ATI: Leadership Missed

Participative leader

A participative leader serves as a resource person and facilitator.

Transformational Leadership

A transformational leader gives group members responsibilities that will enhance their professional development.

A nurse in a mental health clinic is interviewing a client who has a history of substance use disorder. The client reports his experiences from a previous voluntary hospitalization. Which of the following reported experiences by the client constitutes assault? A. "I was threatened with a shot when I refused to take an oral medication that I knew would make me groggy." B. "I was held down against my will and administered a shot." C. "I was told I had to stay in the facility despite my request to leave." D. "I was exposed as a substance abuser to other clients in a group session."

Answer: A. Threatening to medicate clients against their wishes is assault. The tort of assault occurs when a person puts another in fear of nonconsensual contact. Incorrect Answers: B. Performing any procedure on a client without informed consent is battery, not assault. The tort of battery occurs when there is nonconsensual contact with one's person. C. Not allowing clients to leave a health care facility despite their wishes is false imprisonment, not assault. Mental health clients who admit themselves voluntarily to a psychiatric facility retain the right to sign themselves out of the facility. D. Sharing information with others not directly involved in the client's care is a violation of the client's confidentiality, not assault.

A nurse from a facility's float pool receives an assignment to float on a nursing unit. The float nurse tells the charge nurse that she has never worked on this unit before. How should the charge nurse respond? A. "I'll be sure to give you an easy assignment so you won't have any difficulty adjusting to our unit." B. "I will assign you to work with a registered nurse on the unit who is experienced and will act as a resource for you." C. "Don't worry about that. Come find me if you have any questions, and I will try to help." D. "I'll call the supervisor and ask if another float nurse is working who has experience with our unit."

Answer: B Providing the float nurse with a co-assigned resource person is appropriate. This resource is part of a float pool, not just a nurse floating from another unit, and it is likely that she will be assigned to this unit in the future. The charge nurse can facilitate her orientation to the unit by providing a resource person who is skilled in the care provided to clients on the unit. Incorrect Answers: A. While the charge nurse should not overwhelm the float nurse with a difficult assignment, providing the float nurse with an easy assignment will not address the need to be properly oriented to the unit. C. The charge nurse should provide the float nurse with a specific resource nurse who is skilled in the care provided to clients on the unit. D. It is appropriate to facilitate the float nurse's orientation to the unit by providing a resource instead of questioning her abilities by indicating that another nurse would be better.

A charge nurse is making daily assignments for a medical-surgical unit. Which of the following tasks should the nurse delegate to an assistive personnel (AP)? A. Measuring vital signs B. Reinforcing an IV catheter dressing C. Conducting a preoperative admission assessment D. Showing a client how to use a walker

Correct Answer: A. Examples of tasks a nurse can delegate to an AP are measuring and documenting vital signs, performing postmortem care, and measuring and documenting intake and output. Incorrect Answers: B. Caring for invasive lines, performing triage, and creating a nursing care plan are not within an AP's range of function. C. Performing assessments, giving telephone advice, and interpreting data are not within an AP's range of function. D. Providing client education, evaluating the effectiveness of care, and inserting NG tubes are not within an AP's range of function.

A nurse manager notes that a full-time nurse has been absent from work 6 times over the last 6 weeks. Using a nonpunitive approach, which of the following actions should the nurse manager take? A. Verbally remind the employee about the facility's employment standards. B. Recommend that the employee review the facility's policy regarding absences. C. Inform the employee in writing about the facility's employment policy. D. Ask the employee for a written action plan after discussing the reasons for these absences.

Correct Answer: A. Verbal admonishment is the first step in the disciplinary process for this type of infraction. The employee might not know or remember the existing standard, and a verbal reminder may be sufficient to change the employee's behavior. Incorrect Answers: B. Recommending that the employee reviews the policy does not ensure that the employee will read and fully understand the employment standards. C. Written admonishment is the second step in the disciplinary process for this type of infraction. If the employee fails to make a positive behavioral change after being verbally reminded by the manager about the facility's employment standards, the nurse manager should inform the employee in writing. D. This is an example of performance-deficiency coaching, which the nurse manager should use to correct unacceptable behaviors over time.

A charge nurse is making assignments for an oncoming shift. Which of the following clients should the charge nurse assign to a licensed practical nurse (LPN)? A. A client who is to be discharged with a peripherally inserted central catheter (PICC) line B. A client who is disoriented and awaiting a transfer to a long-term care facility C. A client who is 16 hours postoperative following a total laryngectomy D. A client who is newly admitted for abdominal pain of unknown origin

Correct Answer: B. A client who is disoriented will need observation and reality orientation, which is within the LPN's scope of practice. The client's condition can also be categorized as stable since discharge to a long-term care facility is scheduled. Incorrect Answers: A. A client who has a PICC line will require discharge teaching related to PICC line home care. client teaching is not within the LPN's scope of practice. C. A client who has a new tracheostomy is not considered stable and will require frequent assessment, which is not within the LPN's scope of practice. D. A newly admitted client should be assessed by the nurse. This client will also be undergoing many diagnostic tests and will require frequent assessment, which is not within the LPN's scope of practice.

A nurse is preparing to teach the health care team about the concept of critical pathways. Which of the following statements about the purpose of a critical pathway should the nurse plan to include? A. "A critical pathway is a plan of care specific to the nursing interventions necessary for client care." B. "A critical pathway is a tool that legally binds the health care facility to provide services as outlined." C. "A critical pathway is a multidisciplinary tool that guides client care and bases outcomes on an externally imposed timeline." D. "A critical pathway is a plan that may be the same for several similar diagnoses."

Correct Answer: C. A critical pathway outlines the actions that members of the health care team must complete in a timely manner to achieve desired client outcomes and an appropriate length of stay for the particular diagnosis. Incorrect Answers: A. Critical pathways address appropriate nursing care and actions that other disciplines are responsible for as well. They provide a holistic approach to the plan of care. B. Critical pathways are not legal documents. Critical pathways establish the standard of care in an institution, but variances from the pathway often occur for multiple reasons. Documentation of these variances is important, along with the revised plan to correct or address the variance. D. Critical pathways are developed for individual diagnoses. They are based on the typical interdisciplinary needs and length of stay for that particular diagnosis.

A nurse overhears two other nurses discussing a conflict they are having about who should complete certain client-care tasks. The nurses agree that they are tired of the conflict and will let the nurse manager decide who should complete the tasks. The nurse should identify this outcome as which of the following approaches to conflict management? A. Win-win B. Win-lose C. Win-yield D. Lose-lose

Correct Answer: C. A win-yield approach involves both parties no longer trying to resolve the conflict. Instead of taking the initiative to end the conflict, they agree to honor whatever the nurse manager decides. Incorrect Answers: A. A win-win strategy is a collaborative approach. There is no power struggle, and both parties work together for a positive outcome that meets a common goal. B. A win-lose strategy involves one party emerging victoriously and the other losing the struggle. If the losing party continues to pursue the situation, it becomes a competing strategy. D. A lose-lose strategy is also an AVOIDANCE approach. The two parties abandon the struggle and take no further action, but the conflict remains. In this outcome, no one wins.

While participating in a continuous QI program, a nurse is reviewing medical records to determine the time of first postop ambulation of clients who had abdominal surgery. In which type of quality audit is the nurse participating? A. Outcome B. Structure C. Strategic planning D. Process

Correct Answer: D. A process audit measures the interventions used to facilitate expected and desired outcomes for clients. Early ambulation is essential for the prevention of postop complications. Incorrect Answers: A. An outcome audit evaluates how the client's health status changed as a result of an intervention. B. A structure audit evaluates the relationship between quality care and appropriate structure and includes inputs such as the environment in which care is delivered. C. Strategic planning is done as a part of the planning process. It typically examines the purpose, mission, philosophy, and goals of an organization.

A charge nurse on a pediatric unit is delegating tasks to an assistive personnel (AP) who is pregnant and reports that she is unsure of her immune status. Which of the following clients should the charge nurse assign to the AP? A. A 9-year-old child who has fifth disease B. A 4-year-old child who has varicella (chicken pox) C. A 6-year-old child who has rubella D. A 2-year-old child who has impetigo contagiosa (impetigo)

Correct Answer: D. If the AP practices universal precautions, there is no risk of contracting impetigo. Impetigo is a superficial skin infection caused by either Staphylococcus or Streptococcus. Incorrect Answers: A. If the AP has never had fifth disease, the chance of contracting it is significant. Erythema infectiosum is a communicable disease and has been associated with early fetal loss. There is no immunization for fifth disease. B. If the AP has never had varicella or been immunized against it, the chance of contracting it is significant. Varicella is a communicable disease and a known teratogen. C. If the AP has never had rubella or been immunized against it, the chance of contracting it is significant. Rubella is a communicable disease and a known teratogen.

A nurse is caring for a client who has recently been prescribed lithium carbonate. Which of the following assessment findings is the priority for this client? A. Fine hand tremors B. Weight gain of 2.7 kg (6 lb) C. Report of nausea D. Poor motor coordination

Correct Answer: D. When using the urgent vs non-urgent approach to client care, the nurse should determine that the priority finding is poor motor coordination, which is an advanced manifestation of lithium carbonate toxicity. hold the client's medication and notify the provider. Incorrect Answers: B. Weight gain is an expected finding for a client who has recently been prescribed lithium carbonate and can be addressed using diet and exercise. C. Nausea is an expected finding for a client who has recently been prescribed lithium carbonate, and it may continue for a few weeks before subsiding.

A nurse is reviewing laboratory results for a client who is at 12 weeks gestation. Which of the following findings should the nurse report to the provider? A. Hgb 12 g/dL B. WBC 15,000/mm^3 C. Fasting blood glucose 80 mg/dL D. Serum creatinine 0.4 mg/dL

Correct Answer: D. Serum creatinine 0.4 mg/dL This value is below the expected reference range (adult women, 0.59 to 1.04 mg/dL) for a client who is pregnant. The nurse should report this value to the provider. The other values are within the expected reference range for a client who is pregnant.

A nurse is making a client's bed and finds a capsule of medication in the sheets. Which of the following actions by the nurse is consistent with safe nursing practice? (Select all that apply.) A. Administer the medication to the client. B. Notify the provider. C. Complete a variance report. D. Document the finding in the client's electronic medical record. E. Place the medication back in the medication drawer.

Correct Answers: B. C. B. The nurse should notify the provider of the finding as a part of the variance reporting process. C. The nurse should complete an incident or variance report regarding the occurrence. Incorrect Answers: D. The nurse should not document the finding in the client's electronic medical record. The nurse should identify that information in the client's medical record is subject to attorney review should the client decide, for any reason, to file suit against the facility or the healthcare staff. Instead, follow facility policy and report the incident to the nurse manager and risk management through the use of a variance report. In addition, avoid documenting in the medical record that a variance report was filed because this can also allow for the variance report to be subpoenaed should the client decide to file suit. E. The nurse should identify that medications that are no longer packaged are considered contaminated and should be discarded.

A nurse is providing discharge teaching about wound care to a client who has a leg wound. Which of the following pieces of information should the nurse include in the teaching? (Select all that apply.) A. Use cotton balls to clean the infected areas. B. Cleanse the wound with tap water. C. Dry the leg wound after cleaning. D. Microwave the cleaning solution before applying to the wound. E. Discard soiled bandages in a moisture-proof bag.

Correct Answers: B. E. Tap water or 0.9% sodium chloride should be used to cleanse the wound. Soiled bandages and gloves should be placed in double-bagged, moisture-proof bags and not in the regular trash. This prevents the spread of contamination to other family members within the household. Incorrect Answers: C. Drying the leg wound after cleaning should be avoided. The wound should be open to the air to allow the wound to retain moisture and promote healing. D. The nurse should warm the cleaning solution to the client's body temperature if possible; however, using a microwave to warm the solution can make it too hot.

A nurse is teaching a group of newly licensed nurse managers about the principle of justice. Which of the following statements by a nurse manager indicates an understanding of this teaching? A. "I will refer an unhappy employee to the individual with whom a conflict arose." B. "I will allow staff members to schedule their birthday holidays on alternate days, as long as staffing levels are maintained." C. "I will encourage staff participation in choosing new telemetry monitors for the unit." D. "I will compose staff schedules so that each person works two holidays a year." Check Answer Question Feedback Close Explanation

D. Justice means treating everyone fairly. By scheduling each person to work two holidays per year, the nurse manager is requiring staff members to work an equal share of holidays. Incorrect Answers: A. This is an example of the appropriate use of conflict management. By referring unhappy staff members to the individuals with whom they have conflicts, the nurse manager is encouraging individual problem-solving behaviors. B. This demonstrates the principle of autonomy. By allowing staff members to participate in scheduling while maintaining appropriate levels of staffing, the nurse manager is encouraging independent, professional behavior. C. This is an example of change theory. By allowing staff members to participate in decision-making for the unit, the nurse manager is encouraging staff input in the change process.

1 latent conflict 2 perceived conflict 3 felt conflict 4 manifest conflict 5 conflict aftermath

The first stage of the conflict process is latent conflict, which involves awareness of potential situations that can create conflict. Stage 2 is perceived conflict, where those who are affected discuss the situation in an impersonal manner. Stage 3 is felt conflict, which occurs when those who are affected become personally involved. Stage 4 is manifest conflict and is signaled by those who are involved in taking action. In stage 5, or conflict aftermath, those who are involved recognize the positive and negative outcomes of how the situation was managed.