4810 Final

A nurse says, "I am always worried that I will be liable if someone I delegate a task to does something that hurts the client." What is the manager's best response to this concern?

"As long as you follow the five rights of delegation, your liability is minimal."

Which statement by the nurse managing a unit conflict indicates that the integrative decision-making strategy is being used?

"Both parties should come up with as many alternative solutions as possible before our next meeting."

A nurse has a longstanding conflict with another nurse working the same shift. Over the last few days the first nurse has made an effort to smooth over the conflict. Which statement would the nurse manager evaluate as an example of a "smoothing" comment?

"Even though we don't agree on much, I do think you are correct about enforcing the length of lunch breaks."

Which statement made by the nurse manager is an example of the first step of delegation?

"I am going to delegate the responsibility of creating the vacation schedule."

The nurse has attended a "how to" refresher course on successful delegation. Which statement indicates successful learning has taken place?

"I knew that effective delegation made my job easier, but I never thought about how it could benefit the hospital."

A nurse manager is trying to manage a conflict between a staff nurse and a medical student. Which statement by the manager would the nursing supervisor interpret as following the rules of basic mediation?

"I stopped the conversation frequently to have the parties summarize what was being said."

The nurse manager meets with the staff nurses to discuss ways to improve communication among the shifts. Which statement by the nurse manager best exemplifies the final stage of conflict management?

"I will evaluate the outcomes of our strategies on a monthly basis."

During a job interview the nurse manager asks, "What are your short-term goals?" Which statement by the applicant addresses this question?

"My brother and I want to go to on a mission trip in the next year."

The nurse manager has identified physical assessment skills lacking in a new registered nurse. Using goal-setting theory, which statement by the manager would be the most effective in enhancing the nurse's assessment skills?

"Plan to study one body system a week and demonstrate your assessment skills to me every week."

A newly appointed nurse manager has just completed education on time-management skills. Which statement would the instructor evaluate as indicating this nurse understands the basic concepts of time management?

"The key to using time management is to respect my time as well as the time of others."

The nurse manager orienting newly hired nurses has explained the organization's blame-free environment. Which remark by one of the nurses indicates understanding of the policy?

"When I make a mistake, I should report it and look for ways to prevent it from recurring."

A nurse has been asked to teach newly hired nurses how to operate some client care equipment that the unit has just received. The nurse says, "I'd love to do this, but someone else will need to take my clients today." How should the manager respond?

"You will need to work the education into your day as you take care of clients."

The nurse manager is reviewing the current staff to determine who should precept a newly licensed nurse. Which nurse is the most logical choice?

. A nurse who is clinically competent and has the desire to assume the responsibility to train new staff

Which statements would be important for the charge nurse to make when delegating a responsibility? select all

1. "I think it would be important to our organization if you represent the unit on the policy and procedure committee." 3. "I think your attendance at the task force meeting will be a good reflection on our unit."

A nurse is participating in time-management education. This week's assignment is to compile a list of personal goals. Which of these goals should the nurse include? select all

1. "I will lose 10 pounds by Christmas." 3. "I will read for pleasure for 1 hour every day after work." 5. "We will save $200 monthly for the next 12 months for a car down payment."

Which statements would alert a nurse manager that a unit conflict has become disruptive? select all

1. "I won't stop until I have gotten her fired." 2. "He doesn't fight fairly." 3. "I've almost forgotten what started this, I just focused on beating her." 5. "He is so wrong, he just has to go."

In order to develop a succession-planning program as rapidly as possible, the management team has elected to divide the processes up among team members. Which assignments would be expected? select all

1. "Identify the most important things that managers do." 3. "Decide which current nurses would make good managers." 4. "Analyze management training opportunities."

Which statements indicate that a nurse manager is using time reactively? select all

1. "We were so busy yesterday that I did not get the schedule completed." 3. "We have so many new graduates on our unit that our work is never caught up." 5. "I am really concerned about what the nursing supervisor said about our unit. I can't get it off my mind."

The nurse is assigned to the Risk Management Team. Which events would be addressed by this team? select all

1. A client's hand is injured during an arterial blood gas draw. 3. A client leaves the hospital against medical advice (AMA).

Which situation represents an exception to the blame-free environment? select all

1. A nurse routinely changes nursing notes after a client is discharged. 4. A nurse does not complete an incident report after a medication error.

In order to delegate, which must be present? select

1. Accountability for the assignment on the part of the delegate 2. Accountability for the assignment on the part of the delegator 3. Authority by the delegator to assign the task to the delegate 5. Authority of the delegate to accomplish the task as assigned

Which situations are examples of ineffective delegation? select all

1. After delegating committee attendance to a staff nurse, the nurse manager also attends the meetings. 2. The unit clerk asks the nurse manager to "listen for the phones" so the clerk can go to the hospital's celebration of hospital week. 4. The staff nurse asks the UAP to provide simple discharge instructions to a client. 5. The staff nurse often bathes clients because "I like to give bed baths."

A nurse executive is trying to convince the hospital management team that a clinical ladder system would work well in nursing. Which points should the nurse include in this argument? select all

1. Clinical ladders keep very good nurses at the bedside. 2. These programs prove to be worth their cost. 4. Similar programs have been shown to improve nurse job satisfaction. 5. Quality of client care increases with these programs.

Conflict has arisen within the hospital regarding who will staff a proposed high-acuity unit. The nurse executive and other administrators have purposefully not intervened in this conflict. Why is that strategy appropriate? select all

1. Conflict draws attention to an issue. 3. Conflict can stimulate new ideas about how to manage the high-acuity unit. 4. Conflict about the unit will help to identify the compromises necessary to make it a viable part of the hospital system. 5. Conflicts about staffing may make current staff members reexamine their own performance.

A nurse manager has felt overwhelmed by work the last few months. After putting in many hours of unpaid overtime, the workload is beginning to stabilize. The nursing supervisor asks the manager to take on a new task that is exciting and stimulating. What should the manager do? select all

1. Consider how much work will be added to the current workload. 2. Tell the supervisor no. 3. Talk with the supervisor about decreasing another work responsibility if this project is accepted.

During the first staff meeting, a newly promoted nurse manager says, "I would like a commitment from all the nurses to review and improve the way delegation is done on the unit." Why would the manager be interested in delegation? select all

1. Effective delegation allows the manager to focus more time on management tasks. 2. Efficiency is increased by effective delegation. 3. If the manager has more time to focus on managerial duties, there is more chance of career advancement. 5. The manager is interested in developing the entire staff to its maximum potential.

A health care organization has provided intensive education to staff regarding benefits and correct methods of delegation. Why has the organization spent the time and money to sponsor these sessions? select all

1. Good delegation helps to reduce overtime. 2. Absences decrease when delegation is used correctly. 4. Patient satisfaction scores increase when care is efficient and effective. 5. Good delegation increases productivity.

In which ways can nurse managers reduce risks for the organization? select all

1. Investigating a complaint about nursing care from a client's spouse 3. Talking to physicians about ways to improve client care 4. Keeping staff members on task throughout the workday 5. Making sure staff members work minimal overtime

A nurse manager has scheduled several on-the-job instruction sessions. Why would the nurse choose this format? select all

1. It is very cost-effective. 2. Travel expenses are minimized. 4. Transfer-of-learning issues are eliminated. 5. The learners are motivated to learn.

A nurse manager is investigating the application of the principles of equity theory to rewarding staff. Which options are rewards that the manager could influence? select all

1. Job satisfaction 2. Prestige

A nurse manager is orienting newly hired staff nurses to the organization's total quality management program. As part of orientation, the manager has assigned the nurses to interview the organization's internal customers. Which group would the nurses interview? Select all

1. Newly hired radiology technicians 4. Nurses who have worked at the facility over 5 years

What are reasons that nurses fail to manage time effectively? select all

1. Nurses do tasks they enjoy doing before the ones they do not enjoy. 2. Nurses do things that bring the most immediate closure first. 3. Nurses respond on the basis of who wants something. 5. Nurses work on things in the order of their arrival.

A colleague frequently forwards funny e-mails to everyone on her contact list. The nurse manager does not have time to look at the e-mails and is aggravated when they appear. How should the manager handle this situation? select all

1. Set the e-mail filter to divert the messages to a spam folder. 2. Tell the sender that the manager is not allowed to get personal e-mails at work. 4. Send the colleague an e-mail that reads, "Stop wasting my time with these e-mails." 5. Delete the messages without opening them.

The continuous quality improvement (CQI) coordinator is establishing quality measures for a unit. These measures would be written according to which criteria? select all

1. The CQI coordinator has read two research studies that show the process improves client outcomes. 2. The CQI coordinator has evidence that a particular practice is effective in decreasing length of stay. 4. The process being measured produces a desirable outcome. 5. There are very few unexpected bad effects from the process

Which quality improvement initiatives would help the health care organization meet Institute of Healthcare Improvement (IHI) goals? select all

1. The amount of material opened and wasted for surgical procedures will drop by 25 percent this fiscal year. 3. Wait times in the emergency department will decrease by 15 percent this year. 5. Fewer than 5 percent of clients will report inadequate pain control while hospitalized.

A nurse manager often uses negative reinforcers as part of operant conditioning in order to inhibit undesirable behaviors. What often results from this action? select all

1. The employee ducks into a client room each time the manager is seen. 3. No improvement in the frequency of the undesired behavior is seen. 4. The employee calls in sick more often. 5. The manager must constantly monitor the situation.

Which situations would cause concern about liability with regard to delegation? select all

1. The nurse asks the LPN to change a central line dressing. 2. The nursing supervisor asks the nurse for details about a client's history. 4. The supervisor asks the charge nurse to give a nurse a difficult assignment.

Which job behaviors would the nurse executive consider troublesome no matter which unit employed the nurse? select all

1. The nurse made two medication errors today that resulted in poor client outcomes. 3. A manager reports that a nurse used a piece of equipment that had been taken out of service for malfunction. 4. A nurse did not report to work for 2 days and did not call in the absence.

Two staff nurses are in conflict about the summer vacation schedule. The nurse manager is contemplating assigning both nurses to a task that will require frequent contact with each other, hoping that they will resolve the issue themselves. What should the manager consider before making this assignment? select all

1. What is the anxiety level of the nurses in regard to the vacation schedule? 3. Will the conflict decrease the efficiency of the unit while the nurses are self-solving the issue? 4. How intense is the conflict about vacation scheduling?

A newly licensed nurse is considering a job offer at a hospital that offers a residency program. The nurse should expect to be in this program for up to _____ months.

18

Efforts to increase nurses' use of evidence-based practice (EBP) to improve client care in the hospital have failed. Which answers are nurses likely to give when asked why this is occurring? select all that apply

2. "I don't have time to finish everything I already have to do each shift." 3. "I don't want to practice nursing just like everyone else." 4. "The library at our hospital doesn't have many journals." 5. "If administration wanted us to use EBP, they would get us some more nurses to share the work."

The nurse supervisor would like to delegate accreditation preparation activities to the nurse manager. The manager is unsure of what is expected and has no experience with accreditation. How should the manager respond?

2. "I will need some education on the accreditation process before I can accept this task." 4. "Please tell me more about what this assignment entails."

A nurse and a physician are in conflict over the treatment of a client. Which statements by the nurse reflect the best way to handle interprofessional conflict? select all

2. "This client needs an additional day to learn how to care for a complex wound." 3. "It will help this client manage her diabetes more effectively if she is assigned a diabetic educator." 4. "Research has shown that early ambulation helps to reduce the likelihood of pulmonary embolism."

Which situation would be included in reporting for Joint Commission mandatory national patient safety goals? select all that apply

2. A client is left waiting in the hallway because the transport person did not make contact with the client's nurse. 3. A nurse gives a medication by the wrong route. 4. A client developed sepsis after insertion of a urinary catheter. 5. Surgery is done on a client's right eye instead of the left eye.

The procedures for managing client pain are being investigated as part of the hospital's total quality management program. Whom should the manager plan to invite to this meeting? select all

2. A representative from pharmacy 3. A representative from the medical staff 4. A staff nurse who works with clients in pain

Which situations are examples of the nurse directing rather than delegating? select all

2. A staff nurse asks the assistant to sit with the roommate of a client who has just died. 3. During a code blue situation, a nurse tells another nurse to start an IV. 4. A nurse tells an assistant to move a client into the hallway during severe weather.

A nurse manager is looking for evidence-based information regarding wound care. Which criteria should be used to evaluate the usefulness of an intervention? select all

2. Can the manager find two or more research studies that support the use of the intervention? 5. Is the research study that recommends the intervention rigorous in design and execution?

A unit secretary is chronically late returning from breaks. The rest of the secretary's work is excellent and he is always helpful and supportive of nurses and client families. The nurse manager has discussed the lateness with him, but it has not stopped. Thinking this might be an attention-seeking behavior, the manager decides to use extinction as a strategy. What should the manager do? select all

2. Ignore the behavior. 4. Plan to be away from the secretary's area during his break times.

Why does conflict help generate change? select all

2. It brings more attention to an issue in need of change. 3. People get involved because conflict breeds curiosity.

A nurse manager is delegating a new, complex task to the unit secretary. Which strategies should the manager use? select all

2. Make eye contact with the secretary when explaining the task. 3. Talk to the secretary in person rather than by telephone or in e-mail. 5. Discuss the importance of the task to the organization.

During strategic planning, the committee finds a need to develop a succession plan for the facility. What committee findings would draw attention to this need? select all

2. Many of the facility's senior nursing managers indicate they will likely retire within 5 years. 3. The nursing shortage in the area continues to worsen.

Which findings associated with an employee are likely to be considered when discussing performance? select all

2. The employee has been tardy on one occasion when an unexpected snow fell just before shift change. 4. The employee found a purse containing $200 in the cafeteria and turned it in to security. 5. The employee made two work errors requiring incident reports in the last year.

The leader of a continuous quality improvement (CQI) team has asked that an information packet be distributed to members of the resource group. The secretary would prepare packets for which people? select all

2. The hospital CEO 3. The vice president in charge of finance

A nursing supervisor warns the nurse manager, "Having access to electronic communication is not always a blessing." How should the manager interpret this warning? select all

2. The manager does not have to be physically present in the facility for communication to take place. 3. If not used effectively, electronic communication can prevent the manager from getting rest. 4. Along with a flatter organization and easy access, the nurse manager's job responsibilities have increased. 5. In today's health care environment there is pressure to do more with less.

A physician criticizes the care provided by a nurse in an area where others are present. Which actions by the nurse would the manager interpret as a covert conflict behavior resulting from this situation? select all

2. The nurse avoids the physician in the hallway. 4. The nurse is no longer as careful in caring for this physician's clients. 5. The nurse is apathetic about the care of clients.

The nursing supervisor is assessing a unit that has received several written complaints. The nurse manager seems overwhelmed and stressed trying to address many client situations. The charge nurse is trying to help everyone at once. Based on this assessment, what might this supervisor conclude? select all

2. The unit culture may foster distrust and poor communication among staff. 3. Client complaints are usually an indicator of a larger unit problem. 4. Nurses on the unit are in need of additional training and skills.

A hospital increased its RN-to-client ratio 1 year ago. What effects is the hospital likely to see as a result of that choice? select

2. There has been a decrease in client deaths. 4. The overall quality of care has increased. 5. The nosocomial infection rate has dropped.

A nurse executive says, "I would really like to develop our current nurses so they can take a greater leadership role in the future." Why is this a good management plan? select all

2. This method of developing leaders has proved to be cost-effective. 3. The leadership development can be varied according to the needs of the nurse. 4. When leaders are developed from within, management is already aware of their strengths and weaknesses. 5. The specific needs of the organization can be served.

A nurse manager is selecting nurses to serve as teachers in on-the-job instruction. What qualifications should these nurses hold? select all

2. Willingness to teach new nurses 3. Ability to explain procedures accurately and clearly

A staff nurse frequently interrupts the nurse manager with problems that the staff nurse could solve. What should the manager say to correct this behavior? select all

3. "Is this a problem you can handle yourself?" 4. "You have the skills to solve this issue." 5. "I trust you to solve this problem."

The nurse manager must attend to several tasks this afternoon. Which tasks would the manager categorize as urgent? select all

3. Assisting a family whose child is in the emergency department 4. Finding replacements for two staff members on the next shift who called in sick

As part of a new time management initiative, the nurse manager is creating a "to-do" list. How should the manger structure this list? select all

3. Block out time for the unexpected. 4. Be certain the list is flexible.

The nurse manager is facilitating the work of a collaborative team whose mission is to negotiate employment contracts with physicians. The nurse manager does not want to compromise the nurses' concerns in favor of the doctors' concerns. Which strategies would facilitate this outcome? select all

4. Collaborating 5. Competing

Which activities are similar enough that they could be grouped to better manage time? select all

4. Search the Internet for an unfamiliar client diagnosis 5. E-mailing a colleague a question about the schedule

Which strategies would decrease the amount of time the nurse manager spends with "drop-in" visitors to the manager's office? select all

4. Stand up to greet the visitor and remain standing. 5. Encourage appointments for routine matters.

The hospital has an annual campaign in which the staff is divided into two teams to raise money for hospital special events. The team raising the most money gets possession of a "trophy" designed by the administrative staff. This is an example of which type of conflict?

A competitive conflict that is positive to the work environment

The hospital has initiated a new fall risk assessment tool. The nurse manager would like to reward those staff members who use the tool regularly. Which method of reinforcement would be most successful in getting long-term compliance?

A coupon for a free lunch for staff members who, according to a medical record review of nursing documentation, consistently use the tool correctly

A nurse manager must place a telephone call to a colleague who always wants to chat socially for several minutes. The manager does not have time for a social call. What is the best time for the manager to make this call?

A few minutes before the colleague usually goes to lunch

The nurse manager has several tasks that need to be accomplished. Which task is the manager likely to do first?

A task that has been assigned by the supervisor instead of a task that the manager thinks will benefit the unit

The nursing supervisor would like to delegate an information-gathering task. All the people listed have the ability to perform the task. In general, whom should the supervisor ask to do this work?

An unlicensed nursing assistant

The daughter of a hospitalized client comes to the nurse manager's office with a complaint about the care provided on the previous shift. What is the manager's first action?

Ask the daughter to explain what happened.

What action is necessary by a delegate accepting delegation?

Clarify the time line and expectations

The medical residents on a particular unit do not answer pages very quickly, and sometimes do not answer them at all. The nursing staff complains to the nursing supervisor. After several weeks, this conflict has spiraled into a heated disagreement. Which is the most important reason to make the necessary changes to settle this conflict?

Client care and satisfaction will suffer should it be allowed to continue

A difference in opinion has arisen regarding methods to care for clients who are on mechanical ventilators. The nurse manager asks a group of nurses to meet and review evidence-based practice related to this client care situation. Each nurse volunteers to gather data prior to the next meeting. This is an example of which type of problem solving?

Collaboration

The nurse manager is concerned about the apparent lack of staff motivation to improve client care on a unit. How should this manager use motivational theories to help improve this situation?

Combine theories to develop a plan for this specific unit.

The novice nurse manager is hesitant to delegate tasks to competent, experienced staff nurses. Fear of which factor is most likely to explain this hesitancy?

Competition and criticism

The nurse has expressed job dissatisfaction to the unit manager. The manager assigns another staff member as a coach for this nurse. What is the most important aspect of the coach's job?

Conduct the relationship in a confidential manner

A nurse manager states, "I cannot stand all these conflicts in my department. Nothing good can come out of it." Which indicates the best reason the manager's statement is untrue?

Conflict can stimulate more people to become involved in a situation, thus creating more innovative solutions to the issue.

The nurse manager assesses that two staff nurses are engaged in a conflict that is having a negative impact on client care. The manager meets with the nurses involved and identifies the conflict. An attempt is made to resolve the conflict through knowledge and reason. What strategy is this manager using?

Confrontation

The nurse manager presents an issue to the nursing staff for a decision. The group assesses the problem, and a decision is made meeting the needs of both the nurse manager and the nursing staff. This is an example of which conflict management strategy?

Consensus

A registered nurse is dissatisfied with the wages and health benefits available in his current position and decides to seek other employment. This employee's frustration is most linked to which motivational theory?

Content theory

After the second week of orientation the new nurse witnesses the death of a child in the ED. Which role should this nurse's preceptor focus on at this time?

Counseling the new nurse

The nurse prepares the medication ordered for the client. The nurse asks the nurse assistant to give the medication when the client receives breakfast and to report on the task at its completion. The nurse assistant agrees. Which component of the steps of delegation was violated by this request?

Deciding on the delegate

A novice nurse manager is devising a schedule to meet the needs of the staff, clients, and other disciplines on the unit. Which is the most important method to counteract wasted time in nursing?

Delegate routine activities to concentrate on other tasks.

A nurse asks an unlicensed assistant to help with discharging clients since so many are going home at one time. The nurse states, "Can you help get these clients ready to go home by helping them pack?" Which option best describes the statement with regard to effective delegation?

Delegation would have been more effective had the nurse been more specific about which clients and when it should be completed

The nurse and a client are discussing instructions for self-care after discharge. The client's husband says, "I can't take care of her by myself. We need home health like we had before she came to the hospital." This statement reflects which antecedent condition?

Differences in values and beliefs

A staff nurse has experienced disagreements with one of the medical residents about several issues. The resident reacts to this conflict by belittling the nurse in front of colleagues. This behavior is most characteristic of which type of conflict?

Disruptive

The day shift nurses and night shift nurses are in clear opposition regarding the responsibilities that each shift should be assigned. This opposition has created a "we-they" distinction on the unit. This is an example of which phenomenon?

Distancing

A newly licensed nurse is concerned about the legal aspects of delegation. What is the most important question for the nurse to consider prior to delegating a task?

Does this task involve nursing judgment?

When driving towards a meeting, the nursing supervisor gets a call explaining the meeting is to be delayed for about 30 minutes. Which activity is the best use of this supervisor's waiting time?

Drive to the meeting place and read the minutes from the last meeting

A nurse manager wishes to use a model of job performance to help match employees and tasks to achieve the greatest effectiveness. What should the manager do first?

Establish, in writing, the expectations of each task.

In an attempt to decrease tardiness, a hospital gives employees an extra hour's pay for each wage period that the employee has not been late for work. This incentive program is an example of which theory?

Expectancy

The nurse manager needs to delegate specific tasks to the charge nurse of the unit. Which action is an appropriate use of delegation?

Having the charge nurse lead a nursing quality assurance task force

Which is the most important reason that practicing and mastering effective delegation skills is essential for nurses?

Higher client satisfaction

A nurse manager's week is filled with handling routine and repetitive issues. Which strategy should the manager employ to make handling these tasks most effective and efficient?

Hold a meeting each week especially for dealing with routine and nonurgent matters.

Which is the most important factor in whether a conflict will be perceived or felt between two nurses?

How well the nurses know and trust each other

After shift change the nurse discovers that a client's IV heparin has been turned off at the IV controller. The amount of fluid left in the IV bag indicates that the client received half of the dose ordered. Which statement should be documented in the client's medical record?

IV heparin restarted. Physician notified, clients VS unchanged

The nurse manager routinely experiences stress related to deadlines for projects. What should be the nurse's first action to control this stress?

Identify the actual stressor and the precipitating factors.

The nursing staff is continually upset about inability to provide clients with supplies needed because third-party payers will not reimburse for those items. This is an example of which conflict antecedent?

Incompatible goals

The nurse manager asks the staff nurse to work a double shift because the census is high. Although the nurse realizes the staffing for the night shift is low, the nurse has already made a family commitment for the same night. This is an example of which concept?

Intrapersonal conflict

The nursing administration has instituted a "horizontal promotion" system within the nursing department. What benefit is this program to the staff nurse?

It rewards the nurse's clinical excellence.

A staff nurse is not meeting job expectations. The manager has followed some standard strategies such as counseling to try to motivate the nurse, but they have not been successful. When discussing the situation with the supervisor, the manager says, "I think I will try shaping strategies." What can the supervisor expect of the staff nurse's performance?

It should gradually move toward the expected behaviors

A nurse manager is working on several projects and is stressed most of the time. This manager prefers working at the unit desk instead of in the office to be certain nothing on the unit is missed. Which would be the most effective method to decrease this manager's stress?

Keep a structured schedule for "work time" on each project in the office.

A conflict has arisen between two staff nurses who work on the same unit. Which strategy is most important for the nurse manager to consider?

Make a timely decision regarding if and when to intervene.

The nurse manager assesses that there is conflict between two of the charge nurses. The decision is made to postpone an intervention and allow the conflict to escalate. Why might the nurse manager make this decision?

Motivate the participants to seek resolution

There is substantial unrest among the staff of an intensive care unit that has resulted in negative client outcomes. Which employee factors should the manager assess first?

Motivation and ability to be effective in the job

Which statement regarding the use of electronic medical records (EMR) is accurate as associated with quality improvement?

Much more research must be done before the impact of EMR on quality can be determined.

The staff nurses and nursing administration are attempting to construct a method of scheduling that meets the needs of both the clients and the nursing personnel. Because nurses and nursing administration have experienced conflict about the issue, their intent is to arrive at an agreeable solution between both parties. Which option does this process best exemplify?

Negotiation

The nurse manager gave the unit secretary complete responsibility for the unit's staffing, including finding replacements for call-ins and disciplining nurses with excessive call-ins. This is an example of which type of delegation?

Overdelegation

The staff development nurse has elected to use coaching as a staff development technique. Which situation is an example of this technique?

Pairing a nurse with conflict management experience with an employee who has expressed dissatisfaction with the job

For the last several weeks, the nurse manager has felt as if there is not enough time in the day to accomplish all the required tasks. The manager goes home exhausted and does not look forward to going to work in the morning. What strategy may help alleviate some of this stress?

Pick a simple task and complete it just before going home each day.

The newly licensed nurse is delighted to have been hired at a Magnet hospital and says, "They even assigned me a mentor." What is erroneous about this statement?

Preceptors are assigned; mentors choose protégés

The nurse manager has decided to work on personal time-management skills. What should this manager do first?

Review patterns of time use.

The nurse manager is significantly behind in the required paperwork for the job. How can the manager rectify this situation?

Set a goal to work on paperwork for a portion of every day.

A nurse manager has identified that a major time waster is the amount of time spent on the telephone each day. Which strategy would help reduce this time?

Set a specific block of time to return calls.

Which statement represents a situation is which delegation is ineffective or inappropriate?

The RN asks the LPN to assist with admissions by assessing the clients as they get to their rooms.

A new triage area has been built in the emergency department causing conflict between the nurse manager and the nurses who think the design is not "user friendly." After repeated complaints the nurse manager asks maintenance to change the arrangement of the room. What is the most important reason this change occurred?

The complaints motivated the nurse manager to make the change to increase unit effectiveness.

Which situation is an example of reverse delegation?Which situation is an example of reverse delegation?

The licensed practical nurse asks the nurse manager to administer insulin to her client.

A nurse manager has planned orientation activities for a new registered nurse. The new nurse is required to observe shift report and UAP delegation for a week. Then the new nurse is required to take shift report and delegate UAP assignments for a week. What is the rationale for making this orientation assignment?

The manager should focus on those skills specific to the new nurse's role.

A staff nurse asks the nurse manager, "What assignment are you delegating to me today? I would like to begin to organize my day before shift report begins." What is the error inherent in this statement?

The nurse manager is not delegating but rather making daily assignments.

The nursing supervisor states, "I really don't have the time to delegate this task to a nurse manager. I can do it faster!" What is the most likely basis for this statement?

The nursing supervisor is concerned that staff is ill-prepared to assume additional responsibilities.

Which situation indicates the nurse needs additional training on effective delegation?

The office nurse calls in orders for admission on a client following a surgical complication.

For the nurse to effectively and legally delegate, which document must be consulted and followed to reduce the likelihood of liability?

The regulations of the state nurse practice acts

The nurse manager tells a newly licensed nurse that having a mentor is a benefit to career development. What should the new nurse expect from a mentor-protégé relationship?

The relationship will develop through stages.

A nursing supervisor has a report due and just cannot seem to find the time to get it completed. One day before it is due, the supervisor turns it in. This situation best exemplifies which time waster?

The supervisor waited for the deadline pressure to increase the priority.

Which situation represents an obstacle to delegation?

There is a budget shortfall for the current fiscal year

How can a nurse who is consistently falling behind at work improve to become more organized and disciplined?

Use the same system every day to organize client care and required activities such as paperwork.

The job description of the staff nurse states the nurse is responsible for attending hospital committee meetings as assigned. The nurse manager asking the staff member to attend a risk management meeting is an example of which concept?

Work assignment

Which statement reveals the most dangerous result of using measured standards as part of the CQI process?

a manager says im not going to change this process because i'd have to change the eCQI monitors

A client has been told that chemotherapy must be postponed until he is hydrated. The client refuses the intravenous hydration and demands to go home. How would the nurse best categorize this situation?

as a medical legal incident

As part of the process of promoting quality improvement, the nursing manager is comparing data between two hospitals on average length of stay for a total hip replacement. This comparison is an example of which process or step?

benchmarking

The nurse manager holds a regular Wednesday meeting with the charge nurses on the unit. There is no new information to discuss this Wednesday. What should the manager do?

cancel the meeting

An experienced nurse often answers less experienced nurses' questions about client care and teaches hemodynamics during orientation to the unit. The nurse has also participated in research into hemodynamic monitoring of ICU clients. Which clinical ladder designation does this nurse best exemplify?

clinical expert

The nurse manager has planned a meeting that all staff nurses have to attend. Which method would most efficiently notify the staff members of the meeting time?

email

The nurse is working on a unit with a blame-free environment and makes an error that puts a client at risk. What should the nurse do first?

ensure the client's safety as fully as possible

Which part of Six Sigma is vastly different from other quality management programs?

failure is tolerated

The nurse manager is writing annual evaluations for each nurse. In order to promote professional development, it is vital for the nurse manager and nurse to become involved in which activity?

goal setting

The following documentation was entered in the client's medical record: "The client was found lying on the floor. Dr. X was notified. Apparently the restraints were improperly applied." Which statement best describes this documentation?

inappropriate because it places blame on an individual

Which statement reflects a characteristic common to all methods of quality management?

none of the methods are designed to place blame on an individual

goal of quality management is achieved

nurse wipes up spilled drink before clients are allowed to enter a room

Which data would be of most interest to an organization using Lean Six Sigma as a means of quality improvement?

nursing overtime hours increased by 25 percent in the last quarter

Immediately following a barium swallow, a client noticed hives and a feeling of shortness of breath. Although there were no known allergies to food or drugs prior to this incident, the diagnosis was allergic reaction to the preservatives in the barium. Which is the correct risk category for this incident?

procedure complications

The nursing task force is developing measurable goals for each client on the orthopedic unit. The statement "Each client will have a written assessment and plan of care document within eight hours of admission" is an example of which component of quality management?

process standard

A nurse manager and a staff nurse are in conflict. The nursing supervisor has decided to use mediation to arrive at a solution. The supervisor should be most concerned about which person's level of comfort when choosing a place for the mediation meeting?

the staff nurse

The director of quality improvement reports that the hospital will soon be using "dashboards" as part of the quality management process. How should the staff interpret this information?

this electronic tool makes it easy to aggregate and display data

The hospital organization has developed a philosophy based on the client, organizational involvement, quantitative measurement of outcomes, and processes for improvement. In which quality management process are these characteristics typically seen?

total quality management

A nurse frequently has to work late and has no time to do required training while at work. She has to do it on her days off. Choose the work-related time waster that commonly puts nurses in this position.

unscheduled tasks delaying those that are scheduled

In order to come to a solution for an ongoing conflict among several nursing units, the nursing supervisor says, "Your managers will meet to create a voting form representing both sides of this issue. Each of you will vote and the majority will rule." What kind of a solution is the supervisor seeking?

win-lose

A serious conflict between a nurse and a nursing assistant erupted into a shouting match in the hallway. The nurse attempted to slap the nursing assistant. What conflict responses are appropriate for the assistant? select all

withdrawal and avoiding

Which is the most effective method of creating a blame-free environment?

work to develop a just culture within the organization