Prep U Chapter 6: Leadership

The licensed practical nurse/licensed vocational nurse (LPN/LVN) is caring for a client who wants to stop taking a prescribed treatment. Which response should the LPN/LVN make to demonstrate advocacy for this client?

"I will contact your health care provider so you can share your decision."

What is correct about fiscal accountability for staffing?

A critical responsibility of mangers

A nurse working on leadership skills should keep in mind the following accurate statement regarding leaders:

All nurse leaders began as inexperienced nurses.

Mr. David Collins is a 43-year-old client who lives in the rehab center where you work three 12 hour shifts per week. He has a history of quadriplegia resulting from a motorcycle crash in 1999. A nurse at a rehab center is in the midst of assessing client with a history of quadriplegia who reminds the nurse that the client hasn't had a bath yet today. The nurse asks the CNA to complete the bath before lunch. What does this action demonstrate?

All of the options are correct.

Delegation is an integral part of nursing, regardless of the educational level of the nurse. Additionally, the proper use of delegation assures timely, cost-effective care. Which "rights" are included in the five rights of delegation?

All of the responses are correct.

The LPN is in the midst of a client's assessment when the client mentions not having had a bath yet today. The LPN asks the CNA to complete the client's bath before lunch. Just before lunch the LPN checks in with the client about the bath. What does this behavior demonstrate?

All of the responses are correct.

Which is the first step in time management?

Allow time for planning and establishing priorities.

An LPN has worked as a staff nurse in a long-term care facility for three years and is interested in applying for a position as a team leader. This nurse is aware that what skills are necessary to fulfill this position? Select all that apply.

An obligation to ensure that a task is completed Ability to determine if a staff member is able to accomplish a certain task Evaluation of staff members to ensure assigned tasks are completed

The licensed practical nurse/licensed vocational nurse (LPN/LVN) observes an unlicensed assistive personnel (UAP) take wound care supplies to the room of a client being discharged. Which action should the LPN/LVN take to manage resources?

Ask the UAP why the supplies are being taken to a client being discharged.

A client is being discharged after being treated for an exacerbation of chronic obstructive lung disease (COPD). Which action should the licensed practical nurse/licensed vocational nurse (LPN/LVN) take to prevent the client from needing another admission within 30 days for the same health problem?

Ask the team leader if the client can have a referral to home care.

The LPN is assigning clients on a rehabilitation unit. Which of the following nursing actions should the LPN complete prior to assigning any delegated task?

Assess the clients

A nurse manager informs the staff members during a meeting that unlicensed assistive personnel will no longer be allowed to check patients' blood glucose levels. The nurse manager informs the group this was a new policy on the unit, and discussions will not change the enforcement of this policy. What type of leadership style is the nurse manager demonstrating?

Autocratic

The head nurse on a busy floor tells the staff that this year she will be assigning vacation times rather than allowing the others to choose convenient times for them. What type of power is the head nurse displaying?

Coercive

The LPN/LVN team manager has delegated which activity to a UAP that would be considered an indirect client care activity?

Direct the UAP to make sure that clean linen is present in all rooms prior to morning care.

After morning report, the nurse manager held a mini conference with a team member, a licensed nurses' aide, and assigned the following duties: bathe and make beds for all your assigned patients, answer lights, ambulate all those ambulatory and turn nonambulatory patients every 2 hours, and report complaints or needs of the patients. Periodically during the day the nurse manager checked with the aide to determine whether the aide was having difficulty in completing the tasks. The nurse manager was frequently in patient rooms observing and performing her own duties. What is this an example of?

Effective delegation

Nurse L. is having an exceptionally busy shift on an obstetrical unit. Which of the following tasks is Nurse L. justified in delegating to an unlicensed care provider?

Emptying a patient's Foley catheter bag and reporting the volume to Nurse L.

Jon is the only registered nurse at the hospital who is certified to insert percutaneous intravenous catheters. What type of power does this certification provide?

Expert

What is coercive power based?

Fear and punishment

Which of the following describes the purpose of power in regard to people in a leadership role?

For a person in a leadership role to be effective, he or she must have some degree of power to support that role.

How is the action of advocacy best described?

Informing others of their rights and making certain they have sufficient information to make decisions

A team leader in a healthcare facility is using an autocratic leadership style. What should the team leader do when dealing with a life-threatening emergency situation?

Instruct the staff members on duties they need to do

A nurse is responsible for several clients with varying conditions. Place in order from highest to lowest priority the types of needs of each client that require the nurse's attention.

Items critical to maintaining life Items for critical symptom management Items needed to progress in health restoration Items needed to move toward self-care

When delegating tasks to unlicensed assistive personnel, a licensed practical nurse (LPN) should assess the situation. Which of the following is the first step involved in assessing the situation?

Know the client's needs and priorities.

The new graduate licensed practical nurse may have the most difficulty becoming oriented to this new role if employed on a nursing unit that utilizes which form of leadership style?

Laissez-faire

A nurse is successful in promoting change on his nursing division. This nurse would be considered a(an)

Leader

A nurse manager is educating his staff in new forms of charting. Within the education session the manager sets a goal for complete utilization of the charting. Through goal setting the manager is acting as a(an)

Leader

A patient wants to sign them self out of the hospital against medical advice (AMA). After talking with the patient at length, you determine that the patient is fully aware of all the ramifications of this decision. What would the nurse as a patient advocate?

Make sure the patient has a follow-up appointment

What is the first, and very important, step in effective time management?

Make time to plan and establish priorities

In light of the recent transition to a new skill mix that increases the role of unlicensed care providers, the nurse manager of the unit has enacted new policies and procedures to maximize both patient safety and staff performance during the transition to the new model. Which of the following skills has the nurse demonstrated?

Management skills

The LPN team leader has designed a program for the long-term care facility that involves giving out stars to team members who go above and beyond to meet the needs of the residents of the facility. These stars can then be redeemed for items such as tee shirts, and blankets with the long-term care logo on them. This team leader is using which type of power in the team leader position?

Motivational

What is important for the nurse to do when assigning tasks to UAP?

Needs to assess carefully the skills and knowledge of each UAP

A licensed practical nurse/licensed vocational nurse (LPN/LVN) is hired to provide care to residents of a long-term care facility. Which activity will the LPN/LVN perform when managing the care of a group of residents?

Oversee the work of unlicensed assistive personnel (UAPs).

What is the most critical skill in good time management?

Priority setting

A nurse manager she must provide care to her clients and her employees under the constraints of her resources. This involves maintaining the financial constraints of her division. What term best describes this scenario?

Resource management

The manager recognizes a staff nurse as possessing expert power. Which action will the nurse take to exercise this power?

Serve as a mentor for new nurses on the care area.

The LPN is supervising the nursing unit staff when a nonlethal breach in client standards of care occurs. Which situation demonstrates the limitations of supervising client care in the role of the LPN?

The LPN supervisor oversees the staff but has no disciplinary responsibility.

A committee is evaluating a number of LPN/LVNs who have applied to be team leaders. The committee recognizes that which LPN/LVN will have more difficulty in the leadership role if what is identified as a way of managing time on a day-to-day basis?

The LPN/LVN who manages by crisis and completes tasks as the necessity of the task occurs

The staff nurse submits paperwork to transfer to another care area because the current manager practices the laissez-faire leadership style. Which behavior did the manager demonstrate to cause the nurse to want to transfer to another area?

The manager provides infrequent feedback on staff performance.

Prior to delegating any task to a UAP, which information must be known by the LPN/LVN team leader?

The nurse practice act of the state the LPN/LVN practices

What does one realizes when examining leaders and managers?

There is a need to integrate management and leadership.

A new nurse asks a mentor for advice about the best ways to manage time. Which of the following techniques would the nurse mentor be most likely to recommend?

Use a worksheet to identify specific tasks.

The nurse accidentally left a confidential lab report on a table in one of the exam rooms. The nurse is attending to another client in that room and realizes the mistake when the client says, "I didn't know that my neighbor was one of your patients. I must have just missed her!" The nurse plans to tell her supervisor about the mistake immediately upon finishing with this client. This is an example of:

accountability.

Which of the following tasks could be delegated to unlicensed assistive personnel?

assisting patients with hygiene

The RN provides the LPN with an update on current clients, fresh postoperative clients, and expected admissions. The RN also outlines the treatments the LPN is expected to perform and targets specific tasks for the LPN to complete. Which leadership style do her actions demonstrate?

authoritarian

A nurse manager makes all of the decisions for staff activities. What type of leadership is demonstrated by this action?

autocratic

Pre-shift team report occurs with each shift change at the acute care facility where a nurse is employed as a LPN/LVN. The team takes report together and discusses the upcoming duties for the nurse's shift, making sure delegated tasks are clearly understood and all questions are answered. During this time, which management technique is being employed?

collaboration

An LPN has just been named team leader, and is determined to establish a leadership style that encourages input from staff and focuses on effective communication and teamwork. Which leadership style will the LPN be using?

democratic

What type of leader shares decisions and activities with group participants?

democratic

A nurse has been the Wound Care/Stoma nurse at a hospital for many years. The nurse has an amazing rapport not only with colleagues but with clients. People seem to hang on every word of education or encouragement the nurse offers. What type of power does the nurse wield?

expert power

The wound care/stoma nurse at the hospital has an amazing rapport with both colleagues and clients. People seem to hang on every bit of education the nurse offers and to be extremely grateful for encouragement from this nurse during stressful times. Which type of power does this nurse wield?

expert power

The staff development trainer is preparing a teaching tool to help new staff nurses with time management. Which time waster should the trainer include on this tool? Select all that apply.

hurrying socializing poor planning procrastinating

There has been a lot of frustration in the department related to a new manager who doesn't seem to want to take responsibility or provide direction for the team. This "hands-off" approach by the new manager exemplifies which leadership style?

laissez-faire

Morale is at a low level in a healthcare facility. High client loads, frequent call-offs, and increasing acuity levels all add to the discouragement within the unit. A nurse has an idea to encourage co-workers and supervisors. The nurse places a small, anonymous gift in staff members' mailboxes (a few per week) and monitors reactions. Within a month attitudes have improved, people are bringing treats to share, teamwork has improved. What does this action represent?

leadership

Due to many changes within the healthcare facility, employee morale is low. High client loads, frequent call-offs, and increasing acuity levels all contribute to the sense of discouragement within the unit. An LPN begins to place small, anonymous "thank-you" gifts in staff members' mailboxes a few times a week and monitors their reactions. Within a month, attitudes are more positive, staff members are bringing treats to share, and teamwork has improved. These actions represent:

leadership.

The new vice president of client care services arrives on a care area to meet the staff and talk about client care issues. Which type of power will the vice president have by virtue of the position?

legitimate

A director of nursing suggests that a staff nurse apply for a leadership position in an acute care facility. Which quality did the director of nursing identify in the nurse to make this recommendation? Select all that apply.

loyalty integrity charisma empowerment

As part of effective time management, a nurse should prioritize items needed to:

maintain life.

The unit manager always keeps calm, demonstrates strong leadership, is a calming influence during a crisis, and always seems to do the right thing at the right time. Which type of leadership style does this nurse demonstrate?

multicratic

Successfully carrying out the five rights of delegation requires following steps similar to those of the nursing process. The final step includes a very important aspect to unlicensed personnel to perfect their art. What is that aspect?

providing feedback

Morale is at a low level among staff at a healthcare facility. High client loads, frequent call-offs, increasing acuity levels all add to the discouragement. A nurse has an idea to encourage co-workers and supervisors, and places a small, anonymous gift in staff members' mailboxes (a few per week) and monitors reactions. Within a month attitudes have improved, people are bringing treats to share, teamwork has improved. What type of power does this represent?

reward

After working for many years in a hospital which practices team nursing, a nurse accepts an office manager position with a thriving pediatric practice. Which aspect of the new job is the most different from the hospital position?

scheduling staff

Advocating on behalf of clients is one of the most important responsibilities nurses fulfill. They advocate for the client's wishes, even if those wishes counter what the client's family and physician are recommending. Elsie Linstrum is an 85-year-old retiree who has received the diagnosis of metastasized breast cancer. Her physician recommends surgery, radiation, and chemotherapy; her family recommends surgery. Elsie has indicated to her nurse that she wants no extra measures for her care. She continues to ask her physician and family to admit her to hospice for end-of-life care. What is the nurse's responsibility?

supporting Elsie's decision

In an annual message to hospital staff, the CEO of an acute care facility indicated that additional cost-saving measures would be implemented in order to decrease the potential of staff reductions to balance the budget. Understanding that excellent care also includes being frugal with resources, a nurse considers methods of resource management. Which of the following is not prudent resource management?

taking extra dressing supplies into a client's room

An unlicensed assistive personnel (UAP) who was delegated to provide morning care interrupts hand-off communication to report that a client is bleeding from a surgical site. Which staff member is accountable when the client develops hypovolemic shock?

the nurse who delegated the care to the UAP

A worksheet can be an effective tool for identifying specific tasks and assessments that must be completed during a given shift. This tool, sometimes called a "to-do" list or "brain sheet," is helpful in regard to which aspect of management?

time management