ebp final

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:

"I'm sorry, but you will have to enter the information using your own password."

A student nurse is talking with his instructor. The student asks how quality of care is evaluated. What is the BEST response by the instructor?

"Quality of care is evaluated on the basis of process and outcomes."

A nurse hears a co-worker state that anybody could be a nurse since it is so automated with infusion devices and electronic monitoring; technology is doing the work. What is the nurse's best response?

"Technology use has to be combined with nursing judgment."

The nursing value that is reflected by the nurse's concern and advocacy for the welfare of patients, other nurses, and other healthcare professionals is which of the following?

Altruism

Which ethical principle is primarily involved in informed consent?

Autonomy

A patient refuses a simple procedure that you believe is in the patient's best interest. What two ethical principles are in conflict in this situation?

Autonomy and beneficence

What is the role of an effective follower?

Being able and willing to influence team members

According to our Yoder-Wise text, what is the first step to becoming an effective leader?

Being an effective follower

The term "authentic" when applied to leadership is defined as which of the flowing?

Being yourself and honest in relationships

Three gravely ill patients are candidates for the only available bed in the ICU. As the supervisor, you assign the bed to the patient with the best chance of recovery. This decision reflects which of the following ethical principles?

Beneficence

In an ICU, you order new devices to measure heart rhythm and rate, respiratory rate, oxygen levels, and intracranial pressure. These devices involve:

Biomedical technology

Benefits for the staff nurse related to the use of health informatics include

Clinical decision support tools.

Jill is the head nurse on a unit in a large hospital. Two of the staff nurses are constantly arguing and blaming each other, and a resolution has not occurred in months. To solve the existing conflict, which is the most creative conflict resolution?

Collaborating

Two nurses are discussing health care quality. They agree which action contributes to increased health care quality?

Collaboration of multiple health care agencies.

The unit manager was addressing nursing students in the lounge area and was discussing team leadership and team effectiveness. She stated, "One can agree to disagree with another team member's perspective even when one doesn't necessarily see that perspective as being the correct one." In being creative, what did she mean?

Committing to resolution

John is a circulating nurse in the operating room. He is usually assigned to general surgery, but on this day he is assigned to the orthopedic room. He is unfamiliar with the routines and studies the doctor's preference cards before each patient. The fourth patient comes into the room and John prepares a site for a biopsy using a Betadine solution. The surgeon prefers another solution. He notices what John has done and immediately corrects him by rudely insulting John. What is the appropriate approach to conflict resolution in this example?

Compromising

Two nurses on a psychiatric unit come from different backgrounds and have graduated from different universities. They are given a set of new orders from the unit manager. Each nurse displays different emotions in response to the orders. Nurse A indicates that the new orders include too many changes; Nurse B disagrees and verbally indicates why. This step in the process is which of the following in Thomas' stages of conflict?

Conceptualization

In nursing theory, one theorist developed the theory of self-care of patients. In the theory, the nursing action of providing care and educating the patients can be interpreted in the form of followership for the patient. Who was this theorist?

Dorothea Orem

A student nurse observes that her preceptor handles emotionally laden interactions with patients, families, and other staff in a calm, professional and empathetic manner. Before engaging in these types of interactions, he takes time to think about the situation and what he is going to say. The student identifies this as an example of which of the following types of characteristics?

Emotional Intelligence

The nurse manager knows that for change to be successful which of the following must occur?

Empowerment of those involved in the change.

The principle that requires nurses to uphold a professional code of ethics, to practice within the code of ethics, and to remain competent is which of the following?

Fidelity

What type of leadership position is that of a Chief Nursing Officer (CNO )? considered?

Formal leadership

As a student nurse at UNMC, you have pledged to:

Grow as a leader in promoting health throughout your community Use EBP in planning and intervening in patient care Respect those entrusted into your care Hold all patient information in confidence

In an emergency department, the team uses a whiteboard to track patients and their treatments by name and room. For maximum visibility, the whiteboard is hung on a large wall in a central location where there is frequent traffic by members of the health care team, patients, and patients' family members. Which of the following is being violated?

HIPAA

The Fours Agreements (Don Miguel Ruiz) are agreements a person makes with which of the following?

Him- or herself

A nurse is explaining the pediatric unit's quality improvement (QI) program to a newly employed nurse. Which of the following would the nurse include as the primary purpose of QI programs?

Improvement of patient outcomes

Staff at Valley Hospital are concerned that recent staffing cuts will affect their ability to provide quality patient care, and they express their concerns to senior management. The CEO of Valley Hospital makes the following statement: "We need to contain costs because our funding has been decreased." This is a good example of which of the following conditions that propel a situation toward conflict?

Incompatible goals

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:

Informatics competencies

Common exemplars of professional nursing behaviors include:

Integrity, Courage, Compassion

In improvement work, a process change

Is a change to the way a task is performed.

An individual in a wheelchair is applying for the position of receptionist in an outpatient clinic. What does the nurse manager understand based on The Americans with Disabilities Act of 1990 requirements for employers?

Make reasonable accommodations for persons who are disabled.

Kala, a unit manager, in discussing a role the CEO would like her to perform, makes the following statement, "I will sit on the hospital task force on improving morale if you send me to the hospital's leadership training classes next week, so I can further develop my skills and thus be more effective." Which of the following conflict management styles is Kala using?

Negotiating

Nurses entering the work force today are faced with which of the following relationships that could create organizational conflict?

Nurse-nurse relationship Nurse-chief nursing officer relationship Nurse-patient relationship Nurse-auxiliary personnel relationships Nurse-physician relationship

Which of the following are recognized as one of the 5 tenets of nursing practice:

Nurses coordinate care by establishing partnerships, Caring and health are central to the practice of the RN, Nursing practice is individualized

The specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice is:

Nursing Informatics.

In the cardiac intensive care unit, there has been simmering discontent about the new nurse manager, who avoids any discussion about her scheduling and practice decisions. The staff have begun to sort into "different camps" depending on how they feel about the manager or the decisions. Which of the following statements MOST accurately describes this situation?

Patient care may suffer because attention and energy is being diverted toward the unit relationships.

In nursing theory, one theorist developed the idea of new nurses progressing to experienced nurses and playing an important role in patient care in all stages. The new nurses follow their role and progress through stages to advanced nurse. Who was this theorist?

Patricia Benner

As a charge nurse, you counsel your RN staff member that they have has their duty of care by notifying a child's physician regarding concerns about deterioration in the child's status at 0330 hours. The physician does not come in to assess the child and does not provide additional orders. The child dies at 0630 hours. As the charge nurse, you could be held liable for what?

Professional negligence

A nurse manager wants to decrease the numbers of medication errors that occur in her department. The manager arranges a meeting with the staff to discuss the issue. Which of the following would be the most effective approach?

Recommending that a multidisciplinary team should assess the root cause of errors in medication administration

A staff nurse is taking leadership classes in an advanced degree program The instructor requires the students to create a journal and make notes of their feelings when they experience conflicts at work What is the purpose of this assignment?

Reflection of self-awareness

What are two major focus areas of The Joint Commission (TJC) in the delivery of health care?

Safety; quality

A hospital organization is working to improve a feeling of being valued and respected among all staff members. Which action by administration would reinforce the feeling of being valued?

Seek staff input when planning a remodeling project of patient rooms.

The Model of Professional Nursing Practice Regulation culminates at the top to represent:

Self-determination of the nurse in exercising judgements

A part of the ethical code of conduct for nurses is to:

Takes care of herself/himself Maintain the integrity of the profession Collaborate with other health professional

A home health nurse has been assigned to cover a 300-square-mile area of remote Montana. Mrs. Baker has just been discharged home and will need daily contacts for the next 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. This type of technology is called:

Telecommunications

Who is responsible for developing the scope and standards of nursing practice?

The American Nurses Association (ANA)

The nurse is caring for a patient with diabetes who was admitted with an elevated blood glucose level. The patient is on an insulin pump to deliver one unit of insulin per hour through her intravenous (IV) line. How does this technology improve safety for this patient?

The pump helps automate a complex care process.

The nurse manager is aware that conflict is occurring on her unit; however, she is focused on preparing for a state health department visit, so she ignores the problem. What factor can increase stress and escalate conflict?

The use of avoidance

In trying to achieve Magnet® status, the chief nursing officer establishes a shared governance model to help nurses experience job satisfaction. However, some nurses who have enjoyed working with less autonomy resist this change and begin to criticize and make rude comments about managers who embrace this model, as well as colleagues who support it. The comments are largely ignored because those who are making them are well established nurses who are often vocal about their displeasure with the organization. Organizational conflict is arising from which of the following?

Tolerance of incivility

Which of the following is an example of a formal leadership position on a nursing unit?

Unit manager

By following a shared leadership model, the nurse manager believes that staff members will learn to function synergistically. Some teams function synergistically because members:

actively listen to each other.

A patient suffered a brain injury and has not brain activity. The patient has a living will which states no heroic measures. The family requests that no additional heroic measures be instituted for their loved one. The nurse respects this decision in keeping with the nursing value of:

autonomy

Interventions for building a professional identity include:

be accountable for your learning engage in reflection value debriefing develop personal self care habits

The head nurse and a staff nurse are having a conflict over how to use and apply a new procedure for dressings in the medical/surgical area. The staff nurse wishes to use the new procedure based on newly released nursing research. The head nurse wishes to use a protocol that has been used in the department for a number of years. The head nurse later makes comments to other staff on her unit about the credibility of the staff nurse. This behavior is associated with:

bullying.

From the information presented in this chapter, which of the following statements best defines an accomplished team? Effective teams:

can create a form of synergism in which the outcome is greater than the sum of the individual performances.

You volunteer at a free community clinic. A 13-year-old girl presents with chlamydia. The team leader at the clinic advises that:

care can be provided as long as consent is voluntary and information about treatment and options is provided.

Aspects that contribute to a culture of safety in a health care organization include

communication.

A nurse educator is giving a workshop on conflict. During the sessions, he makes various statements regarding conflict. All of the statements are true except:

conflict can decrease creativity, thus acting as a deterrent for the development of new ideas.

One of your staff nurses asks for your advice because a patient refuses to sign a consent for surgery. The patient says that he won't sign because he doesn't understand the nature of the surgery. You advise that:

consent must not be coerced. witnessing a consent is related only to the voluntary nature of the signature. the patient has a right to choose not to consent.

Sarah is a nurse manager in a surgical unit. She is concerned about a conflict between Lucy (a staff nurse) and one of the maintenance personnel. Sarah explains to Lucy that unsatisfactory resolution of the conflict is typically destructive and will result in:

decreased productivity on her part.

While walking past a patient's room, you overhear one of the RN staff telling a patient that the patient has no right to refuse chemotherapy treatment because the family and the doctor think the treatment is the best option for the patient. This patient is 40 years of age and alert. When you meet later to discuss what you heard with the RN, it is important to:

discuss that statute law provides for patient autonomy and refusal of treatment.

The chief nursing officer plans a series of staff development workshops for the nurse managers to help them deal with conflicts. The first workshop introduces the four stages of conflict, which are:

frustration, conceptualization, action, and outcomes.

The mediator suggested to the unit staff that a group agreement needed to be made so meetings could become productive. For example, the group agreement, "We will speak supportively," prevents:

gossip and making negative comments about absent team members.

As part of a going-away party for a nurse, photos are taken of colleagues around the unit. A patient is accidentally included in one photo and no consent was obtained. This is an example of:

invasion of privacy

A member of a patient's family calls the nurse manager of the palliative care unit to express concern that a member of the family, who died on the weekend, had requested analgesics from the RNs on duty. An RN came with the analgesic nearly 45 minutes later, just after the patient had died. The manager is aware that the unit was especially busy that weekend because many patients were seriously ill, staff had called in ill, and the staffing manager was unable to completely replace staff who were absent. The manager is deeply troubled that the family member had to die in pain because it violates what she knows should have been done. This manager is experiencing:

moral distress.

Two staff nurses are arguing about whose turn it is to work on the upcoming holiday. In trying to resolve this conflict, the nurse manager understands that interpersonal conflict arises when:

people see events differently

A sentinel event refers to an event that:

signals the need for immediate investigation and response.

The nurse learns in report that the patient in room 223, Mr. X, has no insurance and entered the country illegally. The nurse provides high-quality care to the other patients to which she is assigned, but is slow to answer Mr. X's call light and is dismissive toward his family. Which nursing value has the nurse violated?

social justice

"I really wish that my supervisor would realize and acknowledge all the things I do well." In nursing, this has been identified as a problem. Which statement is part of the solution? Focus on:

the strengths of the individual rather than the weaknesses.

The mediator noticed that tension was still evident between the nurse manager and staff members. He informed the chief nursing officer that to begin team building, it would be important that everyone:

work together in a respectful, civil manner.