EXAM 2 Leadership 2024

Match the cultural term with the definition. Belief that one's culture is the best way to believe Classification based on common traits of a group Description of differences among groups Feeling of being between cultures but not belonging to either Ethnocentrism Ethnicity Cultural diversity Cultural marginality

Ethnocentrism- Belief that one's culture is the best way to believe Ethnicity- Classification based on common traits of a group Cultural diversity- Description of differences among groups Cultural marginality- Feeling of being between cultures but not belonging to either

Match the type of conflict with its description. Happens when acting in a way that is at odds with one's sense of self Arises due to policies and procedures, codes of conduct, and behavior norms Occurs due to differences of opinion, priority, or approach with others Interpersonal conflict Organizational conflict Intrapersonal conflict

Interpersonal conflict- Occurs due to differences of opinion, priority, or approach with others Organizational conflict- Arises due to policies and procedures, codes of conduct, and behavior norms Intrapersonal conflict- Happens when acting in a way that is at odds with one's sense of self

Match the nursing behavior to the cultural description. Born in the Southwest and shares beliefs with people from there Considers non-English speakers to be less intelligent Relocates to a conservative state and begins to change views on abortion Values the contributions of American Indian nurses within the team Multiculturalism Prejudice Socialization Assimilation

Multiculturalism- Values the contributions of American Indian nurses within the team Prejudice- Considers non-English speakers to be less intelligent Socialization- Born in the Southwest and shares beliefs with people from there Assimilation- Relocates to a conservative state and begins to change views on abortion

Which philosophy of the nursing team enhances cultural humility? a. "Culture will not stop changing, so we must keep learning or our knowledge will be outdated." b. "When we master understanding of one culture, we must shift focus to another one." c. "Our knowledge lets us tell the patient what is best for their treatment." d. "If we improve the cultural competency of a few nurses, it will allow the team to achieve our culture goals."

a. "Culture will not stop changing, so we must keep learning or our knowledge will be outdated." This belief strengthens cultural humility since lifelong learning will be required to keep up with the constant changes.

Which statement by the research patient (participant) confirms proper informed consent was obtained? Select all that apply. One, some, or all responses may be correct. a. "I'm not comfortable with the side effects, so I'm going to use my right to drop out of the trial." b. "A blind trial means I am not allowed to know what you are investigating." c. "If I didn't participate in this trial, my only other option was to have surgery." d. "That really hurts, but I knew what I was getting into, so keep going."

a. "I'm not comfortable with the side effects, so I'm going to use my right to drop out of the trial." c. "If I didn't participate in this trial, my only other option was to have surgery." d. "That really hurts, but I knew what I was getting into, so keep going."

During a conversation for an informed consent, which physician's statement should occur? Select all that apply. One, some, or all responses may be correct. a. "If we do not do the procedure, we may be able to manage your condition with medication, but it is only effective 25% of the time." b. "The plan is to perform a laparoscopic cholecystectomy, but we will do more depending on what we find." c. "The procedure will likely be performed by me but will be done by one of my partners if I am not available." d. "The risks include bleeding, pain, and potentially death." e. "If at any point you change your mind, simply tell us and we will make a different plan."

a. "If we do not do the procedure, we may be able to manage your condition with medication, but it is only effective 25% of the time." d. "The risks include bleeding, pain, and potentially death." The exact procedure to be performed is part of informed consent, but specific alternatives such as possible open laparotomy must be clearly defined. The provider performing the procedure must be identified during the consent process, and any changes require a new consent.

Which patient scenario would likely cause a nurse to experience an ethical conflict? a. A 74-year-old patient with a stroke refuses rehab and exercises their right to return home with their bedbound spouse. b. A 53-year-old patient with advanced cancer refuses aggressive treatment. c. A 96-year-old who has been unresponsive for a week has a physician order to remove the ventilator. d. A 21-year-old develops pancreatitis due to consuming excessive alcohol after 2 years of sobriety.

a. A 74-year-old patient with a stroke refuses rehab and exercises their right to return home with their bedbound spouse. The nurse may have concerns over the refusal of care along with the potential quality of care issues that result from 2 debilitated patients being alone in the home.

Which example of documentation indicates the potential for systemic racism? Select all that apply. One, some, or all responses may be correct. a. African American nurses hold less than 5% of leadership roles at a facility b. Hispanic patients are assigned to semi-private rooms, while White patients are placed in private rooms c. The word "noncompliant" is present in 75% of Black patients' charts compared with 30% of White patients' charts d. Hispanic patient's chart reads "per police gunshot wound is likely gang-related" e. The term "morbidly obese" is used in discharge diagnoses of 30% of White patients and 32% of patients of color

a. African American nurses hold less than 5% of leadership roles at a facility b. Hispanic patients are assigned to semi-private rooms, while White patients are placed in private rooms c. The word "noncompliant" is present in 75% of Black patients' charts compared with 30% of White patients' charts

Which action of the team promotes cultural sensitivity? Select all that apply. One, some, or all responses may be correct. a. Asking if new hires have preferences for some holidays over others b. Notifying the manager if a new nurse is not culturally compatible c. Highlighting team members with similar backgrounds to new employees d. Encouraging each other to recognize nonverbal cues around diversity e. Celebrating stories of culturally specific patient care

a. Asking if new hires have preferences for some holidays over others c. Highlighting team members with similar backgrounds to new employees d. Encouraging each other to recognize nonverbal cues around diversity e. Celebrating stories of culturally specific patient care

An experienced licensed vocational nurse (LVN) is working under the supervision of the registered nurse (RN). The LPN is providing nursing care for a patient who has a respiratory problem. Which activities should the RN delegate to the experienced LVN? Select all that apply. a. Auscultate breath sounds. b. Administer medications via metered-dose inhaler (MDI). c. Evaluate the patient's technique for using MDIs. d. Complete an in-depth admission assessment. e. Initiate the nursing care plan.

a. Auscultate breath sounds. b. Administer medications via metered-dose inhaler (MDI). Independently completing the admission assessment is within the scope of practice of the RN. Initiating the nursing care plan is within the scope of the RN. Evaluating a patient's abilities requires additional education and skills. These are actions within the scope of the RN.

An effective leader will have: Select all that apply. a. Courage and integrity b. The ability to set priorities c. A critical mind- set d. The ability to provide feedback

a. Courage and integrity b. The ability to set priorities c. A critical mind- set d. The ability to provide feedback

Autocratic leaders: a. Give orders and make decisions without consulting the team b. Share leadership with members of the team c. Postpone decision making as long as possible d. Encourage creativity when problem solving

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

Which aspects can lead to conflicts between nurses and other types of healthcare professionals? Select all that apply. One, some, or all responses may be correct. a. Inconsistent language. b. Differences in training. c. Stressful work environment. d. Overlapping areas of patient care. e. Power imbalance.

a. Inconsistent language. b. Differences in training. c. Stressful work environment. d. Overlapping areas of patient care. e. Power imbalance.

A democratic leader consistently works to: a. Share leadership with the group. b. Make little or not attempt to move the group. c. Move the group toward the leader's goals. d. Dampen creativity.

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

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

a. Suggest that the patient's oxygen be humidified.

A registered nurse (RN) is obtaining a signature on a surgical informed consent document. Before obtaining the signature, the RN must ensure which of the following? Select all that apply. a. The patient understands the risks of the procedure. b. A family member is a witness. c. The client is not sedated. d. The patient understands the procedure.

a. The patient understands the risks of the procedure. c. The client is not sedated. d. The patient understands the procedure. The physician needs to provide the information so that the patient is fully informed; the nurse may obtain signature but needs to ensure that the patient is aware and understands.

Which statement describes the overarching goal of culturally specific nursing organizations? Select all that apply. One, some, or all responses may be correct. a. They champion diversity within the nursing workforce. b. They encourage the promotion of non-White nurses. c. They determine benchmarks for minority nursing hires. d. They ensure that minority nurses are held to the same expectations as other nurses. e. They promote the image of minority nurses in the media.

a. They champion diversity within the nursing workforce. d. They ensure that minority nurses are held to the same expectations as other nurses. e. They promote the image of minority nurses in the media.

A nurse is caring for a patient who has a pulmonary embolus. The patient is receiving anti- coagulation with IV heparin. What instructions should the nurse give the nursing assistant who will help the patient with activities of daily living. Select all that apply. a. Use an electric razor when shaving the patient each day. b. Use a rectal thermometer to obtain a more accurate body temperature. c. Be sure the patient's footwear has a non-slip sole when the patient ambulates. d. Use a lift sheet when moving and positioning the patient in bed. e. Use a soft-bristled toothbrush or tooth sponge for oral care.

a. Use an electric razor when shaving the patient each day. c. Be sure the patient's footwear has a non-slip sole when the patient ambulates. d. Use a lift sheet when moving and positioning the patient in bed. e. Use a soft-bristled toothbrush or tooth sponge for oral care.

Which question would be appropriate to be added to the admission assessment to promote LGBTQ+ inclusion? a. What sex were you at birth? b. How long have you been gay? c. Did you receive counseling for your gender? d. Do you like men or women?

a. What sex were you at birth? This question is objective and necessary for providing care, so it would be appropriate to add to it to the assessment.

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

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

Which common practice puts the nurse at liability for invasion of patient privacy? a. Confidential information regarding an admitted patient is released to third-party payers as signed in the admission forms. b. During care, the nurse reveals information about the patient to those in the room. c. The nurse releases information about the patient to the nursing students who will be caring for the patient the next day. d. The nurse conducts a patient care session about a patient whose care is difficult and challenging.

b. During care, the nurse reveals information about the patient to those in the room. Giving out information about a patient without permission is an invasion of privacy.

Effective nurse leaders: Select all that apply. a. Never act on their ideas b. Effectively work together with shared goals c. Are also good followers d. Have a master's degree

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

Which approach by the manager is best to promote culturally sensitive care for LGBTQ+ patients? a. Assigning LGBTQ+ staff to care for LGBTQ+ patients b. Ensuring that assessment forms include gender identity c. Avoiding assigning nurses who are uncomfortable with LGBTQ+ patients d. Standardizing gender assessment to use sex assigned at birth

b. Ensuring that assessment forms include gender identity

Which consideration would be included in an ethical decision-making framework? Select all that apply. One, some, or all responses may be correct. a. Nurse's opinion b. Ethics committee's opinion c. Requirements of the law d. Goals of care e. Nurse practice activities f. Patient's wishes

b. Ethics committee's opinion c. Requirements of the law d. Goals of care e. Nurse practice activities f. Patient's wishes

Which outcome is associated with unresolved conflict in a healthcare organization? a. Better communication. b. Increased absenteeism. c. Improved patient satisfaction. d. Enhanced productivity.

b. Increased absenteeism. Employee frustration and burnout are associated with unresolved conflict. This can lead to increased employee absenteeism and turnover, which ultimately affects the quality of patient care.

A family is keeping vigil at a critically ill patient's bedside. Distant family members call the unit continuously asking for updates and expressing concern. The nurse speaks with the distant family members and states she is referring them to the hospital social worker, whose role is to work with the family in this situation. What role is the nurse assuming through this action? a. Leader. b. Manager. c. Follower. d. Recorder.

b. Manager.

Which scenario is an example of respondeat superior? a. The nurse from the evening shift asks the manager to explain a policy. b. Nurses routinely skip scanning barcoded medications for convenience. c. The manager grants excessive vacation time, creating an unsafe staffing situation. d. The staff nurse on night shift willingly disregards a policy.

b. Nurses routinely skip scanning barcoded medications for convenience. A pattern of behavior that violates standard of care makes the employer accountable since they have not intervened to address the issue under the doctrine of respondeat superior.

Which intervention by the manager is most likely to improve nurse-physician communication? a. Telling nurses not to be afraid of calling a physician b. Providing training on assertive techniques to nurses c. Filing incident reports for any negative interaction d. Meeting with physicians and encouraging better communication

b. Providing training on assertive techniques to nurses

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

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

A nurse is helping a nursing assistant provide a bed bath to a comatose patient who is incontinent. Which of the following actions require the nurse to intervene? a. The nursing assistant log-rolls the client to provide back care. b. The nursing assistant answers the phone while wearing gloves. c. The nursing assistant positions the client on the left side, head elevated. d. The nursing assistant places the incontinence diaper under the client.

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

An emotionally intelligent nurse leader: a. Cannot juggle multiple demands. b. Welcomes constructive criticism. c. Works alone without help. d. Seeks the emotional support of others.

b. Welcomes constructive criticism. Emotionally intelligent leaders understand and manage their own emotions.Emotionally intelligent leaders are able to juggle multiple demands.Emotionally intelligent leaders actively work with members of their team rather than alone.

Which occurrence has improved minority bedside nurses' networking opportunities? a. Minority nurses assuming academic roles b. Employment of international nurses and physicians c. An increase in diversity-related nursing organizations d. Increased chance of two similar minorities working on a unit

c. An increase in diversity-related nursing organizations Diversity-related professional organizations such as the Transcultural Nursing Society have increased in number and given networking opportunities to underrepresented groups.

The manager of a unit is finding it difficult to work with a new graduate nurse. The new nurse has many ideas; however, his manner of presenting them irritates the manager. After reflection and discussion with others, the manager recognizes that she feels threatened by his behavior. She comes to understand that the new nurse is trying to establish his own role on the unit; is not trying to challenge her; and needs guidance, coaching, and affirmation. What is the nurse manager demonstrating in this situation? a. Leadership. b. Acquiescence. c. Deepening self- awareness. d. A positive self-concept.

c. Deepening self- awareness.

A registered nurse (RN) new to the emergency department, documented that "the patient was intoxicated and acted in a crazy manner." The team leader to the RN that this type of documentation can lead to: a. Assault b. Slander c. Defamation of character d. Wrongful publication

c. Defamation of character Charting or saying unsupported defamatory statements can lead to tort litigation.

Transformational nursing leaders have the ability to: a. Pay close attention to the weaknesses and shortcomings of others. b. Work best alone. c. Define the group's mission and communicate that mission to others. d. Increase the negativity of the team.

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

A family is keeping vigil at a critically ill patient's bedside. The nurse approaches the unit manager with concern over the family dynamics for the patient concerned there are patient- family conflicts based on patient's wishes. The nurse suggests that the patient's provider may need to discuss the treatment plan with the family. The unit manager states he will arrange a discussion with the patient's provider and ask the nurse to support the provider's decisions. What is the role of the nurse in this situation? a. Management. b. Evidence-based. c. Followers d. Leadership

c. Followers

Which strategy would be effective in creating diversity in nursing? a. Forming dedicated teams to address culture b. Placing patients of similar cultures on the same units c. Hiring nurses from a variety of backgrounds d. Training for each common culture encountered

c. Hiring nurses from a variety of backgrounds

A unit team leader who fails to provide direction to his or her nursing care team is a(n): a. Democratic leader. b. Autocratic leader. c. Laissez-faire leader. d. Situational leader.

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

Chart audits have revealed significant omissions of data that could have legal and financial ramifications. The unit manager meets with the staff to discuss audit findings and to find approaches that will address the gaps in charting and achieve the desired goals. What is the manager demonstrating? a. Decision making. b. Vision. c. Management. d. Leadership.

c. Management.

The patient with COPD has a nursing diagnosis of Ineffective Breathing Pattern. Which is an appropriate action to delegate to the experienced licensed vocational nurse (LVN) under the registered nurses' supervision? a. Plan a nursing care regimen that gradually increases activity intolerance. b. Consult with the physical therapy department about reconditioning exercises. c. Observe how well the patient performs pursed-lip breathing. d. Assist the patient with basic activities of daily living.

c. Observe how well the patient performs pursed-lip breathing. Experienced LVNs can use observation of patients to gather data regarding how well patients perform intervention that have already been taught.

Which approach is effective at improving teamwork and communication among two departments in conflict with each other? a. Attend leadership conferences. b. Providing staff incivility training. c. Promoting structured cross- training. d. Minimizing interactions.

c. Promoting structured cross- training. Structured shadowing and cross-training experiences across departments can help to improve teamwork and communication. This also can improve the quality of care. Nurse leaders can proactively set up these experiences in anticipation of conflict.

A charge nurse on a busy 40-bed medical/surgical unit is approached by a family member who begins to complain loudly about the quality of care his mother is receiving. His behavior is so disruptive that it is overheard by staff, physicians, and other visitors. The family member leaves the unit abruptly, and the nurse is left feeling frustrated. Which behavior by the charge nurse best illustrates refined leadership skills in an emotionally intelligent practitioner. a. Discuss the concern with the patient after the family member has left. b. Notify nursing administration of the situation. c. Reflect to gain insight into how the situation could be handled differently in the future. d. Try to catch up with the angry family member to resolve the concern.

c. Reflect to gain insight into how the situation could be handled differently in the future.

A respiratory therapist performs suctioning on a patient with a closed head injury who has a tracheostomy. Afterward, the nursing assistant obtains vital signs. The nurse should communicate that the nursing assistant needs to report which vital sign value or values immediately? Select all that apply. a. Respiratory rate of 24 breaths/min b. Pulse oximetry of 95% c. Tympanic temperature of 101.4F (38.6C) d. Heart rate of 96 beats/min

c. Tympanic temperature of 101.4F (38.6C) Suctioning will increase heart rate. This needs needs reporting and reassessment and may be related to the increased temperature. Respiratory rate is often increased with a fever. Pulse oximetry of 95% is acceptable.

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

d. A 58-year-old on airborne precautions for tuberculosis (TB). Many surgical patients are taught about coughing, deep breathing, and the use of incentive spirometry preoperatively.

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

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

For which scenario would the nurse be considered to have a duty toward the patient? a. Stopping to assist a victim of a car accident b. Seeing a person go into cardiac arrest at a park c. Assisting a visitor to walk to the cafeteria d. Finding a vulnerable patient alone during a home visit

d. Finding a vulnerable patient alone during a home visit

The manager calls the staff together to assess a situation in which the family of a seriously ill patient is anxious and is absorbing a great deal of staff time in consultation, discussion, and questioning of treatment decisions. Staff members are becoming distanced from the family. After inviting the concerns of staff, the manager explains that the organization values patient- centered care and that evidence supports that acting as an advocate and a listener is helpful to families. The manager asks the staff for ideas and strategies that are effectively patient- centered in dealing with families in similar situations. What is the role of the nurse manager in this situation? a. Follower. b. Management. c. Visionary. d. Leadership

d. Leadership

Which intervention would be appropriate for a nurse who has religious objections to removing life support? a. Telling the nurse to carry out the order and seek counseling to work through their concerns b. Consulting the ethics committee to evaluate the objection c. Postponing withdrawing life support until the next shift d. Listening to the concerns and asking the nurse if they can care for the patient

d. Listening to the concerns and asking the nurse if they can care for the patient Listening to the nurse's concerns and asking them if they can care for the patient would be appropriate since it gives the nurse a chance to explain their feelings and empowers them to choose.

To ensure adequate staffing, which example of a nurse assignment would be the most appropriate? a. A labor and delivery nurse being floated to the medical-surgical floor b. Assigning an intensive care nurse to the medical-surgical floor c. Reassigning an emergency room nurse to the medical-surgical floor d. Notifying the float pool nurse to report to the medical-surgical floor

d. Notifying the float pool nurse to report to the medical-surgical floor Because float pool nurses are trained to float within a facility, they would be the most appropriate to send to the medical surgical floor.

Effective followers are those who are: a. Less valuable employees b. Skilled and self-directed employees c. Employees who are never supportive of new ideas d. Passive employees

d. Passive employees Effective follower are actively involved in the work of the team. Effective followers are very valuable employees. Although they cannot be expected to support every new idea, effective followers support constructive new ideas.