Delegation & Communication
The charge nurse is preparing the patient care assignments for the day shift, assigning clients to a LPN/LVN and a certified nursing assistant (CNA). Which clients should be assigned to the CNA? (Select all that apply.)
A client pending discharge after a laparoscopic hernia repair who is requesting to ambulate to the bathroom. , A client requesting assistance packing his belongings for discharge later today
The nurse on a busy hospital unit is anticipating the arrival of an acutely ill patient. What task should the nurse delegate to unlicensed assistive personnel (UAP)?
Feeding a patient who is recovering from a stroke
The charge nurse of a step-down coronary care unit has 24 clients in varying degrees of cardiac rehabilitation. The charge nurse must assign the clients to a team consisting of RNs, LPN/LVNs, and one CNA. What is the primary factor for the charge nurse to consider when delegating care?
Skill level and scope of practice of each staff member
Roxanne chooses to seek a consensus when managing the conflict between Fred and Carol. What outcome would most clearly suggest that Fred and Carol have reached a consensus?
Fred and Carol can both support the outcome, even though it is not ideal for either of them
A registered nurse on a busy hospital unit is responsible for several tasks that require clear and accurate communication. For which task should the nurse use the SBAR technique for communication?
Informing a health care provider about a change in a patient's health status
When preparing to take the NCLEX-RN examination, the student nurse recalls which differentiated practice concept that assists with delegating care to a licensed practical nurse/licensed vocational nurse (LPN/LVN)?
LPN/LVNs should be assigned to stable patients with predictable outcomes.
A new graduate nurse believes that a work schedule developed by the nurse manager is unfair, with more weekend shifts assigned to the new nurse than any of the other nurses. The nurse has mentioned these concerns to the manager several times, but the schedule has not changed. Which is the most appropriate action for the RN to take?
Make an appointment to formally discuss this with the nurse manager, bringing previous and current examples of concerning work schedules.
The nurse overhears two nursing assistants in the breakroom discussing their plans to call in sick to work on an upcoming Friday in order to attend a family party. Which action by the nurse is best?
Privately ask to speak to them and let them know you overheard their plans and are concerned about the impact on staffing since you will be working that shift.
The charge nurse (an RN) must determine how best to assign another RN and one licensed practical nurse/licensed vocational nurse (LPN/LVN) to provide care to a group of clients on the day shift. What is the appropriate assignment?
The RN is assigned to care for an unemployed 26-year-old woman, newly diagnosed with acquired immunodeficiency syndrome (AIDS).
A registered nurse delegated the assessment of a patient's vital signs to an LPN/LVN. The LPN/LVN failed to perform this task, and the patient's health status declined until the oversight was discovered 4 hours later. What is the RN's legal responsibility in this situation?
The RN may be liable for not providing adequate supervision to the LPN/LVN.
The charge nurse, who is an RN, is preparing to make assignments for a busy surgical unit. Which concept should the charge nurse consider when making patient care assignments?
The charge nurse should retain the client care activities that only an RN can perform and delegate other activities as appropriate.
The nurse manager explains to the new charge nurse which critical guiding principle with regard to developing patient care assignments?
The nurse shares accountability for delegated tasks
Which statement best defines insubordination?
The refusal to comply with a directive of a superior or manager
The new graduate nurse is preparing to delegate patient care. The nurse recalls that what rights are among the five rights of delegation? (Select all that apply.)
The right person, The right task, The right communication, The right circumstance
A nurse-recruiter determined that an applicant lied about a previous nursing position. Which ethical principle did the applicant violate in providing false information to the nurse-recruiter?
Veracity
A nurse has been late to work several times per week for the last three weeks. When questioned, the nurse states that her tardiness issues are related to new road construction on her route to work. The nurse manager deems that disciplinary action is necessary for the excessive unexcused tardiness. As this is the nurse's first infraction, what should be the nurse manager's choice of discipline?
Verbal admonishment
Which verbal response by the nurse manager is most appropriate when working with an employee whose communication skills are consistently identified as uncivil?
We need to sit down privately in my office so we can talk about this inappropriate work behavior.
The nurse at a long-term care facility is considering whether to delegate some tasks to nursing assistive personnel (NAP). Before doing so, the nurse must:
be familiar with the NAP's knowledge, skills and experience.
When dealing with conflict among staff, what is the best approach by the nurse manager?
create a positive situation
Which pediatric client care assignment is most appropriate for the charge nurse to delegate to the LPN/LVN?
A school-aged child with a fractured femur who is in balanced suspension traction
Which nurse likely faces the highest risk of being bullied in the workplace?
A registered nurse who graduated from a bachelor of science in nursing program three months ago
A new graduate nurse has successfully completed orientation and has also been successfully oriented to the role of charge nurse. Over the course of several weeks, she has noticed that tasks she has delegated to a long-term, experienced certified nursing assistant (CNA) have not been completed by the end of the shift, leaving her to complete them. Which action by the new charge nurse is best?
Approach the CNA in private to discuss the tasks that were not completed.
An RN has delegated care of a newly postoperative client to an LPN/LVN. The LPN/LVN notifies the RN that the client's blood pressure and respirations are elevated from previous readings and that the client is complaining of pain and dyspnea. Which action should the RN take next?
Assess the client, check the client's surgical notes, and gather additional data before calling the surgeon.
Betty was willing to administer Samantha's 8:00 a.m. medications. If Betty were unwilling to accept this delegated task, what would be Samantha's best action?
Assess the reasons why Betty is unable or unwilling to give the medications.
The charge nurse is determining morning care assignments for several elderly clients awaiting discharge to an assisted living facility, including a client on bed rest with a skin tear and hematoma from a fall 5 days ago. What is the best care assignment for this client?
Assign a nursing assistant to help the client with self-care activities.
Which response by the nurse manager is expected when an employee continuously reports late for work?
Coming in late to work has got to stop. Please schedule an appointment with me so we can sit down and discuss why it's happening and what you can do to correct it.
During the admission of pediatric client with a compound fracture of the right femur following a sports injury, which delegation by the charge nurse is most appropriate?
Request that the nursing assistant obtain equipment for the client's care while the RN talks with the client and the family.
What action by Roxanne would best address the latent conflict that underlies Carol's and Fred's active conflict?
Meeting with the unit's nurses to describe current challenges with staffing levels and possible solutions
Which task is appropriate for the nurse to delegate to the experienced nursing assistant?
Obtain a urine specimen from a client with an indwelling Foley catheter.
When dealing with conflict, what actions are important for the manager to do? (Select all that apply.)
Role-model collaborative negotiation, Recognize and accepts difference in team members,seek a win win solution
The nurse recruitment staff at a long-term care facility has decided to move to a team approach to interviewing qualified applicants. What is the most important reason for the staff to move to a team approach?
Reduce individual bias toward applicants
The evening charge nurse, an RN, is making patient care assignments for the next shift, which includes a licensed practical nurse/licensed vocational nurse (LPN/LVN/LVN) and a nursing assistant. Which task should be assigned to the LPN/LVN?
Reinforcing teaching to a patient about the need for a blood transfusion
Which response by the nurse would be correctly identified by the nurse manager as insubordination?
you're asking me to ambulate that patient? She hit me yesterday, so sorry, no way!
A new graduate nurse is interviewing for a position on a medical-surgical floor at a local hospital. During the interview, the nurse manager states, "Tell me about your wife and kids." Which response by the new graduate nurse best addresses the inappropriateness of the question while maintaining a positive interview environment?
f you are concerned that family may interfere with my work, my record of attendance speaks for itself.
Roxanne, the unit manager, demonstrated effective management of a workplace conflict. After becoming aware of a conflict, what action should a leader-manager prioritize?
gathering as much information about the conflict as possible
Betty, a licensed practical nurse/licensed vocational nurse (LPN/LVN), took phone report from the emergency department (ED) and accepted a patient onto the floor. Which of the five rights of delegation does this action violate?
right person
Samantha communicated with Dr. Gonzalez about Mary's health status using the SBAR technique. When applying this technique, a nurse should begin the communication by presenting what information?
specific reason for the call
A nurse has begun working in a new state and is unsure whether tasks involving a patient's intravenous line can be delegated to a licensed professional nurse/licensed vocational nurse (LPN/LVN). What is the best source for identifying whether this task can be delegated?
the state's Nurse Practice Act (NPA)
Which instruction provided by the nurse reflects effective communication regarding delegation to assistive personnel?
Take vital signs every two hours for the patient with the cholecystectomy in Room 6022.
The charge nurse is developing patient care assignments for the evening shift and needs to assign clients to a licensed practical nurse/licensed vocational nurse (LPN/LVN) and a certified nursing assistant (CNA). Which clients should the nurse assign to the LPN/LVN based on skill level and scope of practice? (Select all that apply.)
1.A client requiring a dressing change to the foot 2.A client requiring frequent suctioning 3.A client requiring reinforcement of teaching about a diabetic diet
Which action by a nurse can result in disciplinary action by a State Board of Nursing? (Select all that apply.)
1.Caring for patients in an intoxicated state 2.Release of a client's diagnosis to a neighbor 3.Refusal to care for a pediatric client who has not been immunized
While meeting in the conference room, Fred stated that Carol "freaked out" when he asked for assistance. What response by Carol would be most appropriate?
Fred, can you explain what you mean when you say that I "freaked out"?
What would accurately describe appropriate delegation? (Select all that apply.)
Helps manage the health care team, Is based on clear communication, and increases the scope of the nurses liability
A charge nurse is planning client activities for the day. Which tasks should the charge nurse delegate to the nursing assistant? (Select all that apply.)
Take and record temperatures, pulses, respirations, and blood pressures on all assigned patients. , Empty and record the amount of urine out of Foley bags at the end of each shift. , Restock pediatric patient care rooms with oral rehydration fluids using a standardized check list. , Assist with delivering breakfast trays to clients after checking for correct patient, room number, and diet.
The registered nurse administering a blood transfusion suspects a reaction has occurred. Which signs and symptoms would the nurse expect with an allergic reaction to blood?
Rash and hives
Samantha delegated the administration of her 8:00 a.m. medications to Betty so that she could assess Mary promptly. What criteria must be met for this example of delegation to be safe and appropriate? (Select all that apply.)
Samantha must be able to confirm that Betty has given the medications., Samantha must be familiar with Betty's scope of practice with regard to medications.,Betty must have sufficient time to give each patient his or her medications
After a recent departmental reorganization, the nurse manager observes tension in several interactions among the staff. The manager understands that which of the following common causes for conflict in organizations could be at the root of the tension? (Select all that apply.)
Staffing changes ,Unclear expectations
A registered nurse (RN) on a busy hospital floor is working alongside an "agency nurse," or supplemental RN (SRN). When working with the SRN, the RN should:
collaborate with the SRN in a similar way as with RNs who work on the unit consistently.
A nurse was suspended following excessive absences. The absences continued after the suspension, and now the nurse is to be terminated. The nurse manager is completing a termination conference with the nurse. What response would be the most appropriate for the nurse manager to conclude the conference?
You are a skilled nurse and I wish you the best.
Which statement is the most appropriate for a nurse manager to use when counseling an employee about repeated absences for the first time?
If there something going on in your life that is making it difficult for you to work on Mondays, I can work with you to give you that day off.
A hospital is hiring a nurse manager for the facility's new neonatal intensive care unit set to open in 3 months. In order to find the most acceptable and qualified candidate, which type of interview should be conducted with potential applicants?
Structured interview
The new charge nurse is planning assignments for a team of licensed practical nurses (LPN/LVNs) and registered nurses (RNs). Which patient assignment would be most appropriate for an LPN/LVN?
An adolescent with dehydration who is taking fluids well by mouth
A nursing student is discussing incivility in a leadership class. Which behaviors or statements, if demonstrated by students, would be considered incivility in a classroom setting? (Select all that apply.)
1.Stating, "I don't know and I don't care," when asked a question about the assigned reading. 2.Rolling eyes when the instructor praises another student for a task done well. 3.Telling the instructor, "These are awful exam questions. I can't believe someone would actually write them!" 4.Telling the instructor, "I've never failed a test before, so it must be your fault for not covering the material better."
Carol was visibly angry about the perceived inequity between her work assignment and Fred's work assignment. When managing her own anger, Carol should:
try to identify the specific triggers that caused her to become angry with Fred.
An experienced nurse is applying for a nurse manager position on a similar unit at another hospital. In developing a list of appropriate questions to ask of the recruiter at the first interview, which should the nurse applicant select? (Select all that apply.)
1.Can you tell me about shared governance for nursing at the facility? 2.Do you provide continuing education opportunities? 3.How does the unit currently handle staff scheduling? 4.What is the turnover rate for staff nurses on this unit?
A nurse manager is reviewing acceptable and unacceptable inquiries prior to conducting new-hire interviews in the coming week. Which interview questions are acceptable inquiries for the nurse manager to ask during the interview? (Select all that apply.)
1.How long have you lived in the area? 2.How long are you hoping to stay in this position if you are hired? 3.Do you have a license to practice nursing in the state?
