N450 HESI

Which important consideration of the delegator is applicable to the "selling" in Hersey's model? 1 Delegatee requires explanation. 2 Delegatee requires more guidance. 3 Delegatee requires mutual expectations. 4 Delegatee requires conditions for performance.

1 A delegatee who is termed as sell requires explanation. More guidance is required for a delegatee who is termed as tell. Mutual expectations are required for a delegatee who is termed as participate. Conditions for performance are required for a delegatee who is termed as participate.

The registered nurse (RN) delegates the unlicensed nursing personnel (UNP) to check blood oxygen saturation levels every 6 hours and to report the results. Which activity is the RN performing in this situation? 1 Active delegation 2 Passive delegation 3 Individual accountability 4 Organizational accountability

1 Active delegation by the RN helps him or her assess the situation and determine what is appropriate for client care. The RN must direct the UNP to check the oxygen saturation and record it and to hold the UNP accountable. Functions that are normally performed by a licensed individual are called passive delegations. Individual accountability is a component of delegation that refers to individuals' abilities to explain their actions and results. Making appropriate decisions depends on how well the organization provides adequate resources and is called organizational accountability.

Which is the minimum number of disaster drills the hospital disaster plan committee must plan and implement each year? 1 Two 2 Three 3 Four 4 Five

1 Although it is appropriate to have more than the minimum number of disaster drills each year, the minimum that must be implemented per The Joint Commission (TJC) requirements is twice per calendar year.

Which component of delegation is the ability to perform duties in a specific role? 1 Authority 2 Responsibility 3 Accountability 4 Legal authority

1 Authority is the ability to perform duties in a specific role. Responsibility refers to reliability, dependability, and obligation to accomplish work. Accountability determines whether a person's actions are appropriate and provides a detailed explanation of what occurred. Legal authority is the ability to transfer selected nursing activities in a given situation to a competent individual.

Which noninvasive assessment and management skills certification would the nurse be required to use for airway maintenance and cardiopulmonary resuscitation (CPR)? 1 Basic Life Support (BLS) 2 Certified Emergency Nurse (CEN) 3 Advanced Cardiac Life Support (ACLS) 4 Pediatric Advanced Life Support (PALS)

1 BLS is the certification for emergency nursing that includes assessment and management skills for airway maintenance and CPR. CEN is emergency nursing certification that validates the core emergency nursing knowledge base. ACLS involves invasive airway management skills, pharmacology, electrical therapies, and special resuscitation. PALS involves neonatal and pediatric resuscitation.

Which responsibility of the nurse manager differs from the responsibilities of the nurse leader? 1 Planning the budget 2 Motivating the team 3 Resolving conflicts 4 Penalizing for poor performance

1 Budgeting is the responsibility of the nurse manager. The role of the nurse leader is to motivate the nursing subordinates. Resolving conflicts is the responsibility of both the nurse leader and the nurse manager. Penalizing for poor performance is a behavior of transactional leadership.

Which triage level would the nurse assign to the 60-year-old client is admitted with a head injury after a disaster? 1 Urgent 2 Emergent 3 Expectant 4 Nonurgent

1 Clients with major injuries such as head or cervical injuries should be assigned urgent triage. Emergent should be assigned to clients with immediate life-threatening conditions such as airway obstruction. Expectant is assigned to clients who are dead or are expected to die. Nonurgent should be assigned to clients with minor injuries such as closed fractures or abrasions.

Which description by the nurse is a correct explanation of delegation? 1 The transfer of responsibility for the performance of an activity 2 The person's responsibility and accountability for individual actions or omissions 3 The active process of directing, guiding, and influencing the outcome of an individual 4 The transfer of both the accountability and responsibility from one person to another

1 Delegation is the transfer of responsibility for the performance of an activity. Personal liability defines each person's responsibility and accountability for individual actions or omissions. Supervision is defined as the active process of directing, guiding, and influencing the outcome of an individual. Assignment is the transfer of both the accountability and the responsibility from one person to another.

Which strategy of the nurse leader regarding the quality improvement (QI) process requires revising? 1 The focus is on correcting errors. 2 The task includes staff development. 3 The leader involves the interprofessional team. 4 Outcomes are set with input from clients and staff.

1 The QI process focuses mainly on preventing errors rather than correcting them. The task of the QI process includes staff development. The team of the QI process involves the interprofessional team and the outcomes are set with the input of clients and the staff.

Which member of the health care team is accountable for initial assessment and ongoing evaluation of client care? 1 Registered nurse (RN) 2 Licensed practical nurse (LPN) 3 Primary health care provider 4 Unlicensed nursing personnel (UNP)

1 The RN is accountable for the initial assessment and ongoing evaluation of the client. An LPN is not accountable for the initial assessment and ongoing evaluation of the client. The primary health care provider is accountable for diagnosing the problem and reviewing the client responses. The UNP perform the tasks delegated by the RN or other delegators.

Which health care team member acts as a delegator in the absence of the registered nurse (RN)? 1 Charge nurse 2 Patient care associate 3 Licensed practical nurse (LPN) 4 Unlicensed nursing personnel (UNP)

1 The charge nurse acts as a delegator based on his or her knowledge and experience in clinical settings. In the absence of an RN, the charge nurse usually delegates the tasks. A patient care associate assists and monitors vital signs. LPNs and UNP are considered delegatees due to insufficient experience and training.

During the delegation process, which health care professional acts as a liaison between the team leader and health care providers? 1 Charge nurse 2 Nurse manager 3 Nursing supervisor 4 Chief nursing officer

1 The charge nurse is responsible for acting as a liaison between the team leader and health care providers. The nurse manager cannot act as a liaison between the team leader and other health care providers because the nurse manager is often responsible for more than one unit and has other managerial responsibilities. The nursing supervisor will be delegated to supervise and ensure effective outcomes for the tasks delegated to the delegatees. The chief nursing officer is responsible for establishing the systems for assessment.

Which intervention will the nurse manager and the critical incident stress management team encourage when debriefing nurses after a mass casualty incident (MCI)? 1 Sharing feelings 2 Discussing errors 3 Providing respite 4 Organizing volunteers

1 The critical incident stress management unit works with employees after a disaster to allow members to share and validate feelings. This allows staff to process the incident and begin to heal, as well as minimize the incidence of posttraumatic stress disorder. Errors are not discussed, and respite is not provided during these meetings. Volunteers are organized during the disaster.

Which health care professional would the nurse know is held accountable for the tasks performed by the patient care associate (PCA)? 1 Registered nurse (RN) 2 Licensed vocational nurse (LVN) 3 Unlicensed assistive personnel (UAP) 4 Unlicensed nursing practitioner (UNP)

1 The delegator is held accountable for tasks performed by the delegatee. In this situation, the delegator is the RN; therefore the RN is held accountable for the tasks performed by the PCA. The RN is also accountable for delegation to LVNs, UAPs, and UNPs as delegatees.

While conducting triage under mass casualty conditions, which tag would the nurse use for a client who is experiencing hypovolemic shock due to a penetrating wound? 1 Red 2 Black 3 Green 4 Yellow

1 The nurse would use a red tag for a client who has injuries that are an immediate threat to life, such as hypovolemic shock, during mass casualty conditions. A black tag is used for a client who is expected to die and allowed to die. A green tag is used for a client with minor injuries that do not require immediate treatment. A yellow tag is used for a client who has major injuries requiring treatment.

Which functions would the medical command physician perform with respect to the emergency preparedness and response plan for clients after a natural disaster? Select all that apply. One, some, or all responses may be correct. 1 Anticipates the number of clients 2 Checks the resource needs for clients 3 Monitors and implements the emergency response plan 4 Evaluates each client to determine priorities for treatment 5 Serves as a liaison between the health care facility and the media

1,2 A medical command physician anticipates the number of clients and assesses client needs as part of emergency preparedness and response plan. The hospital incident commander monitors and implements the emergency response plan. A triage officer evaluates each client to determine priorities for treatment. A community relations or public information officer serves as a liaison between the health care facility and the media.

Which biological agents of terrorism can be treated effectively with antibiotics? Select all that apply. One, some, or all responses may be correct. 1 Plague 2 Anthrax 3 Botulism 4 Smallpox 5 Tularemia

1,2,5 Anthrax, plague, and tularemia are treated effectively with antibiotics if sufficient supplies are available and the organisms are not resistant. Botulism is treated with antitoxin, though several vaccines are being studied. Smallpox can be prevented or the incidence reduced by vaccination, even when first given after exposure.

Which characteristics of the licensed practical nurse (LPN) would be considered before delegation of tasks? Select all that apply. One, some, or all responses may be correct. 1 Critical thinking 2 Effective client care 3 Diagnostic reasoning 4 Synthesizing information 5 Accountability of assigned task

1,3,4 Critical thinking, diagnostic reasoning, and the ability to synthesize information from various sources are three factors that are characteristics of the LPN that should be considered before delegating tasks. Planning effective client care is the role of a registered nurse (RN). Accountability for an assigned task is the responsibility of the nurse.

Before delegating tasks to unlicensed assistive personnel (UAP), the nurse is assessing their level of readiness. According to Hersey's model of situational leadership, which specific factors reflect the level of readiness? Select all that apply. One, some, or all responses may be correct. 1 Ability 2 Honesty 3 Reliability 4 Willingness 5 Conscientiousness

1,4 Ability and willingness are two factors that determine the level of readiness according to Hersey's model. Honesty and reliability may not determine the readiness of the UAP to perform a delegated task. Conscientiousness is the desire to complete a task, which may not determine readiness if the UAP does not have sufficient knowledge to perform the task.

Which questions would the delegator assess to determine the right task? Select all that apply. One, some, or all responses may be correct. 1 "Is the task legally appropriate to delegate?" 2 "Is the environment conducive to completing the task safely?" 3 "Does the delegator provide clear and concise directions for the task?" 4 "Is the task appropriate to delegate based on institutional policies and procedures?" 5 "Does the delegatee have the knowledge and experience to perform the specific task safely?"

1,4 The delegator has to determine right task by assessing whether the task is legally appropriate to delegate. The delegator must also check that the task is appropriate to delegate based on institutional policies and procedures. The right circumstance can be assessed by asking, "Is the environment conducive to completing the task safely?" The right direction and communication is assessed by asking, "Does the delegator provide clear and concise directions for the task?" The right person eligible to accomplish the task is assessed by asking, "Does the delegatee have the knowledge and experience to perform the specific task safely?"

The registered nurse (RN) delegates the care of a client in the immediate postoperative period to the patient care associate (PCA). Which tasks are in the scope of practice of the PCA? Select all that apply. One, some, or all responses may be correct. 1 Feeding the client 2 Ambulating the client for the first time 3 Monitoring the vital signs 4 Assisting the client with bathing 5 Teaching leg exercises to the client

1,4 The tasks that may be delegated to the PCA for postoperative client care include providing basic comfort and hygiene. Feeding the client is basic care provided by the PCA. Assisting the client with bathing is the basic hygiene provided by the PCA. Primary ambulation of a postoperative client should be done by the RN or another licensed practitioner. The PCA can monitor vital signs for stable clients but would not be delegated the task of monitoring vital signs for a postoperative client. Primary teaching of leg exercises to the client should be done by the RN.

Which statements are related to a mentorship program organized by the nurse manager in a health organization? Select all that apply. One, some, or all responses may be correct. 1 It expands the knowledge about cultural diversity. 2 It involves learning about the care of different ethnic groups. 3 It evaluates organizational policies that can hinder various cultural practices. 4 It involves selection of mentors who ascribe to transcultural values and beliefs. 5 It should not make people of different cultures pattern their behavior after the prevailing culture.

1,4,5 Mentorship programs are established to expand knowledge of cultural diversity among staff. For these programs, the nurse managers select mentors who ascribe to transcultural values and beliefs. These programs address the staff's cultural diversity and do not try to make people of different cultures pattern their behavior after the prevailing culture. Continuing education programs help in teaching about the care of different ethnic groups. Evaluating the organizational policies that can hinder various cultural practices is one of the techniques for managing multicultural clients in end-of-life care in a long-term care facility.

Appropriate delegation in a health care organization achieves which outcomes? Select all that apply. One, some, or all responses may be correct. 1 Reduces stress 2 Decreases trust 3 Reduces client care 4 Decreases time efficiency 5 Improves treatment outcomes

1,5 Delegation requires empowerment of the delegatee to accomplish the task, and sharing functions reduces stress. As functions are distributed, treatment outcomes improve. Appropriate delegation builds trust between the delegator and delegatees, increases client care, and improves time efficiency.

Which initiatives for leaders and managers are set forth in the National Academy of Medicine's core relevance report "The Future of Nursing?" Select all that apply. One, some, or all responses may be correct. 1 Create state coalitions focused on nursing 2 Reinforce the disparities that occur within health care 3 Support the concept of shared governance in nursing 4 Focus on outcomes, accreditation processes, and nurses' roles 5 Provide a framework for considering how nurses could determine staffing requirements

1,5 The core relevance report "The Future of Nursing" created state coalitions focused on nursing and provided a framework for considering how nurses could determine staffing requirements. The core relevance report "Crossing the Quality Chasm" reinforced the disparities that occur within health care. The concept of shared governance was supported by the core relevance report "Keeping Patients Safe." The focus on outcomes and accreditation processes and nurses' roles is developed by the core relevance emphasis on membership-based organization related to quality measurement and reporting from the National Quality Forum.

Clients in which class are given a yellow tag according to the disaster triage tag system? 1 Class I 2 Class II 3 Class III 4 Class IV

2 Class II clients may have major injuries. Though they have major injuries, they can wait a short time for treatment. They are issued a yellow tag according to the disaster triage tag system. Class III clients are nonurgent clients with minor injuries that do not require immediate treatment. Thus they are given green tags. Class I clients are emergent clients. They require immediate treatment and are identified with red tags. Class IV clients are expected to die and they are issued black tags.

Which high-level cognitive process would the nurse recognize can be improved with practice in delegation? 1 Creativity 2 Critical thinking 3 Problem-solving 4 Decision-making

2 Critical thinking is a high-level cognitive process that can be improved by practice. Creativity is essential for the generation of options or solutions. Problem-solving mainly focuses on resolving an issue. Decision-making is a purposeful and goal-directed effort that uses a systematic process to choose among options.

Who would the nurse contact to receive training as a Community Emergency Response Team (CERT) member? 1 National Disaster Life Support Foundation 2 Federal Emergency Management Agency (FEMA) 3 Centers for Disease Control and Prevention (CDC) 4 Centers for Medicare and Medicaid Services (CMS)

2 FEMA provides CERT training. The National Disaster Life Support Foundation offers core, basic, and advanced disaster life support training courses. The CDC and CMS do not provide disaster preparedness training.

Which type of trauma center would the nurse consider to be most appropriate for a client who survived an accidental fire and has multiple injuries? 1 Level I 2 Level II 3 Level III 4 Level IV

2 Level II trauma centers provide care to the most injured clients. Level III trauma centers stabilize clients with multiple injuries. Level I trauma centers provide a full continuum of trauma services for all clients. Level IV provides advanced life support and basic trauma client stabilization.

Which task is achieved by the delegator when engaging in self-care to enhance his or her ability to care for the health care team? 1 Managing 2 Renewing 3 Explaining 4 Motivating

2 Renewing is the task achieved by the delegator when engaging in self-care to enhance his or her ability to care for the health care team. Managing is achieved when the delegator assists the staff in planning, priority setting, and decision-making. Explaining occurs when the delegator teaches and interprets information for client well-being. Motivating is achieved when the delegator inspires the staff to fulfill a mission.

Which medical relief team would the nurse explain provides relief services ranging from primary health care and triage to evacuation and staffing to assist health care facilities in a massive disaster? 1 Medical Reserve Corps (MRC) 2 Disaster Medical Assistance Team (DMAT) 3 Hospital Incident Command System (HICS) 4 International Medical-Surgical Response Teams (IMSRTs)

2 The DMAT is a team of civilian, medical, and paraprofessionals who are deployed to a disaster area. They provide relief services ranging from primary health care and triage to evacuation and staffing to assist health care facilities in a massive disaster. The MRC is a group of volunteer medical and public health care professionals. The MRC helps health care settings that face personnel shortages in a mass casualty event. The HICS is a facility-level organizational model to homogenize disaster operations. The IMSRTs provide fully functional field surgical facilities in a mass casualty event whenever needed.

Which is the role of the nurse executive as a leader? 1 Orientation 2 Empowerment 3 Employee selection 4 Financial accountability

2 The role of the nurse executive as the leader is to empower followers or to share the authority with the followers by asking them to actively participate in the given task. Orientation of the employee, employee selection, and financial accountability indicate the roles of the nurse manager as leader.

In providing effective nursing care to clients from different cultural backgrounds, which strategy would the nurse follow? 1 Advise clients that some cultural practices may be harmful to health. 2 Provide care that fits the clients' cultural beliefs. 3 Strictly adhere to organization policies regarding nursing care. 4 Ignore the cultural aspect and focus on the medical aspect of care.

2 When providing care to clients from different cultural backgrounds, nurses would be careful to provide care that fits the client's cultural beliefs. It helps provide effective nursing care to the satisfaction of the client. Advising clients against their cultural practices may offend them and should be avoided. Organization policies should be made flexible to incorporate cultural aspects of care. Ignoring the cultural aspect of client care may result in ineffective nursing care.

Which injuries would likely be given a green tag after a disaster? Select all that apply. One, some, or all responses may be correct. 1 Shock 2 Strains 3 Sprains 4 Abrasions 5 Airway obstruction

2,3,4 According to the disaster triage tag system, green tags are applied to clients with strains, sprains, and abrasions. Clients with shock and airway obstruction are marked with red tags according to the disaster triage tag system.

The nurse is told that the nursing model is a team nursing approach. The nurse determines that which scenario is a characteristic of the term-based model of nursing practice? 1. Each staff member is assigned a specific task for a group of clients 2. A staff member assigned to determine the client's needs at home and begin discharge planning 3. A single RN is responsible for providing care to a group of 6 clients with the aid of an AP 4. An RN leads 2 LPNs and 3 APs in providing care to a group of 12 clients

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The nurse leader is planning to provide information about personal hygiene to a group of clients. Which communication methods would the nurse use to talk to the clients? Select all that apply. One, some, or all responses may be correct. 1 Giving abundant information 2 Being sensitive to nonverbal communication 3 Providing the opportunity for dialogue and feedback 4 Presenting information that addresses the listener's self-interest 5 Using primarily written methods, such as email and text messages

2,3,4 The nurse would be sensitive to nonverbal communication because it may require interpretation of key points in complex situations. The nurse would provide the opportunity for dialogue and feedback. The nurse would present information that addresses the listener's self-interest. The nurse would plan the message and would not give too much information, which will paralyze the listener and divert energy away from key responsibilities. The nurse would use face-to-face communication as the primary communication mechanism rather than email or texting.

Which actions can the mentor take to develop effective leadership qualities in the aspiring leader? Select all that apply. One, some, or all responses may be correct. 1 Avoiding criticism 2 Modeling behavior 3 Noting the mistakes 4 Giving timely feedback 5 Providing appropriate advice

2,4,5 The mentor would model professional and desired behavior and give timely feedback and appropriate advice to make the aspiring leader an effective leader. The mentor would not criticize, but rather coach the new aspiring leader to develop a personal leadership style. Noting the mistakes without feedback does not help an aspiring leader become an effective leader.

The registered nurse is planning client assignments for the day. Which is the most appropriate assignment for an AP? 1. A client requiring a colostomy irrigation 2. A client receiving continuous tube feedings 3. A client who requires urine specimen collections 4. A client with difficulty swallowing foods and liquids

3

Which certification would the emergency nursing staff member possess to perform defibrillation or cardioversion and special resuscitation for clients who sustained injuries in a tsunami? 1 Basic Life Support (BLS) 2 Certified Emergency Nurse (CEN) 3 Advanced Cardiac Life Support (ACLS) 4 Pediatric Advanced Life Support (PALS)

3 ACLS certification allows nurses to perform electrical therapies, special resuscitation, and invasive airway management. BLS certification is granted when the nurse performs airway maintenance or cardiopulmonary resuscitation. CEN certification indicates that the nurse has core emergency nursing skill and knowledge. PALS certification is needed to perform neonatal and pediatric resuscitation.

Which action, if performed by the nurse, is inappropriate while caring for different clients after a disaster? 1 Teaching and supervising volunteers 2 Providing on-site first aid and emergency care 3 Evacuating injured and uninjured people from a danger area 4 Teaching clients about procedures that are needed for safety

3 After a disaster, evacuating the injured and uninjured people from the danger area and placing them in a safer place is done by firefighters and other disaster-trained emergency personnel. The nurse would not perform this action because they are not provided with specific rescue training. The nurse would teach and supervise volunteers to effectively perform during disasters. The nurse would provide on-site first aid treatment to the clients. The nurse would also perform the emergency care at the disaster site. Teaching the client about safety measures at home is appropriate.

Which statement by the nurse is true regarding the disaster triage tag system? 1 Class IV clients are issued a red tag. 2 Class III clients are given a black tag. 3 Class II clients are marked with a yellow tag. 4 Class I clients are identified with a green tag.

3 Class II clients who can wait for a short time for care are marked with a yellow tag. Class IV clients who are expected to die or are dead are issued a black tag. Class III clients who require nonurgent care or "walking wounded" are given a green tag. Class I clients who require emergency care are identified with a red tag.

Which would the registered nurse say is the priority action of first responders after a community disaster? 1 Providing on-site first aid 2 Providing emergency care 3 Removing the victims from danger 4 Categorizing victims using triage system

3 First-responders in a disaster include other disaster-trained emergency personnel who had specific search and rescue training. The priority action of first responders is to remove injured and uninjured victims. The nursing staff provides on-site first aid and emergency care. After removing victims from danger, the health care personnel categorize victims using the triage system.

Which activity would the nurse manager complete during an emergency event when acting as the triage officer according to the Hospital Incident Command System (HICS)? Select all that apply. One, some, or all responses may be correct. 1 Facilitating client movement through the system 2 Bringing in personnel and supply resources to meet needs 3 Rapidly evaluating each person who comes to the hospital 4 Identifying the need for and call in specialty providers 5 Determining numbers, acuity, and medical resource needs of clients arriving at the hospital

3 In the role of triage officer, the nurse would rapidly evaluate each person who comes to the hospital, including those triaged in the field. The hospital incident commander facilitates client movement through the system and brings in personnel and resources to meet needs. The medical command physician identifies the need for and calls in needed specialty providers and determines the number, acuity, and medical resource needs of clients arriving at the hospital.

Which theory states that leaders act as change catalysts and innovators? 1 Role theory 2 Trait theory 3 Quantum theory 4 McGregor's Theory X

3 Quantum theory states that leaders must embrace uncertainty and understand behaviors before changing them. Quantum leaders represent change catalysts and innovators. Role theory is a collection of concepts that predict circumstances under which certain types of behaviors are expected. Trait theory is a leadership theory in which leadership traits such as a certain set of physical and emotional characteristics are innate and cannot be learned. McGregor's Theory X describes the workforce motivation by assuming that people basically do not like their work and must be coerced by their manager to perform.

While delegating a specific task, the registered nurse says to the delegatee, "It is important that you measure the client's blood pressure every 15 minutes." Which does this situation indicate? 1 The delegatee requires little guidance. 2 The delegator is providing explanation. 3 The delegator is providing more guidance. 4 The delegator and delegatee are creating mutual expectations.

3 Telling the delegatee that it is important to take the client's blood pressure every 15 minutes indicates that the delegatee has limited knowledge and the delegator is providing guidance. Telling a delegatee that he or she knows what to do and when to report would indicate that the delegatee requires little guidance. Telling the delegatee an explanation about what is needed to accomplish a task indicates that the delegator is providing guidance to the delegatee. If the delegator and delegatee share mutual experiences, it indicates that the delegator and delegatee are creating mutual expectations.

Who undertakes the responsibility of identifying the need for and calling of different specialty-trained providers to care for clients in a disaster? 1 Triage officer 2 Public information officer 3 Medical command physician 4 Hospital incident commander

3 The medical command physician focuses on determining the number, acuity, and medical resource needs available for the clients in a disaster event. They are responsible for identifying the need for and calling specialty-trained providers to care for clients in the hospital. The triage officer reevaluates the acuity for appropriate disposition within the hospital best suited to meet the client's medical needs. The public information officer serves as a liaison between the health care facility and the media. The hospital incident commander's role is to take a global view of the entire situation and facilitate client movement through the system.

The registered nurse (RN) is caring for a client with severe diarrhea. Which part of the client care plan can be delegated safely to unlicensed assistive personnel (UAP) by the RN? 1 Administration of oral antidiarrheal 2 Administration of intravenous antibiotics 3 Administration of oral replacement fluids 4 Administration of intravenous antiemetics

3 The scope of practice of the UAP is limited to performing basic care, feeding, and hygiene. Administering oral replacement fluids can be performed safely by the UAP, because it is a basic task that may be included under feeding. Administering oral medications such as antidiarrheal medications can be delegated safely to a licensed practical nurse or licensed vocational nurse according to guidelines. Administering intravenous medication such as antibiotics or antiemetics is the role of the RN.

Which colored tag has the nurse correctly identified while classifying triage care in mass casualty conditions? 1 Urgent-red tag 2 Expectant-white tag 3 Nonurgent-green tag 4 Emergent-yellow tag

3 When any triage is required in mass casualty conditions, the health care team would classify the clients according to the situation. Nonurgent clients are class III who have minor injuries that do not require immediate treatment and are tagged with a green color. Urgent or class II clients are those who have major injuries that require treatment and are tagged with a yellow color. Expectant or class IV are tagged with a black color. These clients will not receive immediate attention because they are either dead or are expected to die. Emergent or class I clients are those who will receive immediate care due to their life-threatening condition and are tagged with a red color.

The nurse leader is a member of the human resource committee. Which role task would this support? 1 The nurse is engaging in malpractice. 2 The nurse is pursuing higher education. 3 The nurse is staying clear on group outcomes. 4 The nurse is thinking only about personal needs.

3 When the nurse participates as a leader in any leadership opportunities such as on human resource committees, it indicates that she or he is staying clear on group outcomes. Participating on human resource committees does not indicate any involvement in malpractice. Active participation on human resource committees does not indicate pursuing a higher degree. Participating on human resource committees indicates that the nurse is thinking beyond her or his personal needs.

Which qualities would the professional nurse require to lead and manage a team? Select all that apply. One, some, or all responses may be correct. 1 Being insensitive 2 Impeding relationships 3 Exercising self-awareness 4 Motivating self and others 5 Managing emotions in self and others

3,4,5 Managing emotions, such as fear, anxiety, and anger, and responding to those feelings in a healthy manner, as well as avoiding passive-aggressive behavior, are traits that the nurse would require to manage a team. The nurse would have the desire to deepen self-awareness and encourage others to do the same to follow in a team. Motivating or inspiring self and others toward a goal is another quality that the nurse would have to lead a team. The nurse would be empathetic and able to reveal others' perspectives in a situation. Fostering and handling relationships is another one of the abilities the nurse would have when leading and managing a team.

The nurse employed in an emergency department is assigned to triage clients coming to the ED for treatment on the evening shift. The nurse should assign priority to which client? 1. A client complaining of muscle aches, a headache, and a history of seizures 2. A client who twisted her ankle when rollerblading and is requesting medication for pain 3. A client with a minor laceration on the index finger sustained while cutting an eggplant 4. A client with chest pain who stated he just ate pizza that was made with spicy sauce

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The nurse is assigned to care for four clients. In planning client rounds, which client should the nurse assess first? 1. A postoperative client preparing for discharge with a new medication 2. A client requiring daily dressing changes of a recent surgical incision 3. a client scheduled for a chest x-ray after insertion of a nasogastric tube 4. A client with asthma who requested a breathing treatment during the previous shift.

4

After assigning a specific task, the registered nurse observes that the delegatee is unable to perform the task accurately. Which statement made by the registered nurse is appropriate? 1 "It's better if I do the work myself." 2 "We will do the task some other time." 3 "You can't do even this work properly." 4 "Just follow my steps and you can do it."

4 Delegation is a complex process of sharing activities among team members. If a team member is not competent to perform a given task, the registered nurse lowers expectations and helps the delegatee accomplish the task. The appropriate statement of the registered nurse in this situation is to follow his or her example to do the work, because this provides encouragement. If the registered nurse says that it is better for him or her to do the work, it increases time and affects the process of delegation. If the registered nurse says to accomplish the task some other time, it affects the quality of client care. If the registered nurse says to the delegate that he or she cannot do the work properly, it is a verbal attack, which may undermine their relationship.

Which individual would be given "dependent status"? 1 Unit secretary 2 Nurse manager 3 Registered nurse (RN) 4 Licensed practical nurse (LPN)

4 LPNs who work under the direction of a RN or primary health care provider have dependent status. The unit secretary does not have legal recognition. The nurse manager is answerable to the designated delegator. The RN as a delegator assigns the work to LPNs.

Which aspect of client tracking using radiofrequency technology (RFT) would the nurse recognize as a major safety strategy of the emergency department (ED) after a disaster to prevent potentially hazardous consequences in the hospital? 1 Location of client 2 Process of client care 3 Triage priority upon arrival 4 Interactions between client and caregiver

4 Potentially disastrous consequences can occur in the hospital if the client is a potential carrier of the biological, nuclear, or chemical contaminants from the disaster site or if the client is suffering from any communicable diseases. Once clients are in the triage area of the hospital, their interactions with caregivers are tracked using RFT. The location of the client and the process of client care can also be tracked with the help of these automated tracking systems, but these are not as important for preventing potential disastrous consequences. RFT also helps in tracking the triage priority of the client upon arrival to the hospital from the site of disaster.

Which effect is seen in clients exposed to sarin? 1 Acute radiation syndrome 2 Paralysis of cardiac muscles 3 Burns and blisters on the skin 4 Paralysis of respiratory muscles

4 Sarin is a highly toxic nerve gas that can cause death within minutes of exposure. It acts by paralyzing the respiratory muscles. Acute radiation syndrome is caused by a substantial exposure to ionizing radiation; sarin is unrelated to ionizing radiation. Sarin causes paralysis of respiratory muscles, not cardiac muscles. Burns and blisters on the skin are caused by mustard gas.

Which is most likely to be the core body temperature of the hypothermic victim brought to the emergency department in whom shivering is diminished or absent? 1 104°F (40°C) 2 95°F (35°C) 3 89.6°F (32°C) 4 82.4°F (28°C)

4 Severe hypothermia occurs at core body temperatures equal to or below 86°F (30°C). At a body temperature of 82.4°F (28°C), the client would be severely hypothermic; this state is likely to be characterized by diminished or absent shivering. At a body temperature 104°F (40°C), the client would be hyperthermic. At body temperatures of 95°F (35°C) and 89.6°F (32°C), clients would have mild and moderate hypothermia, respectively. Both mild and moderate hypothermia are likely to be characterized by shivering.

The registered nurse (RN) is organizing a community health care program for administering tetanus vaccinations. Which member of the health care team is most suitable for being delegated the task of administering vaccinations? 1 Nursing aide 2 Certified technician 3 Patient care associate (PCA) 4 Licensed practical nurse (LPN)

4 Tetanus vaccination is administered through the intramuscular route. The LPN can administer oral, topical, and intramuscular medications, except for intravenous. The nursing aide, certified technician, and PCA are unlicensed assistive personnel (UAP) whose scope of practice is limited for administering medications.

Which emergency medical service agency offers service for a group of clients admitted to the emergency unit with mass fatalities? 1 Medical Reserve Corps (MRC) 2 Hospital Incident Command System (HICS) 3 International Medical-Surgical Response Teams (IMSRT) 4 Disaster Mortuary Operational Response Teams (DMORT)

4 The National Disaster Medical System (NDMS) is responsible for managing the Federal Government's medical response to medical emergencies and disasters. One of their additional services is the DMORT. DMORTs manage mass fatalities. The MRC offers its services to health care facilities or the community in a supportive to supplemental capacity during times of need, such as a disaster or pandemic disease outbreak. HICS is a part of National Incident Management System (NIMS) that standardizes disaster operations. IMSRT establishes fully functional field surgical facilities.

Which responsibility would the nurse manager assume when designated as a unit chief during the formulation of a Hospital Incident Command System (HICS) for disaster preparedness? 1 Public information 2 Medical command 3 Safety and security 4 Logistics and operation

4 The facility-level organizational model for disaster management is HICS, which is a part of the National Incident Management System (NIMS) implemented by the Department of Homeland Security and the Federal Emergency Management Agency (FEMA) to standardize disaster operations. In this system, roles are formally structured under the hospital or long-term care facility incident commander with clear lines of authority and accountability for specific resources. Chiefs are appointed to manage logistics, planning, finance, and operations as appropriate to the type and scale of the event. Officers, not chiefs, are named to oversee essential emergency preparedness functions such as public information, safety and security, and medical command.

The nurse is teaching breathing exercises to a client who underwent surgery. Which member of the health care team is most suitable for reinforcement of teaching in the client? 1 Certified technician 2 Case manager 3 Cross-trained technician 4 Licensed practical nurse (LPN)

4 The licensed practical nurses (LPN) are most suitable to be delegated the task of reinforcement teaching. A certified technician is an unlicensed member who can only record the vital signs or provide basic hygiene to the client. A case manager can provide primary education to the client. These personnel can delegate the task of reinforcement teaching to the assistive nursing personnel. Cross-trained technicians may perform respiratory therapy, draw blood samples, and monitor electrocardiography.

Which action would the nurse leader take to promote a health care climate where curiosity, reflection, and change are embraced? 1 Serving as a coach or a guide 2 Maintaining a good relationship with the team 3 Working to solve process problems with the team 4 Empowering staff to be lifelong learners and risk takers

4 The nurse leader who empowers staff to be lifelong learners and risk takers is promoting a health care environment where questioning the status quo, reflecting on processes, and advocating for change when appropriate are welcome and encouraged. The nurse leader would serve as coach, maintain a good relationship with the team, and collaborate with the team to problem-solve, but these actions are not specific to creating a culture of curiosity, reflection, and change.

10.A health care team is caring for a client with dental pain. Which task can be delegated to unlicensed assistive personnel (UAP) to provide effective client care? 1 Administering analgesics 2 Administering intravenous antibiotics 3 Administering nerve block anesthesia 4 Administering mouthwash for oral hygiene

4 The scope of practice of UAP includes administering mouth wash to the client. Instructing the UAP to administer medications such as antibiotics or analgesics is inappropriate because the UAP is not eligible to do so and may not have the knowledge to administer medications. Administering nerve block anesthesia would be performed by the anesthesiologist.

The registered nurse (RN) delegated a task to the licensed practical nurse (LPN). The LPN completed the task effectively. Which statement made by the RN is appropriate feedback? 1 "Nice job." 2 "Well done." 3 "Your performance was good." 4 "You performed that procedure safely and professionally."

4 The statement, "You performed that procedure safely and professionally," clearly identifies what the LPN did well, so it can shape the future behavior positively. The RN should not include vague statements, such as, "Nice job," or, "Well done." The statement, "Your performance was good," could have a positive effect, but a specific behavior is not mentioned in the statement.

Which action by the nurse leader is indicative of transactional leadership? 1 Accounting for the needs and abilities of individual employees 2 Encouraging the novel and innovative thinking of the employees 3 Motivating the employees by articulation of an inspirational vision 4 Inspiring the self-interest of the employees by offering external rewards

4 Transactional leadership relies on the power of organizational position and formal authority to reward or punish performance. Offering external rewards to motivate the self-interest of employees is a type of transactional leadership. The transformational leader can motivate employees by accounting for their needs and abilities individually. Encouraging the novel and innovative thinking of employees is a characteristic of transformational leadership. The transformational leader helps motivate employees by articulation of an inspirational vision.

Which task can be delegated to the licensed vocational nurse (LVN)? Select all that apply. One, some, or all responses may be correct. 1 Analyzing vital signs 2 Maintaining oral hygiene 3 Administering intravenous medications 4 Administering oral hypoglycemic agents 5 Administering intramuscular medications

4,5 LVNs and licensed practical nurses (LPNs) are authorized to administer medications through oral and intramuscular routes. Analyzing vital signs should be performed by the registered nurse (RN). Hygiene maintenance can be delegated to unlicensed nursing personnel (UNP). Administering intravenous medications should be done by the RN.

The nurse leader is promoted to nurse manager and has a plan to implement a counseling center for clients in the outpatient department. The nurse gathers data from different health care providers and compares methods. Which type of quality improvement would the nurse implement? 1 Benchmarking 2 Risk management 3 Quality management 4 Performance improvement

Correct1 Benchmarking Benchmarking is a process of conducting a widespread search to identify the best method, which helps identify desired standards of quality performance. Risk management involves analyzing problems and minimizing losses after an occurrence of an adverse event. Quality management refers to a philosophy that defines a health care culture emphasizing customer satisfaction, innovation, and employee involvement. Performance improvement involves individual performance appraisal.

Which theory related to leadership is a nontraditional theory that has emerged from the physical and social sciences? 1 Expectancy theory 2 Complexity theory 3 Motivational theory 4 Management theory

Correct2 Complexity theory Complexity theory is a nontraditional theory emerging from the work of the physical sciences and, more recently, social sciences. Expectancy theory posits that motivational behavior is increased by rewarding good and innovative performance; it is not rooted in the physical sciences. Motivational and management theories are traditional theories of leadership.

Which of Gardner's leadership tasks is the nurse leader following when instructing an obese client complaining of leg pain when ambulating long distances about different exercises to try for relieving the pain? 1 Managing 2 Explaining 3 Motivating 4 Affirming values

Correct2 Explaining The nurse leader is performing the explaining element of Gardner's leadership tasks. Explaining includes teaching and interpreting information to promote client functioning and well-being. Managing involves assisting the client with planning, priority setting, and decision-making while ensuring the organizational systems work on the client's behalf. Motivating is inspiring clients to achieve their vision. Assisting clients in sorting out and articulating personal values in relation to health problems falls under the affirming values task.

Which task followed by the executive nurse is a leadership development task? 1 Maintaining balance 2 Having a clear vision 3 Listening to constituents 4 Maintaining a positive attitude

Correct2 Having a clear vision Having a clear vision and seeing beyond where one is and where one is going is a leadership development task. Maintaining balance, listening to constituents, and maintaining a positive attitude are rules for a leader.

In evaluating risks, which responsibility would the risk manager incorporate? 1 Using a single data source to interpret data 2 Involving perspectives from numerous disciplines 3 Using only quantitative methods in gathering data 4 Analyzing qualitative data for actionable plans to prevent adverse events

Correct2 Involving perspectives from numerous disciplines Involving perspectives from numerous disciplines helps discover underlying problems that a single discipline might miss. Risk managers would use multiple data sources, multiple data collection techniques, and multiple perspectives to collect and interpret data accurately. Both qualitative and quantitative data should be assessed and analyzed for implementation of actionable plans to prevent adverse events.

The nurse leader is working on resolving conflicts between team members. Which action indicates that the nurse is involved in constructive conflict? 1 Deepening the differences in values 2 Making use of authentic communication 3 Diverting energy from a more important issue 4 Polarizing groups, which reduces intergroup cooperation

Correct2 Making use of authentic communication Making use of authentic or genuine communication may help in resolving conflict between team members. Deepening the differences in values and diverting the energy from an important issue are destructive conflicts that may result in negativity from conflict resolution. Polarizing the groups is a destructive aspect of conflict resulting in division of groups and weakening of relationships.

The nurse manager regularly analyzes herself or himself and her or his performance, focusing on developing leadership qualities such as assertiveness, confidence, and task knowledge. Which leadership theory would the manager most likely subscribe to? 1 Style theory 2 Trait theory 3 Transformational theory 4 Situational-contingency theory

Correct2 Trait theory Trait theory describes a set of physical and emotional characteristics of a leader that inspires others toward a common goal. Assertiveness, confidence, and task knowledge are among the traits attributed to strong leaders according to trait theory. Style theory focuses on what leaders do in relational and contextual terms. According to transformational theory, leadership refers to a process by which the leader considers the needs of the followers to raise the motivation and morality to higher levels. Situational-contingency theory explains that leadership effectiveness relies on a leader's task at hand, his/her interpersonal skills, and the favorableness of the situation.

Which type of leadership model explains the effectiveness of leadership, based on a match between a leader's style and the demands of a situation? 1 Path-Goal Model 2 Two-Factor Model 3 Contingency Model 4 Normative-Decision Making Model

Correct3 Contingency Model Fiedler developed the Contingency Model, which explains that the effectiveness of the group depends on an appropriate match between the leader's style and the demands of a situation. The Path-Goal Model was developed by House and Mitchell and explains the personal characteristics of followers and environmental demands. The Two-Factor Model was developed by Herzberg for motivation in leadership. The Normative-Decision Making Model is a problem-solving approach developed by Vroom and Yetton.

The nurse leader sent a team of followers to conduct a community health session that was completed successfully. Which action of the nurse indicates leadership quality? 1 Expecting praise from the followers 2 Asking for rewards from the followers 3 Giving rewards to the followers responsible for the success 4 Asking the followers to give a presentation on the health session

Correct3 Giving rewards to the followers responsible for the success. Followers expect rewards from leaders in appropriate situations. Giving rewards for good performance can motivate and instill interest in the followers. The nurse as a leader would reward the followers for the success. Expecting praise from the followers does not indicate leadership quality. Even though the nurse leader is responsible for the success, she or he should not ask for rewards from followers; this does not indicate professionalism. Asking the followers to give a presentation on the health session indicates professionalism but does not explore the leadership ability of the nurse.

The unit nurse manager comes to work obviously intoxicated. Which action is the staff nurse ethically obligated to take? 1 Call the security guard. 2 Tell the nurse manager to go home. 3 Have the supervisor validate the observation. 4 Offer the nurse manager a large cup of coffee.

Correct3 Have the supervisor validate the observation. The staff nurse would call the hospital supervisor to confirm and handle the problem. The security guard has no authority in this situation. Although sending the nurse manager home removes the nurse manager from the clinical setting, this action misses an opportunity for documenting the situation and the nurse manager is in no condition to drive safely. Drinking coffee does not make a person less intoxicated.

While auditing unit documents, the nurse finds some omissions. Which term best describes how to discuss the findings and communicate ways to achieve the desired goals with the staff? 1 Leadership 2 Followership 3 Management 4 Decision-making

Correct3 Management The process of guiding, planning, and controlling others in a situation in which communication is shared to improve clinical processes and outcomes is referred to as management. Leadership can be defined as a process of identifying a goal or target, motivating other people to act, and providing support and motivation to achieve goals. Followership is the process of following the leader or the manager to ensure the best clinical decision-making and actions taken to achieve organizational outcomes. Decision-making is a process of making crucial decisions.