Managing Patient Care EAQ

patient centered care is a model of nursing care in which

formation of mutual relationships between provider and patient occurs to plan, implement, and evaluate the delivered health care services

the autonomy element of decision making gives the nurse

freedom to develop a plan of care for the patient within the scope of the professional nursing practice. and enables the nurse to make decisions about scheduling work

in team nursing

the leader (RN) delegates tasks to other members of the team

which member of the nursing team is most likely to use transformational leadership for team development? - nurse manager - RN - assistive personnel - Licensed practical nurse

- nurse manager

Dignity & respect, information sharing, participation, & collaboration are the four core concepts for

patient centered care

when was the primary nursing model of care adopted? - During the 1970s - During World War I - During World War II - During the 2000s

- During the 1970s total patient care was developed in world war I. team nursing was developed in response to severe nursing shortage after world war II. the interprofessional model became popular in the 2000s

the registered nurse (RN) checks on a patient with pneumonia. the patient is coughing profusely and requires nasotracheal suctioning. prescriptions include an intravenous (IV) infusion of antibiotics. the patient is febrile and asks the RN if he can have a bath because he has been perspiring profusely. which task is appropriate to delegate to the nursing assistant? - assessing vital signs - changing IV dressing - performing nasotracheal suctioning - administering a bath

- administering a bath the other tasks are the responsibility of the RN

which task is appropriate for a RN to delegate to the nursing assistant? - explaining to the patient the preoperative preparation before the surgery - administering the prescribed antibiotic to the patient before surgery - obtaining the patients signature on the surgical informed consent form - assisting the patient to the bathroom

- assisting the patient to the bathroom

which element of the leadership quality of decision making gives the registered nurse the legitimate power to give commands and make final decisions specific to a given position? - authority - autonomy - responsibility - accountability

- authority

which element of leadership involves the freedom of choice? - authority - autonomy - responsibility - accountability

- autonomy

which statement describes accountability? - managing employees - being answerable for ones action - having freedom to choose aspect of care - recommending appropriate teaching strategies

- being answerable for ones action managing employees= delegation freedom to choose care plan= autonomy recommending strategies= authority

which nursing care delivery model delivers health care services with high quality and cost effective care? - team nursing - patient centered care - total patient care - case management

- case management

which type of care management approach coordinates and links health care services to patients and families while streamlining costs and maintaining quality? - primary nursing - total patient care - team nursing - case management

- case management case management is defines as " a collaborative process of assessment, planning, facilitation, and advocacy for options and services to meet an individuals health needs through communication and available resources to promote quality cost effective outcomes.

which example demonstrates the nurse performing the skill of evaluation? - explaining the side effects of the new blood pressure medication prescribed for the patient - asking the patient to rate pain on a scale of 0-10 before administering the pain med - completing the teaching then observing the patient draw up and administer an insulin injection - changing the patients leg ulcer dressing using the aseptic technique

- completing the teaching then observing the patient draw up and administer an insulin injection

the head nurse is delegating responsibilities to the staff. which order would be given to the nurse manager? select all. - conduct regular staff meetings - make rounds with health care providers - submit staffing schedules for the unit - provide care to the patients using a holistic approach - participate in the development of nursing policies and procedures

- conduct regular staff meetings - make rounds with health care providers - submit staffing schedules for the unit the nurse practitioner provides holistic care. the nurse educator participates in the development of nursing policies and procedures

which duty would a case manager perform? select all that apply. - prescribe medicines to the patient in the health care providers absence - coordinate acute care of the patient in the hospital - supervise the care delivered by other staff - actively coordinate patient discharge planning - provide alternative therapies to the patient

- coordinate acute care of the patient in the hospital - supervise the care delivered by other staff - actively coordinate patient discharge planning a case manager is often an advanced practice nurse who is responsible for helping to improve patient outcomes, optimising patient safety by facilitating care transitions, decreasing lengths of stay and lowering costs. they coordinate patients acute care in the hospital and follows up after discharge. they are not involved in direct care of the patient such as prescribing meds and providing alternative therapy.

the hospital nursing staff is competent and motivated and receives consistently high patient satisfaction scores. which concept is most likely responsible for this achievement? - accountability - magnet recognition - case management - decentralized decision making

- decentralized decision making decision making at the level of the staff members is called decentralized decision making. it allows the managers and staff more active involvement in shaping and determining the success of the organization when increases competency and motivation. magnet recognition is something the hospital may earn but does not facilitate the achievement its self

which leadership quality can result in the success of the health care organization after decentralization? - delegation - decision making - team communication - clinical care coordination

- decision making decentralization is a component of the hierarchical level of decision making found in health care institutions. decision making is a critical component of an effective leader and manager and is a leadership quality that can help in the success of the health care organization after decentralization. delegation is defined as transferring responsibility for the performance of an activity or task while retaining accountability for the outcome. team communication and clinical care coordination do no specifically address decentralization.

which nursing student action toward the assistive personnel indicates effective learning regarding delegation? - delegating a basic patient care task to the AP - allotting a specific time to the AP for clarifying his or her doubts - limiting communication with the AP during the shift for efficiency - providing the AP with feedback after completion of all the tasks

- delegating a basic patient care task to the AP the AP should have as much time as necessary for clarifying doubts, the nursing student should have ongoing communication with the AP/ the nursing student should provide feedback to the AP while tasks are being completed

building an empowered nursing team starts with the nurse executive. which responsibility lies with the nurse executive in this process? - provide training to the nursing staff - maintain the patients record in a systemic way - teach the patients about health and well being - establish a philosophy for the nursing staff to provide quality nursing care

- establish a philosophy for the nursing staff to provide quality nursing care the executives position is critical in uniting the strategic direction of an organization with the philosophical values and goals of nursing. the main responsibility of the nurse executive is to establish a philosophy for the nursing staff to provide quality nursing care. the nurse executive is not responsible for providing training to the staff or maintaining the patients record. teaching the patient about health and well being is done by the nursing staff

which principle is included in time management? select all - goal setting - time analysis - priority setting - interruption control - clinical decision making

- goal setting - time analysis - priority setting - interruption control clinical decision making is part of clinical care coordination

which statement by the nursing student indicated effective learning regarding the authority element of decision making? - i will develop a plan of care for my patients - i will be responsible for my actions and decisions - i will make decisions about the scheduling of work - i will ask the self care team to brief the patient on discharge

- i will ask the self care team to brief the patient on discharge as part of the decision making the nurse has the power to make decisions specific to a position. the nurse can instruct the self care team to breif the patient on discharge.

the nurse manager organizes a committee that includes RN, licensed practical nurses, health care providers, social workers and volunteers. which staff involvement approach is the nurse manager exemplifying? - shared governance - staff communication - interprofessional rounding - interpofessional collaboration

- interpofessional collaboration interprofessional collaboration involves bringing representatives of various disciplines together to work with patients and families. shared governance involves senior clinical staff nurses who establish and maintain care standards for nursing practice on their work unit. interprofessional rounding involves the patient and family in planning care and improving patient care coordination and communication amount the team

while teaching a patient about the dosage regimen, the nurse is called for a staff meeting. the nurse finishes explaining the dosage regiment to the patient then attends the meeting. which leadership skill of time management is the nurse exhibiting? - goal setting - time analysis - priority setting - interruption control

- interruption control

which statement is true regarding responsibility? - it is the freedom of choice - it reflects a persons ownership - it is legitimate power to give a command - it refers to an individual being answerable for his or her actions

- it reflects a persons ownership

the nurse manager is discussing visting hour policies and asks the nurse to write a protocol for visting hours. which skill is the nurse manager exhibiting? - leadership - supervision - patient advocacy - collaborative care

- leadership

which responsibility does a nurse manager have? - recruiting new health care providers - making rounds with the health care provider - dealing with the cost effectiveness of the care plan - establishing structure to achieve the organizational goal

- making rounds with the health care provider the nurse manager is responsible for recruiting new nursing staff not health care providers. the nurse executive deals with the cost effectiveness of the plan and establishes a structure that helps achieve organizational goals

which task is appropriate for the nurse to delegate to assistive personnel? - modify the therapeutic plans - obtain and record vital signs - assess ongoing status of drug therapy - teach the patient about drug administration

- obtain and record vital signs the nurse cannot delegate any of the tasks of the nursing process such as modifying the therapeutic plans, assessing the ongoing status of drug therapy or teaching the patient about drug administration

which characteristic does the primary nursing care delivery model exhibit? - one primary RN assumes the responsibility for a caseload of patients - team members provide direct patient care under the supervision of an RN - the same RN provides care for a group of patients during their entire stay in an agency - there is hierarchical communication from charge nurse to charge nurse - the RN assess the patient, develops the care plan, and delivers appropriate nursing intervention

- one primary RN assumes the responsibility for a caseload of patients - the same RN provides care for a group of patients during their entire stay in an agency - the RN assess the patient, develops the care plan, and delivers appropriate nursing intervention

A nurse must help a hospitalized patient with diabetes eat; the health care provider has also requested a urine sample. Which leadership element would the nurse use in this situation? - autonomy - organizational skills - clinical decision making - transactional leadership

- organizational skills transactional leadership refers to transforming the nursing staff to work at an increased level with team motivation and spirit

which nursing care delivery model improved registered nurse accountability but is rarely used today because of high costs? - primary nursing - total patient care - case management - patient centered care

- primary nursing primary nursing is the nursing care model that improved the accountability but is rarely used today because of high costs.

which nursing model focuses on improving the accountability of nursing for patient outcomes? - team nursing - primary nursing - total care - secondary nursing

- primary nursing primary nursing was developed to improve the accountability of nursing for the patient outcomes. team nursing was developed in response to the severe nursing shortage after world war II. total patient care delivery was the original care delivery model developed during Florence nightingales time. secondary nursing is not a type of nursing care delivery model.

when caring for patient which action would the nurse perform to appropriately delegate the tasks to the assistive personnel in accordance to the five rights of delegation? select all that apply - delegate tasks in any clinical setting - provide appropriate supervision and evaluation - delegate tasks that have minimal potential risk - provide a clear, concise description of the delegated task - provide feedback infront of everybody

- provide appropriate supervision and evaluation - delegate tasks that have minimal potential risk - provide a clear, concise description of the delegated task

which statement made by the student nurse indicates a need for further teaching regarding delegation? - providing appropriate monitoring is the principle of right direction - none of the steps of the nursing process should be delegated - delegation is the act of transferring responsibility but retaining the accountability of the task - one of the rights of delegation, right supervision, provides appropriate monitoring and feedback

- providing appropriate monitoring is the principle of right direction providing appropriate monitoring is the principle of right supervision. providing a clear, concise description of the task is the principle of right direction. steps of the nursing process require appropriate appropriate nursing judgement therefore they are not delegated.

which factor is essential to a philosophy of care? select all that apply - management of patient care - selection of proper interventions - selection of the management structure - selection of a nursing care delivery system - knowledge of roles and responsibilities of a nurse

- selection of the management structure - selection of a nursing care delivery system

a nurse who is an effective leader would possess which characteristics? select all that supply. - take initiative and sustain motivation, especially during times of uncertainty - maintain a neutral approach in decision making - rebound from set backs with positivity - identify the need to change and support change effectively - display impassivity towards others to avoid discrimination

- take initiative and sustain motivation, especially during times of uncertainty - rebound from set backs with positivity - identify the need to change and support change effectively

which task delegated to a newly graduated nurse is the nurses lowest priority? - clearing an obstructed airway - teaching self hygiene home care - teaching the patient about a new drug therapy for an untreated problem taking measure to decrease postoperative complications

- teaching self hygiene home care clearing an obstructed airway is a high priority. anticipating and teaching patient about new drug therapy and taking measures to decrease postop complications are second level

which nursing care delivery model involves the registered nurse providing direct patient care with the help of assistive personnel? - team nursing - primary nursing - total patient care - case management

- team nursing

which unit staffing includes assistive personnel which scenario is characteristic? - the AP have formal training and are able to function independently - the AP do not have clinical duties on a patient care unit - the RN is accountable for the tasks delegated to the AP - delegating tasks to the AP is not in the scope of the RNs practice

- the RN is accountable for the tasks delegated to the AP

which characteristics of team nursing holds true? select all - the RN works directly with the patient and family - the RN assumes responsibility for the caseload of patients - the RN leads the team of other nurses and assistive personnel - the team leader develops patient care plans and coordinates with team members - the team members provide direct patient care under supervision of the RN

- the RN leads the team of other nurses and assistive personnel - the team leader develops patient care plans and coordinates with team members - the team members provide direct patient care under supervision of the RN the registered nurse works directly with the patient and the family in the total patient care model

which task is appropriate for the nurse to delegate to a nursing assistant? - checking a health care providers new prescriptions - changing a patients wound dressing - toileting a patient on a bladder training regimen - taking the blood pressure of a patient who has fallen

- toileting a patient on a bladder training regimen

the nurse asks the assistive personnel to hold the legs of a female patient during an indwelling catheter insertion. this is an example of which aspect of clinical care coordination? - organizational skills - use of resources - time management - evaluation

- use of resources

while inserting the intravenous catheter the nurse asks the nursing assistant to help stabilize the patients hand. which type of clinical care coordination is the nurse following? - priority setting - use of resources - time management - clinical decision making

- use of resources

the nurse assumes responsibility for the decisions and the actions performed as part of the ______ element of decision making

accountability

in primary nursing one RN is responsible for

a caseload of patients from admission to discharge

the case management model is designed to

provide health care services by managing costs effectively and maintaining quality.

the total patient care model states

that the RN is responsible for all aspects of care during a shift of care. this model is used in critical care areas.

total patient care is

very similar to primary nursing on nurse is responsible for all aspects of care for one or more patients during a shift