Jenn N396 Leadership Questions
Answer: A The charge nurse is using her power to make assignments for the unit in order to be able to continue her inappropriate behavior
A charge nurse is inappropriate towards her male coworkers and makes derogatory remarks about their personal relationships and touches them in a way that makes them uncomfortable. She states "you better keep me happy or I will put you on the south wing with all of the difficult patients." Which unprofessional behavior is the charge nurse exhibiting? a. abuse of power b. miscommunication c. poor work ethic d. lack of commitment to the profession
Answer: D Rationale: Seek counseling if needed is a good way to talk out workplace issues and prevent burnout from stress. A, B and C are also good ways to prevent burnout.
A new nurse is seeing burnout with some of the mentors on the unit. This new nurse can utilize techniques to help prevent burnout. Which technique, however, is not likely to be helpful? A. Establish a regular exercise routine B. Get involved in constructive changes to hospital policies and procedures C. Participate in professional organizations D. Avoid counseling to keep workplace issues at work.
Answer: C Rationale: Case - one nurse is responsible for patients on the shift and a nurse admits a pt, develops the plan of care, provides care but only during their shift.
A new nurse joins a hospital on the med/surg floor. Each day she comes in and is assigned 4 patients for her shift, and is responsible for caring for them during the duration of her shift. Which organizational style of nursing care is this an example of? a. Functional b. Team c. Case d. Primary
Answer: C Rationale: A nurse should never place blame on others. Instead, they should take responsibility of their own mistakes and learn from them. A nurse leader should be able to enables others to act, empowers others to embrace their passions and talents, and should be trustworthy.
A new nurse just started a position as a nursing leader. What is not an effective nursing leadership skill? a. enables others to act b. empowers others to embrace their passions and talents c. is able to blame others d. is trustworthy
Answer: A Rationale: no matter what kind of situation your patient is in, you should always treat them with compassion, respect, and have a positive attitude about their recovery process.
A nurse is caring for a patient that has been admitted to the unit for alcoholic detox. She tells the other nurses that she doesn't know why we should treat him or why the patient even bothers to come in for this because he's just going to go back home and start drinking again. What traits is this nurse lacking? a) Positive attitude and compassion b) A stethoscope c) Negativity and hope d) Self-respect
Answer: B Rationale: Administering medications is not within the UAP's scope of practice and therefore should not be delegated to a UAP. Dressing changes, tracheostomy care, and vital signs can be delegated to a trained UAP.
A nurse is caring for a postoperative patient who has a tracheostomy. What task should NOT be delegated to a UAP? A. Dressing changes B. Medication administration C. Tracheostomy care D. Taking vital signs
Answer: A, B, D Rationale: The nurse can delegate medication administration, wound care, and sputum collection to an LPN because it is within their scope of practice. Starting an IV is not within the LPN's scope of practice.
A nurse is working in a clinic where she is the only RN, there are also LPN's and UAP's working. The nurse can delegate which task(s) to an LPN: (Select all that apply.) A. Medication administration B. Wound care C. Start an IV D. Sputum collection
Answer: A Conflicts can be beneficial in serving as a learning experience and helping resolve any issues that may have been hiding internally. Conflicts can become destructive if progression continues. Poor performance may become an issue when conflicts arise due to the fact that staff are not working together as a team. Leaders can arise from conflict because members of that team become aware of their performance and try to be the example of that workplace thereafter.
A nurse leader has been having conflict between two other nurses recently. The nurse leader understands that conflict is all of the following except: A. Not beneficial, so should be avoided at all costs B. Destructive if the problem progresses C. May result in poor performance in the work place D. Leaders can rise from these events
Answer: A Rationale: Fibromyalgia is a musculoskeletal disorder characterized by muscle pain and stiffness.
A nurse suspects that a patient may have fibromyalgia. Which discovery would support this theory? a. Muscle pain and stiffness b. Nausea and vomiting c. Headaches d. Mild fever
Answer: A, B, C Rationale: Rights of delegation include right task, right person, right direction, right circumstances, and right supervision. Right documentation and right route are not rights of delegation.
A nurse wants to delegate the task of calculating intake and output for a patient to the UAP on the floor and wants to keep in mind the rights of delegation while doing this. Which of the following are rights of delegation? (select all that apply) a. Right task b. Right person c. Right direction d. Right documentation e. Right route
Answer: B Rationale: Normative commitment is a feeling of obligation to stay in a profession as a result of benefits received or having positive experiences.
A nurse who has had a satisfying career is beginning to feel a need to take a break from the profession, because she has had many positive experiences and such a satisfying career she feels obligated to stay in the profession. This is an example of which type of commitment? A) Affective commitment B) Normative commitment C) Formal commitment D) Continuance commitment
Answer: B Teaching should not be delegated to UAP. The correct answer could be any of those listed. This is a bad question/answer combo. -J
A nurse works with a CNA who has a great work ethic and learns very quickly on the job. The nurse trusts the CNA and asks the CNA to perform discharge teaching on a patient. This is one of three discharges she needs to complete today and she is already late for her 1300 med pass. Which of the Rights of Delegation specified by the ANA is the nurse violating with this request? a. right person b. right task c. right supervision d. right circumstances
Answer: A Rationale: Assisting patients with positioning and activities of daily living is within the educational preparation and scope of practice of a nursing assistant. Teaching, instructing, and assessing patients all require additional education and skills and are more appropriate for a licensed nurse.
A patient has chronic obstructive pulmonary disease (COPD). Which intervention for airway management should you delegate to a nursing assistant (PCT)? A. Assisting the patient to sit up on the side of the bed B. Instructing the patient to cough effectively C. Teaching the patient to use incentive spirometry D. Auscultation of breath sounds every 4 hours
Answer: B Rationale: The family are expecting anticipatory grief because they are aware that the client only has six months to live. Anticipatory grief is for those who are soon to expect death of someone, although not everyone goes through anticipatory grief.
A patient with colon cancer has been give 6 months to live. The family visits looking tearful and sad. What type of grief would a nurse suspect them to be experiencing? a. Complicated grief b. Anticipatory grief c. Perceived grief d. Disenfranchised grief
Answer: D Rationale: Conflicts are beneficial because it surfaces out issues in the open and can be solved right away. Likewise, members of the team become more conscientious with their work when they are aware that other members of the team are watching them.
A person in place of power, such as a manager, knows that conflict occurs in any organization. Which of the following statements regarding conflict is NOT true? A. Can be destructive is levels are too high B. May create leaders C. Can cause individuals to quit D. Is not beneficial and should be avoided at all costs
Answer: B Rationale: Accountability is the ability/willingness to assume responsibilities and accept consequences. Authority is the right to direct others and their activities. Responsibility is the obligation to meet objectives and perform tasks. Confidentiality is the assurance the client has that private information will not be disclosed without the client's consent.
A student nurse immediately informs his clinical instructor after he realizes that he gave the wrong medications to a patient. Which characteristic is the nursing student displaying? A. Authority B. Accountability C. Responsibility D. Confidentiality
Answer: B Rationale: Leadership is the ability to guide or influence others. The other words are more applicable to the supervision of resources.
According to the definition, which word best describes leadership? a) Allocate b) Influence c) Evaluate d) Control
Answer: A, B, D Rationale: Taking vital signs, measuring input and output, transferring clients, ambulation, postmortem care, bathing, and feeding are all tasks that are within the scope of a UAP. An RN can delegate these tasks to a UAP. Suction or giving medications are not within the scope of practice for a UAP.
An RN is working with a client who is experiencing continuous codes. Which tasks could the RN delegate to the Unlicensed Assisted Personnel (UAP) in order to assist with the other patients on the floor? Select all that apply A) Transferring a client who is experiencing nausea to the bathroom B) Taking the blood pressure of a client who takes a medication with hypertension as a possible side effect C) Suctioning a client with a tracheotomy who is wheezing D) Feeding a client who is on a clear liquid diet E) Giving an insulin injection to a client whose glucose level is 100
Answer: B Conflict can be beneficial.
As a young manager, the nurse knows that conflict occurs in any organization. Which of the following statements regarding conflict is NOT true? a. can be destructive if the level is too high b. is not beneficial so should be avoided at all times c. may result in poor performance d. may create leaders
ANSWER: D Thinking "safety first," it is important to understand that this many patients is too many for 1 RN and 3 CNAs. There needs to be another RN on shift to help cover the patients. While it is important to optimize efficiency, it would still be unsafe for the RN to try to take care of these patients with the CNAs. More CNAs would also not be beneficial because they cannot perform assessments or pass medications, so patient safety would still be compromised.
In a pediatric unit, an RN has called in sick, leaving 10 patients to be cared for by 1 RN and 3 CNAs. What should the RN do? A. Delegate as much work to the CNAs as legally possible B. Plan and organize to create the most efficient way to care for the clients C. Contact the Nursing Manager and request more CNAs be assigned to the unit D. Contact the nursing supervisor and request another RN in the unit
Answer: C Rationale: Autocratic leadership style makes decisions on others behalf. Jeffery did not give opportunity to make decisions. Situational leadership style depends on the task and relationships, there was no evidence to support relationships. Democratic encourages group decision making. Lastly Charismatic leadership style is based on emotional relationships with the committee members.
Jeffery is in charge of a committee and rather than taking votes and discussing events with the committee he takes it upon himself to make all of the decisions. What type of leadership style is Jeffery displaying? A. Democratic B. Situational C. Autocratic D. Charismatic
Answer: A
Katherine is a young Unity Manager of the Pediatric Ward. Most of her staff nurses are senior to her, very articulate, confident and sometimes aggressive. Katherine feels uncomfortable believing that she is the scapegoat of everything that goes wrong in her department. Which of the following is the best action that she must take? A. Identify the source of the conflict and understand the points of friction B. Disregard what she feels and continue to work independently C. Seek help from the Director of Nursing D. Quit her job and look for another employment
Answer: C Rationale: This strategy shuns discussing the issue head-on and prefers to postpone it to a later time. In effect the problem remains unsolved and both parties are in a lose-lose situation.
Mr. Jackson tells the student, ""I don't have time to discuss the matter with you now. See me in my office later" when the student asks if they can talk about an issue. Which of the following conflict resolution strategies is Mr. Jackson using? A. Smoothing B. Compromise C. Avoidance D. Restriction
Answer: C. -Case managers should identify the specific cases that would most benefit from case management, such as the cases of clients with multiple chronic health problems. Generally, case management involves interdisciplinary teams that assume collaborative responsibility for planning and assessing needs and for coordinating, implementing and evaluating care for groups of clients from preadmission through discharge or transfer and recuperation. -Depression is a normal sign of childhood grief and in most cases childhood grief progresses naturally and in a healthy manner with the help of supportive family members and friends. -The 17 year old female has dysmenorrhea (painful menstruation) that may occur for a few hours or up to 3 days and can be treated with bed rest, application of heat to the abdomen, certain exercises, biofeedback and NSAIDs. -Chlamydia can be treated with azithromycin orally in a single dose.
Mrs. Bolt is trying to decide which patient would most benefit from case management. Choose the best option. A. A four year old with feelings of depression after her father dies of cancer. B. A 17 year old female with a headache and menstrual cramps. C. A 57 year old man with diabetes, hepatitis c and hypertension. D. A 25 year old male newly diagnosed with chlamydia.
Answer not listed; could be A, B, or D Rationale: Many surgical patients are taught about coughing, deep breathing, and use of incentive spirometry preoperatively. To care for the patient with TB in isolation, the nurse must be fitted for a high-efficiency particulate air (HEPA) respirator mask. The bronchoscopy patient needs specialized procedure, and the ventilator-dependent patient needs a nurse who is familiar with ventilator care. Both of these patients need experienced nurses
The charge nurse is making assignments for the next shift. Which patient should be assigned to the fairly new nurse (6 months experience) pulled from the surgical unit to the medical unit? a. A 58-year-old on airborne precautions for TB b. A 68-year-old who just came back from bronchoscopy and lung biopsy c. A 69-year-old with COPD who is ventilator-dependent d. A 72-year-old who needs teaching on the use of an incentive spirometer
Answer: A Rationale: Case method because one nurse is responsible for patients on the shift. Functional method is task oriented care by a group of various staff. Team method is a group of staff lead by the RN, who delegates care. Primary method is one nurse is responsible for the patients 24/7.
The client has consistent contact of one nurse during a shift but different nurses on other shifts. Which kind of method is this? A. Case method B. Functional method C. Team method D. Primary method
Answer: B UAPs can reinforce additional fluid intake once it is part of the care plan. Administering IV fluids, developing plans, and teaching families require additional education and skills that are within the scope of practice of an RN. Focus: Delegation, supervision
The client's nursing diagnosis is Deficient Fluid Volume related to excessive fluid loss. Which action related to fluid management should be delegated to a UAP? A. Administering IV fluids as prescribed by the physician B. Providing straws and offering fluids between meals C. Developing a plan for added fluid intake over 24 hours D. Teaching family members to assist the client with fluid intake
Answer: C This is the most moderate and stable patient that can be assigned to the LPN under the supervision of the RN. Remember LPNs cannot do discharge teaching. So answer D would be inappropriate.
The nurse demonstrates correct delegation when assigning which client to the licensed practical/vocational nurse (LPN/LVN) under RN supervision? a) A 62 year old client admitted 8 hours ago with exacerbation of COPD b) A 25 year old client with a concussion from a motorcycle accident the prior evening c) An 81 year old client with chronic heart failure and emphysema admitted 3 days ago d) A 34 year old client newly diagnosed with GERD who will be discharged today
Answer: B, D Rationale: B and D are included in the list of four factors of professional commitment. 1 is wrong because the belief in/acceptance is the professional code not the personal code. 3 is wrong because one should have a strong desire to maintain membership in profession, instead of not maintaining the membership.
The nurse is being instructed on the four factors of profession commitment she should display what would be included in these factors? (Select all that apply) A. Belief in acceptance of personal code B. Willingness to exert considerable personal effort on behalf of profession C. Strong desire to not maintain membership in profession D. Pattern of behaviors congruent with nurses' professional code of ethics
Correct Answer: A and C Rationale: A UAP can walk stable patients, a UAP does not have the training to change central line dressing, a UAP can give a bed bath by themselves if they don't need help moving the patient or navigating sensitive equipment, only the nurse can provide IV care, insertion, and removal
The nurse is busy with an admission and needs to delegate a few tasks to the UAP. Which tasks can the UAP be assigned. (Select all that apply) A. Walk a stable one-day post-operative hip replacement patient down the hall. B. Change the dressing on a central line C. Give a bed bath by themselves to a stable patient admitted for muscle weakness that can help turn themselves D. Remove an IV catheter from a newly discharged patient whose paperwork is complete.
Answer: A Rationale: It is not appropriate for the nursing assistant to answer the phone (personal or work phone) with gloves, especially while working with a patient.
The nurse is helping a nursing assistant provide a bed bath to a comatose client who is incontinent. The nurse should intervene if which of the following actions is noted? A. The nursing assistant answers the phone while wearing gloves. B. The nursing assistant log-rolls the client to provide back care. C. The nursing assistant places an incontinence diaper under the client. D. The nursing assistant positions the client on the left side, head elevated.
Answer: A Rationale: Assisting a client to the bathroom is a task that can be performed by UAP.
The nurse just started administering morning medications when a client needs to be assisted to the bathroom. Who is the most appropriate person for the nurse to delegate this task to? A. Unlicensed assistive personnel B. Charge nurse C. Another registered nurse D. Family member
Answer A: The five rights of delegation are right task, right circumstance, right person, right direction, right supervision. Position is not related to the five rights. Option D only lists four.
What are the five rights of delegation? A. Right task, right circumstances, right person, right direction, right supervision. B. Right time, right task, right circumstances, right person, right direction. C. Right task, right position, right person, right direction, right supervision D. Right supervision, right task, right circumstances, right direction.
Answer A: Affective commitment is an attachment to a profession and includes identification with and involvement. In a profession produces a satisfying experience. The other options are not examples of affective commitment.
What is an example of affective commitment? A. A nurse following up on all the new evidence based practice procedures and participates in her profession's organization and has a strong desire to continue her work. B. A student who goes to class every day. C. A person who goes to mandated meetings and took a class for overtime. D. A nurse who works her shifts and goes
Answer A: An indicator of group commitment would be members being motivated in the group and wanting to do their tasks well. The other options are not good indicators of good commitment.
What is an indication of group commitment? A. Members are motivated by working in the group and want to do their tasks well. B. Members often get into arguments and nothing gets solved. C. Members lack participation D. Members feel that the goals of the group are unattainable and unrealistic
Answer: B Charismatic Leadership- Charming personality evokes feelings of commitment in followers.
What is the definition of Charismatic Leadership? a. Relationship with followers based on exchange for valued resource b. Charming personality evokes feelings of commitment in followers c. Fosters creativity, risk taking, commitment, collaboration with clear, attainable goal d. Aims to distribute decision making among a group of people
Answer: B Administering enemas and antibiotics is within the scope of practice of LPNs/ LVNs. Although some states an facilities may allow the LPN/ LVN to administer blood, in general, administering blood, providing preoperative teaching, and assisting with central line insertion are the responsibilities of the RN. Focus: Assignment
When care assignments are being made for patients with alterations related to gastrointestinal (GI) cancer, which patient would be the most appropriate to assign to an LPN/ LVN under the supervision of a team leader RN? A. A patient with severe anemia secondary to GI bleeding B. A patient who needs enemas and antibiotics to control GI bacteria C. A patient who needs preoperative teaching for bowel resection surgery D. A patient who needs central line insertion for chemotherapy
Answer: C Rationale: the UAP cannot be asked to perform nursing-specific tasks such as assessment, diagnosis, planning, and evaluation of clients, even if they are stable.
When teaching a nursing student about delegating tasks to a UAP, which statement by the student would indicate the need for further teaching? a. "I can ask a UAP to obtain vital signs of a stable patient." b. "A UAP can be asked to assist a client with bathing." c. "The UAP should assess a stable client and report back to me." d. "I cannot ask a UAP to give medications."
Answer: A Feeding or giving a visiting family member an aspirin is inappropriate task for a UAP. Multiple personnel are needed to log roll a patient in cervical-spinal precautions. Bathing patients is within the scope of practice of the UAP.
Which is an appropriate task to delegate to a UAP? a. Bathing a paraplegic patient b. Feeding a visiting family member c. Log rolling a patient in C-Spine precautions by themselves d. Give an Aspirin to a visiting family member.
Answer: B Rationale: the charge nurses displays shared governance by seeking input from the entire nursing staff before making the decision to finalize the holiday schedule. She is seeking input and decision making from others.
Which leadership behavior displays a characteristic of shared governance? a) The charge nurse makes the holiday schedule without any input from other staff members. b) The charge nurse holds a meeting to determine who will be requesting leave for the holidays before making the holiday schedule. The charge nurse also asks for any volunteers to work over the holidays. c) The charge nurse does not make the holiday schedule. She waits until her supervisor asks her to do it. d) The charge nurse only asks her best friend what days she wants off over the holidays before she makes the holiday schedule.
Answer: A Rationale: Functional nursing is focused on tasks and activates and not on the holistic care of the patients.
Which of the following is TRUE about functional nursing? A. Concentrates on tasks and activities B. Emphasized use of group collaboration C. One-to-one nurse-patient ratio D. Provides continuous, coordinated and comprehensive nursing services
Answer: B Rationale: the five rights of delegation are Right Task, Right Person, Right Direction, Right Circumstances, and Right Supervision.
Which of the following is not a Right of Delegation? a. Right Person b. Right Time c. Right Circumstances d. Right Task
Answer: C Rationale: Drinking a cup of cocoa will keep the client awake due to its caffeine content. Exercising before sleeping inhibits the sleeping process. Taking longer naps only decrease night time sleep. Using the bed for sleep only is an appropriate sleep hygiene technique.
Which of the following statements suggests that client teaching on sleep hygiene techniques has been successful? a. "I will drink a cup of cocoa before bed." b. "I will go on a run before bed." c. "I should use my bed only for sleeping." d. "I will take longer naps."
Answer: C an autocratic leader makes decisions for the group based on the belief that individuals are externally motivated and are incapable of independent decision making. The other options involve all the members.
Which one of these individuals is an autocratic leader? A. An individual who shares the decision making process with other members B. An individual who encourages group thinking and members contributing. C. An individual who makes all the decisions because he/she feels that members are not capable. D. An individual who lets everyone else run the meetings and allows open communication.
Answer: A Right dosage is one of the rights of medication.
Which one of these is not one of the five rights of delegation? a. Right dosage b. Right person c. Right supervision d. Right direction
Answer: B, C, E Rationale: Attending to safety and Postmortem care can be delegated to the UAP.
Which tasks may not be delegated to the UAP? Select all that apply. A. Attending to safety B. Assessment C. Client education D. Postmortem care E. Care of invasive lines
Answer: A Oral hygiene is within the scope of duties of the UAP. It is the responsibility of the nurse to observe response to treatments and to help the patient deal with loss or anxiety. The UAP can be directed to weigh the patient but should not be expected to know when to initiate that measurement. Focus: Delegation
You are caring for a patient with esophageal cancer. Which task could be delegated to a UAP? A. Assisting the patient with oral hygiene B. Observing the patient's response to feedings C. Facilitating expression of grief or anxiety D. Initiating daily weighings
Answer: D Rationale: As charge nurse, you must assess the performance and attitude of the staff in relation to this client. After data is gathered from the nurses, additional information can be obtained from the records and the client as necessary. The educator may be of assistance if a knowledge deficit or need for performance improvement is the problem. Focus: supervision and prioritization.
You are the charge nurse. A client with chronic pain reports to you that the nurses have not been responding to requests for pain medication. What is your initial action? A. Check the medication administrations records (MARs) for the past several days. B. Ask the nurse educator to provide in-service training about pain management. C. Perform a complete pain assessment on the client and take a pain history. D. Have a conference with the nurses responsible for the care of this client.
Answer: A Rationale: that's the definition of "Overdelegation".
___________ occurs when the delegator loses control of a situation by providing the delegate with too much authority or too much responsibility. A. Overdelegation B. Reverse delegation C. Fear of loss of control D. Strategic planning
Answer: B Definition of autocratic leadership
______________ leadership involves centralized decision making, with the leader making decisions and using power to command and control others. a. Democratic b. Autocratic c. Laissez-faire d. Aggressive