leadership mod 3
A nurse on the cardiac catheterization team is required to work an overtime shift each week. Which statement(s) by the nurse best reflects the American Nurses Association (ANA) position on mandatory overtime? Select all that apply. A. "I should not be forced to work overtime shifts when I am fatigued." B. "I should assess my level of fatigue before working an overtime shift." C. "I should be okay as long as I only work one extra shift a week." D. "If my level of fatigue is high, I should not accept an overtime assignment." E. "If I don't work overtime I could be charged with patient abandonment."
A. "I should not be forced to work overtime shifts when I am fatigued." B. "I should assess my level of fatigue before working an overtime shift." D. "If my level of fatigue is high, I should not accept an overtime assignment."
Two nurses are discussing the role of collective bargaining in a future decision about patient care delivery. Which statements indicate the nurse understands collective bargaining? Select all that apply. A. "This process for change may improve our working conditions." B. "We will not have a voice during the negations process." C. "Nurses and managers may experience more conflict than cooperation." D. "Collaborative bargaining is not important when promoting change." E. "Collective bargaining equalizes power between employee and employer." F. "We have increased job security when changes are made using collective bargaining."
A. "This process for change may improve our working conditions." C. "Nurses and managers may experience more conflict than cooperation." E. "Collective bargaining equalizes power between employee and employer." F. "We have increased job security when changes are made using collective bargaining."
During a mass causality incident involving exposure to radiation, the nurse should assess the victim for GI symptoms such as as nausea, vomiting, loss of appetite, diarrhea, and/or fatigue for approximately how many hours after exposure? A. 48 B. 12 C. 72 D. 24
A. 48
Which action(s) by the community based nurse are examples of tertiary prevention? Select all that apply. A. A cardiac rehabilitation nurse working with a patient who had a heart attack B. A nurse helping a patient with mobility problems create a safe home environment C. A mental health nurse counseling a physically abused child in therapy D. A nurse helping with glaucoma screening for a elderly couple E. A nurse securing a baby in a car seat when leaving the hospital
A. A cardiac rehabilitation nurse working with a patient who had a heart attack B. A nurse helping a patient with mobility problems create a safe home environment C. A mental health nurse counseling a physically abused child in therapy
The risk manager is teaching a class about decreasing the risk for infectious disease transmission when caring for a patient who has Vancomycin-resistant Enterococci (VRE). Which statement by the staff nurse indicates a need for further education? A. Alcohol hand sanitizer does not prevent the spread of VRE B. Patients who have VRE should have a dedicated thermometer and blood pressure cuff C. We should initiate contact precautions on all patients who have VRE D. I should always wear a gown and gloves while in a patient's room who has VRE
A. Alcohol hand sanitizer does not prevent the spread of VRE
Which of the following is a macro-level change? A. Shift in Medicare payment policies B. Change in shift differentials C. Opening a new unit D. Changing visiting hours
A. Shift in Medicare payment policies
Which of the following is the best indication that a change has been integrated? A. When no one talks about it anymore B. If adoption occured rapidly C. When resistance turns from active to passive D. When a full year has passed since the change was introduced
A. When no one talks about it anymore
A patient in the emergency department waiting area who is impatient to be seen becomes aggressive and threatens the nurse. What is the nurse's best response? A. "If you don't stop threatening me, I will have to call our hospital security." B. "I understand you are not feeling well. What can I do to make your wait easier?" C. "Please be calm. There are other patients who are also sick and you are scaring them." D. "There are patients ahead of you. Would you like something to drink while you wait?'
B. "I understand you are not feeling well. What can I do to make your wait easier?"
Which patient is most likely to seek health care late in the course of his/her disease and deteriorate more quickly than other patients? A. An elderly widow who lives alone B. An individual who is homeless C. A teenager who lives in poverty D. A new immigrant from Mexico
B. An individual who is homeless
Nurses who feel empowered can make significant contributions to a healthcare organization. Feeling empowered includes feeling as if you make a difference, that colleagues value your opinion, and that your voice is important. What is essential to nursing empowerment? A. Belonging to a professional organization B. Participating on a unit practice council C. Reasonable work assignments D. A rewards and recognition program
B. Participating on a unit practice council
The leadership team at an acute care hospital announces a temporary change in nursing assignments designed to help decrease staffing shortages in the ICUs. Which action by the leadership team will help increase the psychological safety of nursing staff? A. Allow individuals to not change until they're ready B. Provide opportunities for individuals to ask questions C. Recognize resistance and work to reduce it D. Provide details about why the change is necessary
B. Provide opportunities for individuals to ask questions
What statement by the nurse is true regarding patient safety and prevention of harm? A. "Medication errors are adverse events." B. "As many as 90% of medication errors are preventable." C. "Poorly coordinated care and nosocomial infections are examples of errors." D. "Errors are usually intentional and occur because of time or resource constraints."
C. "Poorly coordinated care and nosocomial infections are examples of errors."
Creating a culture of safety requires organizational commitment to preventing harm. Which of the following is not a key feature of a culture of safety? A. Provision of adequate resources to provide care and service B. Use of interprofessional collaboration to solve problems and assess risks C. Adherence to staffing ratios D. Encourage the reporting of errors and near misses
C. Adherence to staffing ratios
A private, proprietary for profit hospital has a decentralized organizational structure. Which organizational characteristic should a nurse considering employment in this organization expect to find? A. Work will be divided according to centralized and vertical departmental lines B. Patient care services will generally be heavily influenced by governmental guidelines C. Any profits realized by the organization will be distributed to owners and managers D. The number of employees supervised by each manager will be large
C. Any profits realized by the organization will be distributed to owners and managers
If you are employed at a hospital-owned by a corporation listed on the stock market, in which category does your facility belong? A. Publically (government) supported B. Voluntary, not-for-profit C. For-profit D. All the above
C. For-profit
Communities and regulatory agencies continually challenge hospitals, skilled nursing facilities, and home health companies to enhance, improve, or change care delivery and the care environment to ensure safe, high-quality care. Which factors are important in improving a hospital's care environment? A. Adequate staffing B. Collegial relationships among staff C. Emphasis on staff development D. All of the above
D. All of the above Adequate staffing Collegial relationships among staff Emphasis on staff development
Organizational culture is best defined as: A. The stated vision and mission of an organization B. Policies and procedures C. The type of decor that was chosen for the facility D. An enduring set of shared values and beliefs
D. An enduring set of shared values and beliefs
A clinic for individuals who are uninsured is run by volunteer doctors and nurses. This clinic is most likely what type of healthcare organization? A. Voluntary for profit B. Publicly supported C. Governmental agency D. Not for profit
D. Not for profit
A nurse is completing the morning assessment on a new patient. As the nurse approaches the IV pole, the nurse's foot gets stuck to the floor and the nurse falls to the ground, injuring his knee. It was discovered that an IV bag containing dextrose had leaked onto the floor and was not properly cleaned up. The nurse suffered a sprain and returned to work 1 week later. What does this situation following does this best describe? A. Sentinel event B. Service occurrence C. Minor injury D. Serious incident
D. Serious incident A serious incident occurs when a patient or employee suffers injury without the threat of death. A service occurrence is an error that does not result in harm or a significant interruption in clinical services. A minor injury occurs when medical intervention for a patient or employee is needed outside of the admission reason. Minor physical or psychological harm occurred. A sentinel event results in death or serious permanent injury.
What is the priority assessment for a victim who was exposed to sulfur mustard? A. Cardiac dsrhythmias B. Orientation C. Gastrointestinal dysfunction D. Skin lesions
D. Skin lesions
The nurse is following the critical pathway for a patient who is post coronary artery bypass. How does the nurse best integrate the pathway into the patient's plan of care? A. To complete and record patient education B. To document patient response to treatment C. To arrange referrals at time of discharge D. To develop patient expected outcomes
D. To develop patient expected outcomes
The nurse completes an incident report for which primary purpose? A. Protection for the organization from a lawsuit. B. To identify who left the bed wheels unlocked. C.Documentation for future performance evaluations. D. To promote a culture of safety in the organization.
D. To promote a culture of safety in the organization.
A nurse who was distracted after giving an IM shot was stuck by the needle. What is the nurse's most important action? A. Obtain post-exposure prophylaxis within two hours B. Update her hepatitis B immunization C. Disinfect the site needlestick site D. Report to the employee health nurse at end of shift
A. Obtain post-exposure prophylaxis within two hours
A GN is interviewing for a position in a healthcare organization where supervisors serve as a resource for staff. What conclusion can the GN make about the decision making power of this organization? A. Power is concentrated at the top of the organizational ladder B. Power is delegated, but controlled by the people in authority C. Power is divided according to assigned rigid unit structures D. Power is decentralized throughout groups of autonomous teams
D. Power is decentralized throughout groups of autonomous teams
A Graduate Nurse who just started working in a busy ER recently developed hives, rhinitis, and conjunctivitis. What is the most likely cause of the nurse's symptoms? A. An allergic reaction to the latex gloves B. An environmental auto-immune eczema C. A sinusitis from recent seasonal allergies D. A hypersensitivity to the cleansing agents
A. An allergic reaction to the latex gloves
A RN identifies safety concerns on an inpatient unit and implements changes to improve patient outcomes. What does this scenario best describe? A. Applying quality improvement B. Providing patient-centered care C. Employing evidence-based practice D. Utilizing informatics
A. Applying quality improvement Quality improvement involves identification of errors and safety hazards, as well as designing and implementing interventions to change processes and improve safety. Utilizing informatics involves using information technology to communicate, manage knowledge, mitigate error, and support decision making. Evidence-based practice involves integrating current best practices, research, and clinical expertise into practice. Patient-centered care means the patient's preferences, values, and thoughts are considered. The patient is educated on care provided and decision making is shared.
There are numerous sources of power in an organization. Several are available to nurses. Which one is not? A. Authority B. Reward C. Control of information D. Coercion
A. Authority
What is a priority action for a nurse involved in the decontamination process for victims of a terrorist attack with a chemical weapon? A. Be sure all rescuers are wearing personal protective equipment B. Assure all victims are together before beginning decontamination C. Use warm water to lightly wipe down and rinse off the victims D. Transport victims to the nearest health care facility for decontamination
A. Be sure all rescuers are wearing personal protective equipment
The nurse who works on the night shift enters the medication room and finds a co-worker with a tourniquet wrapped around the upper arm. The co-worker is about to insert a needle, attached to a syringe containing a clear liquid, into the antecubital area. Which is the most appropriate action by the nurse? A. Call the nursing supervisor B. Call security C. Call the police D. Lock the co-worker in the medication room until help is obtained
A. Call the nursing supervisor
What is the most allergic common reaction to latex? A. Contact dermatitis B. Decreased appetite C. Increased headaches D. Vision changes
A. Contact dermatitis
With the changing population of health care consumers, it has become important for the acute care nurse to collaborate with public health and home health nurses. What nursing function has increased in importance because of these changes? A. Discharge planning B. Prescribing medications C. Family involvement D. Collegial relationships
A. Discharge planning
Triage these mass casualty incident victims using the START triage method (red, yellow, green, black) A. Broken wrist, walking around scene B. Unresponsive, grey matter showing C. Responsive, pale, moist skin, respirations 32/minute. D. Deformed tibia and fibula. Oriented, respirations 20, pulse about 100 E. Unresponsive, slow, snoring respirations. Breathing improves when airway opened
A. Green B. Black C. Red D. Yellow E. Red
Which statement by the nurse indicates shared governance is a valued part of a health care organization? A. I serve on the committee created to redesign our nursing philosophy B. I was paid double time to work an extra shift on Sunday C. My nurse manager submitted a plan to change our wound care policy D. I got an extra vacation day for doing a good job last week
A. I serve on the committee created to redesign our nursing philosophy
A graduate nurse employed by a large healthcare organization is most likely to assume which role in nursing research? A. Identify nursing problems for clinical research B. Lead a patient care research project for nurses C. Serve as principle investigator for a clinical study D. Assign patient groups in a proposed clinical study
A. Identify nursing problems for clinical research
What is the best explanation of authority? A. It is position-dependent B. Is it based upon the ability to lead others C. It is expertise-driven D. It resides primarily in the clinents served
A. It is position-dependent
What type of organization employs supervisors whose primary main focus is on planning and providing resources? A. Organic B. Traditional C. Bureaucratic D. Supportive
A. Organic
A community health nurse has scheduled a hypertension clinic in a local mall in which shoppers will have the opportunity to have their blood pressure measured. This activity is an example of what type of prevention? A. Secondary B. Primary C. Preventative D. Volunteer
A. Secondary Secondary Prevention- The focus is on health maintenance and early detection with prompt intervention to prevent or minimize the patient's loss of independence. Examples include health screening such as an annual mammogram, yearly cholesterol levels, and blood pressure screenings
There is an increased number of catheter-associated urinary tract infections (CAUTI) on the medical unit. To help decrease CAUTI numbers, the unit is adopting a new policy on indwelling catheter care. Which action by the director will promote change to the new policy? A. Share a patient's story of how a catheter-associated urinary tract impacted him personally B. Provide staff with a report of infection control measures and their effectiveness C. Present statistics on the number of patients with catheter-associated urinary tract infections D. Inform staff of the Hospital-Acquired Condition Reduction Program
A. Share a patient's story of how a catheter-associated urinary tract impacted him personally
What action best demonstrates a nurse's contribution towards achieving an organization's goal to decrease hospital readmission rates? A. Teaching a post stroke patient to perform self-care B. Arranging follow up physician appointments C. Assuring a patient who had hip surgery has a walker D. Teaching a patient's family about discharge medications
A. Teaching a post stroke patient to perform self-care
Which action by the nurse demonstrates primary prevention in the community health setting? A. Teaching college students about the importance of regular exercise B. Screening people at the mall for high blood pressure C. Checking patients at the free health clinic for elevated cholesterol D. Working to rehabilitate an elderly patient who suffered a stroke
A. Teaching college students about the importance of regular exercise
The community health nurse is working with disaster relief personnel after a hurricane that ruined many homes in the local community. The nurse is working to find housing for the survivors and is organizing counseling services. Which prevention level do the nurse's actions represent? A. Tertiary B. Secondary C. Quaternary D. Primary
A. Tertiary
A patient will need to walk with a two wheeled walker for six weeks after having a total knee replacement. What is most important for the home care nurse to asses during the initial home visit? A. The characteristics of the home environment B. The patient's family members ability to assist C. Available transportation to physician visits D. The patient's Medicare and Medicaid qualifications
A. The characteristics of the home environment
What is the primary reason for the recent growth in home health nursing care? A. The discharge of patients who are more critically ill B. Western focus on disease treatment. C. The chronic nursing shortage D. Nurse's preference to work on the day shift
A. The discharge of patients who are more critically ill
You are a new nurse. the hospital where you work is commited to providing safe, high-quality care. Which of the following activities would let you know that your organization is committed to improving patient safety? A. The hospital has a good catch program for staff who recongnize errors and near misses B. The hospital subscribes to TJC safety publication C. The hospital measures performance every month, montitors quality indicators, and regularluy reports on quality D. All of the above
A. The hospital has a good catch program for staff who recongnize errors and near misses
A home care nurse is planning to visit a new diabetic patient of Japanese heritage. Upon arriving at the home, the nurse notes that there are shoes on a mat next to the door. Which action by the nurse demonstrates cultural competence during the home visit? A. The nurse removes her shoes, places them on the mat, and completes the home health visit B. The nurse leaves her shoes on and explains standard precautions to the patient C. The nurse teaches the patient about peripheral neuropathy and the importance of wearing shoes D. The nurse places shoe covers on her shoes and proceeds with the visit
A. The nurse removes her shoes, places them on the mat, and completes the home health visit
What action by a nurse best indicates the nurse's workplace values a culture of safety? A. The nurse reports he/she made a medication error B. The nurse notifies the physician of an increased BP C. The nurse documents a patient allergy in the chart D. The nurse follows up on a delegated task
A. The nurse reports he/she made a medication error
Which statement by the nurse reflects the appropriate care of a victim who has inhaled anthrax? A. The victim should receive antibiotics as soon as possible after exposure B. When caring for the victim, we must wear a n-95 respiratory mask C. Diagnosis is done by pulmonary function testing and a chest x-ray D. While anthrax is easy to disseminate, it has a moderate morbidity and low mortality rate.
A. The victim should receive antibiotics as soon as possible after exposure
Several of you colleagues are going to join the ANA. You know the annual dues are a little more than you can afford right now but you want to learn more. Your friends think that joining the ANA will help empower them. How do professional organizations empower nurses? A. They represent nurses in the political arena B. They equalize power between employees and staff C. They provide opportunities for promotion D. They provide health insurance
A. They represent nurses in the political arena
What action by the nurse best exemplifies a characteristic of effective quality improvement in health care? A. Using current evidence to improve practice B. Frequent assessments of patients with soft wrist restraints C. Including the patient in planning care D. Responding to call lights quickly
A. Using current evidence to improve practice Utilizing evidence-based practice fits with the characteristic of effectiveness in providing quality health care. Frequent assessments of patients with soft wrist restraints best describes safety as a characteristic of quality in health care. Including the patient in care planning best describes patient-focused as a characteristic of quality in health care. Timely response to patient needs describes the characteristic of timeliness in quality health care.
What action(s) should the nurse take to promote personal safety while making home care visits? Select all that apply A. Park near the patient's home and lock car doors B. Keep car in good working order with a full tank of gas C. Make sure the agency knows visit schedule D. When visit is in high crime area, do not go alone E. Schedule visits during the daylight hours F. Preprogram cell phones with emergency numbers
All the above
A nurse tells a colleague that he gets most of his information on the informal processes of the hospital by watching others. What is this nurse's best response when the colleague asked what he means by informal processes? A. "They are included in the organization's written policies and procedures." B. "They are ways to get things done faster and easier than the formal processes." C. "They are included in memorandums from administrators and staff members." D. "They are reading units linked together available on the educational website."
B. "They are ways to get things done faster and easier than the formal processes."
Which patient is most likely to seek health care late in the course of his/her disease and deteriorate more quickly than other patients? A. An older individual who lives alone B. An individual who is homeless C. A teenager who lives in poverty D. A new immigrant from Mexico
B. An individual who is homeless
Shift work disorder results in a greater risk for accidents, ulcers, heart disease, and chronic fatigue. What action by the night shift worker can prevent or lessen the risk of shift work disorders? A. Do both day and night shifts to allow for more nighttime sleep periods B. If driving home during the morning sunlight, wear sunglasses C. Change scheduled days off to allow for more days off at one time D. Take naps whenever possible during time off
B. If driving home during the morning sunlight, wear sunglasses
In which of the following siutations would a personal change probably be the hardest to make? A. When the need is immediate B. If the benefits will be realized years from now C. When the reward is immediate D. If it is change that keeps you in your comfort zone
B. If the benefits will be realized years from now
When is it most appropriate to dictate (order) change? A. When the change is very complicated B. In an emergency C. When resistance is very high D. If the change is unimportant
B. In an emergency
A RN receives a patient with the diagnosis thrombotic stroke from the emergency department (ED). The pharmacy alerts the RN that a dose of tPA must be administered within the next 15 minutes and sends the medication to the RN. Because tPA is usually administered in the ED before transfer, the RN calls the ED nurse and learns that the ED nurse forgot to document administering the tPA. The RN does not give the tPA from the pharmacy. What does this situation best describe? A. Medication error B. Near miss C. Adverse event D. Risk management
B. Near miss
A nurse manager requires staff members to complete a new form recording individual patient care activities performed during their shift. Although staff members agree to complete the form, the nurse manager finds many of the forms blank or incomplete. The staff members are demonstrating what type of resistance to change? A. Negative resistance B. Passive resistance C. Active resistance D. Change resistance
B. Passive resistance
What is the OSHA requirement for handling of hazardous chemicals? A. Avoid the use of mercury-containing products B. Provide Material Data Safety Sheets C. Minimize the use of toxic disinfectants D. Use air filtration systems to keep the air cleaner
B. Provide Material Data Safety Sheets
A nurse manager is developing a safety program for the unit. Place the steps of safety plan development in the correct order. A. Calculate the costs of the plan B. Recognize potential safety hazards C. Provide the necessary safety supplies and equipment. D. Assess the amount of risk involved
B. Recognize potential safety hazards D. Assess the amount of risk involved A. Calculate the costs of the plan C. Provide the necessary safety supplies and equipment
A new nurse manager plans to implement a new scheduling process. This was met with resistance from the staff who were very happy with their current scheduling process. How can the nurse manager lower their resistance to this change? A. Tell the staff that their concerns about the new schedule are unfounded and plan to post the new schedule B. Share information about the new schedule and discuss its impact on the unit C. Post the schedule and deal with staff on an individual basis D. Ask the staff to come up with an alternative for the nurse manager's consideration
B. Share information about the new schedule and discuss its impact on the unit
Which of the following best describes what is most likely to be within a nurse's comfort zone? A. A new assignment B. Tasks she's done many times C. Change to a different shift D. Addition of several new tasks
B. Tasks she's done many times
What situation best describes a culture of safety in health care? A. An organization focuses on efficiency on the nursing units B. Safety indicators are reported regularly C. After a medication error, a team works to prevent similar errors in the future D. A registered nurse (RN) who made a major medication error was terminated
C. After a medication error, a team works to prevent similar errors in the future
In which practice setting would the nurse be most susceptible to hazardous chemical exposure? A. A medical surgical unit B. An outpatient wound care clinic C. An oncology outpatient facility D. A minor emergency clinic
C. An oncology outpatient facility
What measures are required of healthcare employers to protect staff from workplace injury? Select all that apply. A. At least six weeks orientation with an experienced preceptor B. A permanent primary physician after a qualified exposure C. Immediate treatment if exposed to blood borne pathogens D. Protective equipment including gowns, gloves, and goggles E. Safety and efficacy evaluation of all sharps
C. Immediate treatment if exposed to blood borne pathogens D. Protective equipment including gowns, gloves, and goggles E. Safety and efficacy evaluation of all sharps
A RN has joined the practice council at the hospital network. The RN is able to have some say regarding nursing practice in the network and feels as if administration is listening to the RN's recommendations. Which components of empowerment does this scenario best describe? A. Impact and autonomy B. Meaning and decision making C. Impact and decision making D. Self-determination and autonomy
C. Impact and decision making
The risk manager is investigating a recent med error involving morphine and meperidine. Which statement best describes the primary purpose of the investigation? A. Verify the narcotic count B. Prevent a potential lawsuit C. Improve patient safety D. Identify the person responsible
C. Improve patient safety
A new RN asked an experienced RN how he/she always gets a timely response from the laboratory department. What process is the experienced RN most likely to describe to the new RN? A. Authority B. Formal process C. Informal process D. Reward
C. Informal process
A home care nurse enters the home of a patient and finds that the patient's son is noticeably intoxicated. The son, who is slurring his words, is becoming increasingly agitated. What action by the home care nurse would be most appropriate? A. Tell the son that the police will be notified if there is any trouble B. Ask the son to leave the home until the visit is completed C. Leave the home and reschedule the visit D. Ignore the son's behavior, focusing attention on the patient
C. Leave the home and reschedule the visit
What is this organizational statement an example of? "The purpose of Memorial Hospital is to provide high quality, cost effective patient care." A. Philosophy B. Objective C. Mission D. Policy
C. Mission
What organization should a nurse leader monitor to best learn of new and emerging health hazards? A. Institutes of Medicine (IOM) B. American Nurses Association (ANA) C. National Institute of Occupational Safety and Health (NIOSH) D. Occupational Safety and Health Administration (OSHA)
C. National Institute of Occupational Safety and Health (NIOSH)
A patient suffered a hemolytic transfusion reaction after being given packed red blood cells with an incompatible blood type. The patient recovered. Which type of safety event does this scenario best describe? A. Malpractice B. Accidental incident C. Never event D. Minor injury
C. Never event
A charge nurse who is removing hydroxyzine from the computerized medication dispenser notices hydroxyzine and hydralazine are located in bins next to each other. What is the nurse's best response to this situation? A. Move the hydralazine to a different medication bin B. Put a note on the medication dispenser warning the nurses C. Notify the pharmacist of the location of the two medications D. Lock that particular drawer on the medication dispenser
C. Notify the pharmacist of the location of the two medications
You have been asked to serve on your unit practice council. This is an important role and one that you are excited to perform. What should you know about professional governance so that you are prepared for this work? Professional governance in nursing involves: A. Working longer hours B. Attending a lot of meetings C. Nurses setting nursing standards for daily practice D. Changing the organization's culture
C. Nurses setting nursing standards for daily practice
The community health nurse is preparing to conduct a home visit. When performing the home visit, how should the nurse best implement the principles of infection control? A. Use transmission-based precautions with each patient B. Establish a sterile field in the patient's home before providing care C. Perform hand hygiene before and after giving direct patient care D. Remove the patient's soiled wound dressings from the home promptly
C. Perform hand hygiene before and after giving direct patient care
The triage nurse on scene after a pipe bomb explodes finds a victim with severe dyspnea in close proximity to the initial blast. The nurse suspects the patient has a pulmonary embolism. What is the nurse's best response? A. Tag the victim black and offer comfort B. Position the victim upright, with an open airway C. Place the victim in a prone left lateral position D. Move the victim away from the initial blast area
C. Place the victim in a prone left lateral position Blast lung, caused by the blast wave passing through air-filled lungs, results in hemorrhage and tearing of the lung, hemothorax, pneumothorax, ventilation-perfusion mismatch, and possible air emboli (PE). Symptoms include dyspnea, hypoxia, tachypnea, and apnea. Treatment is based on respiratory support: non-rebreathing mask or endotracheal intubation and mechanical ventilation; chest tube; and placing the patient in a prone left lateral position for a suspected PE.
A surgical unit is being moved to a new area in the hospital that has been remodeled and upgraded with all new equipment. Which actions by management will help facilitate change when the new unit opens? Select all that apply. A. Post job openings with position descriptions when the unit opens B. Ensure the involvement of only a few people to reduce confusion C. Provide in-services on the new equipment before the unit opens D. Hold a staff meeting to explain how and when the move will be made E. Involve staff members in the selection of work station chairs on the unit
C. Provide in-services on the new equipment before the unit opens D. Hold a staff meeting to explain how and when the move will be made E. Involve staff members in the selection of work station chairs on the unit
What is the nurse manager's first action when developing a safety program for the nursing unit? A. Provide the necessary safety supplies and equipment B. Assess the amount of risk involved C. Recognize potential safety hazards D. Calculate the costs of the plan
C. Recognize potential safety hazards
A new graduate is not sure what his job responsibilities are at the organization where he was hired as a staff nurse. This new graduate should take which first action? A. Read the employee handbook B. Ask an experienced RN on the unit C. Review his position description D. Refer to the nursing policy manual
C. Review his position description
Which of the following is a characteristic of a bureaucratic organization? A. Organic structure B. Flexible teams C. Rigid unit structures D. Self-correction and self-control
C. Rigid unit structures
A new nurse asked the charge why upper management has all of the power. What statements by the charge nurse best describe power in a bureaucratic healthcare organization? A. Those at the bottom of the hierarchy have no sources of power B. Power increases with each step up in hierarchy C. Sources of power exist at all levels of the hierarchy D. Power is directly related to the amount of authority one has in an organization
C. Sources of power exist at all levels of the hierarchy
Nurses face threats to safety in their daily work experiences. According to an American Nurses Association (ANA) study in 2011, which of the following is currently the greatest threat to safety of nurses in the workplace? A. Lifting injuries B. Sharps injuries C. Stress D. Patient assaults
C. Stress
There has been a sudden increase in CAUTIs that must be addressed on Jane's unit. What is the best way for Jane to persaude the staff to implement a new foley catheter care protocol? A. Tell them the change has been ordered by the administration B. Present stats proving the need to change C. Tell a compelling story anout why change is needed D. Explain the importance of the change in simple terms
C. Tell a compelling story anout why change is needed
What statement is true regarding an incident report? A. The incident report is completed in the affected patient's chart B. The incident report may not be available during litigation C. The incident report is kept with internal hospital correspondence D. The incident report should contain the nurse's impressions of the event
C. The incident report is kept with internal hospital correspondence
An acute care hospital loses its Joint Commission (JC) accreditation. What consequence will pose the greatest threat to the organization's survival? A. There will be an increased costs in providing healthcare to patients B. The hospital will lose its legislative licensure and funding status C. The organization may not receive Medicare reimbursement money D. The negative public image associated with losing JC accreditation
C. The organization may not receive Medicare reimbursement money
Which statement by the nurse best reflects an understanding of the most current nursing concern for workplace safety identified by the American Nurses Association? A. "Sharps injuries continue to increase despite the use of protective devices." B. "Current attitudes have resulted in more patient assaults on the nursing units." C. "More obese patients in the critical care units resulted in more lifting injuries." D. "Stress from overwork and longer shifts is a major safety concern."
D. "Stress from overwork and longer shifts is a major safety concern."
When designing a technical change, which of the following should be considered? A. Will it work better than the old way? B. Is this change needed? C. Is there a simple way to do this? D. ALl of the above
D. ALl of the above Will it work better than the old way? Is this change needed? Is there a simple way to do this?
Which organization website would be most appropriate for a nurse using the Internet to access research results concerning evidence based practice for nursing care of elderly patients? A. Senior Citizen Groups of America B. Texas Health and Human Services Commission C. American Association for Geriatric People D. Agency for Healthcare Research and Quality
D. Agency for Healthcare Research and Quality
A RN on orientation is learning the layout of emergency department patient rooms. What organizational culture level does this best describe? A. Espoused beliefs B. Organizational culture C. Underlying assumptions D. Artifact level
D. Artifact level
Which of the following organizations partners with other agencies in an effort to conduct research and implement prevention strategies to promote safe and healthy work environments? A. Institute for Medical Response B. The Joint Commission C. National Council of Nursing D. Centers for Disease Control and Prevention
D. Centers for Disease Control and Prevention
A new nurse is unsure about how to irrigate a triple-lumen central line. What action should the nurse take first? A. Refer to the organizational policy manual B. Ask a nurse on the unit for assistance C. Call the unit's assigned nurse educator D. Consult the nursing procedure manual
D. Consult the nursing procedure manual
What action by the nursing director can best improve patient care outcomes on the nursing unit? A. Evaluating only incidents when patient teaching fails B. Increasing focus on improved patient teaching C. Assuring nurse leaders control all decision making D. Encouraging nurses to further their education
D. Encouraging nurses to further their education
A new graduate has a minor hearing impediment. When applying for a job, this new graduate should be aware that which area of employment legislation may help protect from discrimination during the interview process? A. Civil statutory laws B. Judicial rights laws C. Labor standards laws D. Equal opportunity laws
D. Equal opportunity laws
How can you increase your staff's receptivity to an important change in procedures? A. Assign the new procedure to the newest staff member B. Apologize for making their work more complicated C. Provide them with a booklet on preparing for discharge D. Give them time to learn the new procedure
D. Give them time to learn the new procedure
Which of the following organizations is primarily responsible for developing and enforcing workplace safety policies? A. National Safety Council (NSC) B. National Institute of Occupational Safety and Health (NIOSH) C. U.S. Department of Health and Human Services (US HHS) D. Occupational Safety and Health Administration (OSHA)
D. Occupational Safety and Health Administration (OSHA)
What action by the nurse best exemplifies a characteristic of efficient quality in health care? A. Using an interpreter for patients who do not speak the health-care provider's language B. Utilizing the CAUTI bundle to prevent urinary tract infections when placing indwelling urinary catheters C. Working to reduce wait times in the emergency department D. Opening only the supplies that are necessary
D. Opening only the supplies that are necessary Efficiency in health care includes avoiding waste Avoiding injury to patients because of the care provided to them is the characteristic of safety in quality health care. Equitable care is provided by ensuring all patients receive the same care, regardless of patient characteristics. Reduction of wait times is addressing the characteristic of timeliness in quality health care.
What type of reistsance to change is the hardest to overcome? A. The resistance that comes from inertia: "We always do it this way" B. Actice resistance to changing a preferred procedure C. Passive resistance to an unpopular change D. Resistance based upon fear of losing one's job
D. Resistance based upon fear of losing one's job
Your role as a member of a continuous quality improvement (CQI) interdisciplinary team is collecting data on the availability of supplies on the nursing unit. Your team is evaluating which of the three aspects of care? A. Outcomes B. Procedure C. Process D. Structure
D. Structure
What statement is true regarding ergonomic injuries? A. Health-care facilities are required to attempt to keep workplaces free from ergonomic hazards. B. Ergonomic injuries do not occur when safe patient handling technology is used. C. Nurses are not at risk for repetitive stress injuries. D. Unexpected patient movements during transfers can cause back injuries to nurses.
D. Unexpected patient movements during transfers can cause back injuries to nurses.
The nurse is teaching a group of volunteers about the mode of transmission for different bioterrorism agents. Which statement by a volunteer indicates a need for additional teaching? A. Victims who may have smallpox require standard, contact, and airborne precautions B. It is important to use the correct PPE when decontaminating a victim who was exposed to anthrax C. Standard precautions are okay for anthrax victims, as long as they don't have draining wounds D. We need to place patients who have botulism in standard and contact precautions
D. We need to place patients who have botulism in standard and contact precautions Smallpox - standard, contact, and airborne precautions Anthrax - standard precautions (if no draining wounds) Botulism - only standard precautions Individuals who are decontaminating individuals with anthrax powder on them include should wear a respirator (N95 mask or Powered Air Purifying Respirators), and protectaive clothing.
The pneumonia rates for patients receiving ventilator therapy at Hospital X are above the usual thresholds during the most recent month. Which question would be most important for the CQI team investigating the increase in pneumonia rates to ask first to gain a better understanding of the problem? A. Did any patients receive oral care per unit protocol? B. Were the patients with pneumonia surgical patients? C. How long were the patients on ventilator therapy? D. Were any of these patients admitted with pneumonia?
D. Were any of these patients admitted with pneumonia?
