Leadership Marquis Modules

A nurse leader is performing a process audit. Which would be a consideration on a process audit? (Select all that apply.)

- Ensuring that machines are recalibrated according to department policy - Comparing a patient's medication order to the medications the patient has been taking - Checking the completeness of a patient's medical record

A nurse leader at a long-term care facility wants to determine if vital signs are being checked according to policy. What can the leader do to measure this process of care?

A process audit

A new nurse on a medical-surgical unit has an uncomfortable encounter with one of the RNs. Both the RN and the new nurse realize that the encounter was trivial and decide to ignore that it occurred. What type of conflict strategy management is being used?

Avoidance

A health care team has been challenged to determine what other facilities are doing to decrease the number of hospital-acquired infections so that an action plan can be created to decrease the rate in their facility. What will the health care team do to achieve this challenge?

Benchmarking

A nurse manager would like to determine how well the team is doing in terms of meeting the hospital's goal of increased patient satisfaction. What action should the manager take after determining best practices?

Capture when the team is and is not using best practices and the outcomes.

For a nurse leader, what is the optimal goal in resolving conflict between team members?

Create a win-win solution for all

How can the nurse manager best minimize the personal risk for legal liability?

Creating a work environment that prioritizes patient needs

An older adult patient fell out of bed 2 days after a hip replacement and had to return to surgery. What process should be done in order to prevent future negative outcomes such as this?

Critical event analysis

A nurse is tasked with performing an audit on patients in the long-term care facility who are developing pressure ulcers. After identifying the information relevant to the criteria, what is the nurse's next action?

Determine ways to collect data

A patient can give informed consent by verbalizing understanding prior to receiving a complete explanation of medical-surgical treatment options.

False

The American Nurses Association Code of Ethics is legally binding.

False

Which legal act gives patients the right to determine their desired end-of-life care?

Patient Self-Determination Act

Why is conflict an expected occurrence on a large medical-surgical unit? (Select all that apply.)

People who have different goals and People with different values

Quality control tools used by the nurse leader include which of the following?

Process audits and structure audits

Total quality management is referred to as continuous quality improvement and is used to meet the Healthy People Living 2020 goals.

TRUE

Conflict is needed to promote organizational growth.

True

The negotiation strategies mirror that of the nursing process.

True

A new charge nurse is leaving work each day feeling overwhelmed and not completing tasks. What kind of delegation error is the charge nurse making?

Underdelegating

When must you get expressed consent?

- Non emergency situations - Seek informed consent for the patient if not provided - Ensure the patient has received informed consent - Witness the patient signing the informed consent form

Which of the following creates the potential for successful delegation as emphasized by the National Council State Board of Nursing?

Effective communication

Nurse leaders need to understand that in order to be effective, the quality control process must be _______.

Ongoing

What is the role of the change agent?

Seeks to lead or create change

A nurse manager is implementing a quality control tool that is systematic and will allow the official examination of a record for patients with postoperative infections. What type of tool is the nurse manager using to collect and evaluate this data?

An audit

It is not imperative for nurse leaders to understand how to delegate to a diverse workforce because all health care workers receive similar training.

False

Negotiation closure ends with restating the final decision in order to assess individual understanding of the resolution.

False

A patient on a busy neurosurgical unit who just returned from surgery requires neurological checks every hour, but the nurse is too busy to do it and delegates this task to the unlicensed assistive personnel (UAP). What error in delegation has the nurse made?

Improper delegation

A nurse informs the nurse leader that it would be beneficial to delegate more to the UAP, but the nurse leader is reluctant to do so, stating, "Whenever I do, they always come back with so many questions. I need them to just do it!" What kind of delegation error is the nurse making?

Improperly delegating

What is the term used to identify the omission of doing something that a reasonable person would do, guided by the considerations that ordinarily regulate human affairs?

Negligence

A nurse leader is working in the ER when a patient presents with a deep head laceration requiring immediate suturing. The nurse leader went to the medical supply area for antibacterial ointments, gloves, and bandages. However, the nurse noticed that the medical supply cabinet was extremely disorganized, so it took much longer than it should have to find the necessary supplies. The next morning, the nurse leader began to ask team members if they had any input regarding the organization of the medical supplies, and then began to brainstorm a few different ideas, such as rearranging the supplies and relabeling items. What is the next stage of change the nurse leader should address?

Plan

A nurse can have his or her license revoked if he or she is providing patient care while under the influence of drugs or alcohol.

True

Workplace violence is decreasing among health care workers.

False

Which steps will help the nurse minimize the risk of nursing malpractice? (Select all that apply.)

- Attending relevant continuing education programs to upgrade clinical skills - Observing all facility policies and procedures when providing care - Maintaining liability insurance independent of that provided by the facility - Periodically reviewing the scope of practice for nurses

Elements that affect the nurse leader's ability to properly delegate to members of the diverse work force include which of the following?

Social organization

Who can give informed consent?

- A competent adult - A legal guardian or individual holding durable power of attorney - An emancipated or married minor - Mature minor - Parent of a minor child - Court order

Which situations are necessary components for malpractice to occur? (Select all that apply.)

- A direct connection between care given and injury must be present. - Foreseeability of harm must exist. - The practitioner has failed to meet a standard of care, also called a "breach of duty." - A standard of care must be in place whereby the provider has accepted duty for the patient.

When can you act on implied consent?

- Emergency situations - A physician states in progress notes, treatment is needed and in the patient's best interest - Usually must be validated by another physician

The diversity in current health care work force affects how each member approach specific assigned goals which influences completion of delegated tasks. This is thought to be related to the _____.

Differences in approach to tasks related to priority setting

Last month, two nursing units were merged to save on staffing costs. The nursing manager is now inquiring among the staff about how the change is working and if any barriers remain. What stage of change is this?

Integrate

Conflicts resulting from differing or contradictory beliefs among two or more individuals are known as _____.

Intergroup conflicts

The nurse leader should identify _____________ forces prior to attempting to implement change.

Restraining

It is important for nurse leaders to establish a trusting relationship with those involved in the change process.

True

Litigation is the process of bringing forth and trying a lawsuit.

True

What must the person fully comprehend before giving informed consent

- The procedure to be performed - The risks involved - Expected or desired outcomes - Expected complications or side effects - Alternative treatments that are available

As the nursing manager of a unit, which key steps should be performed before implementing a change effort? (Select all that apply.)

- Use a roadmap as a guide to complete the change. - Encourage input from team members who would be impacted by the change. - Investigate the magnitude and complexity of the intended change.

A nurse is planning to delegate tasks to members of a transcultural team. Which tasks would the nurse consider environmental control when delegating to these members? (Select all that apply.)

- Tasks that require imagination, vision, and strategic planning - Tasks with a degree of predictability requiring independent thinking to accomplish - Routine tasks that are done every day

The six aims for improving quality health care as directed by the Institute of Medicine include safe, effective, patient-centered, timely, efficient, and _____.

Equitable

The oncology unit has recently experienced a higher-than-normal patient census, which is requiring that nurses to pick up an additional patient. The hospital CFO has indicated that there are no additional funds available to hire additional full-time nurses. As such, the unit manager anticipates some behavioral responses by the stakeholders of change (the nursing staff) within the unfreezing phase. What are some possible behavioral responses? (Select all that apply.)

- Withdrawal - Anger - Discontentment

A nurse manager is attempting to ensure adequate resources are available in order to meet changing patient needs. What would be the best type of audit for the manager to perform?

A structure audit

The nurse manager on a busy unit that has recently been experiencing shift conflicts. As the staff can have different opinions on conflicts, what is the best first step to take to resolving conflict?

Assessing what factors are affecting the judgment of the people involved in the conflict

The nurse-manager of a surgical unit must hire travel RNs to work during busy times. Knowing that travel nurses typically receive higher hourly salaries as well as completion bonuses for the 13-week assignment, the manager anticipates regular staff will have animosity toward these nurses. The manager has a plan to allow the regular staff to have every weekend off (because part of the travel nurse's contract states that the nurse may be required to work each weekend during the contracted time frame). What type of conflict resolution strategy is the manager using?

Compromising

You are the nurse manager of a medical-surgical unit that is in need of a change in staffing rotation patterns, which will lead to major changes in how the unit is staffed. According to Lewin's Change Theory, what forces are in play to enact these changes?

Driving forces

A new nurse from a foreign country is training in the surgical unit. After working and meeting with the nurse, the charge nurse observes that there is a discomfort in making eye contact while speaking. What task would the charge nurse avoid delegating to this nurse?

Educating a patient and ensuring full understanding

Which of the following is considered a nursing leadership role with regard to quality control?

Embraces, supports, and champions the quality improvement process

_______________ developed a theory which included the stages unfreezing, movement, and refreezing.

Kurt Lewin

The nurse is the manager of a telemetry unit that is undergoing restructuring, resulting in the need for the nursing staff to accommodate both the telemetry unit and the medical rehab unit. Most of the staff on the telemetry unit have worked there for many years, and this change will create conflict. At what stage does this conflict exist?

Latent conflict stage

A nurse is to provide an in-service training on cultural factors that influence delegation and enhance nursing care. Which step to acquiring cultural competence does the nurse determine will involve learning how to read verbal and nonverbal messages?

Learning specific communication strategies

A nurse manager has a high turnover rate of assistant managers in the unit. The current assistant manager states to the manager, "I may not be the right fit for this position. I can't keep up with the amount of work and delegated tasks." What delegation error is the manager making?

Overdelegating

Two nurses were selected to learn about a new piece of technology that could improve the accuracy of patient assessments. This training was to be provided at a long distance from the hospital, and the nurses' employer could only afford travel expenses for one nurse. The hospital chose to send the nurse who had historically shown more proficiency in teaching others about new technology. This displeased the nurse who was not selected, who was then unfriendly to the nurse who was selected. What is the likely source of conflict between these nurses?

Professional competition

A nurse is struggling with time management and thinks it might help alleviate stress and strengthen leadership skills if some tasks are delegated to unlicensed assistive personnel (UAP). What would be important for the nurse to consider when delegating to UAP? (Select all that apply.)

Qualifications of the person who will carry out the task, What can and can't be delegated safely

An older adult patient recently had a hip replacement with an indwelling catheter inserted. The patient developed symptoms of a urinary tract infection (UTI) postoperatively, and the nurse placing the catheter was reeducated by the nurse leader regarding avoidance of UTIs when inserting catheters. Which quality approach did the nurse leader use?

Quality assurance techniques

In order to determine when not to delegate, the nurse needs an in-depth understanding of _____.

The nurse practice act

A nurse manager believes that the nursing unit is experiencing too little conflict. What signs within the organization would indicate that this is true?

The organization has become static.

The unit manager of a medical-surgical unit is transitioning the unit to electronic charting. According to Lewin's model, which of the following roles describes you as the change agent?

The unfreezer

Why should nurses be aware of the rights and duties of legal matters?

They are better able to protect themselves.

HIPAA gives the nurse leader a platform in which the nurse leader can prevent conflicts resulting from ineffective communication among staff members and patients.

True

A nurse leader wants to ensure that the team is always practicing proper hygiene after caring for a patient. A complaint was filed against a nurse for not washing the hands before examining a wound on a child's knee. What is the nurse leader's control criteria?

Whether the team is practicing proper hygiene

A nurse manager determines that a nurse on the team comes from a future-oriented culture. What task may be best delegated to this nurse?

Working on a strategic team plan for the unit

Which of the following are delegation errors made by nurse leaders? (Select all that apply.)

- Failure to provide adequate directions - Failure to provide clear directions - Failure to release control of task - Failure to delegate - Failure to follow up

A few months ago, a new nurse leader at a hospital discovered via evidence-based practice that tablet computers improved accuracy of documentation and decreased patient wait time. The leader noted that these outcomes are beneficial to the facility, staff, and patients, as tablets provide portable access to patient electronic medical records. The nurse leader is currently in the planning stage. Which activities are part of planning stage? (Select all that apply.)

- Anticipating resistance to the change by less tech-savvy staff. - Determining the scope of the change project, a schedule for its implementation, and a budget to submit to administration for approval.

A nursing staff member who is on a unit committee to bring about a planned change is currently in the integrating phase of change. What activities are associated with the integrating phase? (Select all that apply.)

- Assessing how well the new process is accepted and becoming the norm - Assessing how well the change is working against an established measurement for success

The Health Insurance Portability and Accountability Act ensures strong privacy protections for the patient without threatening access to which areas of care? (Select all that apply.)

- Health care plans - Exchange of patient information among appropriate health care providers - Health care clearinghouses

The charge nurse of a step-down unit is implementing a new procedure for charting, which will impact all of the nursing staff. According to Lewin's Model of Change, the "Movement stage" can be more successful if certain things are considered by the change agent. (Select all that apply.)

- Include all stakeholders - Implement the change - Set target dates

The nurse leader must be aware of barriers that can prevent effective mediation. These include which of the following? (Select all that apply.)

- Negative body language - Intimidation - Ridicule - Manipulation

A nurse manager must be aware of what is happening on the unit to prevent injury to the patient and exposing the staff to a potential malpractice situation. What steps would the nurse manager take to accomplish this? (Select all that apply.)

- Regularly checking the credentials of current nursing staff - Providing disciplining those who provide inappropriate care - Assuring adequate staffing - Arranging for relevant staff in-services regarding the operation of equipment

A single parent raising two children and relying on public transportation, is determined to become a registered nurse. What are the restraining forces in this situation? (Select all that apply.)

- Stress of being away from children - Being a single mother - Relying on public transportation

Change should be immediately implemented if the need for change has been identified.

False change should be implemented for an established reason; however, it should be gradual to prevent resistance

What are the focus areas of the To Err is Human recommendations? (Select all that apply.)

- Enhance leadership - Set performance standards for safety - Implement safety systems - Identify errors and provide solutions for prevention - Enhance knowledge

The unit manager of a medical-surgical unit undergoing restructuring changes realizes that to create a more controlled transition for your staff, it will be necessary to incorporate the conflict resolution strategy known as "smoothing". Smoothing is best defined as:

looking toward something that the parties in conflict are in agreement about.

A nurse is planning to delegate tasks to the transcultural team. What situation would be considered appropriate delegation to the team members?

- Delegating the interviewing of a reticent patient to a nurse who is outgoing and inquisitive as a result of her cultural tradition. - Giving a task that requires independent thinking to a nurse who believes in an internal locus of control as a result of her cultural tradition. - Holding a negative performance evaluation in private for a nurse whose cultural tradition puts emphasis on avoiding "losing face".

What must a person giving informed consent for surgery or a procedure fully comprehend in order to give informed consent? Select all that apply.

- Expected complications or potential side effects that may occur as a result of the treatment. - The risks involved - The procedure to be performed - Expected or desired outcomes

The nurse leader is a change agent and needs to identify factors that lead to resistance of change. Identify the factors of resistance. (Select all that apply.)

- Poor timing - Personal energy needed - Comfort with the current way of completing goals or tasks - Lack of trust

Which behaviors by a nurse can result in the suspension or revocation of the nursing license? (Select all that apply.)

- Practicing on an expired nursing license - A felony conviction for drug use - Being convicted of professional negligence - Failing to report an incident of substandard nursing care

A nurse manager is faced with a conflict situation. One of the nurse manager's team members is confused about their hospital responsibilities. This team member is shy and doesn't ask for direction, leading to a lack of communication that decreases the quality of patient care. What questions should the nurse manager ask to analyze the situation? (Select all that apply.)

- What individual factors are involved? - What environmental factors are involved? - Who are the people involved?

What information is accurate when describing the Nurse Practice Acts? (Select all that apply.)

- When considering the law, they are an example of a statute - They focus on the practice of the professional nurse - They identify actions that fall outside of the nurse's scope of practice - They need to be consistent with applicable federal statutes