PC3 Exam 3

Change

A dynamic process that results in altering or making something different

Conflict

A state of disharmony among people and occurs when people have differing views

Compromising

An effective conflict management technique, when compromising, everyone gives something up and everyone gets something they want in return

Hot Hazmat Zone

Any amount of chemical on a patient

Which class of clients during a mass casualty situation would the nurse refer to as the "walking wounded"? A) Class I B) Class II C) Class III D) Class IV

C) Class III

Red (I)

Emergent, see now, have survivability with treatment

Black (IV)

Expectant, dead or not likely to survive

Normative-Reeducative Strategy

Focuses on the relationship needs of staff members, uses peer pressure, and relies on staff members' desire to have satisfactory work relationships

Storming

Occurs as the team begins to work together

Warm Hazmat Zone

Patient has been washed once and is washed again from head-to-toe

Planned Change

Purposeful, calculated, and collaborative, includes the deliberate application of change theories

Critical Incident Stress Debriefing (CISD)

Used to prevent long-term negative outcomes, recovery phase is used to detect and prevent PTSD

Which aspect of change takes place in the refreezing stage of Lewin's Force-Field Model? A) Determination that change is needed B) Achievement of equilibrium C) Exhibiting motivation to change D) Gathering of information occurs

B) Achievement of equilibrium

Change Agent

One who leads and manages the change process

Cold Hazmat Zone

Patient recieves final wash, dried off, given a hospital gown, and can now come into the building

Yellow (II)

Urgent, can wait 30 minutes-2 hours but need reassessed/need treatment in 45-60 minutes

Which initial action would the nurse take when a client reports smoke coming from a utility room on the nursing unit? A) Pull the fire alarm on the unit B) Remove anyone who is in immediate danger C) Obtain a fire extinguisher and report to the fire area D) Close all windows and fire doors and await further instructions

B) Remove anyone who is in immediate danger

Clients with which color triage tag are often referred to as the 'walking wounded' in a mass casualty scene? A) Red B) Black C) Green D) Yellow

C) Green

Which color tag would the nursing team provide to the group of mass casualty survivors with minor injuries? A) Red B) Black C) Green D) Yellow

C) Green

Synergy

Can be described as combining strengths of members of a team to result in remarkable outcomes that would not have been possible if members worked alone

PASS

Pull Aim Squeeze Sweep

The health care team is caring for clients in an ED. How soon would the clients triaged as an ESI-3 be seen by the provider according to the five-level triage system? A) Immediately B) Within 1 hour C) Could be delayed D) Within 10 minutes

B) Within 1 hour

Moving Stage (Lewin's Change Model)

Begins the initiation of the desired change. Information is gathered, the change is planned, and movement toward changing begins

The nurse is planning to triage clients after a disaster. Which client does the nurse categorize into the green-tagged category? A) Airway obstruction B) Open fractures C) Massive head trauma D) Bruises and lacerations on skin

D) Bruises and lacerations on skin

Adjourning

Occurs once the work of the group is accomplished

Unplanned Change

Occurs when the need for change is sudden and necessary to manage a crisis

Which personnel can determine priorities for treatment in an emergency response plan? A) Triage officer B) Public information officer C) Medical command physician D) Hospital incident commander

A) Triage officer

In which color would clients receive care based on triage tag color? A) Red B) Yellow C) Green D) Black

A, B, C, D

Which client would be triaged first based on their condition? A) Severe respiratory distress B) Chest pain resulting from trauma C) Hip fracture in older client D) Cystitis

A) Severe respiratory distress

Which information is represented by the framed question, "why" of change? A) Participant stakeholders B) Rationale C) Timing D) Technique

B) Rationale

Which triaging priority is preferable for the client with severe burns and injuries from a bomb blast admitted in the emergency unit? A) Class I B) Class II C) Class III D) Class IV

A) Class I

The registered nurse is teaching the student nurse about identifying different tags in mass casualty events to prioritize client care. Which statement by the student nurse indicates the need for further teaching? A) "Clients with a red tag should be given first priority." B) "Clients with a black tag should be given least priority." C) "Clients with a green tag should be given third priority." D) "Clients with a yellow tag should be given highest priority."

D) "Clients with a yellow tag should be given highest priority."

Applying the ESI criteria, which client condition is considered least severe? A) Cardiac arrest B) Abdominal pain C) Multiple trauma D) Closed extremity trauma

D) Closed extremity trauma

Which level of ESI would be considered the lowest priority in the ED? A) ESI-1 B) ESI-2 C) ESI-3 D) ESI-4

D) ESI-4

White (V)

Okay physically, but have emotional trauma seeing disaster

Nurses in the emergency room (ER) are complaining about how the medical-surgical unit nurses are responding to them when patients are being transported to the floor. The ER nurses state that the medical-surgical nurses do not want to do their job at times. The medical-surgical unit nurses state that the ER nurses always bring the patients near change of shift. What type of conflict is represented by this situation? A) Interpersonal B) Intergroup C) Organizational D) Intrapersonal

B) Intergroup

A client with which condition would be provided with immediate care? A) Sprains B) Open fractures C) Cold symptoms D) Closed fractures

B) Open fractures

A nurse manager attempts to resolve conflict on the unit between staff members by bringing all sides to the table to have a discussion. What type of conflict management strategy is being displayed? A) Accommodating B) Competing C) Avoidance D) Collaborating

D) Collaborating

How soon would the client who meets the criteria for the ESI level 2 (ESI-2) be seen by the provider? A) Immediately B) Within 1 hour C) Within 2 hours D) Within 10 minutes

D) Within 10 minutes

The nurse would classify a client with a black tag during a disaster situation for which type of injury? A) Young adult with closed fractures of the right leg B) Young adult with bruises and superficial lacerations C) Older adult with massive head trauma and multiple open fractures D) Middle-aged adult with third-degree burns over 20% of his body

C) Older adult with massive head trauma and multiple open fractures

Which action if used by a nurse manager would lead to increased conflict in the clinical setting? A) Assessment of needs versus wants B) Reminding staff that every member should be treated with respect C) Emphasizing the importance of listening D) Using statements that focus on the individual performing the behavior indicating "we" or "you"

D) Using statements that focus on the individual performing the behavior indicating "we" or "you"

Mutual Respect

Those involved in the conflict may need a reminder to be respectful and focus on the issue and not the other person

Empirical-Rational Strategy

Assumes that staff members are essentially self-interested and providing information and education will assist staff in changing behavior and adopting the change or innovation

Which color tag is used for a client who is expected to die after a disaster with mass casualties? A) Red B) Black C) Green D) Yellow

B) Black

Which client condition would require the highest priority for treatment among four clients admitted at the same time under mass casualty conditions? A) Massive head trauma B) Open fracture with a distal pulse C) Shock D) Strains and contusions

C) Shock

The nurse would apply an ice pack as a priority intervention to which of four different clients in a critical rescue situation? A) Frostbite B) Snakebite C) Hypothermia D) Black widow spider bite

D) Black widow spider bite

Which client assessment is triaged to emergent status by the ED nurse? A) Weeping erythema post-sun exposure B) Fever post-immunization booster shots C) Edema and ecchymosis of the wrist post-motor vehicle accident D) Cyanotic mucous membranes and stridor post-exposure to a known allergen

D) Cyanotic mucous membranes and stridor post-exposure to a known allergen

Forming

The initial stage when members of the team first meet each other

Needs Versus Wants

The nurse leader and manager must help those involved differentiate between what they need and what they want

Staying in the "I"

The nurse leader and manager remind those involved to focus on "I" statements and avoid using "you" statements and avoid blaming

Unfreezing Stage (Lewin's Change Model)

The point at which it's determined that change is needed, and driving and restraining forces are identified

According to triage based on tier levels, which client conditions would receive higher priority? A) Stroke B) Skin rash C) Active hemorrhage D) Respiratory distress E) Chest pain with diaphoresis F) Displaced or multiple fractures

A, C, D, E

Which must triage nurses employ when prioritizing care with any model? SATA. A) A caring ethic B) Intensive care experience C) A systematic approach to care D) A baccalaureate degree in nursing E) Solid clinical decision-making skills

A, C, E

Which characteristic is always included when considering making changes in any type of nursing setting? A) It is often met with resistance B) It does not lead to conflict C) As long as stakeholders are vested in the process, there will be no problems with implementation D) All changes lead to improved outcomes

A) It is often met with resistance

Which client would be triaged under ESI-1 based on threat to life and stability of vital functions? A) Chest pain B) Cardiac arrest C) Simple laceration D) Hip fracture

B) Cardiac arrest

Client are sent to an ED for care, and tags are given to them based on priority. Which client would be given a red tag? A) Client with closed fractures B) Client with third-degree burns over 25% of total body surface area C) Client with severe abdominal pain D) Client with bruises and superficial lacerations

B) Client with third-degree burns over 25% of total body surface area

Which statement is accurate with regard to the Phases of Change Model? A) Change always occurs in a comprehensive manner B) Communication and feedback are critical elements C) Time does not affect the potential for change D) Realistic goals are often not achieved

B) Communication and feedback are critical elements

Accommodating

Involves sacrificing ones own needs or goals and trying to satisfy another's desire, needs, or goals. This strategy does not resolve conflict and may result in future conflict

RACE

Rescue Activate Contain Extinguish

Innovation

The process of creating something new after thoughtful analysis of a phenomenon or situation

Performing

The stage in which the members understand their roles, they are flexible, and group energy is channeled into meeting the goal

Compassion and Empathy

Those involved in the conflict may need assistance understanding each other and hearing the other person's position

Which member of the nursing care team will prioritize care for a medical-surgical unit that is expecting a large volume of client admissions after a train derailment? A) Charge nurse B) Nurse supervisor C) LPN D) UAP

A) Charge nurse

Which condition is triaged as urgent among these client conditions? A) Displaced or multiple fractures B) Skin rash C) Strains and sprains D) Simple fracture

A) Displaced or multiple fractures

Which ESI level should be considered a high priority for the nurse caring for clients in the ED? A) ESI-1 B) ESI-2 C) ESI-3 D) ESI-4

A) ESI-1

Which characteristic aligns with prioritizing care into the triage level of 'emergent'? A) Immediate threat to life or limb B) Condition is unlikely to deteriorate C) Could wait for several hours for care D) May be seen soon but not immediately

A) Immediate threat to life or limb

Which level of trauma center provides a full continuum of care for the trauma client? A) Level I B) Level II C) Level III D) Level IV

A) Level I

Which trauma center will the nurse recommend transfer for the most critical clients involved in a multiple-vehicle accident? A) Level I B) Level II C) Level III D) Level IV

A) Level I

In the clinical setting, the hospital organization has changed to a different electronic health record (EHR) system after reviewing several different types of available systems. Of what type of change is this an example? A) Planned change B) Unplanned change C) Innovation D) Crisis resolution

A) Planned change

In a mass casualty event, clients with which color tag would be provided with immediate care based on priority? A) Red B) Black C) Green D) Yellow

A) Red

Which client would be treated immediately according to the disaster triage system? A) Red B) Yellow C) Black D) Green

A) Red

Which tag color according to the disaster triage tag system is assigned to a client who has an immediate threat to life? A) Red B) Black C) Green D) Yellow

A) Red

Which clients are triaged at the non-urgent level by the disaster response nurse after a natural disaster? SATA. A) A client with a sprained ankle B) A client with a simple fracture of the forearm C) A client with a displaced fracture of the femur D) A client with shortness of breath and coughing E) A client with soft tissue injuries to the abdomen

A, B

Which clients are triaged at the emergent level by the disaster response nurse after a natural disaster? SATA. A) A client with unstable vital signs B) A client with active arterial bleeding C) A client with chest pain and nausea D) A client with a simple fracture of the forearm E) A client with a displaced fracture of the femur

A, B, C

In which order are the steps of a primary survey performed to assess a client with severe injuries from a bomb blast? A) Airway B) Breathing C) Circulation D) Exposure E) Disability

A, B, C, E, D

In which priority order would the actions of care be implemented for clients in an emergency? A) Initiate contact with the client B) Identify need for emergent care C) Begin immediate treatment D) Determine interventions for nursing care

A, B, D, C

Which order would the nurse perform from first to last when prioritizing care upon entering a client's room and noticing the trash on fire? A) Rescue clients in immediate danger B) Activate the fire alarm C) Extinguish the fire D) Close doors and windows

A, B, D, C

Which conditions of the clients who are admitted with injuries due to a bus accident are prioritized under the emergent classification? SATA. A) Shock B) Contusion C) Open fracture D) Airway obstruction E) High cervical spinal cord injury

A, D

Collaborating

The best strategy to use in conflict management because it involves a shared approach to resolving conflict, shared goals are identified, and a commitment to working together is implemented by those involved

How soon would the client who meets the criteria for the emergency severity index level 2 (ESI-2) be seen by the provider? A) Immediately B) Within 1 hour C) Within 2 hours D) Within 30 minutes-2 hours

D) Within 30 minutes-2 hours

Refreezing Stage (Lewin's Change Model)

Involves stabilizing the change and achieving equilibrium, the innovation is incorporated into the routine

Avoiding

Involves withdrawal or hiding from the conflict

Green (III)

Non-urgent, could wait several hours, probably can walk

Which potentially life-threatening condition found during the primary triage survey would necessitate priority nursing care? A) Cystitis B) Concussion C) Lacerated arm D) Fractured femur

B) Concussion

The client admitted to the ED after an earthquake in the city with which level of resource intensity would the nurse triage into emergency severity index level I (ESI-1)? A) High resource intensity; frequent consultation and continuous monitoring B) High resource intensity; staff at bedside continuously C) Medium to high resource intensity; complex procedure and multiple diagnostic studies D) Low resource intensity; one simple diagnostic study and procedures

B) High resource intensity; staff at bedside continuously

In a hospital setting, there appears to be conflict between the hospital's administrative personnel regarding hospital performance objectives. What type of conflict could be applied to this situation? A) Intrapersonal B) Organizational C) Interpersonal D) Intergroup

B) Organizational

Which assignment in an ED is a high priority for the nursing providing care for clients during a mass casualty? A) Resolving stock availability problems B) Taking inventory and restocking supplies C) Debriefing to promote effective coping strategies D) Outlining emergency expectations and arrangements

B) Taking inventory and restocking supplies

Which behaviors if utilized by nurse managers would help to establish change in the clinical environment? SATA. A) Rewarding consistent actions at the expense of anticipated change B) Helping to build trust C) Instilling confidence D) Anticipating that change is inevitable E) Not allowing staff to transfer off unit

B, C, D

Power-Coercive Strategy

Based on power and authority and assumes staff will respond to authority and threats of job loss Used when resistance is expected but change will be implemented regardless of how the majority feel

How soon should a client with multiple traumas receive treatment according to the five-level emergency severity index (ESI)? A) Within 2 days B) Within 1 hour C) Within 5 minutes D) Within 10 minutes

D) Within 10 minutes

Norming

Occurs once the team overcomes resistance and progresses through the storming phase