can be safely delegated the task of monitoring electrocardiography?
cross-trained technician
What are the desirable actions of the nurse as a transformational leader? Select all that apply.
fostering a shared vision providing coaching and mentoring
"In today`s workplace, female-male collaboration should provide efficacious models for the future." Which statements support this saying? Select all that apply.
men and women must learn to work together women and men bring separate perspectives to resolving problems
Which question asked by a nurse leader establishes and maintains a human rapport with staff?
"How are your children?"
The nurse leader taught the student nurse the principles of quality management and quality improvement. Which statement made by the student nurse indicates ineffective learning?
"Managers define the quality."
The senior nurse advises a newly promoted nurse concerning various aspects of the leadership role. Which advice by the senior nurse would the newly promoted nurse most likely consider as leading by example?
"Try to be a participant in political activity in the local community."
Which statement of the nurse leader reflects the actions suggested by the Joint Commission for disruptive behavior by a direct care nurse?
"You are terminated, effective now."
The RN assists other registered nurses when there are no safety issues. While assisting, the RN uses the strategy of asking. What is the benefit of this strategy? select all that apply
1 Allows the registered nurse to reassess 2 allows the delegator to examine the situation differently 3 opens lines of communication between delegator and the delegatee
Which aspects are considered when determining the willingness of a nursing assistant before delegating a task? select all that apply
1 Attitude 2 confidence 3 commitment
the registered nurse (RN) is teaching a newly hired nruse how to communicate with a delegatee while delegating a task. Which statments made by the newly hired nurse indicate effective learning? select all that apply
1 I will keep the information simple 2 i will share the information using electronic media 3 i will provide an opportunity to clarify the information
which factors does the RN consider in the decision to delegate process? select all that apply
1 Predictability of outcomes 2 complexity of the task to be performed
the nurse is assessing the level of readiness before delegating tasks to UAP. According to Hersey's model of situational leadership, what specific factors reflect the level of readiness? select all that apply
1 ability 2 willingness
a client is hospitalized with pressure ulcers. Which task could be delegated to an unlicensed nursing professional (UNP)? select all that apply
1 empty wound drainage containers 2 report changes in wound appearance
the nurse manager appointed a registered nurse (RN) to provide hospice care for a client and explained the tasks to be performed. Which tasks has the nurse manager delegated to the RN? select all that apply
1 providing total client care 2 teaching the client and family members 3 teaching the client about personal hygiene
the registered nurse (RN) is delegating tasks to several health care team members caring for a client with a bacterial infection and high fever. Which statements by the registered nurse would be most appropriate for the licensed practical nurse (LPN)? select all that apply
1 you should administer an antipyretic after the meal 2 you should administer prescribed antibiotics to the client twice a day 3 you should collect data that can be used in the assessment of client's condition
In a long-term care facility, the care tasks for a client who is suffering with liver disease are being delegated. Which statement made by the delegator indicates the resposibility for the tasks is with the registered nurse? select all that apply
1 you will assess alleviation of the client's symptoms 2 you will monitor the client care on an hourly basis 3 you will admit the client to the intensive care unit if her condition deteriorates.
Which of these clients can be provided care safely by unlicensed nursing personnel? Select all that apply.
A client who is stable A client who is recovering
Assigning individual duties to different nurses and nursing students for different tasks In the functional model of nursing, different types of duties are assigned to different people and they work independently. A single nurse cares for a single client during the entire work period with the case method model of nursing. Assigning responsibility to a registered nurse for coordinating a group of nursing students is a type of team nursing. In primary nursing, a registered nurse is assigned to work autonomously as the client's primary nurse throughout their stay. Test-Taking Tip: Recall the different responsibilities of the nurses as per the models of nursing.
A hospital is planning to implement the functional model of nursing. Which action performed by a nurse leader would be effective under this model?
Which factors are associated with transformational leadership? Select all that apply.
A shared vision Increased self worth of followers Coaching and mentoring by the leader Transformation leadership involves sharing a vision with team members to accomplish goals. This type of leadership promotes self-worth in the followers through positive reinforcement. The leaders practicing the transformational leadership facilitate coaching and mentoring of followers for skill enhancement. Transactional leadership involves arrangements where the followers do the task and get paid for it. The mistakes that happen during the task are corrected in a reactive manner.
A delegator is providing feedback to four delegatees. Which feedback may undermine a long-term working relationship?
A; "why did you do it in this way? Aren't you aware of the correct procedure?"
The nurse manager is observing the performance of a nursing assistant. Which behavior by the nursing assistant toward a client reflects a boundary violation?
Accepting a gift from the client
The nurse as a leader explains ethical principles to the student nurse. Which example does the leader give for autonomy?
Accepting the client's wish to donate his/her organs after death
Which component of delegation is retained while the delegator is delegating the client's care task to the nursing aide?
Accountability
The nurse leader states, "The people in rural America dress and act differently from those in urban centers." What concept describes this statement?
Acculturation
A nurse manager is helping staff reach optimal functioning to enhance organizational functions. Which Gardner's task is reflected in this leadership behavior?
Achieving workable unity
The nurse executive is seeking to improve client care by helping multidisciplinary leaders achieve optimal functioning. Which behavior related to Gardner's tasks of leading is the executive exhibiting?
Achieving workable unity
A nurse manager in a cancer care facility finds that the nursing care team is demotivated due to consecutive deaths of two terminally ill cancer clients. Which action of the nurse manager would help renew the team's energy?
Arranging a notice board in the unit and posting photos or messages reflecting achievements of the team
A group of staff nurses is dissatisfied with the new ideas presented by the newly hired nurse manager. The staff wants to keep their old procedures, and they resist the changes. Conflict arises from: a. Group decision-making options. b. Perceptions of incompatibility. c. Increases in group cohesiveness. d. Debates, negotiations, and compromises.
B
A new nurse witnesses an experienced nurse documenting an assessment on a patient-controlled analgesia (PCA) pump incorrectly on the computerized flow sheet. Which of the following should the new nurse do? a. Notify the charge nurse that the nurse has a staff development need. b. Bring to the nurse's attention that she is charting incorrectly and offer to demonstrate proper charting on the flow sheet. c. Write her up in an incident report. d. Question her own proficiency and seek out her preceptor for verification of correct procedure.
B
The client is admitted to the ED with a third degree burn over the front of both legs. Which priority intervention should the nurse implement first? a. maintain a sterile environment when caring for the client b. insert two large-bore IV access routes c. administer IV antibiotics d. assess the client's pain level on a scale from 1-10
B
The nurse manager is aware that which incident would be classified as a sentinel event? a. The patient receives an oral anti-diabetic medication 6 hours after it should have been administered. His blood sugar is slightly elevated, but it returns to its normal range within 1 hour. b. The patient receives a second-degree burn from a malfunction in a hypothermia blanket. c. The patient got dizzy and sat down on the floor approximately 1 hour after the administration of an antihypertensive medication. The patient did not experience any injury. d. The patient is using a continuous passive exercise machine after knee surgery when the machine quits working. The patient complains of pain when the knee is removed from the machine. The pain is relieved after the administration of pain medication.
B
Which of the following indicates safe delegation? a. The nurse supervisor for a large urban acute care department asks the unit manager to accept two new acutely ill patients, which the manager does. The unit is short two staff, and the replacement is inexperienced. b. A unit manager agrees to release a staff from her unit to Unit B. The staff member she agrees to release is experienced on Unit B and is agreeable to the change. The unit manager's unit is fully staffed and patients are stable. c. The nurse supervisor asks the head nurse for Unit A to make do without a replacement for an ill staff member because Unit A was originally overstaffed anyway. Patient acuity levels are very high on Unit A and two staff are orientating. d. The nurse supervisor asks the charge nurse on Unit B to cover Unit F, which is two floors up, because the charge nurse for Unit F is ill. The charge nurse for Unit B is an experienced manager but has no experience with the nursing care required on Unit F.
B
As a new leader in a 40-bed step down unit, Jane desires to make an impact on the nurses, patients, and families. In order to survive and thrive as a leader, she knows that she must do which of the following? (Choose all answers that apply). a. Work longer hours to display a passion for her position. b. Maintain a positive attitude. c. Listen to constituents. d. Maintain balance. e. Generate self-motivation. f. Build self-confidence.
B, C, D, E, F
The nurse, as a leader, is planning to provide information about personal hygiene to a group of clients. Which communication methods should the nurse use to talk to the clients? Select all that apply.
Being sensitive to nonverbal communication Providing the opportunity for dialogue and feedback Presenting information that addresses the listener's self-interest
Which topics being taught by the nurse belong to Covey's characteristics of leadership? Select all that apply.
Believing in other people Radiating positive energy Engaging in lifelong learning
When a client with cancer reaches an incurable last stage, the nurse explains the situation to the client and calls the client's family members to provide support. Which need of the client does the nurse prioritize here?
Belonging need
The nurse leader is promoted to nurse manager and has a plan of implementing an effective client counseling center in the outpatient department. The nurse gathers data from different healthcare providers and compares methods. Which type of quality improvement does the nurse implement?
Benchmarking
The leader is devising a strategy to connect individuals, groups, and organizations to attune them toward a common goal. Which political strategy is the leader pursuing?
Building coalitions
The nurse leader performs his or her own honest appraisals on a regular basis and feels good about the job. Which rule is the nurse leader implementing by this action?
Building self-confidence
The nurse leader is referencing the American Nurses Association's nursing-sensitive quality indicators and knows that structure indicators include which element? a. Job satisfaction b. Changes in patient health-care status c. Hours of nursing care per patient d. Deliverance of nursing care
C
The healthcare unit reviews the evaluation report of a newly promoted nurse leader and rates the performance as excellent. At which qualities did the nurse excel? Select all that apply.
Charting new paths that lead to progress Demonstrating positive feelings in the workplace
Who would the registered nurse state is accountable for establishing systems to communicate competency requirements related to delegation?
Chief Nursing officer (CNO)
Who is responsible for establishing systems to monitor and verify the competency requirements related to delegation in an organization?
Chief nursing officers (CNOs)
A client with severe burns and injuries from a bomb blast is admitted in the emergency unit. Which triaging priority is preferable for the client?
Class I
The nurse is caring for four clients in an emergency department. Which client should be given least priority by the primary healthcare provider based on his/her condition?
Client with closed extremity trauma
A nurse who lacks confidence in her performance in a new position is worried about an upcoming review with the nursing director. What type of power does the nursing director hold in this scenario?
Coercive power
Which are considered as nurse competencies within the synergy model of care delivery? Select all that apply.
Collaboration clinical judgement cultural competency
While trying to define a problem, the nurse leader finds out the external and internal constraints on implementing a solution. Which problem-defining process is the leader nurse performing?
Contextualizing the problem
A unit manager of a 25-bed medical/surgical area receives a phone call from a nurse who has called in sick five times in the past month. He tells the manager that he very much wants to come to work when scheduled but must often care for his wife, who is undergoing treatment for breast cancer. According to Maslow's need hierarchy theory, what would be the best approach to satisfying the needs of this nurse, other staff, and patients? a. Line up agency nurses who can be called in to work on short notice. b. Place the nurse on unpaid leave for the remainder of his wife's treatment. c. Sympathize with the nurse's dilemma and let the charge nurse know that this nurse may be calling in frequently in the future. d. Work with the nurse, staffing office, and other nurses to arrange his scheduled days off around his wife's treatments.
D
In delegating to a CNA in a home health setting, which of the following represents the most appropriate delegation communication? a. "you will be taking care of Mrs. S. Mrs. S needs assistance with her bath." b. "you will need to help Mrs. S get into and out of her shower. Ensure that you check the condition of her feet, and let me know if you have any concerns when you check in." c. "I am not sure that you know how to do this, but I am giving you Mrs. S. She is quite obese and needs skin care." d. "Mrs. S needs help to get into and out of her bathtub. Her bath will need to be completed by 10:00. When you are helping her to dry, please check between her toes and toenails, and phone me by 10:30 if you notice nail discoloration or redness."
D
The RN delegates obtaining and recording a client's pulse every 30 minutes. During the last hour, the LPN fails to report the client's elevated heart rate to the RN. Which factor best explains the situation?
Decayed information
Which skill would most likely be associated with an effective nurse leader?
Delegating work appropriately
Which process involves transferring responsibility to multiple players, usually with varying degrees of education and experience, while retaining the ultimate accountability for providing the client care?
Delegation
Which group discussion technique involves a large number of respondents who may be participating in the discussion remotely?
Delphi technique The Delphi technique includes the feedback of anonymous people who may not physically convene. These participants may be located throughout the country or the world. In the case of focus groups, the interaction is face to face. Brainstorming involves listing all ideas without critique or discussion. In the nominal group technique, participants are asked to not talk to each other as they write down their ideas to solve a predefined problem or issue.
Which characteristic of a manager should the nurse leader exclude while addressing the complex issues of the hospital?
Developing a vision
The nurse is caring for a client admitted with fluid overload. Which tasks are most appropriate to be delegated to the patient care associate? Select all that apply.
Documenting vital signs, documenting urine output Repositioning the client every one or two hours
What should the team leader identify as a priority when assigning clients to team members?
Each team member's strengths
Which of the following characteristics exemplified by a registered nurse is a leader trait?
Endorsing and thriving on taking risks that bring about change
What is the application of Roger's diffusion theory?
Engages key leaders in a change to infuse the energy from early adopters
Which activity indicates improper follow-through on the part of the delegatee?
Failure to report results
The nurse is explaining behavior to a nursing assistant. Which characteristic of a behavior usually results in that behavior being viewed and accepted as normal?
Fitting within standards accepted by one's society
Which behavior of the nurse as a leader would be considered a smart trust action according to Covey?
Focusing first on developing character Covey's smart trust actions help leaders develop high trust in a low-trust world. Focusing first on developing one's character is a smart trust action of a leader. Leading a balanced life, engaging in self-renewal, and seeing life as an adventure are Covey's characteristics of leadership.
The chief operating officer conducts an interview for the position of nurse leader and asks about Kotter's eight-step model. Which attribute cited by the nurse relating to helping build the momentum is correct?
Forming a powerful coalition The formation of a powerful coalition may help build the momentum and support individuals through the change experience. Removing obstacles may keep one alert for barriers in structure. A culture with continuous improvement may be created by building on the changes. The changes in the culture are anchored with the recognition of the people who helped make the changes.
Clients that can delay treatment for more than 3 hours and remain stable
Green tag. Yellow tag 30min-2hr
Which activity performed by the registered nurse (RN) indicates effective supervision of the delegatee?
Guiding the delegatee while he or she is performing the task
Which action makes a nurse manager also a nurse leader?
Helping employees reach the highest level of their potential excellence
Which question related to quality of decisions would the nurse leader consider while assessing the degree of conflict resolution?
How creative are the resulting plans? The question about the creativity of resulting plans should be considered while assessing quality of decisions. The willingness of the people to work together, development of understanding, and generation of the mutual respect and concern for each other are related to quality of relationships.
The nurse leader is focused on recognizing the dynamic, complex, and interdependent nature of systems in an organization. Which nursing action indicates an effective implementation of this principle of systems thinking theory?
Identifying and understanding the relationships between clients, families, communities, and local economies
What are the attributes of a nurse leader? Select all that apply.
Identifying the needs of others Using critical-thinking skills in making decisions Using focused energy and stamina to accomplish a vision
The transformational leader demonstrates charismatic behavior and the careful consideration of the value of every individual in the organization. What might be the expected organizational outcomes with this type of leadership? Select all that apply.
Increased loyalty Increased performance
A nurse manager is assessing the qualities of a team that is led by the nurse leader. Which qualities indicate an effective team? Select all that apply.
Informal in the work environment Ability to handle conflicts by open discussions
A direct care nurse has great skill in teaching clients different self-care activities and is sought out by colleagues to teach their clients. Which power does the nurse possess?
Information power
Which organization advocates nurses taking a prominent role in the healthcare arena?
Institute of Medicine
The PCP prescribes a rectal suppository for a client with severe constipation. Which healthcare professional would be delegated the task of administering the suppository?
LPN
The registered nurse is organizing a community health care program for administering tetanus vaccinations. Which member of the health care team is most suitable for delegating the task of administering vaccinations
Licensed practical nurse
Which actions of the nurse exhibit transactional leadership? Select all that apply.
Meeting the targets within the deadline Working according to organizational rules Correcting the errors in a reactive manner
"In today`s workplace, female-male collaboration should provide efficacious models for the future." Which statements support this saying? Select all that apply.
Men and women must learn to work together. Women and men bring separate perspectives to resolving problems. Men and women must learn to work together and value the contributions of others and the differences they bring to any situation. Not all male managers make decisions on limited data. Women and men bring separate perspectives to resolve problems, which can help them function more effectively as a team on the nursing unit. Women may be better at collaborating and getting others to collaborate in accomplishing a task; men reportedly seem to be better at deciphering what needs to be done. Women are perceived to have a more participative management style; however, this does not mean that all male managers use an authoritative management model.
A healthcare team is caring for a client who is hospitalized with severe diarrhea. According to the principle of right of supervision of delegation, what does the RN do in this situation?
Monitor the hemodynamic status
the RN who delegates work to a newly hired LPN says, "please tell me how you will go about performing this procedure, and I will share my expectations with you." Which behavior strategy of Hersey's model is being applied?
Participating
The nurse as a leader teaches staff about organizational disciplines to support change and evolution. Which statement of the nurse is relevant in the context of maintaining self-awareness and using reflection?
Personal mastery fosters openness in the face of change. Personal mastery fosters openness by maintaining self-awareness and using reflection. Team learning promotes the team thinking together to share ideas, knowledge, and perspective. System thinking considers the organization as a complex entity; this helps in seeing the movement of the organization. Shared vision creates a common viewpoint to understand the direction of movement of the organization.
Which member of the healthcare team would the nurse claim performs functions through passive delegation?
Pharmacist
A nurse preceptor is evaluating a nurse who is preparing to administer digoxin intravenously (IV) to a client. The preceptor should stop the nurse from continuing with the procedure when the preceptor observes the nurse doing what?
Piggybacking the digoxin in an existing infusion
Which responsibility of the nurse manager differs from the responsibilities of a nurse leader?
Planning the budget
Which behavior from the nurse leader exhibits charismatic leadership qualities?
Possesses an inspirational quality that makes team members attracted to him or her Charismatic behavior is seen in the transformational leadership style; this inspiring quality attracts team members. By sharing a vision the leader is not attracting team members; therefore this may not be a charismatic leadership behavior. Encouraging innovation and creativity in problem-solving will exhibit a quality of intellectual stimulation and is a transformational leadership behavior. Charismatic behavior is not seen in the transactional leader.
Which qualities of a leader indicate a transformational approach to leadership? Select all that apply.
Possessing charismatic behavior Possessing intellectually stimulating behavior Having inspirational and motivational behavior
Which qualities of a leader indicate a transformational approach to leadership? Select all that apply.
Possessing charismatic behavior Possessing intellectually stimulating behavior Having inspirational and motivational behavior The leader who has a transformational approach to leadership possesses charismatic behavior, intellectually stimulating behavior, and inspirational and motivational behavior. The transformational leader follows an inspirational and motivational approach. The leader who uses the transactional leadership approach has a punitive nature and gives rewards to followers contingently
Which action by the nurse constitutes constructive feedback for the delegatee?
Providing open feedback about specific strategies for change
the charge nurse delegates the task to the healthcare team to provide an IV medication to a group of people who were diagnosed with gastroenteritis due to food poisoning. Which healthcare team member is suitable to provide medication in this situation?
Registered Nurse
A client with dehydration is prescribed an intravenous (IV) fluid infusion. Which healthcare professional would the nurse expect to be delegated this task?
Registered nurse
The client is experiencing postoperative pain and requests a pain shot. Which of the following healthcare providers are legally permitted to administer an intramuscular (IM) injection to the client? Select all that apply.
Registered nurse (RN) Licensed practical nurse (LPN) Licensed vocational nurse (LVN)
Which constructive aspects of conflict does the nurse leader identify? Select all that apply.
Releases pent-up emotions Helps individuals grow personally Builds cohesiveness among people
A nurse encourages employees to implement a Magnet Recognition Program in the organization. The nurses think beyond their own personal needs and are clear about the group outcomes. Which leadership quality according to Gardner's tasks is reflected in the activity of the nurse?
Representing the group According to Gardner's Tasks of Leadership, encouraging employees to implement a Magnet Recognition Program shows that the nurse is representing the group. Trust develops when leaders are clear when providing direction and refrain from misdirecting others in their thinking and actions. The leader may serve as a symbol by becoming involved in public relations events, for example. The nurse as leader can achieve workable unity between and among parties by avoiding, diminishing, or resolving conflicts.
A group of clients who were in a bus accident is admitted to the emergency department with injuries. Which group is considered urgent according to the three-tier triage system?
Severe abdominal pain
The nurse leader and the team received recognition because of a follower on the team. What could be the most important action of the nurse leader?
Sharing the appreciation with the team
A nurse manager receives a complaint from a client that a particular staff member had been rude when providing care. The nurse, rather than punishing the staff member, listens to his or her side of the story and then talks to the client to clarify the misunderstanding. Which leadership theory is reflected in this scenario?
Situational-contingency theory
The student nurse is assisting the registered nurse (RN) in collecting feedback from superiors and peers. The questions they are asking address comments to the RN about his or her work quality that affects the environment and overall productivity. Which theory does the student nurse think the RN is applying practically as a leader?
Style theory Style theory measures the achievement of satisfactory performance. It requires supervisors to pursue an effective relationship with their followers. Therefore leaders need to obtain feedback from their followers, peers, and superiors. Trait theory involves the leader using self-awareness of his/her traits. It is useful in self-development as well as in seeking employment that matches the traits. Transformational theory includes a process in which the leader attends to the needs of the followers. This interaction raises the followers to higher levels of morality. Situational-contingency theory involves leaders considering the challenge of a situation
As a part of informed consent, a surgeon explains to the client who is scheduled for surgery the details of the surgery and the related care. The nurse as a leader witnesses the complete procedure. What information does the nurse leader ensure was provided to the client? Select all that apply.
Surgery procedures Name of the surgeon Description of the risks
Which delivery system was developed to provide care through others as an adaptation to functional nursing?
Team
The registered nurse, while teaching a group of nursing students about the characteristics of a good team player, states, "A good team player should work with determination and refuse to stop until the goal has been accomplished." Which characteristic is the registered nurse describing?
Tenacity
The nurse is making rounds and stops to check a client who has had a total hip arthroplasty. Which action by the unlicensed assistive personnel (UAP) ([continuing care assistant (CCA]) will cause the nurse to intervene?
The UAP (CCA) elevates the client's affected leg on a pillow.
Which critical factors would the nurse say are associated with situational-contingency theory? Select all that apply.
The ability of the leader to reward followers The degree of trust and respect between leaders and followers The task structure about goals and the complexity of the problems being faced Situational-contingency theory considers three factors to be critical. It includes the ability of the leader to reward followers in terms of power and position. It is also comprised of the degree of trust and respect between leaders and followers. The task structure about goals and the complexity of problems faced is a critical factor. Environmental demands and the personal characteristics of followers are contingent variables.
A client is concerned about not receiving treatment due to a Medicare policy change. What is the accurate response of a nurse as a leader?
The change will not affect your treatment. A nurse leader ensures the changes made by the federal government or organization will not cause harm or financial burden to the client. Therefore a nurse leader should support the client by saying that the changes will not affect treatment. Follow-up visits are based on the client's condition, not on the changes made on the insurance policies. Increased duration and decreased effectiveness of the treatment indicates harm to the client and will not be caused by a Medicare policy change.
An environment that is rapidly changing and dynamic "Quantum theory" lays its foundation on an environment that is rapidly changing. It does not focus on a single event. Hygienic factors in the environment are an aspect of the two-factor theory. The nurse leader, through the transformational theory, provides intellectual stimulation. An environment that develops trust between followers and leaders are aspects of the situational-contingency theory.
The chief operating officer (COO) discusses the performance of a newly appointed leader with the nursing staff. The team communicates that the practical approach of the leader fulfills the quantum theory. What type of work environment does the COO understand that the leader creates at the workplace?
Rehabilitation
The nurse manager orders the direct care nurse to assist in providing tertiary care to a client. Which type of treatment would the direct care nurse be involved in?
When facing trivial issues When the other person's solutions appear better When harmonious relationships have to be preserved Appropriate reasons for accommodating to resolve conflict include when the issues are trivial or not important, when the other person's ideas or solutions are better, or when harmonious relationships have to be preserved. Avoiding defensiveness is not an appropriate reason to accommodate when resolving conflict. Gathering more information is not an appropriate reason to accommodate when resolving conflicts, unless that additional information has shown that the nurse has made a mistake.
The nurse resolves a conflict with another nurse by using accommodation. In what situations is accommodation appropriate for resolving conflict? Select all that apply.
"it will identify medication errors." An electronic medication administration record will generate reports to track medication errors with the visibility of near misses. The electronic medication administration record will be accessible to multiple users. It will increase the accuracy of charge capture between administration time and the time when the drug is dispensed. It will improve the accuracy of pharmacokinetic monitoring.
The nursing leader is teaching the newly hired nurse about the use of an electronic medication administration record. Which statement of the newly hired nurse indicates effective learning?
The nurse leader has implemented a change in documentation of nursing care. The nurse leader finds that the licensed practitioner nurse (LPN) is resistant to change and is not participating in the change process. Which approach made by the nurse leader would be appropriate in dealing with the LPN?
To confront the LPN and encourage verbalization of feelings regarding the change
Which example would the nurse consider to be a part of systems thinking theory?
To focus on the needs of all residents in a long-term care facility
Which objective is associated with creating urgency in Kotter's eight-step model?
To generate open dialogue about external and internal realities The attribute of creating urgency is associated with generating open dialogue about external and internal realities. Short-term targets are created for creating short-term wins. Honoring the people who help complete the task anchors the changes in the culture. A culture created with continuous improvement builds on the change.
The nurse resolves a conflict with another nurse by using accommodation. In what situations is accommodation appropriate for resolving conflict? Select all that apply.
When facing trivial issues When the other person's solutions appear better When harmonious relationships have to be preserved
A registered nurse distributes a task to four healthcare professionals. When are both accountability and responsibility transferred to the healthcare professional?
When the task is given to another RN.
Modeling behavior Giving timely feedback Providing appropriate advice The mentor should model professional and desired behavior and give timely feedback and appropriate advice to make the aspiring leader an effective leader. The mentor should not criticize, but rather coach the new aspiring leader to develop a personal leadership style. Noting the mistakes without feedback does not help an aspiring leader become an effective leader.
Which actions can the mentor take to develop effective leadership qualities in the aspiring leader? Select all that apply.
Work individually The core competency of a nurse leader is to work in interdisciplinary teams, but not individually. Utilizing informatics, providing client centered care, and employing evidence-based practice are the core competencies of a nurse leader.
Which is excluded from the competencies of nurse leader?
Quantum theory Quantum theory states that leaders must embrace uncertainty and understand behaviors before changing them. Therefore quantum leaders represent change catalysts and innovators. Role theory is a collection of concepts that predict circumstances under which certain type behaviors are expected. Trait theory is a leadership theory in which leadership traits such as a certain set of physical and emotional characteristics are innate and cannot be learned. McGregor's Theory X describes the workforce motivation by assuming that people basically do not like their work and must be coerced by their manager to perform.
Which theory states that leaders act as change catalysts and innovators?
A nurse manager transfers the task of caring for a client who has undergone appendectomy to a RN. Which element of the healthcare system is the RN practicing?
assignment
the registered nurse is caring for a client with peptic ulcers and dysphagia. Which task does the RN exclude while delegating the care of a client with peptic ulcers and dysphagia to a UAP?
assisting the client in administering the medications
Which aspects are considered when determining the willingness of a nursing assistant before delegating a task? Select all that apply.
attitude confidence commitment
what is a high-level cognitive process that he nurse recognizes can be improved with practice in delegation?
critical thinking
Which characteristics of a licensed practical nurse should be considered before delegation of tasks? Select all that apply.
critical thinking diagnostic reasoning synthesizing info
which activity performed by the registered nurse (RN) indicates following the "Participating" leadership style in hersey's model?
establishing mutual expectations with the delegatee
Which skills would be essential for an effective nurse manager to develop and improve collaboration with others? Select all that apply.
flexibility ability to listen to others ability to share info and ideas
The hospital administration has recently introduced bar coding and radio frequency identification (RFID) scanning for reducing medication errors. After a few days, the scanner is giving false reports and the hospital management gathered all the staff members to discuss ways to solve this issue and find alternatives. What type of decision-making strategy does the nurse manger most likely think to be useful in this situation?
focus groups
what is an important consideration for delegation of care by the nurse when the delegatee has limited knowlege and ability to perform the task?
guidance
the registered nurse is assessing four members of the health care team before assigning a task. which person is best suited for delegation of the task?
has established relationship and espertise
A nurse leader is educating student nurses in helping clients to perform their difficult self-care activities. Which key idea from a Source of Power is this statement referring to?
information power
a client is on a nasogastric tube. which healthcare team member is suitable to provide medications to the client though the nasogastric tube?
licensed practical nurse
the registered nurse is caring for an older client who is admitted with gastric ulcer and joint pains and is unable to perform activities of daily life (ADL). The legal authority has stated, "provide the treatment according to the client's care sheet." which delegatee should take up the task?
licensed practical nurse
While caring for a client with a permanent disability, the delegator delegated a task to the UAP. What type of care is provided to this client?
long-term care
A client reported being administered the wrong dose of medication by the wrong route, which may lead to serious complications. The nurse leader is gathering information to determine what happened. Which phase of client care management is the nurse leader following?
preparation
which definition of delegation given by the nurse is correct?
process for the nurse to direct another person to perform nursing tasks and activities
Why does a nurse manager assign a resource person in a healthcare organization?
to serve as a mentor
a registered nurse is providing feedback to a delegatee after monitoring the work. which feedback is the best for shaping the future behavior of the delegatee?
you performed that proceedure safely and professionally
The nurse leader is teaching a student nurse about the modifications in the patient-focused care model. Which statement made by student nurse indicates ineffective learning?
"It requires a technician to provide client care."
What happens when a registered nurse does not trust other individuals in the healthcare organization? select all that apply
1 altered client care 2 compromised healthcare 3 limited career opportunity
which interventions are in the scope of a LPN?
1 ambulating the client 2 assisting the client with bathing 3 administering intramuscular medications
which questions related to decision making for delegation are appropriate according to the delegation right of "right circumstance"? select all that apply
1 are the equipment and resources available to complete the task? 2 does the delegatee have appropriate supervision to complete the task?
When does delegation become more challenging? select all that apply
1 when the client is stable 2 when school children are receiving care
The nurse leader is calculating the productive hours of the staff nurse for that year. The nurse took a vacation for 19 days. What are the productive hours of the staff nurse? Round your answer using a whole number. _____ hours
1928
Which healthcare professionals would the nurse say work under active delegation?
1LPN administering oral medications as delegated by the RN 2 unlicensed nursing practitioner maintaining oral hygiene of the clients as delegated by the RN
A nurse educator is giving a workshop on conflict. During the sessions, he makes various statements regarding conflict. All of the statements are true except: a. Conflict can decrease creativity, thus acting as a deterrent for the development of new ideas. b. Conflict can arise over the most trivial issues. c. A variety of definitions of conflict are known. d. All conflicts involve some level of disagreement.
A
Four nurse leaders are performing Gardner's tasks of leading and managing. Which nurse leader is implementing Gardner's task of managing?
A Gardner's task of managing involves assisting other executives and corporate leaders with planning, priority setting, decision making, and ensuing human and material resources are available to meet their health needs. Therefore nurse leader A is implementing Gardner's task of managing. Gardner's task of envisioning goals involves assisting staff in formulating their vision of enhanced clinical and organizational performance; this is being done by nurse leader B. Nurse leader C is implementing Gardner's task of motivating by inspiring clients and their families to achieve their visions. Nurse leader D is implementing Gardner's task of developing trust by sharing the organizational information with the team.
The nurse as a leader assists multidisciplinary leaders to achieve optimal functioning to benefit client care delivery. Which Gardner's task is the nurse applying?
Achieving workable unity
A preschool-aged child is about to be admitted to the pediatric intensive care unit after surgery for removal of a brain tumor. The nurse manager should intervene immediately when the child's nurse does what?
Adjusts the bed to the Trendelenburg position
Which task can be delegated to the licensed vocational nurse (LVN)? Select all that apply.
Administering oral hypoglycemic agents administering intramuscular injections
The nurse manager implements a change in the back care routine provided to bedridden clients to help prevent pressure ulcers. The nurse manager observes a decrease in the incidences of pressure ulcers in the unit and appreciates the efforts of the team members who implemented the change. Which step of Kotter's eight-step change model is reflected in this scenario?
Anchoring the changes in the culture
A nurse in charge in the surgical intensive care unit notes that a number of clients do not seem to be responding to morphine that was administered for pain. Later in the evening the nurse finds a staff nurse dozing in the nurses' lounge. When awakened, the staff nurse appears uncoordinated and drugged, with slurred speech. What should the nurse in charge do?
Ask the nurse manager to be present before confronting the staff nurse.
A nurse leader, along with the team, is caring for a client who is scheduled for colonoscopy. Which delegated task requires the leader's supervision?
Assisting the client with an enema
Why does the leader ask the direct care nurse, "Do you block cooperative efforts to resolve issues?"
Avoidance in conflict management style means that conflict is postponed. Often people do this when they have far more important issues pressing, when they have to gather more information, or when people need to cool down. Therefore the question asked by the leader to the direct care nurse, "Do you block cooperative efforts to resolve issues?," indicates that the direct care nurse may be using avoidance. Competing means perusing one's own needs and goals at the expense of others. When a direct care nurse uses competing, often the leader may ask "Are you surrounded by people who agree with you all the time and who avoid confronting you?" Negotiating is similar to trading, and if the direct care nurse practices this often, the leader may ask "Do you ignore large, important issues while trying to work out creative, practical compromises? Accommodation in conflict management style means neglecting our own needs, goals, and concerns in favor of satisfying those of others. With regular use of accommodation by a direct care nurse, the leader may ask "Do you think people are using you?"
The nurse administrator is aware that the 1984 death of a college student from a drug-drug interaction resulted in what standard of medical care? a. Computerized prescribing b. Time out required before beginning any surgery c. Limitation to the number of hours a resident in training may work d. Access to a rapid response team
C
which client care can be safely delegated to a UNP to provide oral hygiene?
Condition: dental caries
The nurse is instructing the student nurse how to administer percutaneous enterostomal gastrostomy (PEG) tube feeding to a client. What should the nurse tell the student? Select all that apply.
Connect tube feeding bag to client and feeding pump. Flush with warm water before beginning feeding. Check prescription for correct client formula. Set correct rate and initiate pump. Check for diarrhea
A nurse of a medical-surgical unite is planning to delegate tasks to an adult volunteer. Which of the following tasks should the charge nurse avoid assigning to the volunteer? a. deliver meal trays to clients in their rooms b. assisting a client who has difficult seeing the foods on the tray while eating c. delivering a routine urine specimen to the labratory d. observing a postoperative client who is confused
D
The nurse as a leader provides feedback to a recently recruited student nurse after checking performance reports that show a disregard for the Organizational Behavior Modification (OB Mod) theory. Which activity of a student nurse would the nurse leader mention during the feedback session?
Discussing the past mistakes of a subordinate
The registered nurse, as a leader, asks student nurses to think "outside the box." Which complexity principle is the nurse applying in this condition?
Focusing on emergence
The Case Management Society of America has identified the standards of practice for nursing case managers. What are the standards that provide effective care? Select all that apply.
Focusing on transitions of care Improving medication reconciliation Expanding the interdisciplinary team
The nurse leader is giving a speech on leadership skills to followers. Which questions enable the nurse leader to evaluate the understanding level of the followers? Select all that apply.
How can you solve a conflict at the workplace?" "What did you 'hear' in the process of this communication?
Which question related to quality of decisions would the nurse leader consider while assessing the degree of conflict resolution?
How creative are the resulting plans?
The RN is teaching a newly hired nurse about active delegation. Which statement made by the newly hired nurse indicates the need for further teaching?
I will instruct the LVN to administer IV medications
The nursing manager is preparing a schedule for delegating appropriate tasks to different health care team members. Which health care team member can be delegated the task of administering oral medications? Select all that apply.
Licensed practical nurse Licensed vocational nurse
A healthcare team is caring for a client who is hospitalized with severe diarrhea. According to the principle of right of supervision of delegation, what does the RN do in this situation?
Monitor the hemodynamic status.
The nurse leader asks the team members not to talk to each other while writing their ideas for solving a predefined problem. Which type of group decision-making style does the nurse leader follow?
Nominal group technique
A client with foot ulcers is admitted to the hospital. The nurse manager should delegate the task of maintaining hygiene to which staff members to maximize efficient use of human resources? Select all that apply.
Patient care associate (PCA) Unlicensed nursing practitioner (UNP)
Which activity performed by the LPN would be appropriate while caring for a client based on the principle of right task of delegation?
Performing the task based on institutional policies
A staff nurse states "I am sorry, I am responsible for the situation" while communicating to the nurse leader. Which communication pattern is the staff nurse using?
Placation Placation means to appease. By saying "I am sorry, I am responsible for the situation," the staff nurse is taking the blame. An irrelevant pattern is used when someone is trying avoid a situation or ignore his or her feelings. Congruence is used when matching inner feelings with words. While blaming others for any situation, attribution of blame is applied.
While reviewing the work of a team, the nurse observes a conflict among the members. How should the nurse build in consultation before and feedback after the negotiations in a conflict resolution?
Providing a forum for open discussion
According to chaos theory, what is the most important factor contributing to a successful organization?
Readiness to accept change
The RN assesses if a UAP new to the unit is capable of carrying out a task. Which principle of delegation does this illustrate?
Right person
The registered nurse tells a nursing student, "In the nursing model, the registered nurse is responsible for all aspects of care for one or more clients during a shift of care and the care can be delegated." Which disadvantage would be most likely related to this nursing model?
The continuity of care is a problem.
Creativity Experience Group process A situation with unpredictable results requires creativity, experience, and group process. Enthusiasm is an important quality of a follower but it would be a secondary factor to be considered in this situation. Independent decision making would not be appropriate to this situation. Rather, the leader should seek expert opinion and involve key stakeholders.
The leader encounters a situation where the nursing outcomes are unpredictable. Which attributes or approaches should the leader utilize to navigate this situation? Select all that apply.
Role conflict Role conflict is easier to recognize because the employees know what is expected from them, but they are either unwilling or unable to meet the requirements. Role theory provides an appreciable framework for the development and evaluation of staff. Role ambiguity in the workplace creates an environment for misunderstanding and hinders effective communication. Individuals do not have a clear understanding of what is expected of their performance or how they are evaluated. Role acquisition is enhanced by the use of clear position descriptions and evaluation standards.
The leader nurse noticed that a staff nurse is unable to meet the responsibilities assigned, though the staff nurse is aware of the working requirements. What is the staff nurse experiencing?
A nurse leader implements the nominal group technique while making decisions about a critical issue but is unable to find a proper solution. What could be the reason for the failure of technique?
The members are talking and discussing with one another while writing down their ideas.
A nurse manager agrees to mentor a newly recruited nurse who wishes to develop leadership qualities. Which statements hold true about this mentor relationship? Select all that apply.
The mentor should serve as a role model. The mentor should provide advice whenever necessary. The mentor should give appropriate feedback to promote improvement.
Maslow's theory Maslow's theory prioritizes the needs of the client and, if applying Maslow's theory, the nurse leader would provide for safety needs of the client first. Role theory is associated with an appreciable framework for the development and evaluation of staff. Complexity theory explains that change is an ongoing experience through which a system is adjusted. Situational leadership theory analyzes an individual's knowledge and the work-related task before delegation.
The nurse leader finds that a client with a severe vitamin B12 deficiency is extremely fatigued and tends to fall. Which theory does the student nurse think that the nurse leader would find appropriate for prioritizing the need of the client?
Veracity Veracity concerns telling the truth and demands involved, giving all the facts of a situation truthfully, and then assisting employees to make appropriate decisions. Justice is the principle of treating all persons equally and fairly and it often arises in times of short supplies for resources. Nonmaleficence states that one should do no harm. Respect for others acknowledges the right of individuals to make decisions and to live by these decisions. Test-Taking Tip: You have at least a 25 percent chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.
The nursing manger wants to transfer a nurse to the intensive care unit (ICU) and describes the roles and responsibilities of the position in detail to the nurse. After disclosing all details, the nurse manager inquires about the nurse's decision. Which type of principle is the nurse manger following?
Inspiring the student nurse to take active participation The leader should inspire and motivate his or her followers to complete the task successfully. Therefore inspiring the student nurse to participate actively in the program explores the leadership ability of the registered nurse (RN). Leaving the student nurse on his or her own to make a decision does not help the student nurse to grow in his or her profession. The leader should not demand his or her followers to do things as this does not indicate effective leadership ability. Reporting the student nurse to other higher level healthcare professionals does not indicate leadership ability. Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.
The registered nurse (RN) finds that a student nurse is unwilling to participate in a community health literacy program conducted for clients with diabetes mellitus . Which action of the RN portrays his or her leadership ability?
"A leader has a formal position." A leader does not necessarily have a formal position to indicate that he or she is a leader; rather, leadership refers to the performance. Leaders are those medical professionals who can intervene with courage when needed. Leaders are also able to organize a group of colleagues to solve an organizational problem. A nursing medical professional becomes a leader after promotion. Test-Taking Tip: Have confidence in your initial response to an item because it more than likely is the correct answer.
The registered nurse is teaching a group of nursing students about leadership principles. Which statement made by a nursing student indicates the need for further teaching?
The nurse manager assigned 5 visits per day to a home health nurse, but the weekly average of the home health nurse is 4.8 visits per day. What reason does the nurse manager expect is the cause for this discrepancy?
The time for one visit took twice the amount of time normally.
An organization having poor work flow was suffering financial losses. A team member introduced creative solutions that were publicly recognized by leadership. Which leadership theory is at work in this scenario?
Transformational theory
Expectancy theory Expectancy theory focuses on the motivations for good behavior. Good behavior is increased if a positive relationship exists between good performance and outcomes or rewards. Style theory focuses on pursuing effective relationships between the leader and subordinates while comprehending the factors in the work environment that influence outcomes. Two-factor theory promotes job enrichment by creating job satisfaction. Transformational leadership refers to a process whereby the leader attends to the needs and motives of followers so that the interaction raises each to high levels of motivation and morality. Test-Taking Tip: Use your knowledge and practical skills to eliminate the wrong options. Read each of the answer options carefully and eliminate the choices one by one. Incorrect options would sound confusing
Which leadership theory is being followed in a hospital if the nurse leader tells newly hired team members that they will be appreciated and rewarded if they perform well?
Recognition Achievement Recognition and achievement are motivating factors that transformational leaders use to inspire work performance. According to two-factor theory, organizations need both hygiene and motivator factors to recruit and retain staff. Salary, security, and working conditions are hygiene factors that should be in place for work to be accomplished.
Which motivator factors to inspire work performance are in accordance with the two-factor theory? Select all that apply.
Situational-contingency theories Situational-contingency theories, which are leadership theories, hold that leadership effectiveness depends on a leader's interpersonal skills. The hierarchy of needs explains that people are motivated first by physiological needs and safety, then by social and self-actualizing needs. Transformational leadership is a process through which the leader attends to the needs and motives of followers. OB modification theory says that the leader should use positive reinforcement to motivate followers and avoid situations that cause discomfort.
Which theory emphasizes that leadership effectiveness depends on the executive nurse's interpersonal skills?
A nurse leader has resolved a conflict within the team. Which further action of the nurse leader prevents the same conflict in the future?
Working with the team members after the conflict
Which component of delegation is retained while the delegator is delegating the client's care task to the nursing aide?
accountability
which component of delegation is defined as the ability to perform duties in a specific role?
authority
The nursing manager issued orders to take the utmost care of a client with myocardial infarction and expects the staff to obey and follow the rules immediately. Which type of decision making is the manager using?
autocratic
which nursing model includes a registered nurse paired with technical assistance?
co-primary nursing model
Which nursing professional has the maximum span of control?
nurse manager
the RN and unlicensed assistive personnel have been working together for two years. which statement made by the RN would be appropriate after delegating a task to the UAP?
you know what to do and when to report
The RN delegated a task to a licensed practical nurse. The LPN completed the task effectively. Which statement made by the RN is appropriate feedback?
you performed that procedure safely and professionally
A nurse is educating a patient about Maslow's hierarchy of needs by citing examples. Which examples mentioned by the nurse belong to the third level of needs? Select all that apply.
"A client is depressed because his/her spouse has passed away." "A client wants to reconnect with old friends after being diagnosed with cancer." "A client never goes to family gatherings because he/she is not accepted by family members."
Which statement made by a nurse indicates being an effective community opinion leader?
"I will try to build a society that treats males and females equally."
which aspects of organizations does the nurse consider during the decision-making process? select all that apply
1 laws 2 policies 3 standards
To work on the plan implemented by the primary nurse In the primary nursing model, the associate nurse has to take charge if the primary nurse is absent and should implement the plan according to the primary nurse's specifications. The associate nurse has no right to change a plan or to implement a new plan. Waiting for the primary nurse to implement the plan would not be appropriate. Soliciting the help of the primary care provider will not be appropriate in this situation because the associate nurse should work on the plan implemented by the primary nurse.
A client with cardiac failure is admitted to the hospital. The primary nurse is unable to attend to the client. The nurse leader appoints the associate nurse in providing care to the client. Which strategy does the associate nurse implement in providing care to the client?
The leader should provide specific feedback for positive performance The leader should elicit feedback from peers, followers, and higher authority Providing specific feedback for positive performance is an important aspect of expectancy theory, not situational-contingency theory. Obtaining feedback from the peers, followers, and higher management is central to style theory, not situational-contingency theory. The critical factors that should be present in an effective leader based on situational-contingency theory are presenting a task structure that has clarity of goals, developing trust and respect between leaders and followers, and providing rewards to followers for excellent work. STUDY TIP: Remember that intelligence plays a vital role in your ability to learn. However, being smart involves more than just intelligence. Being practical and applying common sense are also part of the learning experience.
A newly promoted nurse manager is studying the critical factors that are needed to be an effective leader according to situational-contingency theory. Which statement by the nurse manager indicates the need for further study? Select all that apply.
Explaining the reason behind the change Providing the opportunity for dialogue and feedback Giving information that addresses the listener's self-interest While communicating and explaining the rules of the hospital, listeners should be informed about the reason and values behind the changes. This may help them understand and reinforce the changes effectively. Opportunities for dialogue and feedback should be provided to analyze what was missed and which areas need improvement. Presenting the message in a manner that stimulates the self-interest of the listener may help in effective communication by better attracting the attention of the listener. The message for delivery should be strategically planned. Providing all or too much information can temporarily paralyze the listener and divert energy away from key responsibilities. The use of complex terms, concepts, or ideas may also prevent the learner from hearing the message and lead to ineffective communication. Test-Taking Tip: Be alert for details about what you are being asked to do. In this Question Type, you are asked to select all options that apply to a given situation or client. All options likely relate to the situation, but only some of the options may relate directly to the situation.
A nurse leader wants to communicate and explain changes to hospital rules to team members. Which approaches should the nurse leader follow for effective communication? Select all that apply.
Emphasizing the good qualities of the staff and giving positive direction for growth The principle of non-maleficence states that one should not do harm. Therefore the approach towards this while evaluating the performance of staff includes emphasizing the staff's good qualities and giving positive direction for growth. Fulfilling the commitment of promotion to a preceptor position within the unit is the principle of fidelity. Acknowledging the right of individuals to make decisions and to live by these decisions is respect for others. The principle of justice is used while deciding which staff members are to be promoted or recommended for development opportunities.
A nurse leader wants to implement the principle of non-maleficence while evaluating the staff. What is an effective way to perform this action?
Information power The information power of the nurse's colleague is being utilized to provide education to clients about use of glucose-monitoring devices. Position power is utilized when a person holds a position of authority within the organization. Reward power involves a person's ability to reward someone for desired actions or outcomes. Coercive power involves using fear to influence people.
A nurse working in a medical unit finds that diabetic clients have a knowledge deficit regarding use of glucose-monitoring devices. The nurse requests that a colleague who works in the outpatient diabetic counseling department provide health teaching to the clients. Which type of power does the nurse's colleague hold?
What is the most appropriate time for a nurse manager to schedule a 30-minute nursing education class?
At the overlap of each shift
What competency did the QSEN project add to the competencies set forth by the IOM 2003 report, Health Professions: A Bridge to Quality? a. Informatics b. Safety c. Teamwork and collaboration d. Evidence based practice
B
Which is the priority nursing action to include in a disaster plan for the radioactive dust and smoke that can cause illness from a radiologic dispersal device (RDD)?
Covering the nose
The nurse manager finds that there is an increased infection rate in the unit due to an increased number of client visitors. The nurse believes that a change in the visitor policy could help reduce the infection rates. The leader is initiating an open dialogue about external and internal realities among the team members. Which attribute of Kotter's eight-step model is involved in this action by the nurse manager?
Creating urgency
A key advantage that a nurse manager has in terms of delegating is that: a. clients receive less attention because too many staff make it difficult to coordinate care b. nurses report less pressure to perform necessary tasks themselves c. administration can predict overtime more accurately d. team skills can be used more effectively
D
To inspire followers The primary role of a leader is to inspire the followers by actively participating in the task along with the followers. It also involves changing the workplace to increase work satisfaction. The other roles of a leader are to provide training to the followers, to share views about the task with the followers, and to increase the feeling of self-worth in the followers. All these are reflected in the concept of transformational leadership.
During an interview for a nurse manager position, the panel asks the nurse about the primary role of a leader. Which answer provided by the nurse would be most appropriate?
A nurse working in a medical unit finds that diabetic clients have a knowledge deficit regarding use of glucose-monitoring devices. The nurse requests that a colleague who works in the outpatient diabetic counseling department provide health teaching to the clients. Which type of power does the nurse's colleague hold?
Information power
Which statement is true regarding the satisficing decision model?
It allows for a quick decision, which is important when lack of time is an issue.
While having a group discussion in a decision-making process, the leader has asked the team members to silently write down their ideas. The merits of each idea were discussed, and the best one was chosen based on highest ranking. Which strategy is involved in this scenario?
Nominal group technique The nominal group technique has group members silently provide written input into the decision-making process. Choosing the ideas based on highest ranking is done after discussing the merits of the ideas. This technique allows equal participation among members and minimizes the problem of dominance. The focus group strategy is used to identify problems or to evaluate the effects of an intervention during a face-to-face discussion but not through writing the ideas. The brainstorming strategy is applied during a decision-making process to generate innovative ideas in spite of having criticism from team members. The Delphi technique is used to achieve consensus among team members by reconsidering and judging the opinions.
The nursing manager said, "Nurse leaders must also be excellent change managers." Which statement supports this?
Nurse leaders will ensure that the disruption and chaos of change does not affect client care.
During a therapy group session, a female client begins to cry and tells the other group members that her husband has told her that he wants a divorce. What is the most appropriate initial response by the nurse?
Observing how the group responds to her statement
The nurse is attending a city commission meeting being held to discuss using a community park to build a museum. How should the nurse advocate as a community opinion leader to help maintain a health conscious society?
Oppose building the museum
Which team member is most accountable when delegating a task to the healthcare team?
RN
A nurse is precepting an orientee (newly hired nurse). The nurse observes the orientee caring for an unconscious client with increasing intracranial pressure. The nurse should question which intervention that the orientee performs?
Suctioning the oropharynx routinely
The nurse manager is teaching the nursing team about funds allocated to health departments for personal health services by local, state, and federal governments. Which statement made by a member of the team would indicate effective learning? Select all that apply.
The funds provide care for newborns." "The funds provide care for clients with tuberculosis." "The funds provide care for children with birth defects
Supporting the team Motivating the other nurse Using skills to expand social networks Supporting the team describes the interpersonal competence which is a characteristic of emotional intelligence of leadership. Motivating others promotes emotional self-control and using skills to expand social networks describe the handling of relationships. To follow the rules of organization and expertise in technical skills are the nursing professional aspects.
The registered nurse (RN) is evaluating the student nurse in the aspect of leadership qualities. Which behaviors of the student nurse express emotional intelligence in leadership? Select all that apply.
According to style theory of leadership, which is an action of a nurse leader?
Using feedback from superiors to measure own performance
The nurse is advising a client to carry a prescription of epinephrine autoinjector. Which insect bite or sting is responsible for the nurse providing this advice?
Wasp
Functional model The functional model of nursing is a method of providing client care by which each licensed and unlicensed staff member performs specific tasks for a large group of clients. Team nursing is a small group of licensed and unlicensed personnel, with a team leader, responsible for providing client care to a group of clients. Primary nursing is a model of client care delivery whereby one registered nurse functions autonomously as the client's main nurse throughout the entire hospital stay. Case management is a model of delivering client care based on client outcomes and cost containment.
Which model of nursing is focused on the task-oriented approach to client care?
Managing Managing is the Gardner leadership task that involves assisting the client with planning, priority setting, and decision making. Explaining involves teaching and interpreting information to promote functioning of the client and well-being. Developing trust involves keeping promises to clients and families and being honest in role performance. Envisioning goals involves envisioning client outcomes for client or families.
While serving as a leader, the nurse assists the client with planning, priority setting, and decision making. Which of Gardner's leadership tasks is the nurse putting into practice?
A nurse leader has resolved a conflict within the team. Which further action of the nurse leader prevents the same conflict in the future?
Working with the team members after the conflict The nurse leader should work with the team members or staff after resolving the conflict to learn from the situation and to prevent repetition of the conflict in the future. The nurse leader should teach the importance of unity within the team rather than punishing the responsible member. Separating the member responsible for the conflict does not prevent repetition of the conflict. The nurse leader should supervise the team but should not ask another person to do it.
Which activity performed by the registered nurse in a healthcare organization is considered active delegation?
a registered nurse directing an unlicensed nursing professional to perform certain task
after assigning a specific work to the unlicensed nursing professional, the registered nurse does a critical analysis of the work to be determine if the actions taken were appropriate and provides a detailed explanation of what occurred. Which action related to delegation is the nurse performing?
accountability
How can the lines of communication be improved in a healthcare organization during the process of delegation?
by appreciating and valuing each other's cultural perspectives
which healthcare team member is familiar with all the needs of any individual client?
charge nurse
which task can be delegated to a cross-trained technician when paired with a registered nurse?
drawing blood samples
A nurse leader is teaching about the functional model of nursing to a student nurse. Which statements made by the student nurse indicate effective learning? Select all that apply.
"I will focus on tasks and activities allotted to me." "I will coordinate the unlicensed personnel to provide care to a large group of clients."
The nurse leader is teaching the staff nurses about whistleblowing in the hospital organization. Which statement of the staff nurse indicates effective learning? Select all that apply.
"It is an act that protects federal workers." "I understand the consequences of action and inaction." "This is a warning issued by a current employee of an organization."
The registered nurse (RN) is delegating tasks to licensed practical nurses (LPNs) regarding client care. Which factors should be considered when delegating a task to the LPN? select all that apply
1 client condition 2 complexity of the task 3 predictability of outcomes
Which of the nurse's statements are true regarding delegation? select all that apply
1 delegation is a complex process 2 delegation improves client care outcomes when used effectively
A nurse is evaluating different situations related to Maslow's hierarchy of needs. Which situations come under the second level of needs? Select all that apply.
A client tells the nurse that he or she is taunted by his or her boss every day. A client tells the nurse that his or her spouse belongs to a criminal gang. A client tells the nurse that he or she lives beside a factory that manufactures harmful chemicals.
the nurse is caring for a client with severe menstrual bleeding and abdominal cramps. Which task is appropriate to be delegated to the licensed practical nurse?
Administration of oral analgesics
A nurse is a preceptor for an orientee (newly hired nurse). The orientee is providing postoperative care to a client who recently returned from a laryngoscopy. The orientee reminds the client not to eat or drink anything until instructed to do so. How does the preceptor evaluate the suitability of the instructions given to the client by the orientee?
Appropriate; oral intake after the procedure may result in aspiration
You overhear a newly graduated RN telling one of your colleagues that leadership and management belong to the unit manager and not to her. As a nursing colleague, your response demonstrates understanding that the perception of the new graduate: a. Is correct. Leadership is not the role of the staff nurse b. Would benefit from further understanding of her role as a professional, whose influence may affect the decision making of patients, colleagues, and other professionals. c. Has been influenced by nurse leaders and managers who leave for other positions. d. Is related to the general perception that nurse leaders and managers are not satisfied in their jobs.
B
While supervising the LPN's technique with medication administration, the nurse manager sees the LPN beginning to dispense an incorrect dose. How should the nurse manager respond initially?
By questioning the dosage in the hope that the LPN will identify the error
A student nurse is learning Gardner's Tasks of Leading and Managing. Which position of the health care team has the managing function of priority setting, according to Gardner?
Clinical position
Which theory related to leadership is a nontraditional theory that has emerged from the physical and social sciences?
Complexity theory
Which theory states that leaders should expand and respond to a dynamic change rather than prescribing and approaching change as a lock-step, pre-prescribed method?
Complexity theory
Which type of leadership theory explains the effectiveness of leadership and depends on the match between a leader's style and the demands of a situation?
Contingency Model
The RN enters the client's room and realizes the 9 moth old infant is not breathing. What interventions should the nurse implement? Prioritize the nurse's actions from first to last. a. open the child's airway b. perform cardiac compression 30:2 c. check the infant's brachial pulse d. administer 2 puffs to the infant e. determine unresponsiveness
E, A, D, C, B
A case manager telephones a client with lung disease to evaluate respiratory function with home oxygen use and then contacts the primary care provider. What is the purpose of this communication?
Evaluate expected outcomes
Which statement is true regarding leadership theories?
Expectancy theory states that leaders should provide specific feedback about positive performance.
Which question asked by a nurse leader establishes and maintains a human rapport with staff?
How are your children? Establishing interpersonal relationships and understanding each other's feelings by asking questions such as "how are your children" ensure establishing and maintaining human rapport. Questions such as "how is your daily work going?", "can you tell me some daily obstacles you run into?", and "do you support changes made by the organization?" indicate a professional relationship and do not indicate establishing of human rapport.
The registered nurse (RN) administers intravenous fluids to a client who was in a motorcycle accident. Which assessments made by the nurse would be appropriate based on the principle of right task of delegation?
Institutional policies of drug administration
What statements are related to a mentorship program organized by the nurse manager in a health organization? Select all that apply.
It expands the knowledge about cultural diversity. It involves selection of mentors who ascribe to transcultural values and beliefs. It should not make people of different cultures pattern their behavior after the prevailing culture.
When a bedridden client complains that he or she is thirsty, the nurse leader says, "I want to make you comfortable. Here is a glass of water, please take it." Which communication skill is the nurse leader using to make caring visible?
Making explicit her or his positive intent The nurse is making explicit her or his positive intent by explaining the purpose and by showing what he or she is doing in the client's best interest. Listening actively indicates acknowledging and reflecting back the person's feelings in a nonjudgmental way. Expressing appreciation refers to giving the personal gift of positive reward. Showing caring nonverbally can be done by using a facial expression, intonation, posture, eye contact, and body language to mirror the client's feelings. Test-Taking Tip: On a test day, eat a normal meal before going to school. If the test is late in the morning, take a high-powered snack with you to eat 20 minutes before the examination. The brain works best when it has the glucose necessary for cellular function.
A registered nurse (RN) in charge of a mental health unit has two additional staff members: a licensed practical nurse (LPN) and a nursing assistant (NA). The unit has 20 clients, with one client on constant observation for acute suicidality. What should the nurse in charge do when making the daily assignments?
Provide client care and administrative duties and assign the LPN to administer medications and the NA to maintain constant observation of the suicidal client.
The nurse manager threatens a staff nurse about being penalized for poor performance in the unit. Which type of leader behavior did the staff nurse experience?
Punitive Punitive behavior is experienced in transactional leadership; this occurs when the nurse manager aims at punishing the staff nurse by penalizing for poor performance. Charismatic behavior and intellectual stimulation are seen in transformational leadership. Laissez-faire behavior is the hands-off style in which the manager allows a high degree of autonomy and self rule.
A nurse manager asks for extra help from other nurses in the unit. In exchange, the nurse manager ensures special care for the parent of a staff nurse who is currently a client in the hospital. Which behavior does the nurse manager exhibit?
Quid pro quo
The registered nurse (RN) is evaluating the student nurse in the aspect of leadership qualities. Which behaviors of the student nurse express emotional intelligence in leadership? Select all that apply.
Supporting the team Motivating the other nurse Using skills to expand social network
The nurse manager is explaining how intramuscular (IM) injection techniques are an example of the theory of diversion of innovation. Which statement made by the nurse manger is accurate?
The use of IM injections for pain management has decreased with the use of intravenous and epidural routes.
Which principle of systems thinking theory involves the nurse focusing on the needs of all residents in a long-term care facility?
Thinking of the big picture
The RN is delegating to four unlicensed nursing personnel who are performing various delegated client care activities. Which UNP needs more education and monitoring?
UNP A; Client: DM; Activity: measuring blood glucose levels immediately after a meal
Providing self-care to enhance the ability to care for clients, families, staff, and the organization When the nurse as a leader provides self-care to enhance his or her ability to care for clients, families, staff, and the organization, it indicates Gardner's task of renewing in an executive position. Representing nursing and executive views openly and honestly indicates Gardner's task of developing trust. Assisting other organizational leaders in the expression of community and organizational values indicates Gardner's task of affirming values. When the nurse assists other executives and corporate leaders with planning, priority setting, and decision making, it indicates Gardner's task of managing.
Which behavior of the nurse as a leader indicates Gardner's task of renewing at an executive level?
The registered nurse is delegating tasks for nursing assistants caring for a client who requires more attention. Which element should be considered when selecting the suitable nursing assistant for delegation of a task?
critical thinking
While delegating a specific task, the registered nurse says to the delegatee, "it is important that you measure the client's blood pressure every 15 minutes." What does this situation indicate?
the delegator is providing more guidance.
after delegating the task of administering oral medications to a LPN, the RN ensures that the LPN is supervised until the task is accomplished. Which right of delegation does the scenario reflect?
the right cirucmstance
Which description by the nurse is a correct explanation of delegation?
the transfer of responsibility for the performance of an activity
The nurse leader is executing quality improvement (QI) processes in a team. Why are QI processes important?
they review the nursing activities
A nurse leader is educating student nurses in helping clients to perform their difficult self-care activities. Which key idea from a Source of Power is this statement referring to?
Information power Information power arises from one's possession of selected information that is needed by others. Information power is involved when a leader teaches student nurses to help clients in performing their difficult self-care activities. Position power is possessed by virtue of one's position within an organization or a group. Coercive power arises from fear of someone's real or perceived fear of another person. A referent power is involved when a student nurse is granted association with a powerful person.
A direct care nurse performs exceedingly well on a cancer project. As a result, the managerial team decides to promote the nurse to a managerial position. Which actions by the nurse would justify the decision of the panel? Select all that apply.
Inspiring new ideas Establishing short-term goals Demonstrating positive feelings Maximizing results from existing resources
In evaluating risks, what does the nurse understand is the responsibility of risk managers?
Involving perspectives from numerous disciplines Involving perspectives from numerous disciplines helps to discover underlying problems that a single discipline might miss. Risk managers should use multiple data sources, multiple data collection techniques, and multiple perspectives to collect and interpret data accurately. Both qualitative and quantitative data should be assessed and analyzed for implementing actionable plans to prevent adverse events.
The nurse leader mentors the staff on types of conflict. Which statement of the leader describes intrapersonal conflict?
It arises due to imbalances between the nurse's personal and professional priorities. Intrapersonal conflict arises due to imbalance between the nurse's personal and professional priorities. The conflict due to a difference in opinions with others causes interpersonal conflicts. Organizational conflicts arise from a discord between policies and procedures. Organizational conflict also arises from hierarchical structure and role differentiation among employees.
The nurse is relating to and inspiring the client who has a psychiatric disorder to achieve the client outcomes. Which of Gardner's leadership tasks is reflected in the nurse's actions?
Motivating When the nurse relates to and inspires the client with a psychiatric disorder to achieve the client outcomes, the nurse is motivating according to Gardner's leadership tasks. Gardner's leadership task of envisioning goals involves envisioning client's outcomes for single clients/families. Gardner's leadership task of serving as symbol involves representing the nursing profession and values and beliefs of the organization to clients and families and other community groups. Gardner's leadership task of achieving workable unity involves assisting clients and families in achieving optimal functioning to benefit the transition to enhanced health functions.
The nurse leader asks the team members not to talk to each other while writing their ideas for solving a predefined problem. Which type of group decision-making style does the nurse leader follow?
Nominal group technique In the nominal group technique, team members are asked to write their ideas for problem solving without talking to each other in order to avoid comments and elaboration of the ideas. Focus groups explore issues and generate information in identifying problems. The brainstorming method is used to generate a large volume of creative options. The Delphi technique involves collecting and summarizing opinions and judgments on a particular issue from respondents, such as expert panels, interviews, surveys, or questionnaires.
A client is admitted to the hospital with severe backache and chest discomfort. After reviewing the client's condition, there is a need for 24-hour client care by the registered nurse. Which healthcare professional is responsible for assigning the task to a registered nurse when 24-hour client care is needed?
Nurse manager
The nurse leader is monitoring a student nurse who is accessing various databases. Which search platform should the nurse leader suggest to access a variety of databases including Cumulative Index to Nursing and Allied Health Literature (CINAHL) and MEDLINE? Select all that apply.
OVID EBSCO
The nurse is caring for a client who underwent a hysterectomy and who is admitted to a general medical-surgical unit. Which tasks can be delegated to the unlicensed assistive personnel (UAP)? Select all that apply.
Oral hygeine; assistance with bathing
The nurse manager uses operant conditioning when managing the staff by providing positive reinforcement to motivate them to repeat constructive behavior. Which leadership theory is reflected in this practice?
Organizational behavior (OB) modification
Which behavior is an example of the nurse's role as an executive in the Gardner task of leadership?
Representing the organization and client care services on councils
Which action on the part of the nurse constitutes transactional leadership?
Rewarding the licensed practitioner nurse for high performance
A nurse educator is presenting information about the nursing process to a class of nursing students. What definition of the nursing process should be included in the presentation?
Sequence of steps used to meet the client's needs
Which model of ethics considers broad social issues and involves accountability to the overall institution?
Social justice model
what factors are most important for the nurse to consider when delegating responsibilities?
Staff member's level of education and expertise
The nurse as a leader is using a transactional leadership style. Which effect on followers often results from this style of leadership?
The followers will correct errors in a reactive manner. Transactional leadership depends on the power of the organizational position and the formal authority to reward or punish the employees. Transactional leadership often results in followers correcting errors in a reactive manner. Increased self-worth is a typical effect of transformational leadership on followers. Likewise, a transformational leadership style fosters a sense of being valued and a feeling that the work is challenging and meaningful.
Assisting clients to accomplish optimal functioning Assisting clients to accomplish optimal functioning is a behavior of Gardner's task of Achievable Work Unity. It is applied in practice to benefit the transition to enhanced health functions. Relating to and inspiring clients to achieve their vision and enhance health functions is the motivating task as described by Gardner. Providing self-care to improve the ability to care for staff, clients, and families is the renewing task as described by Gardner. Representing nursing and the unit in task forces and shared governance councils involves the executive position of Gardner's task of developing trust. Test-Taking Tip: Multiple-choice questions can be challenging because students think that they will recognize the right answer when they see it or that the right answer will somehow stand out from the other choices. This is a dangerous misconception. The more carefully the question is constructed, the more each of the choices will seem like the correct response.
The leader has planned to assist staff in order to achieve workplace unity. Which of Gardner's tasks would the leader apply in practice?
The registered nurse is evaluating a group of student nurses after teaching how leaders should maintain balance. Which statement by a student nurse indicates effective learning?
"A good strategy for retaining control is to get control over communication."
During an interview for the position of manager in the healthcare industry, the candidate is asked about the important qualities of a successful manager. Which responses would be appropriate? Select all that apply.
"A successful manager should take risks." "A successful manager should tolerate uncertainty." "A successful manager should experiment with ideas for a unique situation."
A nurse leader honors the team members who use new equipment effectively and ensure clients' safety. Which step of Kotter's eight-step change model does a nurse implement in this situation?
"Anchor the changes in the culture"
A client with rheumatoid arthritis calls the outpatient clinic to report that pain with exercising has increased. What should the nurse suggest to the client to decrease pain?
"Decrease the number of repetitions of the exercises."
A nurse with burnout asks the nurse manager, "What can I do to prevent burnout in the future?" What is the best response by the nurse manager?
"Develop a wide variety of coping strategies."
During a feedback session, the nursing staff communicates that a recently appointed nurse is using "empowerment theory." Which statement of the nursing team members most supports this position? Select all that apply.
"He/she can share power with others." "He/she encourages others to provide input into decisions." "He/she provides considerable information about the decision-making process."
Which statement made by the nurse leader would satisfy the basic expectations of the client?
"I will return at 5 o'clock pm."
During a group meeting a client tells everyone, "I'm about to be discharged from the hospital, and I'm afraid." What is the most appropriate response by the nurse facilitator?
"Maybe others in the group have similar feelings that they would share."
The leader is teaching a nursing student about systems theory. Which statement by the student nurse indicates the need for further teaching? Select all that apply.
"Systems theory accounts for unpredictability." "Systems theory focuses on the effect of random events."
The leader is teaching a nursing student about systems theory. Which statement by the student nurse indicates the need for further teaching? Select all that apply.
"Systems theory accounts for unpredictability." "Systems theory focuses on the effect of random events." Systems theory tends not to account for unpredictability and random events. In contrast, chaos theory focuses on unpredictability and random events. Systems theory involves open as well as closed systems. It is viewed as inputs, throughputs, and outputs. A system theory involves a system that consists of structure, technology, people, and environment.
The registered nurse (RN) and unlicensed assistive personnel (UAP) have been working together for two years. Which statement made by the RN would be appropriate after delegating a task to the UAP?
"You know what to do and when to report"
Which description by the nurse is a correct explanation of delegation?
***not accountability*** The transfer of responsibility for the performance of an activity
Which delegation actions may be performed by unlicensed nursing personnel while caring for a client? select all that apply
1 asking the client to wash the hands before meals 2 instructing the client to wear footwear while walking
The UNP is delegate tasks related to client care. What is the correct order of steps the RN should follow when diciding to delegate the work to the UNP?
1 assessing the client's health status 2 determining the knowledge and skills of the UNP 3 assigning the client-specific tasks to the UNP 4 monitoring the assignments allotted to the UNP 5 Reporting deviations in the client's response 6 providing feedback about the UNP performance
the registered nurse (rn) assigns a task to a licensed practical nurse (LPN) to take care of a client admitted with severe burns. Which task are being performed by the LPN in this situation? select all that apply
1 monitoring the heart rate 2 monitoring the blood pressure 3 administering the oral medication
The nurse is caring for a client who underwent a hysterectomy and who is admitted to a general medical-surgical unit. which tasks can be delegated to the unlicensed assistive personnel? select all that apply
1 oral hygiene 2 assistance with bathing
The nurse manager is planning to delegate tasks to UAPs. What care can be delegated on a medical-surgical unit to a UAP? select all that apply
1 performing a bed bath for a client on bed rest 2 assisting a client who has patient'controlled analgesia (PCA) to the bathroom
The client is experiencing postoperative pain and requests a pain shot. Which of the following healthcare providers are legally permitted to administer an IM injection to the client? select all that apply
1 rn 2 LPN 3 LVN
a nursing supervisor sends an unlicensed healthcare worker to help relieve the burden of care on a short-staffed medical-surgical unit. Which tasks can be delegated to the health care worker? Select all that apply
1 taking routine vital signs 2 answering clients' call lights 3 changing linens on an occupied bed
A nurse manager notices that Nathan, an RN who has been on the unit for approximately 3 years, has a particular interest in technology and seems to be very enthused about working with software and hardware at home. She speaks with Nathan and asks him if he would lead investigation of software applications on the unit. This is an example of: a. Opportunity. b. Delegation. c. Role negotiation. d. Role transition.
A
During staff meetings, you make it a regular practice to encourage shared problem solving and to recognize those who go beyond basic roles and responsibilities to contribute to a positive team environment and to quality patient care. This practice exemplifies: a. Values-based management. b. Shaping of workplace behavior. c. Cooperation and collaboration. d. Recognition of institutional priorities.
A
The nurse leader is observing a new graduate registered nurse and knows that which error would be considered an error of commission? a. The nurse contaminated the IV Cathlon by touching the skin but continued the procedure and inserted it into the patient's forearm. b. The nurse was taking care of a patient who went to radiology for an x-ray. Upon the patient's return, the nurse forgot to administer the patient's medications c. The nurse is caring for a patient who is scheduled to be ambulated three times a day and neglects to walk the patient at all during the shift d. The nurse received an order to change the patient's diet from clear liquid to NPO and forgot to enter the change. The patient ate a liquid meal and surgery had to be delayed until the next morning
A
The nurse manager is working to establish a culture of safety and knows that which element is the most important factor to its establishment? a. No punishment is involved for reporting. b. Policies are easily accessible. c. All policies are communicated to all staff. d. The policy is begun on all units at the same time.
A
Four nurse leaders are performing Gardner's tasks. Which nurse leader is implementing Gardner's task of "serving as symbol"?
A Gardner's task of "serving as symbol" includes the representation of the nursing profession, values, and beliefs of the organization to clients, their families, and other community groups. Therefore nurse leader A implements Gardner's task of "serving as symbol." Being honest and keeping promises to clients and families in the nursing profession indicates the implementation of Gardner's task of "developing trust" by nurse leader B. Nurse leader C implements Gardner's task of "managing" by assisting clients and their families with planning, priority setting, and decision making. Nurse leader D implements Gardner's task of "managing" by ensuring that the organizational systems work on the client's behalf.
A nurse manager is helping staff reach optimal functioning to enhance organizational functions. Which Gardner's task is reflected in this leadership behavior?
Achieving workable unity Achieving workable unity is one of Gardner's tasks for leading and managing. Nurse managers should help staff reach optimal functioning to enhance organizational functions. Nurse managers enact motivation by relating to and inspiring staff to achieve the mission of the organization and the associated vision. Affirming values is involved in assisting the staff in explaining organizational values and strengthening staff members to be more attuned to the organization. Envisioning goals involves creating a vision of how systems support client care objectives and assisting in enhancing the vision of clinical and organization performance.
A nurse is helping a client determine and articulate personal values about health problems. The nurse also explains the effect of these problems on lifestyle adjustments. Which Gardner's task of leadership is the nurse leader applying?
Affirming values Values are the connecting thoughts and inner driving forces that give purpose, direction, and precedence to life priorities. According to the Gardner's tasks of leadership, helping the client sort out and articulate personal values that are related to health problems is affirming values. It also involves explaining the effect of these problems on lifestyle adjustments. Explaining includes teaching and interpreting information to promote well-being in the client. Managing involves assisting the client with planning, priority setting, and decision making. This also includes ensuring that organizational systems work on behalf of the client. Motivating includes inspiring clients or family members to achieve their vision.
The nurse observes a dispute between staff members due to differences in perspective concerning nursing practices. Which approaches of the nurse as a leader would be appropriate in building up negotiation "loop-backs" to resolve the conflict? Select all that apply.
Allowing a cooling-off period if the resolution fails Informing of the full consequences of failing to resolve the issues The principal of conflict resolution through building in the "loop-backs" to negotiation includes a cooling-off period after the failure of a resolution. It also includes reviewing the possible consequences to the members for not resolving the issues. For building in consultation before and after the negotiations, an open forum for discussion is provided. The open forum also includes the use of political skills for facilitating communication before confrontation.
A nurse manager in a cancer care facility finds that the nursing care team is demotivated due to consecutive deaths of two terminally ill cancer clients. Which action of the nurse manager would help renew the team's energy?
Arranging a notice board in the unit and posting photos or messages reflecting achievements of the team A good leader keeps the team's spirits high by helping them renew their energy levels. The nurse manager may post motivating messages or photos on the notice board to motivate the team members. Counseling the team members may not help in motivating them as there could be further similar incidences in the unit. Shifting the team to another nursing unit with less likelihood of deaths may make the team members emotionally weak. The reason for the team members to be low in energy is unlikely to be their emotional attachment to the clients; keeping them emotionally detached may not help motivate them for client care.
Which delegation actions may be performed by unlicensed nursing personnel while caring for a client? Select all that apply.
Asking the client to wash hands before meals Instructing the client to wear footwear while walking
The leader has planned to assist staff in order to achieve workplace unity. Which of Gardner's tasks would the leader apply in practice?
Assisting clients to accomplish optimal functioning
Which behavior of the nurse indicates management skills according to Gardner's task of achieving workable unity?
Assisting staff to achieve optimal functioning to benefit the transition to enhanced organizational functions
Which behavior of the registered nurse would be appropriate for a management position according to Gardner's tasks of leading/managing?
Assisting the staff to interpret organizational values
A nurse manager is informed that a community disaster drill will take place. The disaster scenario will include a bombing in a shopping mall with hundreds of casualties. What location should the nurse consider for triage of casualties when planning for this exercise?
At the scene of the disaster
The nurse leader is promoted to nurse manager and has a plan of implementing an effective client counseling center in the outpatient department. The nurse gathers data from different healthcare providers and compares methods. Which type of quality improvement does the nurse implement?
Benchmarking Benchmarking is a process of conducting a widespread search to identify the best method, which helps to identify desired standards of quality performance. Risk management involves analyzing problems and minimizing losses after an occurrence of an adverse event. Quality management refers to a philosophy that defines a healthcare culture emphasizing customer satisfaction, innovation, and employee involvement. Performance improvement involves individual performance appraisal.
Ms. Bonner is caring for clients on the burn unit. After the shift report which client should Ms. Bonner assess first? The client with full and deep partial-thickness burns who has pain rated 8 on a 1 to 10 pain scale. a. The client with full and deep partial-thickness burns who has pain rated 8 on a 1 to 10 pain scale. b. The client with full-thickness burns who has a urinary output of 120 ml in the past 8 hours. c. The client with full thickness burns on the chest who is having trouble breathing. d. The client who has full-thickness burns to the right leg with no palpable pedal pulse.
C
The nurse is learning about the rules of leaders. Which actions of the nurse indicate effective implementation of these rules in the profession? Select all that apply.
Communicating in a simple language with followers Giving a chance to the followers to express their views Ensuring proper eye contact while communicating with followers
The hospital management is planning a study that compares the benefits and harms of a particular method to the benefits and harms of alternative methods when treating clients with chronic disorders. Which approach does the nurse manager follow to improve client care?
Comparative effectiveness research (CER)
The registered nurse is interviewing for a management position and wants to present a powerful image. What can the nurse focus on when preparing for the interview? Select all that apply.
Conveying positive body language Appearing well groomed and well dressed Showing confidence in work and abilities
The RN is utilizing the QSEN competencies to ensure quality care for patients on a busy surgical unit. Which element of the QSEN competency of teamwork and collaboration is essential to ensure implementation? a. Time management b. Assessment of group dynamics c. conflict resolution d. care coordination
D
The RN must delegate care of an assigned client to a CNA for the shift. Which client would be best to delegate to the CNA? a. a client who would benefit from talking about the recent death of her husband b. a client with a urinary drainage catheter and nasogastric tube feedings who is on bedrest c. a client with an ostomy who has persistent problems with leakage d. a client who was transferred from the CCU 3 days ago and is ambulatory
D
What are the three strategies that the nurse can perform while assisting other nurses in making delegation decisions? Select all that apply.
Doing Asking Offering
Which statement best describes a fundamental aspect of the clinical nurse leader (CNL)?
Evaluates care for evidence-based approaches
Which nursing actions indicate effective implementation of systems thinking theory principle with respect to "thinking of the Big Picture"? Select all that apply.
Focusing on the needs of all the residents in a long-term care facility Knowing about the complications of emergency department overcrowding in an urban setting
The chief operating officer conducts an interview for the position of nurse leader and asks about Kotter's eight-step model. Which attribute cited by the nurse relating to helping build the momentum is correct?
Forming a powerful coalition
The nurse manager noticed that one of the staff nurses is giving excuses for performing one task on time but ignoring another assigned task. What does the nurse manager do in this situation?
Identify the reason for procrastination.
The nurse manager noticed that one of the staff nurses is giving excuses for performing one task on time but ignoring another assigned task. What does the nurse manager do in this situation?
Identify the reason for procrastination. Sometimes nurses procrastinate, so the nurse manager should identify the reason for this behavior and provide the solution to break the task down into manageable pieces so that they can finish the task in time. The nurse manager should not recommend not performing the task, but instead should motivate the nurse to complete the work assigned. Planning to reward the nurse for accomplishing each of the smaller tasks is beneficial; he should not punished. Another technique for this situation is to advise the nurse to select the least attractive element of the task to do first, so that the rest will seem easy.
What would the nurse describe as "leadership" in nursing practice?
The use of individual traits to interpret the environment in an emerging situation to execute a plan Leadership is defined as the use of abilities and traits by an individual to interpret the environment in an emerging situation to execute a defined plan. In followership, each member contributes optimally and follows a peer who leads in the setting. The ability to plan, direct, control, and evaluate other members in situations with a pre-established outcome is management. Collaboration is the transfer of responsibility for the performance of a task while retaining the accountability for the outcome.
After assessing the behavior of team members, the nurse leader concludes that the team is ineffective. Which activities by the team members might have led to this conclusion? Select all that apply.
They are unclear about their assignments. They are uncomfortable with disagreement. They frequently use formal voting to make decisions
The postpartum nurse is delegating tasks to an unlicensed health care worker. Which task should the nurse delegate?
Vital signs on a client 4 hours after delivery
A nurse is conducting a health campaign in a school. During the health campaign, the nurse finds that the school management has replaced the registered nurse (RN) with a trained clerk. What should the nurse, as a community opinion leader, do?
Write a letter to a local newspaper editor opposing the decision of the school board
when assigning a task, the delegator should understand the delegatee's personal values and align them with the organizational values. Which task can be achieved from this delegation?
affirming
Who would the registered nurse state is accountable for establishing systems to communicate competency requirements related to delegation?
chief nursing officer (CNO)
Which initiatives for leaders and managers are set forth in the Institute of Medicine's core relevance report "The Future of Nursing?" Select all that apply.
create state coalitions focused on nursing provide a framework for considering how nurses could determine staffing requirements
Which type of performance appraisal method is depicted when a nurse manager keeps a written record of positive and negative performance of employees in a designated time period?
critical incident model
The nurse leader is teaching the staff that the health care provider continuously strives to work effectively within the cultural context of a client. Which cultural principle is the nurse leader explaining?
cultural competence
Which transformational leadership practices are involved when a leader empowers people and offers praise for the work done by one of the team members? Select all that apply.
enabling encouraging
An obese client leads a sedentary lifestyle and complains of leg pain when walking long distances. A nurse leader is teaching the client different exercises that can relieve the pain and can be performed while working in an office or doing daily activities. Which of Gardner's leadership tasks is the leader nurse following?
explaining
The registered nurse, as a transformational leader, is assigning a task to a practitioner nurse. Which effects on the follower does the nurse expect from transformational leadership? Select all that apply.
increasing self worth coaching and mentoring performing challenging and meaningful work
A registered nurse who has limited clinical experience must delegate in collaboration with an nursing assistant. Which communication method used by the registered nurse while supervising may affect the working performance of the nursing assistant?
occasionally offering derogatory comments
A staff nurse states "I am sorry, I am responsible for the situation" while communicating to the nurse leader. Which communication pattern is the staff nurse using?
placation
the registered nurse delegates the task of caring for a client with a leg fracture to a lpn and asks the lpn to alert her if any issues arise. What approach is the RN taking as delegator in this instance?
providing little guidance
The nurse manager threatens a staff nurse about being penalized for poor performance in the unit. Which type of leader behavior did the staff nurse experience?
punitive
A healthcare provider writes prescriptions for a young child with a tentative diagnosis of Wilms tumor. Which prescription should the nurse question?
renal biposy
the registered nurse assigns a task to a newly hired licensed practical nurse (LPN) to monitor a client's blood pressure. Which is relevant to the delegator in this situation?
requires more guidance
what is the main motto of the Hershey's 2006 model?
situational leadership
the RN oversees five UNP and each UNP cares for five clients, so the RN in effect has resposibility for five UNPs and 25 clients. What do these numbers of subordinate and clients indicate?
span of control
after assigning a task, the delegator makes sure that the instructions are clear to provide feedback related to the task. Which delegation right is referred in this situation?
supervision
During an interview for a nurse manager position, the panel asks the nurse about the primary role of a leader. Which answer provided by the nurse would be most appropriate?
to inspire followers
During a peer review, the manager finds that a newly appointed nurse leader encourages "bottom up" interaction among the workers. To which statement of the staff does the manager relate this?
"He/she involves us in shaping policies for client care."
Several individuals who sustained urgent but nonemergent injuries are seated in the emergency department when an ambulance arrives with a client suspected of having a myocardial infarction. The nurse must explain to the waiting clients that they will have to wait longer for care. Which is the best explanation for the nurse to give?
"I know you have been waiting, but a client's life depends on immediate treatment. You will receive the same attention when you are seen."
A registered nurse as a leader is teaching novice leadership skills to a newly appointed leader. Which statements made by the new leader indicate effective learning? Select all that apply.
"I should resolve conflict." "I should deal with difficult people." "I should learn how to work in groups. Novice leadership skills include resolving conflict, dealing with difficult people, and learning how to work in groups. These skills contribute to future leadership success and can create skills that lead to some expertise. Ensuring that operations run smoothly is a skill of a manager. A manager will ensure that well-developed formulas are applied to situations.
A nurse leader is teaching the nursing staff about preparing objectives. Which statements by a member of the nursing staff indicate effective learning? Select all that apply.
"I will specify the target to be achieved." "I will not include unrealistic and unattainable goals." "I will provide the level of accomplishment for the end result."
During the second group meeting of regressed long-term clients, one of the members asks the nurse, "What do you want us to do today?" What is best response by the nurse?
"It is the group's responsibility, which includes me, to make that decision together."
The nurse organizes a meeting of health care team members after finding no improvement in the condition of a client recovering from major surgery. Which statement made by the nurse during the discussion signifies transformational leadership?
"My active participation will also be required moving forward."
The registered nurse is teaching a group of student nurses about the role of the nurse as a leader. Which statement by a student nurse indicates effective learning
"The goal of the nurse manager is to develop a shared vision of the future with direct care nurses." The goal of a nurse manager as a leader is to develop a shared vision of the future with direct care nurses. The nurse manager ensures that the day-to-day elements of the workplace are being performed correctly. The nurse executive has a plan for identification of charge nurses and should be aware of information on succession planning. The primary goal of the nurse executive is leadership within the workplace.
The nurse manager is teaching the licensed practical nurse (LPN), the evidenced-based practice regarding the use of saline and the low-dose heparin flush solution for capped angiocatheters. Which statement by the LPN indicates they understood the teaching? Select all that apply.
"The use of heparin flushes disappeared in the late 1990s." "The use of high doses of heparin solutions is not recommended in adults."
During an interview for a nurse manager position, the panel asks the nurse about the primary role of a leader. Which answer provided by the nurse would be most appropriate?
"To inspire followers" The primary role of a leader is to inspire the followers by actively participating in the task along with the followers. It also involves changing the workplace to increase work satisfaction. The other roles of a leader are to provide training to the followers, to share views about the task with the followers, and to increase the feeling of self-worth in the followers. All these are reflected in the concept of transformational leadership
A nurse leader is planning to improve the quality of the team members. What should the nursing leader refrain from suggesting when building an effective team?
"You should establish a formal and regimented work environment."
A registered nurse teaches a student nurse about delegation. Which statement made by the student nurse indicates appropriate learning?
"licensed practical nurses can be expected to perform tasks with which they have experience.
While caring for a client with asthma, the delegator assigns the client to a RN and to a LPN. which component of delegation is transferable to the RN? select all that apply
1 autority 2 responsibility 3 accountability
Which questions should the delegator assess to determine the right task? select all that apply
1 is the task legally appropriate to delegate? 2 is the task appropriate to delegate based on institutional policies and procedures?
Which statement is correct regarding delegation? Select all that apply
1 it involves transfer of authority 2 the delegator retains accountability for the outcome 3 principles of delegation outline what nurses need to know about the task
What would the nurse describe as the challenges of delegation?
1 limited resources 2 larger geographical area 3 care for vulnerable populations
The nurse leader is teaching about the role of followers to the nursing staff. Which statement made by the nursing staff is true regarding the followers' traits? Select all that apply.
A follower demonstrates collaborative behavior in daily practice. A follower cooperates with the leader and peers to reach the team goal. A follower demonstrates collaborative and cooperative behavior with staff, to help reach the team goals. Enforcing the policy mandates or contracts and maximizing the results from existing resources are the responsibilities of a manager. Demonstrating a positive feeling at the workplace is the duty of a leader.
The members are talking and discussing with one another while writing down their ideas As per the nominal group technique, members are asked not to talk and discuss anything while writing down their ideas. This may be because a period of silence may lead to the generation of ideas. If a member "passes" because of exhausting his or her list of ideas, this can be an effective way to help make decisions. When ranking options, this gives everyone the chance to choose what they think is a priority. The option that receives the highest ranking by the majority is chosen as the solution. If members are asked to share ideas by displaying them on a flip chart, it avoids comments and elaboration during this phase. Test-Taking Tip: Choose the best answer for questions asking for a single answer. More than one answer may be correct, but one answer may contain more information or more important information than another answer.
A nurse leader implements the nominal group technique while making decisions about a critical issue but is unable to find a proper solution. What could be the reason for the failure of technique?
The nurse executive is seeking to improve client care by helping multidisciplinary leaders achieve optimal functioning. Which behavior related to Gardner's tasks of leading is the executive exhibiting?
Achieving workable unity The leader in an executive position helps multidisciplinary leaders achieve optimal functioning by applying Gardner's task of achieving workable unity. Managing involves helping other executives and corporate leaders with planning, priority setting, and decision making. Affirming values involves helping other organizational leaders in the expression of community and organizational values. Developing trust involves assisting and representing nursing and executive views openly and honestly.
Setting program priorities Capital budgeting Developing cash budget negotiating and revising analysis of variance The first step in the budgeting process is gathering information and planning, which includes setting priorities for programs. The second step is developing units and departmental budgets, including capital budgeting. The third step is developing cash budgets to know the actual cost of the programs that are included. The fourth step is negotiating and revising, which is very important to present a standard budget that should be acceptable. Evaluating is the final step, which includes analysis of variance, after which the critical performance reports are generated.
Arrange the following steps of the budgeting process performance in chronological order.
The nurse manager is conducting an investigation into a series of patient falls that have occurred on the nursing unit in the past 3 weeks. While investigating the issue, the nurse manager identified a number of factors that may have influenced the problem and knows that which one would be classified as a human factor? a. The unit does not have an adequate number of gait belts available to the staff. b. Two unit staff members have been on extended sick leave. c. Bedside rounding has been sporadic. d. The charge nurse is new to the position.
B
What theme do most definitions of critical thinking have in common? a. creativity is at the heart of critical thinking b. most critical thinking methods are both systematic and logical in nature c. critical thinking is best conducted by a single person d. when using critical thinking, it is important to find new data to investigate
B
When planning delegation of tasks to assistive personnel (AP), a nurse considers the five rights of delegation. Which of the following should the nurse consider when using one of the five rights of delegation? a. The AP's ability to prioritize b. The AP has the knowledge and skill to perform the task c. The AP's rapport with clients d. The AP's ability to complete the task without assistance
B
While having a group discussion in an organization, one of the team members criticizes an idea of another team member. Which strategy should the leader apply to resolve the issue?
Brainstorming Brainstorming can be an effective method of generating a large volume of creative and innovative ideas. The leader should apply this strategy to encourage ideas of all the team members, irrespective of any criticism, to resolve the issue. The purpose of focus group strategy is to explore issues, identify problems, and generate information. Delphi technique is a decision-making strategy that involves systematically collecting and summarizing opinions and judgments on a particular issue from followers. Nominal group technique strategy allows group members the opportunity to provide input into the decision-making process.
The mental health nurse is facilitating a therapy group. How can the nurse further develop trust among the members of the group?
By reminding group members about the need for confidentiality within the group
The hospital management is planning a study that compares the benefits and harms of a particular method to the benefits and harms of alternative methods when treating clients with chronic disorders. Which approach does the nurse manager follow to improve client care?
Comparative effectiveness research (CER) CER is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care. Diffusion of innovations describes how innovations spread through society in different stages of decision, implementation and confirmation. PBE is a research methodology that helps inform practice decisions by examining outcomes in the real world. In PAR, the members of the community being studied are integral members of the research team and are involved in identifying the questions and addressing the issues in the research project.
A nurse leader of a state nurse's association (SNA) is advising legislators regarding health policy improvements. Which key idea is involved in this type of leadership power?
Expert power
A direct care nurse performs exceedingly well on a cancer project. As a result, the managerial team decides to promote the nurse to a managerial position. Which actions by the nurse would justify the decision of the panel? Select all that apply.
Inspiring new ideas Establishing short-term goals Demonstrating positive feelings Maximizing results from existing resources
A direct care nurse performs exceedingly well on a cancer project. As a result, the managerial team decides to promote the nurse to a managerial position. Which actions by the nurse would justify the decision of the panel? Select all that apply.
Inspiring new ideas Establishing short-term goals Demonstrating positive feelings Maximizing results from existing resources The leader provides new ideas with a long-term effect on the progress of the organization. He/she should also provide a positive atmosphere by giving an equal importance to the followers. Providing short-term goals and maximizing results from existing resources are the job responsibilities of a manager. The willingness to lead and follow peers is the quality of a good follower.
When a bedridden client complains that he or she is thirsty, the nurse leader says, "I want to make you comfortable. Here is a glass of water, please take it." Which communication skill is the nurse leader using to make caring visible?
Making explicit her or his positive intent
The nurse leader finds that a client with a severe vitamin B12 deficiency is extremely fatigued and tends to fall. Which theory does the student nurse think that the nurse leader would find appropriate for prioritizing the need of the client?
Maslow's theory Maslow's theory prioritizes the needs of the client and, if applying Maslow's theory, the nurse leader would provide for safety needs of the client first. Role theory is associated with an appreciable framework for the development and evaluation of staff. Complexity theory explains that change is an ongoing experience through which a system is adjusted. Situational leadership theory analyzes an individual's knowledge and the work-related task before delegation.
A nurse manager receives a complaint from a client that a particular staff member had been rude when providing care. The nurse, rather than punishing the staff member, listens to his or her side of the story and then talks to the client to clarify the misunderstanding. Which leadership theory is reflected in this scenario?
Situational-contingency theory Situational-contingency theory encourages an adaptive leadership style to focus on the issue being faced. The nurse manager understands the situation and makes a decision based on the complete information obtained. Trait theory explains a set of leadership traits that influence others toward a common goal. Two-factor theory involves application of hygiene factors and motivational factors to avoid and promote job enrichment. Expectancy theory refers to a perceived probability of fulfilling a particular need based on experience.
The registered nurse, while teaching a group of nursing students about the characteristics of a good team player, states, "A good team player should work with determination and refuse to stop until the goal has been accomplished." Which characteristic is the registered nurse describing?
Tenacity Tenacity means giving your all with determination and refusing to stop until the goal has been accomplished. Selflessness is a characteristic that involves putting the other members of the team ahead of oneself. Dependability involves the nurse following through and doing what he or she agreed to do. Collaboration involves each person bringing something to the project that adds value to the team and supports the creation of synergy.
OVID EBSCO OVID and EBSCO are search platforms for a variety of databases including CINAHL and MEDLINE. PubMed is an abstract database of the National Library of Medicine, providing access to over 15 million citations from 1950s to the present. PsycINFO is an abstract database of the behavioral sciences and mental health literature from 1800s to the present. MEDLINE is the largest component within PubMEd, indexing over 5200 journals according to medical subject headings. Test-Taking Tip: Be alert for details about what you are being asked to do. In this Question Type, you are asked to select all options that apply to a given situation or client. All options likely relate to the situation, but only some of the options may relate directly to the situation.
The nurse leader is monitoring a student nurse who is accessing various databases. Which search platform should the nurse leader suggest to access a variety of databases including Cumulative Index to Nursing and Allied Health Literature (CINAHL) and MEDLINE? Select all that apply.
Role discrepancy Role discrepancy is the development of gaps between role expectations and the role performances that may lead to discomfort and frustration of the team. In role exploration, the new nurse leader will be happy, excited, and is confident in exploring the new roles involved in the leadership position. Role negotiation is a strategy that is helpful during conflicting role expectations. When nurse leaders have been in their positions for several years and have internalized their roles, it is referred to as role internalization. Test-Taking Tip: Multiple-choice questions can be challenging because students think that they will recognize the right answer when they see it or that the right answer will somehow stand out from the other choices. This is a dangerous misconception. The more carefully the question is constructed, the more each of the choices will seem like the correct response.
The nursing staff of a unit is frustrated and uncomfortable with the newly appointed nurse leader. Which role transition process is involved?
The registered nurse (RN) is caring for a client who was admitted to the hospital due to severe diarrhea. The RN assigns the unlicensed assistive personnel (UAP) to check on the client hourly and perform hygiene care as needed. Which concept best explains this situation?
delegation
Which characteristics should the nurse possess as a leader, according to theories of transformational leadership? Select all that apply.
empowering staff creating enthusiasm for practice promoting scholarship of practice at the client side
A client is brought to the emergency department following ingestion of pesticides. the primary health care provider orders gastric suction. Which task can be delegated to the unlicensed assistive personnel in this situation?
emptying and measuring the gastric drainage
A nurse is explaining the nursing process to a nursing assistant. Which step of the nursing process should include interpretation of data collected about the client?
evaulation
which behavior of the delegator with respect to the work delegated to a delegatee is characterized as "selling" according to the hershey's model?
explaining or persuading
The senior leader instructs the direct care nurses about asking the right question in PICOT (patient population, intervention, comparison, outcome, and time frame) format. During the discussion, the leader discussed factors such as complication rate, satisfaction, nursing diagnosis, and nursing quality indicator. What do these factors indicate in the PICOT format?
outcome
A client with a severe allergy has been administered a high dose of antihistamine. The nurse finds that the client is drowsy and dizzy. Which type of need would the nurse prioritize in the client according to Maslow's hierarchy of needs?
safety needs
A nurse leader is promoting dialogue within the team successfully. Which actions of the nurse leader are responsible for this success? Select all that apply.
serving as a facilitator Encouraging the sharing of ideas Reacting to changed proposals honestly
A patient care associate (PCA) is delegated a task that can be completed in 2 hours. The PCA has limited knowledge and willingness regarding that particular task. Which leadership style should be implemented by the delegator in this situation?
telling
After communicating with the follower of a nurse leader, the senior nurse assumes that the nurse leader is following the transactional leadership approach. Which statements of the follower support the senior nurse's assumption? Select all that apply.
"I have to face penalties for poor performance." "I have to meet the deadlines of my work at any cost." "I am getting my errors corrected in a reactive manner.
A registered nurse as a leader is teaching novice leadership skills to a newly appointed leader. Which statements made by the new leader indicate effective learning? Select all that apply.
"I should resolve conflict." "I should deal with difficult people." "I should learn how to work in groups
Which statements indicate that the nurse leader is adapting to changes in leadership practices to adjust to complex changes in healthcare systems? Select all that apply.
"I will be clear about purpose and process." "I will involve stakeholders and listen to them." "I will align systems and processes to support the change."
A client is concerned about not receiving treatment due to a Medicare policy change. What is the accurate response of a nurse as a leader?
"The change will not affect your treatment."
The registered nurse is teaching a group of student nurses about the role of the nurse as a leader. Which statement by a student nurse indicates effective learning?
"The goal of the nurse manager is to develop a shared vision of the future with direct care nurses."
the registered nurse (RN) is communicating with a healthcare team regarding the delegation of tasks. which factors can determine the quality of communication between the RN and healthcare team? select all that apply
1 effectiveness 2 meaningfulness 3 understandability
Which care settings are more suitable for UNP? Select all that apply
1 extended care 2 long-term care
The unit is shifting from primary nursing to a team model in an effort to contain costs. Staff members are angry and ask for a meeting to discuss the change. After hearing their concerns related to reduction in professional autonomy and care quality, you: a. Acknowledge the loss b. Explain the reasons for change, emphasizing the need to reduce costs. c. Repeat the information several times, giving detailed budget overviews. d. Adjourn the meeting and provide explanation through e-mail.
A
The change will not affect your treatment A nurse leader ensures the changes made by the federal government or organization will not cause harm or financial burden to the client. Therefore a nurse leader should support the client by saying that the changes will not affect treatment. Follow-up visits are based on the client's condition, not on the changes made on the insurance policies. Increased duration and decreased effectiveness of the treatment indicates harm to the client and will not be caused by a Medicare policy change.
A client is concerned about not receiving treatment due to a Medicare policy change. What is the accurate response of a nurse as a leader?
Time-management skills are important for stress reduction Symptoms such as anxiety and frequent errors in work indicate mental stress. The direct care nurse should develop time-management skills to help manage the stress. Practicing yoga would help to reduce physical stress. Taking more continuing educational courses may increase mental stress. Communicating feelings helps to reduce emotional/spiritual stress. Test-Taking Tip: Read the stem carefully. The symptoms provided in the stem indicate mental stress. Now suggest an answer that would help to manage this type of stress.
A leader observes the direct care nurse making more frequent errors and being anxious. Which advice provided by the leader to the direct care nurse would help to manage the stress?
An example of a care activity that would likely not be delegated by an RN to a UNP is (select all that apply): a. Teaching self-catheterization to a patient with paraplegia who has limited English. b. Basic care for a patient with a head injury who is rapidly deteriorating. c. One-to-one observation with a suicidal patient. d. Assessment of patients being admitted through the Emergency Department. e. Basic hygienic care for a patient who is post MI and stable.
A, B, D
The nurse leader, while teaching a group of nurse leaders, references an approach of evidence-driven consciousness to be applied in the nursing practice. What is the main concern of the nurse leader?
About the safety of the clients
what entity outlined the principles of delegation for registered nurses?
American nurses association
Which healthcare team member is responsible for the coordination and assignments of client care?
Charge nurse
A client is hospitalized with a brain injury and a skull fracture. The registered nurse is delegating tasks to the healthcare team. Which member of the healthcare team is suitable to provide client care? Select all that apply. Correct
Charge nurse newly hired RN
Which employee should be competent in critical thinking, leadership, communication, and time management skills? Select all that apply.
Charge nurse, registered nurse
Which characteristic should the nurse use during the nursing process as a guide for delegation?
Critical analysis
The RN is getting ready to leave the client care unit for a lunch break. The RN asks the LPN to take care of a client during the lunch break. Which concept is emphasized in this situation?
Delegation
What should a nurse manager as a leader do to provide a non-threatening and positive environment to the group members? Select all that apply.
Encourage group members to actively participate Create an environment conducive to solving problems Protect the members and their suggestions from attack
What are the responsibilities of the nurse as a leader? Select all that apply.
Encouraging the direct care nurses to provide input into decisions Ensuring that day-to-day activities of the staff are correctly planned and executed
The intensive care unit at a hospital has recently experienced a turnover of several long-tenured nurses who assumed important leadership roles. As a result the unit has become less effective and productive despite the consistent performance of the remaining nurse leaders. What should the management team do to ensure that effectiveness and productivity remains consistent in the event of future leadership turnover?
Establish a leadership succession plan
Which activity performed by the registered nurse (RN) indicates following the "participating" leadership style in Hersey's model?
Establishing mutual expectations with the delegatee
A nurse leader wants to communicate and explain changes to hospital rules to team members. Which approaches should the nurse leader follow for effective communication? Select all that apply.
Explaining the reason behind the change Providing the opportunity for dialogue and feedback Giving information that addresses the listener's self-interest
Which statement does the nurse recognize as true according to chaos theory?
Health-care organizations must be self-organizing.
A nurse manager determines that one of the nurses in the intensive care unit may be experiencing burnout. What can the nurse manager do to help this nurse begin to confront the problem?
Help the nurse identify personal responses to daily stresses on the job.
Identifiy Assemble Collect data to measure Establish Select Collect data to evaluate The quality improvement process starts with identifying the needs that are most important to the consumer of healthcare services. It further proceeds with assembling an inter-professional team to review the identified consumer needs and services. Then the data are collected to measure the current status of these services. The quality improvement process proceeds with establishing measurable outcomes and quality status. Then selection and implementation of a plan is done to meet the outcomes. Finally, the data are collected for evaluation of the plan implementation and achievement of outcomes.
How would the nurse arrange the steps in the quality improvement process to help the leader to minimize errors and achieve satisfaction on the part of the consumer of healthcare services?
A 9-year-old child has a fractured tibia, and a full leg cast is applied. Which assessment findings should the nurse immediately report to the healthcare provider? Select all that apply.
Inability to move the toes Tingling sensation in the foot Fiberglass cast that is damp after 4 hours
Which actions make the nurse a transformational leader?
Introducing a vision for the future nurses A transformational leader creates and shares a vision or goal for future nurses. Gaining higher education does not indicate leadership. Effective implementation of client-centered care indicates professionalism but not leadership. A transformational leader corrects the errors of followers by coaching and mentoring, not by using a reactive manner.
a client who sustained a leg fracture is prescribed intramuscular analgesic medication. Which healthcare professional can be safely delegated this task?
LPN
Which action by the nurse leader is indicative of transactional leadership?
Motivating the self-interest of the employees by offering external rewards
Who is the designated delegator?
Nurse manager
Which model of nursing care would include working "within the walls" as well as "beyond the walls" of the hospital?
Nursing case-management model
The nurse leader as a manager makes a decision regarding the method of documentation that benefits the nursing team. Which type of decision-making style does the nurse leader utilize?
Paternalistic
An infant with a congenital heart defect is returned to the unit after cardiac catheterization. The nurse manager is observing a nurse newly assigned to the unit. Which nursing intervention should the nurse manager interrupt?
Performing range-of-motion exercises
Which are disadvantages to the functional system of care delivery? Select all that apply.
Poor communication Fragmentation of care changes in client status go unnoticed
which task can the RN safely delegate to the UAP while caring for a client with gastroesophageal reflex disease?
Positioning the bed
What is the role of a nurse administrator in a healthcare setting?
Preparing the budget, staffing, strategic planning of programs and services, employee evaluations, and employee development
What would the nurse state is the primary priority for decreasing a client's risk of morbidity and mortality?
Prevention
What would the nurse state is a characteristic of an effective leader?
Problem-solving skills
The nurse as a leader provides feedback to a newly recruited nursing student after checking the student's progress report. Which action of the registered nurse is most closely aligned with the application of two-factor theory during the feedback session?
Promoting job enrichment by creating job satisfaction
What is the duty of the nurse as delegator if the delegatee has limited knowledge and ability to perform a task?
Provide guidance
Which type of behavior by the registered nurse results in a low-to-stable level of commitment?
Punitive Punitive behavior is a type of transactional leadership behavior that results in a low-to-stable level of commitment as an organizational outcome. Charismatic, inspirational, and intellectual stimulation are transformational leadership behaviors that result in increased commitment as an organizational outcome.
Which action of the nurse as a leader is supported by the Style theories of leadership?
Pursuing effective relationships with subordinates
The RN is caring for a client who underwent brain surgery. The RN delegated the task of reinforcing ambulation to the licensed practical nurse. Who is accountable for the client's care?
RN
Which member of the health care team is accountable for initial assessment and ongoing evaluation of client care?
RN
who is mainly responsible for analyzing the knowlege and work of newly hired unlicensed assistive personnel before delegating a task?
RN
who supervises unlicensed nuring personnel is providing care to the client?
RN
It is determined that a staff nurse has a drug abuse problem. What approach to the staff nurse's addiction should be taken as an initial intervention?
Referred to the employee assistance program
The nurse manager orders the direct care nurse to assist in providing tertiary care to a client. Which type of treatment would the direct care nurse be involved in?
Rehabilitation Tertiary care includes rehabilitation. Chronic care and health maintenance are considered primary care, and prevention of disease complications is classified as secondary care.
Which initiative demonstrated by the registered nurse is an effective art of communication of a leader?
Reinforcing the values behind the change
Which task is achieved by the delegator when he or she engages in self-care to enhance his or her ability to care for the healthcare team?
Renewing
The nurse, as a leader, takes care of himself or herself to promote the nurse's ability to care for the staff. Which of Gardner's tasks of leadership is the nurse applying in practice?
Renewing Leaders generate energy within and among others. When a nurse engages in self-care to enhance his or her ability to care for the staff, the nurse is applying renewing, one of Gardner's tasks of leadership. Affirming values involves assisting the client to sort out and articulate personal values in relation to health problems. Developing trust involves keeping promises given to clients or families. Serving as symbol indicates representing the nursing profession and the values and beliefs of the organization to clients or families.
The nurse notes a conflict between staff members during a meeting. Which principle should the nurse follow, as a leader, to put the focus on mutual interest?
Responding expediently to the issues
The nurse notes a conflict between staff members during a meeting. Which principle should the nurse follow, as a leader, to put the focus on mutual interest?
Responding expediently to the issues Responding expediently to issues will help put the focus on interest in a process of conflict resolution. Providing a forum for open discussion will help build in consultation before and feedback after the negotiations. Reviewing with all parties the likely consequences of not proceeding will help build in "loop-backs" to negotiation. Working with staff or clients after the conflict to learn from the situation will help build in consultation before and feedback after the negotiations.
The nursing staff of a unit is frustrated and uncomfortable with the newly appointed nurse leader. Which role transition process is involved?
Role discrepancy
Which action of the leader signifies the implementation phase of the nursing process to teaching?
Sequencing different tasks
The nurse manager is planning to develop leadership skills in direct care nurses. What activities should the nurse encourage the direct care nurses to participate in to develop these skills? Select all that apply.
Serve on practice councils Join local professional associations Participate in American Heart Association activities
What is the main motto of the Hersey's 2006 model?
Situational leadership
The nurse as a leader obtains feedback from superiors, followers, and peers. Which leadership theory is the nurse putting into practice?
Style theories
Which activity performed by the RN idicates effective delegation?
Supervising and monitoring the licensed practical nurse about the different activities
Which action of the registered nurse (RN) represents his or her leadership ability?
Supervising the tasks assigned to unlicensed nursing personnel The nurse as a leader should supervise the tasks assigned to unlicensed nursing personnel to ensure the client's safety. Pursuing higher professional courses can help in self-growth but does not indicate leadership. Performing home visits and modifying a diet chart indicates the role of the nurse.
the RN delegates a task to the UAP. After the UAP starts the task, the RN asks for feedback related to the task. Which right of delegation is the RN following?
Supervision
Knowledge persuasion Decision Implementation Confirmation Gaining knowledge is the first step of the innovation-decision process, followed by persuasion, decision, implementation, and, finally, confirmation.
The leader asks the student nurse to arrange the steps of the innovation-decision process in the chronological order that would be useful for individual change. What sequence organized by the student nurse shows effective learning?
The nurse leader wants to avoid a conflict and postpone its resolution. What could be the reason for this avoidance?
The leader wants to gather more information.
Which actions of a nurse as a leader demonstrate a hands-off approach in practice? Select all that apply.
The nurse leader avoids making conscious decisions. The nurse leader chooses to do nothing when an intervention is indicated.
Which statement reflects the concept of "referent power" to the nurse?
The nurse manager hires the student nurse she advised to work in the agency after graduation.
Which behavior would the nurse consider suitable for an executive position according to Gardner's tasks of leading/managing?
To assist corporate leaders with planning and priority setting
The nurse manager is promoting a nurse who has the qualities to become a team leader. What responsibilities are allotted to a team leader? Select all that apply.
To be prepared for daily changes in team membership To evaluate the quality of care for the clients assigned to his or her team
Which example would the nurse consider to be a part of systems thinking theory?
To focus on the needs of all residents in a long-term care facility The systems thinking theory would describe the need to focus on all the residents in a long-term facility care facility. Transformational theory is associated with promoting employee development. Leaders obtain feedback from peers and staff according to the style theory. Organizational behavior modification theory believes in avoiding situations that cause discomfort.
A nurse group leader in a mental health center uses a variety of techniques in an effort to promote group cohesion. The nurse identifies group cohesion when the group members do what?
Use the phrase "our group" during discussions
Which point should the nurse exclude when developing strategies to project a powerful image?
Using authoritative language
Focusing on the needs of all the residents in a long-term care facility Knowing about the complications of emergency department overcrowding in an urban setting Focusing on the needs of all residents in a long-term care facility and knowing about the complications of emergency department overcrowding in an urban setting are actions that indicate effective implementation of the "Big Picture" principle by helping the nurse envision his/her work beyond the immediate tasks. Focusing on analyzing morale, working relationships, team work, and the number of clients indicates effective implementation of "Using Measurable versus Nonmeasurable Data Systems" principle of systems thinking theory. Identifying and understanding the relationships of clients, families, communities, and local economies indicates effective implementation of "Recognizing the Dynamic, Complex, and Interdependent Nature of Systems" principle. Recognizing the long-term effects of actions on the organization or client care indicates the "Balancing Short-Term and Long-Term Objectives" principle of systems thinking theory.
Which nursing actions indicate effective implementation of systems thinking theory principle with respect to "thinking of the Big Picture"? Select all that apply.
Flexibility Ability to listen to others Ability to share information and ideas In order to collaborate effectively, the nurse should be flexible, must be willing to listen to others, and must share information and ideas with others. The nurse manager should plan a thoughtful response, consider others' perspective first, and not react hastily. The nurse manager should not share his or her own anger or frustration with other staff. Test-Taking Tip: Be alert for details about what you are being asked to do. In this Question Type, you are asked to select all options that apply to a given situation. All options likely relate to the situation, but only some of the options may relate directly to the situation.
Which skills would be essential for an effective nurse manager to develop and improve collaboration with others? Select all that apply.
The nurse manager hires the student nurse she advised to work in the agency after graduation Referent power is granted by a powerful person having an association. Therefore managers hiring student nurses to work in the agency is considered a use of referent power. The use of empowerment involves the nurse leader sharing power sources. In reward power, the instructor positively perceives the exemplary grades achieved by the student nurse. The direct care nurse who demonstrates good skills in teaching clients who have difficulty with self-care activities is considered to be an example of information power.
Which statement reflects the concept of "referent power" to the nurse?
Great Man theory The trait theory is sometimes referred as the Great Man theory. According to this theory, the leadership traits such as a certain set of physical and emotional characteristics are innate and cannot be learned. Style theory focuses on what leaders do, but not on the leadership qualities. Two-factor theory focuses on motivation and job satisfaction based on hygiene factors and motivational factors. Situational-contingency theory focuses on the challenge of a situation and encourages an adaptive leadership style particular to that situation. Test-Taking Tip: If you are unable to answer a multiple-choice question immediately, eliminate the alternatives that you know are incorrect and proceed from that point. The same goes for a multiple-response question that requires you to choose two or more of the given alternatives. If a fill-in-the-blank question poses a problem, read the situation and essential information carefully and then formulate your response.
Which theory states that the leadership traits in an individual are born and not made?
Management The process of guiding, planning, and controlling others in a situation where communication is shared to improve clinical processes and outcomes is referred to as management. Leadership can be defined as a process of identifying a goal or target, motivating other people to act, and providing support and motivation to achieve goals. Followership is the process of following the leader or the manager to ensure the best clinical decision making and actions taken to achieve organizational outcomes. Decision making is a process of making crucial decisions. Test-Taking Tip: Recall the responsibilities and traits of each role and choose the answer that suits best to the scenario in the question.
While auditing unit documents, a nurse finds some omissions. Which term best describes when the nurse meets with the staff to discuss the findings and communicates ways to achieve the desired goals?
Which quality of the nursing assistant should be known by the delegator when assigning a task?
ability
A nurse leader is given an additional duty of nurse navigator. Which extra responsibilities does the nurse leader need to provide as a nurse navigator? Select all that apply.
address barriers to care provide psychosocial support provide health education about the disease
The RN is caring for a pregnant client with malnutrition due to morning sickness. Which task can be safely performed by the LPN in this condition?
administering oral antiemetics
the healthcare team is caring for a client who has undergone surgery for lung cancer. The client needs respiratory therapy. Which task can be safely delegated to a respiratory therapist paired with a registered nurse?
assessing the respirations
A group member states "Administration won't go for it" while making a decision for a critical issue. Which strategy should a nurse leader implement to deal effectively with this situation?
brainstorming
Which healthcare team member is responsible for the coordination and assignments of client care?
charge nurse
Who acts as a delegator in the absence of the registered nurse?
charge nurse
who functions as a liaison between team leaders and other healthcare providers?
charge nurse
A nurse is preparing to administer an intravenous piggyback medication to a client who is receiving a continuous infusion of intravenous (IV) fluids. What is the priority nursing intervention?
check the compatibility of the medication and the continuous IV solution.
Before assigning a task, the registered nurse makes sure that the delegation process is appropriate to the situation. To which delegation right does this situation refer?
circumstance
the registered nurse is reviewing the clinical data of four clients. Which client care can be delegated to the LPN?
client A; condition: dental pain; medication: non steroidal anti-inflammatory drugs
The registered nurse (RN) is delegating tasks to licensed practical nurses (LPNs) regarding client care. Which factors should be considered when delegating a task to the LPN? Select all that apply.
clients condition complexity of the task predictability of outcomes
which characteristic should the nurse use during the nursing process as a guide for delegation?
critical analysis
Which delegatee requires little guidance form the delegator?
delegatee who is familiar with the task but not the client
Which process involves transferring responsibility to multiple player, usually with varying degrees of education and experience, while retaining the ultimate accountability for providing the client care?
delegation
which element of the healthcare system is the registered nurse (RN) practicing when the delegator shares accountability with the RN?
delegation
the registered nurse is teaching the student nurse about the concepts of delegation. which response given by the student nurse indicates the need for further teaching?
delegation is the transfer of accountability while retaining responsibility
Which decision-making strategy involves systematic collection and summarization of opinions and judgments on a particular issue from the respondents?
delphi technique
Which group discussion technique involves a large number of respondents who may be participating in the discussion remotely?
delphi techniques
The nurse as a leader is sharing organizational information openly and honestly. Which of Gardner's tasks of leadership is the nurse manager applying in practice?
developing trust
What is the status of the unit secretary as a member of the healthcare team, which is in the span of control of a RN
devoid of legal authority
the registered nurse is assessing the conditions of four different clients. Which client's care should the registered nurse delegate to an unlicensed assistive personnel (UAP)?
diarrhea
the RN caring for a postoperative hysterectomy client is delegating tasks to the licensed practical nurse (LPN). Which statement made by the RN indicates the principle of right communication of delegation?
does the LPN understand when to report the vital signs
What is the role of the nurse executive as a leader?
empowerment
A nurse working in a medical unit finds that diabetic clients have a knowledge deficit regarding use of glucose-monitoring devices. The nurse requests that a colleague who works in the outpatient diabetic counseling department provide health teaching to the clients. Which type of power does the nurse's colleague hold?
information power
The client with methicillin-resistant staphylococcus aureus (MRSA) is admitted to the medical unit. Which of the following tasks should be performed by the registered nurse?
initiating intravenous (IV) antibiotic therapy
the newly hired nurse is delegated the task of preparing the client care plan for a diabetic client who underwent amputation. Which task in the care plan is inappropriate according to guidelines?
instructing the LPN to monitor VS.
the delegatee is performing a task and in the process loses confidence in what he or she is doing. Which delegator's action may have contributed to the delegatee's loss of confidence?
intervening when the delegatee is performing the task
Which question does the registered nurse recognize as related to the right of circumstance when delegating?
is the delegation appropriate to the situation?
After assigning a specific task, the registered nurse observes that the delegatee is unable to perform the task accurately. What will be the appropriate statement of the registered nurse in this situation?
just follow my steps and you can do it.
While auditing unit documents, a nurse finds some omissions. Which term best describes when the nurse meets with the staff to discuss the findings and communicates ways to achieve the desired goals?
management
The nurse manager is assisting the nursing staff with planning, priority setting, and decision making. Which Gardner's task of leading is being applied in this practice?
managing
While serving as a leader, the nurse assists the client with planning, priority setting, and decision making. Which of Gardner's leadership tasks is the nurse putting into practice?
managing
According to Kouzes and Posner, which key practices are involved when a leader takes an active role in the work of change and creative thinking about new solutions? Select all that apply.
modeling challenging
Which actions can the mentor take to develop effective leadership qualities in the aspiring leader? Select all that apply.
modeling behavior giving timely feedback providing appropriate advice
=A client underwent angioplasty and is hospitalized for several days for observation. Which task can be delegated by the registered nurse (RN) to a licensed practical nurse (LPN)?
monitoring
A client underwent angioplasty and is hospitalized for several days for observation. Which task can be delegated by the RN to a LPN?
monitoring
What is the role of unlicensed assistive personnel in intravenous therapy for a client?
monitoring clinical manifestations
The nurse is relating to and inspiring the client who has a psychiatric disorder to achieve the client outcomes. Which of Gardner's leadership tasks is reflected in the nurse's actions?
motivating
which strategy should be implemented by the registered nurse to achieve desirable client outcomes?
offering
the registered nurse is assigned to delegate a task. which action by the registered nurse indicates the need for correction?
providing a brief description of the task to the delegatee
Which activity of the registered nurse is included in supervision
providing guidance and oversight in delegating a task
Which theory states that leaders act as change catalysts and innovators?
quantum theory
The registered nurse (RN) is caring for a client who underwent a hysterectomy. Which tasks can be delegated to the unlicensed assistive personnel (UAP) to provide quality care to the client? Select all that apply.
recording VS assisting the client with bathing
the nurse is caring for a pregnant client with hypertension. Which client care tasks are most suitable to be delegate to the patient care associate (PCA)?
recording the vital signs
A staff nurse is requesting that the nurse leader be her preceptor in the emergency department. Which source of power is effective in this situation?
referent power
Which hospital care setting is most appropriate for a case manger to perform tasks as a delegatee?
rehabilitative care
The nurse, as a leader, takes care of himself or herself to promote the nurse's ability to care for the staff. Which of Gardner's tasks of leadership is the nurse applying in practice?
renewing
which task is achieved by the delegator when he or she engages in self-care to enhance his or her ability to care for the healthcare team?
renewing
Which component of delegation is considered a "two ways process?"
resposibility
A registered nurse delegates a task to a licensed practical nurse. The nurse manager asks the registered nurse, "are the equipment and resources available for the LPN to complete the task?" Which right of delegation is the nurse manager preserving?
right circumstance
the nurse with limited clinical experience is preparing a delegation communication template. Which action by the nurse indicates the need for correction?
specifying that no extra time is allotted to report data
which element creates an integrative process that fosters effective delegation decisions by the registered nurse?
stability
Which work is automatically increased for the delegator when there is a decrease in direct client care?
supervision
the registered nurse is delegating work to four delegatees. Which delegatee has an established relationship with the delegator?
task: "Your way of doing is right; continue to do it in the same way."
A client with asthma and depression is admitted to the hospital. Which tasks delegated by the delegator would indicate the task is applicable for the registered nurse?
teach the client how to use a meter dose inhaler
A Patient care associate is delegated a task that can be completed in 2 hours. The PCA has limited knowledge and willingness regarding that particular task. Which leadership style should be implemented by the delegator in this situation?
telling
Which statement about the delegatee condition is true regarding "selling"?
the delegatee has ongoing relationships; however, the task is new
after assessing the delegatee's inability to perform an assigned task, the delegator explains the procedure and demonstrates the task to the delegatee. What can be inferred about the delegatee?
the delegatee may have an ongoing relationship with the delegator, but a new task is assigned.
the registered nurse is evaluating the statements made by a student nurse after teaching about the delegation communication template. Which statement made by the student nurse indicates a need for correction?
the delegation communication template should include only the work that is to be delegate
Which right does the question. "do staffing ratios demand the use of high-level delegation strategies?" indicate?
the right circumstances
Which internal factors affect the decision-making process of a leader? Select all that apply.
values interest knowledge
When does a delegator identify that the delegatee is less able to perform in a given situation?
when the delegatee is knowledge deficient
which condition may increase the potential for nursing malpractice?
when the delegation task is not within acceptable standards
a nurse is assisting another registered nurse in the intensive care unit who is caring for a client with uncontrolled blood pressure. Which action on the part of the nurse indicates "offering" during delegation decisions?
you can use this stethoscope and sphygmomanometer to take the blood pressure
Which conditions make a delegation more challenging for the registered nurses, delegatees, and clients? select all that apply
1 limited resources 2 greater geographical area 3 vulnerable populations receiving care
which activity indicates improper follow-through on the part of the delegatee?
failure to report results
A nurse manager proposes to change a protocol regarding the care of postoperative clients. However, the nursing staff openly expresses their resistance to the change and wants to continue with the original protocol. Which behavioral pattern in response to change best describes the nursing staff?
laggards
A nurse is teaching a group of recently hired staff members about defense mechanisms. An example given is Scarlett O'Hara, in the movie Gone with the Wind, who said, "I'll think about that tomorrow." What defense mechanism does this statement reflect?
suppression
The nurse leader teaches the student nurse about the quality assurance (QA) process. Which statement made by the student nurse indicates ineffective learning?
"The major task is staff development."
the registered nurse is caring for a client who underwent ileostomy. which activity performed by the nurse indicates following the principle of right circumstance of delegation? select all that apply
1 assessing the equipment to determine vital signs 2 providing supervision of the delegatee during the task
Arrange in order the series of tasks to be performed by the registered nurse (RN) to determine active delegation?
1 assessing the situation 2 Determining the care plan 3 directing the unlicensed assistive personnel (UAP) to perform the task 4 monitoring the client
The registered nurse is caring for a client admitted with sudden paralysis in the legs and an inability to walk. Which interventions made by the RN indicate correct active delegation? Select all that apply
1 instructing the licensed practical nurse to report client's vital signs 2 instructing the licensed practical nurse to administer vitamin b12 injection
Hospital management has replaced some equipment to provide more effective treatment. The nurse, as a leader, wants the team to support and implement this change successfully. Which actions of the nurse leader are effective in this situation? Select all that apply.
Conducting a dialogue with the team members Encouraging the team members to develop new skills Encouraging the team members to increase competency in different areas Dialogue allows the team members with different perspectives to come together and find common goals. Discussing the new equipment, developing new skills, and increasing competency in different areas ensure effective action of the leader to bring a change in an organization. Simply gaining knowledge about the change does not allow the team to support the change. The nurse leader should instruct the whole team to implement the change effectively
Which type of leadership theory explains the effectiveness of leadership and depends on the match between a leader's style and the demands of a situation?
Contingency Model Fiedler developed the Contingency Model, which explains that the effectiveness of the group depends on an appropriate match between a leader's style and the demands of a situation. Path-Goal theory was developed by House and Mitchell and explains the personal characteristics of followers and environmental demands. The Two-factor theory was developed by Herzberg for motivation in leadership. Normative-Decision Making Model is a problem solving approach developed by Vroom and Yetton.
The nursing leader stated, "The reimbursed cost is less than the full charge for a service in the hospital." Which type of health reimbursement does the nurse leader describe?
Contractual allowance When the reimbursed cost is less than the full charge for a service in the health organization, a contractual allowance or discount exists. Offering rewards and incentives to high performing organizations is value-based purchasing. In cost-based reimbursement, all allowable costs are calculated and used as the basis for payment. In a prospective payment system, the third-party payer decides in advance what will be paid for a service or episode of care
A successful manager should take risks A successful manager should tolerate uncertainty A successful manager should experiment with ideas for a unique situation A successful manager shows positive qualities in his or her work such as taking risks, tolerating uncertainty, and experimenting with new ideas for a unique situation or environment. A willingness to work as a leader, as well as to follow peers where appropriate, is a quality of any good employee depending on the situation; it is not specific to the role of a manager. Exerting the power to communicate through various channels is the trait of a follower. Test-Taking Tip: Be alert with the options; therefore, try to be smart enough to differentiate between the qualities of a manager, leader, and follower to provide the right answer.
During an interview for the position of manager in the healthcare industry, the candidate is asked about the important qualities of a successful manager. Which responses would be appropriate? Select all that apply.
The nurse leader is representing the nursing unit and the values and beliefs of the organization to staff members. Which leadership task does the nurse's behavior indicate according to Gardner's tasks of leadership?
Serving as a symbol in a management position
As a manager, the nurse leader is planning to implement a change in the client care delivery system. Which initial step taken by the nurse leader as a manager would be most appropriate for this change?
To identify the inefficiency that requires improvement
What is the key idea of role theory in nurse leadership? Select all that apply.
To understand behavior in certain circumstances To collect concepts that predict the actors' performance in a given role
Which theory would the nurse describe as addressing the follower's needs so that the interaction raises the follower to higher levels of motivation?
Transformational theories
Accept responsibility for one's mistakes Give credit to others where credit is due Use business card when introducing yourself to new contacts Accepting responsibility for one's mistakes and then learning from them is a power strategy for a nursing leader. Giving credit to others where credit is due and using business cards when introducing yourself to new contacts, as well as collecting the business cards of those you meet when networking, are power strategies for a nursing leader. Developing the ability to take constructive criticism gracefully and learning to let destructive criticism "roll off your back" is a power strategy for nursing leaders. Learning to be comfortable with conflict and ambiguity as they are the normal states of the human condition, rather than being uncomfortable with conflict and ambiguity is a power strategy for the nursing leader. Test-Taking Tip: A psychological technique used to boost your test-taking confidence is to look into a mirror whenever you pass one and say out loud, "I know the material, and I'll do well on the test." Try it; many students have found that it works because it reduces "test anxiety."
What are the power strategies for nursing leaders? Select all that apply.
the registered nurse is evaluating the statements made by the student nurse after teaching hersey's situational leadership model regarding care competencies of a situational leader. Which statement made by the student nurse indicates a need for correction?
a situational leader is inflexible towards the work
A nurse is helping a client determine and articulate personal values about health problems. The nurse also explains the effect of these problems on lifestyle adjustments. Which Gardner's task of leadership is the nurse leader applying?
affirming values
Which element of the delegation may extend to direct corporate liability for the institution?
failure of the nurse manager to delegate and supervise the task within acceptable standards.
which drawback indicates an improper follow-through on the part of a delegatee?
failure to report results and findings
While interviewing a nurse for the position of leader, the chief executive officer of a healthcare facility asks "How will you develop political skills in your team?" Which answers provided by the nurse most likely will result in an offer for the position? Select all that apply.
i will encourage their participation in Nurse Lobby day I will encourage their active membership in the state nurses' association
The registered nurse is organizing a community health care program for administering tetanus vaccinations. Which member of the health care team is most suitable for being delegated the task of administering vaccinations?
licensed piratical nurse
Style theory In style theory, it is important for leaders seek feedback from followers, peers, or higher authorities in order to understand their style. These leaders are employee-centered and tend to foster an effective, productive work environment. Two-factor theory involves leaders using motivational factors to inspire work performance. When applying the hierarchy of needs, leaders understand factors that affect staff performance and creativity, such as the need for safety and security. In situational-contingency theory, leaders adapt easily to new situations and provide appropriate action based on the people involved. STUDY TIP: You have a great resource in your classmates. We all have different learning styles, strengths, and perspectives on the material. Participating in a study group can be a valuable addition to your nursing school experience.
During a status meeting for a research project, the project leader asks the team members for feedback. What leadership theory is represented by the action of the leader?
A registered nurse is educating a nursing student about the relationship between nursing theory and nursing research. What information should the nurse provide? Select all that apply.
"Theory-generating research helps to discover and describe relationships of phenomena." "Theory-testing research helps to determine the accuracy with which a theory describes a phenomenon." "The relationship between nursing theory and nursing research builds the scientific knowledge base of nursing."
A healthcare team is caring for a postsurgical client who underwent knee sugery. Which task is most suitable to be delegated to a licensed practical nurse to provide effective client care? select all that apply
1 changing the dressing 2 administration of oral analgesics 3 reinforcing leg exercise instructions.
a client is diagnosed with cancer and is physically weak. the delegator has delegated the healthcare team members to care for the client. Which aspects fo the care are most appropriate for the registered nurse (RN)? select all that apply
1 collecting the client's medical history 2 teach the client to be hopeful abut the treatment 3 providing emotional support to the client's family members
which beliefs may be associated with a registered nurse's failure to delegate tasks? select all that apply.
1 delegation is too time consuming 2 more energy is required to delegate others 3 the registered nurse will not receive credit for total client care
what are the tree strategies that the nurse can perform while assisting other nurses in making delegation decision? select all that apply
1 doing 2 asking 3 offering
Which healthcare settings are appropriate for delegating care according to the functional model of nursing? select all that apply
1 emergency units 2 ambulatory clinics
The charge nurse is delegating tasks for the nursing assistant regarding the postpartum care of a client. Which task is appropriate to be delegated to an unlicensed assistive personnel to provide effective client care? select all that apply
1 feeding the client 2 providing basic hygiene 3 encouraging breastfeeding
the registered nurse is planning to provide feedback to the licensed practical nurse. Which questions asked by the RN help in eliciting the LPN's work quality? select all that apply.
1 how did the patient respond? 2 what changes were observed in the client?
while caring for a post-operative client, the delegator has assigned a task to a delegatee. Which statements made by the delegator indicates that the deegatee has the experience to perform the task? select all that apply?
1 i am available to you at any time for report 2 i am aware of your technical competencies
The RN is caring for a client with epilepsy. Which tasks delegated by the RN to the assistive personnel idicates active delegation? select all taht apply
1 instructing the LPN to monitor the vital signs 2 instructing the unlicensed assistive personnel to resposition the client. 3 instructing the unlicensed assistive personnel to place the oxygen mask.
Organizing a group of colleagues to address organizational problems An individual can become an effective leader when he or she mainly focuses on the well-being of the others. Therefore organizing the group of colleagues and addressing organizational problems indicates his or her leadership ability. Treating all clients equally irrespective of race and economic status indicates that the nurse is implementing justice in the profession but not leadership. Following the orders of the primary healthcare provider effectively indicates professionalism but not leadership. Maintaining confidentiality about the client's health indicates that the nurse is adhering to Health Insurance Portability and Accountability Act (HIPPA) rules and regulations. Test-Taking Tip: Identifying content and what is being asked about that content is critical to your choosing the correct response. Be alert for words in the stem of the item that are the same or similar in nature to those in one or two of the options.
A senior nurse is teaching about leadership qualities to a new nurse. Which action of the new nurse represents his or her leadership quality?
Analyze the mission and culture Assess strengths, weaknesses, opportunities Analyze the future environment the marketer is likely to face Determine objectives and goals Formulate the core marketing stratgey Establish benchmarks While implementing strategic marketing planning, the first step is to analyze the mission and culture to which the strategy is contributing. The next step is to assess strengths, weaknesses, opportunities, and threats (SWOT analysis) presented by the external environment. This is followed by analyzing the future environment the marketer is likely to face. Determining the objectives and goals for the relevant planning period should be performed next. To achieve the specified goals, the core marketing strategy needs to be formulated after the objective has been determined. The final step is to establish the benchmarks to measure interim and final achievements.
Arrange the steps in the order that a nurse leader would implement while following the strategic marketing planning process.
A medical care facility is seeking to establish an orthopedic center of excellence. The nurse manager teaches direct care nurses about opportunities available to them in the process. Which task would a direct care nurse be eligible for?
Conducting a literature review In an orthopedic center, the direct care nurse is eligible for participating on the council to conduct a literature review on topics related to orthopedic product lines, innovative orthopedic joint replacement procedures, and programs related to the orthopedics evidence-based practices for joint replacement. The other activities such as developing a budget, conducting a needs assessment, and forming an advisory committee are not the responsibilities of a direct care nurse. The members responsible for developing budget are assistant vice president of client care services and orthopedic product line manager/nurse manager. The Director of Nursing, orthopedic product line manager, and strategic planning and marketing director are responsible for conducting a needs assessment. The members responsible for formation of an advisory committee are the client satisfaction director, physician champion, vice president of client care services, orthopedic staff across the continuum of care, director of rehabilitation services, and vice president of medical affairs.
Vaccinating children in school The nurse as a community leader has the unique opportunity to work with schools, city or county governments, and other community entities. The nurse as a community leader formulates a vision for improving the health of the community through disease prevention and health promotion. Therefore administering vaccines by Nurse leader D to the children in school to prevent disease indicates that the nurse is performing the role of the community nurse leader. Scheduling the client for a surgery may not be done in a community; therefore this action of Nurse leader A does not indicate the role of the community nurse leader. Assisting the client in positioning him or her on a bed can be done wherever possible, such as in client's home or healthcare facility. Therefore this action by Nurse leader B does not indicate the role of the community nurse leader. Teaching the student nurse to administer an intramuscular medication can be done in a healthcare facility also, therefore this action by Nurse leader C does not indicate the role of the community nurse leader. Test-Taking Tip: Chart/exhibit items present a situation and ask a question. A variety of objective and subjective information is presented about the client in formats such as the medical record (e.g., laboratory test results, results of diagnostic procedures, progress notes, healthcare provider orders, medication administration record, health history), physical assessment data, and assistant/client interactions. After analyzing the information presented, the test taker answers the question. These questions usually reflect the analyzing level of cognitive thinking.
Four nurse leaders are performing different tasks. Which nurse leader's action indicates the role of the community nurse leader?
While reviewing the work of a team, the nurse observes a conflict among the members. How should the nurse build in consultation before and feedback after the negotiations in a conflict resolution?
Providing a forum for open discussion Providing a forum for open discussion will help to build in consultation before and feedback after the negotiations. Examining the real issues of all parties will help to focus on interests in conflict resolution. Providing the necessary resources to those involved to offer support will help to impart motivation, skills, and resources in conflict resolution. Allowing a "cooling off" period before reconvening if resolution fails will help build in "loop-backs" to negotiation in conflict resolution
I will call your daughter Did you take your medicine this morning when i was late It is important as a nurse to show visible caring to the client. When the student says "I will call your daughter" and "Did you take your medicine this morning when I was late" there is no indication of visible caring, therefore these statements indicate ineffective learning. The student nurse should say "I will call your daughter for you" and "I hope that someone assisted you with your medications this morning; I am sorry that I was late." By saying "I really admire your courage," the nurse expresses appreciation, which shows caring. "I can imagine this might feel scary for you" shows that the nurse is listening to the client actively, which also reflects care. By saying "I want to make you comfortable. Here's a blanket," the nurse shows his/her clear communication and positive intention, which also reflects visible caring for the client.
The leader teaches the student nurse about the way to make caring visible to a client who has undergone a hip replacement surgery. Which statements made by the student nurse to the client indicate ineffective learning? Select all that apply.
Communicating in a simple language with followers Giving a chance to the followers to express their views Ensuring proper eye contact while communicating with followers An effective leader should use the simplest and fastest method to communicate with followers. An effective leader should give a chance to the followers to express their views, as followers have many questions to ask. Proper eye contact ensures effective communication; therefore an effective leader should maintain proper eye contact while communicating with followers. An effective leader should use critical thinking to decide the actions to be performed but should not instruct the followers. An effective leader should communicate the clear boundaries with followers.
The nurse is learning about the rules of leaders. Which actions of the nurse indicate effective implementation of these rules in the profession? Select all that apply.
Cultural competence Cultural competence is the process in which the health care provider continuously strives to achieve the ability to effectively work within the cultural context of a client, individual, family, or community. Cultural diversity describes a vast range of cultural differences among individuals or groups. Cultural sensitivity describes the affective behaviors in individuals such as the capacity to feel, convey, and react to ideas, habits, and customs or traditions unique to a group of people. Cultural imposition is defined as the tendency of an individual or group to impose their values, beliefs, and practices on another culture for various reasons.
The nurse leader is teaching the staff that the health care provider continuously strives to work effectively within the cultural context of a client. Which cultural principle is the nurse leader explaining?
Offering rewards and recognition to individuals and teams Offering rewards and recognition to individuals and teams is a management task, not a task of followership. Demonstrating accountability to the team effort; offering knowledge, skills, and abilities to achieve the task at hand; and taking reasonable risks as a preventive measure when fearing change or unknown circumstances are implementations of Bleich's tasks of followership. Test-Taking Tip: Chart/exhibit items present a situation and ask a question. A variety of objective and subjective information is presented about the client in formats such as the medical record (e.g., laboratory test results, results of diagnostic procedures, progress notes, healthcare provider orders, medication administration record, health history), physical assessment data, and assistant/client interactions. After analyzing the information presented, the test taker answers the question. These questions usually reflect the analyzing level of cognitive thinking. In a clinical exam, you may be expected to select instruments, arrange instruments, and/or perform some other task. Acquaint yourself with the physical facility. If the required procedures are not clear to you, ask for clarification.
The nurse manager is evaluating different Bleich's tasks of followership performed by members of the nursing team. Which team member's action indicates incorrect implementation of Bleich's tasks of followership?
Being sensitive to nonverbal communication Providing the opportunity for dialogue and feedback Presenting information that addresses the listener's self-interest The nurse should be sensitive to nonverbal communication because it may require interpretation of key points in complex situations. The nurse should provide the opportunity for dialogue and feedback. The nurse should present information that addresses the listener's self-interest. The nurse should plan the message and should not give too much information, which will paralyze the listener and divert energy away from key responsibilities. The nurse should use face-to-face communication as the primary communication mechanism rather than e-mail or texting. Test-Taking Tip: Identify option components as correct or incorrect. This may help you identify a wrong answer.
The nurse, as a leader, is planning to provide information about personal hygiene to a group of clients. Which communication methods should the nurse use to talk to the clients? Select all that apply.
Emotions and personality The staff nurse may be experiencing distress and pent up emotions and may not be able to receive another message. Distractions most commonly come through sensory perceptions, such as poor lighting or background noise, including music, ringing phones, and interruptions by others. Poor planning may not be the cause in this situation. A difference in perception arises because of differences in the way two individuals see the world.
The nursing leader is giving a demo on using computerized provider order entry (CPOE) to a newly hired nurse for automatic dose calculation. The nurse leader observed that the staff nurse was not concentrating on the instructions and seemed distressed. After completing the demo, the nurse leader asked the staff nurse to operate the CPOE, but the nurse misused the system. Which communication barrier does the nurse leader suspect to be the reason?
Encouraging and developing the leadership of the new nurse Effective leadership is responsible for achieving an effective workplace, and therefore succession of the leadership is an important consideration. This can be done by encouraging and developing the leading skills of the new nurse and supporting current leaders to implement their roles effectively. Discouraging the new nurse does not result in succession of the leadership and effects the growth of the organization. Therefore actions such as asking the nurse to stop leading immediately or asking the nurse to act as a leader after the senior nurse retires do not indicate effective leading ability. The senior nurse, as a leader, should guide the nurse to focus on both professional work and leadership. STUDY TIP: Regular exercise, even if only a 10-minute brisk walk each day, aids in reducing stress. Although you may have been able to enjoy regular sessions at the health club or at an exercise class several times a week, you now may have to cut down on that time without giving up a set schedule for an exercise routine. Using an exercise bicycle that has a book rack on it at home, the YMCA, or a health club can help you accomplish two goals at once. You can exercise while beginning a reading assignment or while studying notes for an exam. Listening to lecture recordings while doing floor exercises is another option. At least a couple of times a week, however, the exercise routine should be done without the mental connection to school; time for the mind to unwind is necessary, too.
The senior nurse finds that a novice nurse is mainly emphasizing leadership activities in a healthcare facility. Which action of the senior nurse indicates effective leading ability?
An organization having poor work flow was suffering financial losses. A team member introduced creative solutions that were publicly recognized by leadership. Which leadership theory is at work in this scenario?
Transformational theory Transformational leadership refers to a process by which the leader attends to the needs and motives of subordinates in order to motivate. A creative initiative by an employee and an optimistic attitude of a leader towards subordinates indicates successful impacts of transformational theory. Trait theory explains that a set of leadership traits influences others to work towards a common goal. Style theory involves task behaviors and relationship behaviors that determine leadership effectiveness. Situational-contingency theory considers the challenge of a situation and develops an adaptive leadership style to resolve the issues.
Generate an open dialogue about external and internal realities. Develop a core group of change advocates. Create a vision for change. Communicate the change vision regularly and consistently. Keep an alert for barriers in structure and processes. Report differences and honor the people who implement According to the Kotter's eight-step change model, the first step towards creating a vision and fostering major organizational transformation is creating urgency. Generating open dialogue about external and internal realities will impact the need to change. The next step is forming a powerful coalition. Developing a core group of change advocates will help build momentum as well as support individuals through the change experience. Next, creating a vision for change may involve lots of small alterations, and may or may not be a larger or inspiring vision. Communicating the change vision to people is the next step. People tend to pay attention to what is reinforced, so communicating regularly and consistently is required to sustain the effort. The next step is removing obstacles. This includes having alerts for barriers in the structure and processes that limit the ability to change and removing these barriers. The last step is to report the changes and honor the people who helped make it happen, in order to inspire others.
What is the correct order of steps that should be followed by a leader to create a vision and foster major organizational transformation?
Inspiring a shared vision Improving interpersonal skills Being able to motivate the nursing staff Having a shared vision helps effective transformational leaders and their teams become inspired and committed to a shared goal. Being an effective transformational leader depends on one's interpersonal skills; improving these can help in interactions with the staff. The ability to motivate the nursing staff is also important for a transformational leader because this helps one reach desired goals and improve performance. Acquiring a mentor is not a requirement of transformational leadership. Upgrading one's self-knowledge is beneficial for a nurse leader in decision making.
Which characteristics should a nurse focus on to become an effective transformational leader? Select all that apply
Delphi technique The Delphi technique is a decision-making strategy that involves systematic collection and summarization of opinions and judgments on a particular issue from respondents in order to achieve consensus among the team members and the leader. The purpose of a focus group strategy is to explore issues, identify problems, and generate information. Brainstorming strategy can be an effective method for generating a large volume of creative and innovative ideas irrespective of criticism. Normal group technique strategy gives opportunity to the group members to provide input into the decision-making process. Test-Taking Tip: You have at least a 25 percent chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.
Which decision-making strategy involves systematic collection and summarization of opinions and judgments on a particular issue from the respondents?
Number of staff Leader competency Nurse education level While implementing any change in an organization, the number of staff should be considered to avoid administrative burdens and duplication of endeavors for that change. Effective leadership abilities and nurses' educational levels are essential for successful implementation and good understanding about the change. The financial status and place at which the organization is located do not affect the change; therefore these factors may not be considered while implementing the change.
Which internal factors should be considered while implementing any change in an organization? Select all that apply.
Complexity theory Complexity theory states that the leaders should expand and respond to engaging dynamic change and focus on relationships rather than on prescribing and approaching change as a lock-step, pre-prescribed method. Role theory is a framework used to understand how individuals perform within organizations. Chaos is the theoretical construct defining the seemingly random yet deterministic characteristics of complex organizations. Organizational theory is the systematic analysis of how organizations and their component parts act and interact.
Which theory states that leaders should expand and respond to a dynamic change rather than prescribing and approaching change as a lock-step, pre-prescribed method?
While organizing a community health care program for polio vaccinations, the registered nurse delegates the task of administering vaccines to the members of the health care team. Who among the health care team is most suitable to carry out the task?
licensed practical nurse
While assigning a task, the RN finds that one of the delegatees is not competent to help the current position. Which strategy does the nurse follow for managing this issue during delegation?
lowering the expectations temporarily
What should the delegator do when he or she finds that a delegatee is unable to perform the given task?
make sure to educate and provide feedback to the delegatee
