Review questions:)
As a nurse manager, you want to institute point-of-care devices on your unit. The rationale that you provide to support the point-of-care devices includes: (Select all that apply.) a. reduction in incidents of medication error. b. immediate documentation of care. c. comparison of patient data with previous data. d. immediate access to staffing schedules.
A, B, C Point-of-care devices that allow documentation of assessment, care, and teaching at the bedside reduce the gap in time between care and documentation, thereby reducing error, increasing accuracy, and improving communication of care. Medication devices and patient databases enable accurate clinical decision-making.
In a busy rehabilitation unit, the team manager decided that the best way to reward the staff was to give them a monetary bonus rather than time off. The staff was very concerned about the decision and went to the administration with a number of complaints. Critical thinking isa process that entails a number of steps. What steps did the manager omit? She should have: (Select all that apply.) a. identified what assumptions were underpinning the issues. b. considered why it was important to make this change or the context for the change. c. considered how this change might affect staff relationships. d. attained a majority consensus of all staff.
A, B, C Taking a majority consensus is not a step in the critical thinking process. Points A, B, and C are "what". "why", and "how" questions that are part of effective critical thinking processes
An example of a nursing care activity that would not be delegated by an RN to a UNP is: (Select all that apply.) a. teaching self-catheterization to a patient with paraplegia who has limited English. b. basic care for a patient with a head injury who is rapidly deteriorating. c. one-to-one observation with a suicidal patient. d. assessment of patients being admitted through the Emergency Department. e. basic hygienic care for a patient who is post MI and stable.
A, B, D Functions such as assessment, diagnosis, planning, and evaluation cannot be delegated. In addition, stability, critical thinking, time, and safety are factors that are considered in assessing whether or not to delegate care to a UNP. Teaching self-catheterization to a patient with limited English requires critical thinking; basic care for a patient who is rapidly deteriorating exemplifies concern with stability; and assessment of patients through Emergency is related to the factor of time. An exception to safety and stability in which patients may be delegated to UNPs is when patients are placed on suicide precautions.
The primary difference between a résumé and a CV is that a résumé: a. reflects your skills, knowledge, and background in relation to a specific position. b. offers a detailed listing of positions held and where positions were held. c. includes a long and detailed explanation of academic and work experience. d. provides contact information and focuses on your background, in general.
ANS: A A résumé is a short, customized overview of your professional life that relates to the qualifications of specific positions and how you are able to match your background to the qualifications that are desired. Provision of contact information is common to both the résumé and the CV. Résumés are more effective if details of particular positions that have been held are highlighted as compared with a detailed listing of positions held.
A new graduate is seeking a position in nursing and wants to sell herself effectively. The best strategy is to: a. create a resume b. practice interviewing. c. call the personnel offices. d. create a curriculum vitae.
ANS: A A résumé provides a customized overview of details of your professional background that relates specifically to a position for which you are applying. Résumés advertise your skills to a prospective employer.
Knowing your professional strengths is important to: a. find your fit in positions and a career path. b. maintain a professional status. c. act in a manner that is legal and ethical. d. understand the role expectations of a position.
ANS: A Being aware of your strengths is critical in determining what you will bring to a position and can be used to find your fit and possible career path. Knowledge and experience are important in maintaining the privilege of belonging to a profession and of behaving ethically and legally
A functional résumé focuses on: a. experience and skills gained in positions. b. positions held and specific roles in the positions. c. academic qualifications and achievements. d. relating skills and experience to qualifications in a specific position
ANS: A Functional résumés highlight skills and experience gained rather the details of specific positions. As with résumés in general, skills and experiences are customized to create an image of an individual in a particular position
A cover letter should be included with your resume when applying for a position. A cover letter is the key to: a. getting your resume read and into the interview process b. asking questions about the position. c. listing all of the positions you have held in the past. d. revealing information about your personal life..
ANS: A The key to getting your résumé or curriculum vitae read and entry to the interview process is a cover letter.
A nurse is applying for a new position. This position is one in which she will serve as a liaison between a hospital and a school of nursing. The nurse must update her résumé to include her teaching experience. The goal of creating a curriculum vitae is to: a. have a listing of facts about your professional life. b. provide potential employers with information about where you are in your career. c. respond quickly whenever a position becomes available. d. be certain you can recall facts for a prospective position.
ANS: B A curriculum vitae provides an all-inclusive but not detailed listing of your professional life. This approach allows a prospective employer to find the most recent information quickly and gain a sense of where you are in your career.
To develop a curriculum vitae or résumé, a nurse must develop a personal data file. The goal of a personal data file is to: a. create an opportunity to be interviewed. b. have a listing of facts about your professional life. c. have a tool in place for marketing yourself. d. create a document that lists your skills.
ANS: B A personal data file enables storage and recall of career-specific details that can be retrieved and shaped for a specific purpose using cut-and-paste approaches rather than creating whole new documents.
To enhance team leadership skills for your team leaders, you arrange opportunities for: a. certification. b. continuing education. c. graduate courses. d. volunteerism.
ANS: B Continuing education provides systematic learning opportunities that augment existing skills and knowledge for delivery of quality care and advancement of career goals. Graduate and certification courses provide advanced knowledge and skills.
The department manager makes a list of interview questions for a new position. Which of the following questions are inappropriate? a. What are your short-term and long-term goals? b. Do you have any disabilities we need to know about? c. Will you be able to meet our attendance expectations? d. Do you understand our philosophy and mission?
ANS: B Only questions related to the position and its description are legitimate. Employers should not ask unrelated questions, and applicants should decline to answer if asked inappropriate questions, for example, disabilities.
An experienced staff nurse applies for a distinct position of patient advocate at a new clinic. Based on the various tools available to her, which of the following should she bring to her interview to best present her skills? a. Résumé b. Annual evaluations c. Portfolio d. Patient advocacy project
ANS: C A portfolio enables prospective employers to view evidence of significant achievements and responsibilities that would be pertinent to the position.
A well-written letter of resignation is critical to: a. first announce your intent to resign. b. formally signal discontent in your current position. c. maintain a positive relationship with your former organization and colleagues. d. fulfill your legal obligations as a departing employee.
ANS: C A well-written resignation letter outlines your intent to leave the organization and your appreciation of the organization but should follow an initial meeting with your manager to first discuss your intention. A well-written letter maintains a positive relationship with the organization.
A unit manager recently graduated as a clinical nurse specialist with a focus in gerontology. She applied to take a certification exam. Certification is designed to recognize: a. basic knowledge in a specified area. b. advanced practice in functional roles. c. special knowledge beyond basic licensure. d. continued competence as a registered nurse.
ANS: C Certification is an expectation in some settings for career advancement in advanced practice or in specialized areas and goes beyond basic preparation.
During an interview for a manager's position, you find the supervisor and staff unfriendly. Responses to questions are met with vague responses. After the interview, you decide not to pursue the position. What follow-up, if any, is most appropriate? a. There is no need for you to do anything further. You likely will not be offered the position anyway. b. You should file a complaint with human resources about the supervisor's lack of interviewing skills. c. You should send a thank-you note to the interviewer, indicating appreciation for her time. d. You should call and leave a voicemail, indicating your disinterest in the position
ANS: C Even if you are disinterested in the position or think that the interview has gone badly, an appropriate follow-up is a thank-you note to the interviewer. This recommended follow-up creates a positive impression and may leave open the possibility of future interactions.
On your curriculum vitae, which of the following is the recommended approach for listing employment and educational history information? a. 1979 RN Diploma 1985 BScN 2002 MN b. 2002 Mount Rush Health Center Staff Nurse 1997 Cedar Falls Clinic Staff Nurse 2007 Kilkarney Rehab Center Case Manager c. 2007 MN 2005 BScN d. 1997 Sturgeon County Hospital Head Nurse 2002 Sturgeon County Supervisor 2007 Sturgeon County Director
ANS: C Information that is included in the body of the curriculum vitae should always be in reverse chronological order so that the most recent and, presumably, most relevant job information appears first.
During performance appraisal interviews, Joanne's nurse manager notices Joanne's excitement when she talks about how she has helped patients on a rehab unit understand the complexities of their regimens. When Joanne's nurse manager asks her about her career path plans, Joanne says that she wants to become a nurse administrator. The best response to Joanne would be: a. Nursing administration is rewarding. What experiences would help you along this path? b. You do not appear excited about nursing administration. Unless you are excited by that career path, I wouldn't advise going in that direction. c. You seem to find teaching others very rewarding. Have you considered that as a possible career path? d. You are too inexperienced to consider administration. Work for a few years, and then consider administration.
ANS: C Joanne evidences excitement about teaching patients, and although administration could be a rewarding path for her, education might be a better option for her to consider. Looking at job aspects that are rewarding is helpful in determining which career direction to pursue.
According to the ANA, systematic professional learning experiences designed to augment nurses' knowledge, skills, and attitudes, thereby enriching the nurses' contributions to quality health care and their pursuit of professional career goals is known as: a. accreditation. b. endorsement. c. continuing education. d. entrepreneurialship.
ANS: C Lifelong learning is a professional attribute that also contributes to professional growth. As you assess career construction benchmarks, additional education will be needed.
Professional associations: a. set regulatory requirements and establish entry requirements for nursing. b. offer graduate programs for clinical and career advancement. c. provide opportunities for career networking and support. d. are open to all individuals who meet the criteria for membership
ANS: C Professional associations are frequently, although not always, voluntary groups whose members provide leadership in issues and policies of interest to nurses. Professional associations also offer networks of nurses with similar interests
An example of a career is: (Select all that apply.) a. employment in short-term contract jobs in business, nursing, and whatever is available. b. involvement in an area of practice that is regulated. c. continuous employment in the same position and the same arrangement for 20 years. d. moving into and out of nursing positions in various cities while pursuing travel and education that develop understanding of global health.
ANS: C, D Career refers to progression of skills, consistency, knowledge, and/or status. This movement through nursing life is predicated on having a vision of a career as opposed to a series of jobs. Career styles can be defined as linear, steady state, entrepreneurial, or spiral. Deepening skills in one area is an example of a steady state career style, whereas moving into and out of positions in various cities can characterize an entrepreneurial style. Involvement in a regulated field defines a professional interest but not necessarily a career.
You are offered an opportunity to take a temporary leave from your position as a nurse manager to lead a technology implementation project. Which of the following reasons for accepting the opportunity is most consistent with developing a solid career path? a. You are pressured to do so by your supervisor. b. The organization has no other suitable candidate for the position. c. You have limited knowledge of information technology and no real interest, but this will increase your knowledge. d. Accepting a position outside of your established skill set may establish you organizationally as an innovative, adaptable leader.
ANS: D Although giving into organizational or supervisory pressure may bring an enhanced learning and organizational profile, what is to be gained needs to be assessed against your career goals, interest, and aspirations. Increasing and expanding your skill set within defined career interests is a valid reason to consider a chance opportunity.
In preparing for a fair interview process as a hiring manager, you should: a. put water out for the candidates. b. ensure that you know the names of all candidates. c. dress comfortably and professionally. d. prepare a schedule of questions to be asked of all candidates.
ANS: D Although providing water, knowing names, and dressing appropriately sets a professional and respectful tone for the interview, developing a schedule of questions to be asked of all candidates is important for gathering comparative data and ensuring equitable treatment
Thomas has been a nurse in your ICU for 10 years. In facilitating Thomas' professional development, the nurse manager would focus on: a. certification for the ICU environment. b. discussions about how Thomas can fit with role expectations and relationships. c. possible changes to other ICU environments. d. encouraging him to lead changes that leave long-term impacts after his retirement.
ANS: D Thomas is a mid-career professional. As such, you would expect him to be interested in honing areas of expertise (such as leadership or developing a deeper expertise in a particular area of ICU nursing) as opposed to gaining skills necessary for his work environment such as certification or becoming comfortable with his role and relationships in ICU, which would be critical to an early career nurse. Legacy building is characteristic of mid-career professionals.
Which of the following needs revision on a résumé or CV? a. John Jones 87 Highway Drive City, MI 79110 [email protected] b. M. Howes Anyway Highway City, MO 77700 (H) 777-777-0000 e-mail: [email protected] c. Dr. L. Jones 99 Carway Drive City, NY 84003 (H) 999-999-0000 (Cell) 999-000-9999 d. Tanya Jones 67 Honeywell Drive City, MO 66907 [email protected]
ANS: D When including Web or e-mail addresses, it is important to use addresses that are not overly casual or that communicate personal information.
A cover letter and a résumé together should be no longer than page(s). a. two b. one c. four d. three
ANS: D two pages are recommended for resume and one for a cover letter
The maintenance department wishes to have the nursing lounge renovated, so the lounge will be more ―user-friendly.‖ The department asks the nursing staff to make a wish list of everything that they would like to see in the new lounge. This process is an example of which part of the decision-making process? a. Assessment/Data collection b. Planning c. Data interpretation d. Generating hypotheses
a. Assessment/Data collection In this particular model (a model similar to the nursing model), data collection is the first step toward identifying important alternatives or determining if there is a problem or problems.
In an ICU, you order new devices to measure heart rhythm and rate, respiratory rate, oxygen levels, and intracranial pressure. These devices involve: a. biomedical technology. b. telecommunications. c. retrieval of patient history information. d. Internet.
a. biomedical technology. Physiologic monitoring devices and patient surveillance systems involve biomedical technology.
A recent nursing graduate in a busy Emergency Department triages a patient who has sustained a large, deep puncture wound in his foot while working at a construction site. He is bleeding and is in pain. The nurse enters the triage data that she has obtained from the patient into a computerized, standard emergency patient-classification system. After she enters the assessment data, she notices an alert on the computer screen that prompts her to ask the patient about the status of his tetanus immunization. What system of technology is involved in generating the alert? a. Clinical decision support b. WL technology c. Computerized provider order d. Electronic health record
a. Clinical decision support Clinical decision support (CDS) is a clinical computer system, computer application, or process that helps health professionals make clinical decisions to enhance patient care.
A nurse manager must implement a 2% budget cut on the nursing unit. What approach would the manager use to most effectively empower the staff of the unit? a. Discuss the guidelines for the budget cuts with the staff, making the decisions with those who participate. b. Inform the staff of the budget cuts in a series of small group meetings and accept their ideas in writing only. c. Provide the staff with handouts about the budget cuts and let them make recommendations in writing. d. Hold a series of mandatory meetings on the budget cuts, asking staff for ideas on the cuts.
a. Discuss the guidelines for the budget cuts with the staff, making the decisions with those who participate. Empowerment is the process of exercising one's own power to facilitate the participation of others in decision making and taking action so they are free to exercise power. It means releasing authority and enabling others to have accountability, for participation and decisions.
During orientation of new nurse managers, the chief nursing officer stresses strategies that help nurse managers to achieve a powerful image. What behaviors best contribute to a powerful image for the nurse manager? a. Greeting patients, families, and colleagues with a handshake and a smile; listening carefully when problems arise b. For men, no facial hair, always wearing a suit and tie; for women, always wearing a suit and high-heeled shoes c. Maintaining a soft voice during times of conflict; making unbroken eye contact during interactions d. Smiling all the time; always wearing a suit, carrying a briefcase, and, if a woman, wearing no jewelry
a. Greeting patients, families, and colleagues with a handshake and a smile; listening carefully when problems arise A powerful and positive approach is communicated through confident behaviors such as greeting others, smiling, and showing respect for the opinions of others through listening. Grooming and dress need to be clean, neat, and appropriate to the situation. Speech needs to be firm and confident.
Which of the following would be most in line with Hersey model and concepts? a. The team of caregivers on day shift are familiar with their roles and with the patients. The nurse manager decides to work on the unit budget in her office. b. After a year of working on the unit, Shari, an LPN, is still hesitant about many policies and procedures. The charge nurse decides to challenge Shari withmore difficult patients. c. The nursing supervisor asks one of her charge nurses to lead a technology integration project. The supervisor continuously demands involvement in decisions that the charge nurse is making in the project. d. Team members complain that Alysha, an RN, is unmotivated, and that she refuses assignments that are complex or difficult. The charge nurse suggests that Alysha is relatively new and that she needs time to adjust.
a. The team of caregivers on day shift are familiar with their roles and with the patients. The nurse manager decides to work on the unit budget in her office. The Hersey model/framework suggests that when ability (skills, job knowledge) and willingness are strong, the involvement of the delegator is less.
You are in the process of designing a patient education program that will provide education and monitoring for patients with hypertension. To support your planning, you draw out and present patient data from: a. a clinical database. b. biomedical technologies. c. e-mail. d. Internet sources.
a. a clinical database. Clinical databases are collections of elements organized and structured for the processing, organization, and presentation of data for interpretation as information, which, in this particular instance, includes outpatient data.
The nurse on the 7-7 shift is assigning a specific component of care to an unlicensed nursing personnel (UNP) employee. The night nurse would remain: a. accountable. b. responsible. c. authoritative and liable. d. responsible and task-oriented.
a. accountable. When a registered nurse delegates care to a UNP, responsibility is transferred; however, accountability for patient care is not transferred.
Mr. Cruiser has been surfing the Web. He is looking for healthcare information on low back pain. He shows the clinic nurse a webpage he thinks is great and tells her that he has been following the exercises recommended by the author. He wants to know what she thinks about the site. When the clinic nurse evaluates this site, she discovers that its author is a personal trainer. No credentials are listed. In several testimonials on the page, people say how wonderful they feel after having done these exercises. The exercises all have animated demos when you click on the pertinent highlighted text or icon. They seem easy to follow. The site was posted 5 years earlier and was last updated 3 years before. The clinic nurse advises Mr. Cruiser to: a. avoid this site. b. check with his primary healthcare provider. c. continue with the exercises. d. contact the author for additional exercise and feedback.
a. avoid this site. Patients need coaching as to how to use and decipher information that is available through the Internet. In this situation, the provider on the site lacks credibility because no credentials are listed, and the information is not current.
The charge nurse on a rehabilitation unit recognizes that due to the COVID-19 pandemic, her unit has been left with a shortage of nurses. She understands that delegating responsibilities to competent delegates will be necessary. She also is aware that for positive outcomes it is crucial to: a. educate delegatees on how to implement a delegated responsibility. b. allow UNP/AP's to have autonomy so the RN has less accountability. c. never delegate to a UNP/AP. d. delegate only the most critical patients.
a. educate delegatees on how to implement a delegated responsibility. Educating delegatees on how to implement a delegated responsibility is crucial for positive outcomes. The Research Perspective provides an exemplar of an innovative educational approach to elevate the knowledge, skills, and attitudes of delegates.
To improve outcomes on the stroke recovery unit, the unit manager leads an evidence-based practice (EBP) project. The goal of this project is to: a. enable detection of variations in clinical outcomes from well-researched standards that are supported by confirmatory evidence. b. gain quick access to literature based on studies of patients and families who have experienced stroke. c. develop a list of articles that could be accessed to address clinical issues and problems with stroke patients. d. advance the development of staff who are able to conduct independent nursing research on stroke outcomes.
a. enable detection of variations in clinical outcomes from well-researched standards that are supported by confirmatory evidence. Several "intelligent" clinical information systems are in place that collect good data and then translate nursing knowledge, such as well-researched standards, into reference materials at the point-of-care
The risk manager wants to evaluate the reasons for an increased number of falls on the rehab unit. The risk manager devises a fishbone diagram. A fishbone diagram is a useful tool to: a. identify the root causes of problems. b. list possible solutions to problems. c. help leaders select the best options. d. evaluate the outcomes of decisions made.
a. identify the root causes of problems. A fishbone diagram, also known as a cause-and-effect diagram, is useful for determining the reasons (causes) for an effect (falls).
The nurse manager of a rehab unit wants to purchase a new anti embolic stocking for use with patients. To make a high-quality decision, the nurse manager would: a. involve the rehab staff in the decision. b. involve the sales representative. c. make the decision alone. d. involve administration in the decision.
a. involve the rehab staff in the decision. In a shared decision model, the decisions are made through an interactive, deliberate process and the staff may express and discuss options and preferences. The shared decision model has been shown to increase work performance and productivity, decrease employee turnover, and enhance employee satisfaction.
As a nurse manager representative on a clinical information system selection team, you would be particularly concerned if the favored system: a. involves screen displays that are best configured for nonclinical users. b. requires an upgrade to servers in the facility. c. requires staff orientation and training during implementation of the software. d. minimizes the amount of data entry necessary.
a. involves screen displays that are best configured for nonclinical users. An ideal hospital information system should include as much instrumentation as possible to minimize data entry. As a clinical end user, you would expect orientation and training on how the screen display can be configured so as to suit the purposes and preferences of users in clinical areas.
When assessing the appropriateness of adopting WL COWs for a nursing unit, you need to consider the advantages, which include: a. mobility of the carts. b. small display screen. c. font size. d. speed of operation.
a. mobility of the carts. Installing computers on mobile carts, also known as computers on wheels or COWs, may increase work efficiency and save time.
Leaders in nursing must advocate for information and knowledge systems that support nursing practice. This is best accomplished by: a. participating in organizational information technology committees. b. submitting written requests for needed information systems. c. requesting budgetary funds needed for systems. d. sending staff nurses to conferences that discuss cutting-edge technologies.
a. participating in organizational information technology committees. Nurse leaders and direct care nurses must be members of the selection team, participate actively, and have a voice in the selection decision. The information system must make sense to the people who use it and fit effectively with the processes for providing patient care.
A good nursing decision-maker is one who: a. uses various models to guide the process based on the circumstances of the situation. b. adopts one model and uses it to guide all decision-making. c. decides not to use any models because they are all useless. d. develops a new model each time a decision has to be made.
a. uses various models to guide the process based on the circumstances of the situation. The decision model that a nurse uses depends on specific circumstances. Is the situation routine and predictable or complex and uncertain? Is the goal to make a decision that is "just good enough" (conservative) or one that is optimal?
A nurse manager was orienting new staff members to computerized charting. To understand computerized charting, staff members must understand informatics. The three core concepts in informatics are: a. hardware, software, and printers. b. data, information, and knowledge. c. decision making, data gathering, and reporting. d. wireless technology, voice recognition, and handheld devices.
b. data, information, and knowledge. Informatics is the application of technology to all fields of nursing to facilitate and extend nurses' decision-making abilities and to support nurses in the use, storage, and linkage of clinical information to provide effective and efficient patient care.
Which of the following indicates safe delegation? a. The nurse supervisor for a large urban acute care department asks the unit manager to accept two new acutely ill patients, which the manager does. The unit is short two staff, and the replacement is inexperienced. b. A unit manager agrees to release a staff from her unit to Unit B. The staff member she agrees to release is experienced on Unit B and is agreeable to the change. The unit manager's unit is fully staffed and patients are stable. c. The nurse supervisor asks the head nurse for Unit A to make do without a replacement for an ill staff member because Unit A was originally overstaffed anyway. Patient acuity levels are very high on Unit A and two staff are orientating. d. The nurse supervisor asks the charge nurse on Unit B to cover Unit F, which is two floors up, because the charge nurse for Unit F is ill. The charge nurse for Unit B is an experienced m
b. A unit manager agrees to release a staff from her unit to Unit B. The staff member she agrees to release is experienced on Unit B and is agreeable to the change. The unit manager's unit is fully staffed and patients are stable. When span of control (number of individuals for whom a manager is responsible) is compromised by geographic factors such as lack of proximity, instability in patients' conditions, or lack of experience, the span of control that is being delegated may lead to unsafe care.
The day shift nurse asks an LPN/LVN to complete a task for a patient. The day shift nurse is engaging in what function? a. Delegating b. Assigning c. Sharing d. Authorizing
b. Assigning Delegation refers to transfer of responsibility for work; the day shift nurse retains accountability for the outcomes of patient care therefore is using assigning of the task rather than delegation.
A nurse manager is excited by the possible use of speech recognition (SR) systems for documentation of patient care, especially during crisis situations when staff members need to focus on performing rapid assessments and implementation of procedures. She learns, however, that SR systems would be impractical at this point. What would lead to this conclusion? a. SR systems are not available outside pilot projects. b. The type of speech required for voice recognition is unlikely to occur in a pressured situation. c. The hands-free function has not been perfected in SR technology. d. Wireless communications are prone to unreliability in transmission.
b. The type of speech required for voice recognition is unlikely to occur in a pressured situation. Speech recognition systems rely on staccato-like speech, pauses between words, and programming for each user, any and all of which would be unlikely in a pressured crisis situation. SR is being used primarily for therapeutic purposes and in situations where data entry is stable.
The institution where you are a nurse manager has resisted the adoption of a new document management software, citing cost as a concern. You meet with other nurse managers who are in favor of the software and prepare a proposal to take to the senior executive with the goal of persuading the executive to adopt the software. This is an example of: a. collaboration. b. a coalition. c. networking. d. policy building.
b. a coalition. The formation of temporary groups to achieve particular goals involves the development of coalitions.
You ask Evelyn, a new UNP, to check what is left in Mrs. N.'s inhaler when Evelyn makes visits to Mrs. N. and also to check whether Mrs. N. is receiving any positive effect from the medication. Evelyn reports for 3 weeks that Mrs. N. is using the inhaler and that there is enough medication left in the device. The day of her last visit to Mrs. N., Mrs. N. is admitted to the hospital in severe respiratory distress. When she is admitted, she tells the physician that she has not been using the inhaler for 4 weeks. Before assigning Evelyn to Mrs. N.'s care,the most appropriate action of the care coordinator would have been to: a. determine Evelyn's educational background and preparation for this role. b. ask Evelyn if she has worked with inhalers before and to describe what she knows about them. c. advise that if Evelyn has any questions about what to do with the inhaler, she should come to the coordinator. d. advise
b. ask Evelyn if she has worked with inhalers before and to describe what she knows about them. When delegating tasks, in addition to specifying the task to be completed, outcomes, priorities, time lines, deviations, report time frames, monitoring, and resources, asking the delegatee to give examples of each is helpful in ensuring that communication is clear and has been understood. Preparation of UNPs lacks consistency; therefore, the safest practice is to determine the knowledge and skill level of the UNP in relation to the skill and the patient before delegating.
You ask Evelyn, a new UNP, to check what is left in Mrs. N.'s inhaler when Evelyn makes visits to Mrs. N. and also to check whether Mrs. N. is receiving any positive effect from the medication. Evelyn reports for 3 weeks that Mrs. N. is using the inhaler and that there is enough medication left in the device. The day of her last visit to Mrs. N., Mrs. N. is admitted to the hospital in severe respiratory distress. When she is admitted, she tells the physician that she has not been using the inhaler for 4 weeks. Determination of Evelyn's educational preparation and certification is related to the concept of: a. accountability. b. authority. c. role performance. d. assignment
b. authority Authority refers to the right to do and may be designated by law, educational preparation, or job description.
At a newly built outpatient surgical center, an integrated information system has been purchased. The chief nursing officer creates a series of staff development classes to orient the staff to this new system. One of the advantages of an integrated information system is that client-care data from all sites can be stored in and retrieved from a: a. nursing information system. b. central data repository. c. nurse expert system. d. handheld device.
b. central data repository. Computer information systems manage large volumes of data, examine data patterns and trends, solve problems, and answer questions. In other words, computers can help translate data into information from both within and among organizations. Data from all patient encounters with the healthcare system are stored in a central data repository, where they are accessible to authorized users.
Decision-making is described by the nursing educator as the process one uses to: a. solve a problem. b. choose between alternatives. c. reflect on a certain situation. d. generate ideas.
b. choose between alternatives. The hallmark of decision making is choosing among options. Generating options is one phase of decision making, and solving a problem refers to problem solving, which is problem centered. Decision making does not always begin with problems, but rather is defined as a purposeful, goal-directed effort that uses a systematic process to choose among options.
You ask Evelyn, a new UNP, to check what is left in Mrs. N.'s inhaler when Evelyn makes visits to Mrs. N. and also to check whether Mrs. N. is receiving any positive effect from the medication. Evelyn reports for 3 weeks that Mrs. N. is using the inhaler and that there is plenty medication left in the device. The day of her last visit to Mrs. N., Mrs. N. is admitted to the hospital in severe respiratory distress. When she is admitted, she tells the physician that she has not been using the inhaler for 4 weeks. This incident is an example of: a. incompetence of the UNP. b. failure to follow-through. c. skills but no motivation. d. lack of accountability.
b. failure to follow-through. The nurse should maintain open lines of communication and seek information, and the UNP should know how, when, and what to report. Communication of delegation of tasks includes specific information about what is being delegated, expected outcomes, and deviations (which includes what immediate action needs to be taken). This 2-way communication and follow-through allows patient care to be altered, if necessary, in a timely manner.
Two nurses approach their manager about a conflict regarding the next month's schedule. The nurses are talking loudly and at the same time. The manager most effectively uses communication skills to resolve the conflict by: a. taking both nurses aside, separately and then together, and charging them with resolving the problem without her direct intervention. b. listening to each nurse speak to the other without interruption and asking clarifying questions to help them resolve the issue themselves. c. separating the nurses, instructing each to decide how the problem can be resolved, and meeting with them the next day. d. calling an emergency scheduling committee meeting and asking volunteers to resolve the conflict between the two nurses.
b. listening to each nurse speak to the other without interruption and asking clarifying questions to help them resolve the issue themselves. Negotiation involves the presentation of an opening position with each party, then moving on until they achieve a mutually agreeable result or until one or both move away from a failed negotiation. Negotiation occurs when one party has something that the other party values, such as a desired schedule.
With delegation, responsibility and accountability remain with the: a. physician. b. professional who delegates. c. individual who receives the delegation. d. individual who previously performed the task.
b. professional who delegates. Even though the delegatee (the one who receives the delegation) receives direction from the professional who delegates a task and must have the authority to complete it, the delegator retains accountability for the overall outcome and completion of the activity. The delegatee has responsibility (obligation to engage in the task) and authority for the task.
A primary care clinic in a small urban center sees a high volume of cardiology patients. Patients who attend the clinic have smart cards that they use at hospitals, clinics, and Emergency Departments within that region of the state. A primary benefit of the smart card for these patients would be: a. rapid and accurate treatment in emergency situations. b. reduced wait times to see specialists. c. e-mail notification of test results. d. readily available information regarding medications.
b. reduced wait times to see specialists. Credit card-like devices called smart cards store a limited number of pages of data on a computer chip and serve as a bridge between the clinician terminal and the central repository of the electronic health record (EHR), making patient information available to the caregiver quickly and cheaply at the point-of-service.
During staff-development programs, staff nurses verbalize their frustration about their workloads and having to delegate so many tasks to others. One of the main reasons that delegation has emerged as an issue is because of: a. the amount of paperwork required to complete care. b. the complexity of care required by patients. c. earlier discharge practices. d. the numbers of other disciplines present on a given unit.
b. the complexity of care required by patients. Complexity of client care, a multilevel nursing model (registered nurses, mixed with LPNs/LVNs, and UNPs), and community-based care provide many challenges in determining the care required and outcomes desired and/or mandated and in matching needs with various abilities and authority of regulated and unregulated healthcare providers. The nurse manager should ensure that staff is clinically competent and trained in their roles in patient safety.
During a fire drill, the nurse manager becomes very assertive and directive in her communications with staff. This type of situational leadership depends on: a. supportive behavior by the leader and immature followers. b. the development level of the followers and the behavior based on the situation. c. well-developed followers combined with a strong leader who acts quickly. d. the leader's ability to evaluate personnel and communicate that evaluation.
b. the development level of the followers and the behavior based on the situation. When abilities, relationships, and/or time is limited (as in a crisis situation), the leader assumes a bigger role in guiding and in making decisions or "telling" behavior. Leaders need to behave differently and use different leadership styles in different situations.
John Smith, one of three managers at BSG Labs, drafted a policy that would allow his department to do more testing in his lab. This policy included the times for regular collection as well as a new process for emergency laboratory testing. The policy and procedures were never followed. The reason was that: a. the policy was too lengthy and inundated readers with too much detail. b. the policy made decisions for other departments in the company. c. the staff did not believe that the new policy would be effective. d. testing should not be done in the lab.
b. the policy made decisions for other departments in the company. Two primary criteria make for effective decisions. First, the decision must be of a high quality; that is, it achieves the predefined goals, objectives, and outcomes. Second, those who are responsible for its implementation must accept the decision. Higher quality decisions are more likely to result if groups are involved in the decision-making and problem-solving process. Taking ownership of the process and outcome provides a smoother transition in changes.
An outpatient surgery manager is evaluating new infusion pumps for purchase to use in the operating room. The manager should: a. select the least expensive brand. b. use a decision-making tool to evaluate brands. c. ask the nursing staff which brand they prefer. d. select the vendor the institution usually buys from.
b. use a decision-making tool to evaluate brands. Decision-making tools such as decision grids and SWOT analyses are most appropriate when information is available and options are known.
The charge nurse is making patient assignments for the next shift on the unit. There is one critical patient on the unit, who is going to require more care than the other patients. Before delegating this patient in an assignment, what is the appropriate action by the charge nurse? a. Delegate the admission assessment to the LPN. b. Review the employee's performance assessment for the most recent period. c. Assess the amount of guidance and support needed for the nursing care of the patient. d. Create a task analysis of critical behaviors for the individual.
c. Assess the amount of guidance and support needed for the nursing care of the patient. To delegate effectively, the charge nurse must assess the abilities required in the situation and the abilities that staff have to anticipate the amount of direction, monitoring, explanation, and independence that can be assumed.
An RN colleague, who is a long-standing and collaborative member of your team, is performing a complex dressing with new orders written for the first time for the assigned patient. Which of the following would be the most appropriate communication with her? a. How do you usually do this kind of dressing? b. The dressing needs to be done today and tomorrow with the supplies on this cart. c. Here is what you need for the dressing, and I will show you what needs to be done. d. I know you know what you are doing. Let me know if you have any problems.
c. Here is what you need for the dressing, and I will show you what needs to be done. If a situation involves a new task and the relationship is ongoing (two individuals who will usually continue to work together), the delegator explains what to do and how to do it. Hersey described the leader's behavior as explaining or persuading, which, is characterized as "selling." The RN who is assigned to the patient is an experienced nurse and team member, but is new to this specific situation. In situations where the nurse is experienced but the task is new, explain (and demonstrate) what needs to be done
Despite the implementation of bar-code medication administration (BCMA) on your busy medical unit, you notice that the number of medication errors has not significantly decreased. Which of the following reasons might explain the lack of change in errors? a. A number of new medications have been introduced into the hospital pharmacy that are not yet recognized in the CDS. b. There have been an unusually high number of patients on the unit who have been unable to confirm their identity at the time of medication administration. c. Lack of staff understanding and support for BCMA has led to overrides or failures to scan bar codes during busy times. d. Clinical data that have been entered into the system to guide administration of the medications are outdated.
c. Lack of staff understanding and support for BCMA has led to overrides or failures to scan bar codes during busy times. Most errors related to technology involve mislabeled bar codes on medications, mistakes at order entry because of confusing computer screens, or issues with management of information. Errors also are related to dispensing devices and human factors, such as failure to scan bar codes or overrides of bar-code warnings.
A nurse manager recognizes the need to expand her professional network as she begins a job search for a middle-management position. What action is least likely to expand her job-searching network? a. Reviewing her address book or card file for names and phone numbers of former colleagues who are now in middle-management positions b. Making an appointment to meet with a former instructor from her graduate program in nursing administration c. Making a long overdue return call to a former colleague who is now a chief nurse executive d. Attending a state-level conference for nurse managers and executives and volunteering to help with professional organizations' informal luncheons and receptions
c. Making a long overdue return call to a former colleague who is now a chief nurse executive Networking is the result of identifying, valuing, and maintaining relationships with a system of individuals who are sources of information, advice, and support. Many nurses have relatively limited networks within the organizations where they are employed. Active participation in nursing organizations is the most effective method of establishing a professional network outside one's place of employment.
A manager relies on his director (immediate supervisor) for advice about enrolling in graduate school to prepare for a career as a nurse executive. The director may exercise what kinds of power in the relationship with the manager in this advisory situation? a. Expert, coercive, and referent b. Reward, connection, and information c. Referent, expert, and information d. Reward, referent, and information
c. Referent, expert, and information Because the director is in a leadership role, he comes with knowledge or expertise that is required to assume a leadership role, and he has information that he is willing to share, which gives him the power of information. The employee sees him as credible and seeks his advice, which gives him referent power
A 39-year-old patient awaits a kidney transplant. Because he must immediately arrange to get to the hospital when a donor kidney is available, it is important that he can be reached anywhere and at any time. To ensure that he receives the message, what type of technology is most effective? a. Internet b. Telecommunications c. WL pager d. CDS
c. WL pager Wireless (WL) communication is an extension of an existing wired network environment and uses radio-based systems to transmit data signals through the air without any physical connections. Patients awaiting organ transplants are provided with WL pagers so that they can be notified if a donor is found.
You document your patient's vital signs into a bedside documentation device and are able to compare your patient's vital signs with patients who have similar diagnoses and similar medications, and who are of a similar age. You are accessing: a. e-mail. b. telecommunications. c. a database. d. technology.
c. a database. A database is a collection of data elements stored and organized together for the purposes of interpreting information such as vital signs.
To solve a problem, the nurse manager understands that the most important problem-solving step is: a. the implementation phase. b. identification of numerous solutions. c. accurate identification of the problem. d. evaluation of the effectiveness of problem resolution.
c. accurate identification of the problem. To proceed effectively, it is important to determine if a problem exists and to accurately identify a problem. Failure to resolve problems is most often linked to improper identification of the problem.
County Hospital has position descriptions for all staff, including RN Team Leaders. Sarah, a team leader on the rehab unit, assesses the needs of the patients in her area, assesses the skills and backgrounds of each of the individuals on her team, and then assigns and delegates the appropriate care provider to each patient and task. Sarah provides Colleen, her RN colleague with details regarding the patients to whom Colleen has been assigned on the day shift. This is an example of: a. accountability. b. responsibility. c. assignment. d. delegation.
c. assignment. When an RN assigns care to another RN, it is termed an assignment and not delegation, because both accountability and responsibility are transferred.
The nurse manager used a mediator to help resolve conflicts on the unit. During the mediation process, the nurse manager saw signs of potential team building. One key concept of an effective team is: a. conflict. b. task clarity. c. commitment. d. a designated leader
c. commitment. Team building involves moving toward a common vision, which requires commitment. Conflict and clarification of tasks are components in the development of this commitment.
Select the statement that best defines the difference between problem-solving and decision-making: a. decision-making skills require critical thinking; problem-solving skills do not. b. problem-solving skills require critical thinking; decision-making skills do not. c. decision making is a goal-directed effort; problem-solving is focused on solving an immediate problem. d. problem-solving is a goal-directed effort; decision-making is focused on solving an immediate problem.
c. decision making is a goal-directed effort; problem-solving is focused on solving an immediate problem. Problem solving is focused on solving immediate problems, whereas decision making is a goal-directed process that is aimed at selecting appropriate actions from among options. Not all decisions begin with a problem.
High-quality decisions are most likely to be made in nursing situations when: a. team leaders make the crucial decisions. b. individuals are advised of the problems. c. group size is neither too small nor too large. d. members are passively involved.
c. group size is neither too small nor too large. Research has shown that group size is important. Too small a group means a limited number of options generated. Too large a group can mean lack of structure or lack of meaningful discussion.
Nurses need to know how to operate a computer, compare data across time, and look for patterns in client responses to treatments. These are examples of: a. JCAHO standards. b. information systems. c. informatics competencies. d. requirements for nursing licensure.
c. informatics competencies. The Quality and Safety Education for Nurses (QSEN) project identified informatics competency as a necessary component of the knowledge, skills, and attitudes for quality patient care. Nurses are anticipated to be able to use information and technology to communicate, manage knowledge, mitigate error, and support decision making.
The unit manager is working in a large metropolitan facility and is told that two UNPs are to be assigned to work with her. Delegation begins with: a. acknowledging the arrival of the second UNP on the unit. b. providing clear directions to both UNPs. c. matching tasks with qualified persons. d. receiving reports from the prior shift.
c. matching tasks with qualified persons. In delegating to the UNPs, the nurse must consider what cannot be delegated, as well as the factors of safety, time, critical thinking, and stability of patients.
One day, at coffee, your co-worker suggests that you and she sit with unit members of the hospital research committee. She suggests that this would be an excellent way to get to know people who share her interest in research. Her actions are an example of: a. mentorship. b. politics. c. networking. d. empowerment.
c. networking. Meeting individuals outside the normal work group to share ideas and gain support and encouragement is an example of networking.
Which of the following exemplifies accountability? Karen, the nurse manager on 5E: a. consistently submits her budgets on time. b. gets along well with her staff and with other managers. c. outlines her rationale for reduction of RN coverage on nights to the Nursing Practice Committee after serious patient injury. d. actively solicits ideas regarding scheduling from her staff.
c. outlines her rationale for reduction of RN coverage on nights to the Nursing Practice Committee after serious patient injury. Reliability, dependability, and obligation to fulfill the roles and responsibilities of the nurse manager are consistent with responsibility. Accountability refers to being answerable for actions and results.
A home health nurse has been assigned to cover a 300-square-mile area of remote Montana. Mrs. Baker has just been discharged home following bowel surgery and has a new colostomy. She will need daily contacts for at least 2 weeks and then regular weekly contact following that week. Because it is not possible to visit Mrs. Baker in person every day and see all of the other clients, the nurse gives her a laptop computer with net meeting software installed. Each morning, both dial in at an agreed-upon time and discuss her progress. The home health nurse assesses whether or not the client needs to be seen that day and is able to view the colostomy site. This type of technology is called: a. distance learning. b. knowledge software. c. telecommunications. d. biomedical technology.
c. telecommunications. Telecommunications and systems technology facilitate clinical oversight of health care via telephone or cable lines, remote monitoring, information links, and the Internet. Patients sitting in front of the teleconferencing camera can be diagnosed, treated, monitored, and educated by nurses and physicians. EKGs and radiographs can be viewed and transmitted.
The risk manager informs the nurse manager of an orthopedic unit that her unit has had an increase in incident reports related to patients falling during the 11-7 shift. The nurse manager knows that the best way to resolve the problem is to: a. use creativity. b. obtain support from the 7-3 shift. c. use institutional research. d. identify the problem.
d. identify the problem. Identifying a problem is the first step in problem-solving and occurs before any other step. The most common cause for failure to resolve problems is the improper identification of the problem/issue; therefore, problem recognition and identification are considered the most vital steps
A rural-urban health consortium enables physicians in a rural remote setting to consult with specialists in care through electronic conferencing, which includes consultation usingintranet radiology images. This system may be in which phase of electronic medical technology adoption, according to the Healthcare Information and Management Systems Society (HIMSS)? a. 0 b. 1 c. 3 d. 6
d. 6 According to the HIMSS, this healthcare organization may be in phase 6, which includes the capacity to transmit all radiology images through intranet or another secure source.
Sally is an experienced nurse on the unit and is very experienced with ICP monitoring. She is assigned David, a patient who has been admitted with a severe head injury. In communicating with Sally, what is an appropriate action by the charge nurse? a. Provide a detailed explanation of what she needs to do with ICP monitoring. b. Tell her when she needs to provide an update about David's status. c. Ask her to tell you what she knows about ICP monitoring and share expectations about reporting. d. Advise her that you are available if she needs you.
d. Advise her that you are available if she needs you. The charge nurse and Sally have a well-established relationship, and Sally has the expertise to work effectively with David; therefore, the charge nurse would need to provide little guidance but would need to communicate that they are available if needed. Hersey refers to this leader behavior as "delegating."
Justin is a nurse manager in a rehabilitation unit in a small urban center. There is a high turnover rate among rehab assistants because of the heavy work assignments. Despite his need for staff, Justin decides to review each application thoroughly and interview candidates carefully because he recognizes that it is important to hire staff who can best provide high-quality care and who will fit well with the team. Which of the following decision-making solutions should Justin consider to have a more efficient department? a. Replace staff only with qualified applicants. b. Determine what the problem or problems are before hiring new staff. c. Consult with the human resources department and develop a plan for hiring new staff. d. All listed are appropriate to consider.
d. All listed are appropriate to consider. Decision making involves a goal-oriented consideration of many options that are objectively weighed according to their possible risks, consequences, and positive outcomes. The options should be ranked in the order in which they are likely to result in the desired goals or objectives. The solution selected should be the one that is most feasible and satisfactory and has the fewest undesirable consequences. In this instance, all of the options listed might be considered and weighed.
The clinic nurse has just accessed a client's chart on the computer. The resident comes over and asks her to stay logged on because he needs to add a note to that client's chart. She should say: a. No problem. Just log me off when you're done. b. I'll put the note in for you. What do you want to say? c. Just make sure that you sign your note because it's under my password.. d. I'm sorry, but you will have to enter the information using your own password.
d. I'm sorry, but you will have to enter the information using your own password. System users must never share the passwords that allow them access to information in computerized clinical information systems. Each password uniquely identifies a user to the system by name and title, gives approval to carry out certain functions, and provides access to data appropriate to the user.
When confronted with the controversy and the apparent poor morale of the evening staff, the unit manager decided the staff needed to take some time off. He scheduled holidays for the staff without consulting them. A couple of the staff nurses approached the manager and indicated that the problem was not scheduling, but rather the team leader and her patient assignments. What was the unit manager's first missed step in problem-solving? a. Not using a problem-solving model b. Not considering a number of alternatives c. Poor evaluation of outcomes d. Incorrect problem identification
d. Incorrect problem identification The unit manager did not begin with an accurate identification of the problem. Problem-solving needs to begin with "why?"
What interaction is MOST consistent with the idea of networking? a. Meet with the same colleagues daily to have coffee and share concerns about the workplace and stories about colleagues. b. Join an online workplace forum to gain ideas about how to handle workplace conflict. c. Suggest that you and a new team member meet after work for coffee to review unit guidelines. d. Join a nurse executive interest group to meet other executives for support and for sharing ideas of expertise.
d. Join a nurse executive interest group to meet other executives for support and for sharing ideas of expertise. Networking is the result of identifying, valuing, and maintaining relationships with a system of individuals who are sources of information, advice, and support. Many nurses have relatively limited networks within the organizations where they are employed. Active participation in nursing organizations is the most effective method of establishing a professional network outside one's place of employment. Successful networking involves sharing similar ideas and maintaining relationships within a system of individuals who serve as sources of information, advice, and support.
In delegating to a UNP in a home health setting, which of the following represents the most appropriate delegation communication? a. You will be taking care of Mrs. S., who needs assistance with her bath. b. You will need to help Mrs. S. get into and out of her shower. Ensure that you check the condition of her feet, and let me know if you have any concerns when you check-in. c. I am not sure you know how to do this, but I am giving you Mrs. S. She is quite obese and needs skin care. d. Mrs. S. needs help to get into and out of her bathtub. Her bath will need to be completed by 10:00. When you are helping her to dry, please check between her toes and toenails, and phone me by 10:30 if you notice nail discoloration or redness.
d. Mrs. S. needs help to get into and out of her bathtub. Her bath will need to be completed by 10:00. When you are helping her to dry, please check between her toes and toenails, and phone me by 10:30 if you notice nail discoloration or redness. Delegation communication includes what is being delegated (and what is not), outcomes, specific deadlines (if applicable), specific reporting guidelines (what, when), and who may be consulted. Communication also includes conveying recognition of the authority to do what is expected.
A nurse belongs to several professional organizations, serving on a state-level committee of one group and on two task forces at work. The nurse is committed to a range of health issues and knows the state senator from the nurse's district, as well as the name of the representative in Washington, DC. This nurse exemplifies which level of political activism in nursing? a. Gladiator b. Buy-in c. Self-interest d. Political astuteness
d. Political astuteness Political involvement is a professional responsibility and nurses' perspectives of the critical issues for improving the healthcare system can shape the policy agenda of the nation's political leadership. This nurse exemplifies several of the skills associated with political astuteness.
A nurse manager is experiencing conflicts between herself and staff members. She had tried to develop a team by using a shared leadership model to empower the staff. Staff members are functioning: a. as a team. b. independently. c. interdependently. d. as a group.
d. as a group. A group is a collection of interconnected individuals working together, with a high degree of interdependence, for the same purpose. A team is a unified group that is committed to a common purpose, performance goals, and approach, for which they hold themselves mutually accountable. The conflict indicates that the staff may not be united in a common purpose.
A clinic nurse has observed another nurse deviating from agency policy in performing wound care. The best approach for the clinic nurse to take is to: a. stay out of it. b. inform the nursing supervisor. c. fill out a notification form (incident report). d. assess the risk to the client and the agency before proceeding.
d. assess the risk to the client and the agency before proceeding. If the situation is subjective, nonroutine, and unstructured or if outcomes are unknown or unpredictable, the nurse leader and manager may need to take a descriptive or behavioral approach. More information (such as degree of risk to the client and to the agency) needs to be gathered to address this situation effectively.
During a unit meeting, you notice that Vivian listens attentively when Mary is speaking and offers support and advice when Mary presents ideas to the group. You are surprised because Vivian has often confided that she does not like Mary. Vivian's behavior is best described as: a. insincere. b. networking. c. politically sophisticated. d. collegial.
d. collegial. Collegial behavior requires respect, not friendship.
The night nurse understands that certain factors need to be considered before delegating tasks to others. These factors include the: a. complexity of the task and the age of the delegatee. b. potential for benefit and the complexity of the task. c. potential for benefit and the number of staff. d. complexity of the task and the potential for harm.
d. complexity of the task and the potential for harm. In delegating tasks to others, the nurse considers factors such as stability of the patient, safety of the situation and of the patient, time and intensity involved, and level of critical thinking required to achieve desired outcomes.
As part of an information technology implementation team, you are implementing aclinical decision support system. Particular considerations for successful implementation of this project include: a. ensuring that the system is reliable. b. ensuring that patient information is reliable. c. developing unique identifiers for individuals. d. developing rules that support inferences.
d. developing rules that support inferences. Clinical decision support systems provide support for novice nurses, in particular, as they enable entry of real-time data from patient situations and inferences that apply the logic that expert nurses would use. These inferences require rules to be developed for the system.
The nursing manager of a surgical unit has been asked by administration to evaluate client outcomes post-cardiac catheterization. Using data about client outcomes post cardiac catheterization for the past 6 months in order to modify practice is an example of: a. information. b. cost-effective care. c. meeting standards. d. evidence-based practice.
d. evidence-based practice. Technology enables evidence-based practice by collecting good clinical knowledge, translating nursing knowledge into reference materials that can be accessed at the point-of-care, and, potentially, assisting nurses to take action based on best evidence for practice.
As a nurse manager, one challenge is to orient new staff to your agency's policies and procedures, as well as to provide training across various shifts. A cost-effective and effective learning strategy would be: a. development of new learning modules and software to support document retrieval. b. e-mail distribution to staff home e-mail addresses regarding important policies. c. preparation of DVDs that can be viewed on computers at the nursing station during "downtimes." d. linking policies and procedures to the network for access when required at the point-of-care.
d. linking policies and procedures to the network for access when required at the point-of-care. Knowledge technology consists of systems that generate or process knowledge and provide clinical decision support (CDS). The clinical knowledge embedded in computer applications can range from simple facts and relationships to best practices for managing patients with specific disease states, new medical knowledge from clinical research, and other types of information.
You are working in a home health service and have three unlicensed nursing personnel (UNPs) assigned to your team. You have worked with two of them for 2 years; the third is new. The two experienced UNPs have patients with complex illnesses for whom theyprovide basic care. The third member of the team has been assigned to patients with less complex illnesses. Your best approach to supervising their care is to: a. remain in the office and ask each UNP to check in with you upon arrival at their first patient care site. b. ask another RN to supervise the two experienced assistants so you can be with the new person full time. c. meet the new staff member at the first patient care site and ask the others to call if anything is unusual. d. meet the new staff member at the first patient care site and call the others with questions to determine whether anything is unusual.
d. meet the new staff member at the first patient care site and call the others with questions to determine whether anything is unusual. When ability and willingness are strong, the involvement of the delegator is needed less.
As the head nurse involved in leading determination of which patient surveillance systems to acquire for your unit, one of your aims is to avoid adverse events through the implementation of appropriate technology. This particular aim recognizes that: a. human error is significant in contributing to adverse events. b. documentation of patient data is often illegible and therefore, misinterpreted. c. data systems provide backup documentation with adverse events that staff cannot provide. d. physiologic monitoring systems enable detection of early changes before an adverse event occurs.
d. physiologic monitoring systems enable detection of early changes before an adverse event occurs. Data about adverse events suggests that a majority of physiologic abnormalities are not detected early enough and may be present hours before the event actually occurs. Physiologic monitoring aids in early detection of changes.
You are a member of a team assigned to care for 15 general medical/surgical clients. You have all worked well together in the past in this same type of care. If you are assigned to coordinate this team's work, your best strategy, based on the Hersey model, would be to: a. have a list of tasks to be accomplished and tell each member of the team what he or she must do. b. encourage people to discuss their frustrations in providing this care. c. ignore them—they've done it before. d. provide minimal direction and let them come to you with questions.
d. provide minimal direction and let them come to you with questions. According to the Hersey model, when ability (skills, job knowledge) and willingness are strong, the role of the delegator is less ("delegating behavior").
Leslie, a UNP, transfers a patient while using improper technique. The patient is injured, and as a result, a suit is launched in which both Sarah (the delegator) and Leslie (the delegatee) are named. Sarah is named in the suit because she: a. retains accountability for the care of the patient. b. worked the same shift as Leslie. c. has passive accountability for delegation. d. retains accountability for the outcomes of care for the patient.
d. retains accountability for the outcomes of care for the patient. Whenever care is provided by someone other than a registered nurse, accountability for care remains with the manager/delegator even though others provide aspects of care.
Nurses can use four elements to determine the abilities of the UNP/AP to perform the task or activity when delegating. These four elements are: a. ability, attitude, acuity, and authority. b. skill, diet, communication, and agility. c. accountability, time management, organizational skills, and degree. d. safety, critical thinking, stability, and time.
d. safety, critical thinking, stability, and time. To assist with the challenges of delegating, nurses can use four elements to determine the abilities of the UNP/AP to perform the task or activity. These four elements are safety, critical thinking, stability, and time.
A necessary, basic condition for successful integration of clinical information systemsis: a. software. b. standard medical nomenclature. c. confirmatory evidence from nursing-led studies. d. strong interdisciplinary cultures.
d. strong interdisciplinary cultures. An integrated clinical information system draws on specific knowledge from many involved disciplines that interface at the patient. Successful integration of clinical information systems requires that the various disciplines work together collaboratively to transform the data into meaningful knowledge.
A key advantage that a charge nurse has in terms of delegating is that: a. clients receive less attention because too many staff make it difficult to coordinate care. b. nurses report less pressure to perform necessary tasks themselves. c. administration can predict overtime more accurately. d. team skills can be used more effectively.
d. team skills can be used more effectively. The use of multilevel healthcare providers enables healthcare organizations and nursing to provide patient-centered care, with a focus on abilities and skills that can be employed to perform "what is needed now." As tasks become more complicated, delegating skills to others enables the nurse to effectively deliver a complex level of care.
