Leadership Midterm
Culture is a concept that is best portrayed in nursing with which of the following statements? 1.Culture provides a common bond so members know how to relate to one another and what is valued. 2. A relationship-based nursing care model is used, which represents a belief in patient-centered care. 3.Culture is a multifaceted phenomenon, difficult to comprehend. 4.Culture is a set of values, beliefs, and assumptions that are shared by members of an organization.
2 (always patient-centered care people)
The nurse reports to work for the scheduled shift. The nurse manager tells the nurse to report to the emergency department today as a float nurse due to staffing shortages. The nurse has never worked in the emergency department. What is the best action by the nurse? 1. Refuse to float to the emergency department. 2. Call the supervisor to report the reassignment. 3. Clarify the reassignment with the nurse manager. 4. Check the policies and procedures regarding float assignments.
3 Rationale: (clarifying with the nurse manager can assess if this nurse meets the 5 rights of delegation) Right task. Right circumstance. Right person. Right supervision. Right direction and communication.
A 50-car pileup occurs on a major freeway in California's Central Valley as a result of heavy fog. There are major injuries, and victims are expected to be transported to local emergency departments. Which type of disaster is this classified as? a. Mass casualty event b. Conventional disaster c. Biological disaster d. Radiological disaster
A
A nurse triages clients arriving to the hospital after a mass casualty. What client is correctly classified? a. A 35 year old female with severe chest pain: red tag b. A 55 year old women with a minor scalp laceration: black tag c. A 88 year old man with severe chest pain and shortness of breath: yellow tag d. A 42 year old man with an open fracture and distal pulses: green tag
A
A patient who is not fully informed about his or her health status is an example of a violation of which ethical principle? a. Autonomy b. Justice c. Utilitarianism d. Confidentiality
A
All-hazards disaster is best defined as: a. all types of natural and human terrorist events. b. an event involving floods, tornadoes, hurricanes, and earthquakes. c. an unforeseen and often unplanned event causing great damage. d. any type of biological, chemical, radiological, or nuclear event.
A
Characteristics of a Magnet hospital include: a. multidisciplinary collaboration. b. nursing leader authority. c. physician control. d. social worker retention.
A
Conflict is a natural and inevitable outcome in any group or organization. Select the correct statement from the following statements. A. A defensive framework for conflict resolution includes winning some resources and losing others. B. To build effective interdisciplinary teams, conflict must be present, and managers must not interfere with conflict resolution. C. Conflict can be a positive force in a group, but conflict should be avoided most of the time in a group to get work done. D. Conflict arises when job descriptions are clear, policies and procedures are written, and uniform behaviors are fostered in an organization.
A
If an error occurs as a result of delegation, the nurse is accountable for supervision, follow-up, intervention, and: a. corrective action of the event. b. documentation of the event. c. evaluation of the process. d. summation of the occurrence.
A
Resolving conflict requires interventions. One type of intervention requires preparation and planning, ground rules, clarification and justification, bargaining and a closure with implementation. Which of the following is this type of conflict management? A. Negotiation B. Win-win strategy with problem solving C. Restrict or isolate the conflict D. Compromise
A
Team dynamics will need to be addressed to form an effective team. Select the best strategy to help address the challenges in forming effective teamwork. a. Set group norms on how team members treat each other, how support is demonstrated, how conflict is handled, and the decision-making process to help team members operate with disruptive behaviors. b. Lead group members through "just in time" training to work together to overcome lack of trust and commitment to the team. c. Organize appropriate representation and delegation of authority to the group to help team members avoid confusion about the team's work, accountability, and inattention to results. d. Keep the number of members in groups between 10 and 14, build a structural team, and coach the team to avoid conflict.
A
The nurse is caring for a postoperative client who reports pain. Based on recent evidence-based guidelines, which approach would be best? A. Multimodal strategies B. Standing orders by protocol C. Intravenous patient-controlled analgesia (PCA) D. Opioid dosage based on valid numerical scale
A
The nursing supervisor informs the staff that if they refuse to stay on the nursing unit and work an additional 8-hour shift, they will be reported to the state for patient abandonment. This type of power is known as: a. coercive. b. expert. c. legitimate. d. reward.
A
The organization and individuals engaged in scientific investigation using methods and variables that influence the rate and extent of adoption of practices to improve clinical services is known as: a. translation research. b. evidence-based practice. c. research utilization. d. best practice.
A
The postoperative patient with anterior cervical laminectomy is complaining of tightness in his throat. His voice is raspy. The staff nurse asks the unit secretary to page the healthcare provider stat. This is an example of _____ leadership. A. Authoritarian B. Democratic C. Laissez-faire D. Servant
A
Which of the following will positively influence the sustainability of a practice change? a. Audit and feedback of key indicators. b. Incremental implementation of practice changes. c. Adhering to a strict action plan for implementation. d. The new practice is much different from current practice.
A
______ is a personal quality that is admired in the person with referent power. a. Problem solving b. Authority c. Knowledge d. Coercive power
A
Organizational _____ affects the quality of nursing care and patient outcomes. a. culture b. climate c. fiscal stability d. case mix
A Organizational culture affects the quality of nursing care and patient outcomes. The manner in which staff perceives culture, manages boundaries, and translates values has an impact on patient care.
A staff nurse came in to work the 7 PM to 7 AM shift. She had met her friends for "happy hour" earlier in the evening. Her breath smells of alcohol. If this nurse is allowed to provide care for patients, she may be at risk for: a. maleficence. b. melange. c. nonmaleficence. d. nonmelange.
A (I loved this question)
What are the two major content dimensions of power? (Select all that apply) a. Influence b. Integrity c. Authority d. Dominance e. Control
A and C
Which ethical principle is violated when the RN tells the hospital accountant that the patient is HIV-positive? (Select all that apply.) a. Beneficence b. Veracity c. Confidentiality d. Autonomy e. Fidelity
A and C (Beneficence means "doing good for clients and providing benefit balanced against risk." The hospital accountant had no need to know; therefore, there was no benefit for the patient for him to be told)
Identify the statements about organizational culture that impact nursing practice. Select all that apply. A. Organizational culture affects the quality of nursing care and patient outcomes. B. Mission statements provide a view of strategic priorities for a nursing organization and work setting. C. Culture is developed over time with the shared values that guide members on how to problem solve and manage relationships. D. Organizational culture means there are hidden assumptions about care that should not be questioned. E. Organizational culture is easier to change than the climate within the organization.
A, B and C
Which of the following questions should be considered in the hospital analysis survey of clinical operations readiness in the event of a disaster? (Select all that apply). a. Does the facility have procedures in place to maximize staff safety in a disaster? b. Does the facility have procedures in place for use of PPE? c. Can the facility track patients until discharge or death while maintaining confidentiality? d. Does the facility have a lockdown plan in case of emergency? e. Does the facility have a mechanism of tracking costs associated with the event?
A, B and C
The charge nurse supervising a graduate nurse would need to intervene when the nurse violates health information privacy laws with which action? Select all that apply a. Accesses the medical record of a client not currently assigned, but previously cared for, to assess client improvement b. Advise a client's transport technician, "this client has metastatic breast cancer and must be moved very carefully due to fragile bones" c. Ask a client quietly "when were you diagnosed with diabetes?" during admission assessment in a semiprivate room with the privacy curtain in place between beds d. Explains the results of a client's diagnostic testing to the unit clerk who is organizing paperwork to be included in the client's medical record e. Writes a client's last name on a whiteboard hanging in the nurses' station on which scheduled procedures are logged
A, B and D
The hospital plays an important role in the community in the case of a disaster. What are some of the expected roles of the hospital? (Select all that apply.) a. Stockpiling emergency equipment b. Purchasing personal protective equipment (PPE) c. Providing additional security for the community d. Educating staff on all-hazards preparedness e. Providing emergency shelter to community members
A, B and D
What is the purpose of the Nurse Practice Act for any given state? Select all that apply. a. Define nursing for that state. b. Regulate nursing practice within the state. c. Set standards of care for the state. d. Differentiate practice by education. e. Set standards for nurse education programs.
A, B and D
What are the major roles of nursing leadership in disaster planning? (Select all that apply.) a. Providing clearly defined roles for staff nurses in a disaster situation b. Ensuring the synchronization of department plans c. Encouraging staff to stay at home in the event of a disaster to decrease confusion d. Ensuring that the community is synchronizing internal department plans in the event of a disaster e. Developing or refining the hospital's emergency operations plan.
A, B and E
What nursing actions could result in malpractice? Select all that apply. a. Reassessing a patient in restraints every 4 hours instead of every 2 hours as ordered. b. Forgets to complete a head to toe assessment on a newly admitted client. c. Does not administer a medication because the client's chart states an allergy to it. d. Questions a physician's order about a medication dose. e. Administers a parenteral medication to a combative client trying to harm others without a physician's order.
A, B and E
A unit manager is utilizing her staff as a resource for educational presentations. An RN in her unit has been requested to create a PowerPoint on delegation and supervision. What resources should she include for staff to obtain additional information on delegation and supervision? (Select all that apply.) a. State nurse practice act b. Organization's policies and procedures c. The Joint Commission (TJC) d. American Nurses Association (ANA) e. Board of Registered Nursing
A, B, D and E
The culture of patient care must transition from care that is driven by providers to care that is patient-centered and family-centered in which patient and family norms, values, and preferences are respected. This direction in health care services has been sited within: A. the Affordable Care Act (2009). B. The Future of Nursing: Leading Change, Advancing Health (2011). C. International Council of Nursing (ICN) Code of Ethics for Nurses (2012). D. the Institute of Medicine's Crossing the Quality Chasm (2001). E. National Healthcare Quality Report from the Agency for Healthcare Research and Quality (2002).
A, B, D and E (another evolve question idk if its relevant)
Which of the following traits describe a transactional leader? (Select all that apply.) A. Functions in a caregiver role. B. Surveys their followers' needs and sets goals for them. C. Uses charisma to produce greater effort in followers. D. Focuses on the maintenance and management of ongoing and routine work. E. Motivates followers to perform to their full potential.
A, B, and D (C and E are transformational leader traits)
Disadvantages of group decision making over individual decision making would include: Select all that apply. a. premature decisions. b. delayed decisions. c. individual domination. d. disruptive conflicts. e. timely tracking of outcomes
A, C and D
Empowerment for nurses may consist of three components. Which three of the following components may help nurses become empowered to use their power for better patient care? (Select all that apply) a. A state in which a nurse has assumed control over his or her own practice b. social relationship between two or more people c. A workplace that promotes opportunities for growth d. A nurse's sense of meaning as expressed in values and work role e. Interdependence of personnel
A, C and D
Which of the following behaviors build trust between leaders and employees in an organization? (Select all that apply.) A. Sharing relevant information B. Encouraging competition via winners and losers C. Reducing controls D. Meeting expectations E. Avoiding discussion of sensitive issues
A, C and D
Which actions should the nurse take during a tornado? Select all that apply a. Move beds away from windows b. Open doors to client rooms c. Close windows and curtains d. Relocate ambulatory clients from the hallway back to their rooms. e. Place blankets over patients who cannot get out of bed
A, C and E
Which of the following statements accurately describe the varying mechanisms of power? (Select all that apply) a. Connection power is based on the perception that the influencer has access to powerful people or groups. b. Legitimate power is based on fear. c. Expert power results from expertise, special skill, or knowledge. d. Information power refers to skill in making rational appeals. e. Referent power is based on admiration for a person.
A, C and E
The unlicensed assistive personnel (UAP) reports to the nurse that the client fell when trying to get back into bed. What nursing actions will the nurse complete to follow up? Select all that apply. a. Complete an assessment of the client. b. Reprimand the UAP for allowing the client to fall c. Collaborate the UAP to complete an incident report. d. Discuss the incident with the UAP as a teaching opportunity. e. Report the incident to the nurse manager.
A, C, D and E
Emergency Medical Services (EMS) brings a large number of clients into the emergency room following a mass casualty event. The nurse identifies the clients with which injuries with yellow tags? Select all that apply. A. Partial-thickness burns covering both legs B. Open fractures of both legs with absent pedal pulses C. Neck injury and numbness of both legs D. Small pieces of shrapnel embedded in both eyes E. Head injury and difficult to arouse F. Bruising and pain in the right lower abdomen
A, C, D and F
The nurse and an unlicensed nursing assistant are caring for an older adult client with a diagnosis of emphysema. Which nursing task could be delegated to the nursing assistant to improve oxygenation (Select all that apply). a. Elevating the head of the bed (HOB). b. Adjusting the flow of oxygen and turning it on. c. Teaching pursed lip breathing d. Providing rest periods when assisting the client to ambulate e. Assisting the client with morning care
A, D and E
A health care system's ability to rapidly expand beyond normal capacity to meet an increased demand for qualified personnel, beds, and medical care services in the event of a large-scale emergency or disaster is known as: a. acuity. b. surge capacity c. mass casualty d. natural disaster
B
A hospital nurse manager is involved in conflict management between two staff members. The process of collaborating occurs when: a. one person seeks to satisfy his/her own interests. b. both sides strive to meet the interests of both parties. c. a person chooses to withdraw from conflict. d. one party seeks to appease the other.
B
An emergency room anticipates an influx of injured clients from a large motor vehicle collision on a major freeway. Which client should the triage nurse send to the trauma staff for immediate intervention? a. A young adult male with a suspected closed head injury who has no respirations despite having his airway repositioned by the emergency medical team. b. An adult with a suspected intra abdominal bleed who was not breathing on arrival, but is currently responding since repositioning the airway. c. A teenager with a suspected fractured left leg whose respirations are 26 breaths/minute, capillary refill < 2 seconds, and who can follow simple commands. d. A young adult with a facial laceration that is controlled by pressure and whose respiratory rate, capillary refill, and ability to follow commands are all WNL.
B
Climate is best defined as the: a. health and well-being of the structure of a facility. b. perceptions that individuals have about an environment. c. style in which individuals treat each other. d. temperature in the nursing units of an institution.
B
Effective communication can best be described by which one of the following statements? a. The major part of any communication is the words that we say to others. b. Conversation that is clear, direct, straightforward, and offers frequent message transmission is most effective. c. To respond effectively to communication, place responsibility on others. d. Feedback should be used carefully and only when absolutely necessary, because it inhibits effective communication.
B
Group problem solving is known to be more effective over individual problem solving because of a larger knowledge and information base, increased acceptance of solutions, more approaches to a problem, lower economic costs, and the ability for: a. group development. b. individual expression. c. hierarchical bonding. d. organizational team building.
B
How is culture measured within an organization? a. Through the use of time-motion studies b. Through the use of quantitative instruments c. Through the use of qualitative instruments d. With a combination of qualitative and quantitative measures
B
Nurses derive much of their power from being: a. authority figures in emergent situations. b. central to the delivery of health care services. c. organized through public associations. d. the care coordinator of the health care team.
B
The Institute of Medicine (IOM) report, Crossing the Quality Chasm, was useful in describing the challenges related to moving from _____-centered to _____-centered care. a. patient; provider b. provider; patient c. patient; facility d. provider; financially
B
The charge nurse is following up with a staff nurse following a medication error. Which of the statements by the staff nurse could be the root cause for the error? a. "I checked the client's wristband and asked him to tell me his birthday before I administered the medications." b. "When I entered the room the client was on his way to the bathroom so I gave him his medications right away." c. "I doubled checked the medication dosage and route before I took the medication out of the package." d. "The client was NPO for a lab test so I held the medication until the test was completed."
B
The charge nurse us reviewing another nurse's documentation for a postoperative client who just returned to the unit following abdominal surgery with a general anesthetic. The nurse caring for the client documented that active bowel sounds were heard in all 4 quadrants. What is the most appropriate action by the charge nurse. a. Compliment the nurse on documenting a complete post-operative assessment. b. Question the nurse about hearing bowel sounds when assessing this client. c. Go into client's room and assess the client with a focus on an abdominal assessment. d. Do nothing and wait to see what the nurse documents the next time the client is assessed.
B
The definition of veracity is: a. being loyal and faithful to commitments and accountable for responsibilities. b. the norm of telling the truth and not intentionally deceiving or misleading clients. c. a prohibition of disclosure of information. d. a right of limited physical or informational inaccessibility.
B
The major responsibility for upholding patient care standards belongs to the: a. chief executive officer of the facility. b. nurse manager. c. on-call physician. d. staff nurse providing patient care.
B
The nurse is orienting a new graduate nurse to the unit. Reviewing the policies and procedures is included in the orientation. What statement by the nurse reinforces the importance of complying with the organization's policies and procedures? a. "Always refer to the policies and procedures as a reminder for how to do whatever task you are assigned." b. "If there is a legal question about a practice issue the policies and procedures serve as the standard of care." c. "the policies and procedures are a recipe for success to make sure we all do things the same way." d. "Administration develops the policies and procedures for us so that we are providing cost effective care."
B
The nurse manager is orienting a new nurse to the charge nurse role. What needs to be included in the orientation regarding delegation? a. When delegating to an LPN/LVN the nurse is also delegating accountability. b. The delegating nurse retains accountability for care delegated to non-RN staff. c. The LPN/LVN can re-delegate an assignment to unlicensed assistive personnel (UAP). d. The unlicensed assistive personnel (UAP) has the authority to refuse a delegation task.
B
The nurse on the quality improvement committee has asked the staff nurses on the unit to participate in evaluating the new protocol. What statement by the nurse describes the role of the staff nurses... a. "We will conducting a research project so each nurse will need to read the research proposal b. "Staff nurses on the unit will be implementing the new protocol and documenting your findings." c. "Each staff nurse will be responsible for identifying problems that would be barriers to implementation." The staff nurse will participating in collecting data for the research project not identifying barriers. d. "Once you have implemented the new protocol you will need to report to the committee." The staff nurse will document findings and responses.
B
The nursing leadership role once the all-hazards preparedness plan is completed is to: a. confirm that resources are allocated appropriately. b. ensure that every facility department understands their role is a disaster situation. c. establish goals for all-hazards preparedness. d. provide rewards for the committee's accomplishments.
B
Which amount of time is appropriate for a nurse to spend triaging each client during a mass casualty accident? a. Less than 10 seconds b. Less than 15 seconds c. Less than 30 seconds d. Less than 60 seconds
B
Which postoperative client is manifesting the most serious negative effect of inadequate pain management? A. Demonstrates continuous use of call bell related to unsatisfied needs and discomfort. B. Develops venous thromboembolism related to immobility cause by pain and discomfort. C. Refuses to participate in physical therapy because of fear of pain caused by exercises. D. Feels depressed about loss of function and hopeless about getting relief from pain.
B
A neighbor calls the emergency room nurse who is off- duty and at home to report "My son just fell out of a tree and his eyes are rolled back in his head. Please help me." What is the most appropriate action by the nurse? a. Immediately go to the neighbor's house to assess the boy. b. Call 911 before going over to assess the boy. c. Tell the mother that you are off duty and can't do anything. d. Tell the mother to call her primary health care provider.
B (The first thing the nurse should do is call 911 for emergency help. Once the nurse arrives on the scene, he/ she is obligated to stay until first responders arrive per the Good Samaritan Law)
The LPN reports to the nurse that the client's TPN infusion was inadvertently turned off 1 hour ago. In response to this finding, which statement to the LPN should be the nurse's priority? a. "Please check the client's respiratory rate" b. "Please check the client's blood sugar" c. "Please check the client's blood pressure" d. "Please check the client's level of consciousness"
B (stopping TPN can result in hypoglycemia)
The type of power exhibited when providing the opportunity for others to take responsibility and accountability for their work is: A. referent power. B. empowerment. C. expert power. D. legitimate power.
B Rationale: empowerment entails providing others the opportunity to take responsibility and accountability
A nurse on a medical-surgical floor has been asked to join a research committee. She agrees to this request because of her great admiration for the vice president of nursing. This is an example of _____ dimension of power. a. dependence b. relational c. subversive d. tactical
B Relational dimension of power is a property of a social relationship. Many classic definitions indicate that power has to do with relationships between two or more actors in which the behavior of one is affected by the other.
The nurse is working in a hospice facility for patients with acquired immunodeficiency syndrome (AIDS). The facility is staffed with LPNs and unlicensed assistive personnel (UAP). Which action will the nurse assign to the LPN? A. Assessing patients' nutritional needs and individualizing diet plans to improve nutrition B. Collecting data about the patients' responses to medications used for pain and anorexia. C. Developing UAP training programs about how to lower the risk for spreading infections. D. Assisting patient with personal hygiene and other activities of daily living as needed.
B (The collection of data used to evaluate the therapeutic and adverse effects of medications is included in LPN education and scope of practice. Assessment, planning, and developing teaching programs are more complex skills that require RN educations. Assistance with hygiene and activities od daily living should be delegate to the UAP)
A staff nurse frequently is providing positive comments to get the manager in a good mood before asking about additional vacation time. This influence tactic is known as: a. consultation. b. ingratiation. c. inspiration appeals. d. rational persuasion
B Ingratiation occurs when the agent uses praise, flattery, friendly behavior, or helpful behavior to get the target in a good mood or to think favorably of him or her before asking for something.
After receiving a change of shift report, in what order would the nurse assess the assigned clients? Prioritize in rank order. a. Elderly client with pneumonia being discharged to long-term care later today. b. Client with a white count of 14,000 cells/mm3 and a temperature of 102.8 degrees F. c. Adolescent client admitted for evaluation following a motor vehicle accident d. Confused elderly client with a urinary tract infection receiving IV antibiotics. e. Stable postoperative client who received pain medications about 30 minutes ago.
B > C > D > E > A
What are the two agencies that require all health care facilities to have detailed all-hazard preparedness plans? (Select two that are correct) a. Patient Protection and Affordable Care Act b. Health Insurance Portability and Accountability Act (HIPAA) c. The Joint Commission d. National Response Plan
B and C
A Middle Eastern man has just been diagnosed with terminal cancer. The family has asked the medical and nursing staff to keep this information from the patient because in their culture they are fearful of delivering bad news as it may cause the patient to give up hope. Which ethical principles and dilemmas might be faced by nursing staff? (Select all that apply.) a. Justice b. Autonomy c. Veracity d. Confidentiality
B and C (Autonomy refers to the rights of the patient to participate in decision making. Veracity refers to telling the truth. The nurses caring for the patient may feel that they are not being truthful about the treatment plan and decision-making process in this case)
The charge nurse is explaining to the new nurse the role of the licensed vocation/ practical nurse (LVN/LPN) on the acute care unit. What is included in the LVN/LPN's scope of practice? Select all that apply. a. Developing a plan of care for assigned clients. b. Administering routine medications to stable clients. c. Conducting client teaching d. Collecting subjective and objective data. e. Analyzing assessment data for decision making.
B and D
The nurse is planning an in-service for unlicensed assistive personnel regarding being effective team members. What content should the nurse include? Select all that apply. a. Respect for colleagues. b. identifying who agrees with you. c. Being open to others ideas. d. Communicating clearly. e. Avoid disagreeing with colleagues.
B and D
What are the consequences or outcomes of nurse empowerment? (Select all that apply.) a. Increased compensation and benefits b. Decreased burnout c. Decreased job strain d. Increased job satisfaction and work effectiveness e. Increased trust in the workplace
B, C and D
Why is an interdisciplinary, team-based approach essential in health care? (Select all that apply.) a. Reimbursement protocols and government regulations require them. b. Diverse team's enhanced ability to adapt to continuous or sudden change. c. A collective pool of thinking styles allows for greater exchange of information, ideas, and problem solving. d. Rapid information dissemination is most efficient with multidisciplinary teams. e. Engaging teams in this process allows for diverse points of view, creativity, and innovation.
B, C and E
Testing the all-hazards preparedness plan requires drilling to identify and work through problems. Which of the following are examples of internal drills that can be used to test specific departments and/or hospital responses? (Select all that apply.) a. Surge capacity drills b. Lockdown of hospital entrances c. Prioritization of police response to biological events d. Simulating decontamination processes e. Setting up the command center
B, D and E
A common source of conflict in nursing occurs when the nurse wants to perform patient teaching or counseling, but there are competing priorities and the nurse has inadequate time to spend with the patient. This type of conflict is related to: a. interpersonal conflict. b. intergroup conflict. c. intrapersonal conflict. d. intragroup conflict.
C
A nurse manager is talking to a new hire RN about the duty of care by the nurse to the client. She begins to read the minimum requirements that define an acceptable level of care. These requirements are best located in: a. Federal guidelines and regulations in the Care Standards Act of 2000 b. Nursing Social Policy Statement c. State nurse practice acts, standards published by nursing professional organizations and specialty practice groups, and/or a facility's policy and procedure manuals d. Published standards by the American Nursing Association
C
A patient who has received a kidney transplant has been admitted to the medical unit with acute rejection and is receiving IV cyclosporine and methylprednisolone. Which staff member is best to assign to care for this patient? A. RN who floated to the medical unit from the coronary care unit for the day. B. RN with 3 years of experience in the operating rom who is orienting to the medical unit. C. RN who has worked on the medical unit for 5 years and is working a double shift today. D. Newly graduate RN who needs experience with IV medication administration.
C
Culture is best defined as (the): a. deviation from the majority. b. differences in likes and dislikes. c. shared beliefs and values. d. similar views and opinions.
C
Evidence-based practice includes: a. collaborative practice dynamics between health care professionals. b. documentation of patient care as evidence of nursing practice. c. integration of research with clinical expertise and patient values. d. mutual goal setting and application in the clinical setting.
C
In a disaster, it is most important that the: a. clients are sent home quickly. b. medications and supplies are secure. c. nurses and their families feel safe. e. security department increases its workforce.
C
One mechanism that ensures autonomy in the nursing profession is the: a. American Nurses Association (ANA). b. Department of Health Professionals. c. Nursing Code of Ethics. d. Professional Regulatory Board.
C
The charge nurse, along with two registered nurses (RN), one practical nurse (PN), and one unlicensed assistive personnel (UAP), is working in an emergency department. What activity should be assigned to the UAP? a. Monitor a client with mid-sternal chest pain, nausea, and vomiting. b. Give instructions to the EMS about a patient being transferred to a nursing home. c. Transport a client diagnosed with septicemia to the medical unit. d. Obtain the history from a female client who presents in early labor.
C
The emergency department nurses receive a call that a tornado has hit locally resulting in numerous causalities. The victims will come to the ED. The nurse should take which initial action? a. Obtain additional supplies b. Prepare the triage room c. Activate the emergency response plan d. Call in additional staff
C
The five rights of delegation are right task, right circumstance, right person, right direction and communication, and right: a. interaction. b. outcome. c. supervision. d. time.
C
The nurse is planning assignments for the care of a group of clients. Which client would be a good assignment for an LPN/LVN? a. A client who is newly admitted with possible thrombophlebitis and is receiving IV heparin. b. A client with liver cirrhosis, severe ascites, and orthopnea. c. A client scheduled for repair of a fracture hip who has been placed in Buck's traction d. A client with suspected MI who is having shortness of breath
C
The nurse is the first responder after a tornado. Which victim should the nurse attend to first? a. A pregnant woman who is yelling, "My husband is not moving!" b. A young child who is screaming, "I want my mommy!" next to an adult family member c. A child who says, "My arm is bleeding so bad; it feels like it is going to fall off" d. A man who is crying because his wife is dead.
C
The nurse manager determines that communication style is contributing to problems with delegation on her unit. What tool is used to teach principles of communication, leadership, situation monitoring, and mutual support? a. American Nurses Association (ANA) b. Agency for Healthcare Quality and Research (AHRQ) c. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) d. Institute for Healthcare Improvement (IHI)
C
The nurse notes that an advance directive is in the client's medical record. Which of the following statements represents the best description of guidelines a nurse would follow in this case? a. A durable power of attorney for health care is invoked only when the client has a terminal condition or is in a persistent vegetative state b. A living will allows an appointed person to make health care decisions when the client is in an incapacitated state. c. A living will is invoked only when the client has a terminal condition or is in a persistent vegetative state. d. The client cannot make changes in the advance directive once the client is admitted into the hospital.
C
The nurse who works on night shift enters the medication room and finds a coworker inserting a needle into her arm (yikes). What is the most appropriate action by the nurse? a. Call security b. Call the police c. Call the nursing supervisor d. Lock the coworker in the medication room until help is obtained
C
What does RACE stand for? a. Rescue Assess Call Extinguish b. Report Assess Call Explore c. Rescue Alert Contain Extinguish d. Run Alert Call Explore
C
What is a wrongful act committed against another person or organization or their property that causes harm and can be remedied by a civil lawsuit? a. Malpractice b. Legal liability c. Tort d. Negligence
C
What is the role of the nurse manager/leader during a code blue emergency? a. Initiating CPR b. Distribute code cart supplies and operate/monitor defibrillator c. Communicate with family, contact appropriate personnel, arrange patient transfer d. Direct the overall resuscitative efforts
C
Which pediatric client requires immediate intervention by the nurse? a. A 2-year-old with a twenty-four hour urinary output of 500 ml. b. A 3-year-old with several episodes of nocturnal enuresis. c. A 4-year-old with an easily palpable bladder and frequency. d. A 5-year-old with diuresis following furosemide (Lasix) administration.
C
The most common source of legal liability for nurse managers is a(n): a. medical malpractice suit. b. organizational nursing issue. c. tort. d. vicarious liability.
C (In nursing, harm related to clinical practice commonly arises from negligent acts or omissions (unintentional torts) and a variety of intentional acts (intentional torts), such as invasion of privacy or assault and battery.)
A primary care provider's orders indicated that a surgical consent form needs to be signed. Since the nurse was not present when the primary care provider discussed the surgical procedure, which statement "best" illustrates the nurse fulfilling the client advocate role? a. "The doctor has asked that you sign the consent form." b. "Do you have any questions about the procedure?" c. "What were you told about the procedure you are going to have?" d. "Remember that you can change your mind and cancel the procedure."
C (be the pts advocate)
You are the nurse manager in the burn unit. Which pt is best to assign to an RN who has floated from the oncology unit? a. 23-year-old who has just been admitted with burns over 30% of the body after a warehouse fire b. 36-year-old who requires discharge teaching about nutrition and wound care after having skin grafts c. 45-year-old with infected with partial thickness back and chest burns who has a dressing change schedule d. 57-year-old with full thickness burns on both arms who needs assistance in positioning hand splints
C (an oncology nurse would be familiar with dressing changes of this nature and aseptic technique)
_______ is being loyal and faithful to commitments and accountable for responsibilities. a. Autonomy b. Veracity c. Fidelity d. Values
C (stay loyal homies)
The nurse is preparing assignments for the day shift. It is most important that the client with which diagnosis and description is assigned to a registered nurse? a. Menorrhagia: 24 hours post vaginal hysterectomy. b. Myocardial Infarction: 4-days post infarction, transferred from ICU yesterday. c. Depression: Admitted during the night, following a suicide attempt with an overdose of Tylenol. d. Pneumonia: A 4-year-old who is receiving IV antibiotics.
C (the type of communication needed here is beyond the scope of the LPN or UAP)
The unlicensed assistive personnel (UAP) reports morning vital signs to the primary nurse. Which client should the nurse assess first? a. The client who is diagnosed with myxedema with a temperature of 96.8 F. b. one-day postoperative abdominal surgery with a pulse of 104 beats/minute. b. diagnosed with hypertension and has a blood pressure of 154/94 mm Hg. c. diagnosed with pneumonia and has a respiratory rate of 26 breaths/minute.
C (think ABCs)
When the charge nurse is making assignments, which tasks can be assigned to an unlicensed assistive personnel (UAP)? a. Perform a dressing change, oral suctioning, and admission of a client to the unit. b. Time contractions, determine fetal heart rate, and administer an enema to a client in early labor. c. Take vital signs, give a cleansing enema, and apply soft restraints to an older client. d. Irrigate a nasogastric tube, collect a stool specimen, and measure intake and output.
C (this is all in the UAPs scope of practice)
A new RN is observed breaking sterile technique by the perioperative nurse. This is an example of a violation of which ethical principle? a. Autonomy b. Justice c. Nonmaleficence d. Confidentiality
C (we are to "do no harm" and this could lead to a harmful outcome)
The role of the _____ is to provide leadership and direction for all aspects of nursing services with a focus on integrating the system and building a culture. A. nurse manager B. care provider C. nurse executive D. senior leader
C Rationale: The nurse executive's role and functions concentrate on long-term administration of an institution or program that delivers nursing services, focusing on integrating the system and building a culture
Leadership is best defined as: A. an interpersonal process of participating by encouraging fellowship. B. delegation of authority and responsibility and the coordination of activities. C. inspiring people to accomplish goals through support and confidence building. D. the integration of resources through planning, organizing, and directing.
C (important one, if he doesn't ask this, hands will be thrown)
A charge nurse in the cardiovascular intensive care unit (CVICU) is making shift assignments. There is a new graduate nurse (GN) on the floor. What assignment would be best for the new GN? a. A 45-year-old admitted with shortness of breath (SOB), Sa02 in the 60's in the ER, congestive heart failure (CHF) exacerbation on Bumex. b. A 50-year-old man who had a myocardial infarction (MI), BP 203/102, in and out of ventricular tachycardia (VT); ordered an amiodarone, and nipride drips, along with insertion of an arterial line. c. A 60-year-old man who has been off mechanical intubation for 3 days and needs a 24-hour urine. d. A 65-year-old woman who has failure to thrive, low blood pressure (80/60), weighs 91 lbs., and has been ordered a Swan Ganz catheter.
C (most stable)
Which is a perceived antagonistic process at the individual-organization level of interaction that affects productivity, morale, and teamwork in organizations? A. Interpersonal conflict B. Organizational conflict C. Job conflict D. Social conflict
C (this was an evolve question, idk how relevant it is)
Quality and Safety Education for Nurses (QSEN) was initiated to accomplish which of the following? A. Implementing patient-centered care, teamwork, and collaboration that support quality improvement, safety, and informatics on nursing units B. Gearing toward nurses who have been practicing 20 years and need new competencies through continuing education C. Creating nursing curriculum that emphasizes evidence-based practices, quality improvement, safety, and informatics D. Preparing future nurses with the knowledge, skills, and attitudes necessary to continuously improve the quality and safety of the healthcare system E. Guiding nursing education and continuous education requirements for maintaining nursing licensure across states
C and D
Betty is making the pt assignments for the next shift. On her unit, there are 2 RNs, 1 LPN, and 2 UAPs. Which pts will you assign to the LPN? Select all that apply. a. 68-year-old male pt who is expected to be d/c home with IV ATB therapy b. 25-year-old female pt newly admitted with DKA c. 75-year-old male pt with dementia who has an ileostomy and scheduled tube feedings d. 65-year-old female pt who has an order to remove a foley catheter
C and D (the most stable and require routine care that an LPN can do)
Nurses must use which of these to facilitate change in health care organizations? (Select all that apply) a. Actualization b. Authorization c. Influence d. Ratification e. Power
C and E
Nurses must use which of these to facilitate change in health care organizations? (Select all that apply.) a. Actualization b. Authorization c. Influenced. d. Ratification e. Power
C and E
Work group disruption has been shown to be linked to negative outcomes. What are some factors that can contribute to work group disruptions? (Select all that apply.) a. Budget constraints b. Multidisciplinary attendance c. Reorganization d. Absenteeism e. Turnover
C, D and E Work groups can be disrupted by factors such as downsizing, reorganization, absenteeism, and turnover.
A multidisciplinary committee meets monthly to discuss medication safety issues within the acute care areas. The quality director consistently arrives late for meetings and spends her time in the meeting answering e-mails on her smart phone. What type of disruptive behavior does this exhibit? a. Compulsive talker b. Interrupter c. Squasher d. Unreliable
D
A patient with human immunodeficiency virus (HIV) who has been started on antiretroviral therapy is seen in the clinical for follow-up. Which test will be best to monitor when determining the response to therapy? A. CD4 level B. Complete blood count C. Total lymphocyte percent D. Viral load
D
A temporary group of individuals formed to carry out a specific mission or project is known as a: a. club. b. group. c. meeting. d. task force.
D
After the change of shift, you are assigned the following patients. Which patient should you assess first? a.A 60-year old patient on a ventilator who needs a sterile sputum specimen sent to the lab. b. A 70-year old patient with pneumonia who needs to be started on IV antibiotics. c. A 55-year old with COPD and a pulse oximetry reading from the previous shift of 90%. d. A 50-year old with asthma who complains of shortness of breath after using a bronchodilator.
D
An emergency department (ED) charge nurse prepares to receive clients from a mass casualty within the community. What is the role of this nurse during the event? a. Ask ED staff to discharge clients from the medical-surgical units in order to make room for critically injured victims. b. Call additional medical-surgical and critical care nursing staff to come to the hospital to assist when victims are brought in. c. Inform the incident commander at the mass casualty scene about how many victims may be handled by the ED. d. Direct medical-surgical and critical care nurses to assist with clients currently in the ED while emergency staff prepare to receive the mass casualty victims.
D
Climate is often confused with culture. Which statement best describes aspects of climate? A. Culture is the perceptions of the work environment, and climate is the personality of the organization. B. Climate is the shared beliefs, values, and assumptions that exist in an organization. C. Climate enhances the stability of a social system, and culture is the voice of the organization. D. Culture and climate can both be measured.
D
Interpersonal communication is defined as: a. the conscious intent by one individual to modify the thoughts or behaviors of others. b. a combination of written and spoken communication. c. a theory used to describe a manner of communicating. d. communication between two or more individuals involving face-to-face interaction.
D
Leaders who give and take exchanges aimed at resolving issues are doing which of the following? a. Bargaining b. Effective communication c. Persuasion d. Negotiation
D
Nursing management is defined as: a. delegation of authority and responsibility and the coordination of tasks. b. the integration of resources through planning, organizing, and directing. c. the process of influencing patients to accomplish goals. d. the coordination and integration of nursing resources by applying the management process to accomplish nursing care and service goals and objectives.
D
Personal conflict can arise when trying to ingratiate another person because there is the use of: A. influencing an individual or group to gain a scarce resource. B. providing a pay raise, promotion, or advancement. D. threats, discipline, or negative consequences. D. lavishing praise on another to make him or her feel important to gain favor.
D
Team building is the process of _____ a group. a. forming b. identifying c. organizing d. unifying
D
The nurse is caring for 4 clients on an orthopedic floor: 2 clients with total hip replacements, one client with total knee replacement, and one client with a fractured femur who is in skeletal traction. Which nursing task should the nurse delegate to the unlicensed assistive personnel (UAP)? a. Adjust the setting on the continuous passive motion machine (CPM). b. Clean the skeletal traction insertion sites while performing a.m. care. c. Assist the client to ambulate for the first time after surgery. d. Change the linens for the client with skeletal traction.
D
When determining that delegation of an element of patient care needs to occur, the nurse delegates with a clear, concise description of the task, including its objectives, limits, and expectations. The nurse allows the delegate to clarify without fear of repercussion. Which of the five rights of delegation is being demonstrated? a. Right task b. Right circumstance c. Right person d. Right direction/communication
D
When the group decision-making procedure is that the entire group decides, whether by a two-thirds vote, simple majority, consensus, or some other process, this is known as: a. delegated decision procedure. b. autocratic decision procedure. c. consultative decision procedure. d. joint decision making. Answer: D
D
When working with the community, recognizable nomenclature is important for: a. response b. education c. reporting d. communication
D
A team has formed to determine which methods have worked best and which factors influence the implementation of an evidence-based practice program. This is known as _____ research. a. authoritarian b. autocratic c. transformational d. translational
D Translational research includes testing the effect of interventions aimed at promoting the rate and extent of adoption of evidence-based practices by nurses, physicians, and other health care providers and describing organizational, unit, and individual variables that affect the use of evidence in clinical and operational decision making.
A communication system developed originally to address communication patterns in critical situations is: a. VERA framework. b. NVC model. c. crucial conversations. d. TeamSTEPPS.
D teamSTEPPS includes SBAR
As charge nurse, you are making assignments for the day shift. Which pt would you assign to the nurse who was floated from the post-anesthesia care unit (PACU) for the day? a. 36-year-old with osteomyelitis who needs teaching before hyperbaric oxygen therapy b. 63-year-old with osteomalacia who is being d/c'ed to a long-term care facility c. 69-year-old with osteoporosis given a new orthotic device whose knowledge of its use must be assessed d. 73-year-old with Paget disease who has just returned from surgery for total knee replacement
D (PACU nurse is knowledgable about post-op patients)
A nursing manager is leading a recruitment and retention committee. She manages in a laissez-faire style. Her co-leader is a staff nurse who is very detail oriented. The nurse manager usually leads the meetings. During the meeting, the staff nurse frequently needs to interject information that has not been presented. She also creates the agenda and communicates information with other team members. This scenario depicts which type of conflict? a. Competitive b. Disruptive c. Organizational d. Task
D (Task conflict is an awareness of differences in viewpoints and opinions pertaining to a group task)
A collection of individuals who are led by a strong, clearly focused leader and who come together to share information and ideas and possibly make decisions is known as a: a. committee. b. pseudoteam. c. team. d. work group.
D A collection of individuals who are led by a strong, clearly focused leader and who come together to share information to make decisions is known as a work USNT O group. In a work group, there is little or no collective accountability.
A well-known talk show host presents information to a congressional committee to garner support for cancer research. This type of power refers to _____ power. a. coercive b. expert c. legitimate d. referent
D Referent power is based on admiration for a person who has desirable resources or personal traits.
A nursing manager is leading a recruitment and retention committee. She manages in a laissez-faire style. Her co-leader is a staff nurse who is very detail oriented. The nurse manager usually leads the meetings. During the meeting, the staff nurse frequently needs to interject information that has not been presented. She also creates the agenda and communicates information with other team members. This scenario depicts which type of conflict? a. Competitive b. Disruptive c. Organizational d. Task
D Task conflict is an awareness of differences in viewpoints and opinions pertaining to a group task.
Which ethical principle is violated when there are insufficient community resources to meet the needs of low-income families? a. Nonmaleficence b. Autonomy c. Beneficence d. Justice
D (Justice is the norm of being fair and giving all equal treatment. When low-income families do not get the same community resources as others, justice is not being served)
You are initiating a nursing care plan for a pt with osteoporosis. All of these nursing interventions apply to the nursing diagnosis "Risk for Falls." Which intervention should you delegate to the UAP? a. Identifying environmental factors that increase risk for falls b. Monitoring gait, balance, and fatigue level with ambulation c. Collaborating with the physical therapist d. Assisting pt to the bathroom
D (UAPs can assist with ADLs)
You have just received a nursing report from the previous shift and you are performing your morning patient assessments. You have a total of 4 patients that are either post- op or pre- op for surgery. Which assessment finding requires further nursing action? a. Orange- colored urine in a patient who is taking pyridium and is post- op day 3 from a TURP. b. No stool excretion in a patient who is post- op day 2 from a colostomy. c. Shoulder pain in a patient who is post- op day 1 from a laparoscopic cholecystectomy. d. Pain rating that has decreased from a 10 to a 0 in a patient who is awaiting an appendectomy.
D (this is an emergency, patient will go into shock if not treated)
Paige is a nurse preceptor who is working with a new nurse, Joyce. She notes that Joyce is reluctant to delegate tasks to members of the care team. Paige recognizes that this reluctance is most likely due to: a. Role modeling behaviors of the preceptor b. The philosophy of the new nurse's school of nursing c. The orientation provided to the new nurse d. Lack of trust in the members of the healthcare team
D (this is common because we still hold the responsibility of each task we delegate)
A registered nurse (RN) is caring for several clients on a progressive care "step-down" unit. After assessing the clients, which clerical task should the nurse assign to a unlicensed assistive personnel (UAP)? a. Chart pulse oximeter readings and type of breath sounds auscultated in the medical record. b. Record the presence of blood-tinged urine and the hourly Foley output on the flow sheet. c. Document the type and amount of drainage on a new surgical dressing in the progress note. d. Transcribe the vital signs from a unit worksheet to the individual graphic page in the client charts.
D (within the UAPs scope of practice)
A group of people arrived at the emergency unit by a private car with complaints of periorbital swelling, cough, and tightness in the throat. There is a strong odor emanating from their clothes. They report exposure to a "gas bomb" that was set off in the house. What is the priority action? A. Instruct personnel to don personal protective equipment B. Direct the clients to the cold or clean zone for immediate treatment C. Immediately remove other clients and visitors from the area D. Measure vital signs and auscultate lung sounds E. Direct the clients to the decontamination area
E
Which color tag should be given to "walking wounded" clients according to the disaster triage tag system? a. Red b. Black c. Green d. Yellow
G
