N401 Midterm HESI Questions
A client is diagnosed with Alzheimer disease and is exhibiting hyperorality. Which parameter would the nurse closely monitor to keep this client safe? -For choking at meal times -For the presence of mouth ulcers -For injuries from touching hot foods -For attempts at eating inedible objects
For attempts at eating inedible objects The nurse would closely monitor for attempts at eating inedible objects. Hyperorality is the compulsive need to taste, chew, and put everything in the mouth. Hyperorality is not related to choking at meal times; dysphagia is related to choking. Hyperorality is not related to mouth ulcers; stomatitis refers to mouth ulcers. Injuries from touching refers to hypermetamorphosis, the urge to touch everything.
After communicating with the follower of the nurse leader, the senior nurse concludes that the nurse leader is using the transactional leadership approach. Which statement of the follower supports the senior nurse's conclusion? SATA "I have increased job satisfaction" "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." "I am performing challenging and meaningful work every day"
"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." The transactional leader penalizes followers for poor performance and gives rewards for good performance. The transactional leader monitors work deadlines and corrects followers' errors in a reactive manner. Under a transactional leader, the followers have limited job satisfaction. Under a transformational leader, the followers do challenging and meaningful work every day.
The registered nurse (RN) teaches the student nurse about delegation. Which statement made by the student nurse indicates appropriate learning? "Licensed practical nurses (LPs) are accountable for the tasks they perform." "Complete client care can be delegated to the LPN." "Professional aspects of care can be carefully delegated to the LPN." "LPNs can be expected to perform tasks with which they have experience."
"LPNs can be expected to perform tasks with which they have experience." The delegator can safely delegate the task to the LPN if the task is within the scope of function or if the LPN is very experienced in performing the task. The LPN, being a delegatee, is not held accountable for the delegated work; the LP is held responsible for the delegated task. The delegator is held accountable for the LP's work. The delegator can never delegate complete client care to the LP but can only transfer functions and tasks. Basic skills such as activities of daily living and personal hygiene can be delegated by the delegator, but professional aspects of care should not be delegated.
Which health care professionals would the nurse say work under active delegation? SATA -A health care provider examining clients in the outpatient ward -A nurse giving medication to a client as prescribed by the health care provider -A pharmacist dispensing medicines prescribed by the health care provider to the client -A licensed practical nurse (LP) administering oral medications as delegated by the registered nurse (RN) -The unlicensed assistive personnel (UAP) maintaining oral hygiene of the clients as delegated by the RN
-A licensed practical nurse (LP) administering oral medications as delegated by the registered nurse (RN) -The unlicensed assistive personnel (UAP) maintaining oral hygiene of the clients as delegated by the RN If tasks are delegated to a delegatee after a thorough assessment by the delegator who remains accountable for the delegated tasks, it is called active delegation. The RN's delegation of tasks, such as administering oral medications and maintaining oral hygiene, to LPNs, UAPs, and other nursing personnel are examples of active delegation. Any task performed normally, or as an essential part of practice by licensed individuals such as primary health care providers, nurses, and pharmacists, forms a part of passive delegation.
Which factor would the nurse associate with transformational leadership? SATA -A shared vision -Increased self-worth of followers -Doing the work and getting paid -Coaching and mentoring by the leader -Correction of errors in a reactive manner
-A shared vision -Increased self worth of followers -Coaching and mentoring by the leader Transformational 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 transformational leadership facilitate coaching and mentoring of followers for skill enhancement. Transactional leadership involves arrangements in which the followers do the task and get paid for it. The mistakes that happen during the task are corrected in a reactive manner.
Which of the nurse's statements are true regarding delegation? SATA -Delegation is a complex process. -Delegation involves a single individual to achieve goals. -Delegation involves transfer of responsibility and accountability. -Delegation improves client care outcomes when used effectively. -Delegation includes delegatees who allocate a portion of work to others.
-Delegation is a complex process -Delegation improves the client care outcomes when used effectively Delegation is a complex decision-making strategy implemented to the work-related performance of the staff employed in health care organizations. When used effectively, delegation improves client care outcomes. Delegation always involves at least two individuals, such as the delegator and the delegatee, who engage in open communication to achieve a goal. Delegation involves the transfer of responsibility for the performance of a task from one individual to another while the delegator retains the accountability for the outcome. Delegation includes delegators who allocate a portion of work to others.
Which action would a transformational nurse leader consider desirable? SATA -Fostering a shared vision -Providing coaching and mentoring -Intervening when a problem exists -Correcting errors in a reactive manner -Monitoring performance and taking action
-Fostering a shared vision -Providing coaching and mentoring The transformational leader fosters a shared vision and provides coaching to the other team members. A transactional leader provides intervention only when required, corrects errors in a reactive manner, and monitors performance and takes action.
Which organizational outcome would be expected to occur when a transformational leader demonstrates charismatic behavior and careful consideration of the value of every individual in the organization? SATA -Increased loyalty -Deadlines met -Increased performance -Low-to-stable levels of commitment -Work supervised and completed according to the rules
-Increased loyalty -Increased performance Charismatic behavior and individual consideration are the behaviors of transformational leadership. A leader displaying this behavior would increase the loyalty and performance level of the followers. In transactional leadership, deadlines are typically met but followers have low-to-stable levels of commitment and the work needs to be supervised and completed according to the rules.
Which action by the nurse leader is an example of transactional leadership? -Accounting for the needs and abilities of individual employees -Encouraging the novel and innovative thinking of employees -Motivating employees by articulation of an inspirational vision -Inspiring the self-interest of employees by offering external rewards
-Inspiring the self-interest of employees by offering external rewards Transactional leadership relies on the power of organizational position and formal authority to reward or punish performance. Offering external rewards to motivate the self-interest of employees is a type of transactional leadership. The transformational leader can motivate employees by accounting for their needs and abilities individually. Encouraging the novel and innovative thinking of employees is a characteristic of transformational leadership. The transformational leader helps motivate employees by articulation of an inspirational vision.
Which statement(s) are true regarding delegation? SATA -The delegates are accountable for effective client care. -Open lines of communication must occur between delegator and delegate. -Delegation occurs only when at least two people are involved in a mutual work situation. -The delegation potentials are significantly lower when caregivers such as unlicensed assistive personnel (UAP) are partnered. -Delegation involves sharing activities with other health team members who have the authority to accomplish the work.
-Open lines of communication must occur between delegator and delegate. -Delegation occurs only when at least two people are involved in a mutual work situation. -Delegation involves sharing activities with other health team members who have the authority to accomplish the work. Open lines of communication between delegator and delegate help eliminate any misunderstanding regarding delegated tasks. Delegation occurs only when at least two people are involved in a mutual work situation; one who has the authority to perform specific tasks and the other who holds accountability for the task being performed. Delegation involves sharing activities with others who have appropriate authority to accomplish the work. When delegating a task to a delegate, the delegator retains accountability for effective client care by ensuring that the task is completed by the right person and that the person is supervised appropriately. The delegation potentials are significantly higher when caregivers such as UPs are partnered.
Which action by the nurse manager best accords with the transformational style of leadership? SATA -Providing intellectual stimulation -Intervening only when problems exist -Performing experiments with system redesign -Using motivation to inspire work performance -Monitoring performance and taking corrective action
-Providing intellectual stimulation -Performing experiments with system redesign -Using motivation to inspire work performance Transformational leaders provide intellectual stimulation and encourage follower creativity. They experiment with systems redesign, empower staff, create enthusiasm for practice, and promote scholarship of practice in client care. They use motivator factors liberally to inspire better work performance. Intervening only when problems exist is a behavior related to transactional leadership. Monitoring performance and taking corrective action is a transactional leadership quality.
To apply the two-factor theory, which motivating factor would the nurse leader use to inspire work performance? SATA -Salary -Security -Recognition -Achievement -Working conditions
-Recognition -Achievement Recognition and achievement are motivating factors 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.
The registered nurse (RN) is planning to delegate various tasks. Which actions would the RN take when delegating tasks appropriately? SATA -Avoid communication with the delegatee. -Select an experienced nurse as a delegatee. -Ask open-ended questions to the delegatee. -Provide constructive feedback to the delegatee. -Select a delegatee with similar strengths as those of the delegator.
-Select an experienced nurse as a delegatee. -Ask open-ended questions to the delegatee. -Provide constructive feedback to the delegatee. Delegation is achieving performance of care outcomes by sharing activities with others who have the appropriate authority to accomplish the work. Selecting an experienced nurse helps in providing appropriate delegation because the experienced nurse can adapt easily to new environments. Appropriate delegation can be achieved by asking open-ended questions to the delegate, because this allows the RN to gain pertinent information from the delegate who has been delegated a portion of client care. Providing constructive feedback improves the work performance of the delegate, which creates a collaborative work environment that leads to appropriate delegation. Avoiding communication with the delegate causes improper flow of information, which leads to inappropriate delegation. Selecting a delegatee with similar strengths as those of the delegator does not lead to appropriate delegation because the delegatee tries to do the task of the delegator.
Which action of the nurse leader demonstrates a hands-off approach in practice? SATA -The nurse leader avoids making conscious decisions. -The nurse leader avoids acting in situations beyond their control. -The nurse leader chooses to do nothing when an intervention is indicated. -The nurse leader chooses not to act upon a problem considered to be nonsignificant. -The nurse leader avoids responding to strict mandates imposed by an official in a higher position of authority.
-The nurse leader avoids making conscious decisions -The nurse leader chooses to do nothing when a intervention is indicated A hands-off approach may signify the leader does not make a conscious decision while solving a problem. Moreover, the leader chooses not to act when an intervention is indicated. In a situation beyond the leader's control, the leader not taking any action is an example of the purposeful inaction approach. In such an approach, the leader may consider the problem to be nonsignificant. After strict mandates imposed by higher officials, the nurse leader may avoid any action. However, this is not considered part of the hands-off theory.
Which component of delegation is retained while the delegator is delegating the client's care task to the unlicensed assistive personnel (UAP)? -Authority -Supervision -Responsibility -Accountability
Accountability Accountability is retained by the delegator while delegating a client's care task to the nursing aide. Every individual on the healthcare team has authority for the delegated task. The nursing aide is just responsible for the delegated task, so the delegator retains the accountability. Supervision is a right of delegation.
Which component of delegation is the ability to perform duties in a specific role? -Authority -Responsibility -Accountability -Legal authority
Authority Authority is the ability to perform duties in a specific role. Responsibility refers to reliability, dependability, and obligation to accomplish work. Accountability determines whether a person's actions are appropriate and provides a detailed explanation of what occurred. Legal authority is the ability to transfer selected nursing activities in a given situation to a competent individual.
Which basic health care ethic does the nurse follow when signing the client's consent form as a witness? -Justice -Autonomy -Beneficence -Nonmaleficence
Autonomy Autonomy refers to the commitment to include clients in decisions about all aspects of care as a way of acknowledging and protecting their independence. In the given situation, the nurse ensures that the client has thoroughly understood the new treatment plan before gaining written consent. This ensures that the client is involved in the decision-making process appropriately. Justice refers to fairness. The given situation does not deal with fairness. Beneficence refers to taking positive actions to help others. This involves keeping the interests of the client before self-interest. Nonmaleficence is the avoidance of harm or hurt. Weighing the pros and cons of the new treatment plan would involve nonmaleficence.
The nurse who promotes freedom of choice for clients in decision-making best supports which principle? -Justice -Autonomy -Beneficence -Paternalism
Autonomy The principle of autonomy relates to the freedom of a person to form their own judgments and actions. The nurse promotes autonomy nonjudgmentally so as not to infringe on the decisions or actions of others. Justice means to be righteous, to be equitable, and to act or treat others fairly. Beneficence relates to the state or act of doing good and being kind and charitable. It also includes promotion of well-being and abstaining from injuring others. Paternalism encompasses the practice of governing people in a fatherly manner, especially by providing for their needs.
Which principle did the researcher apply when calculating the risk-benefit ratio and concluding there were no harmful effects associated with a survey of diabetic clients? -Human dignity -Human rights -Beneficence -Utilitarianism
Beneficence Beneficence is defined as the promotion of well-being and abstaining from the injuring of others, as well as doing good and being kind and charitable. In this situation, the possible benefits outweigh the possible harm for the clients participating in a research study. Human dignity and human rights are underlying principles of research ethics but are not directly related to the risk-benefit ratio here. Utilitarianism relates to the ethical doctrine that virtue is based on utility, and that conduct would be directed toward promoting the greatest good for the greatest number of people.
Which statement would be appropriate to include in a lecture for nursing students related to ethics and legal principles? -Beneficence emphasizes promoting good, actively seeking benefit, and ensuring the client's well- being. -After the nurse has delegated a task or activity, the unlicensed assistive personnel (UAP) is accountable for the task or activity. -Social justice is an obligation to protect a client as an advocate when a client is not capable of self- determination. -There is a universal list that all states use that describes tasks that can be safely delegated and assigned to nursing team members.
Beneficence emphasizes promoting good, actively seeking benefit, and ensuring the client's well- being. Beneficence is the ethical principle that emphasizes promoting good, actively seeking benefit, and ensuring the client's well-being. The nurse is always accountable for the task or activity that is delegated. Social justice refers to equality, the idea that all clients should be treated with fairness and equity. Each state designates which tasks may be safely delegated and assigned to nursing team members; there is no universal list that all states use to describe tasks that can be delegated.
In which way is the term beneficence in health ethics different from nonmaleficence? -Beneficence refers to fairness, whereas nonmaleficence refers to the agreement to keep promises. -Beneficence involves taking positive actions to help others whereas nonmaleficence is the avoidance of harm or hurt. -Beneficence applies to all health care professionals, whereas nonmaleficence applies only to nursing professionals. -Beneficence refers to the support of a particular cause, whereas nonmaleficence refers to a willingness to respect one's professional obligations.
Beneficence involves taking positive actions to help others whereas nonmaleficence is the avoidance of harm or hurt Beneficence is the act of taking positive actions to help others; nonmaleficence is the avoidance of harm or hurt. Justice refers to fairness; fidelity refers to the agreement to keep promises. Both beneficence and nonmaleficence apply to all health care professionals. Advocacy refers to the support of a particular cause; responsibility refers to a willingness to respect one's professional obligations.
Which health care team member is familiar with all the needs of any individual client? -Orderly -Social worker -Charge nurse -Unlicensed assistive personnel
Charge nurse The charge nurse is involved in the coordination and assignment of care to individual clients. The charge nurse is the only person familiar with all the needs of any individual client under care. Orderlies are unlicensed assistive personnel delegated to care for the client's basic needs, and they do not have complete knowledge of a client's condition. A social worker is not familiar with all the needs; their focus is on social/emotional support, financial needs, and community resources for the client and family. The UP is involved in basic care of the client.
Which aspect of total client care needs would the nurse manager take into consideration if used on a 24-bed care unit? -Cost of nurses -Training needs -Documentation -Client satisfaction
Costs of nurses Because total client care is provided by a registered nurse it can be very expensive and not realistic to use a highly skilled and extremely knowledgeable professional nurse to provide all the care required in a unit of 24 clients. There are no particular issues with training, documentation, or client satisfaction with total client care.
The RN is delegating work to 4 delegatees, Which delegatee has an established relationship with the delegator? Delegatee A: "It is an easy procedure; you can do it easily." Delegatee B: "Your way of doing is right; continue to do it in the same way." Delegatee C: "Check the client's blood glucose level every morning for 5 days." Delegatee D: "You show me how you are doing it, and then I will show you my way of doing it."
Delegatee B According to Hersey's model, if the relationship between the delegator and delegate is established, the behavior of the delegator is "observing or monitoring."Telling delegate B that their method is correct and to continue doing it in the same way indicates that the delegator is monitoring the delegate's actions, which indicates an established relationship. Recommending delegate A do the procedure because it can easily be done indicates a persuading behavior, which is done when the relationship between the delegator and delegate is developing. According to Hersey's model, if the relationship between the delegator and delegate is limited, the behavior of the delegator is "telling."The delegator is simply telling delegate C to check the client's blood sugar level every morning for 5 days, which indicates a limited relationship between them. Participating in the work of delegate D by demonstration indicates a new relationship.
Which leadership style is best to achieve the group members' goal to participate more fully in life by gaining insight and changing behavior? -Democratic and guiding -Autocratic and directing -Laissez-faire and observing -Passive and nonconfrontational
Democratic and guiding A democratic and guiding leader aims to facilitate and balance the group's forces; this maximizes group potential for growth and change. An autocratic and directing leader makes most of the decisions and controls the group, thereby limiting growth potential. A laissez-faire, observing leader allows group members to take over the group; if there are no members with leadership skills, little is gained from the group. A passive and nonconfrontational leader does not provide adequate leadership to make the group effective.
During the process of delegation, the delegator's behavior is noted to be observing and monitoring. What would be the relationship between the delegator and delegatee in this situation? -Limited -Established -New or developing -Developing or ongoing
Established Observing and monitoring behavior of the delegator indicates delegating, which is done when the relationship between the delegator and delegatee is established. The delegator's behavior is guiding or directing when the relationship between the delegator and delegatee is limited. The delegator's behavior is encouraging or problem-solving when the relationship between the delegator and delegatee is new or developing. The delegator's behavior is explaining or persuading when the relationship between the delegator and delegatee is developing or ongoing
When monitoring the direct care nurse administering pain medication to a client, the nurse leader tells the client, "I will come back in 30 minutes to check your pain level." Which right of the client would the leader fulfill upon returning within 30 minutes? -Fidelity -Veracity -Beneficence -Confidentiality
Fidelity Fidelity addresses the nurse keeping promises or commitments. Veracity is concerned with telling the truth and demands that the truth be conveyed completely. Beneficence states that good actions should be promoted and is the basic obligation for assisting others. Confidentiality involves maintaining the privacy of the client's health records.
Which action would the nurse take to comply with the ethic of nonmaleficence in the health care setting? -Focus on doing no harm -Keep promises made to the client -Respect the autonomy of clients -Keep the best interests of the client in mind
Focus on doing no harm To comply with the ethic of nonmaleficence, the nurse would focus on doing no harm. The health care ethic fidelity requires the nurse to keep promises made to the client by following through on the plan of care. To comply with the ethic of autonomy, the nurse would include the client in the decision-making process when developing a care plan. To comply with the health care ethic of beneficence, the nurse is required to keep the best interests of the client in mind when providing care.
The nurse is caring for a client who is terminally ill with cancer. The health care team meets and agrees to provide the client with information to help the client make decisions regarding treatment. Which ethical principle is applied in this situation? SATA -Justice -Fidelity -Veracity -Autonomy -Beneficence
Justice Fidelity Veracity Autonomy Justice is an ethical principle that involves treating a client fairly without discrimination. Fidelity involves being loyal to the client. The nurse follows the principle of veracity by telling the truth to the client regarding health status. Telling the truth helps the client in decision-making, which is in accordance with the principle of autonomy, allowing the client to make decisions. Beneficence involves acting in a way that causes the least harm to the client, and this principle does not apply because the team is not providing any care or making any health care decisions at this point.
When the staff nurses report the unit is disorganized and there is no guidance from the nurse leader regarding client services, which type of leadership is the unit experiencing? -Directive -Autocratic -Laissez-faire -Participative
Laissez-faire Laissez-faire is a hands-off style of leadership in which the nurse leader allows the staff nurses a high degree of autonomy and self-rule. In a directive style of leadership, the nurse leader sets clear objectives and rules for the nursing staff. Autocratic leadership occurs when the nurse leader places control within the position over a particular work area. Participative leadership is the type of leadership in which the nursing staff participates in the decisions made by the nurse leader.
Which health care team member is the designated delegator? -Unit secretary -Nurse manager -Registered nurse -Licensed practical nurse
Nurse manager The nurse manager is the designated delegator. The unit secretary has no formal medical preparation or legal recognition. The RN is answerable to the delegator. The LP has a dependent status, functioning under the direction of a RN.
Which guide would the associate nurse use to provide client care within the primary nursing delivery model? -Plan of care -Nurse's notes -Primary health care provider's prescriptions -Direction from the charge nurse
Plan of care The associate nurse provides care using the plan of care developed by the primary nurse. The nurse's notes and primary health care provider's prescriptions will not provide adequate information to provide client care. The charge nurse will not provide direction for client care within primary nursing.
Which explanation regarding the term "just culture" is accurate? -Agreement to keep promises -Taking positive actions to help others -Ability to answer for one's actions -Promoting open discussion whenever error occurs without fear of recrimination
Promoting open discussion whenever error occurs without fear of recrimination The term just culture refers to the promotion of open discussion whenever errors occur without fear of recrimination. Fidelity refers to the agreement to keep promises. Beneficence refers to taking positive actions to help others. Accountability refers to the ability to answer for one's actions.
Which health care team member is responsible for analyzing the knowledge and work of newly hired unlicensed assistive personnel before delegating a task? -Charge nurse -Associate nurse -Registered nurse -Nursing manager
Registered nurse The RN must analyze any individual's knowledge before delegating a task. The charge nurse mainly functions as a liaison between team leaders and other health care providers. The associate nurse follows the care plan in the absence of a RN. The nursing manager is responsible for more than 1 unit and has other managerial responsibilities.
Which team member is most accountable when delegating a task to the health care team? -Certified technician -Registered nurse -Licensed practical nurse -Unlicensed assistive personnel
Registered nurse The RN on the health care team is most accountable when delegating a task to the team. The certified technician is responsible for assigned tasks, as are the LPN and UAP.
Which health care team member supervises unlicensed assistive personnel in providing care to the client? -Charge nurse -Nurse manager -Registered nurse -Unlicensed assistive personnel
Registered nurse The RN supervises UPs and licensed practical nurses (LPs) in providing care to the client. The charge nurse and the nurse manager may supervise RNs. The charge nurse delegates tasks to the LPN and UP when the RN does not. The nursing manager is in charge of the RN, LPN, and UAP. The UAP does not supervise other UAPs.
Which description does beneficence in health ethics refer to? -The agreement to keep promises -Taking positive actions to help others -The ability to answer for one's actions -Avoiding harming or hurting an individual
Taking positive actions to help others Beneficence refers to taking positive actions to help others. Fidelity refers to the agreement to keep promises. Accountability refers to the ability to answer for one's actions. Nonmaleficence refers to avoiding harm to an individual.
Which behavior would the delegator adopt when communicating with the delegatee if the relationship between them is new, the delegatee has limited knowledge, and the delegator would not expect the relationship to be ongoing? -Telling -Selling -Delegating -Participating
Telling According to Hersey's Situational Leadership Model, if the relationship between a delegator and a delegate with limited knowledge is new and is not going to be ongoing, the delegator's behavior is characterized as "telling." A delegator's behavior is characterized as "selling" if the delegate and delegator have an ongoing relationship and a new task is being delegated. The delegator's behavior is characterized as "delegating" when the delegatee has expertise and an established relationship with the delegator. If the delegatee has willingness and ability, but the relationship with the delegator is new, then the delegator's behavior is characterized as "participating."
