Leadership NCLEX practice questions

What is a common metabolic cause of hypothermia? 1 Seizure 2 Dehydration 3 Hypoglycemia 4 Hyperthyroidism

2 Hypoglycemia is a common metabolic cause of hypothermia. Seizure does not cause hypothermia. Dehydration can cause hyperthermia. Hypothyroidism, not hyperthyroidism, can lead to hypothermia.

Which healthcare team member would the nurse expect can be delegated with the task of administering oral medication to a client per the functional model? 1 Registered nurse 2 Patient care associate 3 Licensed practical nurse 4 Unlicensed assistive personne

3 The licensed practical nurse can give oral medication to a client. The registered nurse gives IV medication to a client. Patient care associates assist and monitor vital signs. Unlicensed assistive personnel perform all hygienic tasks.

Which is excluded from the competencies of nurse leader? 1 Work individually 2 Utilize informatics 3 Provide client centered care 4Employ evidence-based practice

1 The core competency of a nurse leader is to work in interdisciplinary teams, but not individually. Utilizing informatics, providing client centered care, and employing evidence-based practice are the core competencies of a nurse leader.

Which strategy of the nurse leader regarding the quality improvement (QI) process requires revising? Focus is on correcting errors. The task includes staff development. The leader involves the interprofessional team. Outcomes are set with input from clients and staff.

1. The quality improvement process mainly focuses on preventing errors rather than correcting them. The task of the QI process includes staff development. The team of the QI process involves the interprofessional team and the outcomes are set with the input of clients and the staff.

Which characteristic should the nurse use during the nursing process as a guide for delegation? 1 Leadership 2 Critical analysis 3 Psychomotor task 4 Time management

2 Critical analysis by the registered nurse serves as a guide for delegation in the nursing process. It is applied in assessment, planning, implementation, and evaluation for safe and effective client care. Leadership is a role in which a nurse has charge of the personnel as they perform their tasks. Psychomotor tasks are the common characteristics and essential components that a nurse should possess to provide client care. Time management is essential in performing tasks within specified deadlines during delegacy.

Which theory related to leadership is a nontraditional theory that has emerged from the physical and social sciences? 1 Expectancy theory 2 Complexity theory 3 Motivational theory 4 Management theory

2 Complexity theory is a nontraditional theory emerging from the work of the physical sciences and, more recently, social sciences. Expectancy theory posits that motivational behavior is increased by rewarding good and innovative performance; it is not rooted in the physical sciences. Motivational and management theories are traditional theories of leadership.

What is one strategy that will improve client outcomes, communication, and collaboration between all health care providers? 1 Primary nursing 2 Client-focused care 3 Interprofessional education 4 Community-based transitional program

3 nterprofessional education and collaboration is important and has a positive impact on the outcomes of client care, communication, and collaboration, which is increasingly important as the complexity of health care increases. The care models of primary nursing, client-focused care, and community-based transitional programs do not have the same impact as interprofessional education and collaboration on outcomes, communication, and collaboration.

A client who was in a motor bike accident has a severe neck injury. Which priority nursing care is most needed? 1 Assessing for crepitus 2 Assessing for bleeding 3 Maintaining a patent airway 4 Performing neurologic assessment

3 The nurse should assess, ensure, and maintain a patent airway first in a client with neck trauma. The nurse then may palpate the skin near the esophagus to assess crepitus, which indicates an injury to the esophagus. After ensuring airway patency, the nurse should assess for bleeding or impending shock. The nurse should also perform a neurologic assessment for mental status, sensory level, and motor function, which holds a medium priority.

Which of these clients can be provided care safely by unlicensed nursing personnel? Select all that apply. 1 A client with pain 2 A client who is upset 3 A client who is stable 4 A client who is recovering 5 A client with suicidal intention

3,4 The greater the stability of a client, the more likely it is that unlicensed nursing personnel (UNP) can provide safe client care. It is also easy for a UNP to care for a client who is recovering. A client with pain is anxious and agitated, and it will take the UNP time to calm the client. Client care may be affected when the client is psychologically upset and has suicidal intentions.

Several emergency preparedness agencies are developing emergency response plans in case of an earthquake alert. In which phase of the disaster management continuum would the nurse state this activity is included? 1 Response 2 Recovery 3 Mitigation 4 Preparedness

4 The first phase of the disaster management continuum is preparedness. This is a protective plan designed before the event to structure the response, assess the risk, and evaluate the response. The response phase of the disaster continuum includes the actual implementation of the disaster plan. The recovery phase is related to actions focusing on stabilization of the community and returning it to the previous state. The mitigation phase includes attempts to limit a disaster's impact on human health and community function.Test-Taking Tip: Identify option components as correct or incorrect. This may help you identify a wrong answer.

Which agent of terrorism can cause death within a few minutes? A Sarin gas B Uranium C Iodine-131 D Mustard gas

A Sarin gas is an agent for bioterrorism that can cause death within minutes of exposure by paralyzing respiratory muscles. Uranium and Iodine-131 can be dangerous in close proximities but are not as harmful as sarin gas. Mustard gas causes blisters on the skin but does not cause death within a few minutes.

A client with severe burns and injuries from a bomb blast is admitted in the emergency unit. Which triaging priority is preferable for the client? 1 Class I 2 Class II 3 Class III 4 Class IV

1 A client with severe burns and injuries due to a bomb blast requires emergent treatment to prevent life-threatening complications. Therefore the client should be considered for class I triage. Clients belonging to class II have major injuries that require normal treatment. Clients belonging to class III have minor injuries that do not require immediate treatment. Clients belonging to class IV are not allotted treatment because they are expected to die.

What is the ultimate goal of delegation? 1 To deliver client care as a team 2 To maximize client care outcomes 3 To improve the working ability of the nurse 4 To maintain open lines of communication between delegator and the delegatee

2 The ultimate goal of the delegation is to maximize client care outcomes. Delegation helps to deliver client care as a team and improves the working ability of the nurse but these are not the ultimate goals of delegation. Maintaining open lines of communication between delegator and the delegatee creates a productive work environment in delivering client care.

What entity outlined the principles of delegation for registered nurses? 1. Nurse Practice Act 2 Multilevel nursing model 3 American Nurses Association (ANA) 4 National Council of State Boards of Nursing (NCSBN)

3 The ANA outlined the principles of delegation for registered nurses. The Nurse Practice Act of each state examines the value of unlicensed personnel in client care delivery and declares that the importance of delegation decisions is the safety and welfare of the public. The multilevel nursing model consists of registered nurses, licensed practical nurses, and unlicensed nursing professionals. The National Council of State Boards of Nursing (NCSBN) stated that the state boards of nursing should regulate nursing assistive personnel across multiple settings.

Which healthcare professional would the nurse know is held accountable for the tasks performed by the patient care associate (PCA)? 1 Registered nurse (RN) 2 Licensed vocational nurse (LVN) 3 Unlicensed assistive personnel (UAP) 4 Unlicensed nursing practitioner (UNP)

1 The delegator is held accountable for tasks performed by the delegatee. In this situation, the delegator is the RN; therefore, the RN is held accountable for the tasks performed by the PCAs. The RN is also accountable for delegation to LVNs, UAPs, and UNPs as delegatees.

Which personnel can determine priorities for treatment in an emergency response plan? 1 Triage officer 2 Public information officer 3 Medical command physician 4 Hospital incident commander

1 The triage officer determines the priorities for treatment in an emergency preparedness and emergency response plan. The public information officer serves as a liaison between the healthcare facility and the media. The medical command physician decides the number, acuity, and resource needs of clients. The hospital incident commander assumes overall leadership for implementing the emergency plan.

According to Gardner's Tasks of Leading and Managing, within the managing task, which position assists the patient and family with priority setting? 1 Clinical 2 Executive 3 Following 4 Management

1 According to Gardner, within the task of managing, it is the clinical position that assists the patient and family with priority setting. The clinical position also assists the patient and family with decision-making with respect to the individual health condition of the client. The executive position consists of registered nurses who delegate tasks for different assistants. The following position assists the organizational heads to achieve effective outcomes in prioritizing care. Nursing assistants, licensed practical nurses, and unlicensed nursing personnel are under the following position. The management position consists of the nursing manager and charge nurses who manage the condition for delegating proper tasks according to the priorities given by the health care provider.

Which disasters would the nurse categorize as natural events? Select all that apply. 1 Blizzard 2 Droughts 3 Wildfires 4 Nuclear explosion 5 Industrial accidents

1, 2, 3 Natural disasters include weather-related events that inflict significant damage to life and property, exceeding the resource capabilities of local communities. Blizzards, droughts, and wildfires are a few examples of natural disasters. Man-made occurrences are related to identifiable human actions and also include technological events such as nuclear explosions and major industrial accidents.

The nurse leader noticed that the staff nurse recently promoted to the surgical unit is lacking confidence at work and is worried about a pending review by the nursing director. Which source of power is applicable in this situation? 1 Reward power 2 Coercive power 3 Referent power 4 Connection power

2 Coercive power stems from a real or perceived fear of another person. Reward power is perceived as being able to provide rewards or favors. Association with a powerful person grants referent power. Association with people who are powerful or who have links to powerful people gains connection power.

what are the qualities of an effective leader? Select all that apply. 1 Born with the right stuff 2 Elicit a vision from people 3 Bring out the best in people 4 Engender discipline and obedience 5 Inspire people to bring the vision into reality

2,3,5 Leadership is the ability to elicit a vision from people and to inspire and empower those people to do what it takes to bring the vision into reality. A leadership quality is to bring out the best in people. Leaders are not born with the right stuff; rather they develop these qualities gradually over time when they perform with the right kind of attitude and determination. Leaders must possess the ability to inspire the commitment of followers and allow them to achieve goals autonomously rather than simply engendering discipline and obedience.

The nurse is triaging clients arriving at the hospital after a large-scale disaster. Which condition is most likely to be categorized with a black tag? 1 Contusions 2 Air-way obstruction 3 Massive head trauma 4 Open fracture with distal pulse

3 Black-tagged clients are those who are expected to die. Conditions such as massive head trauma, extensive full-thickness body burns, or high cervical spinal cord injuries requiring mechanical ventilation are categorized with a black tag. Contusions are categorized with a green-tag. Airway obstruction is categorized with a red-tag. An open fracture with a distal pulse is categorized with a yellow tag.

The victims of a large scale near-drowning incident are brought to the emergency department. What is the minimum length of time all such victims should be kept under observation in the hospital? 1 12 hours 2 18 hours 3 23 hours 4 48 hours

3 Complications can develop in victims who are essentially free of symptoms immediately after a near-drowning episode. This secondary drowning refers to delayed death from drowning due to pulmonary complications. Consequently, all victims of near-drowning should be observed in a hospital for a minimum of 23 hours, and longer if they have co-morbidities. Twelve hours and 18 hours are too soon to rule out secondary drowning. The clients need not be kept under observation for 48 hours if they do not have co-morbidities.

which color tagged clients usually make up the greatest number in most large-scale multi-casualty situations, based on the disaster triage tag system? 1 Red 2 Black 3 Green 4 Yellow

3 Green-tags clients usually make up the greatest number in most large-scale multi-casualty situations. These clients have minor injuries and they may actually evacuate themselves from the mass casualty scene and go to the hospital in a private vehicle. Red-tagged clients have major injuries, black-tagged clients are expected and allowed to die, and yellow-tagged clients have major injuries. Clients belonging to these three categories usually do not make up the greatest number in most large-scale multi-casualty situations.

The nurse leader notices that a staff nurse does not participate in bringing forth new ideas, but enthusiastically accepts innovation when brought forth by other staff members. Which type of innovation adopters display these characteristics? 1 Laggards 2 Innovators 3 Early majority 4 Early adopters

3 The characteristic of early majority is observed in people who will not bring forth an innovation but will readily adopt it when it is brought forth by others. A laggard is secure in holding to the past and comfortable only when an idea cannot fail. Innovators actively seek information and have vision for the organization. Early adopters are opinion leaders who learn about an innovation and apply it to their practice and they are effective in communicating the value of innovation.Test-Taking Tip: Once you have decided on an answer, look at the stem again. Does your choice answer the question that was asked? If the question stem asks "why," be sure the response you have chosen is a reason. If the question stem is singular, then be sure the option is singular, and the same for plural stems and plural responses. Many times, checking to make sure that the choice makes sense in relation to the stem will reveal the correct answer.

The nurse leader teaches about attributes that all change agents possess. Which attribute of a change agent is the key to self-support through challenges? 1 Caring 2 Humility 3 Persona 4Sense of humor

4 A sense of humor is the key to self-support through challenges. The caring aspect of the nurse leader is associated with commitment to the clients and their welfare. Humility focuses on the change, not on oneself. Persona is associated with self-motivation.Test-Taking Tip: Identify option components as correct or incorrect. This may help you identify a wrong answer.

The registered nurse is organizing a community health care program for administering tetanus vaccinations. Which member of the health care team is most suitable for being delegated the task of administering vaccinations? 1 Nursing aide 2 Certified technician 3 Patient care associate 4 Licensed practical nurse

4 Tetanus vaccination is administered through the intramuscular route. The licensed practical nurse can administer oral, topical, and intramuscular medications, except for intravenous. The nursing aide, certified technician, and patient care associate are unlicensed assistive personnel whose scope of practice is limited for administering medications.

Which emergency response team helps set up shelters for victims who lost their homes due to a disaster? A American Red Cross B Disaster Medical Assistance Team C International Medical Surgical Response Teams D Disaster Mortuary Operational Response Teams

A The American Red Cross sets up shelters for people who have lost their homes or have been evacuated from their homes after an external disaster. A Disaster Medical Assistance Team (DMAT) provides medical equipment that is sufficient for at least 72 hours. International Medical Surgical Response Teams (IMSuRTs) establish fully functional field surgical facilities wherever they are needed in the world. Disaster Mortuary Operational Response Teams (DMORTs) manage mass fatalities at the disaster site.STUDY TIP: Avoid planning other activities that will add stress to your life between now and the time you take the licensure examination. Enough will happen spontaneously; do not plan to add to it.

Who is mainly responsible for analyzing the knowledge and work of newly hired unlicensed assistive personnel (UAP) before delegating a task? 1 Charge nurse 2 Associate nurse 3Registered nurse 4 Nursing manager

3 The registered nurse must analyze any individual's knowledge before delegating a task. The charge nurse mainly functions as a liaison between team leaders and other healthcare providers. The associate nurse follows the care plan in the absence of a registered nurse. The nursing manager is responsible for more than one unit and has other managerial responsibilities.

Who is the designated delegator? 1 Unit secretary 2 Nurse manager 3 Registered nurse 4 Licensed practical nurse

2 The nurse manager is the designated delegator. The unit secretary has no formal preparation or legal recognition. The registered nurse is answerable to the delegator. The licensed practical nurse has a dependent status, functioning under the direction of a registered nurse.Test-Taking Tip: Sometimes the reading of a question in the middle or toward the end of an exam may trigger your mind with the answer or provide an important clue to an earlier question.

Which component of delegation is retained while the delegator is delegating the client's care task to the nursing aide? 1 Authority 2 Supervision 3 Responsibility 4 Accountability

4 Accountability is retained by the delegator while delegating a client's care task to the nursing aide. Every individual on the healthcare team has authority for the delegated task. The nursing aide is just responsible for the delegated task, so the delegator retains the accountability. Supervision is a right of delegation.

A client with foot ulcers is admitted to the hospital. The nurse manager should delegate the task of maintaining hygiene to which staff members to maximize efficient use of human resources? Select all that apply. 1 Registered nurse (RN) 2 Patient care associate (PCA) 3 Licensed practical nurse (LPN) 4Licensed vocational nurse (LVN) 5 Unlicensed nursing practitioner (UNP)

2,5 Nurses, PCAs, and UNPs can perform the task of maintaining hygiene; however the best use of resources is to delegate to UNPs and PCAs so the nurses can complete medication administration and other skills the UNPs and PCAs are not legally able to perform under their scope of practice.

While organizing a community health care program for polio vaccinations, the registered nurse delegates the task of administering vaccines to the members of the health care team. Who among the health care team is most suitable to carry out the task? 1 Technician 2 Patient care associate 3 Certified nursing aide 4 Licensed practical nurse

4 The licensed practical nurse can be delegated the task of administering oral medications or vaccines. Technicians, patient care associates, and certified nursing aides are unlicensed assistive personnel who are not appropriate for delegation of tasks such as administering medication or vaccines as per the delegation rights. The scope of practice for unlicensed assistive personnel providing client care is limited to providing basic care, comfort, and hygiene.

Which emergency severity index (ESI) level should be considered a high priority for the nurse caring for clients in the emergency department? 1 ESI-1 2 ESI-2 3 ESI-3 4 ESI-4

1 ESI-1 should be considered a high priority for care in the emergency department because the ESI-1 clients are in unstable condition. ESI-2 indicates that clients can wait 10 minutes for care in the emergency department. ESI-3 level clients can wait up to 1 hour as their conditions are stable. ESI-4 clients' treatment can be delayed for longer, depending on the cases in the emergency unit.Test-Taking Tip: You have at least a 25 percent chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.

Who is responsible for establishing systems to monitor and verify the competency requirements related to delegation in an organization? 1 Primary healthcare team 2 Chief nursing officers (CNOs) 3 American Nursing Association 4 National Council of State Boards of Nursing (NCSBN)

2 The chief nursing officers (CNOs) are accountable and responsible for establishing systems to assess, monitor, verify, and communicate competency requirements related to delegation. The primary healthcare team may not establish the principles of delegation. The American Nursing Association and National Council of State Boards of Nursing (NCSBN) mainly helped in outlining the principles of delegation to the registered nurse (RN).

The nurse is an active participant on human resource committees. What does this indicate? 1 The nurse is engaging in malpractice. 2 The nurse is pursuing higher education. 3 The nurse is staying clear on group outcomes. 4 The nurse is thinking only about personal needs.

3 When a nurse participates as a leader in any leadership opportunities such as on human resource committees, it indicates that he or she is staying clear on group outcomes. Participating on human resource committees does not indicate any involvement in malpractice. Active participation on human resource committees does not indicate pursuing a higher degree. Participating on human resource committees indicates that the nurse is thinking beyond his or her personal needs.

When assessing an obese client, a nurse observes dehiscence of the abdominal surgical wound with evisceration. The nurse places the client in the low-Fowler position with the knees slightly bent and encourages the client to lie still. What is the next nursing action? 1 Obtain vital signs. 2 Notify the healthcare provider. 3 Reinsert the protruding organs using aseptic technique. 4 Cover the wound with a sterile towel moistened with normal saline

4 A sterile towel moistened with normal saline will not adhere to the wound, and it will protect the area until the healthcare provider arrives. Obtaining vital signs and notifying the healthcare provider are not the priority; the client has needs that must be met first. Reinserting the protruding organs is contraindicated because it may injure delicate tissues and organs; also it is not within the scope of nursing practice.

A nurse leader is setting priorities for achieving success by using the simplest and fastest method of communication. Which rules and responsibilities does the nurse fulfill by this action? 1 Maintaining balance 2 Building self-confidence 3 Generating self-motivation 4 Maintaining a positive attitude

1 An effective leader maintains work-life balance in his or her own life, as well as facilitating balance for followers. Making communication as efficient as possible is one way of helping to maintain this balance. Self-confidence can be established by performing honest self-appraisal on a regular basis. Spending time on the needs of the followers and offering frequent and lavish praise will help build self-motivation. A positive attitude can be maintained by consistently having answers to the question asked by others, knowing where the organization is going, and taking the initiative to get the group to its goal.Test-Taking Tip: Look for the option based on the responsibilities of a nurse leader when setting the priorities of a team.

Which component is the ability to perform duties in a specific role? 1 Authority 2 Responsibility 3 Accountability 4 Legal authority

1 Authority is the ability to perform duties in a specific role. Responsibility refers to reliability, dependability, and obligation to accomplish work. Accountability determines whether a person's actions were appropriate and provides a detailed explanation of what occurred. Legal authority is the ability to transfer selected nursing activities in a given situation to a competent individual.

Which responsibility of the nurse manager differs from the responsibilities of a nurse leader? 1 Planning the budget 2 Motivating the team 3 Resolving the conflicts 4 Penalizing for poor performance

1 Budgeting is the responsibility of a nurse manager. The role of nurse leader is to motivate the nursing subordinates. Resolving conflicts is the responsibility of both the nurse leader and the nurse manager. Penalizing for poor performance is a behavior of transactional leadership.

In a health care setting, there are a limited number of unlicensed nursing personnel. Who would take up the responsibility of delegation in place of the registered nurse? 1 Charge nurse 2 Chief nursing officer 3 Patient care associate 4 Licensed practical nurse

1 Charge nurses act as delegators as they also have knowledge and expertise in the clinical setting. In cases where there are a limited number of unlicensed nursing personnel, the registered nurse does not delegate tasks. In this instance the charge nurse usually becomes a delegator and delegates the tasks. The chief nursing officer is not the immediate person to delegate the tasks in such instances. Patient care associates and licensed practical nurses act as delegatees.

A client with a severe allergy has been administered a high dose of antihistamine. The nurse finds that the client is drowsy and dizzy. Which type of need would the nurse prioritize in the client according to Maslow's hierarchy of needs? 1 Safety need 2 Belonging need 3 Self-esteem need 4 Self-actualization need

1 Clients suffering from the effects of a high dose of antihistamines have strong safety needs. The belonging need is fulfilled when the client is provided love and compassion. Self-esteem needs are fulfilled by providing recognition. Self-actualization needs may not be the priority of the client in the current situation.

What is the duty of the nurse as delegator if the delegatee has limited knowledge and ability to perform a task? 1 Provide guidance. 2 Observe and motivate. 3 Explain what is to be done. 4 Establish mutual expectations.

1 If the delegatee has limited knowledge and ability to perform a task, the delegator should provide guidance. The delegator is expected to observe and monitor the task performed by the delegatee to ensure he or she has the ability and willingness to establish a relationship and accomplish work. The RN explains the task and how to execute it if the situation involves a new task and the relationship is ongoing. If the delegatee is new to the workplace, but has the ability and willingness to perform a task, the delegator should establish mutual expectations and conditions of performance in order to establish a good relationship.Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.

Which drawback indicates an improper follow-through on the part of a delegatee? 1 Failure to report results and findings 2 Failure to understand the skills and abilities 3 Failure to provide clear and concise directions 4 Failure to cooperate with the other team members

1 Improper follow-through on the part of a delegatee is failure to report results and findings. Improper follow-through occurs when the delegator does not understand the skills and abilities of the delegatee and does not provide clear and concise directions to the delegatee. The lack of cooperation with team members may be improved by educating, guiding, and monitoring the delegatee.

Which task can the registered nurse safely delegate to the unlicensed assistive personnel (UAP) while caring for a client with gastroesophageal reflex disease? 1 Positioning the bed 2 Evaluating the vitals 3 Tube feeding the client 4 Determining calorie needs

1 The UAP should be assigned tasks that are simple and do not involve any complications. Positioning the bed at 30 degrees or more is one of the essential tasks that can be assigned to the UAP under supervision. Evaluating vitals is the duty of the registered nurse. Tube feeding the client is a very sensitive procedure that can be done by a registered nurse or trained licensed practical nurse. Determining the calorie needs of the client is the job of a dietician.

The nursing manager issued orders to take the utmost care of a client with myocardial infarction and expects the staff to obey and follow the rules immediately. Which type of decision making is the manager using? 1 Autocratic 2 Optimizing 3 Laissez-faire 4 Bureaucratic

1 The autocratic method results in rapid decision-making and is more appropriate in a crisis situation. Optimizing decision making is when the nurse considers both pros and cons of each position. Laissez-faire is a "hands-off" approach, which is taken by manager who chooses to do nothing when intervention is indicated. The bureaucratic style is focused on organizational rules and policies

Who functions as a liaison between team leaders and other healthcare providers? 1 Charge nurse 2 Registered nurse 3 Nursing manager 4 Chief nursing officer

1 The charge nurse functions as a liaison between team leaders and other healthcare providers. Registered nurses function as accountable and responsible people for delegated tasks. Nursing managers are responsible for more than one unit and have other managerial responsibilities. Chief nursing officers are accountable for establishing systems to assess, monitor, verify, and communicate competency requirements related to delegation.

Which delivery system was developed to provide care through others as an adaptation to functional nursing? 1 Team 2 Primary 3 Case management 4 Differentiated practice

1 The hallmark of team nursing is "care through others," which was designed as an adaptation to functional nursing. Primary nursing is an adaptation to the case method. Case management is the process of coordinating health care by planning, facilitating, and evaluating interventions across levels of care to achieve measurable cost and quality outcomes. Differentiated practice consists of models of care delivery that are differentiated by level of education, expected clinical skills or competencies, job descriptions, pay scales, and participation in decision making.Test-Taking Tip: Multiple-choice questions can be challenging, because students think that they will recognize the right answer when they see it or that the right answer will somehow stand out from the other choices. This is a dangerous misconception. The more carefully the question is constructed, the more each of the choices will seem like the correct response.

Which nursing intervention should the nurse consider to be a priority for clients with fluid overload? 1 Ensuring client safety 2 Providing drug therapy 3 Providing nutritional therapy 4 Preventing future fluid overload

1 The priority nursing interventions to be followed during care for clients with fluid overload is to ensure client safety and to restore normal fluid balance to prevent complications like pulmonary edema and heart failure. Providing drug therapy and nutritional therapy to the clients are secondary nursing interventions. Prevention of future overload should be done after restoring the fluid levels to normal.Test-Taking Tip: Be alert for details about what you are being asked to do. In this Question Type, you are asked to select all options that apply to a given situation or client. All options likely relate to the situation, but only some of the options may relate directly to the situation.

Which client should be treated first, according to the disaster triage tagging system? 1 Client with red tag 2 Client with black tag 3 Client with green tag 4 Client with yellow tag

1 The red tag is applied to clients who require immediate treatment according to the disaster triage tag system, so client A requires immediate treatment. A black tag is applied to clients who are dead or expected to die and are not prioritized for immediate critical care. The green tags are applied to clients who can ambulate on their own, and there is no need of attending these clients first. The yellow tag is applied to clients who can wait a short duration for treatment and who can be treated after treating clients with red tags.

A registered nurse distributes a task to four healthcare professionals. When are both accountability and responsibility transferred to the healthcare professional? 1 When the task is given to another registered nurse (RN) 2 When the task is given to a licensed practical nurse (LPN) 3 When the task is given to a licensed vocational nurse (LVN) 4 When the task is given to an unlicensed nursing personnel (UNP)

1 When the registered nurse gives a task to another RN, the task can be assigned, but cannot be delegated. When any work is being assigned, the recipient is accountable and responsible for the work. LPNs, LVNs and UNPs can be delegated work for which they can be responsible, but only the delegator is accountable.Test-Taking Tip: Identify option components as correct or incorrect. This may help you identify a wrong answer.

What are the three strategies that the nurse can perform while assisting other nurses in making delegation decisions? Select all that apply. 1 Doing 2 Telling 3 Asking 4 Offering 5 Participating

1, 3, 4 The nurse can assist other registered nurses with delegation decisions by using three strategies: asking, offering, and doing. Telling and participating are the strategies used by the nurse to communicate with the delegatee.

Which questions should the delegator assess to determine the right task? Select all that apply. 1 "Is the task legally appropriate to delegate?" 2 "Is the environment conducive to completing the task safely?" 3 "Does the delegator provide clear and concise directions for the task?" 4 "Is the task appropriate to delegate based on institutional policies and procedures?" 5 "Does the delegatee have the knowledge and experience to perform the specific task safely?"

1, 4 The delegator has to determine right task by assessing whether the task is legally appropriate to delegate. The delegator must also check that the task is appropriate to delegate based on institutional policies and procedures. The right circumstance can be assessed by asking, "Is the environment conducive to completing the task safely?" The right direction and communication is assessed by asking, "Does the delegator provide clear and concise directions for the task?" The right person eligible to accomplish the task is assessed by asking, "Does the delegatee have the knowledge and experience to perform the specific task safely?"

Which skills would be essential for an effective nurse manager to develop and improve collaboration with others? Select all that apply. 1 Flexibility 2 Reacting hastily 3 Showing frustration 4 Ability to listen to others 5 Ability to share information and ideas

1, 4, 5 In order to collaborate effectively, the nurse should be flexible, must be willing to listen to others, and must share information and ideas with others. The nurse manager should plan a thoughtful response, consider others' perspective first, and not react hastily. The nurse manager should not share his or her own anger or frustration with other staff.Test-Taking Tip: Be alert for details about what you are being asked to do. In this Question Type, you are asked to select all options that apply to a given situation. All options likely relate to the situation, but only some of the options may relate directly to the situation.

Which health care providers should be considered when filling a position as case manager for a community health care center? Select all that apply. 1 Social worker 2 Registered nurse 3 Physician assistant 4 Respiratory therapist 5 Certified nursing assistant

1,2 Social workers and nurses may work as case managers, bringing with them their discipline-specific skills and knowledge. A physician assistant is not identified as being appropriate for case management. The respiratory therapist's scope of practice is limited to respiratory function. The certified nursing assistant does not have adequate education to support the total client's needs in the case management model.

Which actions make the nurse a transformational leader? 1 Gaining higher education degrees 2 Introducing a vision for the future nurses 3 Implementing client-centered care effectively 4 Correcting errors of the followers in a reactive manner

2 A transformational leader creates and shares a vision or goal for future nurses. Gaining higher education does not indicate leadership. Effective implementation of client-centered care indicates professionalism but not leadership. A transformational leader corrects the errors of followers by coaching and mentoring, not by using a reactive manner.

which colors are often included in an organizational disaster plan for use during triage? Select all that apply. 1 Red 2 Black 3 Green 4 White 5 Yellow

1,2,3,5 Colors that are often used for triage purposes in an organizational disaster plan include red, black, green, yellow, and blue. White is not a color that is used during the triage process.

Which factor is known to threaten the nurse's ability to triage and prioritize client care accurately? 1 A caring ethic 2 A biased approach to care 3 The shift that is being worked 4 The specific number of years of job experience

2 A biased approach threatens the nurse's ability to triage clients accurately. A caring ethic is known to contribute to effective triage and prioritization of care. The shift that is being worked and the specific number of years of job experience are not directly related to the nurse's ability to prioritize care accurately.

What would the nurse state is a characteristic of an effective leader? 1 Autocratic behavior 2 Problem-solving skills 3 Culture of zero tolerance for violence 4 Emphasis on inconsistent job performance

2 Expertise in problem-solving skills is an effective leadership quality that is increased by risk-taking behaviors by the nurse leader. Adapting autocratic behavior may lead to ineffective leadership. A culture of zero tolerance for violence is an ineffective leadership strategy. Emphasis on consistent job performance is the characteristic of an effective manager.

Which is the essential nursing skill for the triage process in the emergency department? 1 Evaluating care 2 Setting priorities 3 Formulating diagnoses 4 Implementing interventions

2 Setting priorities is an essential nursing skill for the triage, or assessment, process that occurs in the emergency department. Evaluating care, formulating diagnoses, and implementing interventions are all nursing skills used in the emergency department; however, these are not essential during the triage process.

Which color tag is used for a client who is expected to die after a disaster with mass casualties? 1 Red tag 2 Black tag 3 Green tag 4 Yellow tag

2 The disaster triage tag system categorizes triage priority by color. The clients who are expected to die after a disaster are marked with a black tag. The clients who have an immediate threat to life and need emergency treatment are marked with a red tag. The clients who have minor injuries that do not require immediate treatment are marked with a green tag. The clients who have major injuries and require treatment are marked with a yellow tag.Test-Taking Tip: Identify option components as correct or incorrect. This may help you identify a wrong answer.

A Hispanic nurse is celebrating a quinceañera for her 15-year-old daughter. What is the appropriate action of the culturally competent nurse manager? 1 Make a joke about the cultural ritual. 2 Allow the nurse to take time off for this celebration. 3 Ask the nurse not to put so much value in cultural rituals. 4 Suggest that the nurse not invite other staff members to the occasion.

2 The nurse who is celebrating this event for her daughter should have time to make plans and arrangements. The nurse manager should teach staff how cultural differences enrich all of us and make deliberate efforts to include them in their daily lives. The nurse manager should ask staff to value cultural rituals and accept various cultural practices and perspectives. Inviting staff on this occasion of the quinceañera is common, and the nurse manager should not discourage this.Test-Taking Tip: Identify option components as correct or incorrect. This may help you identify a wrong answer.

The nurse is caring for a client with severe menstrual bleeding and abdominal cramps. Which task is appropriate to be delegated to the licensed practical nurse (LPN)? 1 Evaluation of the pain status 2 Administration of oral analgesics 3 Administration of intravenous replacement fluids 4 Assessment of blood reports for hemoglobin levels

2 The scope of practice of the licensed practical nurse is limited to the administration of oral, topical, and parenteral medications with the exception of intravenous. Evaluating the pain status of the client after administration of medication is the role of the registered nurse. Intravenous administration of fluids or medications or blood products should be performed only by the registered nurse. These interventions are outside of the scope of practice of the LPN. Laboratory reports should be assessed by the registered nurse; this task is not within the scope of practice of the LPN.STUDY TIP: A helpful method for decreasing test stress is to practice self-affirmation. After you have adequately studied and really know the material, start looking in the mirror each time you pass one and say to yourself—preferably out loud—"I know this material, and I will do well on the test." After several times of watching and hearing yourself reaffirm your knowledge, you will gain inner confidence and be able to perform much better during the test period. This technique really works for students who are adventurous enough to use it. It may feel silly at first, but if it works, who cares? It will work for performing skills in clinical as well, as long as you have practiced the skill sufficiently.

How should nurses provide effective nursing care to clients from different cultural backgrounds? 1 By advising clients that some cultural practices may be harmful to health 2 By providing care that fits the clients' cultural beliefs 3 By strictly adhering to organization policies regarding nursing care 4 By ignoring the cultural aspect and focusing on the medical aspect of care

2 When providing care to clients from different cultural backgrounds, nurses should be careful to provide care that fits the client's cultural beliefs. It helps provide effective nursing care to the satisfaction of the client. Advising clients against their cultural practices may offend them and should be avoided. Organization policies should be made flexible to incorporate cultural aspects of care. Ignoring the cultural aspect of client care may result in ineffective nursing care.STUDY TIP: Develop a realistic plan of study. Do not set rigid, unrealistic goals.

Which client requires nonurgent treatment after a mass casualty incident? 1 A neonate with body temperature of 103° F 2 An elderly person with a rapidly falling pulse 3 A middle-aged man with skin rash from shaving 4 A pregnant woman with blood pressure of 140/90 mm Hg

3 A middle-aged man with a skin rash requires nonurgent treatment. A neonate with a body temperature of 103° F needs urgent treatment. An elderly person with a rapidly falling pulse requires emergent treatment. High blood pressure in a pregnant woman of 140/90 mm Hg could lead to complications; therefore, the client should be given emergent treatment.

What is the priority nursing intervention for a client with stroke who is transitioned from ED to other settings? 1 Monitoring vital signs 2 Reassuring the client and family 3 Assessing the level of consciousness 4 Monitoring specific client manifestations of stroke

3 Assessing the level of consciousness is the priority nursing action in the client with stroke and who is transitioned from ED to other settings. Monitoring the vital signs, reassuring the client and family, and monitoring specific client manifestations of stroke are ongoing nursing interventions.

Which biologic agent of terrorism is treated with antitoxin? 1 Plague 2 Anthrax 3 Botulism 4 Smallpox

3 Botulism is treated with antitoxin, though several vaccines are being studied. Plague and anthrax can be treated effectively with antibiotics if sufficient supplies are available and the organisms are not resistant. Smallpox can be prevented or the incidence reduced by vaccination, even when first given after exposure.

Which personnel are responsible for identifying the need for and calling in specialty trained providers in emergencies? 1 Triage officer 2 Public information officer 3 Medical command physician 4 Hospital incident commander

3 The medical command physician is responsible for identifying the resource needs of the clients. Therefore the medical command physician identifies the need for and calls in the specialty trained providers in emergencies. Triage officers are responsible for rapidly evaluating each client to determine priorities for treatment. The public information officer serves as a liaison between the healthcare facility and the media. The hospital incident commander is the one who assumes overall leadership for implementing the emergency plan.

Which model of ethics considers broad social issues and involves accountability to the overall institution? 1 Autonomy model 2 Paternalistic model 3 Social justice model 4 Patient-benefit model

3 The social justice model considers broad social issues and is accountable to the whole institution. An ethics committee follows the autonomy model to facilitate decision making for a competent client. The paternalistic model is a type of decision-making style in which the nurse manager decides what to do. The patient-benefit model is accountable in substituted judgment (asking the client caregivers what the client requires in this type of situation).Test-Taking Tip: Recall the different models of ethics and choose the correct option by analyzing the scenario provided.

hich of Gardner's tasks of leadership describes assisting the staff in interpreting organizational principles? 1 Managing 2 Motivating 3 Affirming values 4 Envisioning goals

3 The task of affirming values describes leaders assisting the staff in interpreting organizational values. Managing is assisting the staff with planning, decision making, and priority setting. Motivating is inspiring the staff to achieve the organization's goals. Envisioning goals is visualizing client outcomes and creating a vision to support client care objectives.Test-Taking Tip: Be alert for details. Details provided in the stem of the item, such as behavioral changes or clinical changes (or both) within a certain time period, can provide a clue to the most appropriate response or, in some cases, responses.

Which events can result in adventitious crisis? Select all that apply. 1 Divorce 2 Marriage 3 Terrorism 4 Earthquake 5 Mental illness

3,4 Adventitious crises result from events that are unplanned and that may be accidental, caused by nature, or human-made. Terrorism and earthquakes can result in adventitious crises. Situational crises arise from events that are extraordinary, external rather than internal, and often unanticipated. Divorce can precipitate situational crisis. As the maturation process occurs across the life cycle each developmental stage represents a maturational crisis. Marriage is an example that can precipitate maturational crisis. Mental illness can also precipitate situational crisis.

When does a delegator identify that the delegatee is less able to perform in a given situation? 1 When the delegatee is upset 2 When the delegatee is bored 3 When the delegatee is anxious 4 When the delegatee is knowledge deficient

4 A delegatee is identified as less able to perform a specific work when he or she has a knowledge deficit. When the delegatee is upset, bored, or anxious, the delegator will identify that the delegatee is unwilling to perform a specific task.

A nurse manager works on a unit where the nursing staff members are uncomfortable taking care of clients from cultures that are different from their own. How should the nurse manager address this situation? 1 Assign articles about various cultures so that they can become more knowledgeable. 2 Relocate the nurses to units where they will not have to care for clients from a variety of cultures. 3 Rotate the nurses' assignments so they have an equal opportunity to care for clients from other cultures. 4 Plan a workshop that offers opportunities to learn about the cultures they might encounter while at work.

4 A workshop provides an opportunity to discuss cultural diversity; this should include identification of one's own feelings. Also, it provides an opportunity for participants to ask questions. Although articles provide information, they do not promote a discussion about the topic. Relocation is not feasible or desirable; clients from other cultures are found in all settings. Rotating the nurses' assignments probably will increase tension on the unit.Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.

A nurse manager determines which nurses on the unit will care for particular patients for the upcoming shift. Which element of the health care system is the manager practicing? 1 Delegation 2 Leadership 3 Supervision 4 Assignment

4 Both accountability and responsibility are transferred from one person to the other in assignment. When a nurse manager delegates the task of client care to an RN, responsibility is transferred to the RN. The nurse manager shares accountability with the RN in delegation. The nurse manager, as leader, manages the healthcare team and delegates tasks to members of the healthcare team. In supervision, the nurse manager oversees the RN in completing the task.

The nurse leader mentors the staff on types of conflict. Which statement of the leader describes intrapersonal conflict? 1 It occurs due to difference in opinions with others. 2 It arises when a discord about policies and procedures exists. 3 It is related to hierarchical structure and role differentiation among employees. 4 It arises due to imbalances between the nurse's personal and professional priorities.

4 Intrapersonal conflict arises due to imbalance between the nurse's personal and professional priorities. The conflict due to a difference in opinions with others causes interpersonal conflicts. Organizational conflicts arise from a discord between policies and procedures. Organizational conflict also arises from hierarchical structure and role differen

Which term refers to the nurse's ability to plan, direct, control, and evaluate others in different situations? 1 Delegation 2 Leadership 3 Followership 4 Management

4 Management is defined as the ability to plan, direct, control, and evaluate the nurse staff in various situations. Delegation is the transfer of authority to perform some type of task or work. Leadership can be defined as the use of individual traits and abilities in relationship to others and the ability to interpret the context where a situation is emerging. Followership is that each member of a team contributes optimally, but acquiesces to a leader or manager to ensure the best clinical decision-making.

How soon should a client with multiple traumas receive treatment according to the five-level emergency severity index (ESI)? 1 Within 2 days 2 Within 1 hour 3 Within 5 minutes 4 Within 10 minutes

4 Multiple traumas are considered a level 2 on the emergency severity index (ESI) and require treatment within 10 minutes. Life-threatening and organ-threatening conditions such as cardiac arrest and severe respiratory distress need immediate treatment within 5 minutes. Abdominal pain, gynecologic disorders, and hip fracture in elderly require treatment within 1 hour after the incident. Treatment for minor burns, colds, and other minor conditions may be delayed to within 2 days.

The geographic location of a community makes it vulnerable to storms. The community health nurse teaches the community about safety measures to be taken during a storm. Which phase of disaster management is this action? 1 Recovery 2 Response 3 Mitigation 4 Preparedness

4 Preparedness is the phase in which a plan is designed before the disaster event to best structure the response. Teaching safety measures to the people of a locality is the preparedness phase. The recovery phase involves stabilizing the community after a disaster event. Response is the implementation of the disaster plan. Mitigation is a phase of disaster management in which attempts are made to limit the disaster's impact.

Which action of the registered nurse (RN) represents his or her leadership ability? 1 Pursuing higher professional courses 2 Performing home visits to care for a client 3 Modifying the diet chart as per the client's condition 4 Supervising the tasks assigned to unlicensed nursing personnel

4 The nurse as a leader should supervise the tasks assigned to unlicensed nursing personnel to ensure the client's safety. Pursuing higher professional courses can help in self-growth but does not indicate leadership. Performing home visits and modifying a diet chart indicates the role of the nurse.STUDY TIP: Rest is essential to the body and brain for good performance; think of it as recharging the battery. A run-down battery provides only substandard performance. For most students, it is better to spend 7 hours sleeping and 3 hours studying than to cut sleep to 6 hours and study 4 hours. The improvement in the rested mind's efficiency will balance out the difference in the time spent studying. Knowing your natural body rhythms is necessary when it comes to determining the amount of sleep needed for personal learning efficiency.

What is the priority nursing intervention for a client bitten by a snake? 1 Sucking the bitten area 2 Offering alcohol to the client 3 Applying ice to the affected area 4 Immobilizing the effected extremity using a splint

4 The priority nursing intervention for a client bitten by a snake is to immobilize the affected extremity using a splint because this may limit the spread of venom. The affected area should not be sucked because it will further harm the client. Alcohol should not be offered because it can cause the venom to spread through vasodilation. Applying ice to the affected area is ineffective and may worsen the client's condition.

A registered nurse who has limited clinical experience must delegate in collaboration with a nursing assistant. Which communication method used by the registered nurse while supervising may affect the working performance of the nursing assistant? 1 Asking open-ended questions 2 Providing feedback on behavior 3 Maintaining an open line of communication 4 Occasionally offering derogatory comments

4 This registered nurse who has limited clinical experience should make an attempt to adapt delegation decisions to organization policies. The nurse should not offer derogatory or offensive comments, which can detract from a collaborative and productive work environment. Asking open-ended questions allows the registered nurse to gain pertinent information from the nursing assistant delegated to perform client care. The registered nurse should provide feedback about behavior that will best shape performance. Maintaining an open line of communication with the nursing assistant yields a collaborative and productive work environment.

Which action by the nurse leader is indicative of transactional leadership? 1 Accounting for the needs and abilities of individual employees 2 Encouraging the novel and innovative thinking of the employees 3 Motivating the employees by articulation of an inspirational vision 4 Motivating the self-interest of the employees by offering external rewards

4 Transactional leadership relies on the power of organizational position and formal authority to reward and punish performance. Therefore, offering external rewards to motivate the self-interest of employees is a type of transactional leadership. The transformational leader can motivate employees by accounting for their needs and abilities individually. Encouraging the novel and innovative thinking of employees is a characteristic of transformational leadership. The transformational leader helps motivate employees by articulation of an inspirational vision.

Which task can be delegated to the licensed vocational nurse (LVN)? Select all that apply. 1 Analyzing vital signs 2 Maintaining oral hygiene 3 Administering intravenous drugs 4 Administering oral hypoglycemic agents 5 Administering intramuscular medications

4,5 Licensed vocational nurses and licensed practical nurses are authorized to administer drugs through oral and intramuscular routes. Analyzing vital signs should be performed by the registered nurse. Hygiene maintenance can be delegated to unlicensed nursing practitioners (UNP). Administering intravenous drugs should be done by the registered nurse.

After a mass causality scene, the nurse finds that a group of victims with minor injuries arrived to a hospital in a private vehicle. Which disaster triage tag does the nurse finds on victims? A Red B Black C Green D Yellow

C The green-tagged victims have minor injuries, can move themselves to hospital from a mass causality scene in a private vehicle, and are also called "walking wounded" victims. Red- tagged victims can't ambulate themselves as they are severely injured. The black-tagged victims are dead or expected to die and require ambulances to transfer them. The yellow-tagged victims can have large wounds that require assistance to ambulate.

The nurse leader is teaching the nursing staff about conflicts in an organization. Which statement is inaccurate regarding conflict in an organization? 1 Conflict may result in poor performance. 2 Conflict is detrimental and should be prevented. 3 Conflict can be cdestructive if the conflict is excessive. 4 Conflict can be prevented by having open communication.

If the conflict is too excessive, it may be destructive. Conflicts in an organization may result in poor performance of the employees. Conflict may not be beneficial and should be prevented. The nurse leader should foster open communication and collaboration, which may help in preventing conflicts.Test-Taking Tip: Identify option components as correct or incorrect. This may help you identify a wrong answer.