Final Exam - Leadership

* During the management of a client's pain, the nurse should adhere to the code of ethics for nurses. Which of these actions should the nurse consider first when treating the client's pain? A. The client's self-report of pain is the most important consideration B. Cultural sensitivity is fundamental to client-centered pain management C. Nurses should not judge a client's pain based on the nurses's values D. Clients have the right to have their pain managed promptly

A. The client's self-report of pain is the most important consideration

A nurse wants to apply open communication to obtain a thorough history and to determine cognitive function. Which question represents the use of open communication? a. Is today Wednesday? b. Do you know what day it is? c. Tell me what day of the week today is. d. Do you know what the first day of the week is?

ANS: C The patient must be able to name the day of the week rather than use answer yes or no.

* Which statements concerning licensure as a registered nurse are correct? Select all that apply A. Candidates for licensure must present proof of graduation as required by the state B. It is illegal for states to ask about the mental or physical status of an applicant C. A nursing license cannot be revoked, only suspended D. Each nurse practice act describes requirements for initial licensure E. Candidates for licensure must complete a background check

A, D, E

* The RN is having a very busy morning. He is trying to find a doctor to ask a question when a family member of another patient stops him in the hallway. The RN has his arms crossed and is avoiding eye contact. This is an example of A. Blocking B. False Assurance C. Closed Communication Style D. Conflicting messages

A. Blocking

* What is the key element of success for a nurse manager as a leader? A. Including the direct care nurses in decision-making B. Leading a team with a limited number of team members C. Resolving the financial issues of the organization effectivley D. Allocating different nurses for specific tasks effectively

A. Including the direct care nurses in decision making

* A nurse tells the charge nurse that a terminally ill client has verbalized wanting to end all medical treatment. The client's family is concerned with the client's statement. The best charge nurse response is. A. "It is our duty to recognize the needs of both the client and their family." B. " Always do what is medically necessary to keep the client healthy." C. "A terminally ill client should not make decisions without the family's consent." D. "We need to respect the wishes of our client only."

A

* As a charge nurse, which client would you assign a new RN graduate who is on orientation? A. 67-year-old who had a stroke 3 days ago and has left sided weakness. B. 28-year-old newly admitted client with a spinal cord injury C. 85-year-old with dementia who is being transferred to a long term care facility today. D. 54-year-old with Parkinson's disease who needs assistance with bathing.

A

* The new nurse manager is preparing for a meeting with the staff to come up with ideas for how to reduce the number of falls on the unit. Which approach would be best for the nurse manager to use? A. Have the staff engage in brainstorming B. Conduct an anonymous staff survey C. Present a research article D. Show a presentation of fall data

A

ANS: D After completing all steps in the situation assessment procedure, the client is now ready to justify her selection. In this phase, the person will specify reasons for the action, will clearly present the ethical basis for these reasons, will understand the shortcomings of the justification, and will anticipate objections to the justification.

A client and her husband used in-vitro fertilization to become pregnant. The unused sperm was frozen so the couple could have more children later. The husband is killed while in combat, and the client journals her choices and the possible ramifications. She comes to the fertility clinic after looking at the situation from many perspectives and after considering many alternatives. She asks that the sperm be destroyed because her husband's faith prohibited remarrying, and allowing another person to use the sperm would conflict with her late husband's beliefs. When considering this scenario, the nurse realizes what? a. The client is in the second step of ethical decision making and that the client's value system is influencing her choices of alternative actions. b. A logical line of reasoning has led to validation of the decision to destroy the husband's sperm. c. The client has not been able to navigate the complicated issues inherent in this situation. d. A rational decision was reached that was based on reflection and on the value systems of the wife and the husband.

ANS: D The best way for the new nurse manager to communicate with this employee, who may be an informal leader, is to show respect for the individual's clinical expertise and experience through clear and direct communication. The new nurse manager should attempt to identify the staff nurse's power as an informal leader, should involve him and other staff members in decision-making and change-implementation processes, and should clearly communicate goals and work expectations to all staff members.

A hospital's policy requires that all nurse managers must have a minimum of a bachelor's degree in nursing. A BSN nurse new to the hospital has recently been hired as nurse manager for the oncology unit. An RN who has worked on this unit for many years is unable to be promoted to a nurse manager position because of his educational status and has been commenting to physicians and staff, "The new nurse manager has book sense but no leadership abilities." What is the best approach that can be used by the new nurse manager who is attempting to gain the trust and respect of the nursing staff on the unit? a. Send memos to all staff except the upset nurse to invite them to a luncheon. b. Ask management to transfer the upset nurse to another unit. c. Assign the upset nurse to committees that do not directly affect that nursing unit. d. Acknowledge the clinical expertise of the upset nurse and clearly explain the expectations for teamwork and open, honest communication.

The nurse who admits making a medication error and immediately files an incident report is demonstrating what ethical principle? a. Accountability b. Individuality c. An injustice d. Values clarification

ANS: A Accountability is an ethical duty that states that one should be answerable legally, morally, ethically, or socially for one's actions.

A patient returning from a procedure was somehow "skipped" when daily baths were performed and requests that care now be provided now. The nurse discovers the bed is rumpled and damp. The RN joins with some other staff to bathe the patient, change the bed, and help make the patient comfortable. These staff members are demonstrating what ethical concept? a. Altruism b. Veracity c. Autonomy d. Whistle-blowing

ANS: A Altruism is concern for the welfare of others, including willingness to help others when they are unable to get their assignments completed to ensure that the patient receives high-quality care.

An RN is consistently late to work, causing reassignment of patient care and the need for repeated shift reports. The nurse, who receives a warning for repeated tardiness, states, "My husband left me, I have no car, no family close by, and the bus is always late, which makes me late. The nurse manager doesn't care how hard I try to get here, and I am raising a child by myself." The nurse is using which type of logical fallacy? a. Appeal to emotion b. Appeal to tradition c. Hasty generalization d. Confusing cause and effect

ANS: A An appeal to emotion is an attempt to manipulate other people's emotions for the purpose of avoiding the real issue.

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

ANS: A An internal distraction is one that can be controlled only by the person affected; it is important for each of us to recognize and understand the distracters that inhibit our ability to complete tasks and to meet our objectives and goals.

According to the unit's policy for call-ins, a nurse is suspended for 3 days because of excessive call-ins that occur within 15 minutes of shift change. The nurse states, "You are unfair to me." Which theory would disprove the nurse's statement? a. Authoritative b. Closed systems c. Open systems d. Trait

ANS: A Autocratic/authoritative management style revolves around the assumption that authority confers the right to issue commands within an organization on the basis of impersonal rules and rights, by virtue of the management position rather than any trait ascribed to the person who occupies that position. Other characteristics include the following: Impersonal rules govern the actions of superiors over subordinates, all personnel are chosen for their competence and are subject to strict rules that are applied impersonally and uniformly, and a system of procedures for dealing with work situations is in place.

During a seminar on ethics, the educator realizes that more information is needed when a participant describes which situation as a violation of the ethical principle of autonomy? a. An older person with advanced stages of Alzheimer's disease is denied the right to ambulate in the hallway. b. A mentally competent adult refuses medical treatment for the autoimmune disease lupus erythematosus, stating that this condition reflects the will of a higher power. c. A mentally competent visitor fell during visiting hours but refused to be examined by the physician on call. d. A mentally competent adult with a broken wrist refuses to be given a local anesthetic prior to a procedure.

ANS: A Autonomy is defined as personal freedom, the right to make choices. However, in this case, the patient is not able to be fully informed so they can clearly understand the choices being offered.

A researcher calculated the risk-to-benefit ratio and concluded that no harmful effects were associated with a survey of college sophomores. The researcher was applying which ethical principle? a. Beneficence b. Human dignity c. Justice d. Human rights

ANS: A Beneficence is defined as promoting goodness, kindness, and charity. In ethical terms, beneficence means to provide benefit to others by promoting their good.

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

ANS: A Delegating is giving other people tasks to be accomplished. The benefits of delegation involve (1) assisting in developing the initiative, skills, knowledge, and competence of others; (2) maintaining the level of responsibility and decision making of others; (3) freeing time for more important tasks; (4) extending results that can be accomplished from what one person can do alone to what he or she can manage through others; and (5) ensuring that completing the task is cost effective.

When considering online communication etiquette, which nurse demonstrates a primary rule that should be adhered to by all? a. "My friend's wedding was lovely and anyone wanting to see pictures can view them on my website." b. "I'm not familiar with the details so I'm not going to get into the discuss of whose right or wrong." c. "My cousin's prom dress costed $3,000 and worth every penny her parents spent on it." d. "I got this information at the workshop I attended last month; I'm posting the power points for everyone to review."

ANS: A Interactions online are guided by the same sense of decency that any other style of communication dictates. Certainly, don't fan the flame of conflict or anger. The other options are not respectful of privacy, or potentially copyright laws.

Florence Nightingale is attributed with being intelligent (she developed statistical methods to evaluate health care), dependable (she often worked long hours to care for the injured), and ambitious (she fought against society's perception of nursing). Those who depict her as a leader based on these qualities are practicing which leadership theory? a. Trait b. Chaos c. Bureaucracy d. Organizational

ANS: A Leadership trait theory describes intrinsic traits of leaders and is based on the assumption that leaders were born with particular leadership characteristics. Other traits found to be associated with this leadership theory include intelligence, alertn ess, dependability, energy, drive, enthusiasm, ambition, decisiveness, self-confidence, cooperativeness, and technical mastery.

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

ANS: A Making sure that the first hour of every workday is productive sets the tone for achieving goals. The order of task completion is reliant on priority. The remaining options are considered barriers to efficiency.

A nurse is caring for a client who just consented to an elective abortion. The nurse is unsure of his or her own values as they relate to this issue. What action should the nurse take to address this barrier to providing effective care to the client? a. Reflect on one's personal values and how these values relate to beliefs and the philosophy of nursing b. Be prepared to defend his or her value system c. Ignore his or her own values and provide care d. Realize that values do not change and that they cannot be influenced by others and so decline this assignment

ANS: A Nurses must make a deliberate effort to recognize their own values and must learn to consider and respect the values of others. Health care decisions are seldom made independently of other people. Decisions are made with the client, the family, other nurses, and other health care providers.

A staff nurse provides care based on intuition and always seems to be in control of her personal and professional life—serving on the board of the state nurses association, serving as the nursing unit's representative on the ethics committee, and coaching her daughter's soft ball team. Many of the staff observes how she manages time and provides care. This nurse's power comes from which type of power? a. Referent b. Legitimate c. Information d. Connection

ANS: A Referent power comes from the followers' identification with the leader. Referent leaders are admired and respected and able to influence other nurses because of their desire to emulate her.

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

ANS: A The art of "no detourism" focuses on one task until completed.

An explosion just occurred at the local factory, and hundreds of employees have sustained varying degrees of injury. Which type of nursing leadership is most effective in this situation? a. Autocratic b. Democratic c. Laissez-faire d. Referent

ANS: A The dynamics of the situation demand that the leader take control and direct employees to specific actions in response to the emergency. These are characteristics of the autocratic style.

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

ANS: A The first step in learning the art of saying no is determining when to say it. The cost/benefit ratio of each opportunity must be evaluated in relation to the overall goal. If the activity will provide an overall benefit, obviously it must be given careful consideration. If it will not result in significant benefit, decline gracefully but emphatically. Personal preference may be a consideration but it is not the initial consideration. Neither of the remaining options are significant factors to making a personal decision.

When assessing an ethical issue, what is the nurse's first intervention? a. Ask, "What is the issue?" b. Identify all possible alternatives. c. Select the best option from a list of alternatives. d. Justify the choice of action or inaction.

ANS: A The first step in the situational assessment procedure is to find out the technical and scientific facts and assess the human dimension of the situation—the feelings, emotions, attitudes, and opinions. Assessment can be applied to all areas of patient care, including ethics. Trying to understand the full picture of a situation is time consuming and requires examination from many different perspectives, but it is worth the time and effort.

A nurse manager is concerned with restocking the emergency cart, creating the staff schedule, requesting floor stock from pharmacy, and checking the orders on patient charts. Which type of leader accurately describes this nurse? a. Transactional b. Situational c. Transformational d. Contemporary

ANS: A The transactional leader is concerned with the day-to-day operations of the facility; like those described in the question.

A nurse manager wants his nursing unit to be a place where all nurses want to work, where patient satisfaction is high, and care is innovative and interdisciplinary. Staff are encouraged to chair taskforces to improve quality of care and he counsels staff in areas of measuring patient outcomes. Other managers want to mimic this manager's approach to improve their own units. This nurse is which type of leader? a. Transformational b. Transactional c. Laissez-faire d. Authoritative

ANS: A Transformational leaders mentor followers through a vision and are admired and emulated.

To persuade employees to bargain for another type of health insurance, a handout is circulated that describes the present employees' health care insurance as being insensitive, limiting choices of care providers, and providing inferior care. This reflects which aspect of Lewin's planned change? a. Unfreeze b. Move c. Refreeze d. Acceptance

ANS: A Unfreeze is correct because the change agent promotes problem identification and encourages awareness of the need for change. In alignment with Lewin's stages of change (unfreezing, moving, and refreezing), education and involvement are keys to successful change. People must believe that improvement is possible before they will be willing to consider change.

Throughout their careers, nurses are in an ongoing state of acculturation, gaining experience from formal nursing school classes, clinical experiences, and the ethical issues they encounter in their clinical practice. What are the ideal outcomes of these ongoing experiences with cultural decision making? (Select all that apply.) a. Increased trustworthiness b. Enhanced ability to take into consideration many aspects of ethical situations c. Confidence to make decisions based on experience and ethical intelligence d. Improved clinical decision making and advocacy for patient autonomy e. Authority to make ethical decisions independently that meet personal moral beliefs

ANS: A, B, C, D The desired outcomes of ethics acculturation across the years are integrity, personal growth, practical wisdom, and effective problem solving on behalf of patients and their families. These are the qualities that are characteristics of an ethically sensitive and morally mature person. Trustworthiness is a characteristic of integrity. The ability to take into consideration many aspects of ethical situations is due in part to personal growth and practical wisdom. The confidence to make ethically sensitive decisions comes from experience founded on personal growth and personal wisdom. The ability to be the patient's advocate in ethical decision making is one test of cultural acculturation.

Registered nurses who are entering the workforce will have expanded leadership responsibilities that include what tasks? (Select all that apply.) a. Serving on interdisciplinary care teams b. Being competent to work in several areas independently when dictated by patient census c. Attending a meeting to plan advanced training for unlicensed assistive personnel d. Evaluating outcomes of care that are reported to a standing committee e. Managing units with higher acuity, shorter length of stay, and more diverse patients and staff

ANS: A, C, D, E The new nurses will be placed in many situations that require leadership and management skills: for example, managing a group of assigned patients, serving on a task force or committee, acting as team leaders or charge nurses, and supervising unlicensed assistive personnel and licensed vocational/practical nurses. Diverse patients have comorbidities and require complex interventions delivered during shorter stays with an ever-increasing diverse staff. The new nurses will be placed in many situations that require leadership and management skills, for example, managing a group of assigned patients, serving on a task force or committee, acting as team leaders or charge nurses, and supervising unlicensed assistive personnel and licensed vocational/practical nurses. The new nurses will be placed in many situations that require leadership and management skills, for example, managing a group of assigned patients, serving on a task force or committee, acting as team leaders or charge nurses, and supervising unlicensed assistive personnel and licensed vocational/practical nurses. The new nurses will be placed in many situations that require leadership and management skills, for example, managing a group of assigned patients, serving on a task force or committee, acting as team leaders or charge nurses, and supervising unlicensed assistive personnel and licensed vocational/practical nurses.

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

ANS: A,C Waiting, such as for meetings or oncoming shift, is an external distraction. Socializing with visitors is an external distraction.

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

ANS: B A items should stand out from other items because of their worth and high level of importance. A items are most urgent and may require more energy and time, but they should be completed before any of the B or C items are performed. Client safety is a consideration for A items.

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

ANS: B A perfectionist feels that everything should be completed at the same level of excellence. If you demand extremely high standards for every single task you undertake, you simply will not get everything done. None of the other options present this specific type of barrier to efficient time management.

A male nurse hired to work in the emergency department is observed throwing a contaminated needle into the trash can. The team leader reprimands the nurse for not appropriately disposing of sharps. The nurse states, "You don't care that I threw the needle in the trash. You just want an all-female staff," putting the team leader in a defensive position. This communication technique is referred to by what term? a. Straw man b. Red herring c. Slippery slope d. Confusing cause and effect

ANS: B A red herring is the introduction of an irrelevant topic for diverting attention away from the real issue.

A family requests that no additional heroic measures be instituted for their terminally ill mother who has advance directives in place. The nurse respects this decision in keeping with the principle of what client right? a. Accountability b. Autonomy c. Nonmaleficence d. Veracity

ANS: B Autonomy is the principle of respect for the individual person. Within the concept of autonomy, people are free to form their own judgments and perform whatever actions they choose. They are self-determining agents who are entitled to decide their own destiny.

What is the difference between a leader and a manager? a. A leader has legitimate authority. b. The manager motivates and inspires others. c. A manager focuses on coordinating resources. d. The leader focuses on accomplishing goals of the organization.

ANS: C The terms leadership and management are often used interchangeably, and it is difficult to discuss one without discussing the other. However, these roles have specific traits unique to themselves. The manager is the coordinator of resources (time, people, and supplies) needed to achieve outcomes.

Which nurse is demonstrating a common, productive conflict resolution style? a. The nurse who does not express feelings or ideas that conflict with those of the administration b. The nurse who states," If I cover for you this weekend will you cover for me the weekend before my vacation?" c. The nurse overheard saying, "There is no use fighting this; one solution is as good as another." d. The nurse who regularly insists they have the most insight into the problem being discussed.

ANS: B Compromise occurs when people give up something to get partial goal attainment; such as in the scenario presented. The other options demonstrate avoidance, accommodation, and force as a conflict resolution technique.

Two individuals with no health insurance or money sustained life-threatening injuries during an automobile accident. The decision was made to provide extended care in the trauma center after emergency surgery was performed to save their lives. The care of the two critical clients was based on what ethical principle? a. Utilitarianism b. Deontology c. Autonomy d. Veracity

ANS: B Deontology is an approach that is rooted in the assumption that humans are rational and act out of principles that are consistent and objective and that compel them to do what is right. Deontological theory claims that a decision is right only if it conforms to an overriding moral duty and wrong only if it violates that moral duty.

A patient's spouse was just diagnosed with lung cancer although there was no history of tobacco use. The spouse states, "I am so mad. How can you get cancer without smoking?" Which statement by the nurse represents empathy? a. "Research is identifying many risk factors for cancer besides smoking." b. "I understand how you could feel angry about the diagnosis." c. "He is still a good husband." d. "Why do you think he got cancer?"

ANS: B Empathy is feeling what the other person is feeling and seeing the situation as they see it; entails believing that the other person's feelings are valid, legitimate, and justified. The nurse is placing herself in the wife's position and sharing her emotions.

A teenage patient is using earphones to listen to hard rock music and is making gestures in rhythm to the music. The nurse assesses the amount of urine output in the Foley catheter and leaves the room. What communication technique is demonstrated in both situations? a. Blocking b. Filtration c. Empathy d. False assurance

ANS: B Filtration is the unconscious exclusion of extraneous stimuli in communication.

During a health history interview, the nurse listens to a patient relating the precipitating events that led to the onse t of chest pain. She focuses her attention on the patient, makes eye contact, and acknowledges what the patient has to say. The nurse is exhibiting what communication technique? a. Assertive communication b. Active listening c. Empathy d. Passive communication

ANS: B In active listening a number of techniques can be used by the receiver to enhance the ability to listen; these include (1) providing undivided attention, (2) giving feedback (rephrasing), (3) making eye contact, (4) noting nonverbal messages (body language), and (5) finishing listening before one begins to speak.

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

ANS: B Mental energy is the ability to maintain sustained concentration on a task, to move flexibly between broad and narrow issues, and to be internally and externally focused, as needed by the situation. It includes mental preparation, visualization, positive self-talk, effective time management, and creativity.

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

ANS: B Spiritual energy can be increased by taking time to reflect over events in one's life and allowing time to understand feelings associated with events/happenings. A quiet environment is essential for reflection.

A nurse who was recently certified in chemotherapy administration fails to check compatibility of phenytoin before injecting into a continuous infusion of D5W leading to occlusion of the line. Which statement by the nurse demonstrates a red herring? a. The nurse is upset and states, "I am sure I have injected this before without a problem" and the supervisor interprets this to mean the nurse often take shortcuts. b. The nurse states, "You are just upset because I am certified in chemotherapy administration and you are not." c. "The nurse who started the IV didn't get a blood return but determined the IV was the patient's—that is the problem." d. "This drug always occludes the line because it is so viscous."

ANS: B The nurse diverts attention away from the issue of not checking compatibility to introduce an irrelevant topic of chemotherapy administration certification which is not related to this situation.

What is the first step in both the nursing and problem-solving processes? a. Identifying the problem b. Gathering relevant information c. Considering the consequences of change d. Implementing appropriate interventions

ANS: B The nursing process, which is familiar to nurses who address patient care needs, can be applied to all management activities that require decision making and problem solving. As in the nursing process and the problem-solving process, one must first gather information about the problem or situation.

What situation demonstrates a nurse engaging in active listening? a. While assessing the patient's vital signs, the nurse records the data and states, "You are improving, your vital signs are normal." b. Eye contact is maintained while focusing on the patient as the patient describes the current pain level and location. c. The nurse states, "I know how you feel, I recently lost my father and I am still hurting." d. The nurse has cultural values that are in opposition to the patient but shares that "I agree with your decision to use herbs rather than the prescribed medications."

ANS: B This behavior demonstrates active listening. A number of techniques can be used by the receiver to enhance the ability to listen; these include (1) providing undivided attention, (2) giving feedback (rephrasing), (3) making eye contact, (4) noting nonverbal messages (body language), and (5) finishing listening before one begins to speak.

1. The healthiest form of communication is the ________ style.

ANS: assertive Assertive communicators are honest and direct while valuing and respecting other individuals' views and seeking a win-win solution without the use of manipulation or game-playing.

A 13-year-old female is brought to the family planning clinic by her enraged father, who has just learned that she is pregnant. The pregnant client states, "I want to have this baby and give it up for adoption." However, the father is adamant that she will disgrace the family and demands that the health care providers tell his daughter that she has a physical condition that would prohibit her from carrying this baby to a viable stage. The nurse realizes that this is a conflict that involves what ethical principle? a. Deontology b. Veracity c. Autonomy d. Beneficence

ANS: B Veracity is telling the truth in personal communication as a moral and ethical requirement.

An older adult client is comatose and had one electroencephalogram that indicated no activity. The daughter is very distraught and notices her mother's hand moves when she is talking to her. The daughter asks the nurse, "Is mother responding to my voice?" The nurse, attempting to console the daughter, knows the movement was involuntary but states, "It does appear she did." The nurse is violating which principle of ethics? a. Autonomy b. Veracity c. Utilitarianism d. Deontology

ANS: B Veracity is the principle of telling the truth in a given situation.

In today's world of fast, effective communication, what is the most commonly used means of societal communication? a. Facial expression b. Spoken word c. Written messages d. Electronic messaging

ANS: B Verbal communication, which involves talking and listening, is the most common form of interpersonal communication. An important clue to verbal communication is the tone or inflection with which words are spoken and the general attitude used when speaking.

In which case does the nurse act as "whistle-blower"? a. One staff member on the unit covers for another nurse, who leaves the premises to purchase illegal substances. b. The nurse reports that another nurse is taking medications out of stock medicine for herself or himself. c. A nurse informs respiratory therapy that a patient is now due a treatment. d. The nurse delegating care to unlicensed assistive personnel makes rounds to ensure all care was rendered properly.

ANS: B Whistle-blowing is the reporting of acts or situations that violate the principle of beneficence such as a chemical impairment, negligence, abusiveness, incompetence, or cruelty.

A new mother is experiencing pain after delivering an infant with Down syndrome. The staff nurse states, "I don't think she is really hurting. Let the next shift give the pain medication." The team leader notices the staff nurse looks agitated and anxious and asks about any concerns in providing care to this new mom. The staff nurse admits having a stillborn infant with Down syndrome. This is an example of which component of communication? a. Personal perception b. Past experiences c. Filtration d. Preconceived idea

ANS: B With past experiences that include a variety of positive, neutral, and negative events, the influence that these experiences can and will have on communication may be positive, neutral, or negative. The importance of recognizing that any reaction from the receiver may be biased by previous experience cannot be overstated.

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.

ANS: B, D, E Task that falls within Priority B includes the medium-value items, such as tasks that are not urgent but most likely will not "fall" off the list. Since the dress code must be reviewed and feedback constructed for a morning appointment, this would be level B, it is not urgent nor will it likely fall off the list. Completing patient teaching for a patient to be discharged in 2 hours must be completed but does not take priority over "A" tasks. Reviewing a procedure to be performed later in the day is Level "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

ANS: B,D Planning for the future is an effective time management strategy. Maintaining a log of how you spend your time is an effective time management strategy.

A client is in extreme pain after he was involved in a motor vehicle accident, and morphine has been ordered every hour for pain. The nurse injects saline into the client's IV line and takes the morphine for herself. The nurse is violating which principle of ethics? a. Autonomy b. Utilitarianism c. Beneficence d. Dilemmas

ANS: C Beneficence is providing benefit to others by promoting their good. In general terms, to be beneficent is to promote goodness, kindness, and charity. By taking the client's pain medication and substituting saline, the nurse did harm, not good, for this client.

A nurse is listening to a patient's apical heart rate. The patient asks, "Is everything okay?" The nurse says nothing and shrugs her shoulders. The nurse is demonstrating what form of negative communication? a. Ad Hominem Abusive b. Filtration c. Blocking d. False assurance

ANS: C Blocking occurs when the nurse responds with noncommittal or generalized answers.

A staff nurse states, "I really enjoyed having dinner with the Chief of Medical Staff and the President of the hospital. We hope to meet again soon." Which source of power does this nurse possess? a. Expert b. Legitimate c. Connection d. Reward

ANS: C Connection power results from knowing or associating with power people such as the upper administration.

An older adult is unable to reach the telephone and is found dead at home several hours later. The son of the deceased person arrives at the hospital and asks, "Can I just please stay and hold my dad's hand? He was so afraid of dying alone." Which response by the nurse shows empathy? a. "Of course, you can. I'll let you know when the funeral home is here to transport his body." b. "It must be very hard to know he died alone." c. "I'll close the door so you can spend time with your dad. I will check back in a few minutes." d. "I lost my dad last year. He died alone. He was a policeman. I am just like you. Let me stay here and console you."

ANS: C Empathy is demonstrated by the ability to mentally place oneself in another person's situation to better understand the person and to share the emotions or feelings of the person.

A nurse is overhead saying, "I don't mind working during the election and holiday. My parents are divorced, money is tight, and honestly, I don't trust any politicians anyway. I plan to take a few weeks off next month." She works independently to research strategies to improve patient-centered care for the large number of immigrants that arrived in the area and then works with the team to share ideas. She recommends, "Let's think the suggestions over and come back together next week." This nurse's communication style is consistent with which generation? a. Baby Boomers b. Traditionalist c. Generation X d. Millenniums

ANS: C Generation X individuals grew up in when there was a high rate of divorces; they tend to be more cynical and value work-life balance and teamwork. Holidays are often associated with family gatherings which may have been absent in this generation's family; belief that ALL politicians are untrustworthy may be viewed as cynical. The need to take time to form suggestions to save time and come together to reach team decision are reflective of this generation.

A hospital recently learned that their scorecard did not meet the national benchmark for patient satisfaction and brought in a professional change agent to determine what their issues were and how they could improve their score. The agent collected data and recommended that nurses participate in interdisciplinary walking rounds and allow the patient and family to be participants. Nurses now round every shift and perform "huddles to update the team" as needed throughout the shift as part of best practices. Random visits are made to nursing units to ensure all nurses are participating and patients are interviewed for their involvement. These practices are associated with which stage of Lewin's change process? a. Unfreeze b. Moving c. Refreeze d. Resistance

ANS: C In the refreezing stage, change becomes status quo and the agent reinforces until the change is part of the daily process as in the above situation.

A nurse who is infected with human immunodeficiency virus (HIV) while working in the operating room seeks revenge by deliberately placing clients at risk by not adhering to universal precautions. This nurse is violating what ethical principle? a. Veracity b. Beneficence c. Nonmaleficence d. Autonomy

ANS: C Nonmaleficence means to abstain from injuring others and to help others further their own well-being by removing harm and eliminating threats. The nurse is definitely violating this principle through her actions.

How is the term Ethics as applied to nursing best defined? a. Doing what is best for the client b. Making good decisions about care c. Care based on keeping with the values of the client d. Rules for providing competent care that is based on scientific principles

ANS: C Nursing ethics is a system of principles intended to guide the actions of the nurse in his or her relationships with clients, clients' family members, other health care providers, policymakers, and society as a whole. A nurse must make an attempt to understand what values are inherent in the situation.

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

ANS: C Procrastination is evident when a person is faced with an unpleasant task, a difficult task, or a difficult decision. Usually procrastination is easily recognizable because it involves completing low-priority tasks rather than high-priority ones, and it always welcomes interruptions. Priority setting would consider the more important task to be the NG tube insertion. Introspection is the examination of one's own conscious thoughts and feelings. Energy management ensures that the right amount of effort matches the right task to optimize an outcome.

A nurse gives phenytoin intravenously with lactated Ringer's solution containing multivitamins. The drug precipitates and obstructs the only existing line. When the team leader informs the nurse that these drugs cannot be mixed, the nurse states, "You've disliked me since I refused to switch my vacation time last month." Which type of logical fallacy has influenced the nurse? a. Ad hominem abusive b. Appeal to common practice c. Red herring d. Appeal to tradition

ANS: C Red herring is the introduction of an irrelevant topic in order to divert attention away from the real issue.

Managers who exhibit an authoritative behavioral style are most likely to use which source of power? a. Informal b. Expert c. Coercive d. Reward

ANS: C Seven primary sources of power are known. Coercive power is based on fear of punishment or failure to comply. Coercive power fits well into the authoritative behavioral style because authoritative managers dictate the work with much control, usually ignore the ideas or suggestions of subordinates, and provide little feedback or recognition for work accomplished.

An RN with excellent assessment and psychomotor skills would derive power based on which source? a. Rewards b. Coercion c. Expert d. Legitimate

ANS: C Seven primary sources of power are known. Expert power is based on knowledge, skills, and information.

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

ANS: C Stopping to evaluate what is going on is important because you may have to readjust your plan and reprioritize to reach your goal. None of the other options allow for effective prioritization.

A group of nurses are meeting to decide how to staff the upcoming holidays. Each of the four members freely expresses thoughts about fair staffing but is willing to listen to other thoughts and reconsider their first recommendations. The nurses are avoiding conflict and supporting professional communication through implementation of what communication technique? a. Empathy b. Positiveness c. Supportiveness d. Accommodation

ANS: C Supportive communication occurs when each person's opinion/position is valued and each participant has the freedom to express a position but is willing to change that opinion/position.

A director of nursing (DON) asks the staff to list how their nursing unit can help the organization meet its goal to "provide quality patient care with attention to compassion and excellence." An ad hoc committee is formed to develop a timeline of identified actions. The DON coaches the committee to reach desired outcomes. This DON is demonstrating which other role of leadership and management? a. Transactional b. Clinical consultant c. Corporate supporter d. Autocratic

ANS: C The manager is embracing the mission of the organization by supporting achievement of goals noted in the mission statement.

In attempting to decide which services should be offered to a community, the public health nurse decides to implement hypertension screening and treatment because most of the residents are hypertensive. This decision is based on what ethical principle? a. Veracity b. Values c. Utilitarianism d. Autonomy

ANS: C Utilitarianism is an approach that is rooted in the assumption that an action or practice is right if it leads to the greatest possible balance of good consequences or to the least possible balance of bad consequences. On the basis of this principle, an attempt is made to determine which actions will lead to the greatest ratio of benefit to harm for all persons involved in the situation.

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

ANS: C You need to preplan for the meeting so it can be conducted in a timely manner. One way to have a productive meeting is to prepare a meeting agenda with time allotted for each item and the name of the person responsible for reporting on each item. Send out the agenda prior to the meeting so attendees can come prepared. Meetings seldom have the luxury of unlimited time to discuss issues or to delay the start of the discussion. The agenda should be planned to accommodate emotional topics.

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

ANS: C, D, E Drinking plenty of water promotes physical health. Taking a break every 90 minutes, especially during long shifts such as 12-hour shifts, provides a much-needed time to relax and reorganize. Proper and frequent exercise promotes physical health.

A nurse asks, "What is meant by 'internal' customers?" The correct response should identify which person or persons? (Select all that apply.) a. Insurance companies b. Accreditors such as The Joint Commission c. X-ray technicians d. Clinical pharmacist e. Chief financial officer

ANS: C, D, E Internal customers are employees of an organization at all levels. An x-ray technician is an example of an internal customer. Internal customers are employees of an organization at all levels. A clinical pharmacist is an example of an internal customer. Internal customers are employees of an organization at all levels. A chief financial officer is an example of an internal customer.

A nurse is preparing an exercise program as part of a health promotion program for older adults with osteoporosis. Which question would retrieve the most valuable information about health practices? a. "Do you exercise?" b. "Do you like to exercise?" c. "When do you exercise?" d. "What exercise practices do you participate in?"

ANS: D "What exercise practices do you participate in?" is an open-ended question or statement that requires more information than just yes or no. This type of question augments the gathering of enough facts to build a more complete picture of the circumstances.

Which action represents the key management function of strategic planning? a. Determining that all nurses on the unit understand the current organizational philosophy b. Evaluating the communication process between the pharmacy and the nursing departments c. Monitoring data from the quality management initiative related to the last three orientation programs d. Developing a 5-year plan that will incorporate the clinical nurse leader as a part of all nursing units

ANS: D A strategic plan is a written document that details organizational goals, allocates resources, assigns responsibilities, and determines time frames. The strategic plan generally looks 3 to 5 years into the future.

How do accrediting agencies such as The Joint Commission address staffing? a. Imposing maximum staffing levels b. Requiring a specific staff mix c. Stipulating nurse-patient ratios d. Confirming delivery of satisfactory care

ANS: D Accrediting agencies do not address minimum staffing levels; however, they do look for evidence that patients receive adequate care, and this can occur only with adequate staffing.

Which statement accurately describes communication? a. The components of communication are mutually exclusive. b. Communication is linear. c. Communication involves only the sender and the receiver; everything else is superficial. d. When the receiver becomes the sender, the subcomponent of communication that is in use is feedback.

ANS: D Communication is a process that requires certain components, including a sender, a receiver, and a message. Effective communication is a dynamic process: With a response (feedback), the sender becomes the receiver, the receiver becomes the sender, and the message changes.

A manager just finished the last annual performance review of the staff, reviews the unexpected expenditures for the month due to use of agency nurses, and shares the latest quality indicators with the staff nurses. This manager is performing which management function? a. Directing b. Planning c. Organizing d. Controlling

ANS: D Controlling is the final management function. It includes performance evaluations, financial activities, and tracking outcomes of care to ensure quality.

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

ANS: D Fear of completion is a time management obstacle that may occur if you are afraid of completing a project that is creative and fun. To overcome this obstacle, take the time to understand why you are not completing the task or major project that has been with you for some time. Need for perfection demands extremely high standards for every single task you undertake. The student has demonstrated creativity and has been complimented on it. There is no indication that the goals of the task have not been met.

The most important step in time management is ____________.

ANS: planning It is important to plan before beginning any task, project, or day's activities. Planning involves (1) setting goals and establishing priorities, (2) scheduling activities, and (3) making to-do lists.

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..

ANS: D One must consider many factors when planning a project. Some of the following factors influence how priorities should be established: (1) urgency of a situation, (2) demands of others, (3) closeness of deadlines, (4) existing time frame, (5) degree of familiarity with the task, (6) ease of task completion, (7) amount of enjoyment involved, (8) consequences involved, (9) size of the task, and (10) congruence with personal goals. When the use of time is considered, not all factors carry the same weight, and adjustments will be needed.

A nurse is asked to "float" to another area where the patients require total care. The nurse smiles, picks up her stethoscope, and says, "I'll come back and eat lunch with everyone here." When she enters the elevator she hits the wall and mutters, "Always me. Don't I have any rights"? The nurse is demonstrating which communication style? a. Assertive b. Aggressive c. Passive d. Passive-aggressive

ANS: D Passive-aggressive communication is represented by incongruent actions—the nurse shows friendly gestures by smiling and demonstrating she wants to have lunch with the staff on the original unit; however, she shows her anger by hitting the wall and muttering.

The primary health care provider who insists on providing treatment in spite of the client's wishes because "I know best" is reflecting an attitude referred to as what? a. Autonomy b. Beneficence c. Justice d. Paternalism

ANS: D Paternalism is an action and an attitude wherein the provider tries to act on behalf of the client and believes that his or her actions are justified because of a commitment to act in the best interest of the client. Paternalism is a reflection of the "father knows best" way of thinking.

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

ANS: D Planning is the most important step in time management. Scheduling activities allows people to better use their time and can lead to closure in relation to those goals that will produce the greatest internal satisfaction. An unregulated open-door policy can encourage interrupts that affect daily work flow. The retaining of paper copies is not always necessary and is determined by the organization and need of such references. Telephone calls need to be prioritized and returned according to importance.

A licensed practical nurse (LPN) has been practicing for 25 years on a unit where a newly graduated RN with a bachelor's degree is hired. Before the RN arrives on the unit, the LPN is heard saying, "She'll try to tell everyone what to do because she makes more money. She'll sit at the desk and let us do all the work." This is an example of what communication associated process? a. Interpretation b. Context c. Precipitating event d. Preconceived idea

ANS: D Preconceived ideas are conceptions, opinions, or thoughts that the receiver has developed before having an encounter. Such ideas can dramatically affect the receiver's acceptance and understanding of the message.

A clinical nurse leader (CNL) enters the workforce and hopes to use her interdisciplinary skills to participate on a quality improvement committee. The coordinator of the quality group invites the CNL to join the group. Which type of power is demonstrated by the coordinator of the group? a. Coercive b. Transformational c. Laissez-fair d. Legitimate

ANS: D The coordinator of the committee has an official position within the organizational committee; such as being on the quality improvement committee.

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."

ANS: D The statement "I have the list of patients; let's start with revisions to the plan of care and scheduled activities for the next shift" focuses the conversation during report, keeping personal conversations to a minimum. None of the remaining options focus on solving the problem refocusing on the task at hand.

Which component of an e-mail shown below would be both effective and concise? a. Subject: A short concise subject line: Meeting. b. Body: I would like you to answer these questions before the next meeting: Where would you like to meet? Do you want all the staff to attend? Can we serve refreshments? What is one goal for our unit? c. Body: Dear Staff, As you know, each department must reduce staff by 2%. We will need to discuss how to inform unlicensed staff about the downsizing efforts of the hospital. d. Body: The next staff meeting is scheduled for Tuesday, January 19, at 5 PM in the first-floor auditorium. Please send items for the agenda. Sally Smith, MSN, RN, [email protected] or ext. 5582.

ANS: D This provides a message that is concise and accurate with a clearly conveyed message for the reader and contact information from the sender, all of which are important components of effective e-mail communication.

A nurse is reading about positive reinforcement with the goal of increasing staff motivation. Which action would demonstrate positive reinforcement? a. Every morning at shift change, thank each employee for an excellent job. b. Rotate a monthly "employee recognition award" among all employees on the unit. c. Wait until the annual performance review to recognize accomplishments. d. Give spur-of-the-moment recognition to an employee who has accomplished a goal.

ANS: D To be effective, positive reinforcement should (1) be specific, with praise given for a task done well or a goal accomplished; (2) occur as close as possible to the time of the achievement; (3) be spontaneous and unpredictable (praise given routinely tends to lose value); and (4) be given for a genuine accomplishment.

Practicing nurses participate in employer-sponsored professional development classes that provide case studies related to ethical situations and decision making. Ethical considerations are debated among teams, and an expert helps the class arrive at the "best practices." The nurses are experiencing ethics ______________.

ANS: acculturation Ethics acculturation is the didactic and experiential process of developing ethical reasoning abilities as a part of ongoing professional education.

* The nurse manager informs the nursing staff that the clinical nurse specialist will be conducting a research study about staff attitudes toward client care. All staff are invited to participate in the study if they wish. This type of research participation affirms which ethical principle? A. Justice B. Anonymity C. Beneficence D. Autonomy

D

* The nurse manager learns that the unit expenses have exceeded the budget allowance by $500,000 for the first half of the fiscal year. The nurse manager would use which of the following processes to most effectively prioritize client care activities and control the cost of care? A. Authoritative process B. Management process C. Time management process D. Total quality management process

B

* A patient on the medical surgical unit begins to code. The assigned registered nurse and the charge nurse are at lunch. The newly hired nurse manager begins to direct the resuscitation efforts until the code team arrives, using which one of the following as the basis of power in this situation? A. The manager's intelligence B. The manager's expertise and experience C. The manager's formal position or rank D. The staff's acceptance of direction

C

* The nurse is evaluating the completion of a client's wound dressing that was delegated to a licensed practical nurse. Which nursing action is appropriate? A. Ask the client if the dressing was done. B. Check the medical record C. Visualize the new dressing D. Obtain report from the LPN

C

* The nurse manager is reviewing ways that a nurse may risk disciplinary action related to licensure, Which action would put the nurse's license at risk? A. Maintaining a habit of excessive absences and tardiness B. Arriving to work with evidence of body odor. C. Inserting a central catheter under the direct supervision of a healthcare provider D. Participate in lateral violence and bullying on the unit.

C

* The nurse manager has been notified by central supply that many client items are missing from stock and have not been charged to the client. Which action should the nurse manager implement in regard to the lost charges? A. Send out a memo telling the staff to follow the charge procedures B. Determine whether the items in question are being restocked daily C. Schedule a staff meeting to discuss how to prevent further lost charges D. Form a performance improvement committee to study the problem

C. Schedule a staff meeting to discuss how to prevent further lost charges

ANS: B With federal funding, many controversial health care services will be covered and provided as part of patient care when desired by the patient; therefore, whether a nurse has autonomy to refuse to provide care may not be as clear even when one might request another patient.

The Health Care Reform Act provides insurance for all U.S. citizens and legal residents presenting far-reaching ethical considerations related to diverse individual patient health care beliefs for those delivering nursing care. Nurses must consider their civil rights under the rights of conscience and how new health care agendas such as the Patient Protection and Affordable Care Act (PPACA) could affect their practice in situations that may conflict with their own belief system. What action demonstrates a nurse attempt to act in accordance with this responsibility? a. Remembering it is one's professional duty to render patient-centered care—even when it is in direct conflict with the nurse's own beliefs—or be held liable for withholding treatment. b. Considering whether the right to act according to one's inner beliefs will continue to be permissible when federal health insurance becomes fully enacted. c. Discussing with the patient and family different options in hopes they will accept the nurse's health care beliefs. d. Suggesting to the hospital administration that they not accept federal funding to prevent controversial health practices.

ANS: B The National Council State Board of Nursing's policy on social media prohibits posting of patient information on social media sites. This patient could be identified by knowing where she works and the fact that she was seen in the ED the day before.

The nurse caring for a patient states, "Your blood pressure is dangerously high. Are you taking antihypertensive medicine?" The patient states, "I can't afford my medicine. I have no insurance." The nurse states "I feel really sorry for that patient. I wish it wasn't against policy to give her money." The nurse wants to help and places a note on Facebook that any donations would be appreciated to help a waitress who works at the cafeteria next door to the hospital buy her medications. The nurse posts that "She was so sick last evening when she came to the ED. I can't believe they don't provide insurance. I can't give her money but you all can help." This nurse's action has what possible outcome? a. Showing empathy and if she lets the patient know the money is not from her, she is not violating any social media guidelines. b. Increasing the risk for HIPAA violations c. No legal risk since she has properly followed policy and protected the patient by not using her name. d. The nurse is demonstrating the logical fallacy of slippery slope.