Quizzes
What is not a key concept in a well-functioning team? a. Absence of disagreement or conflict b. Special work that is understood and supported by all c. Willingness to work together respectfully d. Dedication to a mission
A
Which of the following would not be a characteristic of an effective team nurse leader? a. An autocratic perspective b. Excellent communication skills c. Awareness of everyone's abilities d. A genuine interest in team members
A
Which task should the RN assign to the CNA during a code? Question options: a. Perform cardiac compressions b. Draw a blood gas c. Receive orders from the primary care provider who is calling d.Transcribe the orders that are needed now.
A
You are caring for a client who had abdominal surgery yesterday. The client is restless and anxious and tells you that the pain is getting worse despite the pain medication. Physical assessment findings include the following: Temp 110.3 (F); HR 110 bpm; RR 24 bpm; BP 140/90. The abdomen is rigid and tender to touch. You decide to notify the MD. Place the following report information in the correct order according to the SBAR format. "Dr S., this is Nurse J. I'm calling about Mr. D, who is reporting severe abdominal pain." "Would you like to give me an order for any lab tests or additional therapies at this time?" "I have tried to make him comfortable and he is willing to wait until the next scheduled dose of pain medication, but I think his pain warrants evaluation." "He is restless and anxious; temperature is 110.3; pulse is 110 bpm; respiratory rate is 24; BP is 140/90. Abdomen is rigid and tender to touch with hypoactive bowel sounds." "He had abdominal surgery yesterday. He is on PCA morphine, but he says the pain is getting progressively worse."
1 5 4 3 2 Dr.s Surgery restless make him comfortable order
"Stress-buffering" behaviors can be elicited to reduce stress. All of the following behavioral coping responses can be used by nurse managers to reduce and manage stress except: a. Distancing oneself from work. b. Using cognitive reframing to change irrational thoughts. c. Journaling and keeping an informal diary of daily events and activities. d. Exercising regularly
A
A 66-year-old native Chinese patient, hospitalized for a myocardial infarction, asks the nurse manager about seeing his "acupuncture doctor" for treatment of his migraine headache. The best response to this patient would be: a. "How long have you been using acupuncture treatment?" b. "Do you think acupuncture relieves your pain satisfactorily?" c. "What have you told your heart specialist about your migraines and treatment?" d. "Have you tried nonprescription pain medication or been given a prescription drug for your headaches?
A
A Code Red (fire) has been announced on the hospital unit. What is the nurse's first response? A. Remove the clients in danger from the fire. B. Contain the fire C. Report the fire to other staff D. Extinguish the fire.
A
A charge nurse on a busy 40-bed medical/surgical unit is approached by a family member who begins to complain loudly about the quality of care his mother is receiving. His behavior is so disruptive that it is overheard by staff, physicians, and other visitors. The family member rejects any attempt to intervene therapeutically to resolve the issue. He leaves the unit abruptly, and the nurse is left feeling frustrated. Which behavior by the charge nurse best illustrates refined leadership skills in an emotionally intelligent practitioner? a. Reflect to gain insight into how the situation could be handled differently in the future. b. Try to catch up with the angry family member to resolve the concern. c. Discuss the concern with the patient after the family member has left. d. Notify nursing administration of the situation.
A
A charge nurse on a busy 40-bed medical/surgical unit is approached by a family member who begins to complain loudly about the quality of care his mother is receiving. His behavior is so disruptive that it is overheard by staff, physicians, and other visitors. The family member rejects any attempt to intervene therapeutically to resolve the issue. He leaves the unit abruptly, and the nurse is left feeling frustrated. Which behavior by the charge nurse best illustrates refined leadership skills in an emotionally intelligent practitioner? a. Reflect to gain insight into how the situation could be handled differently in the future. b. Try to catch up with the angry family member to resolve the concern. c. Discuss the concern with the patient after the family member has left. d. Notify nursing administration of the situation.
A
A client requires an appendectomy. The surgeon explains the procedure and asks the client to sign the consent. The patient speaks very little English and looks worried. As a nurse, you would: Question options: a. Suggest that an interpreter explain the procedure to the client and answer any questions. b. Ask the client if he has any questions. c. Draw a picture to show the incision. d. Not intervene.
A
A client requires an appendectomy. The surgeon explains the procedure and asks the client to sign the consent. The patient speaks very little English and looks worried. As a nurse, you would: a. Suggest that an interpreter explain the procedure to the client and answer any questions. b. Ask the client if he has any questions. c. Draw a picture to show the incision. d. Not intervene.
A
A colleague asks you to give her your password access so that she can view her partner's healthcare record. This request violates the patient's right to: Question options: a. Privacy. b. Confidentiality. c. Undue authorization of treatment. d. Protection against slander.
A
A major portion of a construction project has collapsed. The Emergency Department has been notified that numerous victims are being transported to the ED. What should be the first action of the ED nurse? A. Assess department for resources-staff, beds, equipment B. Implement personnel recall system C. Discharge stable clients D. Set up a temporary morgue
A
A new graduate is seeking a new position in nursing and wants to "sell" herself effectively. The best strategy is to: a. Create a résumé. b. Practice interviewing. c. Call the personnel offices. d. Create a curriculum vitae.
A
A nurse educator is giving a workshop on conflict. During the sessions, he makes various statements regarding conflict. All of the statements are true except: a. Conflict can decrease creativity, thus acting as a deterrent for the development of new ideas. b. Conflict can arise over the most trivial issues. c. A variety of definitions of conflict are known. d. All conflicts involve some level of disagreement.
A
A nurse manager notices that Nathan, an RN who has been on the unit for approximately 3 years, has a particular interest in technology and seems to be very enthusiastic about working with software and hardware at home. She speaks with Nathan and asks him if he would lead investigation of software applications on the unit. This is an example of: a. Opportunity. b. Delegation. c. Role negotiation. d. Role transition.
A
A nurse raises an issue on giving prioirty to patient needs. Which of the following offers the best way for setting priority? A. Assessing nursing needs and problems B. Giving instructions on how nursing care needs are to be met C. Controlling and evaluating the delivery of nursing care D. Assigning safe nurse:patient ratio
A
A nurse requests a schedule change due to a family issue. The Nurse manager states, "You cannot change the schedule without going through the staffing office" The NM is demonstrating what type of leadership style? a. Autocratic b. Democratic c. Laissez-faire d. Transformational
A
A patient is admitted to a medical unit with pulmonary edema. His primary nurse admits him and then provides a written plan of care. What type of educational preparation best fits the role of primary nurse? Question options: a. Baccalaureate b. Associate c. Diploma d. LPN/LVN
A
A staff nurse asks the nurse manager for a few days off for personal reasons. The nurse manager turns in the request to the human resources office with a note indicating that the staff nurse has demonstrated excellent working skills and is a valued employee. The nurse manager has used the influence of her position to help this staff member. Influence is the process of: a. Using power. b. Empowering others. c. Understanding power. d. Moving past apathy.
A
A unit manager watches a new RN graduate interacting with a patient. When the RN comes out of the room, the unit manager says, "I don't know what they taught you in your nursing program, but if I see you do that again, I will write you up." This example demonstrates: a. Coercive use of power. b. Appropriate application of control. c. Use of informatory power. d. Use of power to provide coaching.
A
All of the following are grounds for immediate dismissal except: a. Failing to pursue further medical help for a patient; patient dies. b. Selling narcotics obtained from the unit supply of narcotics. c. Restraining a patient in bed for 7 hours, unsupervised, as punishment for hitting a staff member. d. Grabbing the unit manager and threatening further physical harm after a poor performance appraisal.
A
All of the following are grounds for immediate dismissal except: Question options: a. Failing to pursue further medical help for a patient; patient dies. b. Selling narcotics obtained from the unit supply of narcotics. c. Restraining a patient in bed for 7 hours, unsupervised, as punishment for hitting a staff member. d. Grabbing the unit manager and threatening further physical harm after a poor performance appraisal
A
An applicant in a wheelchair is applying for the position of receptionist in an outpatient clinic. The nurse manager understands that the Americans with Disabilities Act of 1990 requires that employers: a. Make reasonable accommodations for persons who are disabled. b. Allow modified job expectations for persons recovering from alcoholism. c. Hire disabled individuals before hiring other qualified, non-disabled persons. d. Treat, for purposes of employment, homosexuals and bisexuals as disabled.
A
As a patient care advocate, you regularly coach patients as to how to stay safe in health care by educating them about: a. The need to understand and record all medications being taken. b. Bringing their own linens and other personal items to the hospital. c. Washing hands frequently while in a healthcare environment and using a hand sanitizer. d. Following closely the directions and orders of healthcare providers.
A
At 3 AM, a man walks into your emergency department. He paces back and forth in the waiting area before he approaches staff to ask if he can see his wife, who is a patient on another floor. He speaks rapidly, his face is flushed, he glances around often, and he keeps his hand in his jacket pocket. A best initial response would be to: a. Assess your situation and your surroundings. b. Ask two or three staff to assist in confronting the individual. c. Ask what floor his wife is on and remind him that visiting hours are closed. d. Remain calm as there is no potential for violence here.
A
Before calling a primary care provider about a patient's condition, the nurse should always: a. Assess the patient b. Ask the nurse on the previous shift what happened c. Call the nursing supervisor d. Document the condition
A
Case managed care may enhance profit in a for-profit health organization by: a. Minimizing costs in high resource consumption areas. b. Combining licensed and non-licensed care providers in delivering patient care. c. Increasing reimbursement from third-party payers. d. Reducing the amount of technology used to support clinical decision making.
A
During orientation of new nurse managers, the chief nursing officer stresses strategies that help nurse managers to achieve a powerful image. Which groups of behaviors best contribute to a powerful image for the nurse manager? a. Greeting patients, families, and colleagues with a handshake and a smile; listening carefully when problems arise b. For men, no facial hair, always wearing a suit and tie; for women, always wearing a suit and high-heeled shoes c. Maintaining a soft voice during times of conflict; making unbroken eye contact during interactions d. Smiling all the time; always wearing a suit and carrying a briefcase; women should wear no jewelry
A
The STAR approach to patient safety encourages: a. Focus and reflection. b. Continuing education. c. Multidisciplinary approaches. d. Patient feedback.
A
The difference between staffing and scheduling is that staffing: a. Puts the right person in the right position. b. Puts the right person in the right time and place. c. Refers to the number of nursing hours per patient per day. d. Looks after interpretation of benefits and compensation.
A
The manager of a surgical area has a vision for the future that requires the addition of RN assistants or unlicensed persons to feed, bathe, and walk patients. The RNs on the staff have always practiced in a primary nursing-delivery system and are very resistant to this idea. The best initial strategy in this situation would include: a. Exploring the values of the RN group in relationship to this change. b. Leaving the RNs alone for a time so they can think about the change before they are approached again. c. Dropping the idea and trying for the change in another year or so. d. Hiring the assistants and allowing the RNs to see what good additions they are.
A
The mediator noticed that tension was still evident between the nurse manager and staff members. He informed the chief nursing officer that to begin team-building, it would be important that everyone: a. Work together in a respectful, civil manner. b. Use avoidance techniques when confronted with a conflict. c. Develop a personal friendship with each other. d. Socialize frequently outside of work.
A
The most appropriate person to ask to place the leads back on the patient in 6D who is being monitored is: Question options: a.CNA b. LPN c. RN d. Herself.
A
The nurse educator was giving a workshop on team building. She noted that effective communication is essential for team building. One of the key questions in the workshop was, "What is the best way to check to see if what you have communicated to a team member is understood the way you meant it to be understood?" The correct response is which of the following options? a. Active listening and feedback b. Cues from nonverbal communications c. Content and context clues d. Reliance on paralanguage
A
The nurse preceptor observes the new RN administering medications. The preceptor concludes there is a risk for medications error when the new RN takes which action? A. Answers a physician's page while passing medications. B. Uses military time for documentation C. Asks for help with dosage calculation D. Does not give a medication to a client who questions.
A
Trust is an important aspect of helping relationships, therapeutic communications, and the positive communications model. Which statement does not involve or operationally define trust? Trust: a. Can be described as a belief that although the nurse is capable of helping in times of distress, the nurse is unlikely do so. b. Is the basis by which leaders facilitate the activities and progress of a team. c. Is very critical in teams and interdisciplinary teams. d. Is an important aspect of interpersonal relationships.
A
You need to terminate Gregory, who has had a long-standing history of conflict with you and the staff, and who recently was charged with theft of patient belongings. You consult Human Resources, and together, you develop a plan, which includes: A. A private meeting with Gregory, a Human Resources representative, and you to deliver the news and deliver the termination notice and all other documents that are related. B. Planning an opportunity for Gregory to return and be recognized at a staff farewell. C. Calling Gregory at home to tell him that he is fired, and that his paperwork will be sent to him at a future date. D. Calling him into a meeting in your office on the ward, where assistance is available, should he become upset or agitated.
A
You pull staff together to assess a situation in which the family of a seriously ill patient is anxious and is absorbing a great deal of staff time in consultation, discussion, and questioning of treatment decisions. Staff members are becoming distanced from the family. After inviting the concerns of staff, you explain that the organization values patient-centered care and suggest that evidence supports that acting as an advocate and a listener is helpful to families. You ask the staff for ideas as to strategies that are effectively patient-centered in these situations. In this situation, you are taking on which role? a. Leadership b. Management c. Follower d. Visionary
A
A cohesive team is one that works together in harmony rather than fighting/arguing/belittling/humiliating each other about differences. Together the team can achieve more and achieve their collective goals. However, when there is a conflict, it is essential that all team members remain calm and respectful of one another. Without the respect, a team will disintegrate. In health care, it is particularly important that a team resolve conflict by: (Select all that apply) A. Respecting the fact that any one person can make a mistake at any time. We are all human. B. Calmly speak to one another with respect and candor understanding that we are all human. C. Find common ground to work out issues because we are all human and make mistakes. D. Understand that we are all human and make mistakes. E. Never forget to stay calm, identify the cause of the conflict, and work together to achieve a mutual solution while remembering we are all human.
A B C D E
Ben has recently graduated from a BSN program that focuses on holistic nursing care. As he starts his new position in a dialysis unit, he begins to doubt the need to focus on healing modalities with this chronic population. Jeannette, his preceptor, shares with Ben that healing modalities are useful with any patient. Which of the following nurse healer modalities are appropriate for patients who need chronic care? Select all that apply. A. Promoting nutrition B. Promoting exercise and movement C. Promoting humor, laughter, and play D. Promoting relaxation E. Promoting guided imagery
A B C D E
One of your staff nurses asks for your advice because a patient refuses to sign a consent for surgery. The patient says that he won't sign because he doesn't understand the nature of the surgery. You advise that (select all that apply): A. Consent must not be coerced. B. The patient has a right to choose not to consent. C. The patient must sign the consent because the doctor wants him to sign. D. Witnessing a consent is related only to the voluntary nature of the signature.
A B D
A clinic nurse developed objectives for a diabetic education program. The characteristics of well-written objectives include that they should be what? (Select all that apply.) a. Achievable b. Understandable and specific c. People-oriented d. Manager-oriented e. Means-oriented f. Measurable
A B F
Sarah wonders about the direction that you have given regarding management of incontinent, confused patients. She brings you evidence that she has found regarding incontinence interventions and asks you if she and you could talk about the guidance that you have given after you have had an opportunity to read the articles she has given you. This is an example of (select all that apply): a. Assertiveness. b. Followership. c. Management. d. Insubordination.
A C D
A home health nurse is assessing the safety of a client's home. Which of the following factors may increase the client's risk for falls? (Select all that apply). A. History of previous fall B. Antibiotic therapy C. Reduced vision D. Impaired memory E. House slippers F. Kyphosis
A C D E F
An example of a care activity that would likely not be delegated by an RN to a UNP is (select all that apply): a. Teaching self-catheterization to a patient with paraplegia who has limited English. b. Basic care for a patient with a head injury who is rapidly deteriorating. c. One-to-one observation with a suicidal patient. d. Assessment of patients being admitted through the Emergency Department. E. Basic hygienic care for a patient who is post MI and stable.
A C E
Active listening includes which of the following activities (multiple answers): A Stopping all activity and talking B Relaxing yourself C Asking for clarification during explanation D Using silence E Reflecting on what is being said
A, B, D, E
A nurse is hired and scheduled for orientation. The nurse anticipates learning about which of the following during orientation? Select all of the following that apply: A. Unwritten agency rules B. Policies C. Benefits D. Procedures E. Role expectations
B C D E
A group of staff nurses is dissatisfied with the new ideas presented by the newly hired nurse manager. The staff wants to keep their old procedures, and they resist the changes. Conflict arises from: a. Group decision-making options. b. Perceptions of incompatibility. c. Increases in group cohesiveness. d. Debates, negotiations, and compromises.
B
A nurse manager is experiencing poor staff morale on her unit. While participating in a baccalaureate course, the nurse manager had learned that one of the reasons nurses lack power today is probably because of the past. In the early decades of the profession, nurses lacked power because: a. Nurses freely chose to defer to physicians and administrators with more education. b. Women lacked legal, social, and political power because of legal and cultural barriers. c. The first nursing licensure laws prohibited nurses from making most decisions. d. Nurses astutely recognized the risks of grabbing too much power too soon.
B
A nurse requests a schedule change due to a family issue. The Nurse manager states, "If you cannot come in, we will figure it out." The NM is demonstrating what type of leadership style? a. Autocratic b. Democratic c. Laissez-faire d. Transformational
B
A staff member tells another staff member, "I do not know what time I am taking lunch because I am so busy, so you will just have to wait until I get back!" What type of communication style did she use? A Assertive B Aggressive C Passive D Passive agressive
B
Amy has worked in the dialysis unit on staff for about 12 years. She is frequently consulted by other nursing staff regarding protocols and policies on the unit. What type of power is Amy using? a. Position power b. Expert power c. Personal power d. Competency power
B
As a nursing leadership student, you have had the opportunity to develop a palliative care manual that will be utilized by the palliative care network (PCN) in your region for teaching healthcare professionals. The PCN has requested that you provide a prioritized plan of action for marketing the manual on a regional and state basis. What is the first priority? a. Motivate the target market. b. Research the target market. c. Communicate benefits to the target group. d. Package the product.
B
As the RN charge nurse on the night shift in a small long-term care facility, you've found that there is little turnover among your LPN and nursing assistant (NA) staff members, but they are not very motivated to go beyond their job descriptions in their work. Which of the following strategies might motivate the staff and lead to greater job satisfaction? a. Ask the director of nursing to offer higher wages and bonuses for extra work for the night LPNs and NAs. b. Allow the LPNs and NAs greater decision-making power within the scope of their positions in the institution. c. Help the LPNs and NAs with their work, whenever possible. d. Ask the director of nursing to increase job security for night staff by having them sign contracts that guarantee work.
B
A nurse requests a schedule change due to a family issue. The Nurse manager states, "Find someone to switch with you." The NM is demonstrating what type of leadership style? a.Autocratic b.Democratic c. Laissez faire d. Transformational
C
As the case manager in a home health service, you are interested in trying the Institute for Healthcare Improvement TCAB project in your service. In considering this application, you need to particularly consider: a. Reliability of data gathered by the project. b. Applicability of the project to your setting. c. Lack of patient-centeredness in the project. d. The focus of the project on resource issues
B
Caroline asks family members to leave while she cares for the 16-year-old victim of a recent car accident. The father screams at her and tells her that she has no right to ask his family to leave, and that if she continues to do so, he will "throw her out of the room." Caroline is shaken and tells her head nurse, who tells her that this kind of thing is just part of the job. The guidance of the head nurse: a. Is reasonable. No physical violence was involved. b. Is related to why statistics on violence in health care are likely underreported. c. Acknowledges the deep distress and fear of the family. d. Acknowledges the concern of the nurse.
B
Chart audits have revealed significant omissions of data that could have legal and funding guidelines. As the unit manager, you meet with the staff to discuss audit findings and to find approaches that will address the gaps in charting and achieve desired goals. This is an example of: a. Leadership. b. Management. c. Decision making. d. Vision
B
The hospital administrator approves a case management position for a new rehabilitation unit to help reduce costs. In developing the job description, the nurse manager understands that a key element of case management is: a. Managing of care by nurse managers. b. Coordination of resources for effective outcomes. c. Rapid discharge of clients to decrease costs. d. Managing of care for outpatient clients only.
B
To project staffing needs and to avoid understaffing, it is important that nurse managers consider which of the following? a. Maximum productive hours b. Average nonproductive hours c. Minimum benefit hours d. Maximum vacation time
B
To reduce the incidence of falls in a skilled nursing unit, the nurse manager contacts the risk manager. Risk management is a process that attempts to identify potential hazards and: a. Compensate for previous injuries. b. Eliminate these risks before anyone else is harmed. c. Supersede the need for staff members to file incident reports. d. Discipline staff members who have been involved in previous incident reports.
B
What task should be delegated to the CNA? Question options: a. Give 2 ibuprofen to the patient with COPD in 6B who is uncomfortable from coughing b. Clean up the patient (ESRD) in 6G who was incontinent. c. Change the dressings on the burn patient in 6H d. Call the primary care provider for a discharge order for 6A
B
When interviewing an applicant for a position, the nurse manager describes the unit's care delivery system as one in which each nursing assistant is cross-trained to perform specific tasks, and the RNs do all treatment, medication administration, and discharge teaching. The nurse applicant knows this nursing care delivery strategy to be: a. The case method. b. Functional nursing. c. Primary nursing. d. Nurse case management.
B
Which ethical principle is primarily involved in informed consent? a. Veracity b. Autonomy c. Beneficence d. Nonmaleficence
B
Which of the following indicates safe delegation? a. The nurse supervisor for a large urban acute care department asks the unit manager to accept two new acutely ill patients, which the manager does. The unit is short two staff, and the replacement is inexperienced. b. A unit manager agrees to release a staff from her unit to Unit B. The staff member she agrees to release is experienced on Unit B and is agreeable to the change. The unit manager's unit is fully staffed and patients are stable. c. The nurse supervisor asks the head nurse for Unit A to make do without a replacement for an ill staff member because Unit A was originally overstaffed anyway. Patient acuity levels are very high on Unit A and two staff are orientating. d. The nurse supervisor asks the charge nurse on Unit B to cover Unit F, which is two floors up, because the charge nurse for Unit F is ill. The charge nurse for Unit B is an experienced manager but has no experience with the nursing care required on Unit F.
B
Which of the following is the best guarantee that the patient's priority needs are met? A. Checking with the relative of the patient B. Preparing a nursing care plan in collaboration with the patient C. Consulting with the physician D. Coordinating with other members of the team
B
Which task should Beyonce not delegate to the CNA? Question options: a. Weigh the patient in 6A who came from the ED with cellulitis. b. Explain the side effects of gentamycin to the patient in 6A c. Take vital signs on the patient in 6D who is being monitored. d. Document the I&O for the patient in 6A
B
You overhear a newly graduated RN telling one of your colleagues that leadership and management belong to the unit manager and not to her. As a nursing colleague, your response demonstrates understanding that the perception of the new graduate: a. Is correct. Leadership is not the role of the staff nurse. b. Would benefit from further understanding of her role as a professional, whose influence may affect the decision making of patients, colleagues, and other professionals. c. Has been influenced by nurse leaders and managers who leave for other positions. d. Is related to the general perception that nurse leaders and managers are not satisfied in their jobs
B
Your healthcare organization places a high value on workplace safety and integrates this into all aspects of administrative and patient care processes. As a unit manager, you thoroughly endorse this direction, and during the selection and hiring of new staff, you consistently: A. Refuse to hire applicants who are pushy during interviews. B. Thoroughly follow up with all references before offering a position. C. Ask applicants during the interview if drug or alcohol abuse is a problem. D. Refuse to interview applicants with sporadic work histories.
B
A client is brought back to the unit after a total hip arthroplasty. The client is confused, is moving the operated leg into positions that could dislocate the new hip, and repeatedly attempts to get out of bed. Which of the following actions should the nurse take? (Select all that apply). A. Use a square knot to secure the restraints to the bed. B. Apply leg and arm restraints immediately C. Get an order from the primary care physician D. Have a family member sign the consent for the restraints E. Ensure that only one finger can be inserted between the restraint and and the client.
B C D
Which clients can be appropriately assigned to a newly graduated RN who has recently completed orientation? (select all that apply) A. Anxious client with chronic pain who frequently uses the call button B. Client on second postop day who needs pain medication before dressing changes C. Client with HIV infection who reports headache and abdominal and pleuritic pain D. Client with chronic pain who is to be is charged with a new surgically implanted catheter E. Client who is reporting pain at the site of a peripheral IV line F. Client with a kidney stone who needs frequent PRN pain medication.
B E F
A nursing instructor is teaching a class on conflict and conflict resolution. She relates to the class that conflict in an organization is important, and that an optimal level of conflict will do the following: Generate: a. Creativity, a problem-solving atmosphere, a weak team spirit, and motivation of its workers. b. Creativity, a staid atmosphere, a weak team spirit, and motivation of its workers. c. Creativity, a problem-solving atmosphere, a strong team spirit, and motivation for its workers. d. A bureaucratic atmosphere, a strong team spirit, and motivation for its workers.
C
A unit manager recently graduated as a clinical nurse specialist with a focus in gerontology. She applied to take a certification exam. Certification is designed to recognize: a. Basic knowledge in a specified area. b. Advanced practice in functional roles. c. Special knowledge beyond basic licensure. d. Continued competence as a registered nurse.
C
According to the interpretive statement the nurse "advocates" which means protecting: A. Ethical practice B. Interdisciplinary collaboration in care C. Patient rights D. Organizational functioning
C
All nurses are leaders in patient health care primarily because they: a. Have the most education b. Administrate hospitals c. Know the patient the best d. Are with the patient the longest
C
An LPN ending her shift reports to the RN that a newly hired CNA has not calculated the intake and output for several clients. Which of the following actions should the RN take? a. Complete an incident report b. Delegate this task to the LPN. c. Ask the CNA if assistance is needed to complete the I&O records. . d. Notify the nurse manager.
C
A nurse manager is experiencing conflicts between herself and staff members. She had tried to develop a team by using a shared leadership model to empower the staff. Staff members are functioning: a. As a team. b. Independently. c. Interdependently. d. As a group.
D
A client refuses a simple procedure that you believe is in the client's best interest. The two ethical principles that are directly in conflict in such a situation are: a. Fidelity and justice. b. Veracity and fidelity. c. Autonomy and beneficence. d. Paternalism and respect for others
C
A grievance brought by a staff nurse against the unit manager requires mediation. At the first mediation session, the staff nurse repeatedly calls the unit manager's actions unfair, and the unit manager continues to reiterate the reasons for her actions. What would be the best course of action at this time? a. Send the two disputants away to reach their own resolution. b. Involve another staff nurse in the discussion so as to clarify issues. c. Ask each party to examine her own motives and issues in the conflict. d. Continue to listen as the parties repeat their thoughts and feelings about the conflict.
C
A holistic nursing leader has multiple responsibilities on any given day. To prepare for delivering quality patient care, the nurse must first: A. Pray before interacting with each patient. B. Assume all patients are interested in healing modalities. C. Consider self care needs. D. Provide diagrams and charts of holistic remedies
C
A manager relies on his director (immediate supervisor) for advice about enrolling in graduate school to prepare for a career as a nurse executive. The director may exercise what kinds of power in the relationship with the manager in this advisory situation? a. Expert, coercive, and referent b. Reward, connection, and information c. Referent, expert, and information d. Reward, referent, and information
C
A manager relies on his director (immediate supervisor) for advice about enrolling in graduate school to prepare for a career as a nurse executive. The director may exercise what kinds of power in the relationship with the manager in this advisory situation? a. Expert, coercive, and referent b. Reward, connection, and information c. Referent, expert, and information d. Reward, referent, and information
C
A new graduate RN joins your unit. After a few weeks, she complains about some of her peers on the unit and compares their practices negatively to what she learned in her nursing program. She also is vocal about how she has learned so much here that she did not in her program. She is best described as: a. Having cultural sensitivity. b. Experiencing cultural diversity. c. Experiencing cultural marginality. d. Experiencing acculturation.
C
A nurse is hired to work on a psychiatric unit. The staff expresses frustration with her because they have explained several times her medication regimen, and yet, when she goes on passes, she fails to follow it. The staff believe that, as a nurse, she should be able to understand what is expected. The nurse's failure to follow the regimen indicates: a. Early cognitive impairment. b. Lack of motivation. c. Lack of health literacy. d. Worsening health state.
C
As the nurse manager who wants to increase motivation by providing motivating factors, which action would you select? a. Collaborate with the human resource/personnel department to develop on-site daycare services. b. Provide a hierarchical organizational structure. c. Implement a model of shared governance. d. Promote the development of a flexible benefits package.
C
As the unit manager on the unit that is leading changes to heparin locks, you find that Elizabeth is very valuable in terms of her observations about other units and her knowledge of organizational processes, and now in discussing the new procedure with others. Elizabeth might be considered an: a. Engager. b. Innovator. c. Informal change agent. d. Informant
C
County Hospital has position descriptions for all staff, including RN Team Leaders. Sarah, a team leader on the rehab unit, assesses the needs of the patients in her area, assesses the skills and backgrounds of each of the individuals on her team, and then assigns and delegates the appropriate care provider to each patient and task. Sarah's activity in the example described is termed: a. Passive delegation. b. Passive accountability. c. Active delegation. d. Active responsibility
C
During coffee and other breaks, Rosalie, the new RN, is shut out of conversations with the other staff. When she approaches other staff on the unit to ask questions, they turn and walk off in the other direction. The behavior of the staff is characteristic of: a. Dislike. b. Lack of trust in Rosalie's abilities. c. Horizontal violence. d. Cultural incompetence.
C
In a job interview for a staff position, which of the following indicates your knowledge of patient safety? a. "Will I be able to get overtime hours on your unit?" b. "If there is an opportunity to work extra shifts, I would really like that." c. "Is there a strategy in place to reduce the number of overtime hours on the unit?" d. "I see no reason why I wouldn't be able to work overtime."
C
In which of the following situations would you, as the head nurse, be concerned about potential safety issues? a. Jordan comes to your office to complain about inadequate staffing on the unit. He says that he is concerned because he attributes a recent incident to the staffing levels. b. Henry, a long-standing RN on the unit, has begun to miss work regularly. He calls in but is vague about his reasons for the absences. c. Carla, RN, has just ended a relationship with Jake, RN, and he will not leave her alone. You are meeting with Jake today because colleagues on nights have reported that Jake seems to have been intoxicated last night and the previous night. d. Sarah is very quiet and says almost nothing in team meetings. Lately, she has been much more animated since becoming friendly with a couple of other RNs on the unit.
C
Politics is usually: a. Confined to legislatures. b. Seen in dysfunctional workplaces. c. Found in all social organizations. d. A representation of self-interest.
C
The best response to a COPD patient's wife who asked if her husband's breathing will improve would be: a. "No, COPD is chronic and gets worse as time goes by." b. "Yes, the inhaler will make it better." c. "no, it is a chronic disease but the inhaler should increase the effectiveness of his breathing." d. "Yes, COPD can be managed and new drugs are coming out all the time."
C
The nurse manager of a unit was demoted to staff nurse 6 months ago. Because of being near retirement, the former nurse manager wanted to be employed at the hospital and was offered a position on the same unit. The former nurse manager complains often about how infrequently the current nurse manager is available on the unit and argues with physicians and co-workers. Clients have complained about the attitude of the nurse. The behavior of the former nurse manager can be best explained as being caused by: a. Overwork in the staff nurse position. b. Inadequate mentoring in the new role. c. Anger as a stage of the grieving process. d. Demotion as a threat to personal identity.
C
The oncology clinic manager and the educational coordinator asked nursing staff to complete a brief written survey to assess their attitudes and knowledge related to having used the new infusion equipment for 6 weeks. The stage of change in this situation is: a. Developing awareness. b. Experiencing the change. c. Integrating the change. d. Perceiving awareness.
C
The skills of leadership and holistic nursing: A. Are incompatible B. Have been designed to use holistic remedies only C. Work together to achieve patient outcomes D. Focus on the self-care needs of the nurse
C
To effectively delegate in a team nursing environment, the RN team leader must be familiar with the legal and organizational roles of each group of personnel and must: a. Be able to effectively communicate with patients. b. Build relationships with physicians. c. Be able to adapt to daily changes in staffing. d. Adapt in communicating information to her supervisor.
C
To retain supervisory staff members, the director of nursing develops a mentoring program. The best person to be a mentor for a new supervisor in a leadership position is someone who has: a. Been in exactly the same position and can relate to the new supervisor's problems. b. Had vast leadership opportunities and likes to talk about his or her past experiences. c. Leadership experience and time to spend communicating with the new supervisor about his or her experiences. d. People who can help the new supervisor get what he or she needs to make the organization grow quickly and prosper in the process.
C
You are asked to float to a different nursing unit. During report, you are told that the patient is receiving IV administration of vincristine that should be completed within the next 15 minutes. The IV site is intact, and the patient is not having any problems with the infusion. You are not certified in chemotherapy administration. What is your priority action? A. Ask the nurse to stay until the infusion is finished, because you are not certified. B. Assess the IV site; check the progress of the infusion and the patient's condition. C. Contact the charge nurse and explain that you are not chemotherapy certified. D. Look up drug side effects and monitor, because the infusion is almost complete.
C
A nurse belongs to several professional organizations, serving on a state-level committee of one group and on two task forces at work. The nurse is committed to a range of health issues. This nurse exemplifies which level of political activism in nursing? a. Gladiator b. Buy-in c. Self-interest d. Political sophistication
D
You walk into Mr. Smith's room and find him yelling at the LPN, Miss Jones. He is obviously very upset and after you speak with him regarding his behavior, you determine that he has not slept for three nights because of unrelieved pain levels. The LPN is very upset with Mr. Smith and calls him an "ugly, old man." You acknowledge her feelings and concerns and then suggest that Mr. Smith's behavior was aggressive, but is related to lack of sleep and to pain. "Can you both, together with Mr. Smith, determine triggers for the pain and effective approaches to controlling his pain?" This approach demonstrates: a. Lack of empathy and understanding for Miss Jones. b. Concern with placating Mr. Smith. c. Leadership behavior. d. Management behavior.
C
A nurse and teacher are discussing legal issues related to the practice of their professions. The teacher asks what the functions are of the Nurse Practice Act (NPA) in that state. The nurse would include which thoughts in a response? Select all that apply. Question options: A. Accredit schools of nursing B. Enforce ethical standards of behahior C. Protect the public D. Define the scope of nursing practice E. Determine liability insurance rates
C D
A staff nurse is reviewing the hospital's fire safety policies and procedures with newly hired assistive personnel. The nurse is describing what to do when there is a fire in a client's trash can. Which of the following statements should the nurse include? Select all that apply. A. The first step is to pull the alarm B. Use a Class C fire extinguisher to put out the fire C. Instruct ambulatory clients to evauate to a safe place D. Pull the pin on the fire extinguisher prior to use E. Close all doors
C D E
A community-based pain management program is being planned for your region. As a coordinator of a home care agency, you have been requested to develop a conceptual framework, mission statement, philosophy, and objectives for the program. In what order will you pursue this endeavor? a. Objectives, philosophy, and mission statement b. Philosophy, objectives, and mission statement c. Philosophy, mission statement, and objectives d. Mission statement, philosophy, and objectives
D
A key advantage that a nurse manager has in terms of delegating is that: a. Clients receive less attention because too many staff make it difficult to coordinate care. b. Nurses report less pressure to perform necessary tasks themselves. c. Administration can predict overtime more accurately. d. Team skills can be used more effectively.
D
"I really wish that my supervisor would realize and acknowledge all the things I do well..." In nursing, this has been identified as a problem. Which statement is part of the solution? Focus on: a. New staff. b. Care assignments with which the individual is not familiar. c. Making corrections. d. The strengths of the individual rather than the weaknesses.
D
A nurse requests a schedule change due to a family issue. The Nurse manager states, "Let's develop a system to be proactive for all the staff when things like this happen." The NM is demonstrating what type of leadership style? a. Autocratic b. Democratic c.Laissez-faire d. Transformational
D
A safety and security plan is important to a healthcare organization because it: a. Lays out preventive measures in relation to violence. b. Provides direction as to changes in facilities that protect staff. c. Establishes expectations in relation to behavior and tolerance of violence. d. Establishes policies and practices that guide prevention of violence and expectations in the workplace
D
A unit manager of a 25-bed medical/surgical area receives a phone call from a nurse who has called in sick five times in the past month. He tells the manager that he very much wants to come to work when scheduled but must often care for his wife, who is undergoing treatment for breast cancer. According to Maslow's need hierarchy theory, what would be the best approach to satisfying the needs of this nurse, other staff, and patients? a. Line up agency nurses who can be called in to work on short notice. b. Place the nurse on unpaid leave for the remainder of his wife's treatment. c. Sympathize with the nurse's dilemma and let the charge nurse know that this nurse may be calling in frequently in the future. d. Work with the nurse, staffing office, and other nurses to arrange his scheduled days off around his wife's treatments.
D
After consulting with practice environments about quality and safety concerns in health care, the Dean of Health Programs at US University develops: a. A nursing program that emphasizes the development of a strong disciplinary identity. b. Programming that stresses discipline-based research. c. Partnerships with health care to develop software for reporting of adverse events. d. An interdisciplinary program for nurses, pharmacists, and medical practitioners that emphasizes collaborative learning teams.
D
At Hospital Ajax, staff members are reluctant to admit to medication errors because of previous litigation and a culture that seeks to assign blame. This culture demonstrates: a. QM principles that emphasize customer safety. b. A deep concern with improvement of quality and processes. c. Effective employee orientation and development in relation to QM. d. Goals that are inconsistent with QM.
D
Awareness and use of power have been challenging for nurses in general because of: a. Incidences of punishment by authority figures. b. Too little time in the workplace to collectively develop power strategies. c. Lack of cohesiveness and unity among nurses. d. A tradition of obedience to authority.
D
How would you prepare your unit for a Joint Commission visit? a. Commit staff resources over a six-month period to updating procedure manuals. b. Educate staff through meetings and training sessions regarding appropriate answers to questions. c. Prepare a manual that outlines orientation procedures, and ensure that all safety issues are addressed. d. Ensure that review of patient outcomes and of responses to outcome data is ongoing.
D
In delegating to a CNA in a home health setting, which of the following represents the most appropriate delegation communication? a. "You will be taking care of Mrs. S. Mrs. S. needs assistance with her bath." b. "You will need to help Mrs. S. get into and out of her shower. Ensure that you check the condition of her feet, and let me know if you have any concerns when you check in." c. "I am not sure that you know how to do this, but I am giving you Mrs. S. She is quite obese and needs skin care." d. "Mrs. S. needs help to get into and out of her bathtub. Her bath will need to be completed by 10:00. When you are helping her to dry, please check between her toes and toenails, and phone me by 10:30 if you notice nail discoloration or redness."
D
In the past year, you have noticed an increase in patient falls on your unit. In reading studies related to staffing and patient outcomes, you realize that you will need to plan for: a. Higher patient care hours. b. Safer facilities. c. Institution of a patient classification system. d. An increased number of RN positions.
D
In which of the following situations would you, as the head nurse, be concerned about potential safety issues? A. Jordan comes to your office to complain about inadequate staffing on the unit. He says that he is concerned because he attributes a recent incident to the staffing levels. B. Sarah is very quiet and says almost nothing in team meetings. Lately, she has been much more animated since becoming friendly with a couple of other RNs on the unit. C. Henry, a long-standing RN on the unit, has begun to miss work regularly. He calls in but is vague about his reasons for the absences. D. Carla, RN, has just ended a relationship with Jake, RN, and he will not leave her alone. You are meeting with Jake today because colleagues on nights have reported that Jake seems to have been intoxicated last night and the previous night.
D
Nancy is a staff nurse who works on a rehabilitation unit. Nancy tells you that the assistants are experiencing difficulty with the new lift and wonders what your thoughts on organizing an in-service would be. Nancy is exhibiting which trait of a follower? a. Provides a vision for safety that is communicated b. Thrives on taking risks in identifying the problem with safety c. Coordinates the development of knowledge and skills necessary to use the lift d. Assumes responsibility for identifying a safety concern and concedes authority for solution to you
D
Nursing research has indicated that the foundation for becoming a nursing leader is the ability to: a. Write effectively. b. Speak two or three languages. c. Dialogue with others. d. Think critically.
D
The RN must delegate care of an assigned client to a CNA for the shift. Which client would be best to delegate to the CNA? a) A client who would benefit from talking about the recent death of her husband b) A client with a urinary drainage catheter and nasogastric tube feedings who is on bedrest. c) A client with an ostomy who has persistent problems with leakage. d) A client who was transferred from the CCU 3 days ago and is ambulatory.
D
The best method for the CNA to deal with the task of placing the car seat correctly in the car is: Question options: a. Assist the new parent b. Ask security to assist c.Call the nurse on the maternity unit to assist d. Ask the parent to read the manufacturer's instructions.
D
The chief nursing officer has asked the staff development coordinator to facilitate the development of a clinical competency program for the facility. While making rounds on the units, the staff development coordinator overhears RN staff complaining that they feel it is insulting to be required to participate in a competency program. Which behavior by the staff development coordinator is most appropriate in this situation? a. Disregard staff concerns and continue with development of the program. b. Inform the nurses that this program is a requirement for JCAHO accreditation. c. Schedule a meeting with the chief nurse executive to apprise her of the situation. d. Facilitate a meeting so nurses can articulate their values and concerns about a competency program
D
The chief nursing officer has asked the staff development coordinator to facilitate the development of a clinical competency program for the facility. While making rounds on the units, the staff development coordinator overhears RN staff complaining that they feel it is insulting to be required to participate in a competency program. Which behavior by the staff development coordinator is most appropriate in this situation? a. Disregard staff concerns and continue with development of the program. b. Inform the nurses that this program is a requirement for JCAHO accreditation. c. Schedule a meeting with the chief nurse executive to apprise her of the situation. d. Facilitate a meeting so nurses can articulate their values and concerns about a competency program.
D
The director of nursing has been observing staff interactions in a 20-bed coronary care unit. Based on her observations, which of the following staff members is an obvious leader? a. The unit secretary who knows everyone's business b. The chief nursing officer who is in charge and is responsible for nursing services c. The chief cardiologist who admits the largest number of patients and brings in more revenue than any other physician d. The staff nurse who persuades other staff members to practice by making evidence-based decisions
D
The nurse case manager is working with a client admitted for end-stage renal disease. The case manager's major goal during this hospitalization is to: a. Implement the care MAP on admission. b. Provide direct nursing care throughout the hospitalization. c. Supervise the nursing staff members who implement the care MAP. d. Prevent additional hospitalizations resulting from complications of the client's disease.
D
The wound care nurse decided to involve those to be affected by change early in the change management process. This can positively result in: a. Coordination. b. Resistance. c. Anticipation. d. Participation.
D
To satisfy duty of care to a patient, a nurse manager is legally responsible for all except: a. Notifying staff of changes to policies related to medication administration. b. Scheduling and staffing to ensure safe care. c. Delegating in accordance with practice acts. d. Supervising the practice of the physician.
D
Which information would the nurse omit from written documentation when a reportable incident has occurred? A. Name of witnesses on incident report B. Nursing interventions in medical record C. Time MD was called on incident report D. That an incident report was submitted in medical record
D
Which strategy should a nurse leader use to build a culture for staff development? A. Expect all staff to attend each activity B. Aggressively pursue funding from administration C. Add development activities based on managers' preferences D. Schedule staff development activities at a variety of times
D
