Collaboration W/ Rationales

Nurses who demonstrate mindsight are able to A. interpret events and emotions from another person's perspective B. recognize their personal triggers to stress that result in conflict, then retrain their brain to respond differently C. predict events that will occur in the future with reasonable certainty D. focus on being "in the moment" so that they can dedicate their full attention to the events and emotions they are currently experiencing

B. recognize their personal triggers to stress that result in conflict, then retrain their brain to respond differently Mindsight is a term that describes being​ self-aware of​ one's triggers to stress that can result in​ conflict, and purposefully​ "retraining" the brain to respond differently. Improving​ one's self-awareness is salient to growing as a leader and being able to redirect the typical response and course of action in a given situation. Taking steps to decrease or manage stress levels helps to reduce the likelihood of initiating conflict.

Which of the following is a primary barrier to effective nurse-physician collaboration that has persisted over time? A. The view among the general population that nurses' contributions to client care are less important to health and well-being than physicians' contributions B. A lack of published evidence regarding the effectiveness of collaborative efforts among and between nurses and physicians C. A general lack of education among health professionals about the ways in which nurse-physician collaboration improves healthcare quality D. A lack of support at the federal level for efforts to improve healthcare among the general population through increased nurse-physician-client collaboration E. Nurses' and physicians' perceptions of inequity in their roles, with nurses assuming a subservient role and physicians assuming leadership and a superior role in healthcare settings

E. Nurses' and physicians' perceptions of inequity in their roles, with nurses assuming a subservient role and physicians assuming leadership and a superior role in healthcare settings

An experienced nurse is delivering a presentation to a group of nursing students about the importance of collaboration in the healthcare environment. The nurse wants to use evidence from the literature to support her argument. Which of the following are documented benefits of collaboration that the nurse should discuss in her presentation? SATA A. Improved client outcomes B. Higher level of job satisfaction C. Reduction in duplication of healthcare services D. Increased overall cost of healthcare services E. Decreased client morbidity and mortality

A, B, C, E

A home healthcare nurse is planning care for an older adult client. Which interdisciplinary program would best support the needs of an older adult client within the community? SATA A. Programs of All-Inclusive Care for the Elderly (PACE) B. Meals on Wheels C. Outpatient clinic D. YMCA E. Assertive community treatment (ACT)

A, C

_______ occurs when two or more individuals show or feel honor or esteem toward one another, and it is an important element of successful collaborative practice. A. Mutual respect B. Effective communication C. Conflict management D. Trust

A. Mutual respect Mutual​ respect, trust, conflict​ management, and effective communication are all important elements of successful collaborative practice. Mutual respect occurs when two or more individuals show or feel honor or esteem toward one another. Trust occurs when an individual is confident in the actions of another individual. Conflict management involves​ addressing, containing, and resolving disagreements among team members in a constructive way. Effective communication involves sharing information and ideas both clearly and in a way that demonstrates respect and appreciation for other team members.

The nurse is caring for a client with rheumatoid arthritis who expresses the desire to remain active as long as possible. In order for the client to meet this goal, what should the nurse prepare to do? A. Provide referrals to other professionals who can help the client meet this goal B. Tell the client that activity limitations are inevitable with rheumatoid arthritis C. Teach the client about nutrition and joint exercises D. Ask the client about the reasons for this goal

A. Provide referrals to other professionals who can help the client meet this goal When a client expresses the desire to live as normally as​ possible, the nurse should refer the client to professionals who can help the client meet that goal. The nurse can provide the client with some teaching about nutrition and joint exercises but cannot go into the depth that this client would require. A client with a chronic disease should not be told there is no hope but should be helped toward reaching desired goals. Asking the client the reason for the desired goal is irrelevant to the situation.

A client with type 1 diabetes mellitus has developed an open sore on the shin and is having trouble meeting daily goals for exercise. The client is scheduled for discharge in a couple of days. When planning for this patient's continued care, who will the nurse notify regarding the client's postdischarge needs? A. The pharmacy B. The physical therapist C. The case manager D. The occupational therapist

C. The case manager The​ client's needs and progress have​ changed, so the nurse should contact the case manager to coordinate appropriate modifications in the​ client's postdischarge care plan. A physical therapist may be​ needed, but the nurse would best coordinate care by notifying the case manager. Based on the information​ presented, the pharmacy would not be a necessary part of the care team at this time. An occupational therapist mainly deals with upper body areas that require​ rehabilitation, and the client currently does not require such assistance.

A school-age client is admitted to the pediatric intensive care unit (PICU), unconscious and with multiple traumatic injuries, after a skateboard accident that included a closed head injury. Many health professionals are involved in the client's care, and the scene is chaotic. The client's parents are extremely anxious and want to know what is happening. The case manager asks for an interdisciplinary team meeting to speak with the client's parents. Which is the rationale for this meeting? A. To allow for each specialty to practice independently B. To allow the primary healthcare provider to make all decisions regarding the client's care C. To prevent the client's parents from trying to change the plan of care D. To share and evaluate information for care planning and implementation, and to prevent priority conflicts, redundancy, and omissions in care

D. To share and evaluate information for care planning and implementation, and to prevent priority conflicts, redundancy, and omissions in care Interdisciplinary collaboration engages each​ professional's contribution to joint care​ planning, implementation, and accomplishment of client​ goals, often with less​ redundancy, more​ efficiency, and fewer care omissions. The parents of a minor child should be involved in all aspects of care and decision making.

Nurses leaders in a local hospital created a neurotrauma (NT) unit healthcare team focused on improving outcomes for stroke clients. This team includes acute care nurses, physicians, other care partners (e.g., physical therapists, social workers, case managers, dietitians), and representatives from the NT outpatient clinic. The team is led by a physician who makes treatment decisions based on the treatment plans developed by individual team members who each communicate with the clients, asking the same or similar questions to obtain data needed for the treatment plan. Which type of communication and action is represented in this scenario? A. Co-management and referral B. Parallel functioning C. Coordination and consulation D. Information exchange E. Parallel communication

E. Parallel communication This team is using parallel communication. Parallel communication occurs when each professional communicates with the client independently and asks the same or similar questions. It represents the lowest level along the continuum of communication and collaboration among health team members. Parallel​ functioning, information​ exchange, coordination and​ consultation, and​ co-management and referral all represent higher levels on the continuum. Parallel functioning occurs when communication may be more​ coordinated, but each professional has separate interventions and a separate plan of care. Information exchange involves planned​ communication, but decision making is​ unilateral, involving​ little, if​ any, collegiality. Coordination and consultation represent midrange levels of collaboration seeking to maximize the efficiency of resources.​ Co-management and referral represent the upper levels of​ collaboration, in which providers retain responsibility and accountability for their own aspects of care and clients are directed to other providers when the problem is beyond the initial​ provider's expertise.

A community hospital wants to implement a labor-delivery-recovery-postpartum unit to replace the labor and delivery and mother/baby units. The nurses who work on the mother/baby unit are concerned that they will not be able to care for laboring mothers and may lose their jobs. The nurse manager for both units supports the plan for an integrated unit, reports that jobs will not be lost, and involves the team members in the planning process, which includes cross-training all nursing staff. Based on the information presented, what causes of conflict may occur despite the nurse manager's effort for a smooth transition? SATA A. Ambiguous role expectations B. Resistance to change C. Mistrust D. Ineffective leadership E. Miscommunication

B, C

The nurse is discussing follow-up care with a client who is being discharged. The client and his family cross their arms and state angrily that the care team's suggestions are not acceptable. Which response by the nurse is appropriate? A. "Perhaps you did not understand the recommendations" B. "Let's discuss other options that might work well for you and your family" C. "We only want what's best for you" D. "We will leave you alone to discuss your options"

B. "Let's discuss other options that might work well for you and your family" Major objectives of interdisciplinary collaborative practice include providing​ client-directed, client-centered​ care; improving client and family satisfaction with​ care; and promoting mutual​ respect, communication, and understanding between the client and members of the healthcare team. Of the choices listed​ here, the response that best supports achievement of these objectives is​ "Let's discuss other options that might work well for you and your​ family." Leaving the room might lead the client and family to feel abandoned by the healthcare team. Stating that the team​ "only wants what is​ best" sends the message that the client does not know what is​ best, when, in​ fact, a​ well-informed client does know what is best and should be able to make the correct choice. Suggesting that the client and family do not understand the recommendations may be interpreted as​ demeaning, even if it is true.

A nurse is discussing the plan of care with a client who is preparing for discharge. The client has a strong objection to portions of the plan of care. The nurse recognizes that there is a conflict. Which response by the nurse indicates an understanding of the client's position and a willingness to collaborate regarding the discharge plan? A. "I will ask your family to help convince you that this plan of care is best" B. "Let's talk about your objections and possible solutions or alternatives" C. "You are not being cooperative in your plan of care" D. "This plan of care was ordered by the physician"

B. "Let's talk about your objections and possible solutions or alternatives" The nurse attempts to resolve the conflict with the client by listening to the​ client's concerns and then negotiating with the client. This action helps build the​ client's trust in the medical team. Telling the client that these orders were made by the physician continues the conflict and brings the physician into it. The nurse would not want to include the​ client's family in the conflict and cause problems between family members. Telling a client that he or she is being uncooperative is likely to anger the client and cause further conflict.

A home health nurse is planning care for an adult client who is being discharged from the hospital after experiencing complications of diabetes mellitus. The client requires an extensive dressing change twice per day, help with activities of daily living, and comprehensive education. To ensure these needs are met, the nurse is coordinating home visits from aides and therapists. Which role is the nurse assuming by coordinating this client's care? A. Health promoter B. Case manager C. Client advocate D. Health educator

B. Case manager A case manager is responsible for ensuring that clients receive fiscally​ sound, appropriate care in the best setting. Part of the case​ manager's duties include identifying which services a client will require​ postdischarge, locating providers of these​ services, and coordinating visits from these providers. In this​ scenario, the home health nurse is assuming the role of case manager. Although the client requires​ education, the home health​ nurse's primary role is not that of health educator.​ Similarly, although case managers often engage in client advocacy and health promotion​ activities, these tasks account for just a portion of the​ nurse's duties in this scenario.

A staff nurse learns before reporting to work that a close family member has been diagnosed with terminal cancer. When receiving the shift report, the nurse finds that this family member has been assigned as a client. The nurse who cared for this individual on the outgoing shift states that the client is very demanding and complains a lot. Which action by the staff nurse who is assigned care for the oncoming shift is appropriate? A. Resolve to refrain from reacting negatively to the client B. Discuss the situation with the charge nurse C. Ask the healthcare provider to help control the client D. Tell the client to change the behavior

B. Discuss the situation with the charge nurse The best action to prevent conflict would be to explain the personal situation to the charge nurse and ask for a reassignment. The nurse can resolve to not react to the​ client, but the nurse should have the presence of mind to understand that the​ client's personal ability to cope is impaired. It would not be appropriate to confront the client at this time. The nurse should not ask anyone other than the charge nurse to intervene.

A nurse manager overhears two staff nurses talking about a third nurse, who has the day off. The two nurses are making unflattering comments regarding the third nurse in front of several other nurses who work on the unit. The nurse manager discreetly asks to speak to the two nurses in private and states, "This behavior isn't OK, especially in a hospital like ours with a 'zero-tolerance policy.' If you have an issue with another nurse, please deal with that nurse directly. If you'd like me to help you with this, please let me know, and the four of us can meet." The nurse manager's behavior modeled strategies for dealing with which type of workplace conflict? A. Sexual harrassment B. Horizontal violence C. Intrapersonal conflict D. Intergroup conflict

B. Horizontal violence In quietly and respectfully confronting the two nurses about their disparaging​ comments, the nurse manager modeled strategies for dealing with horizontal violence​ (HV). HV is a form of workplace bullying that involves aggressive acts committed against a nurse by one or more nursing colleagues. The​ director's positive steps to address HV included reminding the nurses about the​ hospital's "zero-tolerance" attitude toward​ bullying; demonstrating to the other nurses that she takes the issue of bullying​ seriously; and offering to help the nurses appropriately address with their colleague the behavior that prompted the disparaging comment. There is not enough information presented to know whether sexual harassment was an issue. Intrapersonal conflict refers to conflict within an​ individual, which is not necessarily evident in this scenario.​ Similarly, intergroup conflict involves conflict between teams that are in competition with each​ other, which is not the case in this scenario.

A case manager assembles a team of healthcare professionals, including a client's primary healthcare provider, physical therapist, and social worker, for the purpose of collaborative discharge planning and decision making. Which type of team did the case manager assemble? A. Interorganizational team B. Interdisciplinary team C. Intradisciplinary team D. Management team

B. Interdisciplinary team Interdisciplinary teams include professionals of varied backgrounds who share decision making. This is the type of team the case manager assembled. In​ comparison, an intradisciplinary team includes members of the same profession. An interorganizational team includes members from more than one​ organization, and the scenario​ doesn't mention whether multiple organizations are involved. A management team is an​ executive-level team that runs the​ day-to-day operations of a department or organization.

The nurse managers in a community hospital have been charged with reviewing the job descriptions of unlicensed assistive personnel (UAP), and they have questions about the delegation of certain client care activities to UAP by nurses. To which group, organization, or individual would the committee members direct their questions to obtain definitive answers about the parameters of nurse delegation to UAP? A. The American Nurses Association B. The state board of nursing C. The hospital's Chief Executive Officer D. The hospital's Chief Nursing Officer

B. The state board of nursing The parameters of nurse delegation to UAP are delineated by state boards of nursing and statutes contained in state administrative codes.

Which of the following is an example of covert conflict? A. Warning a client that inappropriate contact and comments will not be tolerated B. Telling a manager that you think she is being unnecessarily harsh C. Complaining to a friend about an assigned job task D. Yelling at a coworker who has insulted another coworker

C. Complaining to a friend about an assigned job task In covert​ conflict, the conflict is not discussed​ openly; it may be avoided or ignored. Covert conflict is exhibited in​ reactive, repressive, and avoidant behaviors. Complaining to a friend about a job task is an example of a reactive behavior that would qualify as covert conflict. All of the other answer options reflect overt​ conflict, in which the individuals or group members who are in conflict address the conflict openly.

The nurses in the emergency department (ED) and the staff nurses on the neurology unit are experiencing conflict. The ED nurses are not pleased with the amount of time it takes for the neurology unit's admitting nurse to receive face-to-face handoff communication for clients who are being admitted to that unit. Which type of conflict is being experienced by these nurses? A. Interpersonal conflict B. Interorganizational conflict C. Intergroup conflict D. Intrapersonal conflict

C. Intergroup conflict Because the conflict involves two teams of nurses from different​ units, it would be classified as intergroup conflict. This conflict is likely driven by each​ team's wish to provide quality care for its patients in a context of limited resources or lack of role clarity. Intrapersonal conflict describes stress or tension within the individual that results from real or perceived pressure associated with incompatible expectations. Interpersonal conflict is characterized by conflict between individuals​ (rather than service areas as in this​ situation). Interorganizational conflict typically involves competition between two organizations existing in one market.

Which of the following individuals would be included on an interdisciplinary healthcare team but not on an interprofessional healthcare team? A. Pharmacist B. Physical therapist C. Laboratory technologist D. Nurse practitioner

C. Laboratory technologist The term interprofessional usually refers to professionals from various​ disciplines, whereas the term interdisciplinary is often used to denote that paraprofessionals or others​ (such as clients or family​ members) are also included. Nurse​ practitioners, pharmacists, and physical therapists are all​ professionals, so they could be part of both interprofessional and interdisciplinary teams. In​ contrast, a laboratory technologist is considered a​ paraprofessional, so he or she would be part of an interdisciplinary team but not an interprofessional team.

In arranging community services for a client who is diagnosed with schizophrenia, the nurse case manager discusses options with the assertive community treatment (ACT) team. Which team disciplines should the nurse expect will be part of the client's ACT interdisciplinary team? A. Speech pathologists, occupational therapists, nurses, physicians B. Transportation providers, nurses, physicians, social workers C. Psychiatrists, nurses, social workers, employment counselors D. Teachers, school administrators, psychiatrists, nurses

C. Psychiatrists, nurses, social workers, employment counselors ACT provides mental health and support services in the community for individuals with serious mental​ illness, such as schizophrenia or bipolar​ disorder, to promote optimal functioning at home and within the community. Professionals participating in an individual​ client's care team may include​ psychiatrists, psychologists, social​ workers, pharmacists, advanced practice​ nurses, employment​ counselors, and peer support specialists. A client with schizophrenia would not require speech pathology​ remediation, occupational​ therapy, teacher​ assistance, or school administration intervention. Although transportation providers may be​ used, they would not be part of the ACT team.

A nurse who is caring for an adult client in the intensive care unit (ICU) is given a verbal prescription by a first-year medical resident. The nurse determines that the best course of action is to check with the attending healthcare provider before implementing the prescription. What is the most likely reason why the nurse is experiencing conflict regarding this situation? A. The resident seems unsure of the prescription B. The nurse does not like first-year residents C. The nurse may not trust the resident to make the best care decisions D. The nurse only takes prescription orders from attending healthcare providers

C. The nurse may not trust the resident to make the best care decisions This type of conflict is most likely related to a lack of trust in the resident on the part of the nurse. Nurses who work in critical care learn to validate orders given by residents because mistakes can take a​ client's life. The nurse may not like​ residents, but that is not a reason to question their orders. There is no evidence here that the resident is unsure of the order given. Residents can give​ orders, preferably​ written, but the nurse is wise to confirm the order with the managing physician.

Which of the following conflict-related communication styles involves attempting to satisfy the concerns of others while neglecting the self? A. Avoiding B. Competing C. Compromising D. Accommodating

D. Accommodating The five main styles of​ conflict-related communication are​ competing, collaborating,​ compromising, avoiding, and accommodating. Accommodating involves attempting to satisfy the concerns of others while neglecting the self. In​ comparison, competing is an​ assertive, power-oriented approach where one focuses on the​ self; collaborating is a cooperative approach that involves gaining insight to the perspectives of​ others; compromising is an approach where both parties are partially​ satisfied; and avoiding is refusing to address a conflict.

A nurse is working as the designated leader of a group of healthcare providers in a community clinic setting. The team members are working to decrease the number of adolescent pregnancies in the community. They have defined the problem and are now focusing on objectives and considering various viewpoints presented by the group. The nurse is tasked with helping the team stay focused in order to address the defined problem. Which of the competencies of collaboration does this describe? A. Trust B. Mutual respect C. Communication D. Decision making

D. Decision making Collaboration involves shared responsibility for decision making. The team must follow each step of the​ decision-making process, beginning with a clear definition of the problem. Team decision making must be directed at the objectives of the effort. It requires full consideration and respect for diverse​ viewpoints, and often guidance and direction from a group leader. Mutual respect occurs when two or more people show or feel honor or esteem toward one another. Trust occurs when an individual is confident in the actions of another individual. Communication occurs when two or more parties are committed to understanding each​ other's professional roles and appreciating each other as individuals. Although mutual​ respect, trust, and communication may indeed be part of this​ team's collaborative​ effort, the situation described here is most clearly illustrative of the competency of decision making.

The nurse is preparing for the discharge of a client who will require physical therapy (PT) for rehabilitation following a total knee replacement. After reading the healthcare provider's order for PT, what should the nurse do next? A. Teach the client's family the exercises that will be included in the client's PT regimen B. Call home health and schedule a therapist to visit the client's home for PT C. Set up outpatient appointments for the client with the hospital's PT department D. Inform the client about the settings in which PT may occur and have the client choose the venue

D. Inform the client about the settings in which PT may occur and have the client choose the venue Major objectives of interdisciplinary collaborative practice include providing​ client-directed, client-centered​ care; improving client and family satisfaction with​ care; and promoting mutual​ respect, communication, and understanding between the client and members of the healthcare team. Of the choices listed​ here, the option that best supports achievement of these objectives is informing the client about the settings in which PT may occur and having the client choose the desired venue. The nurse would not refer the client for outpatient therapy or schedule home PT unless the client specifically requested either form of therapy.​ Also, because the client requires therapy that must be performed by a professional physical​ therapist, providing teaching about exercises that will be included in the​ client's PT regimen encroaches on the expertise of another healthcare professional. OK

A group of nurses are in a staff meeting on a medical-surgical unit headed by the new unit nurse manager. The manager announces that nurses should not criticize and make fun of other nurses or there will be repercussions. Several nurses at the meeting suggest that the nurse manager talk to the individual nurses who are exhibiting this behavior. When assessing the staff's group dynamics, which action by the nurse manager is appropriate? A. Insist that this is an appropriate new policy B. Discipline the staff nurses who spoke out C. Request a transfer to another unit D. Recognize that the group already has defined behavioral norms

D. Recognize that the group already has defined behavioral norms Behavioral norms are established by a group or the leader of the group. In this​ case, the manager should recognize that the group does not see this as an issue because it has already established behavioral norms. The new manager should simply offer support for any nurse who is unable to resolve such interpersonal conflicts. Insisting on initiating the new policy could be harmful to the goals of the group as a whole. Rather than​ transfer, the manager could observe the dynamics of the group and adapt to the findings. Disciplining those who spoke out would negatively affect the cohesiveness of the entire group.