EAQ- QESN Teamwork
A client on the psychiatric unit who is receiving high-dosage risperidone is exhibiting tremors of the hands. What will be the nurse's first intervention?
Contacting the primary healthcare provider
The registered nurse is teaching a group of student nurses about the role of the nurse as a leader. Which statement by a student nurse indicates effective learning?
"The goal of the nurse manager is to develop a shared vision of the future with direct care nurses."
Which actions can the mentor take to develop effective leadership qualities in the aspiring leader?
Modeling behavior Giving timely feedback Providing appropriate advice
A staff nurse states "I am sorry, I am responsible for the situation" while communicating to the nurse leader. Which communication pattern is the staff nurse using?
Placation
A nurse manager works on a unit where the nursing staff members are uncomfortable taking care of clients from cultures that are different from their own. How should the nurse manager address this situation?
Plan a workshop that offers opportunities to learn about the cultures they might encounter while at work.
The nurse as a leader provides feedback to a newly recruited nursing student after checking the student's progress report. Which action of the registered nurse is most closely aligned with the application of two-factor theory during the feedback session?
Promoting job enrichment by creating job satisfaction
Which task can be safely delegated by a registered nurse (RN) to unlicensed nursing personnel (UNP) for a client with thrombocytopenia
"Positioning the client"
The registered nurse is evaluating the statements made by a student nurse after teaching Hersey's situational leadership model regarding core competencies of a situational leader. Which statement made by the student nurse indicates a need for correction?
"A situational leader is inflexible towards the work."
During a peer review, the manager finds that a newly appointed nurse leader encourages "bottom up" interaction among the workers. To which statement of the staff does the manager relate this?
"He/she involves us in shaping policies for client care."
A client with burns tells the nurse that the primary healthcare provider stated that skin grafts would be required. The client asks when the procedure will be performed. Which response by the nurse is most appropriate initially?
"Tell me what your primary healthcare provider said about the graft procedure."
The student nurse is collecting a clean-catch midstream urine specimen from a client suspected of urinary tract infection. After reviewing the results, the head nurse instructs the student nurse to repeat the procedure. Which finding in the urinalysis report supports the head nurse's instruction?
10 4 organisms/mL
The registered nurse finds that two nursing students are arguing with each other. Which action by the registered nurse best represents a leadership quality?
Assessing the condition and strategizing to resolve the matter by reducing the difference
The registered nurse is caring for an elderly client who is admitted with severe asthma. Which task delegated by the nurse is most suitable to be performed by the client attendant
Assisting the client during nebulization
The nurse is hired to work in a Magnet hospital. What should the nurse expect when providing care in this organization?
Attend clinical care conferences to discuss client care needs
A nurse is determining which tasks to delegate. Which actions should a registered nurse perform while caring for a client in traction?
Determining correct body alignment Assessing complications associated with immobility Teaching the client about range-of-motion (ROM) exercises
The nursing team is involved in effective pain management. Which task would be performed by a registered nurse (RN) in this case?
Developing a treatment plan for client's pain
Who is most accountable for an initial assessment and the ongoing evaluation of client care?
Registered nurse
The nurse manager has delegated tasks to a registered nurse (RN) and unlicensed assistive personnel (UAP) who are paired to provide care for a client with substance abuse. Which hospital care setting uses this model to deliver care to the clients?
Rehabilitative care
Which statement about the delegatee condition is true regarding "selling"?
The delegatee has ongoing relationships; however, the task is new.
After delegating the task of administering oral medications to a licensed practical nurse (LPN), the registered nurse (RN) ensures that the LPN is supervised until the task is accomplished. Which right of delegation does the scenario reflect?
The right circumstance
Which model of nursing is focused on the task-oriented approach to client care
Functional model
A nurse is hired to work in a facility where the nurse assumes responsibility for a number of clients' needs. What is this nursing care delivery system called?
Primary care nursing
Which definition of delegation given by the nurse is correct
Process for the nurse to direct another person to perform nursing tasks and activities
After a bomb blast in a city, why would the federal government send the Medical Reserve Corps (MRC) to the site?
To establish first aid stations or special-needs shelters
The nurse manager is implementing a change in evening care for clients to include back rubs to promote sleep. The nurse manager convinces the managers of various nursing units and also supports nursing staff who are willing to implement the change. Which component of Kotter's eight step model is involved in this scenario?
Forming a powerful coalition
The head nurse of the emergency department (ED) is assigning duties to volunteer nurses to care for a group of clients injured in a mass casualty situation. Which assignments are appropriate in this situation?
The trauma nurse manager should organize ancillary services. The medical-surgical nurse should recommend clients for discharge. The ED nurse leader should direct the ancillary departments to deliver supplies.
The charge nurse is assigning client care to oncoming staff. The new nurse on the unit expresses an inability to care for the assigned client and is requesting to be reassigned. What should the delegator do in this situation?
Understand the delegatee's motivation in the situation.
A registered nurse is teaching a student nurse regarding the precautions to be followed while caring for a client infected with Ebola virus. Which statement by the student nurse indicates the need for further teaching?
"I will not touch the prepared food for the infected client."
After the completion of training under the newly appointed transactional leader, the nurse manager intends to judge the performance of the new leader through interaction with the staff. What type of statements would the manager expect to receive when asking about the outcome of training?
"We fulfill the task to avoid punishment." "We are paid only after our work is satisfactorily completed." "We tend to minimize errors; otherwise, it gets corrected in a reactive manner."
The nurse is developing a care plan for a client with postpartum psychosis. Which priority intervention should the nurse implement?
Referring the client to a psychiatric healthcare provider as prescribed
A critically injured client was brought to the hospital following a car accident and the client should be immediately triaged for determining the nature and acuity of the injuries. Who is delegated to perform the task?
Registered nurse
Which element creates an integrative process that fosters effective delegation decisions by the registered nurse?
Stability
The leader nurse noticed that a staff nurse is unable to meet the responsibilities assigned, though the staff nurse is aware of the working requirements. What is the staff nurse experiencing?
Role conflict
The primary healthcare provider confirms that the client has myopia. Which type of test did the nurse perform to help the primary healthcare provider reach this conclusion?
Snellen eye chart
The nurse as a leader obtains feedback from superiors, followers, and peers. Which leadership theory is the nurse putting into practice?
Style theories
To improve client care, the registered nurse (RN) has delegated tasks involved in assisting the client with activities of daily life (ADLs) to a certified nursing aide, and the administration of oral medications to the licensed practical nurse. Which member of the health care team would be accountable for the final client care?
Registered nurse
The nursing staff of a unit is frustrated and uncomfortable with the newly appointed nurse leader. Which role transition process is involved?
Role discrepancy
A registered nurse is teaching a student nurse about the functions and utilization of trauma centers. Which statement of the student nurse indicates effective learning?
"Clients requiring stabilization with major injuries should be sent to a level III trauma center."
Which behaviors indicate that a care provider is functioning as a primary nurse?
Completes the client's plan of care Coordinates care needs with ancillary staff Discusses approaches to improve care responses
The nurse, as a leader, is planning to provide information about personal hygiene to a group of clients. Which communication methods should the nurse use to talk to the clients?
Being sensitive to nonverbal communication Providing the opportunity for dialogue and feedback Presenting information that addresses the listener's self-interest
What should the manager take into consideration when identifying a delivery model for client care?
Budget Unit objectives Client population Organizational goals
The nurse leader performs his or her own honest appraisals on a regular basis and feels good about the job. Which rule is the nurse leader implementing by this action?
Building self-confidence
The hospital management is planning a study that compares the benefits and harms of a particular method to the benefits and harms of alternative methods when treating clients with chronic disorders. Which approach does the nurse manager follow to improve client care?
Comparative effectiveness research (CER)
A nurse is caring for clients who are undergoing therapy for dependence on alcohol. Which member of the health team has the primary responsibility for their rehabilitation?
Client
For which situations would total client care be an appropriate delivery system?
Client with an endotracheal tube for pulmonary sepsis Client recovering from cardiovascular bypass graft surgery Client recovering from the placement of a cerebrospinal fluid shunt
A client is diagnosed with cancer and is physically weak. The delegator has delegated the healthcare team members to care for the client. Which aspects of the care are most appropriate for the registered nurse (RN)?
Collecting the client's medical history Teaching the client to be hopeful about the treatment Providing emotional support to the client's family members
After delegating a task to the unlicensed assistive personnel (UAP), the registered nurse (RN) provides clear and concise directions to the delegate, to whom she assigned the task. Which right of delegation is the RN following?
Communication
Which is the critical factor among healthcare professionals, state agencies, and federal agencies to determine when and how to evacuate safely during a natural disaster?
Communication
Which activity indicates improper follow-through on the part of the delegatee?
Failure to report results
The nurse is instructing the student nurse how to administer percutaneous enterostomal gastrostomy (PEG) tube feeding to a client. What should the nurse tell the student?
Connect tube feeding bag to client and feeding pump. Flush with warm water before beginning feeding. Check prescription for correct client formula. Set correct rate and initiate pump. Check for diarrhea.
A delegator is providing feedback to four delegatees. Which feedback is constructive feedback that can help the delegatee to improve quality of care?
Delegatee- D
The registered nurse (RN) is caring for a client who is currently hospitalized for a stroke. What is the most effective professional management strategy for the RN to improve the safety and quality of client care?
Delegation
The hospital management wants to prevent post-traumatic stress in the nursing staff. Which implemented strategies will be ineffective in pursuing this goal?
Encouraging the staff to work for more than 12 hours per day
Which disaster management team provides voluntary medical service to people?
Medical Reserve Corps (MRC)
A registered nurse is explaining the Quality and Safety Education for Nurses (QSEN) competencies to a nursing student. What information should the nurse provide about the competency teamwork and collaboration?
"A nurse should be able to work effectively within nursing and interprofessional teams by promoting open communication and shared decision-making to provide client care."
During a feedback session, the nursing staff communicates that a recently appointed nurse is using "empowerment theory." Which statement of the nursing team members most supports this position?
"He/she can share power with others." "He/she encourages others to provide input into decisions." "He/she provides considerable information about the decision-making process."
The senior manager reviews the performance of the transformational leader on the basis of the feedback given by the nurse leader's team. Which statements describe the attributes of a transformational leader?
"He/she is charismatic." "He/she is motivational." "He/she shows individualized consideration."
A nurse manager is selecting direct care nurses for a client-care project. The manager asks a direct care nurse about treatment priorities. Which answer provided by the direct care nurse would be appropriate?
"I will give preference to the problems that have the greatest urgency."
The nurse is teaching a nursing student how to care for a client who underwent stereotactic radiosurgery for a pituitary adenoma. Which statement made by the student indicates effective learning?
"I will monitor serum osmolarity."
A near-term client reports that her fetus is moving less this week than last week. Which responses by the nurse are appropriate at this time?
"It would be good for you to come to labor and delivery to be evaluated today." "Always call the healthcare provider if you're worried that your baby isn't moving enough." "Let me teach you how to conduct a kick count, and then you can call me when you've done one."
A client with a history of ulcerative colitis is admitted to the hospital because of severe rectal bleeding. The client engages in angry outbursts and places excessive demands on the staff. One day an unlicensed healthcare worker tells the nurse, "I've had it. I am not putting up with that behavior. I'm not going in there again." What is the best response by the nurse?
"The client's frightened and taking it out on the staff. Let's think of approaches we can take."
The registered nurse is instructing the student nurse regarding the gross anatomy and physiology of the kidneys prior to client examination. Which statement made by the student nurse indicates the nurse needs to intervene
"The right kidney is a little longer and narrower than the left kidney."
A nurse manager notices that a previously effective nurse appears to be distracted, at times forgets to document changes in clients' status, and rarely completes the required workload without help from another nurse. What should the nurse manager say to the nurse?
"You seem to be having difficulty completing your assignments. What can I do to help?"
Which example would the nurse consider to be a part of systems thinking theory
To focus on the needs of all residents in a long-term care facility
A nurse with burnout asks the nurse manager, "What can I do to prevent burnout in the future?" What is the best response by the nurse manager?
A nurse with burnout asks the nurse manager, "What can I do to prevent burnout in the future?" What is the best response by the nurse manager?
A delegator is providing feedback to four delegatees. Which feedback may undermine a long-term working relationship?
A - why did you do it in this way? Aren't you aware of the correct procedure?
Which statement best describes the navigator?
A person who removes barriers to receiving health care
The nurse is assessing the level of readiness before delegating tasks to unlicensed assistive personnel (UAP). According to Hersey's model of situational leadership, what specific factors reflect the level of readiness?
Ability, Willingness
After assigning a specific work to the unlicensed nursing professional, the registered nurse does a critical analysis of the work to determine if the actions taken were appropriate and provides a detailed explanation of what occurred. Which action related to delegation is the nurse performing?
Accountability
A client who works in the leather industry reports bloody discharge and persistent pain after the treatment of sinusitis. The client has a history of smoking. The nurse suspects a tumor of the nasal cavity and suggests the client consult a primary health care provider immediately. Which type of leadership does the nurse exhibit?
Adaptive leadership
A client with hypoglycemia is admitted to the hospital. Which duties can the registered nurse (RN) safely delegate to the licensed practical nurse (LPN)?
Administering oral medications Administering intramuscular medication
The nurse manager enlists 10 direct care nurses for a project addressing the needs of the human immunodeficiency virus (HIV). The project successfully completes within the timeline. What would be the most essential factor for the success of the nursing manager?
Allowing the direct care nurse to share ideas
A primary nurse managing client case records finds that the discharge teaching plan for a client is inadequate. The nurse consults other team nurses and formulates a better teaching plan. Which element of the decision making process is the nurse exercising?
Authority
The registered nurse is caring for an elderly client in the medical unit. The registered nurse wants to transfer the responsibilities and accountability to someone. Who should the registered nurse utilize to fulfill the condition?
Charge nurse
Which employee should be competent in critical thinking, leadership, communication, and time management skills?
Charge nurse Registered nurse
What does "information salience," a characteristic of communication, refer to according to Anthony and Vidal?
Clarity of information
A direct care nurse leader is communicating with four followers on the team. The nurse leader then assumes that one of the followers has potential to become a leader. Which statement illustrates the direct care nurse's leadership potential?
Client A
Which client's healthcare requirements cannot be delegated?
Client C Teaching
Which theory of nursing leadership involves the traditional organizational hierarchy playing a less significant role as the "keeper of high-level knowledge?"
Complexity theory
Hospital management has replaced some equipment to provide more effective treatment. The nurse, as a leader, wants the team to support and implement this change successfully. Which actions of the nurse leader are effective in this situation?
Conducting a dialogue with the team members Encouraging the team members to develop new skills Encouraging the team members to increase competency in different areas
What is discussed in Hersey's 2006 model related to delegation?
Core competencies of a situational leader
The leader encounters a situation where the nursing outcomes are unpredictable. Which attributes or approaches should the leader utilize to navigate this situation? Select all that apply.
Creativity Experience Group process
Which terms, synonymous with critical pathways, will the nurse educator include in a presentation regarding the role of the case manager?
Critical path Integrated care pathway Collaborative care pathway Multidisciplinary care pathway
A staff member tells a nurse that an older client becomes irritable when asked to assist with activities of daily living. On what general information about older adults should the nurse base a response?
Decreased ability to cope
A client is admitted to the postanesthesia care unit after abdominal hysterectomy. Which assessment should the nurse report to the primary healthcare provider immediately?
Decreased urine output
A client at 20 weeks' gestation visits the prenatal clinic for the first time. Assessment reveals temperature of 98.8° F (37.1° C), pulse of 80 beats per minute, blood pressure of 128/80 mm Hg, weight of 142 lb (64.4 kg) (pre-pregnancy weight was 132 lb (59.9), fetal heart rate (FHR) of 140 beats per minute, urine that is negative for protein, and fasting blood glucose level of 92 mg/dL (5.2 mmol/L). What should the nurse do after making these assessments?
Document the results because they are expected at 20 weeks' gestation.
A nurse discusses the type of anesthesia that will be used for a vaginal birth with a client who has class I cardiac disease. Which type of block is most appropriate for this client?
Epidural
Which characteristics of the delegatee should be considered to determine that he or she is the "right person"?
Experience Willingness Competence
Which behavior of the delegator with respect to the work delegated to a delegatee is characterized as "selling" according to the Hershey's Model?
Explaining or persuading
Which activity performed by the registered nurse (RN) indicates effective supervision of the delegatee?
Guiding the delegatee while he or she is performing the task
Which action of the clinical nurse is consistent with Gardner's task of "achieving work unity"?
Helping clients accomplish optimal functioning
A client arrives at the fertility clinic for a diagnostic workup and is told by the nurse to prepare for a Papanicolaou (Pap) test. The client states, "I do not want this test. I want to speak to the person in charge." How should the nurse respond to this statement?
Inform the primary healthcare provider of the client's request.
The registered nurse (RN) finds that a student nurse is unwilling to participate in a community health literacy program conducted for clients with diabetes mellitus . Which action of the RN portrays his or her leadership ability?
Inspiring the student nurse to take active participation
The registered nurse (RN) is caring for a client with epilepsy. Which tasks delegated by the registered nurse (RN) to the assistive personnel indicates active delegation?
Instructing the licensed practical nurse (LPN) to monitor the vital signs Instructing the unlicensed assistive personnel (UAP) to reposition the client Instructing the unlicensed assistive personnel (UAP) to place the oxygen mask
The nurse is caring for a client who is receiving intermittent intravenous piggyback doses of vancomycin every 12 hours. The primary healthcare provider prescribes trough levels of the antibiotic. The nurse schedules the blood sample to be obtained at what time?
Just before the medication is administered
A nurse manager proposes to change a protocol regarding the care of postoperative clients. However, the nursing staff openly expresses their resistance to the change and wants to continue with the original protocol. Which behavioral pattern in response to change best describes the nursing staff?
Laggards
Which healthcare team member would the nurse expect can be delegated with the task of administering oral medication to a client per the functional model?
Licensed practical nurse
Which is an advantage to the use of a team nursing approach to client care
Lower level organizational decision making
A 36-year-old primigravida is receiving treatment for preeclampsia at 29 weeks' gestation. In light of the latest information on the client's record, which nursing intervention is of the highest importance at this time?
Notifying the primary healthcare provider regarding the epigastric pain, headache, and blurred vision
The behavior of four nurses in different situations is given below. Which nurse exhibits a behavior that can be characterized as delegation according to Hersey's model?
Nurse B Observing and monitoring
The registered nurse is assigned to delegate a task. Which action by the registered nurse indicates the need for correction?
Providing a brief description of the task to the delegatee
What are the various challenges related to delegation?
Providing clear direction to the delegatee Understanding the skill set of the delegatee Maintaining an open line of communication with the delegatee
A nurse is providing education to a coworker who is caring for a client who is scheduled to have a thoracentesis for a pleural effusion. Which information will be appropriate for the nurse to include?
Rapid removal of large amounts of fluid may precipitate cardiovascular collapse.
The nurse leader asks, "Do I avoid taking a stand so that I can escape risk?" Which behavior is the nurse most likely practicing?
Rarely using competing
Which action of the nurse leader indicates implementing Gardner's task of "explaining"
Teaching and interpreting the information to ensure clients' functioning and well-being
Which actions of a nurse as a leader demonstrate a hands-off approach in practice?
The nurse leader avoids making conscious decisions. The nurse leader chooses to do nothing when an intervention is indicated.
Continuous positive-pressure ventilation therapy by way of an endotracheal tube is started in a newborn with respiratory distress syndrome (RDS). The nurse determines that the infant's breath sounds on the right side are diminished and that the point of maximum impulse (PMI) of the heartbeat is in the left axillary line. How should the nurse interpret these data?
These findings indicate that the infant may have a pneumothorax and that the health care provider should be contacted immediately.
The nurse leader has implemented a change in documentation of nursing care. The nurse leader finds that the licensed practitioner nurse (LPN) is resistant to change and is not participating in the change process. Which approach made by the nurse leader would be appropriate in dealing with the LPN?
To confront the LPN and encourage verbalization of feelings regarding the change
The nurse is preparing to discharge a 3-day-old infant who weighed 7 lb (3175 g) at birth. Which finding should be reported immediately to the healthcare provider?
Weight of 6 lb 4 oz (2835 g)
When does a delegator identify that the delegatee is less able to perform in a given situation?
When the delegatee is knowledge deficient
The nurse manager reviews the performance report of a direct care nurse and asks the nurse to focus on "emotional intelligence" in order to be promoted as the nurse leader. Which statement would the nurse leader most likely use while advising the nurse on areas for improvement?
"Try to be more sensitive to the experiences of others."
While caring for a post-operative client, the delegator has assigned a task to a delegatee. Which statements made by the delegator indicates that the delegatee has the experience to perform the task?
"I am available to you at any time for report." "I am aware of your technical competencies."
A registered nurse teaches a new orienting nurse about interventions to be followed for a client with burns due to inhalation injury. Which statement made by the new orienting nurse indicates the new nurse needs more orientation?
"I should check pulses distal to burns."
The registered nurse is evaluating the statements of the student nurse after teaching about the span of control in a group of individuals working in a healthcare organization. Which statement made by the student nurse indicates a need for correction?
"The unit secretary in a healthcare organization has legal recognition."
What does a psychiatric nurse identify as the primary purpose of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition ( DSM-5)?
Provide a classification of types of mental disorders and guidelines to aid in making a diagnosis.
The registered nurse (RN) is caring for a client who underwent surgery for a pituitary tumor. Which task can be delegated to unlicensed nursing personnel (UNP)?
Monitoring vital signs
The nurse is caring for a client with Alzheimer disease who exhibits behaviors associated with hyperorality. To meet the client's need for a safe milieu, what instructions will the nurse give the staff to monitor the client?
For attempts at eating inedible objects
Based on the client's reported pain level, the nurse administers 8 mg of the prescribed morphine. The medication is available in a 10-mg syringe. Wasting of the remaining 2 mg of morphine should be done by the nurse and a witness. It is most appropriate for the nurse to ask which member of the healthcare team to be the witness?
Licensed practical nurse (LPN)
What does the decision strategy of "offering" include in delegation
Making a suggestion to facilitate the achievement of a desirable client care outcome
Which actions in the delegation process represent accountability?
Monitoring client care Seeking the outcome report
A nurse delegator assigns work to a delegatee who has the ability and willingness to do the work but the relationship between the delegator and delegatee is relatively new. How is the delegator's behavior described according to Hersey's Model?
Participating
Which is a theme in the design of "Transforming Care at the Bedside"?
Reliability
A client who recently gave birth is transferred to the postpartum unit by the nurse. What must the nurse do first to prevent a charge of patient abandonment?
Report the client's condition to the responsible staff member assuming her care.
The nurse notes a conflict between staff members during a meeting. Which principle should the nurse follow, as a leader, to put the focus on mutual interest?
Responding expediently to the issues
A registered nurse (RN) diagnosed with chemical impairment issues is transferred to work at a rehabilitation center as a part of treatment. Which actions performed by the nurse manager at the new work place result in effective outcome of treatment for chemical impairment?
Restricting the RN from working near the abused chemical Restricting the RN from administering any controlled substances
The nurse is caring for a client with severe preeclampsia. The nurse compares the client's current vital signs to the vital signs obtained on admission. In addition, the nurse performs a physical assessment. What is the nurse's initial action, in light of these assessments?
Stopping the infusion and notifying the primary healthcare provider
Which activity performed by the registered nurse (RN) indicates effective delegation?
Supervising and monitoring the licensed practical nurse (LPN) about the different activities
The postpartum nurse is providing care to four maternal/infant couplets who have all delivered within the past 24 hours. After receiving the handoff report from the off-going nurse, which client is a priority for the nurse to see first?
The term infant with a transcutaneous bilirubin reading of 8.6 mg/dL (90 mcmol/L)
