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A nurse educator was explaining the difference between a nurse leader and a nurse manager. The student correctly identifies the characteristics of a nurse leader with which statement? 1. "Nurse leaders influence others through relationship skills." 2. "Nurse leaders plan and organize the budget of the nursing unit." 3. "Nurse leaders establish and enforce the rules of a nursing unit." 4. "Nurse leaders oversee patient care."

1

Before undertaking a leadership role in a nursing organization, what task would be found to be most helpful to the nurse leader's ultimate success in the endeavor? 1. Complete a self-assessment that evaluates the potential leader's own capabilities. 2. Ask a nurse educator to rate the potential leader's capabilities. 3. Complete an intellectual intelligence test to determine the ability to lead. 4. Take a business course to understand how to manage groups of people.

1

The nurse is caring for a patient who is scheduled for an upcoming surgical procedure. Which action by the nurse is an example of the ethical principle of fidelity? The nurse 1. refuses to disclose the patient's personal information to a family friend. 2. asks the patient to share the information about the procedure the surgeon gave them. 3. asks the patient's family member to sign the consent for the procedure. 4. informs the patient of their diagnosis even though the family did not want them to know.

1

The nurse leader of an acute care facility has set up a policy for the nursing staff concerning using vacation time. This policy states that nursing staff may use only 40 hours of vacation at any one time to prevent staffing deficiencies. A nurse requests to use 80 hours of vacation to be able to take a cruise. The decision is that 40 hours of vacation time is the maximum allowed. What ethical theory is the nurse leader using in this situation? 1. Utilitarianism 2. Deontology 3. Principlism 4. International Council of Nurses Code of Ethics

1

Ethical dilemmas can arise anytime in the clinical setting. When there is an ethical dilemma related to care delivery, who can refer the situation to the ethics committee for consultation? Select all that apply. 1. The nurse assigned to the patient 2. A family member 3. A chaplain 4. The physician caring for the patient 5. A physical therapist

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The nurse educator is preparing a group of registered nursing students for graduation and licensure and completes a discussion of the professional values. The students identify which values as part of the five core professional values for nurses? Select all that apply. 1. Integrity 2. Beneficence 3. Human dignity 4. Altruism 5. Veracity

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A patient with terminal pancreatic cancer says to the nurse, "I have decided to stop treatment." Which is the best response by the nurse? 1. "Are you sure that is the best decision?" 2. "I will support whatever decision you make." 3. "You need to discuss this with your doctor first." 4. "Why don't I call you a chaplain so you can discuss this with him?"

2

The nurse is caring for a patient who suffered a broken hip after attempting to go to the bathroom. The nurse had assigned a nursing assistant to assist this patient to the bathroom. It is determined that the nurse is not guilty of malpractice. Which element was not present for malpractice to be charged? The 1. injury was not very severe. 2. nursing assistant had assisted many patients to the bathroom. 3. nurse was not aware that a fall could cause an injury. 4. nurse did not have a duty to the patient because the nursing assistant was responsible.

2

The nurse leader has assembled a team to develop a plan to decrease the number of patient falls on the unit. Which statement by a team member is the best example of an exemplary follower? 1. "I think we are doing all that we can do. There is no way we can add anything else and still complete patient care." 2. "I have noticed that the last few patients who fell were experiencing dementia. What if we focused on those patients first?" 3. "I think that no matter what we do, patients will still fall. We can't be with them 24 hours a day." 4. "I can't believe we are going to do this again. All we will come up with is another form to fill out."

2

The nurse is aware that what leadership responsibilities are important to all nurses? Select all that apply. 1. Working independently 2. Developing delegation skills 3. Ignoring conflicts in the workplace 4. Maintaining effective working relationships 5. Using communication that implies authority

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A nurse leader is responsible for discipline and at times must notify the state board of nursing if the situation that involves the nurse is serious enough. For which situation would the nurse leader most likely notify the state board of nursing? Select all that apply. 1. The nurse made a medication error and notified the health-care provider and stayed with the patient until the medication had passed through the patient's system. 2. The nurse took money from the drawer next to the patient's bed while the patient slept. 3. The nurse was convicted of driving 20 miles over the speed limit and not wearing a seat belt. 4. The nurse was convicted of driving while under the influence on the way home from work. 5. The nurse wrote vital signs in a patient's chart without taking vital signs.

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A new nurse leader has adopted a laissez-faire style of leadership that may result in what characteristics of those who report to this leader? 1. Team members may be very good at time management but poor on job satisfaction. 2. The staff may be very knowledgeable but have a lack of focus on the job at hand. 3. Team members experience disagreements among themselves. 4. Productivity is high with low job satisfaction.

3

A nurse approaches another nurse and says, "I can't remember my password for the computer, can I use yours?" Which of the following is the best response by the nurse? 1. "Sure, let me write it down for you." 2. "No, you need to contact the nursing supervisor for the general password." 3. "I am sorry, but I cannot share my password because it violates policy." 4. "I'm too busy, go ask another nurse."

3

A nursing student shares with the clinical instructor that a patient refused to take his blood pressure medication, saying that he normally takes his medication before bedtime. The student asks the instructor if she can make the patient take the medication. The instructor explains to the student that forcing the patient to take his medication in the morning rather than at bedtime would violate which ethical principle? 1. Fidelity 2. Justice 3. Autonomy 4. Beneficence

3

The nurse is caring for a patient who has a health-care practitioner's order to ambulate three times a day. The last two times the nurse has requested the patient ambulate, the patient has refused. After explaining both the benefits of ambulating and the consequences of not ambulating, the patient still refuses to get out of bed. The nurse documents that patient's refusal and notifies the health-care provider. What core professional value is the nurse upholding with this patient? 1. Integrity 2. Human dignity 3. Autonomy 4. Altruism

3

The nurse is sharing information received during a patient interview with different health-care providers. In which of these interactions does the nurse breach the patient's confidentiality? 1. The nurse shares with the patient's health-care provider that the patient has been drinking four to six beers per day. 2. The nurse documents in the patient's health-care record that the patient is unable to adequately see an insulin syringe. 3. The nurse discusses the patient's marital difficulties with nurses from another unit. 4. The nurse calls the social worker because the patient states he is unable to afford the prescribed medication.

3

A nurse is preparing for a leadership role at an acute care facility and knows that leadership theories grew from which field? 1. Psychology 2. Sociology 3. Anthropology 4. Business

4

On admission, a patient is given a copy of the rights of all patients and that health-care facility's policy and procedures to protect these rights. When asked by the patient the reason for this paperwork, the nurse replies that it is required by what governmental legislation? 1. Health Insurance Portability and Accountability Act (HIPAA) 2. Good Samaritan Law 3. Safe Medical Devices Act 4. Patient Self-Determination Act

4

The charge nurse on a rehabilitation unit is discussing a patient with a physical therapist. Which information should the nurse share with the physical therapist? 1. Explain that it is a breach of privacy and confidentiality to disclose patient information. 2. Require the physical therapist to get permission from the patient before disclosing patient information. 3. Discuss all information about the patient shared with the nurse during admission. 4. Provide the physical therapist with necessary information required for continuity of care.

4

The nurse leader is working with a team to develop a more effective admission assessment process. Which team member is an example of one who participates in the team by "standing by"? 1. A team member who often works with team members who are new to the team and helps to mentor them in their role 2. A team member who appears to function against the goals set up by the team leader 3. A team member who is flexible and ready to make any needed changes 4. A team member who requires detailed instructions concerning the leader's expectations

4

A nurse has just begun a leadership role and aspires to utilize what skills that are part of the five distinct domains of the American Organization for Nursing Leadership (AONL)? Select all that apply. 1. Professionalism 2. Management 3. Communication and relationship building 4. Knowledge of disease process 5. Business skills

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A nurse approaches the nurse manager to inform them that a patient with terminal cancer requested a DNR from the health-care provider, but the health-care provider refused and ordered another round of chemotherapy. The nurse leader is aware that the nurse may be experiencing a threat to their moral integrity that includes which of the following? Select all that apply. 1. Moral distress 2. Moral obligation 3. Moral courage 4. Moral uncertainty 5. Moral resilience

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A nursing assistant approaches the nurse manager and complains of bullying behavior by one of the registered nurses. The nurse leader is aware that what behaviors constitute or are a result of bullying? Select all that apply. 1. Claims the actions cause humiliation 2. Gossiping occurs around the nursing assistant 3. Registered nurse (RN) does not use please or thank you when discussing required tasks 4. Nursing assistant feels nauseated every time it is time for work 5. States the RN told others that the nursing assistant does not work hard enough

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A nurse educator is discussing the classifications of law that relate to nursing practice with a group of students. When discussing criminal law, what examples of felonies should be included? Select all that apply. 1. HIPAA violations 2. Failing to report child abuse 3. Using the title of "Registered Nurse" without a license 4. Diverting controlled substance 5. Attempting to use a suspended nursing license

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The nurse leader is responsible for patients on six different units in the acute care facility, including the newborn nursery and the intensive care unit. In which nursing unit would the nurse leader face potential liability? 1. The newborn nursery has to admit 10 babies from labor and delivery and only 7 cribs have been cleaned completely and released back to the nursery. The nurse leader tells the nurses to clean the necessary number of cribs themselves and the housekeeping staff will finish the cleaning in the morning. 2. The medical-surgical unit experiences a patient fall related to a patient neglecting to use the call button to ask for assistance. 3. The intensive care unit experienced a patient injury after an experienced nurse administered the incorrect medication. 4. The orthopedic unit had a patient who became septic and had to be moved to the intensive care unit because a nursing assistant, employed by the facility for 15 years, forgot to check the patient's vital signs as ordered.

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A lawsuit pertaining to professional negligence must include which of the following? Select all that apply. 1. Duty owed the patient 2. Foreseeability of harm 3. Intent and risk 4. Breach of duty owed the patient 5. Causation

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A nurse has accepted a management position and knows that what characteristics are necessary to be an authentic leader? Select all that apply. 1. Self-discipline 2. Value 3. Fiscal responsibility 4. Determination 5. Heart

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A new chief operating executive believes that patients will receive better care and be more satisfied in a unit that is specific c to their disorder. A nurse manager heads a unit that has functioned for the last 10 years as a general medical-surgical unit but will now become a specialty unit for patients with chronic respiratory issues. What is the nurse manager's priority responsibility during this transition? 1. Assist the staff to feel more comfortable in their new roles. 2. Ensure that the patients receive safe care by qualified staff. 3. Survey the patients daily to determine whether needs are being met. 4. Hold briefings daily with the staff to determine common problem areas.

2

A nurse is aspiring to move from a staff nurse's position to a leadership and management role. What activity would be most helpful to this nurse in achievement of this goal? 1. Complete a leadership survey. 2. Enroll in a graduate leadership program. 3. Read a leadership book. 4. Request a change in position weekly from the charge nurse.

2

The nurse is caring for four patients. In which patient situation is the nurse utilizing the core professional value of social justice? 1. The nurse notifies a social worker after talking to a patient who is unable to keep his blood glucose within a normal range and discovers that the patient is unable to shop for himself and depends on family members to bring him food, much of which is fast food. 2. The nurse is caring for a patient who is hearing impaired and ensures that a sign language interpreter is present when the health-care provider explains the patient's lung cancer treatment plan. 3. The nurse is caring for a patient who is waiting for the results of a lung biopsy. When the patient asks the nurse if the biopsy is back and what does it show, the nurse responds, "Yes, the biopsy is back and your health-care provider will be here within 30 minutes to discuss the results with you." 4. The nurse is caring for a patient who refuses to receive any blood products even though the patient's hemoglobin is 5.7 mg/dL. The nurse discusses the benefits of receiving the transfusion, but the patient still refuses so the nurse notifies the health-care practitioner of the patient's decision.

2

The nurse leader believes that a mentorship program for new nursing graduates would benefit t the organization in what way? 1. New nurses will require no supervision after the mentorship program is completed. 2. Mentorship leads to new nurses remaining with the organization longer than those nurses who did not engage in a mentorship program. 3. The nurse who completes the mentorship program will understand better how to care for patients without assistance. 4. Engaging in a mentorship program helps that individual to work longer hours without fatigue.

2

The nurse leader has decided to adopt a quantum leadership style. Team members can expect what characteristics in the nurse leader related to this leadership style? 1. Focusing on getting the job done 2. Incorporating flexibility and adaptability 3. Providing a vision to the team members that includes the input of all team members 4. Including team members in the leadership process

2

The nurse leader is supervising the entire acute care facility and is notified that many employees have called in sick related to an outbreak of influenza. The nurse leader sends a registered nurse who works on a transitional care unit to the emergency department to provide care. In what area could this nurse potentially experience liability? 1. Failure to warn 2. Inappropriate assigning of staff and failure to supervise 3. Negligent retention practices 4. Unsafe staffing

2

The nurse manager is evaluating several nurses who have expressed an interest in leadership activities and knows that the nurse who demonstrates which type of followership has the most potential for a leadership role? 1. Standing by 2. Doing following 3. Resisting following 4. Passive follower

2

The nurse student is aware that what feature is now a part of the newest nursing leadership theories? 1. Self-discipline 2. Flexibility 3. Motivation 4. Visionary

2

A nurse manager has begun to use transformational leadership theory and knows that this theory uses what aims of the Institute of Medicine (IOM)? Select all that apply. 1. Nurse-centered 2. Efficient 3. Timely 4. Safe 5. Inexpensive

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Good Samaritan Laws protect people who render care at the scene of an accident under which of the following conditions? Select all that apply. 1. Care is provided by a licensed health-care professional 2. Care is not grossly negligent 3. Care is provided at the scene of the accident 4. Care is rendered without pay 5. Care is provided according to appropriate standards

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The nurse manager is acting as a staff advocate in which of the following situations? Select all that apply. 1. Assigning a rigid schedule for staff lunch breaks 2. Implementing a self-scheduling model for staff 3. Promoting a positive work environment 4. Reprimanding a nurse for refusing to administer an unsafe dosage of an ordered medication 5. Encouraging staff to engage in self-care

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A nurse makes an entry on social media concerning a patient situation that occurred during a recent shift at an acute care facility. The patient was notified by an acquaintance who recognized the patient from the description in the entry. Did the nurse who posted the entry commit malpractice? 1. No, because the nurse did not foresee that this would bring harm to the patient. 2. Yes, because the nurse had a duty to the patient and breached that duty through the posted entry. 3. No, because not all five elements of malpractice were present. 4. Yes, because all five elements of malpractice are present.

3

The nurse manager is aware that what aspect of leadership relates to the ability to make a promise, keep it, and carry through on that promise? 1. Compassion 2. Confidence 3. Connectedness 4. Commitment

3

The nurse is caring for a 95-year-old patient recently diagnosed with stage 4 pancreatitis and who is refusing to eat. After explaining the consequences of not eating, the patient still refuses to eat. The nurse documents that patient's refusal and notifies the health-care provider. Which ethical principle is the nurse upholding by supporting the patient's decision? 1. Veracity 2. Fidelity 3. Autonomy 4. Nonmaleficence

3

The nurse leader is seeking an effective leadership style. The nurse should avoid which leadership style that limits innovation and the ability for team members to feel engaged in the outcomes of the organization? 1. Connective leadership 2. Transformational leadership 3. Transactional leadership 4. Authentic leadership

3

As leadership theories have evolved in the last 20 years, how have nursing leadership theories shifted from the industrial models? They have become more 1. attribution focused. 2. laissez-faire focused. 3. relationship focused. 4. situational focused.

3

The director of nursing at the county health department is aware that which ethical theory is most commonly used by nurses in public health agencies? 1. Deontology 2. Principlism 3. Utilitarianism 4. Principle of duty

3

A nurse who is endeavoring to increase emotional intelligence knows that what are the core components necessary to the development of this leadership characteristic? Select all that apply. 1. Empathy 2. Motivation 3. Intellectual skills 4. Leadership 5. Self-awareness

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The psychiatric home health nurse is making a visit to a patient with a history of schizophrenia to administer an intramuscular injection that produces a prolonged therapeutic effect. On entering the house, the nurse observes the patient to be standing up with a rigid posture. What criteria will the nurse use to determine whether this patient should be treated at this time? Select all that apply. 1. The benefit of treatment outweighs any harm that the nurse may incur. 2. The patient has never been violent with the nurse before. 3. The nurse's care will probably prevent harm, loss, or damage to the patient. 4. The patient is at a significant risk of harm, loss, or damage if the nurse does not assist. 5. The nurse must respect the patient's autonomy.

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The nurse is aware that in which situation is there a potential for a violation of a patient's right to confidentiality? The patient's 1. medical record was read by an unauthorized person. 2. conversation with a family member was overheard by someone in the hall. 3. interview with the nurse was shared with the patient's sister. 4. social security number is copied by an unauthorized person.

3

A nurse in the emergency department treated a 6-week-old infant who had sustained fractures of the right femur and right humerus, and the nurse files a report with the state agency that oversees possible child abuse cases. After 6 months it was determined the infant had a congenital condition that caused the fractures. Today the nurse received word that a lawsuit had been filed against the nurse. This nurse recognizes that protection from this lawsuit is available because of what legislation? 1. Good Samaritan Law 2. State disclosure statute 3. State employment laws 4. State Nurse Practice Act

2

A nurse manager is known to use an autocratic style of management. The nurses who work for this nurse manager know that this style of management leads to what possible result? Team members 1. exhibit high job satisfaction with low productivity. 2. may become demoralized because of the management style. 3. are expected to contribute to the decision-making process. 4. experience high production and satisfaction.

2

In each state, who/what defines the legal boundaries of nursing? 1. The legal counsel of the state 2. The Nurse Practice Act 3. The ANA Standards of Practice 4. The ANA Code of Ethics

2

The nurse manager of a medical-surgical unit is discussing conscientious objection at a monthly staff meeting. Which of the following statements by a nurse indicates additional education is needed? 1. "Acts of conscientious objection cannot be based on personal preferences or bias." 2. "I must notify my supervisor, in advance if possible, if an assignment is morally objectionable to me." 3. "I can refuse to care for a patient anytime I feel my moral integrity is in jeopardy." 4. "I must ensure another nurse can care for my patient to avoid abandonment."

3

Which of the following statements best describes beneficence? 1. Self-determination 2. To do no harm 3. One's actions should promote good 4. Keeping promises to others

3

A staff nurse approached the director of nursing to discuss steps that would be helpful in moving to an administrative position. The director of nursing told the staff nurse not to consider leadership because this nurse was not a "born leader." What leadership theory is the director of nursing using to make this judgment? 1. Behavioral theory 2. Situational leadership theory 3. Contingency leadership theory 4. Great Man theory

4

The nurse is caring for a teenage girl who just gave birth to a baby girl. The patient tells the nurse that she is planning to breastfeed, but the nurse responds, "I'm just going to bring you formula for your baby. You are very young and breastfeeding requires a lot of patience and is difficult for women who are much more mature than you are." What nonethical principle is the nurse demonstrating in this statement and action to the patient? 1. Paternalism 2. Malpractice 3. Negligence 4. Deception

1

The nurse manager of a busy medical-surgical unit has received an anonymous note that one of the unit's LPNs has routinely been documenting care that has not been given. What is the best action of this nurse manager concerning this situation? 1. Immediately report the LPN to the state board of nursing. 2. Question each RN about the anonymous note. 3. Ask the LPN if the anonymous note is true. 4. Check the LPN's documentation after observing the LPN.

4

The question of whether a nurse's actions reflect what a reasonable and prudent nurse should do under the same circumstances can be proven by which of the following: 1. The defendant's explanation of what the nurse did 2. The testimony of an expert medical witness 3. The trial judge based on prior similar court cases 4. The testimony of an expert nurse witness

4

A nurse seeking to advance to a leadership position within the health-care organization has become the mentee of a nurse manager. What is the primary responsibility of the mentee in this relationship? 1. Follow the mentor in all activities. 2. Work to dialogue with other nurse leaders and managers. 3. Request a monthly meeting with the mentor to discuss leadership attainment. 4. Ask the mentor to place the mentee in a minor leadership position.

2

A staff nurse has been caring for a patient with chronic obstructive pulmonary disease (COPD) through repeated hospitalizations, and his condition continues to get worse despite multiple treatments. The patient states that he is "ready to die" and wants the doctor to "make him a DNR" (do not resuscitate). The doctor refuses to write the order and instead insists that there is a chance the patient will improve and have some quality of life. The nurse notifies the chair of the hospital ethics committee about the situation and knows the doctor will most likely be very upset by this development. What has the nurse displayed by doing this? 1. Moral distress 2. Moral courage 3. Moral uncertainty 4. Moral trepidation

2

The director of nurses has implemented a new salary scale that does not take into account the educational level of the nurse. The director of nurses may have violated which ethical principle? 1. Beneficence 2. Justice 3. Fidelity 4. Veracity

2

Who is accountable for obtaining informed consent? 1. The patient's nurse 2. The health-care professional performing the procedure 3. The nurse assisting the health-care professional performing the procedure 4. The health-care agency's attorney

2

A nursing student is required to take a nursing leadership course and questions why this type, of course, is necessary when the initial primary role of the graduate nurse is to perform bedside patient care. What is the nurse educator's best response to this student? 1. "It is a part of the curriculum that is required by all state boards of nursing." 2. "Though new graduates begin at the bedside, most take on leadership positions within the first 6 months of employment." 3. "Leadership competencies are required even at the bedside to help in navigating the evolving health-care landscape." 4. "All nurses report to someone, so you have to understand leadership so you know whom you report to."

3

A patient dies as the result of a wound infection. When the family sues the hospital and the nurses involved in this patient's care, it is discovered that wound care was only charted three times despite a twice daily order from the health-care provider. What category of nursing practice will be the focus of the resulting lawsuit? 1. Failure to act as a patient advocate 2. Failure to assess and monitor 3. Failure to document 4. Failure to communicate

3

The nurse is caring for a patient who has limited vision. Which ethical principle is the nurse upholding by ensuring that there are no obstacles present between the patient's bed and the bathroom? 1. Veracity 2. Confidentiality 3. Fidelity 4. Beneficence

4

The nurse is responsible for administering medications to a patient with hypertension. The health-care provider decreased the patient's dose of antihypertension medication at 7 p.m. The next morning, the nurse administered the original dose of antihypertension medication to the patient. The nurse notes the error immediately upon documentation and notifies the health-care provider. The nurse checks the patient's blood pressure frequently, and no significant drop in blood pressure is noted. What essential element of malpractice is lacking in this medication error? 1. Breach of duty owed the patient 2. Foreseeability of harm 3. Duty owed the patient 4. Injury or harm

4

The nurse leader is preparing to present the vision for reworking the nursing responsibilities within the organization. Which leadership characteristic is measured by the leader's ability to keep his or her word? 1. Compassion 2. Character 3. Connectedness 4. Commitment

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