Leadership Quiz 1 Study Guide (after the fact)

(Missed) which pt to see/med to admin first

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(Missed)Which of the following statements by the graduate nurse shows an understanding of reality shock as it applies to nursing? a. " Reality shock is the period when a person moves from school into the workforce. b. "Reality shock is the realization that practice and education are not the same." c. "Reality shock is the period from graduation to becoming an experienced nurse." d. "Reality shock is a transition phase that new graduates go through before changing jobs."

ANS: A "Reality shock" is a term often used to describe the reaction experienced when one moves into the workforce after several years of educational preparation. The new graduate is caught in the situation of moving from a familiar, comfortable educational environment into a new role in the workforce where the expectations are not clearly defined or may not even be realistic. The realization that practice and nursing school are not the same is often associated with "going native." When nurses move from one position to another, they have already experienced reality shock. Becoming an experienced nurse takes time and is not part of the definition of reality shock.

(Correct) A nurse has been out of school about 6 months. Which of the following would indicate that the nurse is having problems with burnout? a. Having chronic fatigue, increased irritability, and feelings of helplessness b. Feels angry regarding the type of care being delivered and scheduling of staff coverage c. Signs up for extra courses for an advanced degree and works double shifts for extra money d. Is disorganized regarding patient care and has to stay late to finish shift work

ANS: A Fatigue, irritability, and feelings of helplessness are all early signs of burnout. Anger regarding care may be very appropriate; how the anger is directed is important. Overscheduling oneself is something that may promote early burnout, as are disorganization and poor time management.

(Correct) A student in the last semester of nursing school has established a goal of making a successful role transition to graduate nurse. Which statement by the student indicates his/her understanding of how to achieve this goal? a. "I should care for increased numbers of patients to enhance work organization skills." b. "I will observe staff nurses as they perform nursing procedures to refine technique." c. "I should seek increasingly close guidance from the nursing instructor to reduce errors." d. "I will evaluate my progress every 7 weeks or more to allow time for growth."

ANS: A It is important for the student to start taking care of increased numbers of patients to help with time management and work organization. The student should also be able to function without close guidance from the nursing instructor. Although it is good for students to observe staff, a student in the final semester should be able to perform tasks with minimal observation and should instead focus on implementing care and time management. Waiting 7 weeks to evaluate progress would not be helpful to the student. Although regular self-evaluation is an important process, it is the actual experience of taking realistic patient assignments and working typical shift hours that assists with successful role transition

(Correct)A nurse is trying to avoid burnout. Which of the following actions is a valid way to achieve this? a. Refusing to constantly work extra shifts b. Withdrawing from peer support group c. "Going native" d. Changing jobs every 6 to 12 months

ANS: A One of the quickest ways to experience burnout is to "overwork the overtime." Set priorities with your mental and physical health being the highest priority. Learning to say "no" to extra shifts is a positive means of coping of avoiding burnout. "Going native" is the term that describes how recent graduates begin to copy and identify the reality of their role transition experience by rejecting the values from nursing school and functioning more like a team member at their place of employment. Withdrawing from peer support groups, "going native," and changing jobs every 6 to 12 months would increase the chance of the nurse experiencing burnout. The nurse should instead focus on his/her practice and seek out support from other nurses.

(Correct) A student nurse is feeling stressed about the combination of nursing courses and clinical experience in the semester. What actions can the student nurse take to reduce stress level based on biological rhythms? a. Schedule difficult activities at high-energy times. b. Shorten sleep time to accommodate increased study times. c. Study before bedtime to increase memorization. d. Only study when not feeling stressed

ANS: A Student nurses should create schedules that work with their biological rhythms, such as scheduling difficult activities at their high-energy times. Shortening sleep, studying right before bed, and only studying when they are not feeling stressed are not advised.

(Missed) A student nurse is in the last semester of nursing school. Which action by the nursing student indicates appropriate preparation for the transition experience? a. The nursing student requests additional experiences in performing skills and procedures. b. The nursing student maintains close contact with a nursing instructor to observe nursing procedures. c. The nursing student practices nursing assessments and care on one or two patients to become more competent. d. The nursing student increases communication with a nursing instructor to maintain a resource person after graduation.

ANS: A Students should get all the experience, not just observation, you can before graduation. Ask to perform procedures and skills and request feedback from staff nurses and instructors. Students should also begin to build resources that will be available after graduation. It is during the last semester that students begin to care for more complex patients (and more patient numbers) to gain experience in the "real world" of nursing management, as well as less begin to have less reliance on the nursing instructor as a resource person.

(Missed) A public health nurse is giving a presentation on the recovery stage of a disaster to a group of nursing managers. The teaching has been effective when one of the nurse managers states: a."The recovery stage deals with operations that occur after the disaster." b."The recovery stage deals with operations during a disaster." c."The recovery stage deals with operations before a disaster." d."The recovery stage involves the process of dealing with disasters."

ANS: A The recovery mode of a disaster deals with operations that occur after the disaster. During the recovery stage, the nurse may be confronted with unexpected or sudden loss of key personnel, patients, and the management of mental health issues related to the disaster. The preparedness mode of a disaster deals with operations done before a disaster. The response mode of a disaster deals with operations during a disaster.

(Missed) The graduate nurse understands that transitions occur throughout life. What major factor does the nurse identify as influential in a successful transition from school to practice? a. Level of new knowledge and skills required in the new environment b. Amount of classwork required to obtain a degree c. Personal history of previous developmental transitions d. Influence of classmates and their transitional experiences

ANS: A The transition from student to practice reflects a situational transition that is most often affected by the anticipation of changes in the new work environment. Classwork no longer affects this transition. A personal history of previous developmental transitions and the influence of classmates are not as prominent as the anticipated requirements to function in the new environment of work.

(Correct) A nurse is one of the first responders on the scene of a disaster. What is initial priority? a.Triage the patients. b.Delegate care to additional personnel as they arrive. c.Task assignment. d.Prioritize care.

ANS: A Triage can be used by lightly trained emergency department (ED) personnel and is not to supersede or instruct medical techniques. A common triage system is known as START (Simple Triage and Rapid Treatment). Triage is used during natural disasters and mass casualty events. Delegation, assigning tasks, and prioritizing care are daily functions done by the nurse manager.

(Missed) Which action would greatly help the graduate nurse when seeking out employment? (Select all that apply.) a. Plan out interviews. b. Ask to speak to nurses who work on the unit. c. Wait until the interview to gather all of the information. d. Find out what type of nursing care is delivered. e. Determine the length of orientation.

ANS: A, B, D, E It is important for the graduate nurse to be prepared when seeking out employment. Planning out interviews, speaking to nurses who work on the units, finding out what type of nursing care is provided, and determining the length of orientation are all actions the graduate nurse can take to prepare for employment. Waiting to gather information at the interview can leave the graduate nurse feeling frazzled and disorganized.

(Correct) Which action by the nurse exemplifies a sense of spiritual health? a. Belonging to a church b. Feeling purposeful and fulfilled c. Feeling loved and cared for d. Changing religious affiliations

ANS: B A sense of spiritual health simply means that we have a daily awareness that there is something more to living than mere human existence. People who have a sense of spiritual being find their lives to be positive experiences and feel good about the future. Belonging to a church, feeling loved and cared for, and changing religious affiliations are not identified as ways that one exemplifies a sense of spiritual health.

(Correct) An infection control nurse is educating a nurse about potential bioterrorism agents. The nurse knows the teaching has been effective when the nurse states: a."Smallpox has three routes of exposure to humans." b."Anthrax has three routes of exposure to humans." c."Botulism is caused by a bacterium found only in animals." d."Tularemia is transmitted via ingestion of toxin-contaminated food."

ANS: B Infection with Bacillus anthracis, the cause of anthrax, can occur via three routes of exposure: cutaneous, gastrointestinal, and inhalation. Botulism can be transmitted via ingestion of toxin- contaminated food. The toxin can be aerosolized and inhaled (artificial). Tularemia is not known to be spread from person to person and is caused by the bacterium Francisella tularensis, which is found in animals (especially rodents, rabbits, and hares).

(Correct) The nurse has an adequate understanding of smallpox when the nurse states which of the following? a."Smallpox does not exist because of vaccines." b."Smallpox can easily be spread from person to person." c."Smallpox must be ingested for a person to become sick." d."Smallpox is resistant to vaccines."

ANS: B The nurse has an adequate understanding when the nurse states that smallpox an easily be spread from person to person. Smallpox does still exist, does not need to be ingested for a person to become sick, and is not resistant to vaccines.

(Correct) A nurse manager is preparing a group of newly hired nurses to work on the unit. After educating them on reality shock, a student raises their hand and asks what physical and psychological symptoms the nurse may experience? The nurse manager replies: (Select all that apply.) a. "It is not possible to experience any physical or psychological symptoms from reality shock." b. "You may experience headaches." c. "It is possible that you will experience gastrointestinal upset." d. "You could experience insomnia." e. "Women may experience menorrhagia."

ANS: B, C, D Reality shock can cause physical and psychological symptoms that are important for the nurse to be aware of. These can include headache, insomnia, feeling stressed out, gastrointestinal upset, and post-student blues. Menorrhagia (excessive menstrual bleeding) is not a typical physical symptom of reality shock but is caused by uterine fibroids, endometriosis, or uterine polyps. Amenorrhea (absent menstrual flow) may be experienced because of stress associated with reality shock.

(Correct) A nurse is considering pursuing additional education in nursing and hopes to be promoted to a management position. What action should the nurse take to best achieve this? a. Wait until "the time is right" and inquire about program and promotion opportunities. b. Be the best nurse possible and hope a scholarship or promotion will be awarded. c. Set long-range, mid-range, and short-range goals with specific related activities and time frames to meet these goals. d. Read three books on time management.

ANS: C Set goals so that you can prioritize your approach, along with identifying specific activities and time frames to work toward a management promotion are keys to success. Assess the situation and see what activities will provide the highest payoff. Waiting for the right time to achieve promotion, hoping for a scholarship or promotion, and reading books on time management are not effective; instead, the nurse must take action to achieve a goal.

(Correct) A nurse manager is educating a new hire on which form of standardized structure is implemented in the hospital during an emergency response. The teaching has been effective when the new hire states: a."Emergency System for the Advance Registration of Volunteer Health Professionals (ESAR- VHP) is implemented to coordinate and standardize command and operations." b."START system of triage is implemented to coordinate and standardize command and operations." c."Hospital Incident Command System (HICS) is implemented to coordinate and standardize command and operations." d."Initiation of the Medical Reserve Corps (MRC) is implemented to coordinate and standardize command and operations."

ANS: C The Hospital Incident Command System (HICS) is a standardized command structure that allows for coordination and collaboration across jurisdictions and professions within a hospital facility during an emergency response. ESAR-VHP is a registry of health professionals that can be accessed and executed to recruit medical and clinical professionals (e.g., retired, nonlicensed) during an emergency response. START is a form of triage care used during a mass casualty event. MRC is a registry of medical reserve corps persons who can be recruited for overall assistance with a health or hospital facility during an emergency response.

(Correct) Which statement indicates the nurse's understanding of effective time management? a. "The purpose of effective time management is to save hours, minutes, and seconds." b. "The purpose of effective time management is to do as much as possible in as short a time as possible." c. "The purpose of effective time management is to do as little as possible." d. "The purpose of effective time management is to achieve personal and professional goals."

ANS: D Making time to meet your individual, family, professional, and career needs and goals is vital to overall success and is the primary purpose of time management. Stating the purpose of effective time management as saving time or doing as much or as little as possible in a short time would not indicate the nurse's understanding. Procrastinating and doing as little as possible are not characteristic of effective time management.

(Correct) What actions should a graduate nurse take in the first work experience to avoid problems with burnout? a. Cross-train to work in different areas of the hospital. b. Develop a social group of nurses with whom to share work experiences. c. Plan on several sessions with a counselor regarding managing stress. d. Develop social contacts outside of nursing and maintain good nutrition and good sleep habits.

ANS: D Taking care of oneself is a primary component to preventing burnout—for example, avoiding alcohol, maintaining good nutrition, getting adequate amounts of sleep, and avoiding cigarette smoking. Developing social contacts outside the work environment also facilitates reduction of stress from work. Cross-training in different areas of the hospital, developing a social group with nurses to share work experiences, and meeting with a counselor would not be helpful to the graduate nurse in avoiding problems with burnout in the first work experience.

(Missed) The nurse professor is lecturing to students in their final semester of nursing school. Which statement by the nurse professor about mentoring is accurate? a. "Mentoring involves solving an individual's problems." b. "Mentoring focuses on the needs of someone else." c. "Mentoring means helping someone reach his or her long-term goals." d. "Mentoring requires pairing an experienced person with a novice."

B "Mentoring focuses on the needs of someone else."

(Correct) A group of nursing students is discussing mentors. One of the students correctly states a characteristic of a successful mentor when stating: a. "They ensure that their mentees do not fail." b. "They push the mentees to a higher level." c. "They always ask a lot of questions of their mentees." d. "They encourage mentees to question their skills so they can improve."

B "They push the mentees to a higher level."

(Missed) You are a graduate nurse in search of a mentor. To find a good "match," what should you look for? a. Choose an experienced nurse who is successful. b. Look for things you and the potential mentor have in common. c. Be very specific with the questions you ask of the possible mentor. d. Be careful not to disclose too much personal information.

B Look for things you and the potential mentor have in common.

(Correct) difficulty swallowing question

assess airway

(Missed) BP question

assess cardiovascular

(Missed) which pt to see first

pt that just arrived to unit/has not been assessed yet