Leadership exam 1

A nurse leader new to the organization has a transactional leadership style. The staff members who work with this leader are aware that what is the leader's focus? 1. The goals of the organization 2. The goals of the nursing unit 3. The welfare of the staff of the nursing unit 4. The satisfaction of the individual patients

1

An individual has a seizure while walking down the street. During the seizure, a nurse from a physician's office is noticed driving past without stopping to assist. The individual sues the nurse for negligence but fails to win a judgement for which reason? 1. The nurse had no duty to the individual 2. The nurse did what most nurse's do in the same circumstance 3. the nurse did not cause the client's injuries 4. The nurse was off duty

1

The nurse manager has encouraged the nurses to provide patients on the unit any toiletries that are needed but to determine if the patient needs these supplies before providing them. Which one of the Institute of Medicine's Six Aims for Health Care in the 21st Century is the nurse manager using? 1. Efficient 2. Equitable 3. Patient-centered 4. Effective

1

The nurse manager is aware that preventable medical errors are associated with what communication failure? 1. Lack of interprofessional communication 2. Lack of upward communication 3. Lack of intraprofessional communication 4. Lack of downward communication

1

The nurse manager is aware that what element of communication is essential to the transmission of relational information? 1. Feedback 2. Nonverbal communication 3. Responding 4. Receiving

1

Which term can also be used to describe teamwork? 1. Interprofessional collaborative practice 2. Individual decision making 3. Maintaining individual autonomy 4. Individual problem solving

1

The nurse manager is preparing to institute the use of SBAR for interprofessional communication. The nurse manager has based this decision on what benefits to this tool? Select all that apply. 1. Assertive dialogue between professionals 2. Most essential information delivery 3. Safer delivery of patient care 4. Decreased continuity of patient care 5. Increased time spent in interprofessional communication

1 2 3

A nurse who is endeavoring to increase emotional intelligence knows that what are the core components necessary to the development of this leadership characteristic? Select all that apply. 1. Empathy 2. Motivation 3. Intellectual skills 4. Leadership 5. Self-awareness

1 2 5

A nondisabled client who will turn 65 years of age in 6 months asks the nurse about Medicare. Which statements by the nurse are true concerning Medicare eligibility? Select all that apply. 1. "Individuals become eligible for Medicare at 65 years of age." 2. "To be eligible for Medicare, an individual must have worked a minimum of 5 years." 3. "The individual must have paid into the Medicare Trust Fund while employed." 4. "Children who are disabled are eligible for Medicare." 5. "Medicare is available for all persons who have low income."

1 3

The nurse manager is working to create a culture of safety and is aware that which characteristics are fundamental to designing processes for high-reliability organizations? Select all that apply. 1. Sensitivity to operations 2. Desire to simplify 3. Preoccupation with failure 4. Creation of expertise 5. Resilience

1 3 5

Which examples represent improper use of delegation in the clinical setting by a registered nurse (RN), licensed practical nurse (LPN), or unlicensed assistive personnel (UAP)? Select all that apply. 1. UAP delegating a task to a LPN 2. RN delegating a task to a UAP or a LPN 3. LPN delegating a task to a RN 4. RN delegating a task to a RN 5. UAP delegating a task to a RN

1 3 5

The director of nursing has decided to begin a quality improvement program, and staff members with what skills should be included on the initial committee to ensure the success of this program? Select all that apply. 1. Have experience in working with interdisciplinary teams 2. Have experience in error justification 3. Have experience in providing efficient care 4. Have experience in performing self-assessment 5. Have experience in designing and testing interventions to change a care process

1 4 5

The nurse is trying to explain the requirements of the Patient Protection and Affordable Care Act (ACA) and knows that which provisions are required of the act? Select all that apply. 1. There is a $500,000 annual limit on coverage. 2. Employers must provide health insurance if the company has more than 50 employees. 3. Children may stay on their parent's health plans until age 26. 4. Cost sharing is eliminated. 5. Insurance coverage cannot be denied because of preexisting conditions.

2 3 5

A new nurse leader has adopted a laissez-faire style of leadership that may result in what characteristics of those who report to this leader? 1. Team members may be very good at time management but poor on job satisfaction. 2. The staff may be very knowledgeable but have a lack of focus on the job at hand. 3. Team members experience disagreements among themselves. 4. Productivity is high with low job satisfaction.

3

A nursing student is required to take a nursing leadership course and questions why this type of course is necessary when the initial primary role of the graduate nurse is to perform bedside patient care. What is the nurse educator's best response to this student? 1. "It is a part of the curriculum that is required by all state boards of nursing." 2. "Though new graduates begin at the bedside, most take on leadership positions within the first 6 months of employment." 3. "Leadership competencies are required even at the bedside to help in navigating the evolving health-care landscape." 4. "All nurses report to someone, so you have to understand leadership so you know who you report to."

3

The nurse manager has decided to use the strategies of the Institute of Medicine (IOM), To Err Is Human, to improve health care on the nursing unit. The nurse has identified that patient safety, practice consistent with current medical knowledge, and what other strategy must be implemented in this endeavor? 1. Work in interdisciplinary teams. 2. Work in intradisciplinary teams. 3. Meet the expectations of the patient. 4. Meet the expectations of the nurses.

3

The nurse manager has just been informed that a patient received a medication intravenously that should have only been administered as an intramuscular injection. The patient suffered a respiratory arrest and is being transferred to the intensive care unit. The nurse manager is aware that this is known as what type of error? 1. Near miss 2. Error of omission 3. Sentinel event 4. Lapse

3

A staff nurse approached the director of nursing to discuss steps that would be helpful in moving to an administrative position. The director of nursing told the staff nurse not to consider leadership because this nurse was not a "born leader." What leadership theory is the director of nursing using to make this judgement? 1. Behavioral theory 2. Situational leadership theory 3. Contingency leadership theory 4. Great Man theory

4

The nurse leader as a part of the patient-centered care Quality Safety Education in Nursing (QSEN) competency has encouraged all nurses to be advocates for their patients. The nurse leader knows that this concept is understood when the nurses demonstrate which action? 1. Patients state they believe they have access to information and resources and have the opportunity to learn and grow. 2. Patients state that they have all the supports necessary to manage their own disease. 3. Patients state they have the ability to read, understand, and act on information about their diseases. 4. Patients state that the nursing staff knew about their desires and allowed them to make their own decisions.

4

The nurse understands that improvement of safety in nursing is dependent on evidence-based practice and which element of the safety competency? 1. Resilience 2. Human factors engineering 3. High-reliability organizations 4. Standardized protocols

4

All Levels of Nurses at a Magnet Hospitals are what kind of leader? A) Transformational B) Autocratic C) Lassez-faire D) Situational

A

As a patient care advocate, you regularly coach patients on how to stay safe in health care by educating them about: a. The need to understand and record all medications being taken. b. Bringing their own linens and other personal items to the hospital. c. Washing hands frequently while in a healthcare environment and using a hand sanitizer. d. Following closely the directions and orders of healthcare providers.

A

In accordance with changes by the Joint Commission (TJC), Pleasant Valley Hospital amends its safety practices and policies to emphasize: a. Safety goals specific to Pleasant Valley. b. Decision-making processes. c. Sufficient staffing for safe care. d. Increased numbers of baccalaureate-prepared RNs.

A

Sarah is a second-year nursing student. The clinical instructor overhears Sarah telling a patient that she "always" checks patients' bracelets before giving medication and she is not sure how the nurses on the unit "get away with" not making more errors than they do. The clinical instructor pulls Sarah aside and explores with her how her communication might affect the patient and what it reflects about her beliefs related to the team. The actions of the clinical instructor reflect competencies outlined by: a. QSEN. b. IHI. c. DNV/NIAHO. d. AHRQ.

A

The SBAR approach to patient safety encourages: a. Consistency in assessment and practices. b. Continuing education. c. Multidisciplinary approaches. d. Patient feedback

A

The adage "leaders are born and not made" reflects which of the following ideas around leadership? a. Management can be taught; leadership depends on abilities. b. Mentorship is important in developing innate skills of leaders. c. Leadership is a natural skill that cannot be refined or developed. d. Succession planning and formal education related to leadership are ineffective.

A

The patient with COPD has a nursing diagnosis of Ineffective Breathing Pattern. Which is an appropriate action to delegate to the experienced LPN under your supervision? A. Observe how well the patient performs pursed-lip breathing B. Plan a nursing care regimen that gradually increases activity intolerance C. Assist the patient with basic activities of daily living D. Consult with the physical therapy department about reconditioning exercises

A

The risk manager wants to evaluate the reasons for an increased number of falls on the rehab unit. The risk manager devises a fishbone diagram. A fishbone diagram is a useful tool to: a. Identify the root causes of problems. b. List possible solutions to problems. c. Help leaders select the best options. d. Evaluate the outcomes of decisions made.

A

Three gravely ill patients are candidates for the only available bed in the ICU. As the supervisor, you assign the bed to the patient with the best chance of recovery. This decision reflects which of the following ethical principles? a. Beneficence b. Autonomy c. Veracity d. Nonmaleficence

A

When a nurse manager makes a decisions regarding the management of the nursing unit without input from the staff, the type of leadership style that the nurse manager is demonstrating is: a) autocratic b) situational c) democratic d) laissez-faire

A

Which characteristic is included in the American Nurses Association (ANA) Nurses' Bill of Rights? A. To function as a patient advocate without fear of retribution B. Compensation for clinical practice is based solely on the fiscal budget of the employer C. Practice setting safety addresses patients only D. Negotiation for conditions of employment is not included as a basic right

A

Which of the following would managers and staff review annually in order to ensure compliance with the Joint Commission (TJC) to improve patient safety? a. Appropriateness of charting terms and abbreviations b. Nursing hours per patient c. Acuity of patient admissions d. Wait times for care

A

Part of the Institute of Medicine (IOM), To Err is Human(2000) identified the number of deaths attributed to patient safety issues. This resulted in a second report Crossing the Quality Chasm(2001) identifying six major aims in providing health care that apply equally to all professions. Which terms are a part of the major aims of providing health care? Select all that apply. A. Safe B. Ineffective C. Efficient D. Patient- centered E. Inequitable

A C D

The RN is evaluating a task that has been delegated to a UNP earlier in the shift. Which of the following questions would be appropriate to ask? (Select all that apply) a. Has the work/task been completed? b. Do you need me to finish the task? c. How did the patient respond? d. What changes were observed with the patient?

A C D

What are the benefits of the meaningful use of EHRs? (SATA) A. Patient confidentiality B. Complete and accurate information C. Better access to information D. Patient empowerment

B C D

A nurse manager in a hospital is deeply concerned that senior administration makes decisions about budgetary directions that affect staffing and other resources without sharing the rationale for changes or demonstrating concern as to how these changes may affect patients or staff. She says she does not feel respected and is emotionally tired as a result. This situation represents: a. Bureaucratic organization. b. Realities of current health care. c. Negative organizational culture. d. Quantum leadership.

D

As a nurse manager on the West Surgery Unit, you are interested in increasing patient safety and reducing morbidity and mortality on your unit. Which of the following recommendations would be consistent with the IOM The Future of Nursing report? a. Careful screening of nursing staff for substance use and abuse b. Increased RN staffing on the unit c. Salary and benefits that reflect nursing accountabilities d. Increase in the percentage of baccalaureate-prepared nurses to 80%

D

As the head of a nursing program, you consistently invite the ideas of your team about innovations in teaching, community partnerships, and curriculum design and invite participation in decisions. Many of these ideas have been implemented successfully, and your staff members are keen to try on other ideas. You are employing _____ leadership. a. Situational b. Trait-based c. Contingency-based d. Transformational

D

In preparation for redesignation as a MagnetTM Hospital, how would you prepare? a. Commit staff resources over a 6-month period to updating procedure manuals. b. Educate staff through meetings and training sessions regarding appropriate answers to questions. c. Prepare a manual that outlines orientation procedures and ensure that all safety issues are addressed. d. Ensure that there are empirical data to support review of patient outcomes, actions taken, and results of actions.

D

Jenna is a nurse from the medical-surgical unit of a tertiary hospital. She was asked to float on the orthopedic in which she has no prior experience on working on. Which client should be assigned to her? A. A client with a cast for a fractured femur and who has numbness and discoloration of the toes. B. A client with balanced skeletal traction and needs assistance with morning care. C. A client who had an above-the-knee amputation yesterday and has currently has a temperature of 101.4ºF. D. A client who had a total hip replacement two days ago and needs blood glucose monitoring.

D

Role theory has its underpinnings in management theory. Management theories influence managers' leadership styles. Which of the following theories would a nurse manager be most likely to follow when redesigning the staffing schedule? a. Humanistic b. Productivity c. Psychological d. Quantum

D

The manager in the coronary care unit believes that the most important ethical considerations in performance evaluations are that they include the employee's good qualities and that they give positive direction for professional growth. This belief is an example of: a. Justice. b. Fidelity. c. Beneficence. d. Nonmaleficence.

D

The nurse is communicating to the health-care provider the patient's current medications, allergies, vital signs, and current laboratory values and is using which section of SBAR in giving this information? 1. Situation 2. Background 3. Assessment 4. Recommendation

2

The nurse manager plans to implement which communication strategy that has been found to reduce errors and improve patient safety while increasing patient satisfaction? 1. TeamSTEPPS 2. Interprofessional team rounding 3. Diagonal communication 4. Oral report in the conference room

2

A nurse manager has begun to use transformational leadership theory and knows that this theory uses what aims of the Institute of Medicine (IOM)? Select all that apply. 1. Nurse-centered 2. Efficient 3. Timely 4. Safe 5. Inexpensive

2 3 4

You pull staff together to assess a situation in which the family of a seriously ill patient is anxious and is absorbing a great deal of staff time in consultation, discussion, and questioning of treatment decisions. Staff members are becoming distanced from the family. After inviting the concerns of staff, you explain that the organization values patient-centered care and that evidence supports that acting as an advocate and a listener is helpful to families. You ask the staff for ideas as to strategies that are effectively patient-centered in these situations. In this situation, you are taking on which role? a. Leadership b. Management c. Follower d. Visionary

A

What are the five components of the magnet recognition Model? A) Transformational Leadership B) Structural Empowerment C) Exemplary Professional Practice D) Autocratice Leadership E) New Knowledge Innovation and Improvement F) Empirical Outcomes

A B C E F

What makes a hospital a Magnet Hospital? (Select all that apply) A) Safe work environment B) Physician-to-nurse collaboration C) reported incidences of nurse-to-nurse harrasment D) A more satisfying work environment

A B D

The IOM Health Professions Education report highlighted patient safety concerns as: a. A normal risk in professional practice. b. A result of disciplinary silos. c. A reflection of frontline staff. d. Related to systems errors.

B

The following initiative by the Institute of Healthcare Improvement sought to decrease in-hospital morbidity and mortality, and is responsible for instigating the standardization of rapid response systems. A. To Err is Human (2000) B. "100,000 Lives Campaign" (2005) C. Crossing the Quality Chasm (2001) D. The Magna Carta (1215)

B

Which of the following is considered the most important goal in nursing today? a.Adapting to technological advances such as electronic medical records b.Demonstrating caring as the basis of nursing practice c.Distinguishing nursing care from medical care d.Seeking evidence-based outcomes to demonstrate nursing's contribution to care

B

Which statement describes an example of an intraprofessional team with regard to nursing in the clinical setting? A. Nurses who work in the emergency room department B. All nurses who work in the facility at both staff and supervisory levels C. Entire hospital staff composed of nurses and ancillary team members D. Chief nursing officer (CNO) of the facility and medical staff

B

The nurse manager in the Emergency Department needs to implement new staffing patterns. As a transformational leader, the nurse manager should: a. Explain in detail how well the new idea will work. b. Reinforce how this change will respond to the ideas and solutions generated by staff members. c. Reason with staff members that the new idea will save money and allow more free time. d. Imply that raises will be smaller than anticipated if the new idea is not accepted.

B

Which ethical principle is primarily involved in informed consent? a. Veracity b. Autonomy c. Beneficence d. Nonmaleficence

B

A nurse manager approaches a nursing staff member and gives her a book to read about bedside nursing. What kind of leadership is the manager using? A) Transactional B) Transformational C) Vertical and Collaborative D) None of the above

B

During a fire drill, several psychiatric patients become agitated. The nurse manager quickly assigns a staff member to each patient. This autocratic decision style is most appropriate for: a. Routine problems. b. Crisis situations. c. Managers who prefer a "telling" style. d. Followers who cannot agree on a solution.

B

Kari, a head nurse on the dialysis unit, has been informed during budget planning meetings that budget cuts are likely. She discusses this at the next unit meeting and tells staff members that unless they do their jobs well, their positions may be terminated, and there will be no replacement. Kari is enacting which management style? a. Transformational b. Transactional c. Trusting d. Truthful

B

A family is keeping vigil at a critically ill patient's bedside. Other, distant family members, not yet able to come, call the unit continuously, asking for updates and wanting to express concern. You speak with the distant family members and suggest that you are going to refer them to the hospital social worker, whose role is to work with people in such situations. In response to this situation, you approach the unit manager to apprise her of your concerns that the family dynamics of the patient involved may lead to staff-family and patient-family conflicts. You suggest that the physician may need to discuss the treatment plan with the family. The unit manager advises that he will arrange this discussion. If, after the meeting with family members, this is identified as a desired approach, you support the manager's decision. Your actions indicate that you are acting in what role? a. Leadership b. Management c. Follower d. Evidence-based

C

A hospital is working toward becoming a Magnet™ hospital. The chief nursing officer is aware that professional nursing departments of the future will: a. Not be directed by nurses. b. Be virtual organizations. c. Be designed to maintain nursing standards of practice. d. Be entitled to have client care departments.

C

A nurse manager has worked rapidly to bring the staff to accept changes in the unit's mission, so that downsizing can be avoided. This nurse manager is using quantum leadership by: a. Focusing on past concerns related to the mission. b. Teaching staff members how to self-manage themselves. c. Determining accurately the direction of change in the institution. d. Requiring all staff members to review and reinforce their technological skills.

C

A patient refuses a simple procedure that you believe is in the patient's best interest. The two ethical principles that are directly in conflict in such a situation are: a. Fidelity and justice. b. Veracity and fidelity. c. Autonomy and beneficence. d. Paternalism and respect for others.

C

A staff nurse in the area that you manage has excelled in the delivery of patient education. You are considering implementing a new job description that would broaden her opportunity to teach patients and orient new staff members to the value of patient education. The ethical principle that you are most directly reinforcing is: a. Justice. b. Fidelity. c. Paternalism. d. Respect for others.

C

As the clinical director of 24 employees, you have been asked to explain to staff members why they are not getting a raise this year, even though they have been working short-handed for many months and patient satisfaction scores have never been higher. Because you believe yourself to be a transformational leader, you will approach this problem by: a. Telling the assistant clinical director and asking her to share the bad news with the other staff members. b. Posting a note on the bulletin board that includes the phone number of the chief nursing officer, so anyone who has complaints may express them. c. Showing staff members the budget and asking for input about how to cut costs so that raises will be possible in the future. d. Meeting with a small group of seasoned staff members and asking them how to break the news.

C

In keeping with standards of The Joint Commission (TJC), the nurse manager organizes an orientation for new staff members. As part of the orientation, the nurse manager reviews the employee handbook. Employers may be bound to statements in the employee handbook: a. Under the doctrine of apparent agency. b. Under the doctrine of respondeat agency. c. Based on the employee's or the employer's expectations. d. Based on the theory that the handbook creates an explicit contract.

C

The hospital administration is discussing the possibility of closing hospital beds in your unit because of a nursing shortage and the increased amount of overtime required to care for patients. As the leader on the unit, which of the following examples best demonstrates your transformational leadership style? a. Your entire staff walks out on strike. b. Your staff sends an ultimatum to the clinic director demanding higher pay. c. A group of your staff members goes to the administration to propose closing of a different unit. d. A group of your staff members goes to the administration to request that they be allowed to work the overtime hours.

C

The principle that requires nurses to uphold a professional code of ethics, to practice within the code of ethics, and to remain competent is which of the following? a. Veracity b. Autonomy c. Fidelity d. Honesty

C

Joint commission is a non profit that tries to get patientss the best care by encoring what acronym?

SPEAKUP speak about questions pay attention to ur care educate yourself ask a family member to be avocate know ur medicines use a good facility participate in your care

A family is keeping vigil at a critically ill patient's bedside. Other, distant family members, not yet able to come, call the unit continuously, asking for updates and wanting to express concern. You speak with the distant family members and suggest that you are going to refer them to the hospital social worker, whose role is to work with people in such situations. What role are you assuming through this action? a. Manager b. Leader c. Follower d. Laissez-faire

a

The nurse has recently been assigned to manage a pulmonary progressive unit at a large urban hospital. The nurse's leadership style is participative, with the belief that all staff members assist in decision making and the development of the unit's goals. The nurse is implementing which leadership style? a) democratic b) laissez faire c) auticratic d) situational

a

A nurse wants to develop better leadership. She asks her manager what she can do to improve her ability to lead. Which of the following did the manager tell her to do? (select all that apply) A) Lead by example B) Accept responsibility C) Have a clear vision D) Read leadership books

a b c

2. Which of the following is NOT an attribute of an effective team? A. Leadership is shared B. Assignments are clearly stated C. Feelings are freely expressed D. Autocratic leadership

d

The nurse leader is beginning a quality improvement (QI) project on the nursing unit and is aware that what is most important to the ultimate success of the project? 1. All members of the nursing unit are involved in the project. 2. Registered nurses implement the project. 3. Nursing assistants are used to collect data. 4. The nurse leader is ultimately responsible for the success of the project.

1

The nurse is triaging clients from a large disaster. Which client should receive care first? 1. client w/ lrg shard of glass piercing chest wall, RR 32 2. client w/ forearm disfigured w/ protruding bone, finger cap refill 2 seconds 3. child w/ 3-in. oozing laceration on leg 4. woman who is 2 months pregnant, partial-thickness burn on forearm

1

The nurse manager in a for-profit health-care facility explains to a new staff nurse that the profits from care are used in what capacity? 1. Pay for a new magnetic resonance imaging (MRI) machine 2. Increase the pay for all staff members 3. Provide for extra services for patients 4. Give bonuses to executives of the facility

1

There has been a large disaster, and nurses have been floated to help with the lrg influx of clients. Which client is most appropriate to assign to the nurse floated from the mother-baby unit? 1. 1 day postop hemicolectomy male with foley cath 2. women in pelvic traction who is 3 mo. pregnant 3. elderly woman who has herpes zoster 4. male admitted for hearing command voices to kill himself

1

Which aspects are included in how nurses develop nursing judgment? Select all that apply. 1. Academic experience 2. Use of experience to help form an opinion 3. Analysis of information to help arrive at a decision 4. Leadership style 5. Level of administrative experience as opposed to being a staff nurse

1 2 3

The nurse educator is preparing a group of registered nursing students for graduation and licensure and completes a discussion of the professional values. The students identify which values as part of the five core professional values for nurses? Select all that apply. 1. Integrity 2. Beneficence 3. Human dignity 4. Altruism 5. Veracity

1 3 4

Which members would be included in an interprofessional team approach in the clinical setting? Select all that apply. 1. Selected members from different departments throughout the hospital 2. All of the nurses who work full time at the facility 3. Both licensed and nonlicensed employees who work in the hospital setting 4. A collection of individuals who work in the hospital and/or community of interest who are considered to be stakeholders 5. Nursing staff and community health department

1 3 4

The director of nursing is encouraging the nurse managers to begin seeking Magnet status for the facility and knows that this status is associated with what positive outcomes for both nurses and patients? Select all that apply. 1. Increased patient satisfaction 2. Decreased morbidity with static mortality rates 3. Decreased numbers of peripheral intravenous infiltrations 4. More nursing autonomy 5. Decreased nurse burnout

1 4 5

The HCP orders a med in a dose that is considered toxic. The nurse administers the med to the client, who later suffers a cardiac arrest and dies. What consequence can the nurse expect from this situation. SATA 1. the HCP can be chrgd w/ negligence, being the person who ordered the dose 2. as the employing agency, only the hospital can be charged w/ negligence 3. the nurse and the physician may be terminated from employment to prevent a charge of negligence to the hospital 4. negligence will not be charged, as this event could have happened to any reasonable person 5. The nurse can be charged with negligence for administering the toxic dose

1 5

A nurse forgets to administer a client's diuretic and the client experiences an episode of pulmonary edema. The charge nurse would consider the medication error to constitute negligence b/c the situation contains which element? 1. purposeful failure to perform a healthcare procedure 2. unintentional failure to perform a healthcare procedure 3. Act of substituting a different med for the one ordered 4. failure to follow a direct order by a physician

2

A physician has ordered a rectal suppository to be administered to a 25-year-old male patient. The registered nurse (RN) delegates this task to the licensed practical nurse (LPN). The LPN would prefer not to complete this task. The RN tells the nurse manager about this issue. How would the nurse manager interpret this refusal by the LPN to perform a delegated task? 1. Underdelegation 2. Possibility of a delegate-related barrier 3. Overdelegation 4. Possibility of a delegator-related barrier

2

The nurse is talking with a patient who was just admitted to an acute care health facility and just recently enrolled in Medicare Parts A, B. The patient is concerned that Medicare benefits will not cover hospitalization, and the nurse knows that which statement is true concerning this individual. 1. The patient is not covered because Part C is necessary for hospital benefits. 2. The patient is covered, Part A covers hospital benefits. 3. The patient is covered, Part B covers hospital benefits. 4. The patient is not covered because Part D is necessary for hospital benefits.

2

The nurse leader is supervising the entire acute care facility and is notified that many employees have called in sick related to an outbreak of influenza. The nurse leader sends a registered nurse who works on a transitional care unit to the emergency department to provide care. In what area could this nurse potentially experience liability? 1. Failure to warn 2. Inappropriate assigning of staff and failure to supervise 3. Negligent retention practices 4. Unsafe staffing

2

The nurse manager in a not-for-profit health-care facility is aware that what issue may arise due to the funding for this type of organization? 1. The care provided to patients is of lower quality than the care given in for-profit health-care organizations. 2. There is a possibility that staff must be reduced because of decreased available funds. 3. The health-care organization will move all inpatient to outpatient care. 4. If available funds are reduced, managers will be let go and each unit will run itself.

2

The nurse manager is working to establish a culture of safety and has encouraged the staff to use the CUS communication system. Which statement by a staff nurse indicates the proper use of this system? 1. "I know that this procedure has resulted in an error before but I believe that I can complete it without making any mistakes." 2. "I don't feel comfortable beginning this procedure. An event occurred the last time it was completed." 3. "I think this procedure should become the focus of a study, but I believe it can still be used while it is being reviewed." 4. "All procedures are safe as long as the nurse performing the procedure knows exactly what to do."

2

What is the most important aspect to determine when deciding which nursing care delivery system should be used? 1. staff preference 2. staff licensure 3. number of staff 4. experience of staff

2

Which is the best instructional guidance for the nurse-manager to include for the staff nurses when delegating the responsibility to revise the unit's educational policies? 1. "Let me know if you need anything" 2. "Complete the tasks in six weeks" 3. "Give your suggestions and I'll decide" 4. "Tell me what you think after looking at everything"

2

Which statement best reflects the concept of accountability with regard to delegation of tasks? 1. Nursing state practice acts do not require nurses to be held accountable for their actions. 2. Accountability exists at both nursing and organizational levels. 3. An organization's obligation to accountability is based on its ability to offer quality care regardless of nurse staffing. 4. The competency of the nurse is not considered as being relevant to accountability.

2

Which statement reflects the difference between a preceptor and a mentor? 1. Preceptors provide a lifelong learning relationship, whereas mentors provide shorter-term learning relationships. 2. Mentors do not have to be nurses but preceptors do. 3. A mentoring relationship exists only at the beginning graduate nurse level, whereas preceptors occur across experience levels. 4. It is the type of communication pattern that is maintained.

2

A nurse-manager appropriately behaves as an autocrat in which situation? 1. planning vacation time for staff 2. directing staff activities if a client has a cardiac arrest 3. evaluating a new medication administration process 4. identifying the strengths and weaknesses of a client education video

2 common in emergency situations

The nurse leader is developing a quality improvement (QI) project for the nursing unit and knows that what characteristics are necessary to determine the priority of the issue to be investigated? Select all that apply. 1. Failure in performance is known to occur infrequently. 2. The problem itself occurs frequently. 3. The problem has at some time caused serious consequences to health. 4. The problem has caused issues that are costly. 5. The problem may be very difficult to fix.

2 3 4

The nurse manager is responsible for designing a new pediatric oncology unit and plans to ensure that it is designed with a culture of safety. The nurse manager is aware that this culture of safety requires what necessary principles to accomplish this task? Select all that apply. 1. Patient safety must be the responsibility of the unit leadership team. 2. Work processes are to be simplified. 3. Train all members of the nursing unit to work as a team. 4. Redesign work processes to prevent accidents. 5. Discourage the use of simulation and focus on actual patient care.

2 3 4

The nurse manager is using the Principles of Collaborative Relationships: Effective Communication by the American Nurses Association (ANA) to improve communication on the nursing unit and knows that these principles require the staff nurses to use what communication practices? Select all that apply. 1. Speak to multiple persons about the issue. 2. Use active listening techniques. 3. Keep the environment closed and private. 4. Ensure accuracy in the information transmitted. 5. Know the purpose of the message transmitted.

2 4 5

A client is referred to a surgeon by the general practitioner. After meeting the surgeon, the client decides to find a different surgeon to continue treatment. The nurse supports the client's action, utilizing which ethical principle? 1. beneficence 2. veracity 3. autonomy 4. privacy

3

A client with cancer has decided to discontinue further tx. Although the nurse would like the client to continue tx, the nurse recognizes the client is competent and supports the client's decision using which ethical principle? 1. Justice 2. Fidelity 3. Autonomy 4. Confidentiality

3

A patient dies as the result of a wound infection. When the family sues the hospital and the nurses involved in this patient's care, it is discovered that wound care was only charted three times despite a twice daily order from the health-care provider. What category of nursing practice will be the focus of the resulting lawsuit? 1. Failure to act as a patient advocate 2. Failure to assess and monitor 3. Failure to document 4. Failure to communicate

3

Nurses are aware that the Quality and Safety Education in Nursing (QSEN) competency, Teamwork and Collaboration, requires what specific type of collaboration? 1. Multidisciplinary 2. Interdisciplinary 3. Interprofessional 4. Customized care

3

The director of nursing at the county health department is aware that which ethical theory is most commonly used by nurses in public health agencies? 1. Deontology 2. Principlism 3. Utilitarianism 4. Principle of duty

3

The nurse is aware that the optimal healing environment, which is a component of the Patient-Centered Care Quality and Safety Education in Nursing (QSEN) competency, is designed to assist the patient in what way? 1. Has enough room for family members 2. Provides for privacy 3. Helps the patient heal himself or herself 4. Ensures a pleasant hospital experience

3

The nursing team consists of one RN, one LPN, and one UAP. What is the most appropriate assignment for the RN to delegate to the LPN? 1. pass the dinner trays 2. empty the Foley cath 3. admin morning daily meds 4.suction client who is one day postop after tracheostomy

3

Which is an example of a staff nurse functioning in the role of an informal leader? 1. verifying adequate staff coverage for a shift 2. filling out a discipline form on a nursing assistant 3. encouraging a peer to join a committee 4. attending a hospital-wide policy meeting

3

Which task should not be delegated to a licensed vocational nurse (LVN) by a registered nurse (RN) who is working with a LVN and unlicensed assistive personal (UAP) as part of the team? 1. Performing oral hygiene for a patient who has oral ulcerations 2. Feeding a patient with dysphagia 3. Transferring a patient from the bed to a chair 4. Monitoring a blood transfusion

3

A nurse and teacher are discussing legal issues r/t the practice of their professions. The teacher asks what the functions are of the Nurse Practice Act (NPA) in that state. The nurse would include which thoughts in response? Select all that apply. 1. accredit schools of nursing 2. enforce ethical standards of behavior 3. protect the public 4. define the scope of nursing practice 5. determine liability insurance rates

3 4

The nurse working in an acute care environment would utilize which strategies to reduce the risk of malpractice litigation? Select all that apply. 1. discuss any errors with the client and family in detail 2. keep incident reports on file 3. maintain expertise in practice 4. offer opinions to clients when the situation warrants 5. report unsafe staffing levels to supervisor

3 5

A client asks why a dx test has been ordered and the nurse replies, "I'm unsure but I will find out for you." When the nurse later returns and provides an explanation, the nurse is acting under which principle? 1. Nonmaleficence 2. Veracity 3. Beneficence 4. Fidelity

4 keeping promises

A hospitalized client with a diagnosis of anorexia nervosa and in a state of starvation is in two-bed hospital room. A newly admitted client will be assigned to this client's room. Which client would be inappropriate to assign to this two-bed room? a) a client with pneumonia b) a client who can perform self-care c) a client with a fractured leg that is casted d) a client who is scheduled for a diagnostic test

A

A new unit nurse manager is holding her first staff meeting. The manager greets the staff and comments that she has been employed to bring about quality improvement. The manager provides a plan that she developed and a list of tasks and activities for which each staff member must volunteer to perform. In addition, she instructs staff members to report any problems directly to her. What type of leader and manager approach do the new manager's characteristics suggest? a. Autocratic b. Situational c. Democratic d. Laissez-faire

A

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

A

________ is designed for hospitals to achieve recognition of excellent nursing care through a self-nominating, self-appraisal process to achieve A) Magnet Recognition Program B) American Nursing Program C) National Nursing Recognition Program D) Total Care Program

A

A patient is admitted with hypotension, shortness of breath, flushing, and hives. All levels of staff have been trained to assess vital signs. Given budget restrictions and proper delegation rules, to which care provider would the RN delegate the task of obtaining the initial blood pressure reading? a. RN b. LPN/LVN c. Nursing assistive personnel (NAP) d. Use the blood pressure obtained in the ambulance, because it was assessed via electronic monitoring.

A patient is unstable

An experienced LPN, under the supervision of the team leader RN, is providing nursing care for a patient with a respiratory problem. Which actions are appropriate to the scope of practice of an experienced LPN? Select all that apply. A. Auscultate breath sounds B. Administer medications via metered-dose inhaler (MDI) C. Complete in-depth admission assessment D. Initiate the nursing care plan E. Evaluate the patient's technique for using MDI's

A B

Which intervention for a patient with a pulmonary embolus could be delegated to the LPN on your patient care team? A. Evaluating the patient's complaint of chest pain B. Monitoring laboratory values for changes in oxygenation C. Assessing for symptoms of respiratory failure D. Auscultating the lungs for crackles

A B

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

A B C

Some nurses are debating about the appropriate action to take in relation to a particular family. The father is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, "It is a wife's responsibility to care for an ill husband." Which of the following ethical approaches is being used by this nurse? a.Consequentialism b.Communitarianism c.Deontological ethics d.Principlism

C

A nurse manager frequently stays in the office, rarely checking in on the staff or making rounds in patient rooms. This manager recently made a decision to improve quality care. A new nurse asks the manager how to carry out this new decision, but the manager replies, "Ask another nurse. Just figure it out. I don't have time to explain." Which standards for a healthy work environment is the manager lacking in this situation? (Select all that apply) A) Collaboration B) Communication C) Decision making D) Accountability E) Self-actualization

A B D

A nurse was feeling overwhelmed and decided to try to pass meds as fast as possible. When giving a patient his pain medication, she realized that she almost passed a blood pressure medication. What could be done to prevent these near misses? (Select all that apply) A.Ensure adequate staffing ratios B.Minimize distraction during med passes C.Just act like it never happened in the first place D.Assess other possible risks for passing wrong medications

A B D

A student nurse has her clinical o a medical-surgical unit. She has been encouraged to be a leader, but does not know how to be a leader as a student. Which is a way she can apply her leadership abilities? (select all that apply) A) Learn to deal with conflict B) Be on time for clinical C) Evaluate her nursing interventions and their outcomes D) Work as hard as she can by herself.

A C

An orienting nurse on a neurological surgical floor asks her nurse manager why she has to know and understand legal principles, such as the nurse practice acts, negligence and malpractice, confidentiality, privacy, etc. What responses by the nurse manager are correct? Select all that apply A) "If you know and understand legal principles, it will minimize your own and my liability." B) "You don't have to know them, that is my job only." C) "You will be a more competent nurse and will know how to better respond to certain situations." D) "You don't actually have to know and understand legal principles, that is the job of the hospitals lawyers."

A C

A newly hired RN is being trained on a medical unit. The nurse manager is assessing her knowledge about delegation. Which of the following rights of delegation would indicate the nurse's competence in this area? (Select all that apply) a. Circumstance b. Patient c. Direction/communication d. Supervision

A C D

A nurse manager leading a huddle is teaching a refresher course on informed consent to her staff. Which statements made by the nurse manager are correct? Select all that apply A) Nurses must assess the patient's health literacy before having them sign informed consent B) Patients understand most medical jargon C) Informed consent is based on legal capacity, voluntary action, and comprehension three requirements for informed consent to be considered legal document D) If pt. is confused about what the HCP explained and asks the nurse about it, the nurse is required to inform the HCP E) Minors are never allowed to sign informed consent

A C D

You have called a staff meeting to discuss caseload complaints as an entire group. You facilitate them in a conversation and come up with a mutually agreed upon solution. As a result from this group decision your staff: SELECT ALL THAT APPLY a. Feels valued and respected b. Knows they have a voice in all future caseload decisions c. Has a higher morale toward the decision d. Will have higher participation in the solutions implementation e. Will leave with every member completely satisfied

A C D

The nurse should use which guideline(s) to plan delegation and assignment-making activities? Select all that apply. a. Ensuring client safety b. Requests from the staff c. The clustering of the rooms on the unit d. The number of anticipated client discharges e. Client needs and workers' needs and abilities

A E

A nurse manager was explaining the process of quality management to an RN on the med surg floor. What would be a proper statement for the nurse manager to make? A. Quality improvement is a process that one person performs to assess risks and identify ways to reduce risks. B. Quality improvement is focused on patient care and how it could be improved on. C. Quality improvement is only necessary when there is a clear problem that needs addressed. D. You should not have to worry about quality improvement because that is not the job of the nurses on the floor.

B

Nurse Channing is caring for four clients and is preparing to do his initial rounds. Which client should the nurse assess first? A. A client with diabetes being discharged today. B. A 35-year-old male with tracheostomy and copious secretions. C. A teenager scheduled for physical therapy this morning. D. A 78-year-old female client with pressure ulcer that needs dressing change.

B

ou are assigned to provide nursing care for a patient receiving mechanical ventilation. Which action should you delegate to an experienced nursing assistant? A. Assessing the patient's respiratory status every 4 hours B. Taking vital signs and pulse oximetry readings every 4 hours C. Checking the ventilator settings to make sure they are as prescribed D. Observing whether the patient's tube needs suctioning every 2 hours

B

A group of nurse managers are reviewing a new job description for a staff nurse on a medical-surgical unit. Which observation if found would indicate that the job description needs revision with regard to delegation? 1. Delineation of roles and responsibilities 2. A listing of tasks that the nurse can complete 3. No mention of the nursing position authority 4. Listing of minimum qualifications for the nursing position

C

A nurse has received the assignment for the day shift. After making initial rounds and checking all of the assigned clients, which client should the nurse plan to care for first? a. A client who is ambulatory b. A client scheduled for physical therapy at 1 pm c. A client with a fever who is diaphoretic and restless d. A postoperative client who has just received pain medication

C

A nurse notes that a postoperative client has not been obtaining relief from pain with the prescribed opioid analgesics when a particular licensed practical nurse (LPN) is assigned to the client. The appropriate action for the nurse to take is to: a) reassign the LPN to the care of clients not receiving opioids b) notify the physician that the client needs an increase in opioid dosage c) review the client's medication administration record immediately and discuss the observations with the nursing supervisor d) confront the LPN with the information about the client having pain control problems and ask if the LPN is using the opioids personally

C

A registered nurse suspects that a colleague is substance impaired and notes signs of alcohol intoxication in the colleague. The Nurse Practice Act requires the registered nurse do which of the following? a) talk with the colleague b) call the impaired nurse organization c) report the information to a nursing supervisor d) ask the colleague to go to the nurse's lounge to sleep for a while

C

In differentiating between a leader and a manager, a: a. leader has legitimate authority. b. manager motivates and inspires others. c. manager focuses on coordinating resources. d. leader focuses on accomplishing goals of the organization

C

Nurse Skye is on the cardiac unit caring for four clients. He is preparing to do initial rounds. Which client should the nurse assess first? A. A client scheduled for cardiac ultrasound this morning. B. A client with syncope being discharged today. C. A client with chronic bronchitis on nasal oxygen. D. A client with diabetic foot ulcer that needs a dressing change.

C

Some nurses are debating about the appropriate action to take in relation to a particular family. One member of the family is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, "But it doesn't have to be an either/or situation. Perhaps each family member could take a turn calling in sick just 2 or 3 days. That way they could all take a turn at helping and yet not upset their employers. Wouldn't that be fair?" Which of the following ethical approaches is being used by this nurse? a.Communitarianism b.Deontology c.Principlism d.Utilitarianism

C

Some nurses are debating about the appropriate action to take in relation to a particular family. One member of the family is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, "It's not up to us; it's the family's decision. They know what is best for them." Which of the following ethical approaches is being used by this nurse? a.Communitarianism b.Deontology c.Principlism d.Utilitarianism

C

Which of the following is the first and most crucial step in a generic ethical decision-making process? a.Assess the context or environment in which the decision must be made. b.Consider the various ethical principles or theories. c.Identify the ethical issues and dilemmas. d.Make a decision and act on it.

C

You are responsible for the care of a postoperative patient with a thoracotomy. The patient has been given a nursing diagnosis of Activity Intolerance. Which action should you delegate to the nursing assistant? A. Instructing the patient to alternate rest and activity periods B. Instructing the patient to alternate rest and activity periods C. Encouraging, monitoring, and recording nutritional intake D. Monitoring cardiorespiratory response to activity

C

A nurse is delegating to the newly hired nursing assistive personnel (NAP) the task of assisting with oral hygiene, knowing that this assignment "does not require decisions based on the nursing process." The nurse is correctly using which of the five rights of delegation? a. Supervision b. Communication c. Person d. Circumstance

D

After change of shift, you are assigned to care for the following patients. Which patient should you assess first? A. A 60-year old patient on a ventilator for whom a sterile sputum specimen must be sent to the lab B. A 55-year old with COPD and a pulse oximetry reading from the previous shift of 90% saturation C. A 70-year old with pneumonia who needs to be started on intravenous (IV) antibiotic D. A 50-year old with asthma who complains of shortness of breath after using a bronchodilator

D

Based upon a request made by the client's spouse and children, a physician asks a nurse to discontinue the feeding tube in a client who is in chronic debilitated and comatose state. The nurse understands the legal basis for carrying out the order and first checks the client's record for documentation of: a) a court approval to discontinue the treatment b) approval by the institutional Ethics Committee c) a written order by the physician to remove the tube d) authorization by the family to discontinue the treatment

D

Nurse Adonai is working on the night shift with a nursing assistant. The nursing assistant comes to the nurse stating that the other nurse working on the unit is not assessing a client with abdominal pain despite multiple requests. Which of the following actions by the nurse is best? A. Ask the other nurse if she needs help. B. Assess the client and let the other nurse know what should be done. C. Ask the client if he is satisfied with his care. D. Contact the nursing supervisor to address the situation.

D

Paige is a nurse preceptor who is working with a new nurse Joyce. She notes that the Joyce is reluctant to delegate tasks to members of the care team. Paige recognizes that this reluctance is mostly likely due to: A. Role modeling behaviors of the preceptor. B. The philosophy of the new nurse's school of nursing. C. The orientation provided to the new nurse. D. Lack of trust to the members of the healthcare team.

D

Some nurses are debating about the appropriate action to take in relation to a particular family. One member of the family is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, "The whole family is being affected and will fall apart if they don't focus on their family's needs first before anything else." Which of the following ethical approaches is being used by this nurse? a.Communitarianism b.Deontology c.Principlism d.Utilitarianism

D

The nurse is giving a bed bath to an assigned client when an unlicensed assistive personnel (UAP) enters the client's room and tells the nurse that another assigned client is in pain and needs pain medication. Which is the most appropriate nursing action? a. Finish the bed bath and then administer the pain medication to the other client b. Ask the UAP to find out when the last pain medication was given to the client c. Ask the UAP to tell the client in pain that medication will be administered as soon as the bed bath is complete. d. Cover the client, raise the side rails, tell the client that you will return shortly, and administer the pain medication to the other client.

D

Which intervention for a patient with a pulmonary embolus could be delegated to the LPN on your patient care team? A. Evaluating the patient's complaint of chest pain B. Monitoring laboratory values for changes in oxygenation C. Assessing for symptoms of respiratory failure D. Auscultating the lungs for crackles

D

Which of the following would confirm that the nurse's advocacy has been truly successful or effective? a.Audiences agree with the nurse who is serving as advocate. b.Legislators discuss appropriate legislation to better allocate resources. c.People verbalize that the disenfranchised should be better treated. d.Systematic social changes are made to improve quality of life.

D

You are a nurse manager working in the ED. A patient has just arrived and a full trauma has been activated. The patient requires immediate attention and you give directions to your staff using this decision making style. a. Shared b. Informative c. Optimizing d. Autocratic e. Decisive

D

1. What are the key concepts of teams? Select all that apply A. Conflict resolution B. Planning C. Singleness of mission D.Willingness to cooperate E. Commitment

a b d e

A seasoned nurse is orienting a newly licensed nurse to the Med Surg unit. When explaining the reasoning behind flushing an IV with saline before and after administering IV push medications, the seasoned nurse is explaining the process of a. Traditional nursing practice b. Evidence based practice c. Research d. Randomized controlled trials

b

Adam has had a poor attitude towards other staff members, and often appears to be short tempered while talking to management. Sarah realizes that the issues are arising for a misunderstanding about authority. What should Sarah tell Adam about authority? a.) Authority is based on knowledge b.) Authority is based on participation and experience c.) Authority is based on age d.) Authority is based on number of years hired

b

How does a Not-for-profit hospital operate? Select all that apply. A. Paying taxes B. Reinvesting all profits back into the organization to better serve the public C. Profits redistributed to investors and managers D. Not paying taxes

b d

A nurse manager has identified a problem on the nursing unit and holds unit meetings for all shifts. The nurse manager presents an analysis of the problem and proposals for actions to team members and invites the team members to comment and provide input. Which style of leadership is the nurse manager specifically employing? a) situational b) laissez-faire c) participative d) authoritarian

c

A nurse moves from California to Arkansas and due to having 20 years of experience as a registered nurse is immediately placed in charge of the telemetry unit. The staffing consists of LPNs and two unlicensed assistive personnel. The RN is unsure of the scope of practice of the LPNs and reviews the nurse practice act for Arkansas, which lacks clarity on some tasks. The RN should: a. query the state nursing association to determine their stance on the role of LPNs. b. ask the LPNs on the unit to list what tasks they routinely performed. c. contact the state board of nursing to determine legal scope of practice for LPNs. d. Refer to California's nurse practice act because the scope of LPNs/LVNs is consistent across the United States.

c

A patient with sleep apnea has a nursing diagnosis of Sleep Deprivation related to disrupted sleep cycle. Which action should you delegate to the nursing assistant (PCT)? A. Discuss weight-loss strategies such as diet and exercise with the patient B. Teach the patient how to set up the BiPAP machine before sleeping C. Remind the patient to sleep on his side instead of his back D. Administer modafinil (Provigil) to promote daytime wakefulness

c

During orientation, an RN learns that LPN/LVNs in the facility receive additional training to perform some tasks such as hanging continuously infusing intravenous fluids that have no additives. It is important for the RN to understand that: a. the health care facility can override the state practice act by having all LPN/LVNs and nursing assistive personnel (NAPs) participate in on-site training. b. LPN/LVNs are licensed, and accountability for their own practice rests with each LPN/LVN. c. NAPs cannot be held responsible for their own actions or inactions. d. the nurse practice act and state regulations related to delegation override the organization's policies.

d