LEADERSHIP FINAL EXAM

A charge nurse notes that a staff nurse delegates an unfair share of tasks to the assistive personnel (AP) and the nurses on next shift report the staff nurse frequently leaves tasks uncompleted. Which of the following statements should the charge nurse make to resolve this conflict?

"I need to talk to you about unit expectations regarding delegating and completing tasks."

A nurse manager hears a staff nurse on the unit speak openly about her dislike of a recent policy change regarding client care. When discussing the issue with the nurse, which of the following statements by the nurse manager is appropriate?

"Let's talk about your concerns about the new policy."

____ is defined as the accomplishment of specified activities during the time available.

Time management

A nurse is caring for a client who is scheduled to have surgery. In preparing the client for surgery, which of the following actions is considered outside the nurse's responsibilities?

Explaining the operative procedure, risks, and benefits

A nurse is caring for several clients. For which of the following situations should the nurse complete an incident report?

A client discovers that his dentures are missing

A nurse manager is reviewing the admission history of four adults who were admitted to the medical-surgical unit during the shift. Which of the following situations is the nurse required to disclose information to an outside agency about the client or the client's circumstances?

A dependent adult admitted for the treatment of a spiral fracture

A nurse is triaging clients in an urgent care clinic. Which of the following clients should the nurse have the provider care for immediately?

A middle adult male who is diaphoretic and reports epigastric pain

A charge nurse is making a room assignment for a client who has scabies. In which of the following rooms should the nurse place the client?

A private room

Following a tornado, a nurse is determining which of the clients assigned to her care can be discharged to free up beds for injured clients. Which of the following clients should the nurse recommend for discharge?

A young adult client who has Crohn's disease and is 1 day preoperative for an ileostomy.

A nurse is caring for a group of clients. The nurse demonstrates adherence to the ethical principle of fidelity by doing which of the following?

Keeping an appointment with a client.

A nurse is planning to assign care activities to the assistive personnel (AP) on her team. Which of the following activities can the nurse assign to the AP? (Select all that apply.)

Accompany a client who has depression to occupation therapy. Check the position of a client in soft wrist restraints. Sit with a client who has alcohol use disorder and who last drink was five days ago.

A charge nurse is providing an in service for staff nurses on the use of new IV pumps. Which of the following actions should the charge nurse take to best evaluate staff competency with the new equipment?

Allow time during the workday when each nurse can demonstrate proficiency.

A nurse on a medical-surgical unit is assigning tasks to an assistive personnel (AP). Which of the following tasks should the nurse delegate to the AP?

Ambulate a client who has a cane, Transfer a client to a stretcher, Record urinary output.

A nurse on a medical-surgical unit is assigning tasks to an assistive personnel (AP). Which of the following tasks should the nurse delegate to the AP? (Select all that apply.)

Ambulate a client who has a cane. Transfer a client to a stretcher. Record urinary output.

A nurse on a medical unit is planning care for several clients. Which of the following clients should benefit most from the nurse acting as advocate?

An older adult client who has no family and is uncertain about moving to assisted living.

A client who fell and broke his hip while being assisted to the bathroom by a nurse states he plans to sue the nurse. The nurse should know that, in a legal proceeding, the standard that will be used to determine if the nurse was negligent is which of the following?

Another staff nurse provides testimony about how a reasonable, prudent nurse would have handled the situation.

The nurse manager on a medical-surgical unit wants to change to walking rounds in the patients' rooms for change of shift report. In the past it has been face to face at the nurses station. The nurse manager is meeting resistance from the staff because they think that it will take longer and the nurses will not finish their shift on time. What could the manager do to increase the nurses acceptance of this change?

Ask the nurse to participate in the planning and implementation of the change.

A nurse has been reassigned from her regular area of work to a unit that is short staffed. Which of the following actions should the nurse take first?

Ask what she will be assigned to do.

Which of the following exemplifies a safety climate within a nursing unit?

Asking staff to report near-misses of adverse events.

A nurse on a medical-surgical unit is preparing to contact a provider about a client's condition. The client is 6 hr postoperative from a total hysterectomy. The nurse notes the client's postoperative oxygen saturation is 94% and her apical heart rate is 110. The nurse should include information about the client's oxygen saturation level and heart rate in which component of the SBAR report?

Assessment

The postoperative patient with anterior cervical laminectomy is complaining of tightness in his throat. His voice is raspy. The staff nurse asks the unit secretary to page Dr. Julio stat. This is an example of ____________ leadership

Authoritarian

A nurse is caring for an older adult client who has a terminal illness and is ventilator-dependent. The client is alert and oriented and wants to discontinue the use of the ventilator. The nurse should be aware that continued treatment against the client's wishes is a violation of which of the following ethical principles?

Autonomy

A nurse manager has several complaints from her staff that she is inaccessible during the day. What is the best strategy the nurse manager takes to improve her staff satisfaction?

Block time for daily rounds with staff

A nurse participates in quality improvement to decrease hospital readmissions for clients who have heart failure. Which of the following actions should the nurse expect to perform?

Compare performance to current practice standards.

A nurse is caring for an older adult client who is disoriented and has a history of falls. Which of the following actions should the nurse take? (Select all that apply.)

Check on the client hourly. Instruct the client in the use of the call light. Apply an ambulation alarm to the client's leg.

A nurse is preparing to administer a soap suds enema to a client who has constipation. As the nurse explains the procedure, the client states, "The doctor didn't tell me I was supposed to receive an enema." Which of the following nursing actions is appropriate at this time?

Check the client's medical record for the provider's prescription

A nurse is working with an assistive personnel (AP) to care for a group of clients on the pediatric unit. Which of the following tasks should the nurse have the AP perform first?

Check to see if the elbow restraint is in place for an infant who is postoperative from a surgical correction of a cleft palate.

A professor at the local college of nursing is teaching at a new clinical site. She notes that the nurses greet each other and their clients with warmth and a smile. She also notes that the policies and procedures encourage nursing autonomy. Nurses and physicians seem to have a collegial relationship. The observations best describe the ___ of the unit.

Climate

A nurse on a quality control committee is evaluating the results of recently implemented measures designed to reduce client medication errors. Which of the following methods should the nurse use to evaluate the success of the changes?

Compare the number of medication errors before and after the action was implemented.

A nurse is caring for a client who is preoperative. The nurse signs as a witness on the client's consent form. The nurse's signature on the consent form indicates which of the following?

Confirms the client appears competent to provide consent.

A nurse is discussing the morning stage of the group development process with a student nurse. Which of the following statements by the student indicates understanding of the discussion?

Consensus evolves in this stage.

Utilizing the DECIDE acronym for the process of decision making what are the first and final steps in the process.

Define the problem and determine why anything should be done about it, Evaluate the decision through monitoring, troubleshooting, and feedback.

A nursing executive is leading a multidisciplinary team of professionals who have worked well on prior initiatives. Which of the following leadership styles might work best in this situation?

Democratic

A nurse is caring for a client who is scheduled for surgery. The nurse's role in regards to informed consent is which of the following?

Determining the client's level of understanding about the procedure

A nurse is caring for a client who is scheduled for surgery. The nurse's role in regard to informed consent is which of the following?

Determining the client's level of understanding about the procedure.

A nurse manager has received information from the facility's risk management department that a former client is pursuing a lawsuit. The nurse manager should anticipate a deposition will be required during which phase of the legal process?

Discovery phase

How is SBAR used in decision making?

Effective communication technique.

The personal leadership skill for nurses that consists of self-awareness, discipline, motivation, social awareness, and relationship management is known as what?

Emotional intelligence

There is evidence of a link between ______ employees with higher productively more satisfied customers.

Empowered

A nurse suspects that a coworker is diverting opioid analgesics. Which of the following is an adverse effect of opioid medications?

Euphoria

The nurse is caring for a client on the medical-surgical unit. The client has been taking warfarin at home and her laboratory values reveal her INR is 3.5. The client states she is checking herself out of the hospital and refuses to wait until the provider can discuss the situation with her. Which of the following actions should the nurse take?

Explain the risk that the client faces if she leaves the facility

_________ are vital to good leaders because they are able to take the vision of the leader and achieve the determined goals.

Followers

An assistive personnel (AP) tells the nurse manager that she observed a nurse of the unit removing a small amount of morphine from syringes prior to administering the medication to clients. Which of the following actions should the nurse manager take first?

Gather data about the nurse's work performance and attendance history.

An assistive personnel (AP) tells the nurse manager that she has observed a nurse on the unit removing a small amount of morphine from the syringes prior to administering the medication to clients. Which following actions should the nurse manager take first?

Gathering data about the nurse's work performance and attendance history

A charge nurse is working with an assistive personnel (AP) who provides excellent care to clients and is an effective team member. Which of the following actions should the nurse take first to recognize the AP's contributions to client care?

Give positive feedback directly to the AP

A charge nurse is working with an assistive personnel who provides excellent care to clients and is an effective team member. Which of the following actions should the nurse take first to recognize the AP's contributions to client care?

Give positive feedback directly to the AP.

A group of nurses is showing resistance to changes the manager is making with regard to staffing. Which of the following ways can the manager deal with the emotionality of the situation? (Select all that apply.)

Give the nurses adequate notice of change. Explain the rationale and patient impact.

A nurse is caring for a client who has named a person to serve as his healthcare proxy. The client states about this type of advanced directives. Which of the following statements by the client indicates a need for clarification?

I have chose a family member as my healthcare proxy

A nurse in a long-term care facility has assigned a task to an assistive personnel (AP). The AP refuses to perform the task. Which of the following is an appropriate statement for the nurse to make?

I need to talk to you about the unit policies regarding the client assignments

A nurse is caring for a client who has advanced lung cancer. The client's provider has recommended hospice services for the client. Which of the following statements by the client indicates a correct understanding of hospice care?

I should expect the hospice team to help me manage my dyspnea

A nurse manager is reviewing the Good Samaritan laws with a group of newly licensed nurses. Which of the following statements is appropriate by the nurse manager?

If you render aid in an accident, do not leave the scene until another competent person can take over

A nurse is participating in a quality improvement study of a procedure frequently performed on the unit. Which of the following information will provide data regarding the efficacy of the procedure?

Incidence of complications related to procedure.

Which of these clinical decisions poses the greatest risk for committing an error?

Independent interpretation of medication order

The use of a new idea or method is the definition of?

Innovation

Leadership is best defined as.

Inspiring people to accomplish goals through support and confidence building.

A nurse in the emergency department is caring for a client who has a compression fracture of a spinal vertebra. During transport to the facility, the client was medicated with intravenous morphine. On arrival, the neurosurgeon determined urgent surgical intervention is indicated for the fracture. Staff members have been unable to reach the client's family. Which of the following actions should the nurse anticipate the neurosurgeon taking?

Invoking implied consent.

Which of the following is true of management activities?

Management is focused on task accomplishment.

A charge nurse has access to the facility's electronic client records. It is appropriate for the charge nurse to share her personal password with whom?

No one

A nurse is caring for a client who is dying of metastatic breast cancer. She has a prescription for opioids for pain that is PRN. The nurse is concerned that administering the dose of pain medication might enhance her death quickly. Which of the following ethical principles would the nurse implement to not administer the medication?

Non-maleficence

A nurse is caring for a client who is participating in a research study for an experimental chemotherapy medication. After three treatments, the experimental medication is discontinued due to evidence of rapidly advancing kidney failure. The nurse should understand that discontinuing this medication demonstrates which of the following ethical principles?

Nonmaleficence

A nurse on a medical-surgical unit has accepted a transfer to the intensive care unit (ICU). Prior to transfer to the ICU, the nurse completes an online critical care and emergency nursing course. The nurse is demonstrating which of the following ethical principles?

Nonmaleficence

A nurse on a medical-surgical unit is planning to delegate tasks to an adult volunteer. Which of the following tasks should the charge nurse avoid assigning to the volunteer?

Observing a postoperative client who is confused.

A nurse assigns care for a client who has diabetes mellitus to the LVN and AP. Which of the following tasks should be delegated to the LVN?

Obtain capillary blood glucose

An RN on a medical surgical unit is making assignments at the beginning of the shift. Which of the following tasks should the nurse delegate to the LVN?

Obtain vital signs for a client who is 2 hr post procedure following a cardiac catheterization

A nurse is caring for a client who has rheumatoid arthritis and is experiencing difficulty feeding herself using adaptive devices. The nurse should initiate a referral with which of the following members of the interprofessional healthcare team?

Occupational therapist

The nurse in a medical-surgical unit is working short staffed due to a sick call. Which of these is an example of prioritization?

Omitting personal hygiene in favor of timely medication administration.

A situational leader can best be described by which of the following statements?

This leader tailor his or her leadership style based on the employee, experience and circumstances.

A nursing unit has demonstrated lower patient satisfaction scores during the last quarter. The manager of the unit has formed a small team to set long and short term goals for the unit with action plans to increase patient satis faction. This is an example of which management process?

Planning

A nurse in a provider's office is reviewing the laboratory findings for a client who is scheduled for surgery. Which of the following findings requires follow up by the nurse?

Platelet count 60,000/mm3

A nurse manager has ordered equipment for a new unit. The company has sent two notices that the equipment is on backorder. The nurse manager is debating whether to wait for the equipment on back order or to cancel the order and go with another company. She discusses this issue with another nurse manager and they determine that the equipment is urgent for patient safety in the new unit. The manager orders the necessary equipment from another company even though it is slightly more expensive. This is an example of?

Prioritization

A nurse is preparing to bathe a client. Which of the following actions should the nurse plan to take?

Pull the curtain around the client's bed.

A nurse in an acute care setting is serving on a committee whose charge is to use the auditing process to client care. Which of the following aspects of client care is measured by a process audit?

Quality of nursing care provided.

A nurse overhears two AP from the medical-surgical unit discussing a hospitalized client while in the cafeteria. Which of the following is the priority nursing action?

Quietly tell the APs that this is not appropriate.

A nurse overhears two assistive personnel (AP) from the medical-surgical unit discussing a hospitalized client while in the cafeteria. Which of the following is priority nursing action?

Quietly tell the APs that this is not appropriate.

A nurse on a medical-surgical unit is providing care for a group of clients. The nurse should delegate collection of which of the following specimens to the assistive personnel (AP)?

Random stool specimen

A nurse is serving on a continuous quality improvement (CQI) committee that has been assigned to develop a program to reduce the number of medication administration errors following a sentinel event at the facility. Which of the following strategies should the committee plan to initiate first?

Review the events leading up to each medication administration error.

A new nurse manager is provided with a smartphone in order to efficiently manage her time. What is the most effective method of managing stress related to e-mail?

Schedule blocks of time to tackle e-mail

A new nursing manager is falling behind on the staffing schedule, the monthly budget, and employee evaluations. She says to her director, "I'm working 60 hours per week and I still don't have enough time to do it all." The nursing director suggests which of the following to her?

Scheduling blocks of time for each activity to be accomplished.

Which of the following behaviors build trust between leaders and employers in an organization?

Sharing relevant information, Meeting expectations

A coworker puts an arm around a nurse and says, "I bet you are a great lover." Which of the following is an appropriate response by the nurse?

Speaking to me like that make me uncomfortable

A nurse is caring for a client who falls in his room. After the nurse assesses the client, notifies the client's provider, and completes an incident report. Which of the following actions should the nurse take?

Submit the incident report to the risk manager

A staff nurse has applied for a promotion. The hiring manager insinuates that if there was a sexual relationship between the two of them, the nurse's promotion request would get increased consideration. Which of the following actions should the staff nurse take first?

Tell the hiring manager in clear terms that this conduct causes feelings of discomfort and that the behavior should stop immediately.

Nurses who are successful at time management?

Tend to accomplish specific activities within a time frame.

When planning delegation of tasks to assistive personnel (AP), a nurse considers the five rights of delegation. Which of the following should the nurse consider when using one of the five rights of delegation?

The AP has the knowledge and skill to perform the task

A nurse is planning to delegate tasks to a licensed practical nurse (LPN). Which of the following entities is important for the nurse to understand when delegating tasks to the LPN?

The State Nurse Practice Act

A nurse finds that a client did not receive a scheduled dose of furosemide (Lasix). Which of the following should the nurse include in the incident/variance report? (Select all that apply.)

The date of the incident. The time the client was to receive the medication. The client's vital signs.

The difference between the focus of managers and leaders is best described by which of the following statements?

The manager focuses on systems and structure, and the leader focuses on people and innovation.

A nurse on a medical-surgical unit the nurse is discussing/reviewing a newly admitted client's medication about medication reconciliation with a new licensed nurse. The nurse should include which of the following information?

The purpose of a medication reconciliation to prevent adverse medication reaction

An assistive personnel (AP) comes to work with a new set of artificial nails. The nurse takes the AP to a private location to discuss the issue. Which of the following statements by the nurse is appropriate?

There is a higher risk of infection for our clients associated with artificial nails

A nurse is participating in a disaster simulation in which a toxic substance is released into a crowded stadium. Multiple clients are transported to the facility. Which of the following activities would be the lowest priority for the nurse?

Transferring a client to the discharge location.

A volunteer assigned to the pediatric unit reports to the charge nurse for an assignment. Which of the following assignments is unsafe for the volunteer?

Transporting a school-age client who is in traction to another department

A nurse is obtaining informed consent from a client who is preoperative. Which of the following actions should the nurse take? (Select all that apply.)

Validate the signature is authentic. Verify the client understands the surgical procedure. Confirm that the consent is voluntary.

While caring for a client a nurse experiences a needle stick injury. Which of the following actions should the nurse take first?

Wash the site of the injury with soap and water.

A nurse is caring for a client who has severe head injuries and is declared brain dead. The transplant coordinator has spoken to the client's family about organ donation. The client's spouse states she is confused and does not know what to do. Which of the following responses by the nurse is appropriate?

What do you think your spouse would have wanted?

A nurse is caring for a client who is dying. The nurse should incorporate the principle of nonmaleficence into practice by taking which of the following actions?

Withholding a dose of narcotic pain medication when the client has respiratory depression

The chief nursing officer (CNO) of a hospital system works with senior leadership for approval to initiate an electronic health system. He recruits a nursing informaticist and a chief medical informatics officer to begin the process of planning the education and rollout of the new electronic system. The CNO could be viewed as the

change agent