Cherry and Jacob Final

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*The ___ management style encourages staff involvement in the decision-making process.

*Democratic/Participative*

*ANA's Principles for Delegation provides nurses with guidance when delegating patient care to __.

*nursing assistive personnel*

21. The most important step in time management is ____________.

*planning*

*26. When focusing on maintaining emotional energy, the nurse should focus on personal: a. Reality checks. b. Self-confidence. c. Balance between work and rest. d. Flexibility

*According to the definition, which word best describes leadership? A. Allocate B. Influence C. Evaluate D. Control

*In order to best address workplace satisfaction among its nursing staff, a hospital's administration provides: A. Yearly salary raise B. Tuition reimbursement C. Additional vacation time D. An extra 15-minute break per shift

*Which activity demonstrates the organizational Chaos Theory? A. Preparing the yearly unit budget B. Planning for unexpected staffing shortages C. Preparing a rubric to guide staff performance reviews D. Setting unit goals related to quality control of client care

*Which of the following is the best example of a situation where a nurse could demonstrate workforce advocacy? A. A client wishes to become an organ donor in spite of family opposition. B. A client feels pressured by a health care provider into agreeing to a specific medical procedure. C. A nurse volunteers time to participate in a fund raiser to provide toys for a hospital's pediatric unit. D. Staff on a particular unit feel that the nurse manager is showing favoritism when granting vacation time.

1. A bill is pending in the state legislature that will mandate teaching health promotion related to smoking cessation. Which action by the nurse should have the greatest impact on passage of the bill? a.Explain the rationale for the bill to the school board. b.Contact the elected representative's office by phone to request support for the bill. c.Support a health advocate to run for election as state representative. d.Tell all students about the bill.

1. A proposed city ordinance is pending with the local government that will require public buildings and restaurants to be smoke and tobacco free. Which action by the nurse should have the greatest effect on passage of the bill? A. Explain the rationale for the bill to your book club and gain their support. B. Contact the elected representative's office by phone to request support for the bill. C. Support a health advocate to run for election as city councilman. D. Tell all fellow students about the bill.

10. A male nurse hired to work in the emergency department is observed throwing a contaminated needle into the trash can. The team leader reprimands the nurse for not appropriately disposing of sharps. The nurse states, "You don't care that I threw the needle in the trash. You just want an all-female staff," putting the team leader in a defensive position. This communication technique is known as: a. straw man. b. red herring. c. slippery slope. d. confusing cause and effect.

11. A nurse who was recently certified in chemotherapy administration fails to check compatibility of phenytoin (Dilantin) before injecting into a continuous infusion of D5W leading to occlusion of the line. Which statement by the nurse demonstrates a red herring? a. The nurse is upset and states, "I am sure I have injected this before without a problem" and the supervisor interprets this to mean the nurse often take shortcuts. b. The nurse states, "You are just upset because I am certified in chemotherapy administration and you are not." c. "The nurse who started the IV didn't get a blood return but determined the IV was the patient's—that is the problem." d. "This drug always occludes the line because it is so vicious."

11. An RN delegates to an experienced LPN/LVN the task of administering oral medications to a group of patients. The LPN/LVN accepts the assignment, and the RN knows that the LPN/LVN has had the training and has acquired the skills needed to complete the task. The RN then observes the LPN/LVN recording a patient's medication administration just before entering the patient's room. The priority intervention by the RN is to: a. check the patient's drug packages to ensure that the correct drugs were given. b. stop the LPN/LVN immediately and discuss the possible consequences of his actions in a nonjudgmental manner. c. contact the nurse manager and ask that the LPN/LVN's license be suspended. d. call the pharmacy and ask for replacement medications for the patients.

11. An inexperienced nurse has heard of other novice nurses who take shortcuts in providing patient care. This nurse feels that this is unacceptable and that all tasks must be performed faultlessly, which leads to her inability to complete all assigned tasks. This nurse would benefit from the seminar "Obstacles to Time Management: How to Deal with: a. Creativity." b. Perfectionism." c. Failure." d. Downtime."

11. The occupational health and safety nurse would like to develop programs designed to decrease mortality and morbidity among the workforce. When considering factors related to mortality among health care workers, the nurse should focus efforts on prevention of: A. Suicide. B. Violence related injury. C. Bloodborne disease. D. Ergonomic hazards.

12. A candidate who is taking the NCLEX-RN examination received only 75 questions before the test was stopped. She called her professor and stated, "I passed. I had to answer only 75 questions." The professor correctly responds by saying: a. "You are now officially licensed; you answered the more difficult questions correctly." b. "It is possible to receive only 75 questions and not be successful; however, we will keep a positive attitude." c. "If you were given only 75 questions, you will have to retest because this is not enough to determine competency." d. "You must have been extremely close to the passing standard because the computer shut off."

12. An experienced nurse volunteers to serve on a task force intended to improve the quality of care because she possesses excellent patient care skills and has selected a career goal of working in quality management. However, the nurse is unable to concentrate on any one task or issue and is unable to view the health care milieu sensibly. Which source of energy is missing in this nurse? a. Physical b. Mental c. Spiritual d. Emotional

12. During a health history interview, the nurse listens to a patient relating the precipitating events that led to the onset of chest pain. She focuses her attention on the patient, makes eye contact, and acknowledges what the patient has to say. The nurse is exhibiting: a. assertive communication. b. active listening. c. empathy. d. passive communication.

12. Throughout the history of health care in our nation, one particular piece of federal legislation provided funds for hospital construction. As the number of hospitals rapidly increased, the need for nurses to staff hospitals also increased, and the shift from community-based nursing care to hospital-based nursing care began. This fundamental piece of legislation was the: a. Sheppard-Towner Act. b. Hill-Burton Act. c. Veterans Bill. d. Access to Health Care Bill.

12. Throughout the history of health care in our nation, one particular piece of federal legislation provided funds for hospital construction. As the number of hospitals rapidly increased, the need for nurses to staff hospitals also increased, and the shift from community-based nursing care to hospital-based nursing care began. This fundamental piece of legislation was the: a.Sheppard-Towner Act. b.Hill-Burton Act. c.Veterans Bill. d.Access to Health Care Bill.

13. A nurse is concerned because novice nurses are having their orientation period shortened and are being placed in charge nurse positions. The nurse has documented unsafe care and decisions by these novice nurses. *To be protected from retaliation by the employer, this nurse must "blow the whistle" by:* A. Holding a public forum in the agency cafeteria to discuss concerns. B. Reporting concerns to state and/or national agencies regulating the agency. C. Calling coworkers outside the workplace to informally discuss wrongdoing. D. Contacting The Joint Commission to report unsafe conditions.

13. Nurses in a nonunionized health care facility are concerned about patient safety because of the requirement for nurses to work overtime. Which organization can address the needs of these nurses? a.United American Nurses b.Center for American Nurses c.Occupational Safety and Health Administration (OSHA) d.American Association for Mandatory Overtime

13. The nurse is demonstrating active listening when: A. While assessing the patient's vital signs, the nurse records the data and states, "You are improving, your vital signs are normal." B. Eye contact is maintained while focusing on the patient as the patient describes the current pain level and location. C. He or she states, "I know how you feel, I recently lost my father and I am still hurting." D. cultural values are in opposition to the patient but share that, "I agree with your decision to use herbs rather than the prescribed medications."

14. A group of registered nurses with ADN degrees are concerned that the minimum educational standard for licensure as a registered nurse is being raised to the bachelor's (BSN) level. After contacting the American Nurses Association, they learn they will be "grandfathered" in. Under the "grandfather clause," nurses with associate degrees will: a. be required to complete a bridge program to earn a BSN and then be tested only on material that was not part of the ASN curriculum. b. continue to use the title "registered nurse." c. have 10 years to obtain a BSN or the license will be revoked. d. use whatever title is established for associate degree nurses.

14. A student nurse wants to meet other nursing students from different countries and to learn of employment possibilities. The student nurse should: a. participate in the clinical facility's employee satisfaction task force. b. join the Student Nurses Association. c. take part in self-mentoring. d. postpone taking the licensure examination so he or she can take a tour of foreign countries.

14. Members of a state's constituent member association meet at a local restaurant to plan a Nurse Walk to support the local food bank. When entering the restaurant, the nurses note the environmental inspection report shows deficiencies because food handlers were not wearing hairnets and rodents were spotted, resulting in a score of 60 out of 100. This certificate of inspection is health policy enforced at which level of government? a.Local b.State c.Federal

15. A nurse takes a day to travel to a state park where she can sit by the river alone to reflect over recent events and put things into perspective. She recalls the time she was complimented for her ability to deal with a difficult patient and another time when she was criticized for lack of teamwork. This nurse is improving which source of energy? a. Emotional b. Spiritual c. Physical d. Mental

15. An experienced nurse working in oncology is shocked to realize that he feels little empathy when a patient explains, "I developed cancer from having to work in the dry cleaning industry since I was only 8 years old to help support my younger siblings during the depression. Now they have all moved away and refuse to help me financially, and it takes everything I have to pay for my chemotherapy medicine." The nurse is experiencing: a. burnout. b. compassion fatigue. c. reality shock. d. horizontal hostility.

15. The Institute of Medicine report (2011): a. Recommended that only physicians have the legal privilege to prescribe medications. b. Called for increasing the number of baccalaureate-prepared nurses in the workforce to 80% by 2020. c. Called for a minimum staffing ratio be in place in no later than 10 years. d. Called for nurse technicians to provide care during the nursing shortage.

17. A graduate is preparing for the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination. Based on the latest practice survey, the candidate would focus the most amount of time on which content? a. Stages of grief b. Pharmacologic pain management c. Practices to promote rest and sleep d. Prioritization of workload to manage time effectively

17. During height and weight assessments at a school's health fair, a child admits to drinking a cup of coffee with his mother every morning, and another child reports enjoying a morning cup of coffee on the commute to school. These two children are both below average on the height chart, and the nurse states, "Drinking coffee stunts a child's growth." This logical fallacy is referred to as: a. appeal to common practice. b. confusing cause and effect. c. ad hominem abusive. d. red herring.

17. Nurses in Tennessee, Mississippi, and Arkansas gather for a conference related to improving quality and safety in practice and nursing education. They are awarded continuing education (CE) credit for participation and evaluation of the conference. One nurse from California states, "I need these CEs to renew my license." The nurse from Mississippi replies, "You do not need CEs for license renewal or advance practice certification renewal." Which statement about CEs would help these nurses? a. All states require proof of continuing education for renewal of license with the number of hours varying. b. The purpose of continuing education is to ensure competence of the workforce after graduation, but each state determines if CEs are required. c. Continuing education is required if nurses work across state lines. d. Initial licensure provides evidence of a minimum safety and competence, so it is illegal for states to require continuing education for renewal of license.

17. Which of the following situations would be appropriate for the supervisory level of initial direction and/or periodic inspection? a. Experienced RNs work together to provide care for a group of patients newly diagnosed with meningitis. b. The RN assigns the LPN tasks within her scope of practice and checks back during the shift to ensure the tasks are completed correctly. c. A new graduate nurse is assigned care to a male patient with a hematocrit of 11.0 g of hemoglobin per deciliter and is receiving a blood transfusion. The charge nurse checks on the patient status every 15 to 30 minutes and asks the graduate to explain "next steps." d. No supervision is necessary since both are registered nurses.

18. A patient's spouse was just diagnosed with lung cancer although there was no history of tobacco use. The spouse states, "I am so mad. How can you get cancer without smoking?" Which statement by the nurse represents empathy? a. "Research is identifying many risk factors for cancer besides smoking." b. "I understand how you could feel angry about the diagnosis." c. "He is still a good husband." d. "Why do you think he got cancer?"

19. When reading about nursing as a career, a student is interested in learning about violence in the profession. Which statement accurately reflects violence in health care and the profession of nursing? A. Nursing is the most trusted profession and therefore violence is rare. B. All nurses should be advocates for violence prevention programs. C. Physical violence between peers constitutes lateral violence; however, verbal assault is not recognized as violence. D. Professional organizations have recognized a need to evaluate all nurses for the risk of committing acts of violence.

2. A novice nurse is assigned a patient who has an order to draw blood for culture and sensitivity from a central line before antibiotic therapy is started. The novice reads and rereads the procedure manual. An hour later he stands at the bedside of the patient and stares at the central line, without knowing how to proceed. This phase of reality shock is termed: a. honeymoon. b. shock or rejection. c. recovery. d. resolution.

2. A teenage patient is using earphones to listen to hard rock music and is making gestures in rhythm to the music. The nurse assesses the amount of urine output in the Foley catheter and leaves the room. What communication technique is demonstrated in both of these situations? a. Blocking b. Filtration c. Empathy d. False assurance

20. The nurse caring for a patient states, "Your blood pressure is dangerously high. Are you taking antihypertensive medicine?" The patient states, "I can't afford my medicine. I have no insurance." The nurse states "I feel really sorry for that patient. I wish it wasn't against policy to give her money." The nurse wants to help and places a note on Facebook that any donations would be appreciated to help a waitress who works at the cafeteria next door to the hospital buy her medications. The nurse posts that "She was so sick last evening when she came to the ED. I can't believe they don't provide insurance. I can't give her money but you all can help." This nurse: A. Is showing empathy and as long as she lets the patient know the money is not from her, she is not violating any social media guidelines. B. Is at risk for HIPAA violations. C. Has properly followed policy and protected the patient by not using her name. D. Is demonstrating the logical fallacy of slippery slope.

22. A patient presents with chest pain that increases when lying flat and low-grade fever. Assessment reveals muffled heart sounds, tachycardia, and 3+ edema in the lower extremities. The nurse asks the patient to learn forward, which eases respiratory efforts. The nurse then places the stethoscope at which area on the chest to facilitate auscultation? The above question represents which type of alternate-format question written at which level of Bloom's taxonomy? a. Multiple-response item, comprehension level b. Hot-spot item, analysis level c. Chart/exhibit item, application level d. Drag-and-drop item, knowledge level

26*. The most important concept to remember when using both verbal and nonverbal communication is that: A. people are more likely to accept verbal messages than nonverbal ones. B. nonverbal messages are accepted as true more often than verbal ones. C. touch as a nonverbal form of communication should be avoided. D. avoiding eye contact is viewed as being untruthful by all cultures.

3. Computerized adaptive testing implies that: a. the candidate must be computer literate. b. competency is determined on the basis of difficulty of questions, knowledge of the nursing process, and the number of questions answered correctly. c. testing facilities have been adapted for the physically challenged candidate. d. questions cannot be adapted to the needs of the student.

3. In today's world of fast, effective communication, what are the most commonly used means of social communication? a. Facial expression b. Spoken word c. Written messages d. Electronic messaging

3. Studies conducted to determine enrollment trends in nursing schools have found that in the last years: a. a greater number of individuals chose nursing as a career but could not meet entrance requirements. b. more young people chose to enter the profession of nursing. c. fewer career opportunities exist in the profession of nursing and fewer opportunities are projected to exist for women. d. men have dominated the profession, and women feel that they have experienced discrimination.

3. The first step in the nursing process and in the problem-solving process is to: a. Identify the problem. b. Gather information. c. Consider the consequences. d. Implement interventions.

4. On the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination, when the candidate is asked to set goals in collaboration with other members of the health care team, the nurse is being tested in the area of: a. assessment. b. planning. c. analysis. d. implementation.

4. The novice nurse arrives on the nursing unit, is introduced to the staff, is assigned a preceptor, and is asked to participate in the next staff meeting. This introduction into nursing is appropriately termed: a. biculturalism. b. socialization. c. transition. d. "going native."

4. To ensure that nursing legislation is current and is reviewed by specific dates, if a nurse practice act fails to be reviewed, it is automatically rescinded under which law? a. Nurse review act b. Sunset legislation c. Mandatory revocation d. Grandfathering

5. Current trends in telecommunications and increased mobility of nurses have led to the approval of a mutual recognition model of nursing regulation, in which nurses are allowed to practice in states that are compact states without obtaining a license in each state. On which website would a nurse find a list of current compact states? a. National League for Nursing (NLN) b. National Council of State Boards of Nursing (NCSBN) c. American Association of Colleges of Nursing (AACN) d. Commission on Collegiate Nursing Education (CCNE)

6. A new mother is experiencing pain after delivering an infant with Down syndrome. The staff nurse states, "I don't think she is really hurting. Let the next shift give the pain medication." The team leader notices the staff nurse looks agitated and anxious and asks about any concerns in providing care to this new mom. The staff nurse admits having a stillborn infant with Down syndrome. This is an example of which component of communication? a. Personal perception b. Past experiences c. Filtration d. Preconceived idea

6. A student nurse is concerned about delegation practices and wonders why hospitals employ unlicensed assistive personnel (UAP) and LPN/LVNs. The student nurse refers to the National Council of State Boards of Nursing and learns that the role of these personnel is to: a. supplement the staffing pattern when an RN is not available. b. aid the RN by performing appropriately delegated care tasks. c. replace the RN when the health care facility provides long-term care. d. provide patient teaching, allowing more direct care to be provided by the RN.

6. When using the ABC system of managing time, those items coded A include: a. calling the pharmacy to see whether a drug insert is available for a patient. b. checking to see why a ventilator is alarming. c. organizing the medication cart. d. writing memos to remind everyone to contribute to the boss's birthday gift.

6. Which nurse is more prone to burnout? The nurse who: a. graduated last in the class. b. is industrious and conscientious. c. refuses to work an extra shift even though he or she needs the money. d. volunteers to serve on only one committee and keeps in touch with schoolmates.

7. A nurse gives Dilantin intravenously with lactated Ringer's solution containing multivitamins. The drug precipitates and obstructs the only existing line. When the team leader informs the nurse that these drugs cannot be mixed, the nurse states, "Everyone just pushes the medicine slowly. No one checks for compatibility. There isn't even a compatibility chart on the unit." Which type of logical fallacy has influenced the nurse? a. Ad hominem abusive b. Appeal to common practice c. Appeal to emotion d. Appeal to tradition

*28. When considering the establishment of a to-do list, it should be: a. Readily available and easily accessed b. Hand written to ensure personalization c. Created so that frequent revision is not necessary d. Reviewed mid-shift to evaluate completion of goals

*Based on current trends, which nursing care environment has the greatest employment potential for new nurses? A. Long-term care facilities B. Hospital emergency departments C. Pre- and postsurgical departments D. Primary health care provider practices

*In order to best ensure client safety, which of the following questions should a staff nurse ask first when determining whether to accept a client assignment that is made when several staff members have reported off sick? A. "Do I have the experience and knowledge to care for these patients?" B. "Is this a staffing crisis or a result of typical staffing patterns?" C. "Can I expect to be mandated to stay an additional shift?" D. "How long will it be before I get additional help?"

*Which hospital-wide policy would best address the nurse's negative view of job satisfaction? A. Making it possible to earn additional personal leave time based on their absentee records B. Providing a dedicated parking area close to the hospital for nursing staff C. Instituting biannual staff recognition days that include a free meal in the cafeteria D. Providing security backup when there is a perceived sense of workplace violence

*Which of the following activities engaged in by a nurse manager would be expected to have the greatest impact on patient care? A. Role modeling effective communication between all levels of staff B. Conducting a survey to identify factors affecting staff job satisfaction C. Providing all nursing staff with opportunities to influence unit policies D. Providing all staff members with written copies of organizational policies

*Which skill is most important for a nurse to possess when attempting to exercise or earn informal power within an organization? A. Ability to persuade others B. Expert level nursing knowledge C. Understanding of management goals D. Willingness to compromise with everyone in the team

1. During orientation, a novice nurse sits and "virtually spends" the first few paychecks, envisioning the money going into a personal bank account. In the dream state, the nurse smiles and knows that the pain of nursing school was worth it. Which phase of reality shock is the nurse experiencing? a. Honeymoon b. Shock or rejection c. Recovery d. Resolution

1. Graduates from approved schools of nursing cannot sign their charting as registered nurses (RNs) until they: a. pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN®). b. provide evidence of mental competency. c. supply written proof of physical fitness. d. have signed an employment contract with a health care facility.

1. In an attempt to persuade employees to bargain for another type of health insurance, a handout is circulated that describes the present employees' health care insurance as being insensitive, limiting choices of care providers, and providing inferior care. This reflects which aspect of Lewin's planned change? a. Unfreeze b. Move c. Refreeze d. Acceptance

1. In deciding whether to say no to a request that involves a time commitment, the professional nurse must consider: a. the cost-benefit ratio. b. the time commitment of coworkers. c. ways to buffer saying no. d. personal preference.

1. The task of completing and signing the initial assessment on a newly admitted patient who is about to undergo minimally invasive procedures on an outpatient basis can be delegated to: a. the registered nurse (RN). b. the licensed practical/vocational nurse (LPN/LVN). c. unlicensed assistive personnel (UAP). d. all levels of staff, because the information is about the past and cannot change.

10. When delegating care, the RN assigns one nurse to care for a patient with shingles and a different nurse to care for a patient with human immunodeficiency virus/acquired immunodeficiency disease syndrome (HIV/AIDS). This represents which category of nursing care? a. Safe and effective care environment b. Health promotion and maintenance c. Psychosocial integrity d. Teaching/learning

10. When participating in a nurse licensure compact, the nurse: a. is held responsible for complying with the nursing practice laws in the state where practicing at the time care is rendered. b. must purchase a license in each state but does not retake the licensure examination. c. determines residency based on the state where educated as registered nurse. d. may practice using one license in any state or territory in the United States that recognizes the NCLEX as the source of licensure.

12. A certified oncology nurse notices that a novice nurse is unsure of decision making and lacks technical skills. The novice nurse gains confidence by sharing and learning with the experienced nurse. This relationship continues and builds, allowing the novice nurse to become more confident. This relationship is known as: a. mentoring. b. role modeling. c. a preceptorship. d. socialization.

12. A nurse holds a license in one state but wishes to practice in a second state that is not participating in a nurse licensure compact agreement. The nurse is granted licensure on payment of a fee but does not retake the licensure examination. The nurse obtains licensure in the second state: a. by licensure and by endorsement. b. through mandatory continuing education. c. by the statutory process known as being grandfathered. d. through sunset legislation.

13. A nurse practicing in the early 1900s was awarded a permissive license. These licenses: a. were voluntary; however, a nurse who failed the examination could not use the title RN. b. required a maximum of 1 year of formalized nurse training. c. allowed nurses who did not pass the licensure examination to still practice. d. allowed nurses the choice of taking a written or oral licensure examination.

13. After keeping a log of activities designed to improve time management, the nurse divides the distractions into internal and external sources. The nurse would classify which distraction as internal? a. Responding to recurring crises at work or in one's personal life b. Unsuccessful attempts to communicate with the unit manager c. Talking with potential faculty candidates d. Being given unclear job responsibilities

14. In the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination test plan, client needs form the organizing framework of the examination with questions in four categories: safe and effective care environment, health promotion and maintenance, psychosocial integrity, and physiologic integrity. Certain processes are then integrated throughout the categories of client needs. Which process is integrated into all client need categories? a. Teaching/learning b. Health promotion c. Infection control d. Pharmacology

15. A staff nurse provides care based on intuition and always seems to be in control of her personal and professional life—serving on the board of the state nurses association, serving as the nursing unit's representative on the ethics committee, and coaching her daughter's softball team. Many of the staff observes how she manages time and provides care. This nurse's power comes from which type of power? a. Referent b. Legitimate c. Information d. Connection

15. Who establishes the "rules" for nursing practice? a. Individual state boards of nursing b. Employer, based on area of practice c. United States Department of Health and Human Services d. Local health officials

16. A nurse is completing the degree requirements for an advanced practice role as a nurse practitioner and is concerned about certification requirements. Which statement concerning certification for advanced practice is true? a. All states require certification for all specialty roles that are identified as advanced practice. b. Nurse anesthetists and nurse-midwives are the only advanced practice role that require certification in the state nurse practice acts. c. Scope of practice remains unclear in state nurse practice acts due to the increasing number of new advanced practice roles. d. Certification is automatic when the nurse applies for an advanced practice license.

16. As part of a quality assurance project, a nurse is to round on every patient daily for 1 month to ensure the intravenous tubing is labeled with date hung and nurse's initials. The nurse is hoping to be promoted to a full-time position within the quality department, and her success on this project is very important to her receiving the position. The nurse retains all other assignments, and she is often interrupted to help other staff or answer call lights. The nurse discusses her concerns with the manager, who frees her for 1 hour each day to make rounds. During this 1 hour each day the nurse will organize herself and environment by practicing the: a. Art of "no detourism." b. Reducing stacked-desk syndrome. c. Art of "wastebasketry." d. Managing e-mail and memo mania.

16. The RN instructs the LPN to "Give an enema to the patient in room 327 who is being discharged but is complaining of being constipated. Then be sure to document on the medication administration record when given." Which of the five rights was missing in this situation? The right of: a. direction and communication. b. task. c. person. d. circumstances.

16. The nurse prepares to apply sterile gloves needed for a procedure. After introducing self and verifying patient information, the nurse performs hand hygiene. The nurse should open the outer package and then perform the following steps in order: (items on left will be moved in correct order on the right) Open inner package, taking care not to touch inner surface. Put the glove on the nondominant hand using the sterile gloved hand. Put glove on dominant hand by grasping folded cuff edge, touching only inside of cuff. Adjust each glove carefully by sliding finders under the cuffs. The above question represents which type of alternate-format question written at which level of Bloom's taxonomy? a. Drag-and-drop item, comprehension b. Chart/exhibit item, analysis c. Multiple-response, application d. Hot-spot item, knowledge

17. A nurse manager wants his nursing unit to be a place where all nurses want to work, where patient satisfaction is high, and care is innovative and interdisciplinary. Staff are encouraged to chair taskforces to improve quality of care and he counsels staff in areas of measuring patient outcomes. Other managers want to mimic this manager's approach to improve their own units. This nurse is which type of leader? a. Transformational b. Transactional c. Laissez-faire d. Authoritative

7. An RN delegates to the unlicensed assistive personnel (UAP) the task of performing blood pressure checks for a group of patients on a nursing unit. The UAP accepts the task and is responsible for: a. delegating the task to another UAP if he or she does not have the time or skill to complete the task. b. keeping the RN informed of any abnormal blood pressure readings. c. calling the physician when the patient's vital signs are not within established parameters. d. informing the dietary department to initiate a low-sodium diet for patients who are hypertensive.

19. A candidate is taking the NCLEX-RN examination when the computer turns off. The candidate was aware they had reached the 6-hour time limit. A count of completed questions had been recorded on the note pad, and 100 questions were answered. How will the examination be scored? a. The computer will analyze the last 60 questions and if above the passing standard, the candidate passes. b. The candidate will be administered an additional 50 questions to determine ability to reach the 95% confidence interval. c. If the time runs out, the candidate automatically fails the examination because it is impossible to determine if candidate is safe. d. The candidate has the option to complete a simulated examination to show competence.

19. A novice nurse is in the "rejection phase" of stress and wonders if she made the right decision when deciding nursing was her chosen career. Which strategy would help the novice nurse cope with transition into practice and reduce stress? a. When asked by the charge nurse to accept the new admission even though she had no discharges, the novice nurse stops and considers if this request is acceptable and safe, then accepts the assignment based on two patients having a low acuity level. b. Refusing to eat anywhere but the hospital cafeteria to ensure a balanced diet and time to socialize with other staff and visitors. c. Avoid wasting time by listening to coworkers' problems or ideas on how to staff the unit during the upcoming holiday since the novice nurse's time is valuable and better spent getting her own work completed. d. Make an effort to "win over" hostile or angry coworkers who find fault with the novice nurse's work performance.

19. A nurse is concerned about the risk of delegating tasks to licensed practical nurses and unlicensed assistive personnel. What is the best way for the nurse to determine competency of an inexperienced delegatee? a. Actually observe the delegatee perform the assigned task. b. Ask the delegatee how many times he/she has performed the task. c. Ask the patient if the care provided was satisfactory. d. Ask other nurses if they feel the delegatee is competent.

2. Which statement concerning the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination is correct? a. Graduates from all three types of nursing programs (diploma, associate degree, and baccalaureate degree) take the same examination. b. The examination is scored on an interval scale rather than on a pass-fail basis. c. The examination is offered twice a year in major urban areas. d. The candidate has the option of choosing a pencil-and-paper format.

21. "A patient with end-stage renal disease has a potassium level of 7.5 mEq/L. Based on this laboratory result, the nurse interprets which symptom as significant prompting which action? a. Drowsiness, stimulate the patient every 30 minutes b. Confusion, ask the patient to state their name and date of birth c. Irregular heartbeat, evaluate the patient's capillary refill d. Muscle cramps, elevate the affected limb"

27*. The most likely reason a 9-year-old child cries and refuses to cooperate with an injection is: A. the child's past experiences with injections. B. the environment the child finds himself in, such as a hospital emergency room. C. the precipitating event, such as a fall that resulted in the need for a local anesthetic. D. the nurse's verbal and nonverbal communication with the child about the injection.

29*. Nursing's primary concern related to the appropriate use of social media is to preserve: A. confidentiality. B. professionalism. C. cultural sensitivity. D. effective communication.

3. Nurse practice acts: a. are written and passed by legislators. b. cannot be influenced by special interest groups. c. reflect only the concerns of RNs. d. are affected by the practice of dentists.

3. Time can be maximized to produce the best outcomes by: a. making the first hour of each workday productive. b. completing trivial tasks before performing important tasks. c. eliminating all recreational activities. d. omitting breaks until the entire task has been completed.

3. Which task is most likely to be considered in a state's practice act as appropriate to delegate to a LPN/LVN if the patient's condition is stable and competence in the task has been established? a. Administer an enema for an elective surgery patient. b. Administer an antiarrhythmic medication IV while interpreting the patient's rhythm on the cardiac monitor. c. Develop a plan of care for a stable patient admitted for observation after a head injury. d. Teach a patient how to instill eye drops for glaucoma.

4. A patient is admitted with hypotension, shortness of breath, flushing, and hives. All levels of staff have been trained to assess vital signs. Given budget restrictions and proper delegation rules, to which care provider would the RN delegate the task of obtaining the initial blood pressure reading? a. RN b. LPN/LVN c. Unlicensed assistive personnel (UAP) d. Use the blood pressure obtained in the ambulance, because it was assessed via electronic monitoring.

4. An explosion just occurred at the local factory, and hundreds of employees have sustained varying degrees of injury. Which type of nursing leadership is most effective in this situation? a. Autocratic b. Democratic c. Laissez-faire d. Referent

5. Several novice nurses share lunch breaks and have comments such as, "I have insomnia from worrying about what I forgot to do for my patient," and "I have no energy," and "I can't believe I can't do my job correctly." These novice nurses are each experiencing different symptoms of: a. burnout. b. low self-esteem. c. lack of confidence. d. resilience.

5. When choosing to delegate, the nurse should delegate the task to the most qualified person or to the person he or she wishes to: a. develop. b. promote. c. punish. d. reward.

6. The primary purpose of the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination is to: a. ensure that practitioners have the minimum skills and knowledge needed to provide care that will produce the best patient care outcomes. b. regulate nursing education. c. determine the mandatory educational level required for nurses to practice. d. accredit schools of nursing.

7. Florence Nightingale is attributed with being intelligent (she developed statistical methods to evaluate health care), dependable (she often worked long hours to care for the injured), and ambitious (she fought against society's perception of nursing). Those who depict her as a leader on the basis of these qualities are practicing which leadership theory? a. Trait b. Chaos c. Bureaucracy d. Organizational

8. A nurse manager is concerned with restocking the emergency cart, creating the staff schedule, requesting floor stock from the pharmacy, and checking the orders on patient charts. Which type of leader accurately describes this nurse? a. Transactional b. Situational c. Transformational d. Contemporary

8. A nurse who is licensed in Georgia and moves to Oregon: a. must check Oregon's nurse practice act related to licensure for endorsement. b. will automatically be grandfathered in as a licensed registered nurse. c. may request certification in Oregon rather than licensure, so as not to have to retake the NCLEX-RN®. d. should contact the American Nurses Credentialing Center to determine whether he or she is eligible to practice in an another state.

8. An RN is consistently late to work, causing reassignment of patient care and the need for repeated shift reports. The nurse, who receives a warning for repeated tardiness, states, "My husband left me, I have no car, no family close by, and the bus is always late, which makes me late. The nurse manager doesn't care how hard I try to get here, and I am raising a child by myself." The nurse is using which type of logical fallacy? a. Appeal to emotion b. Appeal to tradition c. Hasty generalization d. Confusing cause and effect

8. The novice nurse calls a supervisor and requests that a "float nurse" be assigned to help with all "assessments of new admissions and postoperative patients." The supervisor asks, "How many admissions and surgery patients have you received?" The novice nurse becomes flustered because she has not checked the census but simply bases the need on feeling overwhelmed. This situation best indicates a lack of _____ skills. a. organizational b. communication c. interpersonal d. clinical

9. According to the unit's policy for call-ins, a nurse is suspended for 3 days because of excessive call-ins that occur within 15 minutes of shift change. The nurse states, "You are unfair to me." Which theory would disprove the nurse's statement? a. Authoritative b. Closed systems c. Open systems d. Trait

9. When the novice nurse asks, "What will happen if this task is not completed," which skill is being demonstrated? a. Priority setting b. Delegation c. Organization d. Clinical skills

A certified oncology nurse notices that a novice nurse is unsure of decision making and lacks technical skills. The novice nurse gains confidence by sharing and learning with the experienced nurse. This relationship continues and builds, allowing the novice nurse to become more confident. This relationship is known as: a. mentoring. b. role modeling. c. a preceptorship. d. socialization.

A client who insists on leaving the hospital against medical advice (AMA) after being properly advised signs the necessary form. In order to avoid legal consequences regarding the client's decision, the nurse should: A. objectively document all the details of the situation thoroughly but concisely in the client's medical record. B. notify the nursing supervisor of the client's decision and that all reasonable efforts were made to dissuade the client from leaving. C. have a member of the security staff escort the client off the facility's property and into their private vehicle or public transportation. D. with the client's permission notify a contact person that the client is leaving the hospital against medical advice.

A group of nurses meet with a state representative to explain the importance of allowing registered nurses the right to sign death certificates for patients who were under their care. As constituents and nurses, they requested that the senator vote against the bill restricting this practice. These nurses are serving as: a. lobbyists. b. policymakers. c. officials with regulatory power. d. advocates for the Patient Safety and Quality Improvement Act.

A novice nurse is in the "rejection phase" of stress and wonders if she made the right decision when deciding nursing was her chosen career. Which strategy would help the novice nurse cope with transition into practice and reduce stress? a. When asked by the charge nurse to accept the new admission even though she had no discharges, the novice nurse stops and considers if this request is acceptable and safe, then accepts the assignment based on two patients having a low acuity level. b. Refusing to eat anywhere but the hospital cafeteria to ensure a balanced diet and time to socialize with other staff and visitors. c. Avoid wasting time by listening to coworkers' problems or ideas on how to staff the unit during the upcoming holiday since the novice nurse's time is valuable and better spent getting her own work completed. d. Make an effort to "win over" hostile or angry coworkers who find fault with the novice nurse's work performance.

A nurse entering the job market wants to be certain that the first position is rewarding and allows for growth as a registered nurse. According to the Hallmarks of the Professional Nursing Environment, the nurse should ask: a. about the philosophy related to clinical care to determine the role of RNs in deciding outcomes related quality outcomes. b. if professional development opportunities are supported through paid leave and tuition reimbursement. c. how compensation packages compare to others in the same area and nationally. d. what the projected need for RNs is in the next 5 years and current turnover rate.

A nurse groups patients with criteria such as "high risk for falls," "infection protocols," and "special communication needs" to determine the mix and number of staff needed on a telemetry unit. The nurse is using: a. a patient classification system to determine safe staffing levels. b. diagnostic-related groups for Medicare billing. c. case management to coordinate care. d. clinical pathways to determine care.

A nurse interested in an entry level position as a registered nurse prepares the cover letter. A correctly written cover letter might include: a. "I am interested in a position where community outreach is valued as noted in your organization's mission statement." b. "I am highly educated and have several degrees including an Associate Degree in accounting, a certification in word processing, a Bachelor's degree in journalism, and a Bachelor's degree in nursing." c. "I am looking for a position that will allow me to develop my skills and still have a balanced home and work life." d. "I am married, a Christian, a single parent, and due to the downturn in the economy will be willing to work any shift or nursing unit."

A nurse notices that care is often withheld until an interpreter arrives, if the nurse is not multilingual. The nurse discusses this with the management team and suggests a three-part series be presented to the nursing staff to teach some commonly used medical terms in Spanish. This nurse is involved in the role of: a. change agent. b. educator. c. manager. d. coordinator.

A team of experienced nurses work together to develop algorithms that are converted into checklists to ensure standardization of commonly performed procedures. The focus of this team is primarily on which Institute of Medicine (IOM) competency? a. Safety b. Timely c. Equitable d. Patient-centered care

According to the Quality Chasm report: a. health care providers should be proactive rather than reactive to patient needs. b. common needs rather than individual preferences should be the priority. c. medical information should be confined to the primary care provider. d. specialized providers or case managers should control health care decisions.

An RN has critical care experience and is proficient in advanced cardiac life support and often helps to lead "codes" and is an expert clinician with superior health assessment skills. Enjoying a challenge of a fast-paced environment with autonomy, this nurse would best be suited for which nursing role? a. Flight nurse b. Home health nurse c. Hospice nurse d. Occupational health nurse

Cover letters: a. should signify an interest in the employer and let the employer know that you took time to research the organization. b. must be handwritten so the employer can determine whether charting will be legible. c. should be limited to one paragraph because time is of the essence. d. let the employer know your desired salary, shift, and area of practice.

During orientation, a novice nurse sits and "virtually spends" the first few paychecks, envisioning the money going into a personal bank account. In the dream state, the nurse smiles and knows that the pain of nursing school was worth it. Which phase of reality shock is the nurse experiencing? a. Honeymoon b. Shock or rejection c. Recovery d. Resolution

If a nurse practicing in a mental health agency could only belong to one professional organization, what criteria could be used to select the organization with the biggest impact? a. The American Nurses Association has a strong voice representing the nation's entire RN population. b. Specialty organizations such as the American Psychiatric Nurses Association lobby for higher education requirements for nurses. c. State nursing associations have limited power because they can lobby only state representatives. d. Professional organizations such as The American Association for the History of Nursing (AAHN) record the history of mental health nursing.

Nurses on a unit provide personal hygiene, administer medications, educate the patient and family about treatments, and provide emotional support. These nurses provide patient care based on which nursing delivery system? a. Total patient care b. Partnership nursing c. Team nursing d. Functional nursing

People are living longer and with older age comes a higher risk of terminal illness. Many individuals have chosen to maximize their quality of life but stop aggressive life-sustaining treatments. Nurses who work with terminally ill patients and their families to provide end-of-life care, pain management, and family support are practicing in which role? a. Hospice b. Infection control c. Coordinator d. Case manager

Regardless of the term used to describe high-quality health care, the focus of quality is: a. what the consumer needs and wants. b. economical care. c. having the greatest technologic advancement. d. services equally distributed among populations.

Several novice nurses share lunch breaks and have comments such as, "I have insomnia from worrying about what I forgot to do for my patient," and "I have no energy," and "I can't believe I can't do my job correctly." These novice nurses are each experiencing different symptoms of: a. burnout. b. low self-esteem. c. lack of confidence. d. resilience.

The forensic nurse would most likely be involved in: a. performing an assessment of rape victim and collecting specimens needed for court. b. assigning a patient with chest pain to be seen first, followed by a patient with an insect bite of unknown origin with red streaks but no respiratory distress. c. assessing a patient at home by asking the patient to place a receiver over the pacemaker to evaluate capture of pacing stimuli and transmitting the results to another state where nurse located. d. performing pediatric life support at the scene of an accident to stabilize then transport via helicopter to the nearest trauma center.

The novice nurse calls a supervisor and requests that a "float nurse" be assigned to help with all "assessments of new admissions and postoperative patients." The supervisor asks, "How many admissions and surgery patients have you received?" The novice nurse becomes flustered because she has not checked the census but simply bases the need on feeling overwhelmed. This situation best indicates a lack of _____ skills. a. organizational b. communication c. interpersonal d. clinical

The nurse manager is planning staffing levels and realizes that the first step is to: a. know the intensity of care needed by patients according to physical and psychosocial factors. b. examine the educational level of the staff. c. assess the skill level of caregivers. d. review the budget to determine the financial consequences of past staffing patterns.

The primary focus of the care provider role for the nurse involves: a. using the nursing process to provide guidance to the patient in recovery. b. encouraging consumer self-responsibility and emphasizing health promotion/maintenance. c. focusing on increasing satisfaction among professional nurses. d. advancing nursing practice through research.

The staff on a nursing unit notes that patient satisfaction varies from month to month. They plot the degree of patient satisfaction each month for 1 year to determine when the periods of greatest dissatisfaction are occurring. The staff uses which type of graph? a. Time plot b. Pareto chart c. Flowchart d. Cause-and-effect diagram

The surgical team arrives in the operating room and one member states, "Everyone stop. Let's identify the patient and operative site. Now does anyone have any questions or concerns?" This process is known as: a. time-out. b. a critical pathway. c. special cause variation. d. lean methodology.

Time is becoming crucial for the nurse to address issues related to sponsoring programs to include hearing aid costs as part of Medicare coverage. The nurse involved in grassroots political actions realizes that the least timely mode by which to reach elected officials would be via: a.letter. b.telephone. c.e-mail. d.facsimile (fax).

When the novice nurse asks, "What will happen if this task is not completed," which skill is being demonstrated? a. Priority setting b. Delegation c. Organization d. Clinical skills

Which message would be appropriate to leave on answering systems? a. "You have reached 910-999-1212. Please leave your name and number and I look forward to returning your call as soon as possible." b. Music that has messages that might be offensive to some callers downloaded as the response when applicant is unavailable. c. "Hi, I'm not here. Sorry you missed me. Call again." d. "I am interviewing for positions, hope to be home soon. If you are calling about an interview, please leave your name, number, and possible positions available."

8. The National Council of State Boards of Nursing determines acceptable National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination questions on the basis of: a. the geographic location of the candidate. b. research that indicates needed skills for positions in which most entry level nurses are employed. c. surveys conducted by employers to determine the weaknesses of entry level nurses. d. surveys of physicians performed to determine what nurses must know to provide safe care.

9. Although the NCLEX-RN examination has new formats for questions, the most common format is the: a. fill-in-the-blank item because candidates are not provided with clues from distracters. b. multiple-choice question item, which allows candidates to select the one correct answer. c. multiple-response item because these questions require a higher level of critical thinking. d. hot-spot item because these questions are written at the application level of Bloom's analysis.

9. Hospitals surveyed nurses who terminated their employment to determine why they chose to leave. One of the most common reasons for leaving was: A. decreased pay for alternative shifts. B. that the nurse/patient ratio prevents safe care. C. that most facilities are choosing an all-RN staff, which decreases opportunities for advancement. D. that agency and foreign nurses are favored by the administration over full-time nursing staff.

9. The new director of nurses has instituted "walking rounds" on all nursing units, rather than the usual taped shift reports. A veteran nurse exclaims, "She doesn't know how we do things here!" The nurse is demonstrating: a. appeal to emotion. b. appeal to tradition. c. red herring. d. straw man.

9. When practicing in a compact state: a. the nurse must abide solely by the practice act of the largest state. b. patients' rights in relation to the nurse practice act are protected by the mutual recognition model. c. the nurse must pay for a license in all states that participate in the mutual recognition model. d. the nurse must refer to the nurse practice act for the list of skills that can be performed.

A concerned nursing student calls the office of an elected official to voice support for the bill to ban smoking in all public places. The secretary asks, "Are you a constituent?" What does the term constituent mean? a.A member of a professional organization who supports the organization's political issue b.A citizen who is registered and is eligible to vote for a representative c.An elected official who proposes legislation to be considered as a potential law d.A member of the House of Representatives who is seeking support for a particular bill

A hospital converts to a system of care delivery in which RNs, LPNs, and unlicensed assistive personnel (UAP) are responsible for implementing a specific task, such as medication administration or personal hygiene, for the entire nursing unit. This type of delivery system is: a. total patient care. b. functional nursing. c. team nursing. d. primary nursing.

A hospital is concerned that the number of medication errors has increased significantly in the past year. A project revealed four causes of medication errors. The above chart was used to help staff and administration know where to focus efforts to reduce errors. Which process improvement tool is used in this situation? a. Run chart b. Pareto chart c. Flowcharts d. Cause-and-effect diagrams

A hospital standard states, "All intravenous (IV) sites must be rotated every 72 hours." The nurse who assesses and records variations from this standard is fulfilling which role of nursing? a. Infection control b. Quality management c. Coordinator position d. Counselor

21. A nursing student is in the final term of an Associate Science of Nursing (ASN) program and is preparing for licensure. Prior to licensure the candidate must provide evidence of: (select all that apply) a. graduation from a nursing program. b. graduation from high school or high school equivalency. c. evidence of current malpractice insurance. d. evidence of plan to continue study to obtain a minimum of a BSN within 2 years. e. validation of skills competence provided by a certifying agency.

A, B

What characteristics are associated with the clinical nurse leader? (select all that apply) a. Is a generalist prepared at the master's level. b. Provides care at the bedside for complex patients. c. Identifies the best resources at the lowest price to achieve best health outcomes for a client. d. Serves as care coordinator whose practice is limited to acute care settings. e. Is an advanced practice nurse with an earned doctorate in nursing.

A, B

21. Which statement made by an RN regarding delegation indicates the need for additional teaching? (select all that apply) a. Unlicensed assistive personnel (UAP) can assess vital signs during the first 5 minutes for a patient who is receiving a blood transfusion because a reaction at this time is unlikely. b. An LPN/LVN can administer a PPD (tuberculin skin test) if there is no history of a positive PPD. c. When dopamine is ordered continuously, the LPN/LVN can administer dopamine at a low dose for the purpose of increasing renal perfusion. d. UAPs can transfer a patient who is being discharged home from the wheelchair to the bed if they have received training and demonstrated competency. e. Responsibility can be delegated to the UAP, but the delegator retains accountability.

A, B, C

22. A novice nurse notices a patient is pacing the floor and twisting his hands. When the nurse enters the room, the patient stares at her and mumbles, "Can't anyone understand what I want?" while smiling and reaching out to shake the nurse's hand. The nurse recognizes a risk for violence based on which clinical findings? (select all that apply) a. Glaring at the nurse b. Nervousness, twisting of hands c. Murmuring when talking d. Diagnosis of a terminal illness e. Isolation, desire to be alone

A, B, C

A novice nurse notices a patient is pacing the floor and twisting his hands. When the nurse enters the room, the patient stares at her and mumbles, "Can't anyone understand what I want?" while smiling and reaching out to shake the nurse's hand. The nurse recognizes a risk for violence based on which clinical findings? (select all that apply) a. Glaring at the nurse b. Nervousness, twisting of hands c. Murmuring when talking d. Diagnosis of a terminal illness e. Isolation, desire to be alone

A, B, C

An interdisciplinary team is evaluating the hospital's care of patients admitted with a myocardial infarction (heart attack) compared to national standards. The team analyzes the hospital's clinical indicator, which would be: (select all that apply) a. aspirin order within 24 hours of discharge. b. patient teaching related to stopping smoking completed prior to discharge. c. beta blocker administered upon arrival. d. support of employer to modify stress in workplace. e. patient's willingness to adhere to a strict cardiac diet after discharge.

A, B, C

A nurse responsible for staffing a medical-surgical unit must consider: (select all that apply) a. the patient census. b. physical layout of the unit. c. complexity of care required. d. educational level of all staff. e. task preferences of the nurses.

A, B, C, D

Which incidences are the basis for disciplinary action by state boards of nursing? (Select all that apply.) A. Falsification of nursing records B. Medicare fraud C. Misappropriation of a patient's personal belongings D. Practicing without a valid license E. History of employment absenteeism

A, B, C, D

*What elements are considered when addressing workforce advocacy? *Select all that apply* A. Staffing B. Social factors C. Physical environment D. Support of health care policies E. Workflow design

A, B, C, E

23. Which functions can be delegated only to another RN with appropriate experience and training? (select all that apply) a. Assessment of skin integrity on third day of hospitalization b. Evaluation of patient teaching related to turn, cough, and deep breathing exercises c. Nursing judgment related to withholding medication based on vital signs d. RNs do not delegate to other RNs, they delegate only to licensed practical nurses or unlicensed assistive personnel e. Formulation of nursing diagnosis "potential for fall"

A, B, C, E

*What interventions will a nurse manager implement when coaching a newly licensed nurse regarding the way a patient's complaint was handled? (Select all that apply) A. Ask, "What will you do differently the next time this situation occurs?" B. Begin the discussion with a personal interpretation of the situation C. Focus on how to achieve the "ideal situation" D. Approach the conversation in a nonjudgmental fashion E. Use close ended questions to help focus the conversation on the situation

A, B, D

1. A nurse is concerned about older persons living alone at home without telephone service to contact emergency services. The nurse is advised to take part in grassroot efforts to address the situation. The nurse would: (Select all that apply.) a.Post signs to support the county's political candidates whose platform support services for poor and underserved person such as older adults. b.Visit with local politicians running for office and ask specific questions such as "Would you support providing free emergency phone service for older adults living alone?" c.Limit voting to only presidential elections in which the President promises to initiate health care reform related to Medicare for older adults. d.Join the American Nurses Association and constituent member association. e.Contact representatives from surrounding states to garner support for free medical alert systems for older adults.

A, B, D

When preparing a portfolio, the nurse should include: (select all that apply) a. copies of diplomas awarded by colleges/universities. b. copies of college transcripts. c. a personal photograph, if not included with the application. d. letters of recognition for scoring high on national achievement tests while in nursing school. e. a copy of the voter's registration card.

A, B, D

20. Managers at an acute care facility value the contributions of their aging nursing workforce and make recommendations to accommodate for an aging nursing workforce. Which changes do they institute? (select all that apply) A. Supplies such as dressing change and Foley catheter kits are placed on the nursing unit. B. Teamwork and development of new roles such as admission nurse are encouraged. C. Daycare centers for sick children are put in place to prevent the stress of having to find alternative daycare. D. Assistive devices for lifting as recommended by ANA's Handle with Care are made available. E. A work-design consultant is hired to redesign the nursing unit to reduce wasted motion.

A, B, D, E

Which factors would be considered in the first steps in developing an effective patient classification system? (select all that apply) a. Planned procedures b. Ethnic diversity of patients c. Clinical competency of staff d. Educational level of nurses e. Age of patients

A, B, E

20. A nurse is hoping for a promotion and seeks the help of a coach to improve time management skills. The first task assigned by the coach is for the nurse to list all external distractors that prevent organization and completion of tasks. The nurse would include *select all that apply*: a. Waiting for oncoming shift to start walking rounds. b. Failure to delegate tasks to the licensed practical nurse and unlicensed assistive personnel and instead, completing task herself. c. Talking with a patient's family member who is also a personal friend. d. Spending time thinking about the vacation to the beach. e. Using the Internet to read about a new drug that will be administered; then taking time to look for news about the profession, new legislation about the Patient Protection and Affordable Care Act, and new uniforms for the season.

A, C

23. The nurse prepares to apply sterile gloves needed for a procedure. After introducing self and verifying patient information, the nurse performs hand hygiene. The nurse should open the outer package and then perform steps in which order. Put a comma and space between each answer choice (e.g., a, b, c, d). a. Open inner package, taking care not to touch inner surface. b. Put the glove on the nondominant hand using the sterile gloved hand. c. Put glove on dominant hand by grasping folded cuff edge, touching only inside of cuff. d. Adjust each glove carefully by sliding finders under the cuff.

A, C, B, D

20. A group of graduates were just notified that they had successfully passed the licensure examination. During the orientation process at the hospital, one asks, "I am looking at my license, but I don't really know the duties performed by the board of nursing." The staff development nurse explains that the board of nursing: (select all that apply) a. grants nursing licensure. b. constructs the licensure examination. c. assigns disciplinary action when the nurse acts in a manner that results in harm to a patient. d. members are appointed. e. conducts certification examinations for advanced practice nurses.

A, C, D

A nurse wants to become an advanced practice nurse and investigates the requirements for a: (select all that apply) a. nurse practitioner. b. nurse executive. c. certified nurse-midwife. d. certified registered nurse anesthetist.

A, C, D

*Which characteristics are expected to be represented in a health care facility's mission statement? (Select all that apply) A. Commitment to professional excellence B. Providing the most economical health care services C. Ethical treatment of all patients and staff D. Teamwork to deliver quality care E. Utilization of innovated service delivery methods

A, C, D, E

20. Registered nurses who are entering the workforce will have expanded leadership responsibilities that include: (select all that apply) a. serving on interdisciplinary care teams. b. being competent to work in several areas independently when dictated by a patient census. c. attending a meeting to plan advanced training for unlicensed assistive personnel. d. evaluating outcomes of care that are reported to a standing committee. e. managing units with higher acuity, shorter length of stay, and more diverse patients and staff.

A, C, D, E

A patient with complicated diabetes is scheduled for a below the knee amputation at 7 AM. The surgical team adheres to the 2012 National Patient Safety Goals by implementing which protocols? (select all that apply) a. The surgical team asks the patient to verify his or her name, type of surgery, and limb to be removed. b. Ask each member of the surgical team to provide a copy of licensure and, if applicable, certification to patient and family. c. The surgical team uses the chart number and name/hospital number to ensure they have the correct patient. d. Mark the procedure site with "X" and again ask the patient to verify correct site. e. After arrival in the operating room, perform a "time-out" for final identification of patient and operative site along with agreement of what procedure is scheduled.

A, C, D, E

Nonpayment hospital acquired conditions include: (Select all that apply.) A. A Stage III pressure ulcer B. Stress-related hypertension C. Hypoglycemic coma D. Catheter associated urinary tract infection (UTI) E. Vascular catheter associated infection

A, C, D, E

Which situation frequently results in a nursing negligence claim? (Select all that apply.) A. Communication B. Cure C. Reporting D. Monitoring E. Safety

A, C, D, E

While participating in a task force to proactively plan for nursing care delivery over the next 20 years, a nurse learns that dramatic changes will occur as a result of: (select all that apply.) a. the increase in the number of minimally invasive procedures being performed for disease treatment. b. care provided for patients over an extended period in acute care settings. c. the reduction in the number of nurses and other health care professionals who are available to provide care. d. the widespread illiteracy and decreased self-efficacy of the aging patient population. e. the need to focus on social and environmental influences, educational level, and individual characteristics and values of the patient. f. the devaluing of nursing as a means of improving patient outcomes.

A, C, E

A new nurse decides to use the Internet to apply for possible positions. How does applying online compare to applying by more traditional methods? (select all that apply) a. Regardless of how one applies, it is important to check the resume for correctness. b. Follow-up with Internet applications is no sooner than 90 days compared to a 1-week follow-up for traditional applications. c. Researching the mission and philosophy of the agency is not necessary with Internet searches and applications. d. The resume and cover letter should be reviewed by someone with excellent skills in grammar and writing to ensure the first impression is one of professionalism and attention to detail. e. Internet applications should include specific questions to be answered prior to accepting an interview such as pay, shifts available, nurse-patient ratio, and autonomy of practice.

A, D

A nurse preparing a resume for the first position is anxious to demonstrate all achievements, which included completing a rigorous accelerated program and maintaining a high GPA while also serving in many community projects and leadership positions. The applicant finds It impossible to include all the accolades on one page and researches tips for professional cover letters and resumes and learns: a. margins should be at least 0.5 inch on all four sides, making conciseness important. b. paper should be bright colored to catch the attention of the recruiter. c. legal size paper may be used when applicants have many accolades or extensive work history. d. standardized cover letters present a professional image as opposed to those that stress the applicant's perspective too heavily. e. include in the cover letter that after researching other position, this is the applicant's preference.

A,E

34*. What observations made by the nurse manager indicate that a nurse demonstrated positive conflict management interventions when a patient's family member angrily accuses the nurse of neglecting the patient's need to be ambulated more frequently? *Select all that apply.* A. Moved the discussion to the privacy of the patient's room B. Kept culturally appropriate eye contact with the family member while discussing the issues C. Shared that the patient often refuses to ambulate when the offer is made D. Suggested the family member discuss their concerns with the nurse manager E. Kept refocusing the discussion to the patient's needs associated with ambulation

ABE

28*. Match the following conflict manage styles with their definition. 1. One person puts aside his or her goals to satisfy the other person's desires. 2. One person achieves his or her own goals at the expense of the other person. 3. One person uses passive behaviors and withdraws from the conflict; neither person is able to pursue goals. 4. Both people actively try to find solutions that will satisfy them both. 5. Both people give up something to get partial goal attainment. A. Force B. Compromise C. Collaboration D. Avoidance E. Accomodation

ANS: 1 - E. Accomodation 2 - A. Force 3 - D. Avoidance 4 - C. Collaboration 5 - B. Compromise

32*. Place the following activities in the proper sequence in order to best achieve the development of a professional communication style. 1. Recognize one's personal use of negative communication techniques like blocking 2. Understanding the influence of gender, cultural, and age has on the communication process 3. Adopting the use of "I messages," conveying empathy, and open communication 4. Developing an effective personal conflict management style techniques 5. Avoiding the use of negative communication techniques like cognitive distortions

ANS: 4, 5, 1, 3, 2 -develop conflict mgmt style -avoid negative communication -recognize use of negative communication -use "I" messages -understand influences of gender, culture, age

A new graduate secures the first interview and wants to work where cultural diversity is appreciated. The applicant feels that accepting this interview was the right choice when the recruiter states, "We do not discriminate based on sex, race, or age and practice inclusiveness of diversity." Which question would reflect this statement? a. "Nurses must work a master schedule where one month is Monday through Friday and the next month is the weekend shift. What is your religious belief about working on Sunday?" b. "We offer many benefits for employees such as educational benefits and health insurance." c. "Our mission is to provide patient-centered care that reflects the belief of the patient and family with an aim to win them over to Western medicine and less superstition, don't you agree?" d. "Do you have any issues with working with patients who are from a disadvantaged background because we have many people who refuse to work then want free care?"

A nonprofit organization that distributes to governmental agencies, the public, business, and health care professionals knowledge related to health care for the purpose of improving health is the: a. Institute for Safe Medication Practices. b. Institute of Medicine. c. National Committee for Quality Assurance. d. The Joint Commission.

A novice nurse is assigned a patient who has an order to draw blood for culture and sensitivity from a central line before antibiotic therapy is started. The novice reads and rereads the procedure manual. An hour later he stands at the bedside of the patient and stares at the central line, without knowing how to proceed. This phase of reality shock is termed: a. honeymoon. b. shock or rejection. c. recovery. d. resolution.

A nurse explaining the above graph indicates the frequency of falls in 2011 to detect and possibly explain causes of variation. The peaks in June were attributed to regular staff vacations during which agency nurses were used. The nurse is employed in which role? a. Case Manager b. Quality Manager c. Forensic Nurse d. Occupational Health Nurse

A nurse in an acute care facility helps patients understand how to prevent diabetic neuropathies. This nurse is functioning in the role of: a. change agent. b. educator. c. manager. d. coordinator.

A nurse is assisting with the delivery of twins. The first infant is placed on the scale to be weighed. The physician requests an instrument stat. The nurse turns to hand the instrument to the physician, and the infant falls off the scale. When evaluating the incident, the nurse and her manager list contributory factors such as the need for two nurses when multiple births are known, and the location of the scale so far from the delivery field. These nurses are performing a(n): a. standardization of care. b. root cause analysis. c. process variation. d. analysis of a deployment flowchart.

A nurse is preparing to administer a medication by using the vastus lateralis site and is unfamiliar with the process. A step-by-step reference that shows how to complete the process is called a: a. deployment flowchart. b. top-down flowchart. c. Pareto chart. d. control plot.

A nurse is removing a saturated dressing from an abdominal incision and must cut the tape to remove the dressing. The nurse accidentally cuts the sutures holding the incision, and evisceration occurs. In quality improvement, this incident is best identified as a: a. root cause. b. sentinel event. c. variation in performance. d. causal factor.

A nurse is responsible for determining the incidence rates of hospital-acquired diarrhea on a pediatric ward after receiving reports that five children admitted with uncontrolled asthma had developed diarrhea while hospitalized. The nurse is working in the role of: a. quality management. b. infection control. c. occupational health. d. forensics.

A nurse manager is mentoring a novice nurse manager in determining staffing needs. The mentor explains, "We must determine the acuity level of the patient by: a. assessing patient satisfaction with nursing care." b. quantifying the amount and intensity of care required." c. examining the skill mix and educational preparation of the staff." d. determining the number of hospital days required by the patients."

A nurse plans care knowing when specific recovery milestones are expected. The nurse is providing care via: a. patient classification systems. b. clinical pathways. c. functional nursing. d. case management.

A nurse who is participating in a health fair asks, "Other than nursing, what are some opportunities for careers in the health care professions, and what education is required?" The nurse informs participants that a baccalaureate degree is required as the minimum standard for the role of: a. speech therapist. b. occupational therapist. c. nurse-midwife. d. nurse anesthetist.

A nurse would like to obtain background information and learn the political platform of a candidate who is running for national office. The nurse should contact the: a.National Registry for Candidates. b.American Nurses Association Nurses Strategic Action Team (N-STAT). c.National League of Nurses. d.National Council of State Boards of Nursing.

A nursing unit is comparing team nursing to the partnership model and finds that: a. with the partnership model, an RN does not have to be part of the mix. b. leadership abilities of the RN is a major determinant of effectiveness of care for both models. c. the RN teaches the LPN/LVN or unlicensed assistive personnel (UAP) how to apply the nursing process in team nursing. d. with team nursing the RN cares for the patient while the team members work with the family or significant others.

A patient has decided to stop hemodialysis because his renal failure progresses and he wishes to spend more time with family. Palliative care will continue, and the approach will be discussed with the patient and family as needed and at change of shift. The care delivery model in this situation is termed: a. partnership. b. patient-centered. c. case management. d. total patient care.

A patient is admitted for a hysterectomy, and the RN develops and implements the plan of care but also delegates to the LPN/LVN the responsibility of administering oral medications. While off duty, this RN receives a call requesting a change in the plan of care because the patient has developed deep vein thrombosis. The nurse who originally planned the care is practicing which type of nursing care delivery? a. Modular b. Primary c. Team d. Functional

A patient is admitted with coronary artery disease and is scheduled for coronary artery bypass grafting (CABG). According to the clinical pathway the patient should be extubated and discharged from critical care the day after surgery. During surgery the patient's oxygen saturation decreased drastically as a result of chronic tobacco abuse. Subsequently, the patient remained on the ventilator an additional 2 days postoperatively. According to the clinical practice guideline for CABG, this situation represents a: a. patient outcome. b. variance. c. goal. d. standard.

Accountability

An ethical duty stating that one should e answerable legally, morally, ethically or socialy for one's activities

Beneficence

An ethical principle stating that one shoudl do good and prevent or avoid doing harm

deontology

An ethical theory stating that moral rule is binding

utilitarianism

An ethical theory stating that the best decision is the one that brings about the greatest good for the most people

Nonmaleficence

An ethicla principle stating the duty not to inflict harm

A patient is admitted with pneumonia. The case manager refers to a plan of care that specifically identifies dates when supplemental oxygen should be discontinued, positive-pressure ventilation with bronchodilators should be changed to self-administered inhalers, and antibiotics should be changed from intravenous to oral treatment, on the basis of assessment findings. This plan of care is referred to as a: a. patient classification system. b. clinical pathway. c. patient-centered plan of care. d. diagnosis-related group (DRG).

A student nurse wants to meet other nursing students from different countries and to learn of employment possibilities. The student nurse should: a. participate in the clinical facility's employee satisfaction task force. b. join the Student Nurses Association. c. take part in self-mentoring. d. postpone taking the licensure examination so he or she can take a tour of foreign countries.

A task force is considering factors that contribute to high-quality safe staffing. Which statement reflects an understanding of the American Nurses Association's (ANA) recommendations? a. Because patient needs remain constant on a daily shift, staffing needs at the beginning of the shift should be sufficient to provide safe, high-quality care. b. Staffing should allow time for the RN to apply the nursing process so decisions result in high-quality, safe patient outcomes. c. Patient acuity levels affect staffing by increasing the need for unlicensed personnel to provide routine basic care rather than increasing RNs in staff mix. d. RN staffing is not cost-effective; thus is it important for staffing models to limit the number of RNs assigned per shift.

A valuable tool for determining whether a potential employer is suitable for your career goals is to: a. call The Joint Commission (TJC) to ask whether the organization meets required standards. b. assess the work climate by walking through the facility. c. review financial statements of the institution. d. ask what they can do for you rather than what you can do for them.

An RN testifies at a trial where domestic violence is being investigated. She had previously assisted with specimen collection and had assessed the victim. The nurse is involved in _____ nursing. a. triage b. forensic c. flight d. entrepreneurial

An experienced nurse working in oncology is shocked to realize that he feels little empathy when a patient explains, "I developed cancer from having to work in the dry cleaning industry since I was only 8 years old to help support my younger siblings during the depression. Now they have all moved away and refuse to help me financially, and it takes everything I have to pay for my chemotherapy medicine." The nurse is experiencing: a. burnout. b. compassion fatigue. c. reality shock. d. horizontal hostility.

Each month data on admission assessments that are based on the following standard are entered: "All patients will be assessed by an RN within 2 hours of admission." The target goal for this standard is 97% compliance. Data are displayed on a graph that shows number and time of admission assessments and compliance variation limits. This pictorial representation is: a. Pareto chart. b. control chart. c. deployment chart. d. top-down flowchart.

In differentiating between interprofessional and multidisciplinary: a. multidisciplinary refers to the care of many diverse patients by one discipline. b. interprofessional involves members of many disciplines working together to provide patient care to a distinct population. c. interprofessional refers to members of the same discipline working together to provide patient care to a distinct population. d. interprofessional is the use of multiple interventions by nurses with varying levels of education.

It is important for nurses to know the functions of the branches of the federal government. At a local meeting of the state nurses' association, an officer reminds members that the branch that is capable of originating major policy initiatives is the: a.executive branch. b.legislative branch. c.judicial branch. d.administrative branch.

Many nursing professionals have portfolios that include: a. family pictures. b. letters of commendation. c. articles that describe lack of quality in health care. d. high school achievements.

Nurses working on an orthopedic unit use personal digital assistants (PDAs) to review medications prior to administration to reduce potential drug interactions. Software is also installed that provides video clips of common procedures performed by nurses. Nurses on this unit are best demonstrating which QSEN competencies? a. Patient-centered care b. Informatics c. Teamwork d. Quality improvement

Patients with heart failure have extended lengths of stay and are often readmitted shortly after they have been discharged. To improve quality of care, a type of "road map" that included all elements of care for this disease and that standardized treatment by guiding daily care was implemented. This road map is referred to as a(n): a. benchmark. b. critical pathway. c. algorithm. d. case management.

Political action committees (PACs) are established for the purpose of: a.financially supporting candidates. b.persuading policymakers to support certain policies. c.lobbying legislators. d.recommending health care policy.

The novice nurse arrives on the nursing unit, is introduced to the staff, is assigned a preceptor, and is asked to participate in the next staff meeting. This introduction into nursing is appropriately termed: a. biculturalism. b. socialization. c. transition. d. "going native."

The nurse manager determines that four RNs, five LPN/LVNs, and two unlicensed assistive personnel (UAP) are required per shift to meet the needs of the patient population on the unit, according to acuity and census. The nurse manager is concerned with: a. assignments. b. staffing. c. output. d. productivity.

The nurse who is responsible for following the patient from admission through discharge or resolution of illness while working with a broad range of health care providers is called a: a. nurse manager. b. case manager. c. coordinator of patient-centered care delivery. d. team leader in team nursing care delivery.

The nurse who organizes screenings for employees, assesses the work environment for hazards, and teaches health-promoting activities is employed in the field of: a. infection control. b. occupational health. c. informatics. d. transportation specialization.

The public's right to expect to receive treatment that meets the standards of nursing care is protected by: A. state law. B. federal law. C. reporting law. D. common law.

When the policy process is compared with the nursing process, identifying the issue is consistent with which step of the nursing process? a.Assessment b.Diagnosis c.Planning d.Implementation

Which nurse is more prone to burnout? The nurse who: a. graduated last in the class. b. is industrious and conscientious. c. refuses to work an extra shift even though he or she needs the money. d. volunteers to serve on only one committee and keeps in touch with schoolmates.

While performing a job search, a nurse reviews the list of Magnet hospitals of the American Nurses Credentialing Center because: a. these hospitals are able to hold on to revenue gained from patient care. b. nursing longevity, autonomy, and self-governance are important features of these institutions. c. all RNs have a minimum of a master's degree and are credentialed in the area in which they provide care. d. these hospitals have the most up-to-date diagnostic equipment such as magnetic resonance imagery.

18. A nurse who wishes to practice in another state: (select all that apply) a. must retake the NCLEX-RN for that state. b. should determine whether the state is a compact state. c. may obtain licensure by endorsement. d. must revoke licensure in the current state because nurses cannot be licensed in more than one state concurrently.

B, C

A new graduate is excited about finding the first job but doesn't want to make the costly mistake of taking the first job offered or taking a job that doesn't meet her career goals. She learns the best way to know the culture of the potential employer is networking with: a. the executives at the competing agency. b. alumni that graduated from the same school and work in the area. c. nurses currently working in the agency. d. friends or people who have been patients at the agency. e. nurses who are former employees.

B, C, D, E

*Which characteristics are associated with patient advocacy? (select all) A. Promotion of an optimal nursing working environment B. Cornerstone of the nursing profession C. Delivery of quality nursing care D. Enhancement of health care systems' accountability E. Promotion of safe patient care

B, C, E

21. A nurse is interviewing for a job and recently read the American Nurses Association's (ANA) recommendation for questions to ask regarding before accepting employment. Which questions should the nurse ask? a. Do you have flexible scheduling? b. What are the expectations for advancement? c. How long do staff nurses stay before resigning? d. What is the mission of the parent organization? e. Does the organization have a means for staff nurses to have an active role in decision making by participation and accountability for the outcomes of practice decisions?

B, C, E

31*. What are the characteristics of SMART goals. *Select all that apply* a. Simple b. Achievable c. Manageable d. Tangible e. Reasonable

B, C, E

17. A nurse is having difficulty managing assignments at work, which results in a feeling of "failure" and tasks that are not completed or that are not completed satisfactorily. The mentor suggests some tips for time management. These include: *select all that apply* a. Focusing on activities to be completed, rather than on objectives. b. Planning for tomorrow today. c. Making certain that the last hours are the most productive in tying up loose ends. d. Maintaining a log of how the nurse spends time (no need to worry about using complete sentences). e. Picking five major objectives for the day and not stopping until they are achieved.

B, D

21. Faculty comes to class to present information about joining the Student Nurses Association (SNA). A student is heard saying, "Why join this organization? It is just a bunch of students like us. I'll wait and join the real nursing organization after graduation." This student is not aware of which benefits of SNA? (select all that apply) a. Members are eligible to sit for the licensure examination at a reduced rate. b. Leadership skills can be refined by working with other schools of nursing. c. The National SNA provides discounted rates for study abroad opportunities. d. A global view of nursing can be obtained through networking internationally. e. Lobbying efforts are a major benefit of belonging to SNA.

B, D

Faculty comes to class to present information about joining the Student Nurses Association (SNA). A student is heard saying, "Why join this organization? It is just a bunch of students like us. I'll wait and join the real nursing organization after graduation." This student is not aware of which benefits of SNA? (select all that apply) a. Members are eligible to sit for the licensure examination at a reduced rate. b. Leadership skills can be refined by working with other schools of nursing. c. The National SNA provides discounted rates for study abroad opportunities. d. A global view of nursing can be obtained through networking internationally. e. Lobbying efforts are a major benefit of belonging to SNA.

B, D

19. A nurse hopes to improve time management skills using the ABC prioritization approach. Which tasks would be prioritized as "B"? *select all that apply* a. Turn in time sheet due in 3 days. b. Review dress code policy to give feedback before appointment in the morning. c. Perform blood glucose test on a patient admitted with Kussmaul respirations and change in level of consciousness. d. Complete patient teaching prior to discharge in 2 hours. e. Review procedure for inserting a PIC line to assist with procedure later this morning.

B, D, E

Advanced practice nurses are prepared minimally at the master's degree level with prescriptive privileges; these professionals include: (select all that apply) a. clinical nurse leader. b. nurse practitioner. c. nursing administrator. d. certified nurse-midwife. e. clinical nurse specialist.

B, D, E

20. In orientation, a new graduate is surprised to learn of workplace violence in health care agencies and asks, "What kind of violence is common in hospitals?" The educator describes workplace violence as: (select all that apply) a. care of patients admitted who are victims of domestic violence. b. experienced nurses withholding pertinent information from coworkers to portray them as incompetent. c. coworkers participating in an employee assistance program (EAP) to learn more about anger management for adult children living at home. d. care of persons being held for treatment prior to be incarcerated for committing homicide. e. statements such as "The new nurse has book sense but can't perform an admission physical without the help of everyone on the unit."

B, E

In orientation, a new graduate is surprised to learn of workplace violence in health care agencies and asks, "What kind of violence is common in hospitals?" The educator describes workplace violence as: (select all that apply) a. care of patients admitted who are victims of domestic violence. b. experienced nurses withholding pertinent information from coworkers to portray them as incompetent. c. coworkers participating in an employee assistance program (EAP) to learn more about anger management for adult children living at home. d. care of persons being held for treatment prior to be incarcerated for committing homicide. e. statements such as "The new nurse has book sense but can't perform an admission physical without the help of everyone on the unit."

B, E

A nurse educator is explaining to licensed staff that health care is no longer safe and describes The Quality and Safety for Nursing (QSEN) recommended competencies for educating nursing professionals. These include: (select all that apply) a. advanced health assessment techniques. b. patient-centered care. c. prescriptive pharmacology content. d. quality improvement. e. safety.

B. D. E

14. A nurse moves from California to Arkansas and due to having 20 years of experience as a registered nurse is immediately placed in charge of the telemetry unit. The staffing consists of LPNs and two unlicensed assistive personnel. The RN is unsure of the scope of practice of the LPNs and reviews the nurse practice act for Arkansas, which lacks clarity on some tasks. The RN should: a. query the state nursing association to determine their stance on the role of LPNs. b. ask the LPNs on the unit to list what tasks they routinely performed. c. contact the state board of nursing to determine legal scope of practice for LPNs. d. refer to California's nurse practice act because the scope of LPNs/LVNs is consistent across the United States.

14. An older adult is unable to reach the telephone and is found dead at home several hours later. The son of the deceased person arrives at the hospital and asks, "Can I just please stay and hold my dad's hand? He was so afraid of dying alone." Which response by the nurse shows empathy? a. "You are just too late for that. Where were you when he needed you?" b. "Did you ever consider purchasing a cell phone for your dad to prevent this from happening?" c. "I'll close the door so you can spend time with your dad. I will check back in a few minutes." d. "I lost my dad last year. He died alone. He was a policeman. I am just like you. Let me stay here and console you."

15. An RN makes the following assignments at the beginning of the shift. Which assignment would be considered high-risk delegation? a. A novice RN is assigned a patient with diabetes mellitus requiring mixing of regular and NPH insulin. b. An LPN is assigned an older adult with pneumonia and who requires dressing changes on a foot wound. c. An unlicensed assistive person is assigned the task of assisting a patient with late stages of Huntington's disease to ambulate a short distance in the hallway. d. A float RN from the oncology unit is assigned a patient with a white blood cell count of 4000 mm3.

16. A staff nurse states, "I really enjoyed having dinner with the Chief of Medical Staff and the President of the hospital. We hope to meet again soon." Which source of power does this nurse possess? a. Expert b. Legitimate c. Connection d. Reward

18. A hospital recently learned that their scorecard did not meet the national benchmark for patient satisfaction and brought in a professional change agent to determine what their issues were and how they could improve their score. The agent collected data and recommended that nurses participate in interdisciplinary walking rounds and allow the patient and family to be participants. Nurses now round every shift and perform "huddles to update the team" as needed throughout the shift as part of best practices. *Random visits are made to nursing units to ensure all nurses are participating and patients are interviewed for their involvement. This stage of Lewin's change is:* A. Unfreeze. B. Moving. C. Refreeze. D. Resistance.

18. A novice nurse is placed in charge just after orientation ends. Which statement by the novice nurse would ensure a smooth delegation experience when delegating to an experienced staff member? a. "You have the patients in rooms 1 to 7. These patients require little skill so you will be fine." b. "Your assignments are posted in writing by the nurses' station. Be certain all your tasks are completed so the next shift is not behind." c. "You have patients in rooms 5 through 10 and I will administer all IV medications. I will let you know if I have to adjust. If you see you need help let me know." d. "Everyone is capable of providing the best care, so please sign up for the patients you would like to be assigned to."

19. A nurse wants to apply open communication to obtain a thorough history and to determine cognitive function. Which question represents the use of open communication? a. Is today Wednesday? b. Do you know what day it is? c. Tell me what day of the week today is. d. Do you know what the first day of the week is?

2. An RN recently relocated to another region of the country and immediately assumed the role of charge nurse. When determining the appropriate person to whom to delegate, the RN knows that: a. the role of the LPN/LVN is the same from state to state. b. the LPN/LVN can be taught to perform all the duties of an RN if approved by the employer and if additional on-the-job training is provided. c. he or she must review the state's nurse practice act for LPN/LVNs, because each state defines the role and scope of practice of the LPN/LVN. d. The Joint Commission has certified and established roles for the LPN/LVN.

2. One difference between a leader and a manager is that: a. A leader has legitimate authority. b. A manager motivates and inspires others. c. A manager focuses on coordinating resources. d. A leader focuses on accomplishing goals of the organization.

2. The primary purpose of licensure for RNs is to: a. prevent others from using the title nurse. b. demonstrate a specialized body of knowledge. c. protect the public. d. enhance recognition for the profession.

2. When participating in grassroots political strategies, the nurse should: A. Refuse to vote in all elections until access to health care is universal B. Withdraw membership to professional nursing organizations until the nurse/patient ratio is reduced nationally C. Educate candidates about the effects of the nursing shortage on the quality of patient care and patient safety D. Avoid raising issues of economic uncertainty in health care

20. The order reads: Administer 500 mg of Kefzol (cefazolin sodium) Intramuscular. Using information located on the medication vial above, the nurse will administer how many mL? The above question represents which type of alternate-format question written at which level of Bloom's taxonomy? a. Multiple-response item, comprehension level b. Hot-spot item, application level c. Chart/exhibit item, analysis level d. Drag-and-drop item, knowledge level

20. Care delivery using the team-based approach is used on a telemetry nursing unit. The team consists of one registered nurse (RN), two licensed practical nurses (LPNs), and one unlicensed assistive personnel (UAP). Staff have been charged to improve quality of care while ensuring cost containment. Which assignments would meet both criteria? a. The RN administers all medications to all patients. b. The LPN performs sterile dressings and IV tubing changes on all central lines. c. The experienced UAP places telemetry electrodes and attaches to cardiac monitor. d. The RN administers an enema to a stable patient who has an order "administer fleet enema PRN when no bowel movement in 2 days."

21. A group of nurses are meeting to decide how to staff the upcoming holidays. Each of the four members freely expresses thoughts about fair staffing but is willing to listen to other thoughts and reconsider their first recommendations. The nurses are avoiding conflict and supporting professional communication through: a. empathy. b. positiveness. c. supportiveness. d. accommodation.

23. A nurse is overhead saying, "I don't mind working during the election and holiday. My parents are divorced, money is tight, and honestly I don't trust any politicians anyway. I plan to take a few weeks off next month." She works independently to research strategies to improve patient-centered care for the large number of immigrants that arrived in the area and then works with the team to share ideas. She recommends, "Let's think the suggestions over and come back together next week." This nurse's communication style is consistent with which generation? a. Baby Boomers b. Traditionalist c. Generation X d. Millennials

25*. When a client expresses doubt whether a complicated procedure will actually help his condition, the nurse best avoids blocking the communication by responding: A. "I can understand your concern. We can talk more about it whenever you want." B. "Your physician has performed this procedure many times and with great success." C. "What makes you doubt that your condition will benefit from having the procedure done?" D. "Would you like me to arrange for someone who has had the procedure talk to you about it?"

3. According to Kramer, nurses in the shock phase should ask themselves: a. "How can I fit in with other staff?" b. "Why can't I perform as everyone expects?" c. "What changes can I make to make me feel good about the choice to become a nurse?" d. "How can I get the rest of the staff to change?"

31*. The primary goals of good relationship building and client care are best achieved when all members of the interprofessional care team: A. have identified the team's leader. B. are experts in their field of care. C. have developed a trusting relationship. D. recognize their role in the client's care.

4. To conduct a productive meeting, the nurse should: a. provide each person all the time needed to discuss desired topics. b. cover all emotional topics first. c. create an agenda with specific times allotted for each agenda item. d. wait for latecomers and ask for their excuse for being late.

5. An RN with excellent assessment and psychomotor skills would derive power on the basis of which source? a. Rewards b. Coercion c. Expert d. Legitimate

6. A new graduate nurse is applying for the exciting first position and states, "I am only applying to Magnet hospitals because those work environments: A. attract physicians who are the best health care providers to improve quality of care." B. require all registered nurses to be certified in the area of practice." C. not only attract but also retain professional nurses." D. discourage nurses from advancing their current level of education and I don't want to return to school for many years."

6. Managers who exhibit an authoritative behavioral style are most likely to use which source of power? a. Informal b. Expert c. Coercive d. Reward

7. A novice nurse notices the medication nurse hurriedly gathering medications to be administered for the entire day, removing them from the packages, and placing them in a paper cup with the patient's name and room number on the cup. When one of the patients points at a pill and asks, "What is this?" and "What does this do?" the medication nurse is uncertain, because it has long since been removed from the packaging. The novice nurse speaks to the nurse manager about her observations and describes her concerns. The novice nurse has assumed the role of: a. loner. b. "rutter." c. change agent. d. "native."

7. A student nurse who is preparing to graduate and take the licensure examination asks, "What is compulsory licensure?" The appropriate response of the nursing advisor is which of the following? a. All candidates wishing to take the licensure examination must pass a drug screen. b. Candidates must not have a felony conviction. c. To practice as an RN, the nurse must be licensed as an RN. d. An impaired nurse must sign a legal document to acknowledge limitations on his or her practice.

7. When deciding whether and when a task should be completed, a nurse must: a. complete all tasks as they are thought of to prevent having to take time to consider which is most important. b. procrastinate and hope that someone will volunteer to do it. c. ask, "What will happen if I don't complete the task now?" d. view large projects holistically and not as many small pieces.

9. A novice nurse is unsure of his ability to insert a nasogastric tube for one of the assigned patients who is vomiting coffee ground emesis. The novice nurse waits, hoping that someone with more experience will volunteer to do the job, or he just waits until the end of the shift. This nurse is practicing: a. energy management. b. priority setting. c. procrastination. d. introspection.

9. An LPN/LVN has transferred to a nursing unit and arrives for the first day. The RN checks with the LPN/LVN often throughout the shift to provide support and determine if assistance is needed. The RN is providing which level of supervision? a. There is no supervision, because at times the LPN/LVN is not with the RN. b. Periodic inspection is being used. Because the LPN/LVN is licensed, the RN is relieved of the need to evaluate care. c. Continual supervision is being provided until the RN determines competency. d. Initial supervision is being provided because this is the LPN/LVN's first day on the unit.

A graduate nurse should begin the job search knowing that: a. few jobs are available for RNs because of a failing health care economy. b. it would be more promising to apply to a rural hospital than to an urban hospital. c. although efforts have been made to reduce expenditures for health care, the need for RNs remains stable. d. the demand for nurses to work in acute care hospitals has decreased because most services are being shifted to outpatient and ambulatory settings.

A hospital is concerned with nurse retention and realizes that job satisfaction is a major influence. To enhance employee satisfaction related to staffing, the management team: a. negotiates for additional agency nurses. b. hires more part-time employees. c. includes participatory management into staffing decisions. d. uses "float" nurses to cover vacancies.

A new graduate desires a position in labor and delivery; however, no position is available. What is the best advice for this nurse? a. Continue to study to keep skills current and wait for desired position. b. Return to college until a position in labor or delivery opens. c. Accept another nursing position and transfer into labor and delivery when a position is available. d. Practice obstetrical skills in a simulation lab then present evidence of competency to potential employer.

A novice nurse is placed in charge just after orientation ends. Which statement by the novice nurse would ensure a smooth delegation experience when delegating to an experienced staff member? a. "You have the patients in rooms 1 to 7. These patients require little skill so you will be fine." b. "Your assignments are posted in writing by the nurses' station. Be certain all your tasks are completed so the next shift is not behind." c. "You have patients in rooms 5 through 10 and I will administer all IV medications. I will let you know if I have to adjust. If you see you need help let me know." d. "Everyone is capable of providing the best care, so please sign up for the patients you would like to be assigned to."

A novice nurse is unsure how to correctly administer an injection using the Z-track method. What is the best approach for learning this procedure? a. Read the procedure manual and follow the steps exactly. b. Make an appointment at the skills laboratory of the former nursing school to practice. c. Ask to observe the skill as it is being performed; then perform it under direct supervision. d. Try to remember how the task was previously performed during a simulation.

A novice nurse notices the medication nurse hurriedly gathering medications to be administered for the entire day, removing them from the packages, and placing them in a paper cup with the patient's name and room number on the cup. When one of the patients points at a pill and asks, "What is this?" and "What does this do?" the medication nurse is uncertain, because it has long since been removed from the packaging. The novice nurse speaks to the nurse manager about her observations and describes her concerns. The novice nurse has assumed the role of: a. loner. b. "rutter." c. change agent. d. "native."

A nurse is asked to "float" to a telemetry floor and is to place a patient on telemetry monitor. The nurse is unfamiliar with placement of EKG leads and would consult which type of chart to learn the correct placement? a. Time plots b. Time plots c. The Pareto chart d. The cause and effect diagram

A nurse tallies the patient satisfaction surveys and approves the use of an agency nurse because of the high census. This nurse is involved in which nursing role? a. Change agent b. Educator c. Manager d. Coordinator

A nurse working in a factory performs routine hearing tests for employees. The factory uses 90 dB as the safe limit for an 8-hour day's exposure to machine noise rather than 85 dB as recommended by the Occupational Safety and Health Administration. The nurse is functioning in the role of: a. quality management. b. informatics nurse specialist. c. occupational health nurse. d. case manager.

A patient is admitted for a hip replacement complicated by uncontrolled diabetes and early dementia. The nurse coordinates referrals to an endocrinologist to establish an insulin protocol and organizes out-patient physical therapy in an Alzheimer's assisted living facility upon discharge. The role of this nurse is the: a. informatics specialist. b. educator. c. case manager. d. quality manager.

A patient is ordered a low-protein, low-calorie diet but the patient's family brings fish, lentils, and unleavened bread for a meal to observe a cultural practice. The nurse works with the dietitian to adjust the next few meals to accommodate for this variance. This situation would represent: a. a sentinel event. b. an adverse event. c. patient-centered care. d. the communication technique of "call-out."

A person from an underrepresented background in nursing is interested in entering nursing school and researches the ethnicity, age, and gender make-up of the nursing profession and finds: a. nursing is a career field that is primarily made up of women younger than 30 years. b. the number of male RNs has steadily increased and is equal to the number of female RNs. c. the majority of RNs are white or non-Hispanic. d. more than half of all RNs are ages 55 through 65.

A potential applicant reviews the application process and learns that preemployment physicals often include: a. cholesterol screening. b. pregnancy testing. c. urine drug screening. d. vision and hearing tests.

According to Kramer, nurses in the shock phase should ask themselves: a. "How can I fit in with other staff?" b. "Why can't I perform as everyone expects?" c. "What changes can I make to make me feel good about the choice to become a nurse?" d. "How can I get the rest of the staff to change?"

According to the Hallmarks of the Professional Nursing Environment, a nurse should ask a potential employer: a. how salaries compare with those of larger facilities. b. what benefits are provided to RNs that are not available to other health care providers. c. what role nurses have in determining the quality of care. d. how the employer plans to provide long-term economic security to RNs.

Customer satisfaction is primarily based on: a. access to modern, up-to-date facilities. b. availability of an extensive menu selection. c. personal interactions with employees. d. having to undergo fewer invasive procedures.

In the near future, the largest segment of the population will be those over age 65 years. To advocate for this vulnerable population, a nurse was a strong supporter for the Medicare Modernization Act (Medicare Part D), which: a. provided vision care benefits to elderly persons who were diagnosed as legally blind. b. removed limits to access to mental health/substance abuse services which are the most commonly used service in this population. c. provided coverage for medications for Medicare enrollees that constituted a huge expense for the elderly. d. expanded the practice opportunities for advanced practice registered nurses (APRN) who provide the majority of care for this population.

In what situation may a nurse deliver care that is not considered at the level of required standard of care? A. When directly ordered to do so by a physician B. When the nursing area is considered understaffed C. When the situation is determined to be an emergency D. When the client refuses care that would meet the standard of care.

Institute for Healthcare Improvement (IHI) proposed a process for quality improvement with steps known as "PDCA." When explaining the steps to a group of nurses interested in improving the process of medication reconciliation for heart failure patients with high rates of recidivism, the instructor states: a. P stands for process. Following a top-down flowchart provides the steps for reviewing patient medications taken at home compared to those prescribed during hospitalization. b. D stand for deviation, which is an alteration in the expected drugs ordered. c. C is for check if the process for change worked. Was there an improvement in accurate reconciliation? And what was learned? A stands for algorithm, which includes all steps of the process. d. A stands for algorithm, which includes all steps of the process

Nurses, physicians, and social workers finalize the plan of care and coordinate discharge for a homeless person who will need wound care and follow up over the next 4 weeks. Each member contributes based on his or her area of expertise but also recognize other members' strengths. Which of the QSEN competencies are being demonstrated? a. Quality improvement b. Evidence-based practice c. Teamwork and collaboration d. Patient-centered care

The RN who identifies the best resources at the lowest cost to achieve optimal health outcomes for the client is fulfilling the role of: a. informatics specialist. b. educator. c. case manager. d. quality manager.

The appropriate procedure for addressing a cover letter when the applicant is unsure of the name and title of the person to whom the letter should be addressed is to: a. address the letter to "To Whom It May Concern." b. address the letter to "Nurse Recruiter." c. call the facility to inquire about the name and title of the person. d. leave the salutation blank if the name and the title are unknown.

The number of IV site infections has more than doubled on a nursing unit. The staff determine common causes include the site is cleaned using inconsistent methods, dressing frequently becomes wet when patient showers, IV tubing is not changed every 48 hours per protocol, and inadequate hand washing of RN prior to insertion. A bar graph demonstrates the frequency in descending order, with 80% of infections being attributed to inadequate hand washing. The quality tool used is a: a. cause-and-effect diagram. b. run chart. c. Pareto chart. d. flowchart.

To determine basic competency, the interview for a nursing position may include a test in: a. pathophysiology. b. correctly writing nursing diagnoses. c. pharmacology. d. computer skills.

To ensure that new laws are implemented as proposed, nurses must realize that: a.regulations must be enacted exactly as intended by the U.S. Department of Health and Human Services (DHHS). b.hearings to discuss the new laws and regulations are closed to the public, and only lobbyists are invited to attend. c.proposed regulations are published and are open to public comment for a time before they are formally adopted. d.final published regulations only suggest how the law will be implemented.

When a bill is presented to Congress, the subcommittee may choose to "mark up" the bill, meaning to: a.obtain oral testimony about the bill from the executive branch. b.conduct additional hearings about the bill. c.amend the bill before recommending it to the full committee. d.have the full committee vote on recommendations.

When comparing mentoring and role modeling, the role of mentoring is represented by which of the following situations? a. The experienced nurse is unaware that the novice nurse is observing him or her gathering supplies needed to start intravenous antibiotics. b. The novice nurse mimics conversations with his or her own patients that were unobtrusively overheard between the experienced nurse and his or her patients. c. The novice nurse receives feedback from the experienced nurse related to the use of a new occlusive dressing product and is told, "I couldn't have done it better myself." d. An experienced nurse is nominated for outstanding employee of the month by the novice nurse.

When deciding which staffing option to use on a nursing unit that will open soon, the manager realizes that: a. continuity of care is enhanced and errors are reduced when nurses provide care over longer shifts and consecutive workdays, such as 12-hour shifts on 3 consecutive days per week. b. the use of part-time nurses provides the variability needed to meet diverse patient needs. c. satisfaction of the staff equates to satisfaction of patients. d. nurses provide the same level of care, regardless of the work environment.

When should a follow-up letter be written to a recruiter? a. Before the interview to thank him or her for granting you the interview b. Approximately 2 weeks after you did not get the job to inquire c. A few days after the interview d. When you are sure you got the position

When the job applicant is asked to identify weaknesses, one appropriate reply for the novice nurse might be: a. "I have no weaknesses." b. "Are you trying to set me up?" c. "Delegating to peers." d. "Caring requires weakness."

Which nursing action best complies with the expectations for nursing care defined by the "never events" identified by the 2012 Rules of Participation for Hospitals? A. Requiring all unlicensed nursing personal to attend shift reports B. Providing care when convenient for the client whenever possible C. Attending an in-service on evidence-based practice on urinary catheter care D. Reporting suspected elder abuse to the nursing manager immediately

Which of the following occurrences would be classified as a sentinel event? a. A postpartum patient who elects to breastfeed only twice daily develops mastitis. b. A newly diagnosed diabetic patient self-injects insulin in the abdominal area rather than the upper thigh as instructed by the patient educator. c. A nurse assisting with the delivery of twins places the "Twin 1" name tag on the second-born twin, causing the first-born twin to undergo surgery that was scheduled for the other twin. d. A nurse administers 3 units of regular insulin rather than 3 units of NPH insulin subcutaneously, resulting in a drop in the patient's serum glucose from 160 to 100 mg.

Which of the following situations fails to meet the criteria for establishing nursing negligence or malpractice? A. A nurse comes to work under the influence of alcohol. B. The nurse leaves a client's bed in the raised position, resulting in a fall. C. The nurse fails repeatedly to document a client's response to pain medication. D. A nurse assigns first-time ambulation of a postop client to an aide and the client falls.

22. A nursing administrator who is considering the feasibility of an all-RN staff reviews the report, Keeping Patients Safe: Transforming the Work Environment of Nurses (2003) and determines that RNs: (select all that apply) a. are more costly and less efficient than LPNs. b. have little or no effect by being proactive but instead are reactive to patient care errors. c. have a positive effect on patient outcomes when managing patient care. d. are effective overseers of patients' overall health condition. e. lack the training to be effective delegators.

C, D

*Which situations have been identified as positive factors in achieving job satisfaction among nurses? (Select all that apply) A. Having policy and practice decisions made by administration B. Managers taking care not to interfere when a patient focused crisis occurs C. Professional development opportunities made available at the facility D. Attention is paid to fostering excellent nurse-physician relationships E. Respect is given to and expected by all members of the health care team

C, D, E

18. A nurse is having difficulty keeping up with the six assigned patients and serving on the ethics committee. In order to take charge of both personal and work life, the nurse focuses on improving physical energy by: *select all that apply* a. Telling herself, "I provide safe quality care and will provide this level of care to all my patients." b. Taking a deep breath and remaining calm to develop patience. c. Keeping a bottle of water available to consume a minimum of 24 ounces each shift. d. Going into the nurse's break room every 90 minutes to eat a healthy snack and prioritize remaining care. e. Enrolling in the hospital's fitness program, Nurses Need Nurturing.

C, D, E

21. A nurse asks, "What is meant by 'internal' customers?" The correct response is: (select all that apply) a. insurance companies b. accreditors such as The Joint Commission c. X-ray technicians d. clinical pharmacist e. chief financial officer

C, D, E

A new graduate nurse is preparing for an interview for her first position and knows that: (select all that apply) a. the primary goal for the first job is to complete orientation and should be considered as an extension of nursing school. b. appointments for interviews should be scheduled immediately after graduation to avoid rushing into a position. c. self-confidence can be improved with self-talk, which reminds the graduate that peers from her school are effective practitioners. d. work history of even nonmedical positions can demonstrate commitment and reliability so letters from these employers should be in portfolio. e. it is best to arrive 10 to 15 minutes before the scheduled interview dressed for success.

C, D, E

19. Which statements concerning licensure as a registered nurse are correct? (select all that apply) a. Nurses who graduate from different types of nursing education programs are granted different types of licenses, those with a baccalaureate degree having the most expanded role. b. A nursing license cannot be revoked, only suspended. c. Each nurse practice act describes requirements for initial licensure. d. It is illegal for states to ask about the mental or physical status of an applicant. e. Students who graduate in the top 10% of their class are exempt from taking the NCLEX-RN for licensure. f. Candidates for licensure must present proof of graduation as required by the state.

C, F

*When considering the philosophy and values of a health care facility, ____is the highest priority.

Compassion

11. A patient is brought to the unit with mediastinal chest tubes with no fluctuation in the water seal chamber; arterial blood gas results reveal pH, 7.55; CO2, 55; HCO, 28 mEq/L, and O2, 98%. Carotid artery pulsation is visible with the head of the bed elevated and the use of tangential lighting. The first action of the nurse is to: The above question represents which level of Bloom's taxonomy? a. Knowledge b. Comprehension c. Application d. Analysis

11. A person who is covered by Medicaid moves from one state to another and asks the nurse at the health department why the benefits changed. The correct response by the nurse is: a."Local government controls which benefits each county can provide to Medicaid recipients." b."The federal government does not fund any part of Medicaid, so each state must find ways to pay for benefits." c."Each state determines benefits on the basis of the present economy." d."Medicaid is funded by both state and federal governments, but benefits vary from state to state."

11. Which action represents the key management function of strategic planning? a. Determining that all nurses on the unit understand the current organizational philosophy b. Evaluating the communication process between the pharmacy and the nursing departments c. Monitoring data from the quality management initiative related to the last three orientation programs d. Developing a 5-year plan that will incorporate the clinical nurse leader as a part of all nursing units

A nurse is interested in practicing in a faith-based community; when researching the role of the parish nurse, the nurse finds that: a. certification is available at a basic level after a qualifying examination is completed and a set number of practice hours have been worked, as defined by the state's nurse practice act. b. this advanced practice role focuses on health promotion and disease prevention. c. this role has no set standards or scope of practice but instead follows the doctrine of the denomination being served. d. this role is recognized by the American Nurses Association (ANA) as a specialty with a defined set of practice guidelines.

A nurse makes patient care assignments as follows: RN1 has rooms 200-210; RN2 has rooms 211-221; RN3 has rooms 222-232. The two unlicensed assistive personnel have half the rooms, with one assigned to 200-215 and the second to 216-232. The care delivery model used in this situation is: a. team. b. primary. c. partnership. d. modular.

A nurse researcher is attempting to describe the demographics of today's RNs and reports that: a. less than half of all RNs work in hospital settings. b. the average age for an RN is 50 years. c. approximately 25% of RNs are male. d. most RN are practicing with a bachelor's degree.

12. A hospital's policy requires that all nurse managers must have a minimum of a bachelor's degree in nursing. A BSN nurse new to the hospital has recently been hired as nurse manager for the oncology unit. An RN who has worked on this unit for many years is unable to be promoted to a nurse manager position because of their educational status, and now they've been commenting to physicians and staff, "The new nurse manager has book sense but no leadership abilities." *What is the best approach that can be used by the new nurse manager who is attempting to gain the trust and respect of the nursing staff on the unit?* A. Send memos to all staff except the upset nurse to invite them to a luncheon. B. Ask management to transfer the upset nurse to another unit. C. Assign the upset nurse to committees that do not directly affect that nursing unit. D. Acknowledge the clinical expertise of the upset nurse and clearly explain the expectations for teamwork and open, honest communication.

12. According to the Needlestick Safety and Prevention Act (2000): a. Employers ask nurses in managerial positions to evaluate safe needle devices. b. Registered nurses who sustain a needle stick are required to pass a test before resuming medication administration. c. Each state must determine the type of safe needle devices to be used. d. Employers are required to document how and where a sharps injury occurred, including the brand of device that was involved.

A nurse who is applying for a position contacts an expert on writing résumé and cover letters and is told: a. to use correction fluid sparingly. b. that when an error is made, a single line should be used to cross through the mistake, and initials should be inserted above the error. c. to limit margins to one half inch so that the page appears full of information. d. to be concise, limit the resume to a single page.

A nurse would like to advocate for increased protective services and reporting mechanisms for elder abuse and attends the "meet the candidate" session at the town hall meeting. This is an important time for the nurse to: a.educate the public about the nurse's political platform. b.be spontaneous and not deliver a rehearsed speech. c.address the person as "candidate" rather than using a first name that implies a working relationship. d.learn what the key issues are in the candidate's platform.

12. Which statement related to delegation is correct? a. The practice of unlicensed assistive personnel (UAP) is defined in the nurse practice act. b. Nursing practice can be delegated only when the LPN/LVN and UAP have received adequate training. c. Supervision is not required when routine tasks are delegated to a competent individual. d. The RN must be knowledgeable about the laws and regulations that govern nursing practice, as well as those that have no clearly defined parameters, such as for UAP.

13. A clinical nurse leader (CNL) enters the workforce and hopes to use her interdisciplinary skills to participate on a quality improvement committee. The coordinator of the quality group invites the CNL to join the group. Which type of power is demonstrated by the coordinator of the group? a. Coercive b. Transformational c. Laissez-fair d. Legitimate

13. During orientation, an RN learns that LPN/LVNs in the facility receive additional training to perform some tasks such as hanging continuously infusing intravenous fluids that have no additives. It is important for the RN to understand that: a. the health care facility can override the state practice act by having all LPN/LVNs and unlicensed assistive personnel (UAP) participate in on-site training. b. LPN/LVNs are licensed, and accountability for their own practice rests with each LPN/LVN. c. UAPs cannot be held responsible for their own actions or inactions. d. the nurse practice act and state regulations related to delegation override the organization's policies.

A recruiter is explaining benefits to a group of nursing externs who are highly sought for employment. The recruiter states, "We are the only hospital in town that offers a residency program." The recruiter further explains that a residency program: a. provides housing for the graduate nurse to decrease expenses until income is established. b. partners a medical resident with a nurse resident to learn interprofessional care. c. allows new graduates to work on a higher degree in nursing while being paid full- time. d.offers extended time for both theory and clinical activities that promote problem solving and clinical decision making.

Accrediting agencies such as The Joint Commission address staffing by: a. imposing maximum staffing levels. b. requiring a specific staff mix. c. stipulating nurse-patient ratios. d. looking for evidence that patients receive satisfactory care.

An organization's emergency preparedness task force meets to discuss how it should react in case of a terrorist attack and develops a disaster evacuation plan that details how each department will assist individuals in reaching safety. This type of diagram is referred to as a: a. Pareto chart. b. control chart. c. top-down flowchart. d. deployment chart.

An orthopedic unit is considering different types of care delivery models and staff have an opportunity to ask questions about how the models differ. The nurse manager provides an overview and uses the above visual to demonstrate which model of care delivery? a. Team b. Partnership c. Primary d. Functional

14. A nurse is concerned about a trend in the hospital to regularly "float" nurses to different areas of the hospital based on staff shortage regardless of recent experience in caring for the population on the unit. When deciding to accept a staffing assignment in this situation, the nurse considers a "safe harbor." *What is meant by "safe harbor"?* A. In an emergency situation, nurses may move patients to one location designated to be areas safe from natural disasters or acts of terrorism. B. Nurses work in teams to care for patients who have no communicable disease and do not pose a safety issue due to infection. C. Horizontal violence is not tolerated and nurses report any form of violence to administration. D. It is a written notice about recurrent staffing issues that allows nurses to continue to care for patients placed in their care but protects their nurse's license while an investigation is conducted.

14. A nurse realizes that much time is wasted during shift report when coworkers discuss personal items such as recent movies or department store sales. Which statement would help with time management during this critical interaction? a. "Let's talk only about one movie you recently watched." b. "I like to know about department store sales, but we need to get through this report, so let's talk about sales as we walk between patient rooms." c. "I know your shift has been busy. What went wrong?" d. "I have the list of patients; let's start with revisions to the plan of care and scheduled activities for the next shift."

15. A nurse is preparing an exercise program as part of a health promotion program for older adults with osteoporosis. Which question would retrieve the most valuable information about health practices? a. "Do you exercise?" b. "Do you like to exercise?" c. "When do you exercise?" d. "What exercise practices do you participate in?"

15. Which action would help a student successfully prepare for the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination? a. Make note cards that can easily be retrieved to list only facts. b. Avoid timing oneself while studying and when in the actual testing mode to decrease anxiety. c. Ask peers for help because they had the same resources; especially seek their help for difficult concepts requiring critical thinking. d. Practice taking NCLEX-RN examination-type questions and reviewing rationales for correct and incorrect answers.

16. A recruiter is explaining benefits to a group of nursing externs who are highly sought for employment. The recruiter states, "We are the only hospital in town that offers a residency program." The recruiter further explains that a residency program: a. provides housing for the graduate nurse to decrease expenses until income is established. b. partners a medical resident with a nurse resident to learn interprofessional care. c. allows new graduates to work on a higher degree in nursing while being paid full-time. d. offers extended time for both theory and clinical activities that promote problem solving and clinical decision making.

16. The priority intervention to improve work-related quality of life for nurses is to: A. provide safe harbors for unjust or unsafe work assignments. B. improve nurse-physician communications. C. require professional development courses for bedside nurses. D. determine strategies to improve vertical working relationships between staff nurses and nursing administration.

16. Which component of an e-mail shown below would be both effective and concise? A. Subject: A short concise subject line: Meeting. B. Body: I would like you to answer these questions before the next meeting: Where would you like to meet? Do you want all the staff to attend? Can we serve refreshments? What is one goal for our unit? C. Body: Dear Staff, As you know, each department must reduce staff by 2%. We will need to discuss how to inform unlicensed staff about the downsizing efforts of the hospital. D. Body: The next staff meeting is scheduled for Tuesday, January 19, at 5 PM in the first floor auditorium. Please send items for the agenda. Sally Smith, MSN, RN, [email protected] or ext. 5582.

17. A novice nurse is stressed due to always being behind with her assignments. She is overheard saying, "No one here worries about checking nasogastric tube placement before they give medications and hang feedings. Skipping that step would save me an extra 30 minutes to be used for charting. If they can do it, so can I." This nurse is experiencing which stage of reality shock? a. loner. b. "rutter." c. change agent. d. "native."

17. Nurses entering the workforce at a large urban hospital soon began volunteering for excessive overtime. A focus group found that upon graduation, many of these nurses purchased expensive cars and furniture. They lacked skills in managing their checkbook and were often unable to pay recurring bills; this finding would be relevant to which component of the Workforce Advocacy Ecosystem Model? a. Staffing b. Workflow design c. Organizational factors d. Personal and social factors

18. A registered nurse (RN) is assigned as charge nurse for the first time. She knows to consult the state board of nursing to determine scope of practice for licensed practical nurses (LPN) and unlicensed assistive personnel (UAP). She also realizes there are common policies which exist in most state practice acts that include: a. the RN is held accountable for the decision to delegate, but responsibility rests only with the delegatee. b. the RN may only delegate tasks that are not in the scope of practice of the LPN if the delegatee is certain they are competent to perform the task. c. since the LPN is licensed, they practice professional nursing. d. to determine what tasks can be safely delegated, the RN must first assess the patient.

18. An acute care facility values job satisfaction among its registered nurses by implementing a shared governance model. Which element is a fundamental characteristic of this model? a. The administration has an open door policy b. Established dispute resolution process c. Implementation of mandatory reporting d. Nurses have an active role in patient care decision making

18. Which strategy would promote a high rate of success on the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination? a. Since the examination is time limited, skip questions when unsure of the answer and return later if time permits. b. Work quickly through the examination to answer as many questions as possible. c. Mark questions that may need to have the answer reviewed to make it possible to quickly go back and make change after answering all questions. d. Read the entire question and all possible answer options before selecting an answer.

19. A manager just finished the last annual performance review of the staff, reviews the unexpected expenditures for the month due to use of agency nurses, and shares the latest quality indicators with the staff nurses. This manager is performing which management function? a. Directing b. Planning c. Organizing d. Controlling

2. One workplace issue—the nursing shortage—is caused by several complex issues, including: A. movement of nurses into acute care settings. B. the use of unlicensed assistive personnel to replace RNs. C. a mass of Baby Boomers who have chosen nursing as a career. D. an aging nursing workforce.

2. Positive time management skills include: a. maintaining an open-door policy. b. retaining all paperwork. c. returning all telephone calls immediately. d. scheduling daily activities.

22. A nurse is asked to "float" to another area where the patients require total care. The nurse smiles, picks up her stethoscope, and says, "I'll come back and eat lunch with everyone here." When she enters the elevator she hits the wall and mutters, "Always me. Don't I have any rights"? The nurse is demonstrating which communication style? a. Assertive b. Aggressive c. Passive d. Passive-aggressive

4. Qualified nursing school applicants have continued to be turned away, limiting enrollment due to a shortage of faculty, which is attributed to several factors, including: A. Nursing faculty are subject to high levels of burnout and job dissatisfaction. B. Only the number of faculty in Associate Degree programs remain stable. C. The mean age of nursing faculty continues to decrease and older faculty mentors have left the profession. D. Increasing job competition from higher paying clinical sites, even as the economy recovers.

4. Which statement accurately describes communication? a. The components of communication are mutually exclusive. b. Communication is linear. c. Communication involves only the sender and the receiver; everything else is superficial. d. When the receiver becomes the sender, the subcomponent of communication that is in use is feedback.

5. A licensed practical nurse (LPN) has been practicing for 25 years on a unit where a newly graduated RN with a bachelor's degree is hired. Before the RN arrives on the unit, the LPN is heard saying, "She'll try to tell everyone what to do because she makes more money. She'll sit at the desk and let us do all the work." This is an example of a(n): a. interpretation. b. context. c. precipitating event. d. preconceived idea.

5. A nurse is delegating to the newly hired nursing unlicensed assistive personnel (UAP) the task of assisting with oral hygiene, knowing that this assignment "does not require decisions based on the nursing process." The nurse is correctly using which of the five rights of delegation? a. Supervision b. Communication c. Person d. Circumstance

5. The key to organizational success for health care facilities is: a. Hiring younger, more energetic nurses. b. Offering incentives such as sign-on bonuses. c. Hiring highly qualified advanced practice nurses. d. Retaining professional nurses.

5. The length of the National Council Licensure Examination for Registered Nurses (NCLEX-RN) examination is based on the: a. last four numbers of the candidate's social security number. b. location of testing. c. candidate's educational preparation. d. performance of the candidate.

6. The first field of nursing to certify advanced practitioners was the field of: a. adult nurse practitioners. b. nurse-midwifery. c. clinical nurse specialist. d. nurse anesthesia.

7. A graduate of a nursing school in the United States plans to practice nursing in Paris, France. To request licensure to practice in Paris, the nurse: a. must contact the Graduates of Foreign Nursing Schools to complete a special examination. b. realizes that education in the United States is so generalized that he or she is eligible to practice in other countries without additional licensure. c. is required to take a language proficiency examination for the primary language of that particular country, as well as a cultural assessment test, prior to licensure. d. should contact the International Council of Nurses or the nursing regulatory board of that country.

7. Which situation would be considered a workforce advocacy issue that is reportable to the state nurses association or the Center for American Nurses if it is not resolved at the local level? a. Nurses prefer to wear navy blue scrubs, but the institution requires burgundy scrubs, which interferes with autonomy. b. The cafeteria often serves fried vegetables rather than healthier baked vegetables, causing the potential for hyperlipidemia. c. The hospital pharmacy does not fill employee prescriptions upon receiving them; instead, they fill employee prescriptions after all inpatient prescriptions have been filled. d. The key needed to change the sharps container is locked in the supervisor's office after 3 PM on weekdays and all day on weekends, which prevents changing of the container when needed and places nurses at risk for needlesticks.

8. A newly hired nurse is asked to serve on a committee formed to recruit and retain nurses. At the committee meeting, the nurse learns that: A. older nurses are being encouraged to retire so that younger, more efficient nurses can practice. B. Magnet hospitals are able to attract nurses with sign-on bonuses and flexible work hours but fail to retain nurses because insufficient autonomy over professional practice is provided. C. multitasking is seldom desired by the younger generation of nurses. D. many younger workers are less concerned with longevity and are willing to change institutions to achieve professional advancement and flexible work hours.

8. When planning, a nurse should: a. delay planning until the "first task of the morning" has been completed. b. recognize that rewarding oneself has a negative consequence. c. rotate between several tasks to stimulate creativity. d. remember that most tasks take longer than anticipated to complete.

8. Which task is appropriate for the RN to delegate to the unlicensed assistive personnel (UAP) provided the delegatee has had experience and training? a. Evaluate the ability of a patient to swallow ice after a gastroscopy. b. Assist a patient who is postoperative hip replacement to ambulate with a walker for the first time. c. Change the disposable tracheotomy cannula for a new postoperative tracheotomy patient if secretions are thick and tenacious. d. Obtain a sterile urine sample from a patient with a Foley catheter that is connected to a closed drainage system.

A group of nurses is presenting the importance of high-quality care during a system-wide meeting of medical-surgical nurses. They point out a finding of the Quality Chasm that: a. being insured has little effect on a person's longevity and the quality of care received. b. lobbyists for the drug companies are able to gain permission for the use of new drugs within 1 year of their discovery. c. although a greater number of lawsuits stem from medication errors, more people actually die from human immunodeficiency virus (HIV) and acquired immunodeficiency disease syndrome (AIDS). d. medication-related errors place a tremendous financial burden on the U.S. health care system.

A new graduate arrives for the first interview feeling prepared and excited about beginning a nursing career but quickly becomes concerned when the recruiter asks which illegal question? a. "Have you been convicted of a crime other than a minor traffic violation?" b. "We are very interested in hiring you but you do understand the position is contingent on the results of the preemployment physical and background check?" c. "What do you consider to be your major weaknesses for this particular position?" d. "Because you are applying for a position in the operating room, you must be able to be on call. How many children do you have responsibility for at home?"

A novice nurse is stressed due to always being behind with her assignments. She is overheard saying, "No one here worries about checking nasogastric tube placement before they give medications and hang feedings. Skipping that step would save me an extra 30 minutes to be used for charting. If they can do it, so can I." This nurse is experiencing which stage of reality shock? a. loner. b. "rutter." c. change agent. d. "native."

*22. An important factor when determining the usefulness of electronic devices in managing the clinical setting is to consider their: a. Size. b. Cost. c. Ease of use. d. Effect on workflow.

1. When an RN is asked to accept an assignment that he or she may not be qualified to perform, the nurse should: a. accept the assignment as appropriate if assigned by a legitimate power. b. be primarily concerned with the number of patients being assigned. c. ask how other nurses have handled the assignment in the past. d. determine whether he or she is familiar with the types of patients being assigned.

10. A nurse is concerned about safe staffing levels at a facility and observes that several units have no RN coverage but instead have RNs who float among several units. *In determining whether this staffing concern should be reported to an outside agency, the nurse understands that with whistle-blowing*: A. Reporting unsafe staffing levels to The Joint Commission provides protection from the employer. B. Keeping copies of documented, inappropriate staffing patterns in the nurse's own personal file is illegal. C. When observing inappropriate staffing, the nurse should record her personal thoughts concerning the outcomes. D. One should seek guidance from a trusted individual who can provide an objective point of view.

10. A nurse is reading about positive reinforcement with the goal of increasing staff motivation. Which action would demonstrate positive reinforcement? a. Every morning at shift change, thank each employee for an excellent job. b. Rotate a monthly "employee recognition award" among all employees on the unit. c. Wait until the annual performance review to recognize accomplishments. d. Give spur-of-the-moment recognition to an employee who has accomplished a goal.

10. A student nurse assigned to work with the charge nurse is given the opportunity to help revise the nursing assessment form. She receives several compliments from management and her nursing instructor for her creative suggestions. The student nurse enjoys the project and attention she is receiving and begins to prolong the conclusion of the project. Although she constantly adds new information, she filters this out slowly to others. The student nurse is subject to the time management obstacle of: a. need for perfection. b. fear of losing creativity. c. unclear goals. d. fear of completion.

10. In distinguishing between evaluation methods used in school versus those used in the work environment, it is noted that the work environment evaluation includes: a. determining whether steps are logical. b. formulating increments in correct order. c. efficiently organizing stages of the procedure. d. appraising outcomes according to policy.

11. A new graduate from a master's entry program in nursing announces, "I just passed my clinical nurse leader certification examination." Certification as a clinical nurse leader: a. is granted by the state board of nursing. b. denotes minimum level of knowledge and skills to practice safely. c. allows independent nursing practice, often in primary care. d. recognizes achievement of advanced skills and knowledge.

During the night, a patient fell in the bathroom and sustained a hip injury. The patient was very upset because of being unable to attend a granddaughter's wedding in 2 days. The team looked at the process and determined that the patient had been medicated with a narcotic, had urinary urgency so had not taken the time to put on shoes, failed to turn on the light because the door to the hall let in some light, and stumbled over a towel that had been placed to collect water leaks caused by construction that was in progress to replace damaged sinks. Which factor was a special cause variation? a. Failure to take time to put on shoes due to urgency b. Unsteady gait due to narcotic administration c. Poor lighting that led to decreased vision d. Improper construction that caused the leak and towel placement

In distinguishing between evaluation methods used in school versus those used in the work environment, it is noted that the work environment evaluation includes: a. determining whether steps are logical. b. formulating increments in correct order. c. efficiently organizing stages of the procedure. d. appraising outcomes according to policy.

The role of the Clinical Nurse Leader (CNL) would include: a. diagnosing a patient with pneumonia and prescribing antibiotics. b. teaching members of a faith community how to avoid skin cancer and referring those with suspicious lesions. c. participating in the team who is investigating possible abuse of elderly persons by members of a gang known to sell illegal drugs. d. coordinating care of a patient admitted 4 days ago with stage IV heart failure and chronic bronchitis by revising care plan to include ambulation 50 feet with assistance.

When preparing the education section of a resume: a. list high school, followed by the first college attended. b. include all colleges attended, even if a degree was not awarded. c. omit the address of the university unless requested by the potential employer. d. list in reverse chronological order the names, dates, and addresses of universities that awarded degrees.

Which of the following statements concerning the Institute of Medicine (IOM) competencies is correct? a. Each competency is mutually exclusive. b. The competencies focus on individual efforts to reduce errors. c. Physicians lead the team to achieve each competency. d. The competencies address both individual and system approaches to transform care.

1. A nurse who is interested in graduate school wants to learn about recently passed legislation regarding changes in Medicare reimbursement for care provided by clinical nurse specialists. The best source for information on changes in federal programs is the__________ _____________.

FEDERAL REGISTER

2. The greatest barrier to access to health care for a poor Hispanic person living in downtown Chicago is ________

LACK OF HEALTH INSURANCE.

____________ occurs when a professional fails to meet the standard of conduct required of all similar professionals.

Malpractice

*Match the following health hazard categories with the appropriate examples: 1. Mandatory overtime 2. Bacteria, viruses, fungi, or parasite infections 3. Injuries resulting from lifting and repeated hand motions 4. Cytotoxic agents 5. Violence a. Physiologic b. Ergonomic c. Psychologic d. Biologic e. Chemical

Mandatory overtime: *Psychologic* Bacteria, viruses, fungi, or parasites: *Biologic* Injuries from repeated use: *Ergonomic* Cytotoxic agents: *Chemical* Violence: *Physiologic*

*29. Match the term with the appropriate description. 1. The social or physical setting of an event 2. An attainable act in a specific period of time 3. A measurable and identifiable act that implements the desired action. a. Goal b. Milieu c. Objective

1. --b. Milieu 2. --a. Goal 3. --c. Objective

*27. Consider the roles during a meeting. Match the role with the responsibility: 1. Creates the meeting's minutes 2. Calls the meeting to order 3. Assures that the meeting is kept on schedule a. Leader b. Recorder c. Timekeeper

1. --b. Recorder 2. --a. Leader 3. -- c. Timekeeper

*30. Place the following pre-meeting tasks in the proper order (1 is the first step and 6 is the final step) a. Send out a reminder of the meeting b. Determine the meeting's purpose c. Determine who needs to attend the meeting d. Create a list of the meeting's topics e. Determine and announce the date, time, and location of meeting f. Create the meeting's agenda

1. --d. Create a list of topics 2. --e. date, time, location 3. --b. determine purpose 4. --f. create an agenda 5. --c. determine who needs to go 6. --a. send out reminder

*__ __focuses on managing the increasingly complex requirements of documenting patient care activities.

Principles for Nursing Documentation

ethics

Science or study of moral values

30*. Anyone who wishes to convey an idea or concept to others is referred to as a ______.

Sender

Code of ethics

Set of statements encompassing rules that apply to people in professional roles

Bioethics

The study of ethical problems resulting from scientific advances

veracity

an ethical duty to tell the truth

33*. Relaying information using words, letters, symbols, or body language is referred to as _____ .

communication

*25. Ensuring that the right amount of work matches the right task is a part of _____________.

energy management

values

ideas of life, customs, and ways of ehaving that society regards as desirable

Quality is defined by the ____________.

patient

Autonomy

personal freedom and right to make choices

23. It is important for novice nurses to know that "self-esteem = self-confidence + self-______."

respect

While taking a shower, a patient pushes the emergency light. When the nurse arrives, the patient complains of feeling dizzy and unsteady. The nurse turns to reach for the patient's walker and the patient falls, hitting the right side of the face resulting in loss of vision in the right eye. This scenario represents a _______ event.

sentinel

24. The healthiest form of communication is the ________ style.

Assertive

___________ occurs when a standard of care is not met by the responsible caregiver.

Breach of duty

*23. When setting priorities, the nurse who is faced with two urgent tasks will: a. Multitask. b. Reassess. c. Delegate. d. Replan.

*24. Which statement demonstrates a problem in a nurse's attitude regarding the need to change? a. "Tell me what needs to be changed." b. "Why does this need to be change c. "This has always worked; it doesn't need to be changed." d. "What makes changing so very difficult to achieve?"

*A nurse manager will likely have which of the following types of power? A. Referent B. Informal C. Legitimate D. Connection

1. A nurse is listening to a patient's apical heart rate. The patient asks, "Is everything okay?" The nurse says nothing and shrugs her shoulders. The nurse is demonstrating: a. open communication. b. filtration. c. blocking. d. false assurance.

1. The advanced practice nurse who is seeking information about requirements for practice in a specialized area should contact the: a. American Nurses Association (ANA). b. National League for Nursing (NLN). c. American Nurses Credentialing Center (ANCC). d. National Council of State Boards of Nursing (NCSBN).

10. An RN is counseled by the nurse manager regarding inappropriate delegation when the: a. RN instructs the nursing assistant to greet ambulatory surgery patients and show them to their rooms. b. nursing assistant informs the RN that she has not been trained to collect a sputum specimen and the RN states, "I will show you this time and you can show me the next time." c. RN assigns the float LPN/LVN the task of completing a plan of care for a stable patient who was admitted for routine replacement of a feeding tube. d. LPN/LVN who has demonstrated competence is asked to perform a dressing change for a patient before she is discharged home.

11. When comparing mentoring and role modeling, the role of mentoring is represented by which of the following situations? a. The experienced nurse is unaware that the novice nurse is observing him or her gathering supplies needed to start intravenous antibiotics. b. The novice nurse mimics conversations with his or her own patients that were unobtrusively overheard between the experienced nurse and his or her patients. c. The novice nurse receives feedback from the experienced nurse related to the use of a new occlusive dressing product and is told, "I couldn't have done it better myself." d. An experienced nurse is nominated for outstanding employee of the month by the novice nurse.

13. A novice nurse is unsure how to correctly administer an injection using the Z-track method. What is the best approach for learning this procedure? a. Read the procedure manual and follow the steps exactly. b. Make an appointment at the skills laboratory of the former nursing school to practice. c. Ask to observe the skill as it is being performed; then perform it under direct supervision. d. Try to remember how the task was previously performed during a simulation.

13. On the basis of changes effective with the April 2010 test plan, candidates who take the NCLEX-RN examination: a. will have to answer more than 75 questions to be 95% certain that they are above the passing standard. b. will be required to submit a 100-word essay on an important nursing topic to evaluate safe nursing practice. c. should study and take practice examinations written at the application and analysis level to ensure that they can meet the higher standards of nursing care and health care delivery. d. will have additional time to complete the examination because most questions will be prepared in the alternate format, thereby requiring critical thinking.

14. A director of nursing (DON) asks the staff to list how their nursing unit can help the organization meet its goal to "provide quality patient care with attention to compassion and excellence." An ad hoc committee is formed to develop a timeline of identified actions. *The DON coaches the committee to reach desired outcomes. This DON is demonstrating which additional role of leadership and management?* a. Transactional b. Clinical consultant c. Corporate supporter d. Autocratic

22. Nurses who are expected to work overtime as dictated by their employer are being subjected to a ___________ hazard in the workplace.

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