NUR 5 exam 2

A sentinel event is: a. a major change in a patient's status. b. an unexpected incident involving a death or serious physical or psychological injury to a patient. c. a way to identify processes for improvement based upon analysis of their care over a long period of time. d. an occurrence involving a sentinel or someone who is watching.

B A sentinel event is an unexpected occurrence involving a death or serious physical or psychological injury to a patient. The results of the analysis of a sentinel event generally lead to process improvement, but they tend to be based upon the events surrounding the individual occurrence.

A group of professionals has joined together in a team to address the issue of low morale among employees. During which stage of team formation would interpersonal issues come into play? a. Norming b. Adjourning c. Performing d. Storming

D During the storming stage of team development, opposing opinions or interpersonal agendas or issues can surface, increasing the potential for conflict or uneasiness. This is a natural part of team formation and should be expected whenever people from a variety of disciplines, specialties, and experiences work together.

Which of the following is the change theory proposed by Lewin? a. Phases of change b. Six-step change model c. Diffusion of innovations theory d. Force-field model

D Lewin's change theory is entitled force-field model. Lippitt's model is entitled phases of change. Havelock's model is six-step change model. Rogers's model is called diffusion of innovations theory of change.

Some questions may be asked during your interview. Which question, if asked, do you not need to answer? a. Why do you want to work here? b. What would your references say? c. What are your strengths? d. What do you plan to do with your children if you work overtime?

D Questions concerning family relationships such as your marital status or children cannot legally be asked during job interviews. Other topics that are not legal are questions related to your social organizations, political or sexual orientation, age, cultural heritage, or health/medical history.

A nurse is hired & scheduled for orientation. The nurse anticipates learning about which of the following during orientation? Select all that apply 1. Unwritten agency rules 2. Policies 3. Benefits 4. Procedures 5. Role expectations

2,3,4,5 Orientation should provide info about certain policies, procedures, role expectations, and employee benefits. Rules should be written and if there are unwritten expectations regarding behavior, these are not learned at orientation

The nurse manager is conducting an in-service with the staff regarding quality improvement. Which principles of quality improvement would the manager most likely include? Select all that apply. a. The priority is to benefit patients and all other internal and external customers. b. Quality is achieved through the participation of everyone in the organization. c. Improvement opportunities are developed by focusing on the work process. d. Decisions to change or improve a system or process are made based on data. e. It is difficult to improve the quality of service in a health care facility that is financed by federal dollars f. Improvement of the quality of service should be implemented biannually.

A, B, C, D Quality improvement is a continuous process and should be implemented by all health care organizations. Quality improvement benefits internal and external customers. Quality is achieved through the efforts of all individuals in the organization. Opportunities are developed by focusing on the work process. Organizational changes or improvements are based on obtained data.

Nurses in a small town that experienced the devastation of a number of tornados last year have formed a group to address the issue of disaster planning in their community. Which of the following are actions the nurses might take to prepare for another potential disaster? Select all that apply. a. Form a disaster plan for their own families b. Complete continuing education in disaster preparedness c. Encourage all residents of the town to move to a more urban area d. Become a volunteer for local or national disaster relief organizations e. Obtain information about rights and responsibilities in employment settings and under state law f. Do nothing because disasters such as tornados cannot be prevented

A, B, D, E The nurses could take several actions including forming a disaster plan for their own families, completing continuing education in disaster preparedness, becoming a volunteer for local or national disaster relief organizations, and obtaining information about rights and responsibilities in employment settings and under state law. It would be unrealistic to encourage all residents of the town to move to a more urban area. While the nurses cannot prevent future tornados, they should be knowledgeable in methods related to disaster preparedness.

A new nurse would most likely receive information on which of the following during the general orientation? Select all that apply. a. Hospital procedures b. CPR competency c. Pulse oximetry set up d. Safety issues e. IV monitoring equipment f. Hospital policies

A, B, D, F The general orientation for the new nurse should include: hospital policies and procedures, CPR competency, and safety issues. Orientation on the pulse oximetry set up and IV monitoring equipment will most likely be done during the unit-specific orientation.

Which of the following would be considered a barrier to a nurse's effective communication? Select all that apply. a. Interrupting b. Attentive listening c. Being defensive d. Experiencing stress e. Developing trust f. Offering false reassurance

A, C, D, F Barriers to effective communication include interrupting, being defensive, and offering false reassurance. When an individual is experiencing stress, this may become a barrier to effective communication. Attentive listening, developing trust, clarifying, using silence, and providing information are strategies which will facilitate communication.

When a primary survey of a trauma client is conducted, what is considered one of the priority actions? 1. Obtain a complete set of vital sign measurements 2. Palpate & auscultate the abd 3. Perform a brief neuro assessment 4. Check the pulse ox reading

Answer: Perform a brief neurologic assessment Rationale: A brief neurologic assessment to determine level of consciousness and pupil reaction is part of the primary survey.

A common barrier to communication is: a. management styles. b. different language. c. sadness and frustration. d. decreased face-to-face contact.

B Some of the most common barriers to communication are language, gender, culture, anger, generational differences, illiteracy, and conflict.

You are preparing your résumé or cover letter for a new job. Which of the following should you include? a. sarcasm and jokes to show your sense of humor b. bad-mouthing of former employers to negate any negative feedback they may give c. double checking spelling and grammar after the computer spell check is completed d. repete certain information several time to emphasize your point

C When writing résumés and cover letters it is important to double check spelling and grammar after the computer spell check is completed. Also, effective job seekers do not use sarcasm, bad-mouth former employers, or utilize repetitive information.

The nurse manager of your unit has often been referred to as a real "change agent." You recognize that one characteristic you manager depicts in her role as change agent is which of the following? a. Restrained b. Manages change c. Objective d. Trustworthy

D Characteristics of a change agent are trustworthy, open, respected, maintains vision of change, able to empower people, and intuitive.

A conflict management technique where both sides work together to develop an optimal outcome is called: a. avoiding. b. competing. c. confronting. d. collaborating.

D Collaborating is when both sides work together to develop an optimal outcome. Avoiding is ignoring the conflict. Competing is when two or three sides are forced to compete, and it produces a winner. Confronting is an obvious movement to stop conflict at the very start.

The nurse is the first responder at the scene of a school bus accident. The nurse triages the victims from highest to lowest priority as follows: 1. Confused child with bright red blood pulsating from a leg wound 2. Child with a closed head wound and multiple compound fractures of the arms and legs 3. Child with a simple fracture of the arm complaining of arm pain 4. Sobbing child with several minor lacerations on the face, arms, and legs

Triage systems identify which victims are the priority and should be treated first. Rankings are based on immediacy of needs, including victims with immediate threat to life requiring immediate treatment (emergent), victims whose injuries are not life-threatening provided that they are treated within 1 to 2 hours (urgent), and victims with sustained local injuries who do not have immediate complications and can wait several hours for medical treatment (nonurgent). Victim 1 has a wound that is pulsating bright red blood; this indicates arterial puncture. The child is also confused, which indicates the presence of hypoxia and shock (emergent). Victim 2 has sustained multiple trauma, so this victim is also classified as emergent and would require immediate treatment; however, victim 1 is the higher priority because of the arterial puncture. Victim 3 sustained injuries that are not life-threatening provided that the injuries can be treated in 1 to 2 hours (urgent). Victim 4 sustained minor injuries that can wait several hours for treatment (nonurgent).

In the work setting, what is your primary responsibility in preparing for management of disasters, including natural disasters and bioterrorism incidents? a. Knowing the agency's emergency response plan b. Being aware of the signs and symptoms of potential agents of bioterrorism c. Knowing how and what to report to the Centers for Disease Control and Prevention d. Making ethical decisions about exposing self to potentially lethal substances

a. Knowing the agency's emergency response plan

A group of people arrive at the ED by private care reporting extreme periorbital swelling, cough and tightness from their clothes. They report exposure to a "gas bomb' that was set off in their house. What is the priority action? a. Measure vital signs and listen to lung sounds b. Direct the clients to the decontamination area c. Instruct clients to don personal protective equipment d. Direct the clients to the cold or clean zone for immediate treatment

b. Direct the clients to the decontamination area

A nurse manager implementing a FOCUS process understands that each work process should be evaluated for which of the following? a. Redundancy and value b. Clarity and simplicity c. Simplicity and frequency d. Currency and researchability

A The nurse manager implementing a FOCUS process would understand that each work process should be evaluated for redundancy and value. If a step of the work process is repeated or does not have any value for the customer, it should be eliminated.

The plan-do-study-act cycle begins with: a. three questions. b. four stages. c. five agendas. d. two concepts.

A The plan-do-study-act (PDSA) cycle, a process improvement tool, starts with three questions: 1) What are we trying to accomplish?, 2) How will we know that a change is an improvement?, and 3) What changes can we make that will result in improvement?

As a new graduate, you recognize that one of the reasons to introduce change is to: a. solve a problem. b. maintain relationships. c. sort out the causes of chaos. d. acknowledge that change is inevitable.

A There are three basic reasons to introduce a change: 1) to solve a problem, 2) to improve efficiency, and 3) to reduce unnecessary workload for some group. Change for the sake of change is an unnecessary and stressful

In dealing with conflict it is important to approach it in a/an: 1. Cooperative manner 2. Destructive manner 3. Ambivalent manner 4. Competitive manner

1

A nurse manager plans to start data collection about venipuncture as it is performed on the nursing unit. Which tool should the manager use to facilitate this process? 1. Plan-Do-Study-Act (PDSA) 2. National Quality Forum (NQF) 3. Agency Healthcare Research & Quality (AHRQ) 4. Quality Plus Program

1 The PDSA is a tool used for data collection. It measures the current status of procedures. This guideline provides quick and easy direction in data collection. The NQF and Quality Plus Program provide resources to evaluate standards of care. AHRQ provides evaluation tools for inventory standards of practice

Resistance to change has three major sources, which are: 1. Staffing concerns, physical needs, threats to hierarchy needs 2. Technical concerns, psychosocial needs, threats to a person's position 3. Technology concerns, personal needs, threats to hospitalized clients 4. Prior concerns, social needs, threats to self-actualization

2

After noting an increase in the # of medication error on the night shift, the nurse manager wishes to reduce them. The manage decides to review the processes used on the unit and in the hospital from the time an order is written until the medication arrives on the unit. A nurse who is assisting the manager understands that what process is being used? 1. Quality assurance 2. Quality improvement 3. Process management 4. Evidence-based research

2 Quality improvement is the ongoing effort of ID potential error in processes and systems and improving work and prevention errors. Quality assurance, on the other hand, is the ID of errors, but without the focus on prevention of errors.

The nurse is working at the emergency health clinic in a disaster shelter. Which intervention is priority when initially assessing the client? 1. Find out how long the client will be in the shelter. 2. Determine whether the client has his or her routine medications. 3. Document the client's health history in writing. 4. Assess the client's vital signs, height, and weight.

2. During a disaster, the priority is to determine whether the client has rou- tine medications that can be taken while in the shelter. If clients do not have life-sustaining medications, then obtaining the medications becomes priority. Remember, psychiatric med- ications are life sustaining.

Change is best implemented when: 1. Management insists on the change 2.Reason for the change is least understood 3. Individuals participate in the change 4. Change causes stress

3

When issues and problems arise that can not be resolved through discussion,the next step might be: 1. Arguments 2. Discussion 3. Negotiations 4. Problem- solving

3

A staff nurse must solve a complex problem. Which is the nurse's MOST effective resource? 1. Organization chart of the institution 2. Nursing procedure manual 3. Unit's nurse manager 4. Nursing supervisor

3 Generally, in the chain of command of an organization, the staff nurse works under the direction of and reports to the unit's nurse manager. The nurse manager is generally an experienced nurse and is the primary resource person for the staff nurse. The staff nurse should seek guidance from the nurse manager when assistance is needed to solve a complex problem

A nurse has received the assignment for the day shift. After making initial rounds and checking all of the assigned clients, which client should the nurse plan to care for first? 1. A client who is ambulatory 2. A client scheduled for physical therapy at 1 PM 3. A client with a fever who is diaphoretic and restless 4. A postoperative client who has just received pain medication

3 Rationale: The nurse should plan to care for the client who has a fever and is diaphoretic and restless first because this client's needs are the priority. The client who is ambulatory and the client scheduled for physical therapy later in the day do not have priority needs related to care. Waiting for pain medication to take effect before providing care to the postoperative client is best.

The charge nurse in the ICU is notified of a bus accident with multiple injuries, and clients are being brought to the ED. The hospital is implementing the disaster policy. Which intervention should the nurse implement first? 1. Determine which clients could be transferred out of the ICU. 2. Call any off-duty nurses to notify them to come in to work. 3. Assess the staffing to determine which staff could be sent to ED. 4. Request all visitors to leave the hospital as soon as possible.

3 Most disaster policies require one nurse to be sent immediately from each area; therefore, this intervention should be implemented first. The charge must determine which staff nurse would be most helpful in the ED without compro- mising the staffing in the ICU.

The hospital has declared a major disaster. Which action should the charge nurse of the medical unit implement first? 1. Make rounds with the discharge officer. 2. Instruct the staff in the disaster plan. 3. Send one nurse to the disaster command post. 4. Maintain the functioning of the unit.

3 The charge nurse must send a quali- fied nurse to the command post to assume duties during the disaster. This is the first intervention.

The nurse at a disaster site is triaging victims when a woman states, "I am a certified nurse aide. Can I do anything to help?" Which action should the nurse implement? 1. Request the woman to please leave the area. 2. Ask the woman to check the injured clients. 3. Tell the woman to try and keep the victims calm. 4. Instruct the woman to help the paramedics.

3 Unlicensed assistive personnel have the ability to keep the victims calm; there- fore, this is an appropriate action. This action is not critical to the safety of the victims.

When delegating a specific procedure to a UAP, the aide refuses to perform the procedure. Which should the nurse do FIRST? 1. Assign procedure to another UAP 2. Explain it is part of UAP job description 3. Explore why UAP refuses to perform the procedure 4. Send the UAP to the procedural manual to review

3 The nurse must first explore the reason for the UAP's refusal to perform the procedure. The employee may have an acceptable reason for refusing to comply. When the reason is ID, the the nurse manager can take an informed action.

Creativity is especially important in which phase of problem-solving: 1. Evaluating the solutions 2. Implementing the solutions 3. Identifying the issue 4. Generating possible solutions

4

A nurse identifies a client a high risk for development of pressure ulcers and orders an air mattress for the client. This nurse is attempting to accomplish which of the following? 1. Risk management 2. Culture of safety 3. Quality assurance 4. Risk reduction

4 In risk reduction, the nurse identifies that the client may develop poor outcomes and takes measures to prevent negative client outcomes. Risk management analyzes problems. Quality assurance is focused on getting the task done correctly. Providing a culture of safety is a strategy in which the organization designs system to prevent and detect errors.

The nurse leader needs to develop a plan with the nursing staff about how to best reduce the # of falls on the unit. several nurses have ideas about the best action to take. Which approach should the nurse take to achieve consensus with the team? 1. Change the rules for decision making according to how convo processes 2. Pay special attention to the details of what is being discussed 3. Use firm words when communicating with each staff member 4. Encourage continued discussion and point out areas of agreement

4 It is always best to include group members in decision making, this action increases adherence to rules and support for new ideas. this helps keep the group energized and focused.

The nurse manager has implemented a change in the method of the nursing delivery system from functional to team nursing. An unlicensed assistive personnel (UAP) is resistant to the change and is not taking an active part in facilitating the process of change. Which is the best approach in dealing with the UAP? 1. Ignore the resistance. 2. Exert coercion on the UAP. 3. Provide a positive reward system for the UAP. 4. Confront the UAP to encourage verbalization of feelings regarding the change.

4 Rationale: Confrontation is an important strategy to meet resistance head on. Face-to-face meetings to confront the issue at hand will allow verbalization of feelings, identification of problems and issues, and development of strategies to solve the problem. Option 1 will not address the problem. Option 2 may produce additional resistance. Option 3 may provide a temporary solution to the resistance, but will not address the concern specifically.

The nurse employed in an emergency department is assigned to triage clients coming to the emergency department for treatment on the evening shift. The nurse should assign priority to which client? 1. A client complaining of muscle aches, a headache, and malaise 2. A client who twisted her ankle when she fell while rollerblading 3. A client with a minor laceration on the index finger sustained while cutting an eggplant 4. A client with chest pain who states that he just ate pizza that was made with a very spicy sauce

4 Rationale: In an emergency department, triage involves brief client assessment to classify clients according to their need for care and includes establishing priorities of care. The type of illness or injury, the severity of the problem, and the resources available govern the process. Clients with trauma, chest pain, severe respiratory distress or cardiac arrest, limb amputation, and acute neurological deficits, or who have sustained chemical splashes to the eyes, are classified as emergent and are the number 1 priority. Clients with conditions such as a simple fracture, asthma without respiratory distress, fever, hypertension, abdominal pain, or a renal stone have urgent needs and are classified as a number 2 priority. Clients with conditions such as a minor laceration, sprain, or cold symptoms are classified as nonurgent and are a number 3 priority.

A nurse leader attempts to resolve conflict between two nurses. Which communication skill should the leader use first? 1. Clarification 2. Confrontation 3. Nonverbal Acknowledgement 4. Active Listening

4 The first action by the leader is active listening. The leader needs to listen to both nurses separately then together (meeting). During the meeting, the nurse leader should clarify issues that are ambiguous. Acknowledgment should occur during the meeting to indicate all parties are listening.

A nurse manager surveys clients about their perception of services while receiving care on the nursing unit. The nurse assisting with data collection understands that this activity represents which component of quality improvement? 1. Intermitten analysis 2. Process effectiveness 3. Error prevention 4. Customer satisfcation

4 The nurse manager is collecting data on satisfaction with services provided. Most surveys do not address error prevention. Intermittent analysis and process effectiveness are not components of quality improvement

A group of Nurse Practitioners have been informed that changes are being planned for a new computerized charting system. The NPs are excited about the change and have offered to lead the change. According to Rogers, these NPs would be considered which of the following? a. Innovators b. Early adopters c. Early majority d. Laggards

A According to Rogers, the NPs would be considered Innovators. Innovators embrace change, enjoy the challenge of change, and often lead change. Early adopters are open and receptive to change, but they are not obsessed with it. Early majority enjoy and prefer the status quo, but they do not want to be left behind; consequently, they adopt change before the average person. Laggards are the last group to adopt a change. They prefer tradition and stability to innovation, and they are somewhat suspicious of change.

A nurse writes a cover letter to a potential employer. The nurse recognizes that one of the major components of a cover letter is that it should be: a. one page in length b. a detailed commercial about yourself c. one to two pages in length d. started with a general salutation

A A cover letter is a type of marketing and advertising strategy for presenting oneself to a potential employer. They should be no longer than one page in length and provide a brief (not detailed) commercial about you, and should be specifically addressed to a person, not a company or a general salutation.

The nurse manager recognizes that the goal of studying outcomes is to: a. determine staff needs. b. identify potential problems. c. predict the quality of patient care. d. incorporate change in nursing practice.

B By studying outcomes, the nurse manager is able to identify potential areas of concern (problems). The outcomes can be short or long term and may lead to an investigation of the structure and process to determine any root causes for a negative outcome.

The conflict resolution technique in which each side gives up something and gains something is called: a. avoiding. b. accommodating. c. competing. d. compromising.

D In compromising, each side gives up something and gains something. Avoiding is ignoring the conflict. In accommodating, one side gives in to the other side. In competing, two or three sides are forced to compete for the decision.

A nurse leader audits clients' charts to identify documentation errors. After analyzing the data gathered, which action should the nurse take to prevent documentation errors? 1. Educate nursing staff on documentation techniques 2. Reinforce importance of proper documentation 3. Identify nurses who made documentation errors 4. Develop a documentation quick reference sheet for nurses.

1 A preventative measure to avoid documentation errors is comprehensive education on approved documentation techniques. A documentation quick reference sheet should not be used w/o proper education in documentation techniques. In fact, inappropriate use of these sheets could create errors. Reinforcing documentation techniques is effective. Nurses should not be punished for making errors nor should they be singled out; this strategy is punitive and should be avoided.

A nurse manager is experiencing staff resistance when implementing change. Which is the MOST important action by the nurse manager to overcome resistance to change? 1. ID the reason for the resistance 2. Restate the purpose of the change concisely 3. Modify the objectives to appeal to more key people 4. Emphasize the positive consequences of the planned change

1 This is essential to overcome resistance to change. There are many different reasons people resist change. Each person will respond to different strategies. There are four different types of interventions to overcome resistance: providing information, disproving current held beliefs, maintaining psychological safety, and admin an order or command.

Which is the FIRST thing the nurse should do when planning to apply for a new position within an agency? 1. Review the job description 2. Provide at least several positive references 3. Identify if power is associated with the position 4. Locate the position on the agency's Table of Organization

1 This is one of the most important actions by the RN seeking a new position. The job description provides an overview of the requirements and responsibilities of the role. Job descriptions include factors such as education and experiential requirements, job responsibilities, subordinates to be supervised, and to whom one reports in the chain of command

The nurse is teaching a class on disaster preparedness. Which are components of an Emergency Operations Plan (EOP)? Select all that apply. 1. A plan for practice drills. 2. A deactivation response. 3. A plan for internal communication only. 4. A pre-incident response. 5. A security plan.

1,2,5 1.Practice drills allow for troubleshoot- ing any issues before a real-life incident occurs. 2. A deactivation response is important so resources are not overused, and the facility can then get back to daily activities and routine care. 5.A coordinated security plan involving facility and community agencies is the key to controlling an otherwise chaotic situation.

Which of the following safety measures on a unit should be included by a nurse manager on a plan to reduce errors and improve client safety? Select all that apply 1. Use lock options on IV pumps 2. Implement targeted checks and balance systems. 3. Utilize chart audits 4. Attempt to identify critical errors 5. Adopt the use of scanners for medication administration

1,2,5 Safety measures on any medical unit should include lock options on IV pumps to prevent clients or staff from changing the program. Check and balance systems allow staff to verify the right care is given to the right client at the right time. Scanners for medication administration are components of a system that assures the nurse is giving the correct medication to the right client. Chart audits and error identification are not safety measures.

Which statement is significant in relation to the concept of change theory in the health-care environment? 1. Barriers to change can be overcome by embracing new ideas uncritically. 2. Change generates anxiety by moving away from the comfortable 3. Behaviors are easy to change when change is supported 4. Change is effective when spontaneous

2 Changes causes one to overcome from comfortable to uncomfortable and is known as the unfreezing in Lewin's Change Model. It involves moving away from that which is known to the unknown, from the routine to new, and from expected to unexpected. The unknown, new and unexpected can be threatening, which can increase anxiety

Which strategy should the nurse leader use to foster a climate of collaboration on the nursing unit? 1. Place emphasis on task to be accomplished during each shift. 2. Display an open attitude toward new ideas & suggestions 3. Focus on high-quality care and benchmarking results 4. Use firm communication about items of importance to the nurse leader

2 The best strategy a nurse can use to foster collaboration is developing openness toward new ideas and suggestions of nursing staff.

The administrative supervisor is staffing the hospital's medical surgical units during an ice storm and has received many calls from staff members who are unable to get to the hospital. Which intervention should the supervisor implement first? 1. Inform the chief nursing officer. 2. Notify the on-duty staff to stay. 3. Call staff members who live close to the facility. 4. Implement the emergency disaster protocol.

2 The first action for the administrative supervisor is to make sure the clients receive care. The supervisor cannot allow the on-duty staff to leave until replacement staff members have been arranged.

A facility purchases new IV pumps. Which strategy should the nurse leader use to educate the current staff about the new pumps? 1. Web-enhanced instruction 2. In-service 3. Orientation 4. User manual

2 The most effective strategy is an in-service, which gives the nurses an opportunity to handle the pumps and ask questions.

A nurse who is the nursing unit representative to the hospital Nursing Practice Committee gathers information about the frequency and severity of client falls on the assigned nursing unit. The nurse explains to a new graduate nurse that this activity represents which step of the quality improvement process? 1. Priority setting 2. Data collection 3. Evaluation 4. Communication

2 The nurse is clearly in step five of the quality improvement process, which is data collection and organization. Priority identification is earlier in the process, and this question does not indicate priority. Evaluation occurs after data collection, and communication is last in process.

A charge nurse explains a new procedure to a staff nurse; however, the staff nurse is upset about working understaffed. The charge nurse recognizes that which barrier to communication is influencing this dialogue ? 1. Distracting noise 2. Emotions 3. Structure 4. Space

2 The only option that fits this scenario is emotions. The nurse is upset about the shortage off staff, and this prevents the nurse from focusing on the information the charge nurse attempts to convey. There is no information in the question that references a distracting noise (1), structure(3), or space(4)

The nurse in a disaster is triaging the following clients. Which client should be triaged as an Expectant Category, Priority 4, and color black? 1. The client with a sucking chest wound who is alert. 2. The client with a head injury who is unresponsive. 3. The client with an abdominal wound and stable vital signs. 4. The client with a sprained ankle which may be fractured.

2 This client has a very poor prognosis, and even with treatment, survival is unlikely.

A RN team implements an agreed-upon plan of action & most goals are achieved. The nurse leader concludes that this team is in which phase of team development? 1. Forming 2. Performing 3. Storming 4. Norming

2 the team is in the performing stage of development. characterized by carrying out the action plan and focusing on getting the task done to achieve goals.

A nurse leader reviews the work of the team. The nurse leader interprets what which attribute of the team is consistent with effective collaboration? 1. Independent work 2. Setting goals 3. Decision making 4. Delegating responses

2 Goal setting is consistent with effective collaboration

A 27 year old client is admitted with pneumonia and dies for a MI within 24 hours of admission. The nurse manager works with staff to investigate this incident as which of the following? 1. Accident 2. Error 3. Sentinel event 4. Malpractice

3 A sentinel event is a very serious, unexpected incident that leads to death or major injury. The cause of the event is usually determined in debriefing. Often, an accident or error in care or treatment may contribute to the sentinel event

The community health nurse is triaging victims at the scene of a building collapse. Which intervention should the nurse implement first? 1. Discuss the disaster situation with the media. 2. Write the client's name clearly in the disaster log. 3. Place disaster tags securely on the victims. 4. Identify an area for family members to wait.

3 Client tracking is a critical component of casualty management. Disaster tags, which include name, address, age, loca- tion, description of injuries, and treat- ments or medications administered, must be securely attached to the client.

The nurse is assigned to care for four clients. In planning client rounds, which client should the nurse assess first? 1. A client scheduled for a chest x-ray 2. A client requiring daily dressing changes 3. A postoperative client preparing for discharge 4. A client receiving nasal oxygen who had difficulty breathing during the previous shift

4 Rationale: Airway is always the highest priority, and the nurse would attend to the client who has been experiencing an airway problem first. The clients described in options 1, 2, and 3 have needs that would be identified as intermediate priorities.

The community health nurse is triaging victims at the site of a disaster. Which client should the nurse categorize as black, priority 4? 1. The client who is alert and has a sucking chest wound. 2. The client who cannot stop crying and can't answer questions. 3. The client whose abdomen is hard and tender to the touch. 4. The client who has full thickness burns over 60% of the body.

4 This client should be categorized as black, priority 4, which means the injury is extensive and chances of sur- vival are unlikely even with definitive care. Clients should receive comfort measures and be separated from other casualties, but not abandoned.

A nurse leader needs to notify staff RN about a change in the staff RN position description. Which method should the nurse leader use to communicate the change? 1. Announce the change in a staff meeting 2. Post a notice on the bulletin board in the nurse's lounge 3. Speak to each nurse individually 4. Provide notification and a copy of the changes in writing

4 if changes are made in a position description, the staff needs to be notified in writing. The position description contains performance standards against which an employee's job performance will be evaluated. A staff meeting/ posting a notice doesn't guarantee every nurse will be aware of the change

During your job interview you are asked several questions. Which topic would be considered illegal for the interview to request that you answer? a. your religious affiliation b. your career goals c. your strengths and weaknesses d. problems you foresee

A Asking a question regarding your religious affiliation would be illegal. However, the interviewer can ask about your career goals, your strengths and weaknesses, and problems you foresee.

The Quality Improvement Team has begun assessing and analyzing the care given to TB patients. This is an example of which organizational strategy for quality and process improvement? a. Benchmarking b. Identifying opportunities for system change following a sentinel event review c. Using a storyboard d. Meeting regulatory requirements

A Benchmarking is a continual and collaborative discipline of measuring and comparing the results of key work processes with those of the best performers, and it uses those best processes (practices) to improve work design and patient care delivery. It identifies gaps in performance and provides options for improvement. A benchmarking study can be clinical (reviewing outcomes of patient care such as in the case of the TB patients), financial (examining the length of stay), and operational (assessing the function of the ER or case management system). If a TB patient had died unexpectedly in the OR or ER and contaminated staff, then the analysis of this particular case could be termed a sentinel event, and a storyboard may have been used in the descriptive process. By reporting a sentinel event, one would be complying with regulatory requirements.

In an effort to provide evidence-based care, the nurse manager of the unit informs the staff that they will be benchmarking their wound care practices with that of the major medical center in the area. The staff recognizes that they will be doing which of the following? a. Measuring their wound care practices against one of their hospital's toughest competitors, a recognized leading hospital in the area b. Competing with another hospital to determine who provides the better care c. Comparing the number of cases of wound care in their hospital with the number of cases in the other hospital d. Working harder for longer hours each shift

A Benchmarking is defined as the continuous process of measuring products, services, and practices against the toughest competitors or those customers recognized as industry leaders (The Joint Commission, 2009; Camp, 1994). The purpose of benchmarking is not to compare number of cases, compete with the other hospital, or for the staff to work harder.

You are adding a cover letter to the resume that you are sending to a potential employer. You recognize that a cover letter important because of which of the following? a. It can be one of your first marketing strategies. b. It is a good way to get your foot in the door. c. It can be used to detail your accomplishments to a potential employer. d. It can be used in lieu of a resume.

A Cover letters are one of the first opportunities you have in presenting yourself to a potential employer. They are good marketing and advertising techniques and should be worded carefully and precisely.

Several nurses have been assigned to a new team. They come to the first meeting with a sense of curiosity, adventure, and a little apprehension. The team is most likely in which stage of the team process? a. Forming b. Storming c. Norming d. Adjourning

A During the forming stage of team development, relationships are developed. Team orientation, identification of role expectations, beginning team interactions, explorations, and boundary setting occur.

The level of communication that is concerned with communication between individuals is: a. interpersonal. b. intrapersonal. c. public. d. physiological.

A Interpersonal communication is concerned with communication between individuals, either person to person or in small groups. Intrapersonal communication is self-talk. Public communication is communicating with a group of people with a common interest. Kinesthetic communication involves touch and physiological responses.

During your transition from student nurse to your first position as a staff nurse, your general an unit orientation are a key component of the transition. Which of the following questions would be most appropriate for you to ask about orientation? a. How long should I expect to be in orientation? b. How will I be paid for my time in orientation? c. Do I have to attend every orientation session? d. Will I be graded during the orientation?

A It is appropriate for the new graduate to ask about the length of the orientation program. It would not be appropriate to ask about pay for orientation, grading of performance or whether the graduate should attend all sessions. Hospitals invest a great deal of funds in orientating new employees and it is expected that they will participate in the orientation fully.

A local hospital is implementing a systematic process of organization-wide participation and partnership in planning and implementing improvement methods to test evidence-based practices at all levels of the services. The hospital is most likely implementing which of the following? a. QI b. QA c. QM d. TM

A QI (quality improvement) is an organization (system-wide) process of organization-wide participation and partnership in planning and implementing improvement methods to understand and meet customer needs and expectations. It is proactive in its approach, and other terms that may be used interchangeably for QI are TQM (total quality management) and PI (process improvement).

A new nurse is beginning to establish short term goal to be addressed in the nurse's performance appraisal. The nurse recognizes that part of the goal setting process would include which of the following? a. goals should be developed by the nurse in collaboration with the nurse's manager b. one goal would be to successfully complete an advanced practice certificate c. goals should be vague and general d. goals do not have to be measurable but they must be achievable

A The establishment of performance goals (short term) are an essential part of any performance appraisal. They are especially important for new nurses as they provide opportunities for mentorship and guidance from one's immediate supervisor for attainable goal setting. Some aspects of effective goals setting: they are developed by the nurse and the nurse's manager, are clearly articulated, are measurable, and are attainable. The goal of successfully completing an advance practice degree is not a sound short-term or initial goal for a new nurse graduate. However, it can be a long-term goal. The initial goals set by the new nurse and the nurse's manager should be short term and attainable within a short period of time, such as "become an active participant in a unit-based or hospital wide committee."

You are conducting a meeting with a group of nurses. Today, you plan to discuss role expectations and the purpose of the team. You ask each individual to introduce themselves and share a little about their background in nursing. Your group is most likely in which stage of Tuckman and Jensen's team process? a. Forming b. Storming c. Norming d. Performing

A The group is most likely in the forming stage of the team process. During this stage, relationships begin developing. There is team orientation, identification of role expectations, beginning team interactions, explorations, and boundary setting.

An indicator for successful implementation of a project is: a. people owning the change. b. change perceived as neutral. c. time limits on change d. learning curve status.

A There are two characteristics that indicate successful implementation of a project. The most important is that the people affected by the change begin to own the change. The second characteristic of successful implementation is that the change is perceived as an improvement. Usually not enough time is allowed for the change to be effective, and a learning curve must be identified.

During a job interview the Nurse Recruiter asks you questions about your age, marital status, the number of children you have, your political affiliation, your past work experiences, and an example of when you demonstrated leadership. Questions regarding which of the following is considered a violation of the law? Select all that apply. a. age b. marital status c. number of children d. political affiliation e. past work experience f. example of when you demonstrated leadership

A, B, C, D Questions concerning family relationships such as your marital status or children cannot legally be asked during job interviews. Other topics that are not legal are questions related to your social organizations, political or sexual orientation, age, cultural heritage, or health/medical history.

Which of the following are the focus of quality improvement (doing the right thing)? Select all that apply. a. Meeting the needs of the customer proactively b. Building quality performance into the work process c. Employing a scientific approach and using data for assessment and problem solving d. Assessing the work process to identify opportunities for improved performance e. Reviewing only chart audits and incident reports f. Improving health care performance and changing the health care system continuously as a management strategy, not just when standards are not met

A, B, C, D, F All of the options are part of the focus of quality improvement except option "e." By only reviewing chart audits and incident reports, limited data would be obtained. Quality improvement requires obtaining data from numerous sources.

The members of a team have achieved their goals and begin to review their activities and evaluate their progress and outcomes. The team is most likely in which stage of the team process? a. Norming b. Adjourning c. Forming d. Storming

B During the adjourning stage of the team process, the team is involved in termination. Team goals and activities are met, leading to closure, evaluation, and outcome review. This may also lead to reforming, when the need for improvement or further goal development is identified.

Your unit is undergoing planned change. Most of the nurses have expressed openness and receptivity to change. These nurses would be considered which of the following? a. Innovator b. Early adopter c. Early majority d. Late majority

B Early adopters are open and receptive to change, but they are not obsessed with change. Innovators embrace change and enjoy the challenge of change. The early majority enjoys and prefers the status quo, but does not want to be left behind. The late majority adopts change after expressing negative feelings.

A nursing instructor has just completed a lecture on career planning for professional nurses. The instructor questions the students about the criteria that is most effective in career planning. response by a student Which would indicate that further clarification is needed? a. vision b. mission c. goal setting d. strategic planning

B Further clarification is needed if a student responds mission. Career planning does not require the individual to have a mission. Three primary elements for effective control of one's career planning are developing a vision (long-term goals), creating goals, and making plans to achieve them (strategic planning).

You are meeting with your mentor who asks you about the elements needed for effective strategic career planning. If you give the following responses, which would your mentor want to further clarify? a. assessing your values, interests, and the job market b. determining your career path c. planning and implementing a job search d. performing ongoing evaluation to assure alignment with your vision and goals

B Further clarification is needed if you responded determining your career path. The four criteria for effective strategic planning in relation to career planning include; determining your vision and goals (not just your career path); assessing your values, interests and the job market; planning and implementing a job search; and performing ongoing evaluation to assure alignment with your vision and goals.

Two nurses disagree on the approach to be taken when caring for a hostile patient. One nurse feels the patient should be treated in the same manner that the patient treats the nurse. The second nurse feels that the patient should be further assessed to determine the possible cause of the patient's hostility. These nurses are experiencing which type of conflict? a. Intrapersonal conflict b. Interpersonal conflict c. Organizational conflict d. System conflict

B In interpersonal conflict, the source of disagreement may be between two people or groups or work teams. Intrapersonal conflict is the type of conflict that occurs within the individual. Organizational conflict is often referred to as intergroup conflict. Conflict can be defined as a disagreement about something of importance to each person involved.

During which step in the change process would the who, how, and when of the change be determined? a. Assessment b. Planning c. Implementation d. Evaluation

B In the planning step, the who, how, and when of the change are determined. The assessment step identifies what the problem is or the opportunity for improvement through change by collecting and analyzing data. In the implementation step, the plan actually goes live. The evaluation step includes identifying measurable expected outcomes.

When the nurse says to himself, "I can do this procedure," it is a form of what level of communication? a. Interpersonal b. Intrapersonal c. Nonverbal d. Nonpublic

B Intrapersonal communication can be thought of as self-talk. It is what people do within themselves, and it can present as either doubts or affirmations. Interpersonal communication is communication between individuals or small groups. A nurse presenting a workshop is an example of public communication. Nonverbal language deals with body language or facial expressions.

The local hospital in your area has begun to implement evidence-based nursing care. The last patient care unit to implement the change has frequently been skeptical and suspicious about the change. According to Rogers's theory, these individual would be considered which of the following? a. Rejectors b. Laggards c. Innovators d. Late majority

B Laggards are the last group to adopt a change. They prefer tradition and stability to innovation and tend to be somewhat suspicious of change. Rejectors openly oppose and reject change. They may be surreptitious or covert in their opposition and may even hinder the change process to the point of sabotage. Innovators embrace change, enjoy the challenge of change, and often lead change. The late majority, often known as the followers, are often skeptics, but they adopt change after expressing their negative feelings.

A new graduate is interviewing for a nursing position. The nurse recruiter begins to ask the graduate a number of questions. The graduate recognizes that the nurse recruiter can legally ask about which of the following? a. citizenship b. career goals c. cultural heritage d. medical history

B Not all questions asked in interview situations are legal. Legally acceptable questions include your reason for applying for the job, career goals, any problems you foresee, and your strengths and weaknesses. Some illegal questions that may come up in interviews concern your citizenship, cultural heritage, medical history, age, membership in social or political organizations, family characteristics, gender preference, and sexual orientation.

An effective nurse manager adopts several quality improvement methods in the management of the ICU. The manager's approach is based on the understanding that some of the primary benefits to this approach includes which of the following? a. Empowers staff and provides an outlet for critical theory b. Views every problem as an opportunity to improve and to improve staff satisfaction c. Decreases necessary expenses from lost business and helps customers think you care about them d. Involves staff in how work is planned and done and increases the customer's perception that you care by designing processes that meet the provider's needs

B Some principle benefits of adopting quality improvement methods include viewing every problem as a possible opportunity for improvement; involving staff in how the work is designed and delivered (improves staff satisfaction); empowering staff to identify and implement improvement, resulting in increased patient outcomes; and increasing the customer's perception that you care by designing health care processes to meet customer needs, as opposed to the health care provider's needs.

The last group to adopt change is called the: a. rejectors. b. laggards. c. early majority. d. late majority.

B The laggards are the last group to adopt a change. They prefer tradition and stability to innovation. Rejectors openly oppose and reject change. The early majority enjoys the status quo but does not want to be left behind. The late majority adopts change after expressing negative feelings.

Communicating with physicians need not be stressful for new nurses if they remember to: a. work through emotions before talking with the physician. b. keep the patient's goal central to the discussion. c. maintain shoulder-to-shoulder dialogue. d. document patient changes thoroughly.

B The nurse's goal is to strive for collaboration, keeping the patient goal central to the discussion. Collaboration allows all parties to be satisfied and improves quality.

A nursing instructor is evaluating a student's understanding of the primary difference between QA and QI. Which response by the student would indicate that the student understood? a. QI is reactive, and QA is proactive. b. QA's emphasis is on maintaining minimum standards of care, and QI's emphasis is upon identifying real and potential problems. c. QA documents quality, and QI reports incidents and errors. d. QI is more a single program, and QA is more a management approach.

B The primary focus of QA (quality assurance) is upon maintaining the minimum standards of care, and it tends to be reactive rather than proactive. The main focus of QI (quality improvement) is on the identification of real and potential problems, and it tends to be proactive instead of reactive.

A nurse manager wishes to implement the Model for Improvement with the rest of the team. The nurse manager knows that the Model for Improvement begins with three questions. following is not necessarily one of the three questions? a. What are we trying to accomplish? b. What change is needed for improvement? c. What change can we make that will result in improvement? d. How will we know that a change is an improvement?

B The three primary questions that the Model for Improvement begins with are "What are we trying to accomplish?", "How will we know that a change is an improvement?" (not "What change is needed for improvement?"), and "What change can we make that will result in improvement?" These three questions begin the PDSA cycle for improvement for this model.

The two biggest problems in health care today are related to: a. centralized patient data and flow of information. b. patient safety and soaring health care costs. c. physician/patient conflicts and consumer groups. d. clinical expertise and conflict management skills.

B The two biggest problems in health care today are related to patient safety and soaring costs.

Your preceptor is providing you with a unit-specific orientation. Which of the following would be included in the unit-specific orientation? a. benefits b. IV pumps c. patient safety standards d. CPR

B Unit-specific orientation focuses upon information and competencies that a new nurses needs to care for the diagnoses and ages of the patients on the assigned unit. Some elements in the unit-specific orientation include unit-specific policies and procedures such as IV pump usage and acquisition and paperwork needed for new admissions and discharges. Benefits, patient safety standards, and CPR validation are covered during general orientation.

Your grandmother who was a nurse for 50 years at the same hospital finds you working at the dining room table and asks what you are doing. You explain that you are career planning. You grandmother then states, "You already graduated from a good nursing program and secured a nice position at the hospital. What more is there to plan?" Your best response to your grandmother would be which of the following? a. "I'm trying to decide if I made the right choice for my career. b. "Career planning requires that I develop my vision, create goals, and making plans to achieve those goals." c. "I don't want to spend my life in a dead-end job" d. "Grandma, did you really enjoy working in the hospital as a staff nurse?"

B Your best response would be to tell your grandmother that career planning requires developing a vision, creating goals and making plans to achieve those goals. The other responses do not explain the essence of career planning and would not fully address your grandmother's question.

One of the nurses on your team states, "I enjoy working with you and the other team members. We support each other and are willing to share resources. If there are any problems, we work together to solve them. It's good to work with a team where there is trust and it's easy to work together to complete our tasks." Your team is most likely in which stage of Tuckman Jensen's team process? a. Forming b. Storming c. Performing d. Adjourning

C According to Tuckman and Jensen's team process, the team is most likely in the performing stage. During this stage, team roles become more functional and flexible, and structural issues are resolved, leading to supportive task performance through group-directed collaboration and resources sharing.

You are preparing a chronological style of résumé which: a. highlights skills and experiences rather than job sequences b. is good to illustrate experience in multiple careers c. can highlight work experiences from a position of lesser to greater power d. can be used to highlight a dramatic career change or focus

C Chronological-style résumé lists jobs in reverse chronological order, is good for those with little or no gaps in their work history, and can highlight work experiences from a position of lesser to that of greater power. Functional-style résumés are good for those who wish to highlight their skills and experiences rather than job sequences. Functional-style résumés can also be used to illustrate experience in multiple careers and highlight a dramatic career change or focus.

A nurse is exhibiting the conscientious, explicit, and judicious use of the current best evidence in making decisions about the care of individual patients. The nurse's actions are an example of which of the following? a. Evidence-based models b. Evidence-based practice guidelines c. Evidence-based practice d. Evidence-based nursing practice

C Evidence-based practice (EBP) is a total process that makes a conscientious, judicious effort to utilize the most current and best evidence for clinical decision making regarding patient care. It uses evidence-based models and guidelines, and when it is applied to nursing practice, it is called evidence-based nursing practice.

The nurse manager knows that for change to be successful which of the following must occur? a. Autocratic approach must be used. b. Only RNs should be involved in the change process. c. Empowerment of those involved in the change must occur. d. Physicians should be the initiators of change on the unit.

C For change to be successful, the change agent must empower people to control the change project as it affects their lives. Those most affected by the change must be involved in assessing, planning, implementing, and evaluating the change.

You are a new graduate and have been hired at the local hospital. Which of the following would be least likely to be included in this orientation? a. validation of CPR b. human resource policies c. specific requirements for certain units d. policies related to medication administration

C General orientation usually includes information and skills measurement that all nurses new to the facility need to know regardless of their unit. Some examples are validation of CPR, human resource policies, policies related to medication administration, opportunities to hear from representatives from various departments, and patient safety concerns (per the Joint Commission). Specific requirements for certain units will come during the unit-specific orientation.

The nurse educator explains to the nursing student that an evidence-based practice (EBP) guideline is: a. a guideline for assessing practice. b. a descriptive tool for identifying specified care in unique situations. c. a standardized specification for care of a typical patient in the typical situation. d. used in medical credentialing.

C In evidence-based practice, guidelines are standardized tools or specifications of how care should be delivered, and they are used to guide practice treatment and intervention.

A career counselor is meeting with a group of nursing graduates to discuss the preparation of their résumés. During the discussion the counselor asks the students which elements are important to include in a quality resume. Which element suggested by a student would indicate to the counselor that further clarification is needed? a. accurate dates b. off-white or ivory high quality paper with matching envelopes c. humorous references are always appreciated d. accurate spelling and grammar

C Other qualities of good résumés include certain criteria regarding formatting and material presented. Some of these are; accurate dates, off-white or ivory high quality 8.5" x 11" paper with matching envelopes, accurate spelling and grammar, and proofreading of the final document. The use of humor or sarcasm in your résumé is never appropriate.

Just as there are certain components that should be included in cover letters, there are also those that should not be used. Which in the list of these is not necessarily correct? a. name signed in non-black or blue ink b. repeating information c. non-indented paragraphs d. more than one page in length

C Some elements that should not be included in cover letters are signature in any color other than black or blue ink, repeating information, indented paragraphs, and more than one page in length.

A nursing instructor quizzes students on the 360-degree feedback evaluation tool. Which comment by a student would indicate that further clarification is needed? a. potentially provides a broader more balanced assessment b. is time consuming c. does not include patient interviews or assessments d. includes peer reviews

C The 360-degree evaluation tool is used by some health care organizations where an individual is assessed by a variety of people in order to provide a broader perspective. Some other aspects of this evaluation tool include peer reviews, evaluation by the nurse's immediate supervisor, and patient interviews, and it is time consuming yet yields valuable information from a number of different sources.

A staff nurse asks the nurse manager, "What does the mnemonic FOCUS in FOCUS methodology stand for? The best response by the nurse manager is that it stands for: a. Focus, Organize, Clarify, Understand, Substantiate. b. Focus, Opportunity, Continuous, Utilize, Substantiate. c. Focus, Organize, Clarify, Understand, Solution. d. Focus, Opportunity, Continuous (process), Understand, Solution.

C The FOCUS methodology uses a stepwise process for how to move through the improvement process. The five steps involved are 1) focus on an improvement idea, 2) organize a team that knows the work process, 3) clarify the current process, 4) understand the degree of change needed, and 5) solution (select a solution for improvement).

A student nurse read an article that mentioned PDSA. When the student nurse asks the nurse educator what PDSA is, the nurse educator responds that PDSA is: a. a national quality improvement campaign. b. process, demonstrate, supervise, and analyze. c. an acronym for an EBP model. d. a type of quality improvement outcome that is part of the 100,000 Lives Campaign.

C The Model for Improvement, an evidence-based practice (EBP) model, uses the plan-do-study-act (PDSA) format as the basis for its process.

The goal of the local hospital is to increase the ability to predict the effect that one or more planned changes in the provision of patient care will have an impact. The hospital would most likely implement which of the following? a. FOCUS b. QA c. PDSA d. Risk Management

C The PDSA (plan-do-study-act) methodology is used to analyze the potential effect of a certain change or changes if they had been implemented. It involves who will do what, when will they do it, and where will they do it in relation to the proposed change(s).

Which conflict resolution technique has the advantage of being the best solution for the conflict and encompassing all important goals to all sides? a. Competing b. Confrontation c. Collaboration d. Negotiating

C The advantage of the collaboration conflict resolution technique is that it is the best solution for the conflict, and it encompasses all important goals to all sides. In competing, the advantage is that it produces a winner and is good when time is short and stakes are high. The advantage of confrontation is that it does not allow conflict to take root. In negotiating, stakes are very high, the solution is rather permanent, and it often involves powerful groups.

Your organization is planning to make educational and cultural changes. Which model of change is most often used in this type of situation? a. Force-field model b. Phases of change model c. Six-step change model d. Diffusion of innovations theory of change model

C The six-step change model is used most often for educational change or cultural change. The force-field model is used for most situations and organizations. The phases of change model is used for process changes and general change. The diffusion of innovations theory of change is for permanent change that is general in nature for organization and group change.

The unit secretary is sending an e-mail message to all staff. Recognizing e-mail etiquette, the secretary would do which of the following? a. Use capital letters generously for emphasis b. Respond immediately to an angry message c. Refrain from forwarding e-mail messages from others without their permission d. Include a joke at the end of the e-mail so readers will be more likely to read the entire message

C Tips for communicating by e-mail include the following: No capital letters, be brief, use clear subject lines, cool off before responding to an angry message, forward e-mail messages from others only with their permission, forward jokes selectively, and use good judgment because e-mail may not be private.

A new graduate nurse recognizes that there are a variety of methods that can be used in planning and implementing an effective job search.. The nurse would hypothesize that the least productive method would involve which of the following? a. networking through family, friends, and acquaintances b. reviewing positions advertised in the newspaper c. attending a job fair d. showing up at as many hospitals as you can and asking for a job

D Some effective methods to incorporate into your plan for implementing a job search are networking through family, friends, and acquaintances; reviewing positions advertised in the newspaper (also Internet searches and recruitment agencies/Web sites); and attending a job fair. Showing up at as many hospitals as you can and asking for a job is not a productive means of job searching, even though one may stumble upon a position inadvertently. It is best to do a preliminary search and research the targeted facilities before contacting them.

Which conflict resolution technique might have the disadvantage of becoming bigger than anticipated and being more important to one person or group than to others? a. Collaboration b. Confrontation c. Competing d. Avoiding

D The disadvantage of avoiding is that it can become bigger than anticipated, and it might be more important to one person or group than to others. In collaboration, the disadvantage is that it takes a lot of time and requires commitment in order to succeed. The disadvantage of confrontation is that it may leave an impression that conflict is not tolerated, and it may make something big out of nothing. In competing, the disadvantage is that it produces a loser, which may cause anger and resentment on the losing side.

The nurse manager poses the following question to a group of staff nurses, "What changes can we make that will result in improvement?" The nurse manager's question is an integral part of which of the following? a. TQM b. PI c. FOCUS d. PDSA

D This question is one of three that are utilized at the beginning of each application of the PDSA (plan-do-study-act) methodology for improvement. Other questions include "What are we trying to accomplish?" and "How will we know that a change is an improvement?"