SynQ4(CH 20, 24, 25, 26)

The novice nurse calls a supervisor and requests that a "float nurse" be assigned to help with all ―assessments of new admissions and postoperative patients." The supervisor asks, ―How many admissions and surgery patients have you received?" The novice nurse becomes flustered because she has not checked the census but simply bases the need on feeling overwhelmed. This situation best indicates a lack of what type of skills? A. Organizational B. Communication C. Interpersonal D. Clinical

A

Which of the following are phases of Tanner's Clinical Judgment model (TCJM)? (Select all that apply.) A. Noticing B. Planning C. Interpreting D. Responding E. Implementing

A, C, D,

A novice nurse is assigned a patient who has an order to draw blood for culture and sensitivity from a central line before antibiotic therapy is started. The novice reads and rereads the procedure manual. An hour later he stands at the bedside of the patient and stares at the central line, without knowing how to proceed. This phase of reality shock is identified with what term? A. Honeymoon B. Shock or rejection C. Recovery D. Resolution

B

An RN delegates to an experienced LPN/LVN the task of administering oral medications to a group of patients. The RN then observes the LPN/LVN recording a patient's medication administration just before entering the patient's room. What is the RN's initial intervention? A. Checking the patient's drug packages to ensure that the correct drugs were given. B. Stopping the LPN/LVN immediately and non judgmentally discuss the possible consequences of this action. C. Contact the nurse manager and ask that the LPN/LVN's license be suspended. D. Call the pharmacy and ask for replacement medications for the patients.

B

Which nurse is more prone to burnout? A. The one who graduated last in the class B. The one who accepts most offers of overtime C. The one who has worked on the oncology unit for 3 years D. The one who regularly states, "I'm not able to make it better for my patients."

B

Which nursing action best demonstrates the expected outcome of an assessment? A. Turning a comatose patient every 2 hours B. Noticing the patient's fingernails have a bluish cast C. Documenting the patient's intake and output for the last 24 hours D. Having a patient score their pain 30 minutes after receiving an analgesic

B

Which situation would be appropriate for the supervisory level of initial direction and/or periodic inspection? A. Experienced RNs work together to provide care for a group of patients newly diagnosed with meningitis. B. The RN assigns the LPN tasks within her scope of practice and checks back during the shift to ensure the tasks are completed correctly. C. A new graduate nurse is assigned care to a male patient with a hematocrit of 11.0 g of hemoglobin per deciliter and is receiving a blood transfusion. The charge nurse checks on the patient status every 15 to 30 minutes and asks the graduate to explain "next steps." D. No supervision is necessary since both are registered nurses.

B

A novice nurse is unsure how to correctly administer an injection using the Z-track method. What is the best approach for learning this procedure? A. Read the procedure manual and follow the steps exactly. B. Make an appointment at the skills laboratory of the former nursing school to practice. C. Ask to observe an experienced nurse as the skill as it is being performed; then perform it under direct supervision. D. Try to remember how the task was previously performed during a simulation.

C

An RN is counseled by the nurse manager regarding inappropriate delegation when the RN engages in what activity? A. Instructing the nursing assistant to greet ambulatory surgery patients and show them to their rooms. B. When asking a novice nursing assistant to collect a sputum specimen, the RN states, "I will show you this time and you can show me the next time." C. Assigning the float LPN/LVN the task of completing a plan of care for a stable patient who was admitted for routine replacement of a feeding tube. D. Asking an LPN/LVN who has demonstrated competence to perform a dressing change before the patient is discharged home.

C

In addition to identifying a client's strengths and weaknesses, while analyzing the assessment data, what should the nurse be doing? A. Formulating care outcomes B. Evaluating client response to treatment C. Recognizing potential health problems D. Prioritizing appropriate interventions related to client needs

C

In what phase/stage is it appropriate for the nurse to refer to quality improvement activities regarding client care? A. Assessing B. Analyzing C. Evaluating D. Implementing

C

A novice nurse is stressed due to always being behind with her assignments. She is overheard saying, ―No one here worries about checking nasogastric tube placement before they give medications and hang feedings. Skipping that step would save me an extra 30 minutes to be used for charting. If they can do it, so can I.‖ This nurse is experiencing which stage of reality shock? A. Loner B. Rutter C. Change agent D. Native

D

A nurse is delegating to the newly hired nursing unlicensed assistive personnel (UAP) the task of assisting with oral hygiene, knowing that this assignment ―does not require decisions based on the nursing process.‖ The nurse is correctly using which of the five rights of delegation? A. Supervision B. Communication C. Person D. Circumstance

D

A nurse realizes that much time is wasted during shift report when coworkers discuss personal items such as recent movies or department store sales. Which statement would help with time management during this critical interaction? A. "Let's talk only about only one movie you recently watched." B. "I like to know about department store sales, but we need to get through this report, so let's talk about sales as we walk between patient rooms." C. "I know your shift has been busy. What went wrong?" D. "I have the list of patients; let's start with revisions to the plan of care and scheduled activities for the next shift."

D

The most important step in time management is ____________.

planning

It is important for novice nurses to know that "self-esteem = self-confidence + self-______."

respect

When the novice nurse asks, "What will happen if this task is not completed," which skill is being demonstrated? A. Priority setting B. Delegation C. Organization D. Clinical skills

A

Which task is most likely to be considered in a state's practice act as appropriate to delegate to a LPN/LVN if the patient's condition is stable and competence in the task has been established? A. Administer an enema for an elective surgery patient. B. Administer an antiarrhythmic medication IV while interpreting the patient's rhythm on the cardiac monitor. C. Develop a plan of care for a stable patient admitted for observation after a head injury. D. Teach a patient how to instill eye drops for glaucoma.

A

Which statement made by an RN regarding delegation indicates the need for additional teaching? (Select all that apply.) A. Unlicensed assistive personnel (UAP) can assess vital signs during the first 5 minutes for a patient who is receiving a blood transfusion because a reaction now is unlikely. B. An LPN/LVN can administer a PPD (tuberculin skin test) if there is no history of a positive PPD. C. When dopamine is ordered continuously, the LPN/LVN can administer dopamine at a low dose for increasing renal perfusion. D. UAPs can transfer a patient who is being discharged home from the wheelchair to the bed if they have received training and demonstrated competency. E. Responsibility can be delegated to the UAP, but the delegator retains accountability.

A, B, C

Which statements demonstrate characteristics would be desirable in a mentor? (Select all that apply.) A. "How were you taught to do this is school?" B. "Can you think of a way to make this easier for the patient?" C. "Let me know when it's a good time to show you how to do this new scale." D. "Everybody here does it this way." E. "Today was rough but there are fewer admissions scheduled for tomorrow."

A, B, C, E

The first task assigned by the time management coach is for the nurse to list all external distractors that prevent organization and completion of tasks. What would the nurse include on this list? (Select all that apply.) A. Waiting for oncoming shift to start walking rounds B. Failing to delegate tasks to the team members but instead, completing task herself C. Talking with a patient's family member who is also a personal friend D. Spending time thinking about the vacation to the beach E. Using the Internet to read about a new drug that will be administered

A, C

A nurse is unable to concentrate on any one task or issue and is unable to view the health care milieu sensibly. Which source of energy is missing in this nurse? A. Physical B. Mental C. Spiritual D. Emotional

B

A student nurse is concerned about delegation practices and wonders why hospitals employ unlicensed assistive personnel (UAP) and LPN/LVNs. The student nurse refers to the National Council of State Boards of Nursing and learns that the role of these personnel is to focus on what? A. Supplementing the staffing pattern when an RN is not available B. Aiding the RN by performing appropriately delegated care tasks C. Replacing the RN when the health care facility provides long-term care D. Providing patient teaching, allowing more direct care to be provided by the RN

B

The nurse has been assessing a client's vital signs every 4 hours as ordered. After noting that the client's blood pressure has fallen 6 systolic points over the last 2 assessments, the nurse begins to assess the vital signs every two hours. This is an example of what process associated with clinical judgment? A. Reflecting B. Responding C. Evaluating D. Implementing

B

When using the ABC system of managing time, which event should be coded A? A. Calling the pharmacy to see whether a drug insert is available for a patient B. Checking to see why a ventilator is alarming C. Organizing the medication cart D. Writing memos to remind everyone to contribute to the boss's birthday gift

B

A nurse is having difficulty managing assignments at work, which results in a feeling of ―failure‖ and tasks that are not completed or that are not completed satisfactorily. The mentor should suggest what tips for time management? (Select all that apply.) A. Focusing on activities to be completed, rather than on objectives. B. Planning today for tomorrow's activities and needs. C. Making certain that the last hours are the most productive in tying up loose ends. D. Maintaining a log of how the nurse spends time. E. Picking five major objectives for the day and not stopping until they are achieved.

B, D

Faculty comes to class to present information about joining the Student Nurses Association (SNA). A student is heard saying, "Why join this organization? It is just a bunch of students like us. I'll wait and join the real nursing organization after graduation." This student is not aware of which benefits of SNA? (Select all that apply.) A. Members are eligible to sit for the licensure examination at a reduced rate. B. Leadership skills can be refined by working with other schools of nursing. C. The National SNA provides discounted rates for study abroad opportunities. D. A global view of nursing can be obtained through networking internationally. E. Lobbying efforts are a major benefit of belonging to SNA.

B, D

A nurse hopes to improve time management skills using the ABC prioritization approach. Which tasks would be prioritized as ―B"? (Select all that apply.) A. Turn in time sheet due in 3 days. B. Review dress code policy to give feedback before appointment in the morning. C. Perform blood glucose test on a patient admitted with Kussmaul respirations and change in level of consciousness. D. Complete patient teaching prior to discharge in 2 hours. E. Review procedure for inserting a PIC line to assist with procedure later this morning.

B, D, E

In orientation, a new graduate is surprised to learn of workplace violence in health care agencies and asks, ―What kind of violence is common in hospitals?‖ The educator describes workplace violence bases on what statement? (Select all that apply.) A. It is the care of patients admitted who are victims of domestic violence. B. It is experienced nurses withholding pertinent information from coworkers to portray them as incompetent. C. It encourages coworkers participating in an employee assistance program (EAP) to learn more about anger management for adult children living at home. D. It involves the care of persons being held for treatment prior to be incarcerated for committing homicide. E. It is demonstrated in statements such as "The new nurse has book sense but can't perform an admission physical without the help of everyone on the unit."

B, E

A novice nurse is placed in charge just after orientation ends. Which statement by the novice nurse would ensure a smooth delegation experience when delegating to an experienced staff member? A. "You have the patients in rooms 1 to 7. These patients require little skill so you will be fine." B. "Your assignments are posted in writing by the nurses' station. Be certain all your tasks are completed so the next shift is not behind." C. "You have patients in rooms 5 through 10 and I will administer all IV medications. I will let you know if I must adjust. If you see you need help let me know." D. "Everyone is capable of providing the best care, so please sign up for the patients you would like to be assigned to."

C

A nurse moves from California to Arkansas and due to having 20 years of experience as a registered nurse is immediately placed in charge of the telemetry unit. The staffing consists of LPNs and two unlicensed assistive personnel. The RN is unsure of the scope of practice of the LPNs and reviews the nurse practice act for Arkansas, which lacks clarity on some tasks. What should the RN do to best acquire the necessary information? A. Query the state nursing association to determine their stance on the role of LPNs. B. Ask the LPNs on the unit to list what tasks they routinely performed. C. Contact the state board of nursing to determine legal scope of practice for LPNs. D. Refer to California's nurse practice act because the scope of LPNs/LVNs is consistent across the United States.

C

A nurse notices the novice medication nurse hurriedly gathering medications to be administered for the entire day, removing them from the packages, and placing them in a paper cup with the patient's name and room number on the cup. When one of the patients points at a pill and asks, "What is this?" and What does this do?" the medication nurse is uncertain, because it has long since been removed from the packaging. What role is the nurse playing when taking his/her observations, concerns, and suggestions to the nurse manager? A. Mentor B. Rutter C. Change agent D. Role model

C

According to Kramer, nurses in the shock phase should ask themselves what? A. "How can I fit in with other staff?" B. "Why can't I perform as everyone expects?" C. "What changes can I make to make me feel good about the choice to become a nurse?" D. "How can I get the rest of the staff to change?"

C

An LPN/LVN has transferred to a nursing unit and arrives for the first day. The RN checks with the LPN/LVN often throughout the shift to provide support and determine if assistance is needed. The RN is providing which level of supervision? A. There is no supervision, because at times the LPN/LVN is not with the RN. B. Periodic inspection is being used. Because the LPN/LVN is licensed, the RN is relieved of the need to evaluate care. C. Continual supervision is being provided until the RN determines competency. D. Initial supervision is being provided because this is the LPN/LVN's first day on the unit.

C

A nurse is having difficulty keeping up with the six assigned patients and serving on the ethics committee. To take charge of both personal and work life, what activities should the nurse focuses on improving physical energy? (Select all that apply.) A. Telling himself/herself, "I provide safe quality care and will provide this level of care to all my patients" B. Taking a deep breath and remaining calm to develop patience C. Keeping a bottle of water available to consume a minimum of 24 ounces each shift D. Going into the nurse's break room every 90 minutes to eat a healthy snack and prioritize remaining care E. Enrolling in the hospital-sponsored fitness program

C, D, E

To conduct a productive meeting, the nurse should focus on what? A. Providing each person all the time needed to discuss desired topics B. Covering all emotional topics first C. Creating an agenda with specific times allotted for each agenda item D. Waiting for latecomers before starting the work of the meeting

C

What process is a nurse engaging in when making the decision that no action is required when assessing a 40-year-old client's blood pressure and noting that it is 116/78 mmHg? A. Critical thinking B. Nursing process C. Clinical judgment D. Clinical reasoning

C

What tactic is the inexperienced novice nurse using when prioritizing a client's bed bath before the need to insert a nasogastric tube (NG) into a client vomiting coffee ground emesis? A. Energy management B. Priority setting C. Procrastination D. Introspection

C

When comparing mentoring and role modeling, the role of mentoring is represented by which of the following situations? A. The experienced nurse is unaware that the novice nurse is observing him or her gathering supplies needed to start intravenous antibiotics. B. The novice nurse mimics conversations with his or her own patients that were unobtrusively overheard between the experienced nurse and his or her patients. C. The novice nurse receives feedback from the experienced nurse related to the use of a new occlusive dressing product and is told, "I couldn't have done it better myself." D. An experienced nurse is nominated for outstanding employee of the month by the novice nurse.

C

When considering the feasibility of an all-RN staff, a nursing administrator determines what fact concerning the RN's role? (Select all that apply.) A. They are generally costlier and less efficient than LPNs. B. They are usually more reactive than proactive to patient care errors. C. They have a positive effect on patient outcomes when managing patient care. D. They are effective overseers of patients' overall health condition. E. Their training makes them effective care delegators.

C, D, E

Which statement related to delegation is correct? A. The practice of unlicensed assistive personnel (UAP) is defined in the nurse practice act. B. Nursing practice can be delegated only when the LPN/LVN and UAP have received adequate training. C. Supervision is not required when routine tasks are delegated to a competent individual. D. The RN must be knowledgeable about the laws and regulations that govern nursing practice, as well as those that have no clearly defined parameters, such as for UAP.

D

An RN delegates to the unlicensed assistive personnel (UAP) the task of performing blood pressure checks for a group of patients on a nursing unit. The UAP accepts the task and is responsible for what associated task? A. Delegating the task to another UAP if he or she does not have the time or skill to complete the task B. Keeping the RN informed of any abnormal blood pressure readings C. Calling the physician when the patient's vital signs are not within established parameters D. Informing the dietary department to initiate a low-sodium diet for patients who are hypertensive

B

An experienced nurse working in oncology is shocked to realize that he/she feels little empathy when a patient explains, "I developed cancer from having to work in the dry cleaning industry since I was only 8 years old to help support my younger siblings during the depression. Now they have all moved away and refuse to help me financially, and it takes everything I have to pay for my chemotherapy medicine." What term is used to describe this situation?A. Burnout B. Compassion fatigue C. Reality shock D. Horizontal hostility

B

An inexperienced nurse feels that all tasks must be performed faultlessly, which leads to his/her inability to complete all assigned tasks. This nurse would benefit from the seminar focusing on what potential obstacle to efficiency? A. Creativity B. Perfectionism C. Failure D. Downtime

B

The novice nurse arrives on the nursing unit, is introduced to the staff, is assigned a preceptor, and is asked to participate in the next staff meeting. This introduction into nursing is appropriately identified using what term? A. Biculturalism B. Socialization C. Transition D. Going-native

B

A novice nurse is in the ―rejection phase‖ of stress and wonders if she/he made the right decision when deciding nursing was her/his chosen career. Which strategy would help the novice nurse cope with transition into practice and reduce stress? A. When asked by the charge nurse to accept the new admission even though she/he had no discharges, the novice nurse stops and considers if this request is acceptable and safe, then accepts the assignment based on two patients having a low acuity level. B. Refusing to eat anywhere but the hospital cafeteria to ensure a balanced diet and time to socialize with other staff and visitors. C. Avoid wasting time by listening to coworkers' problems or ideas on how to staff the unit during the upcoming holiday since the novice nurse's time is valuable and better spent getting her own work completed. D. Try to "win over" hostile or angry coworkers who find fault with the novice nurse's work performance.

A

A nurse is concerned about the risk of delegating tasks to licensed practical nurses and unlicensed assistive personnel. What is the best way for the nurse to determine competency of an inexperienced delegatee? A. Personally observe the delegatee perform the assigned task. B. Ask the delegatee how many times he/she has performed the task. C. Question the patient to confirm that the care provided was satisfactory. D. Ask other nurses if they feel the delegatee is competent.

A

A patient is admitted with hypotension, shortness of breath, flushing, and hives. All levels of staff have been trained to assess vital signs. Given budget restrictions and proper delegation rules, to which care provider would the RN delegate the task of obtaining the initial blood pressure reading? A. RN B. LPN/LVN C. Unlicensed assistive personnel (UAP) D. Since all are trained, the task can be delegated to anyone

A

After keeping a log of activities designed to improve time management, the nurse divides the distractions into internal and external sources. The nurse would classify which distraction as internal? A. Responding to recurring crises at work or in one's personal life B. Unsuccessful attempts to communicate with the unit manager C. Talking with potential faculty candidates D. Being given unclear job responsibilities

A

A certified oncology nurse notices that a novice nurse is unsure of decision making and lacks technical skills. The novice nurse gains confidence by sharing and learning with the experienced nurse. This relationship continues and builds, allowing the novice nurse to become more confident. This relationship is identified by what term? A. Mentoring B. Role modeling C. A preceptorship D. Socialization

A

A student nurse wants to meet other nursing students from different countries and to learn of employment possibilities. The student nurse should consider doing what? A. Participating in the clinical facility's employee satisfaction task force B. Joining the Student Nurses Association C. Taking part in self-mentoring D. Postponing the licensure examination to take a tour of foreign countries

B

The nurse should consider delegating the task to which person? A. The one needing to develop related skills B. The one who is up for promotion C. The one who has failed with similar tasks D. The one deserving of a reward

A

A recruiter is explaining benefits to a group of nursing externs who are highly sought for employment. The recruiter states, "We are the only hospital in town that offers a residency program." What further information should the recruiter provide about a residency program? A. It provides housing for the graduate nurse to decrease expenses until income is established. B. It partners a medical resident with a nurse resident to learn interprofessional care. C. It allows new graduates to work on a higher degree in nursing while being paid full-time. D. It offers extended time for both theory and clinical activities that promote problem solving and clinical decision making.

D

A student nurse assigned to work with the charge nurse finds the work to be satisfying and receives several compliments from management and the nursing instructor for several creative suggestions. The student nurse enjoys the project and attention and begins to prolong the conclusion of the project. This behavior is indicative of what time management obstacle? A. Need for perfection B. Fear of losing creativity C. Unclear project goals D. Fear of completion

D

During orientation, an RN learns that LPN/LVNs in the facility receive additional training to perform some tasks such as hanging continuously infusing intravenous fluids that have no additives. It is important for the RN to understand that what is the basis for this practice? A. The health care facility can override the state practice act by having all LPN/LVNs and unlicensed assistive personnel (UAP) participate in on-site training. B. LPN/LVNs are licensed, and accountability for their own practice rests with each LPN/LVN. C. The RN can determine what tasks are legally delegable to the LPN/LVNs on his/her care team. D. The nurse practice act and state regulations related to delegation override the organization's policies.

D

In distinguishing between evaluation methods used in school versus those used in the work environment, it is noted that the work environment evaluation includes what? A. Determining whether steps are logical B. Formulating increments in correct order C. Efficiently organizing stages of the procedure D. Appraising outcomes according to policy expectation

D

Positive time management skills include an effective approach to what aspect of planning? A. Maintaining an open-door policy B. Retaining copies of paperwork C. Returning telephone calls immediately D. Scheduling daily activities

D

What principle should a nurse apply to assure effective daily planning? A. Delay planning until the ―first task of the morning‖ has been completed. B. Recognize that rewarding oneself has a negative consequence. C. Rotate between several tasks to stimulate creativity. D. Remember that most tasks take longer than anticipated to complete.

D

Which task is appropriate for the RN to delegate to the unlicensed assistive personnel (UAP) provided the delegate has had experience and training? A. Evaluate the ability of a patient to swallow ice after a gastroscopy. B. Assist a patient who is postoperative hip replacement to ambulate with a walker for the first time. C. Change the disposable tracheotomy cannula for a new postoperative tracheotomy patient if secretions are thick and tenacious. D. Obtain a sterile urine sample from a patient with a Foley catheter that is connected to a closed drainage system.

D

The nurse recognizes that an appropriately developed nursing diagnosis contains what component parts? (Select all that apply.) A. Etiology B. Timeframe C. Diagnostic label D. Expected behavior E. Relevant signs and symptoms

A, C, E

A nurse takes a day to travel to a state park where she/he can sit by the river alone to reflect over recent events and put things into perspective. Time is spent recalling the time he/she was complimented for the ability to deal with a difficult patient and another time when he/she was criticized for lack of teamwork. This nurse is improving which source of energy? A. Emotional B. Spiritual C. Physical D. Mental

B

A novice nurse caring for a post-operative client discovers that the client's abdominal wound has dehisced. After the client is returned to surgery for the needed repair, the nurse manager encourages the novice nurse to engage in the process of reflection. What questions would be included in this process? (Select all that apply.) A. "What should I've done differently?" B. "Did any of my actions turnout poorly?" C. "Which of my actions had a positive effect?" D. "Where there any of my actions that were unnecessary?" E. "Did I learn everything I needed to know about a dehisced wound in nursing school?"

A, B, C, D

Which functions can be delegated only to another RN with appropriate experience and training? (Select all that apply.) A. Assessment of skin integrity on third day of hospitalization B. Evaluation of patient teaching related to turn, cough, and deep breathing exercises C. Nursing judgment related to withholding medication based on vital signs D. RNs do not delegate to other RNs, they delegate only to licensed practical nurses or unlicensed assistive personnel E. Formulation of nursing diagnosis ―potential for fall‖

A, B, C, E

As part of a quality assurance project, a nurse is to round on every patient daily for 1 month to ensure the intravenous tubing is labeled with date hung and nurse's initials. The nurse is hoping to be promoted to a full-time position within the quality department, and success on this project is very important to receiving the position. The nurse retains all other assignments, and is often interrupted to help other staff or answer call lights. The nurse discusses these concerns with the manager, who frees him/her for 1 hour each day to make rounds. During this 1 hour each day the nurse will organize herself/himself and environment by practicing what organizational method? A. Art of "no detourism" B. Reducing stacked-desk syndrome C. Art of "wastebasketry" D. Managing e-mail and memo mania

A

During orientation, a novice nurse sits and ―virtually spends‖ the first few paychecks, envisioning the money going into a personal bank account. In the dream state, the nurse smiles and knows that the pain of nursing school was worth it. Which phase of reality shock is the nurse experiencing? A. Honeymoon B. Shock or rejection C. Recovery D. Resolution

A

How can time be maximized to produce the best outcomes? A. Making the first hour of each workday productive. B. Completing trivial tasks before performing important tasks. C. Eliminating recreational activities in the work environment. D. Omitting breaks until the entire task has been completed.

A

Several novice nurses share lunch breaks and have comments such as, ―I have insomnia from worrying about what I forgot to do for my patient," and "I have no energy," and "I can't believe I can't do my job correctly."These novice nurses are each experiencing different symptoms of what process? A. Burnout B. Low self-esteem C. Lack of confidence D. Resilience

A

The RN instructs the LPN to ―Give an enema to the discharged patient in room 327 who is reporting being constipated. Then be sure to document on the medication administration record when given." Which of the five rights was missing in this situation? The right of A. direction and communication. B. task. C. person. D. circumstances.

A

The task of completing and signing the initial assessment on a newly admitted patient who is about to undergo minimally invasive procedures on an outpatient basis can be delegated to whom? A. The registered nurse (RN) B. The licensed practical/vocational nurse (LPN/LVN) C. Unlicensed assistive personnel (UAP) D. All levels of staff, because the information is about the past and cannot change

A

When deciding whether to say no to a request that involves a time commitment, the professional nurse must consider what initially? A. The cost-benefit ratio B. The time commitment of coworkers C. Ways to buffer saying no D. Personal preference

A

An RN makes the following assignments at the beginning of the shift. Which assignment would be considered high-risk delegation? A. A novice RN is assigned a patient with diabetes mellitus requiring mixing of regular and NPH insulin. B. An LPN is assigned an older adult with pneumonia and who requires dressing changes on a foot wound. C. An unlicensed assistive person (UAP) is assigned the task of assisting a patient with late stages of Huntington's disease to ambulate. D. A float RN from the oncology unit is assigned a patient with a white blood cell count of 4000 mm3.

C

An RN recently relocated to another region of the country and immediately assumed the role of charge nurse. When determining the appropriate person to whom to delegate, the RN bases decisions on what fact? A. The role of the LPN/LVN is the same from state to state. B. The LPN/LVN can be taught to perform all the duties of an RN if approved by the employer and if additional on-the-job training is provided. C. Review of the state's nurse practice act for LPN/LVNs is vital since it defines the role and scope of practice of the LPN/LVN. D. The Joint Commission has certified and established roles for the LPN/LVN.

C

Care delivery using the team-based approach is used on a telemetry nursing unit. The team consists of one registered nurse (RN), two licensed practical nurses (LPNs), and one unlicensed assistive personnel (UAP). Staff have been charged to improve quality of care while ensuring cost containment. Which assignments would meet both criteria? A. The RN administers all medications to all patients. B. The LPN performs sterile dressings and IV tubing changes on all central lines. C. The experienced UAP places telemetry electrodes and attaches to cardiac monitor. D. The RN administers an enema to a stable patient who has an order "administer fleet enema PRN when no bowel movement in 2 days."

C

The nurse is prioritizing hypotheses related to a patient's primary areas of concern. Which nursing statement reflects the outcome of this process? A. Ambulate patient 4 times daily. B. Are you currently thinking about committing suicide? C. At Risk for Injury related to Falling evidenced by unsteady gait. D. Patient resting quietly 30 minutes after receiving pain medication.

C

What action is appropriate when deciding whether and when a task should be completed? A. Completing all tasks as they are received. B. Arranging according to the tasks' time requirements. C. Asking, "What will happen if I don't complete the task now?" D. Viewing large projects holistically and not as many small pieces.

C

When determining the scope of practice for licensed practical nurses (LPN) and unlicensed assistive personnel (UAP), which statement accurately describes the common policies which exist in most state practice acts? A. The RN is held accountable for the decision to delegate, but responsibility rests only with the delegatee. B. The RN may only delegate tasks that are not in the scope of practice of the LPN if the delegatee is certain they are competent to perform the task. C. Since the LPN is licensed, they practice professional nursing. D. To determine what tasks can be safely delegated, the RN must first assess the patient.

D

Which statement made by a novice nurse best demonstrates the use of clinical experience when engaging in clinical judgment? A. "I think I should call the primary care provider immediately." B. "I'll ask my nurse manager what I should do until the primary care provider arrives." C. "Another nurse suggested I call the primary care provider to get a PRN pain medication." D. "The primary care provider prescribed a sedative when a patient had a similar reaction."

D