Leadership Exam 2 Review Questions

Which statement made by the RN demonstrates a lack of effective delegation to a LPN? (Select all that apply.) A. "Remember the patient is depressed so don't say anything to make her more sad." B. "Which mandatory competency testing session are you planning to attend?" C. "If you begin that complex dressing change while I'm off the floor, get someone to help you." D. "Have you ever cared for a postoperative patient who experienced a total mastectomy?" E. "Don't change the patient's catheter until you are sure the correct one has arrived on the unit."

A--"Remember the patient is depressed so don't say anything to make her more sad." C--"If you begin that complex dressing change while I'm off the floor, get someone to help you."

Which actions demonstrate a nurse's understanding and implementation of QSEN's competencies? (Select all that apply.) A. Asks for assistance when transferring a large patient onto a stretcher B. Attends an in-service on a piece of equipment new to the unit C. Deviates from facility's hand hygiene practice policy only when caring for noninfectious patients D. Encourages a patient newly diagnosed with terminal cancer to talk about their end-of-life concerns E. Shares a patient's religious food preferences with members of the health care team

A--Asks for assistance when transferring a large patient onto a stretcher B--Attends an in-service on a piece of equipment new to the unit D--Encourages a patient newly diagnosed with terminal cancer to talk about their end-of-life concerns E--Shares a patient's religious food preferences with members of the health care team

Which infections are currently considered a Never Event by Medicare and Medicaid? (Select all that apply.) A. Coronary artery bypass graft site B. Eye infection postcataract surgery C. Site of implanted cardiac electronic device (CIED) D. Abdominal incision site associated with bariatric surgery E. Catheter-associated urinary tract infection

A--Coronary Artery Bypass Graft Site C-- Site of implanted cardiac electronic device (CIED) D--Abdominal incision site associated with bariatric surgery E--catheter-associated urinary tract infection

According to the national Patient Safety goals, how can nursing reduce the risk of patients developing associated infections? (Select all that apply.) A. Creating mandatory competencies associated with the care of surgical incisions B. Implementing current WHO hand washing guidelines C. Instituting sterile technique policies related to the care of central lines D. Ambulating postsurgical patients as soon as their physical condition allows E. Striving to remove indwelling urinary catheters as soon as possible

A--Creating mandatory competencies associated with the care of surgical incisions B--Implementing current WHO hand washing guidelines C--Instituting sterile technique policies related to the care of central lines E--Striving to remove indwelling urinary catheters as soon as possible

Which characteristics are expected to be represented in a health care facility's mission statement? (Select all that apply.) A. Ethical treatment of all patients and staff B. Utilization of innovated service delivery methods C. Providing the most economic health care services D. Commitment to professional excellence E. Teamwork to deliver quality care

A--Ethical treatment of all patients and staff B--Utilization of innovated service delivery methods D--Commitment to professional excellence E--Teamwork to deliver quality care

Which situations demonstrate effective delegation by the RN to the LPN? (Select all that apply.) A. LPN asks, "Where will you be if I need help with the dressing I've been assigned?" B. LPN states, "I'll do whatever is necessary to keep my patients free of pain." C. RN adjusts the LPN's assignments when a patient's condition becomes unstable. D. RN asks the LPN, "Do you have any concerns about your assignment for today?" E. RN assumes responsibility for ambulating a patient when he reports, "I'm feeling dizzy."

A--LPN asks, "Where will you be if I need help with the dressing I've been assigned?" C--RN adjusts the LPN's assignments when a patient's condition becomes unstable. D--RN asks the LPN, "Do you have any concerns about your assignment for today?" E--RN assumes responsibility for ambulating a patient when he reports, "I'm feeling dizzy."

Which statements reflect common nurse practice acts policies? (Select all that apply.) A. The RN must evaluate patient outcomes resulting from the delegated activity. B. The LPN works under the supervision and direction of the RN. C. Only nursing tasks can be delegated, not nursing practice. D. The RN can delegate only what is within the scope of nursing practice. E. The LPN practices professional nursing.

A--The RN must evaluate patient outcomes resulting from the delegated activity. B--The LPN works under the supervision and direction of the RN. C--Only nursing tasks can be delegated, not nursing practice. D--The RN can delegate only what is within the scope of nursing practice.

What factors will be focal considerations when a facility begins developing its own set of clinical pathways? (Select all that apply.) A. The most costly diagnoses treated by the facility's staff B. The facility's most commonly treated diagnoses C. Accepted standards of specialized nursing care D. Physician input as a primary source of decision making E. Dietary and physical therapy are viewed as principal contributors

A--The most costly diagnoses treated by the facility's staff B--The facility's most commonly treated diagnoses C--Accepted standards of specialized nursing care

When considering nursing care what events are associated with the term "churning" and responsible for up to 70% of nursing care on a typical 20 bed medical-surgical unit? (Select all that apply.) A. Two patients are in the ER department with orders to be admitted as soon as a bed is available. B. Twelve patients have needs that require assistance with bathing and elimination. C. Five patients will have initial visits from physical therapy staff. D. Seven patients have been written discharge orders by their physicians. E. Five patients will be admitted for scheduled surgeries tomorrow between 7-8 am.

A--Two patients are in the ER department with orders to be admitted as soon as a bed is available. D--Seven patients have been written discharge orders by their physicians. E--Five patients will be admitted for scheduled surgeries tomorrow between 7-8 am.

Which skill is most important for a nurse to possess when attempting to exercise or earn informal power within an organization? A. Ability to persuade others B. Expert-level nursing knowledge C. Understanding of management goals D. Willingness to compromise with everyone in the team

A. Ability to persuade others Informal leadership is exercised by the person who has no official or appointed authority to act, but is able to persuade and influence others. The informal leader may have considerable power in the work group and can influence the group's attitude and significantly affect the efficiency and effectiveness of workflow, goal setting, and problem solving.

Which example of discharge teaching addresses a never event as identified by The Centers for Medicare & Medicaid Services? A. Signs and symptoms of both hypo- and hyperglycemia B. Need for good medication compliance in managing schizophrenia C. Suggested exercise options for the immediate postdelivery period D. Food choices for a low-fat, low-carbohydrate diet

A. Signs and symptoms of both hypo- and hyperglycemia The manifestations of poor glycemic control have been identified as a never event by The Centers for Medicare & Medicaid Services.

When considering staffing needs, what is the registered nurse's (RN) primary concern? A. The client acuity levels B. The number of available licensed staff C. The history of staff absenteeism D. The availability of support staff

A. The client acuity levels The primary considerations for staffing a specific nursing unit are the number of patients followed by the level of intensity of care required by those patients (commonly referred to as patient acuity). Knowing only the number of patients that require care is an ineffective way to plan staffing because of the wide range of care requirements needed by individual patients.

Health care institutions are automatically approved by The Centers for Medicare & Medicaid Services (CMS) under what circumstance? A. The institution has earned The Joint Commission (TJC) accreditation. B. The institution has demonstrated their commitment to quality improvement. C. The institution has provided care to a substantial number of Medicare and Medicaid clients. D. The institution has incorporated ORYX® performance measurements into their goals.

A. The institution has earned The Joint Commission (TJC) accreditation. Health care organizations that are accredited by TJC automatically meet foundational approval from the CMS.

How is cultural humility best achieved? A. Through regular self-evaluation of biases B. Demonstrating tolerance of the culturally diverse C. By caring for the culturally diverse D. By embracing the cultures of others

A. Through regular self-evaluation of biases We can all aspire to achieve cultural humility, which incorporates a lifelong commitment to self-evaluation and self-critique. The other options will have little impact without effective self-evaluation.

Acceptance of others regardless of their cultural background is referred to using what term? A. Tolerance B. Enculturation C. Respect D. Stereotyping

A. Tolerance reflects an attitude that accepts differences

What interventions will a nurse manager implement when coaching a newly licensed nurse regarding the way a patient's complaint was handled? (Select all that apply.) A. Use close-ended questions to help focus the conversation on the situation B. Asks, "What will you do differently the next time this situation occurs?" C. Approach the conversation in a nonjudgmental fashion D. Focus on how to achieve the "ideal situation" E. Begin the discussion with a personal interpretation of the situation

B--"What will you do differently the next time this situation occurs?" C--Approach the conversation in a nonjudgmental fashion E--Begin the discussion with a personal interpretation of the situation

Which situations have been identified as positive factors in achieving job satisfaction among nurses? (Select all that apply.) A. Managers taking care not to interfere when a patient focused crisis occurs B. Respect is given to and expected by all members of the health care team. C. Attention is paid to fostering excellent nurse-physician relationships. D. Having policy and practice decisions made by administration E. Professional development opportunities made available at the facility

B--Respect is given to and expected by all members of the health care team. C--Attention is paid to fostering excellent nurse-physician relationships. E--Professional development opportunities made available at the facility

What are the primary foci for nurses caring for patients currently being admitted to acute care facilities that make traditional nursing models less effective? (Select all that apply.) A. Rescue B. Stabilization C. Rehabilitation D. Prevention E. Transition

B--Stabilization E--Transition

Which nursing activity best demonstrates the quality management principle of "all one team?" A. Doing a search of the literature regarding prevention of postoperative bleeding in smokers B. Asking a wound care team nurse how to best educate a client on wound prevention C. Encouraging clients to determine when they want their daily bath D. Attending a seminar on the latest recommended therapy to reinforce cognitive function in the elderly

B. Asking a wound care team nurse how to best educate a client on wound prevention Demonstrating faith in the people who comprise the health care team and recognizing the expertise of particular team members reflects the "all one team" principle. Quality is demonstrated by considering clients as those who define whether their care is appropriate and of high value. Knowledge, especially when evidence based, demonstrates the scientific approach to client care.

What action demonstrates a nurse's correct understanding of patient-centered care? A. Being careful to use costly dressing supplies appropriately but with their cost in mind B. Discussing the client's wish to include herbal preparations to treat an illness C. Referring to evidence-based practice when planning client care D. Promptly medicating clients when they request their PRN analgesic

B. Discussing the client's wish to include herbal preparations to treat an illness Patient-centered care involves providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions. Efficient care includes avoiding waste, effective care is based on scientific knowledge, and timely care focuses on reducing waits and delays in care delivery.

According to the definition, which word best describes leadership? A. Control B. Influence C. Evaluate D. Allocate

B. Influence Leadership is the ability to guide or influence others

After first having a strong understanding of the standards of practice that govern delegation, what information must the registered nurse possess? A. The expected outcomes of the care to be delegated B. The condition and needs of the patient whose care is being delegated C. All patient care tasks that are being considered for delegation D. The skill and knowledge level of the staff member who is being delegated to

B. The condition and needs of the patient whose care is being delegated The RN must then know the client whose care is being delegated. The client's condition and stability must be determined before tasks and outcomes can be determined or consideration be given to the skill level of the staff being delegated to.

What is the most basic factor contributing to the effective supervision of unlicensed assistive personnel (UAP) by the nurse? A. The nurse's experience managing other members of the health care team B. The nurse's confidence in his or her ability to delegate appropriately C. The nurse's ability to communicate effectively with others D. The nurse's ability to teach UAPs the necessary skills for their assigned tasks

B. The nurse's confidence in his or her ability to delegate appropriately Because RNs are becoming increasingly responsible for delegation and supervision in today's health care system, it is imperative that they have confidence in their delegation skills and understand the legal responsibility that they assume when delegating to and supervising licensed personnel and UAP. RNs must know what aspects of nursing and health care can be delegated.

When considering supervisory responsibilities, what statement is accurate? A. A charge nurse is actually supervising only the LPNs and UAPs on the unit. B. When two RNs work together to move a client, neither nurse is in a supervisory position. C. Supervision is required only when staff is new to the unit, the patient, or the task. D. All supervision is done with the RN being immediately available to the staff.

B. When two RNs work together to move a client, neither nurse is in a supervisory position. One RN is working with another RN in a collegial relationship, and neither RN is in the position of supervising the other. Each RN is responsible and accountable for his or her own practice. However, the RN in a supervisory or management position (e.g., team leader, charge nurse, nurse manager), as defined by the health care organization, will be in a position to supervise other RNs.

How can a nurse manager best foster high-quality and safe nursing care among the nursing staff? A. Praise the staff's efforts to provide care that is both safe and of high quality. B. Place great emphasis on how important safe, high-quality nursing care is to the client's health. C. Create a unit culture where asking questions about health care interventions is encouraged. D. Offer incentives to those providing specific interventions that are safety and quality focused.

C. Create a unit culture where asking questions about health care interventions is encouraged. Health care organizations focusing on quality and safety encourage inquiry, making it okay to ask questions and providing resources to access information needed through various means, including informatics. Although praise and incentives are appropriate, they are not effective if the unit culture is not accepting. Placing emphasis on such interventions alone will not be successful if not supported by nursing managers and leaders.

Which statement made by an unlicensed assistive personnel (UAP) would cause the registered nurse team leader the most concern? A. "The nurse will follow up to make sure the client is well cared for." B. "I've only been working on this unit for a month and things are still new to me." C. "It's good to know that the nurse is really the one responsible for the client's care." D. "I wonder who I can ask about how to use this new electronic thermometer."

C. It's good to know that the nurse is really the one responsible for the client's care." The UAP is responsible for his or her own actions. A belief that the nurse is fully responsible is a concern and needs immediate attention by the nurse. It is true that the nurse will follow up and evaluate the client's care.

The nurse responsible for unit staffing must recognize that client care is most affected positively by what factor? A. A mix of high- and low-acuity client needs B. Nursing staff that hold advanced nursing degrees C. Nurses who report high levels of job satisfaction D. Units that implement the job-sharing model

C. Nurses who report high levels of job satisfaction Nurses who are satisfied with their work generally provide higher-quality, more cost-effective care. Staffing systems should consider the quality of work life for the nursing staff as important as the quality of patient outcomes.

What is a widely used approach of encouraging cooperation between the health care professions? A. SBAR (Situation; Background; Assessment; Recommendation) B. Quality and Safety Education for Nurses (QSEN) C. Team Strategies and Tools to Enhance Performance and Patient Safety (Team STEPPS) D. The Robert Wood Johnson Pilot School Collaboration

C. Team Strategies and Tools to Enhance Performance and Patient Safety (Team STEPPS)

When considering the philosophy and values of a health care facility,________________is the highest priority.

Compassion

An emergency department nurse will likely provide care according to which care delivery model? A. Team B. Primary C. Total care D. Functional

D. Functional Emergency departments often use functional approaches to care because emphasis is on efficient assessment and immediate treatment.

The implementation of a "Medication Nurse" is an example of what nursing care delivery model? A. Primary B. Team C. Total patient care D. Functional

D. Functional In the functional nursing method of patient care delivery, staff members are assigned to complete certain tasks for a group of patients rather than care for specific patients.

When considering clinical pathways, the nurse recognizes what definition of an outcome as appropriate? A. It is the result of a collaborative intervention of the health care team. B. It is an event that can prevent or help a patient reach wellness. C. It is an unexpected event that determines a need to change the plan of care. D. It is the end result of interventions provided by the health care team.

D. It is the end result of interventions provided by the health care team. Patient outcomes are the end result of interventions by the health care team. Inter-professional intervention is the collaborative effort by all disciplines. Variance is any event that may alter the patient's progress through the clinical pathway. Triggers alert the caregiver that an unexpected event has occurred and a change in the plan of care may be indicated.

A nurse manager will likely have which of the following types of power? A. Informal B. Referent C. Connection D. Legitimate

D. Legitimate Legitimate power is based on an official position in the organization. Through legitimate power, the manager has the right to influence staff members, and staff members have an obligation to accept that influence.

Which activity demonstrates the organizational Chaos Theory? A. Preparing a rubric to guide staff performance reviews B. Preparing the yearly unit budget C. Setting unit goals related to quality control of client care D. Planning for unexpected staffing shortages

D. Planning for unexpected staffing shortages The Chaos Theory suggests that a degree of order can be attained by viewing complicated behaviors and unpredictable situations as predictable by planning for them.

A nursing school best demonstrates an understanding of strategies that support recruitment of minority nursing students when engaging in what behavior? A. Offering a number of scholarships reserved for minority students B. Offering remediation to those for whom English is a second language C. Arranging for campus housing for all minority students D. Providing same-culture mentors from among faculty and student populations

D. Providing same-culture mentors from among faculty and student populations. Strategies such as mentoring by a same-culture professional are effective in recruiting and retaining minorities in nursing because this provides both role models and culturally sensitive support.

Which activity engaged in by a nurse manager would be expected to have the greatest impact on patient care? A. Conducting a survey to identify factors affecting staff job satisfaction B. Providing all staff members with written copies of organizational policies C. Providing all nursing staff with opportunities to influence unit policies D. Role modeling effective communication between all levels of staff

D. Role modeling effective communication between all levels of staff Positive role modeling is an effective tool the nurse can use to create a positive team spirit and promote high-quality patient care. Positive role modeling simply means that the nurse performs the job in such a way that he or she demonstrates ideal performance as a professional nurse; others hopefully will follow the example.

Which factor has the greatest impact on whether safe delegation of nursing tasks is possible? A. Whether the client is experiencing an acute or a chronic medical health issue B. The degree of trust shared between the nurse and the client C. The level of competency displayed by the unlicensed assistive personnel (UAP) D. Whether the client's physical condition is considered stable at the time

D. Whether the client's physical condition is considered stable at the time Generally the more stable the patient, the more likely delegation is to be safe. However, it is also important to remember many tasks that can be delegated may also carry with them a nursing responsibility.

The belief that one's own culture is superior to all other cultures is called.....

Ethnocentrism

A ________________is a measurable condition that results from interventions that can be either positive or negative in nature.

Patient outcome

The active process of directing, guiding, and influencing the outcome of an individual's performance of an activity or task is referred to as ______________________.

Supervision

A _____________________is an individual or group who seek a product or service and whose needs and expectations to determine the quality of the service.

customer

The __________________management style encourages staff involvement in the decision-making process.

democratic/participative