Professional Practice End of Chapter Questions

14.10 A new graduate plans on moving into nursing administration. What steps should the graduate take to ensure this goal is reached? (Select all that apply) A. Further professional education B. Meet the specific requirements for the entry-level job position C. Seek new experiences D. Volunteer to work on communities E. Find a mentor

A. Further professional education C. Seek new experiences D. Volunteer to work on communities E. Find a mentor

15.1 Which of the following organizations supports nursing education? A. NINR B. NLN C. AMA D. ANA

B. NLN the national league for nursing supports nursing education

14.8 When conducting a SWOT analysis, the "T" represents" A. Time spent in education B. Threats to obtaining a position C. Terminal degree expectations D. Talking points for the interview

B. Threats to obtaining a position S-strengths W-weaknesses O-opportunities T-threats

10.9 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

Ch 1.4 The NCLEX for nurses is exactly the same in every state in the United states. The examination: A. Guarantees safe nursing care for all patients B. Ensures standard nursing care for all patients C. Ensures that honest and ethical care is provided D. Provides a minimal standard of knowledge for a registered nurse in practice

D. Provides a minimal standard of knowledge for a registered nurse in practice The NCLEX exam ensures that the registered nurse has achieved the minimum knowledge and skills necessary to enter practice

8.6 What is brainwriting? 1. A strategy to encourage the free flow of ideas 2. A mutually beneficial negotiation result 3. A winning approach to formal negotiation 4. A devaluation reaction to negotiation

1. A strategy to encourage the free flow of ideas A creative approach to problem-solving. Similar to brainstorming, it offers everyone a chance to share ideas; however, by writing their ideas before the discussion, there is less likelihood of being influenced by early ideas.

7.3 Bedside shift report is one of the things that Jane reviews at the staff meeting. She stresses the way she would prefer the report to start. Which of these would be the LEAST important to share with the oncoming nurse? 1. Telling the oncoming nurse what happened on the unit during the shift 2. Introducing the client and his or her diagnosis to the oncoming nurse 3. Sharing the nurse's personal opinion of the client 4. Reviewing new medication orders and the medication administration record (MAR)

2. Introducing the client and his or her diagnosis to the oncoming nurse Introducing the client and his diagnosis ensures that the sender and receiver of the communication are familiar with the client and share pertinent care needs, nursing interventions, and client progress with goals of care.

9.8 Nurses who feel empowered can make significant contributions to a health-care 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 nurse empowerment? 1. Belonging to a professional organization 2. Participating on a unit practice council 3. Reasonable work assignments 4. A rewards and recognition program - -

2. Participating on a unit practice council Direct control over work and the ability to influence clinical and organizational decisions are essential to feeling empowered.

7.4 TJC attributes 80% of all medical errors to: 1. Poor hygiene and hand washing 2. Poor hand-off communication 3. Poor work environment 4. Lack of care

2. Poor hand-off communication Ineffective hand-off communication or miscommunication between caregivers during the transfer of care is estimated to contribute to 80% of serious medical errors. Poor hand-offs can lead to delays in treatment, inappropriate treatment, and prolonged hospital stays.

8.10 If an informal negotiation session becomes too highly emotional, what should the nurse manager do? 1. Let the feelings flow 2. Cancel the negotiation 3. Deal with the feelings first 4. Tell them to ignore the feelings and deal with the issues

3. Deal with the feelings first The first step in any negotiation is to manage emotions. Emotions should be acknowledged and never responded to with added emotion. Once acknowledged, the team can move forward.

7.1 Jane is a new nurse manager who will be holding her first staff meeting tomorrow. She has learned that the staff members have not been following important patient care policies. What is the most important communication skill that she should use at the meeting? 1. Talking to the staff 2. Laughing with them 3. Listening 4. Crying

3. Listening Listening to staff is the most critical communication skill because it helps the manager understand the situation and the staff's rationale for their actions

11.4 Studying errors and identifying how they occur helps organizations improve patient safety. Which category of errors is the most useful in identifying and remedying vulnerabilities in an organization? 1. Sentinel event 2. Adverse event 3. Near miss event 4. Wrong procedure event

3. Near miss event Near misses are potential errors interrupted before they occur They are useful in identifying and remedying vulnerabilities in the system before harm can occur.

7.2 As Jane speaks with the team, she learns why the staff members have had difficulty following policies. Which of these would be considered barriers to effective communication? 1. The charge nurse is unavailable to help the nurses when they have questions about policies. 2. Some staff are afraid to ask particular charge nurses for help for fear of retribution. 3. The use of acronyms is confusing to staff members who are new to the unit. 4. All of the above

4. All of the above

15.6 Jean Paul has practiced nursing for 5 years and wants to continue his education. He has an associate degree and is trying to decide whether to pursue a nursing degree or a nonnursing degree. Which of the following is an advantage of choosing a nursing degree? 1. Higher time demand of the nonnursing degree 2. Opportunity to learn about other professions outside nursing 3. Broader focus of the nonnursing degree 4. Opportunity to advance knowledge and skills in his profession

4. Opportunity to advance knowledge and skills in his profession advancing one's knowledge and skills in one's own profession is the primary goal of obtaining a higher degree.

Ch 1.9 Which of the following represent the knowledge and skills expected for the professional nurse? (select all that apply) A. Accountability B. Advocacy C. Autonomy D. Social Networking E. Participation in nursing blogs

A. Accountability B. Advocacy C. Autonomy Accountability for one's work and responsibilities. Advocating for patients and families. Autonomy in making decisions within the scope of practice.

12.7 A suburban hospital recently announced that staff nurses could no longer choose their shift. Instead, they would be assigned to either a 12 hour day shift or a 12 hour night shift on an as- needed basis. An informal group of staff nurses met to discuss this new policy. They came up with several arguments against it. Which of the following suggestions would help to alleviate the deleterious effects of this new policy? A. Allow self-scheduling by staff nurses in each unit B. Provide free dinner for nursing staff nurses in each unit C. Allow staff members to request consistent days off D. End listing hours before the day shift ends so that the night shift nurses do not have to deal with visitors.

A. Allow self-scheduling by staff nurses in each unit C. Allow staff members to request consistent days off Self-scheduling allows staff to consider both their personal needs and the unit's needs in assigning work shifts. Consistent days off reduce the circadian rhythm disturbance

4.8 Effective nurse leaders: (Select all that apply) A. Are also good followers B. Effectively work together with shared goals C. Never act on their ideas D. Have master's degrees

A. Are also good followers B. Effectively work together with shared goals Every leader is at times a follower. Effective leaders work with their teams on shared goals.

6.3 A nurse is caring for a patient who has chronic obstructive pulmonary disease (COPD) and is 2 days postoperative after a laparoscopic cholecystectomy. Which intervention for airway management should the nurse delegate to an NAP? A. Assisting the patient to sit up on the side of the bed B. Instructing the patient to cough effectively C. Teaching the patient to use incentive spirometry D. Auscultating breath sounds every 4 hours

A. Assisting the patient to sit up on the side of the bed Assisting patient with positioning and activities of daily living is within the educational preparation and scope of practice of a nursing assistant.

15.5 Who may become a member of the NSNA? (Select all that apply) A. Associate degree program students B. Graduates of associate degree programs C. Diploma school students D. Baccalaureate degree students

A. Associate degree program students C. Diploma school students D. Baccalaureate degree students Assocaites degree students, Diploma school students, and Baccalaureate degree students are eligible for NSNA membership

6.7 An experienced LPN is working under the supervision fo the RN. The LPN is providing nursing care for a patient who has a respiratory problem. Which activities should the RN delegate to the experienced LPN? SATA A. Auscultate breath sounds B. Administer medications via metered-dose inhaler (MDI) C. Complete in depth admission assessment D. Initiate the nursing care plan E. Evaluate the patient's technique for using MDIs

A. Auscultate breath sounds B. Administer medications via metered-dose inhaler (MDI) The LPN is capable of gathering data and making observations, including noting breath sounds and performing pulse oximetry. Administering medications, such as those delivered via metered dose inhaler (MDIs), is within the scope of practice of the LPN.

4.4 The situational leadership model focuses on: A. Both followers and the task B. The Task C. The follower D. The behavior of others

A. Both followers and the task The situational leadership approach considers the complexity of the situation, which would include followers and the task at hand.

4.7 An effective leader will have: (select all that apply) A. Courage and integrity B. A critical mind-set C. The ability to set priorities D. The ability to provide feedback

A. Courage and integrity B. A critical mind-set C. The ability to set priorities D. The ability to provide feedback All of these are qualities of an effective leader

8.2 Differences in status and authority within the health-care team can generate conflict. What is the most common cause of conflict? A. Disrespect and incivility B. inappropriate language and sarcasm C. Blaming and finger pointing D. Physical violence.

A. Disrespect and incivility Disrespect and incivility are the leading cause of conflict within health-care teams.

14.9 Which of the following represents the "S" in the SWOT analysis? A. Flexibility B. Difficulty adapting to change C. Nursing shortage D. Competition among health-care facilities

A. Flexibility

Ch 1.5 APRNs generally: (select all that apply) A. Function independently B. Function as unit directors C. Work in acute care settings D. Work in the university setting E. Hold advanced degrees

A. Function independently E. Hold advanced degrees Function independently as guided by the nurse practice acts of the individual states. Are educated at the master's level or higher.

14.1 A nursing student is graduating in 3 months. The student is looking for a position. Where should the student begin the search? (select all that apply) A. Health-care organizations B. Online job boards C. National Council of State Boards of Nursing D. American Association of Colleges of Nursing E. Recommendations from peers and professionals

A. Health-care organizations B. Online job boards E. Recommendations from peers and professionals Today, job seekers look to online job boards. Contacting specific health-care institutions and organizations and filling out a job application lets employers know that you are interested in working with them.

12.4 Actions to address violence in the health-care workplace include: SATA A. Identifying the factors that contribute to violence and controlling as many as possible. B. Allowing the violence to escalate C Assessing staff attitudes and knowledge regarding response to violence D. Providing weapons training to those identified as having a potential for physical violence.

A. Identifying the factors that contribute to violence and controlling as many as possible. C Assessing staff attitudes and knowledge regarding response to violence One of the first steps in violence prevention is to identify what contributes to violence and devise ways to control these things. Learning how much staff members know about handling episodes of violence is essential to preparing staff education programs.

14.6 What is the purpose of a cover letter when applying for a position? A. Introduces the applicant B. States the employment goal C. Outlines the applicant's position in the community D. Describes the reason for entering nursing

A. Introduces the applicant The cover letter will be your introduction. If it is true that the first impressions are the lasting ones, the cover letter will have a significant impact on your prospective employer.

9.6 What is the best explanation of authority? A. It is position dependent B. It is based upon the ability to lead others C. It is expertise-driven D. It resides primarily in the clients served.

A. It is position dependent Authority is position dependent. It is assigned based on the organizations hierarchy. The higher the position, the more authority.

15.8 As a new graduate, what features should you look for in a TPP program? (Select all that apply) A. Match with an experienced nurse mentor B. Shortest transition time possible C. Rapid movement to full assignment D. Opportunities to network with peers

A. Match with an experienced nurse mentor D. Opportunities to network with peers Being matched with an experienced nurse mentor is very valuable for the new graduate. Opportunities to network with peers provide support and a chance to hear others ideas for making a successful transition

12.8 Which of the following are considered reasonable accommodations for an employee with a disability? SATA A. Modification of the work schedule B. Salary reduction to reflect lower output C. Additional days off and extended vacations D. Adjustment of work procedures

A. Modification of the work schedule D. Adjustment of work procedures Modification of a work schedule is a reasonable accommodation. Adjustment of work procedures to accommodate a person's disability is also a reasonable response.

7.7 Social media is commonly used to update friends and groups on things we have going on in our lives. Health-care organizations routinely use social media to promote medical facts, services, and recognitions. What is important for nurses to remember when deciding to post something work related on a social media site? A. Nurses should never post protected health information on a social media site B. Stories with good outcomes can be posted to your media page. C. Stories and photos can always be shared if the patient's name or face is not visible D. Posting stories on personal time is OK because the nurse is not working.

A. Nurses should never post protected health information on a social media site Protected health information must be protected and never shared without expressed written permission. A patient's privacy and confidentiality are paramount.

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

A. Observe how well the patient performs pursed-lip breathing Experienced licensed practical nurses and licensed vocational nurses can use observation of patients to gather data regarding how well patients perform interventions that have already been taught.

11.10 The HHS is charged with protecting the health of all Americans and providing essential health services. Which of the following HHS quality initiatives is currently under way? A. Post-acute care reform initiative B. National health-care research and quality indicators aimed at helping improve access to care C. NDNQI D. Health IT

A. Post-acute care reform initiative Post-acute care reform is a health and human services initiative aimed at reducing care fragmentation and unsafe transitions of care such as from acute care hospitals to skilled nursing facilities.

11.3 Medical errors account for 250,000 deaths per year. It is estimated that as many as 50% of these errors may be preventable. What steps would you take to avoid a medication error? A. Review the patient's medication administration record during bedside shift report B. Ask your collegues to get your medication so that you can give it on time. C. Call the pharmacist. D. Review the medication administration policy.

A. Review the patient's medication administration record during bedside shift report Review of the MAR with the off-going nurse allows you to review the list of medications and learn of any issues, possible reactions to medication, or missed doses.

15.2 What is an important contribution of the nursing special organizations? A. Setting standards for special practice B. Improving nursings image on television C. Supporting the associates degree in nursing education D. Providing collective bargaining agreements

A. Setting standards for special practice Nursing specialty organizations support the interests of a defined practice area or special interest group

10.1 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 Macro-level changes happen on a large scale. Changes in national medicare payment policies are large and far reaching because medicare encompasses the U.S. health-care system.

Ch 1.8 Nursing practice in the 21st century is an art and science that focuses on: A. The client B. The nursing process C. Cultural Diversity D. The health-care facility

A. The client Health-care reform and nursing practice focus on client- or patient- centered care.

11.1 You are a new nurse. The hospital where you work is committed 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 recognize errors and near misses B. The hospital subscribes to TJC safety publications C. The hospital measures performance every month, monitors quality indicators, and regularly reports on quality. D. All of the above.

A. The hospital has a good catch program for staff who recognize errors and near misses The good catch program is a strategy designed to identify system improvement opportunities aimed at reducing risk or harm to patients by staff reporting errors or near misses without fear of punishment or reprisal.

6.1 A nurse is helping an NAP provide a bed bath to a comatose patient who is incontinent. Which of the following actions requires the nurse to intervene? A. The nursing assistant answers the phone while wearing gloves. B. The nursing assistant log-rolls the client to provide back care C. The nursing assistant please an incontinence diaper under the client. D. The nursing assistant positions the client on the left side, head elevated.

A. The nursing assistant answers the phone while wearing gloves. The gloves are contaminated and should be removed before answering the phone.

9.10 Several of your colleagues are going to join the American Nurses Association (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. The 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 Professional organizations create a collective voice for nurses that can be stronger and more likely to be heart, especially at the national, state, and local levels. Your membership and participation let your voice be heard.

Ch 1.10 Professional accountability serves the following purpose: (Select all that apply) A. To Provide a basis for ethical decision making B. To respect the decision of the client C. To maintain standards of health D. To elevate new professional practices and reassess existing ones E. To belong to a professional organization

A. To Provide a basis for ethical decision making B. To respect the decision of the client C. To maintain standards of health D. To elevate new professional practices and reassess existing ones To provide a basis for ethical decision making is a characteristic of professional accountability. To respect the decision of the client is a characteristic of professional accountability. To maintain standards of health is characteristic of professional accountability. To evaluate new professional practice and reassess existing ones is a characteristic of professional accountability.

11.6 To achieve safe patient care, a culture of safety must exist. What are characteristics of an organization with a culture of safety? A. Transparency, openness, reporting of errors is rewarded, blame-free environment B. Honesty, studying of serious events C. Privacy, reporting of errors appreciated D. Blame-free environment, openness, error reporting is encouraged.

A. Transparency, openness, reporting of errors is rewarded, blame-free environment A culture of safety requires a blame-free environment where error reporting is rewarded

Ch 1.7 Which of the following is unique to a professional standard of decision making? (select all that apply) A. Weighs benefits and risks when making a decision B. Analyzes and examines choices more independently C. Concrete thinking D. Anticipates when to make choices without others assistance

A. Weighs benefits and risks when making a decision B. Analyzes and examines choices more independently Professionals look at risks and benefits before making a decision. They analyze choices in order to make sound decisions

10.10Which of the following is the best indication that a change has been integrated? A. When no one talks about it anymore B. If adoption occurred 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 When a change has truly been incorporated into the daily routine, it has been integrated. Usually staff will no longer refer to the practice as new or a change because they have integrated it into their work.

9.7 There are numerous sources of power in an organization. Several are available too nurses. Which one is not? A. authority B. reward C. control of information D. coercion

A. authority Nurses do have the authority to control clinical resources and make patients care decisions by virtue of their position and licensure.

15.7 Which of the following characterize the transition from nursing student to practicing nurse? (Select all that apply) A. increased number of assigned patients B. Higher productivity expectations for the student compared with the practicing nurse C. Greater emphasis on efficiency in practice D. Short hours, fewer workdays back to back in practice

A. increased number of assigned patients C. Greater emphasis on efficiency in practice Students generally are assigned fewer patients. Efficiency is emphasized more in practice than in school.

14.3 A nursing student is preparing a resume to send to prospective employers. What qualities should the nursing student emphasize? (select all that apply) A. responsibility and accountability B. Integrity C. Interpersonal skills D. social skills E. Family values

A. responsibility and accountability B. Integrity C. Interpersonal skills In addition to passing the NCLEX, employers cite responsibility, integrity, and interpersonal skills, along with oral and written communication.

6.9 The nursing assistant tells a nurse that a patient who is receiving oxygen at a flow rate of 6 L/min by nasal cannula is complaining of nasal passage discomfort. What intervention should the nurse suggest to improve the patient's comfort for this problem? A. suggest that the patient's oxygen be humidified B. suggest that a simple face mask be used instead of a nasal cannula C. Suggest that the patient be provided with an extra pillow D. Suggest that the patient sit up in a chair at the bedside

A. suggest that the patient's oxygen be humidified When the oxygen flow rate is higher than 4 L/min, the mucous membranes can be dried out. The best treatment is to add humidification to the oxygen delivery system. Application of a water soluble jelly to the nares can also help decrease mucosal irritation.

6.2 A nurse is caring for a patient who has a pulmonary embolus. The patient is receiving anticoagulation with IV heparin. What instructions should the nurse give the NAP who will help the patient with activities of daily living? SATA A. use a life sheet when moving and positioning the patient in bed B. use an electric razor when shaving the patient each day C. Use a soft-bristled toothbrush or tooth sponge for oral care D. Use a rectal thermometer to obtain a more accurate body temperature E. Be sure the patient's footwear has a non-slip sole when the patient ambulates.

A. use a life sheet when moving and positioning the patient in bed B. use an electric razor when shaving the patient each day C. Use a soft-bristled toothbrush or tooth sponge for oral care E. Be sure the patient's footwear has a non-slip sole when the patient ambulates. These are appropriate in the care of a patient receiving anticoagulants.

12.5 According to NIOSH, a common reaction to latex allergy is: A. Increased appetite B. Allergic contact dermatitis C. Increased falls D. An increase in violent outbursts.

B. Allergic contact dermatitis Allergic contact dermatitis is a frequent reaction to latex for those who are allergic to it.

14.4 What type of resume is useful in showing stable employment without gaps or many job changes? A. Standard B. Chronological C. Functional D. Combination

B. Chronological Chronological resumes list work experiences in order of time, with the most recent experiences listed first. This style is useful in showing stable employment without gams or many job changes.

8.9 Nursing management and the nursing union are having differences on several issues. There may be a need for negotiation. Which of the following is a serious disadvantage to using collective bargaining to resolve this conflict? A. Protecting the right to fair treatment B. Creating an adversarial relationship between staff and management C. Lacking professionalism on the part of the collective bargaining unit members D. Failing to uphold important standards of care.

B. Creating an adversarial relationship between staff and management. Discussion between management and union representatives about the issue may create conflict, which can be constrictive or become emotional and competitive. If emotions are not managed, the interaction can become adversarial and delay resolution.

7.6 The EMR has many advantages compared with paper charting. It helps track data through time and can help monitor things such as preventative care in primary care practices. Jane is the office nurse in a local practice. She is meeting a new patient for the very first time who informs her that he was recently hospitalized. Jane pulls up the patients EMR and sees no information regarding his recent hospital stay. How could this have happened? A. The patient's discharge was so recent that it is not available yet B. EMRs are usually practice or hospital specific, so the patient's information would be accessible to Jane C. The patient was hospitalized out of state. D. The patient has not signed the necessary consents to give Jane access.

B. EMRs are usually practice or hospital specific, so the patient's information would be accessible to Jane EMRs are usually hospital or practice specific, so Jane would not have access to the patients hospital EMR. Recent changes in technology and the creation of health information exchanges are making EMR information available to hospital and practice affiliates.

14.5 A nursing student who is graduating in a few weeks is preparing a resume. What should the nursing student highlight first? (select all that apply) A. Family status B. Educational degrees C. Community service D. Employment experience E. Leadership experiences in school

B. Educational degrees D. Employment experience If you are a new nursing graduate and have little or no job experience, list your educational background first. Remember that positions you held before you entered nursing might support experience that will be relevant in your nursing career.

14.7 What is the STAR method for interviewing? A. Focuses on communication B. Emphasizes behaviors C. Allows the employer to ask personal questions D. Creates a relaxed interviewing environment

B. Emphasizes behaviors Many employers use the STAR method, which focuses on behaviors. Be prepared to discuss a situation and describe the task, and action taken, and the result.

8.7 Florence has two team members who continually criticize each other despite being told to stop. Which approach is the most appropriate for this situation? A. Refer each of them for employee counseling B. Engage in problem resolution C. Bring in a union representative D. Engage in a formal negotiation process

B. Engage in problem resolution Florence has addressed both of her staff members about their behavior, and there has been no improvement.

15.10 Professional careers typically go through several phases. Which of the following would be the final phase of the successful career? A. Promise phase B. Harvest phase C. Transition Phase D. Momentum phase

B. Harvest phase The harvest phase is the time when you reach your prime, usually the final phase of your career

10.8 In which of the following situations 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 If the benefits will not be realized for several years, it makes it harder to make the change because there may be more at risk.

10.7 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

11.7 The purpose of QI is to continuously improve the capability of everyone involved to provide safe, high-quality patient care. What is important to know about the QI process? A. It is independent of teamwork B. It is a data-driven approach to improving process C. Common safety indicators are not used to evaluate quality of care. D. Opportunities for QI are selected by organization leadership.

B. It is a data-driven approach to improving process Data are used to identify opportunities for improvement and to monitor performance

4.2 A unit team leader who fails to provide direction to his or her nursing care team is an: A. Democratic leader B. Laissez-faire leader C. Autocratic leader D. Situational leader

B. Laissez-faire leader These leaders are passive, inactive leaders who would not provide direction

11.9 When evaluating the quality of care, a health-care organization must consider structures, processes, and outcomes of care delivery. Which of the following is a good example of an organizational process? A. Budgeting adequate money for nursing salaries B. Preparing a patient for discharge C. Monitoring for infections D. Increasing time between clinic visits

B. Preparing a patient for discharge Preparing a patient for discharge is a care delivery process that consists of care interventions and decision making between the care team and the patient.

15.3 Benefits of membership to the ANA include all but which of the following? A. Advocacy for nurses's rights B. Provision of lower-cost health insurance C. Work towards a safer workplace D. Improvement of patient safety

B. Provision of lower-cost health insurance the ANA does not provide health insurance

8.1 The purpose of learning how to negotiate conflict is to: A. eliminate conflict entirely B. Resolves conflicts more effectively C. Win D. reduce stress

B. Resolves conflicts more effectively the use of negotiating skills can resolve conflicts more effectively by helping differing parties see each other as people with similar needs, concerns, and dreams instead of as competitors or blocks in the way of progress.

10.4 A new nurse manager plans to implement a new scheduling process. This was met with resistance from the staff who were very happy with the 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 Sharing information about the new scheduling process and how it can benefit the staff offers them time to learn about the new process and possibly have input into the proposed change.

4.9 Effective followers are those who are: A. Passive employees B. Skilled and self-directed employees C. Less valuable employees D. Employees who are never supportive of new ideas

B. Skilled and self-directed employees The most effective followers are not only competent but self-directed.

10.2 Which of the following best describes what is most likely to be within the nurse's comfort zone? A. A new assignment B. Tasks she's done many times C. Change in a different shift D. Addition of several new tasks.

B. Tasks she's done many times The nurse is accustomed to the daily routine, knows what to expect, and understands what to expect. This puts the nurse in his or her comfort zone.

11.8 Structured Care Methodologies (SCM's) are: A. nursing tools designed to identify best practices and facilitate standards of care B. Used to create a stable set of performance indicators to measure outcomes. C. Used to assist employees with wellness and injury prevention D. Helpful when making staffing assignments

B. Used to create a stable set of performance indicators to measure outcomes. SCMs facilitate the standardization of patient care and provide a mechanism for quality enhancement, outcomes measurement, and research that informs nursing practice.

9.2 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 inter professional collaboration to solve problems and assess risk C. Adherence to staffing ratios D. Encourages the reporting of errors and near misses

C. Adherence to staffing ratios Although staffing ratios may improve patient safety, they are not required to ensure a culture.

14.2 A nursing student is preparing for a first job interview. What should the nursing student research about the organization before going to the interview? A. Review the salary scale B. Research the benefits package offered to employees C. Become familiar with the organization's mission and core values. D. Ask nurses who work at the agency how many patients they are assigned.

C. Become familiar with the organization's mission and core values. Before attending an interview, review the organizations philosophy, mission, and values. This demonstrates to the prospective employer that you have an interest in the position and organization.

15.4 What does the NSNA provide to its members? A. Help in improving course grades B. Guidance in choosing a good nursing school C. Career development information D. Opportunities for graduate school

C. Career development information The NSNA does provide career development information

4.6 Transformational nursing leaders have the ability to: A. Increase the negativity of the team B. Work best alone C. Define the group's mission and communicate that mission to others D. Pay close attention to the weakness and shortcomings of others

C. Define the group's mission and communicate that mission to others Transformational leaders help their teams define their mission and see how their work helps them achieve their mission

9.1 If you are employed at a hospital owned by a corporation listed on the stock market, in which category does your facility belong? A. Publicly (government) supported B. Voluntary, not-for-profit C. For-profit D. All of the above

C. For-profit For-profit hospitals are corporately owned and listed on the stock market. Decisions are driven by the shareholders.

4.10 Autocratic leaders: A. Postpone decision making as long as possible B. Share leadership with members of the team C. Give orders and make decisions without consulting the team D. Encourage creativity when problem solving

C. Give orders and make decisions without consulting the team Autocratic leaders frequently give orders and make decisions without consulting the team members.

12.2 A surprisingly dangerous job in the united states is working: A. In a coal mine B. As a window cleaner in New York City C. In a health-care facility D. As a police officer

C. In a health-care facility Few people realize the many risks encountered by individuals employed in health-care facilities

Ch 1.6 Nurses at a community hospital are in an education program to learn how to use a new pressure-relieving device for patients at risk for pressure ulcers. This is which type of education? A. Continuing education B. Graduate education C. In-service education D. Professional registered nurse education

C. In-service education In-service education takes place within an institution or agency. It is usually directed at teaching nurses who work in the institution about a new policy, standard, or type of equipment.

7.9 ISBARR provides a framework for communicating critical client information. ISBARR is an acronym for: A. Identify, Study, Background, Assess, Recognize, Read-back B. Issue, Situation, Better, Advise, Refer with Recommendation C. Introduce, Situation, Background, Assess, Recommend, Read-back D. None of the Above

C. Introduce, Situation, Background, Assess, Recommend, Read-back

15.9 What can the new graduate do to make a successful transition from student to practicing nurse? A. Try to maintain one's student identity B. Move into nursing management as soon as possible C. Learn about the organization as a whole as well as about your assigned unit D. Focus on the stress of making this difficult transition

C. Learn about the organization as a whole as well as about your assigned unit The organization is the context in which a nurse practices and has an important influence on the practice environment

7.10 Who is responsible for accepting, transcribing, and implementing physician orders? A. Unit Clerk B. Medical Intern or resident C. Professional nurse D. medical assistant

C. Professional nurse The professional nurse is responsible for accepting, transcribing, and implementing health-care provider orders.

Ch 1.1 Nursing has its origins with A. Florence Nightingale B. The Knights of Columbus C. Religious Orders D. Wars and Battles

C. Religious Orders Religious orders such as the sisters of mercy assumed the role of "nursing" the sick and infirm

6.4 A nurse is caring for a patient who is diagnosed with coronary artery disease and sleep apnea. Which action should the nurse delegate to the NAP? A. Discuss weight-loss strategies such as diet and exercise with the patient. B. Teach the patient how to set up the CPAP machine before sleeping C. Remind the patient to sleep on his side instead of his back. D. Administer modafinil (Provigil) to promote daytime wakefulness.

C. Remind the patient to sleep on his side instead of his back. The nursing assistant can remind patients about actions that have already been taught by the nurse and are part of the patients plan of care.

9.5 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 Right unit structures are characteristic of a bureaucratic organization. They are very organized and formal. Organizational charts depict each department, and decision making is a very formal , organized process.

4.3 The democratic nurse leader consistently works to: A. Move the group toward the leader's goals B. Make little or no attempt to move the group C. Share leadership with the group D. Dampen creativity

C. Share leadership with the group Democratic or participative leaders are characterized by their inclusion of team members in important decisions.

10.5 There has been a sudden increase in catheter-associated urinary tract infections that must be addressed on Jane's unit. What is the best way for jane to persuade the staff to implement a new Foley catheter care protocol? A. Tell them the changes has been ordered by the administration B. Present statistics proving the need to change C. Tell a compelling story about why change is needed. D. Explain the importance of the change in simple terms.

C. Tell a compelling story about why change is needed. Telling a story about a patient gives the nurse manager an opportunity to appeal to the staff members' emotions, which compels staff to act, can increase receptivity to change, and may even create a sense of urgency for change.

8.5 What its the most desirable result of a problem resolution? A. win-lose B. lose-lose C. Win-win D. none of the above

C. Win-win Allows both sides to come together to identify the issue, and each side gains some benefit from the solution.

4.1 An important competencyt that nurse leaders need to develop in order to lead effectively is the: A. ability to be firm and inflexible B. ability to be close-minded and to ignore negative feedback C. ability to communicate effectively with others D. Ability to follow orders without questioning them

C. ability to communicate effectively with others ability to communicate effectively with other people is one of the 3 competencies.

9.9 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 organizations culture

C. nurses setting nursing standards for daily practice Nurses set standards of practice for their organization. Because you are closest to the bedside, you see and experience the realities of clinical practice. Your input ensures that clinical practice standards are relevant and that nursing care is delivered in a safe, high quality manner.

6.5 A nurse is assigned to care for the following patients. Which patient should the nurse assess first? A. A 60 year old patient on a ventilator for whom a sterile sputum specimen must be sent to the laboratory B. A 55 year old with COPD and a pulse oximetry reading from the previous shift of 90% saturation C. A 70 year old with pneumonia who needs to be started on IV antibiotics D. A 50 year old with asthma who complains of shortness of breath after using a bronchodilator

D. A 50 year old with asthma who complains of shortness of breath after using a bronchodilator The patient with asthma did not achieve relief from shortness of breath after using the bronchodilator and is at risk for respiratory complications. This patients needs are urgent.

Ch 1.3 You are participating in a clinical care coordination conference for a patient with terminal cancer. You talk with your colleagues about using the nursing code of ethics for professional registered nurses to guide care decisions. A non-nursing colleague asks about this code. Which of the following statements best describes this code? A. Improves communication between the nurse and the patient B. Protects the patient's right of autonomy C. Ensures identical care to all patients D. Acts as a guide for professional behaviors in giving patient care

D. Acts as a guide for professional behaviors in giving patient care Codes of ethics provide guidelines for appropriate professional behaviors and guide practice

11.2 Your new organization is committed to quality patient care. Which of these are considered characteristics of quality health care? A. The nurses use evidence-based research to guide care delivery. B. The nurses are respectful and responsive to their clients' individual preferences. C. The nurses perform an independent double check when administering chemotherapy medication. D. All of the above

D. All of the above

11.5 Nursing standards of care and the organization's policies and procedures greatly decrease risk to patient safety. Which of the following steps can a nurse take to further reduce risk? A. Submit event or incident reports for near misses B. Follow medication administration policies and procedures C. Always report significant data on care to patients and providers in a timely manner D. All of the above

D. All of the above

7.5 Implicit bias affects our understanding in an unconscious manner. A person's ability to recognize these biases can improve communication with patients and colleagues alike. Which of the following statements is true about implicit bias? A. Implicit bias forms during a lifetime. B. Implicit bias can influence clinical decision making and treatment C. Implicit bias contributes to an individual's social behavior D. All of the above

D. All of the above

8.3 The hospital has recently reorganized; Therefore, several departments were closed. The patient census on the unit has increased. The staff have always had a strong team spirit, but the nurse manager knows that workflow changes can cause conflict. What can the nurse manager do to reduce the possibility of conflict among her team? A. monitor the quality of patient care B. Ensure that supplies and equipment are readily available C. Assess the quality of nursing assignments D. All of the above

D. All of the above

9.4 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

9.3 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. Shared values and beliefs are the foundation of organizational culture.

12.6 A common ergonomic occupational- related risk in the health-care environment is: A. Indoor air pollution B. Active shooters C. Nosocomial infection D. Back injuries.

D. Back injuries.

12.3 A federal agency that partners with other agencies throughout the nation to investigate health problems, conduct research, implement prevention strategies, and promote safe and healthy environments is known as the: A. FDA B. IOM C. ANA D. CDC

D. CDC The Centers for Disease Control and prevention is a federal agency that does investigate a wide range of health concerns.

12.1 OSHA, a federal government agency, is responsible for: A. Providing training to handle difficult clients and their families B. Providing research and education training C. Upholding the standards of nursing practice D. Developing and enforcing workplace safety and health regulations

D. Developing and enforcing workplace safety and health regulations This is the best, most specific description of the purpose and focus of OSHA

10.3 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 change. D. Give them time to learn the new procedure.

D. Give them time to learn the new procedure. Allow time to learn or practice the new procedure lets staff gain confidence and reduce the threat of failure. This can make the staff more receptive to proposed change.

7.8 You are working on the trauma unit today, and your new patient with a femur fracture complains of leg pain and seems a little diaphoretic and short of breath. You assess the patient and prepare to contact the surgeon. In preparation for contacting the physician, you: A. Immediately page the MD; it could be a pulmonary embolism, and time is of the essence. You will give him the particulars when the MD arrives B. Wait for the MD to round on his patient because it should be within the next hour or so. C. medicate the patient for pain and plan to contact the MD when he rounds. D. Jot down notes about the situation as it is presented to you, review the patients history, focus your assessment, and determines what you need for the patient.

D. Jot down notes about the situation as it is presented to you, review the patients history, focus your assessment, and determines what you need for the patient. Describing the situation, background, assessment, and recommendations is best. Reporting on situational change is designed to provide concise, pertinent, and factual information to members of the health-care team. This approach to the sudden change in patient condition allows you to communicate information or concerns, and the need for action.

Ch 1.2 Who stated that the "function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death)"? A. Henderson B. Rogers C. Robb D. Nightingale

D. Nightingale Florence Nightingale defined nursing function in both the sick and well state.

12.10 Stephanie Beals was a little nervous during her first week of work as a licensed nurse. Distracted by a lead nurse behind her, her hand slipped, and she stuck by the needle she had just used. What is most important for stephanie to do? A. Disinfect the side of the needlestick B. Apologize to the patient, clean the site, and properly dispose of the needle C. Update her hepatitis B immunization D. Report the incident and obtain post exposure prophylaxis within 2 hours.

D. Report the incident and obtain post exposure prophylaxis within 2 hours. PEP includes the necessary actions to be taken.

10.6 What type of resistance to a change is hardest to overcome? A. The resistance that comes from inertia: "We always do it this way" B. Active 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 Resistance based on the fear of losing one's job is the most difficult type of resistance to overcome because the person perceives that there is a threat to his or her way of life, which the person will guard at all cost. The individual does not feel that he or she can speak freely without jeopardizing his or her job., so although the individual disagrees with the change, he or she keeps silent to stay employed.

6.6 A respiratory therapist performs suctioning on a patient with a closed head injury who has a tracheostomy. Afterward, the NAP obtains vital signs. The nurse should communicate that the NAP needs to report which vital sign value or values immediately? SATA A. Heart rate of 96 beats/min B. Respiratory rate of 24 breaths/min C. Pulse oximetry of 95% D. Tympanic temperature of 101.4 F

D. Tympanic temperature of 101.4 F The patient has a tracheotomy an is at risk for infection. A tympanic temperature of 101.4 indicates an infection and needs to be reported immediately.

4.5 An emotionally intelligent nurse leader: A. Seeks the emotional support of others B. Cannot huddle multiple demands C. Works alone without help D. Welcomes constructive criticism

D. Welcomes constructive criticism Emotionally intelligent leaders welcome criticism that is constructive and acknowledges other team members perspectives

8.8 Which of the following issues may be addressed in a collective bargaining agreement? A. shift differentials B. safe working environment C. grievance procedures D. all of the above

D. all of the above

8.4 Nursing and respiratory departments both experienced job cuts. The nurse manager notices the members of his staff are having more trouble getting a fast response from a respiratory therapist. What source of conflict is probably operating here? A. Union-management conflict B. interpersonal problem C. cultural differences D. work intensification

D. work intensification Work intensification causes everyone involved to increase their workloads to accommodate the job cuts. Nurses and respiratory therapists adjusting to this change may be unable to request service or respond to a request for service in a timely manner.

12.9 Which of the following procedures and modifications contributes to reducing indoor air pollution? a. Windows that may be opened by staff as needed b. More powerful ventilation systems and air filtration c. Select ozone products with more polyvinyl chloride (PVC) d. Increased use of medical waste incinerators

b. More powerful ventilation systems and air filtration Improved ventilation and filtration may reduce indoor air pollution.

6.8 An assistant nurse manager is making assignments for the next shift. Which patient should the assistant nurse manager assign to a nurse with 6 months of experience and who has been floated from the surgical unit to the medical unit? a) A 58-year-old on airborne precautions for tuberculosis (TB) b) A 68-year-old who just returned from bronchoscopy and biopsy c) A 69-year-old with COPD who is ventilator dependent d) A 72-year-old who needs teaching about the use of incentive spirometry

d) A 72-year-old who needs teaching about the use of incentive spirometry Many surgical patients are taught about coughing, deep breathing, and the use of incentive spirometry preoperatively.