Leadership Midterm
While organizing a community healthcare program for polio vaccinations, the registered nurse delegates the task of administering vaccines to the members of the healthcare team. Who among the healthcare team is most suitable to carry out the task? Technician Patient care associate Certified nursing aide Licensed practical nurse
LPN
6) A mediator suggests that the nurse manager and the other staff decide on a strategy to resolve conflicts. It is important to have agreements about how team members will work together because: a) If there are no agreements, each team member will make up his or her own procedures without a general agreement. b) The team members are naturally difficult and will not work well together without the agreements. c) The team members will naturally ask for agreements about how to be together. d) A way to eliminate ineffective team members must be available
a
7) The team leader is successful when working with team members. Which action is most likely to be characteristic of this leader? a. Dictating to other members on a day-to-day regime b. Filling in for regular staff during times of need c. Scheduling staff with few changes d. Providing rigid criteria to keep the team on task
b
A charge nurse notifies a nursing staff that they need to float to the ICU. The nursing staff states, "I've never worked in the ICU before, I don't want to start today." The charge nurse informs the staff nurse that the ICU is very short staffed and need someone and it is the staff nurses turn to float. The charge nurse walks away, and the staff nurse continues on with there tasks and acts like the conversation with the charge nurse never happened. What type of strategy did the staff nurse use? A. Avoidance B. Accommodating C. Smoothing D. Negotiating
A
A medical-surgical unit reports higher rates of patient satisfaction coupled with high rates of staff satisfaction and productivity. Which of the following is attributed to the data findings: a) Effective leadership b) Management involvement c) Mentoring d) Rewards and recognition
A
An intoxicated client comes into the emergency unit with uncooperative behavior, mild confusion, and slurred speech. The client is unable to provide a good history but he verbalizes that he has been drinking a lot. Which of the following is a priority action of the nurse? A.Administer IV fluid incorporated with vitamin B1 as ordered B. Administer Naloxone (Narcan) 4mg as ordered C. Contact the family to get information about the client D. Obtain an order for the determination of blood alcohol level
A
Effective leadership is an integrated blend of leadership principles and characteristics with management principles and techniques. Principles of leadership and management are best described by which of the following statements? A)Critical skills in leadership are interpersonal, decision making, and problem finding and solving B) Important skills for leading include diagnosing, adapting, and directing C) Followership is a process whereby leaders participate in group decisions D) Empowerment is the ability to lead a group successfully
A
In conducting a primary survey on a trauma patient, which of the following is considered one of the priority elements of the primary survey? a. Brief neurologic assessment b. Client's allergy history c. Initiation of pulse oximetry d. Complete set of vital signs
A
The nurse calls the health care provider (HCP) regarding a new medication prescription because the dosage prescribed is higher than the recommended dosage. The nurse is unable to locate the HCP, and the medication is due to administered. Which action should the nurse take? A. Contact the nursing supervisor B. Administer the dose prescribed C. Hold the medication until the HCP can be contacted D. Administer the recommended dose until the HCP can be located
A
The nurse has just assisted a client back to bed after a fall. The nurse and health care provider have assessed the client and have determined that the client is not injured. After completing the incident report, the nurse should implement which action next? a. Reassess the client b. Conduct a staff meeting to describe the fall c. Document in the nurse's notes that an incident report was completed. d. Contact the nursing supervisor to update information regarding the fall
A
The nurse in the ER is notified by EMS that several victims who survived a plane crash will be transported to the hospital. Victims are suffering from cold exposure because the plane plummeted and was submerged in a river. What is the initial action of the nurse? a. Call the nursing supervisor to activate the agency disaster plan. b. Supply the triage rooms with bottles of sterile water and normal saline. c.. Call the intensive care unit to request that nurses be sent to the emergency department. d. Call the laundry department, and ask the department to send as many warm blankets as possible to the emergency department.
A
The postoperative patient with anterior cervical laminectomy is complaining of tightness in his throat. His voice is raspy. The staff nurse asks the unit secretary to page the healthcare provider stat. This is an example of _____ leadership. a) Authoritarian b) Democratic c) Laissez-faire d) Servant
A
These activities are included in the care plan for a 78-year-old patient admitted to the hospital with anemia caused by possible gastrointestinal bleeding. Which activity can you delegate to an experienced UAP? A. Obtaining stool specimens for fecal blood test (Hemoccult) slides B. Having the patient sign a colonoscopy consent form C. Giving the prescribed polyethylene glycol electrolyte solution (GoLYTELY) D. Checking for allergies to contrast dye or shellfish
A
The nurse manager is studying ways to improve communication skills. Which factors can have a negative effect on successful communication? SELECT ALL THAT APPLY a) Overusing reassuring statements b) Using nonverbal feedback c) Using selective listening d) Making quick inferences
A C D
Which of the following traits describe a transactional leader? (Select all that apply.) A) Functions in a caregiver role. B)Surveys their followers' needs and sets goals for them. C) Uses charisma to produce greater effort in followers D)Focuses on the maintenance and management of ongoing and routine work. E) Motivates followers to perform to their full potential.
A,B,D
Which of the following behaviors build trust between leaders and employees in an organization? (Select all that apply.) a) Sharing relevant information b) Encouraging competition via winners and losers c) Reducing controls d) Meeting expectations e) Avoiding discussion of sensitive issues
A,C,D
Emergency medical services (EMS) brings a large number of clients to the emergency department following a mass casualty incident. The nurse identifies the clients with which injuries with yellow tags? (Select all that apply) a. Partial-thickness burns covering both legs b. Open fractures of both legs with absent pedal pulses c. Neck injury and numbness of both legs d. Small pieces of shrapnel embedded in both eyes e. Head injury and difficult to arouse f. Bruising and pain in the right lower abdomen
A,C,D,F
The health care provider prescribes these actions for a client who was admitted with acute substernal chest pain. Which actions are appropriate to delegate to an experienced LPN who is working with you in the ED? (Select all that apply.) a. Attaching cardiac monitor leads b. Giving heparin 5000 units IV push c. Administering morphine sulfate 4 mg IV d. Obtaining a 12-lead electrocardiogram (ECG) e. Asking the client about pertinent medical history f. Having the client chew and swallow aspirin 162 mg
A,D,F
The nurse finds that an 80-year-old client's family is not caring for the client properly. Which action of the nurse indicates leadership quality? A.) Advocating on behalf of the patient B.) Discussing the client's problem with the other nurse C.) Arranging a permanent accommodation in the hospital D.) Suggesting the family join the client in a long-term healthcare facility
A.) Advocating on behalf of the patient
The nurse is reviewing the roles and responsibilities of different levels of health care providers (HCPs) on the unit when considering tasks that can be delegated. What specific action or responsibility is included in the nurse manager role? A.) Develop unit budget B.) Assist a client using walker C.) Draw blood through a central line D.) Assess and document heart and lung sounds
A.) Develop unit budget
A nurse leader is setting priorities for achieving success by using the simplest and fastest method of communication. Which rules and responsibilities does the nurse fulfill by this action? A.) Maintaining balance B.) Building self-confidence C.) Generating self-motivation D.) Maintaining a positive attitude
A.) Maintaining balance
4. Which of the following is the best strategy to use in resolving conflict between two staff nurses who requested the same time off for vacation? A.Accommodation B.Collaboration C.Competition D.Avoidance
B
A client admitted to the hospital with a diagnosis of cirrhosis has massive ascites and difficulty breathing. The nurse performs which intervention as a priority measure to assist the client with breathing? a. Repositions side to side every 2 hours b. Elevates the head of the bed 60 degrees c. Auscultates the lung field every 4 hours d. Encourages deep breathing exercises every 2 hours
B
A client with a history of suicide attempts is admitted to the mental health unit with the diagnosis of depression. Upon the client's arrival, the client's therapist reports to the nurse that the clients telephoned the therapist earlier in the evening and reported having a overwhelming suicidal thoughts. Keeping this information in mind, the priority of the nurse is to assess for: a. Interaction with peers b. The presence of suicidal thoughts c. The amount of food intake for the past 24 hours d. Information regarding the past medication regimen
B
A nurse is triaging a group of clients following a disaster. Which of the following clients should the nurse recommend for treatment first? a. A client who has a neck injury and is unable to breathe spontaneously b. A client who has two open chest wounds with a left tracheal deviation c. A client who has major burns over 75% of her body surface area d. A client who has bipolar disorder and is exhibiting signs of hallucination (Class 3)
B
A nurse manager in a long term care facility threatens to fire subordinates who refuse to work overtime when needed. This manager is displaying what type of power. A.Informational power B.Coercive Power C.Referent Power D.Expert Power
B
A staff nurse makes a negative comment about a unit manager's leadership style, and the unit manager overhears the staff nurse. Which action by the unit manager would be appropriate? A.Propose a tentative solution regarding the comments, and discuss it with the staff nurse B.Encourage the staff nurse to discuss the comments C.Tell the staff nurse to stop making the comments D.Persuade the staff nurse to stop being so critical
B
A very young nurse has been promoted to nurse manager of a complex medical care unit. The nurse is concerned that older nurses may not respect the manager's authority because of the age difference. How can this nurse manager best exercise authority? A. Use critical thinking to solve problems on the unit. B.. Give assignments clearly, taking staff expertise into consideration. C. Understand complex health care environments. D. Maintain an autocratic approach to influence results.
B
When care assignments are being made for patients with alterations related to gastrointestinal cancer, which patient would be most appropriate to assign to an LPN under supervision of a team leader RN? a. A patient with severe anemia secondary to GI bleeding b. A patient who needs enemas and antibiotics to control GI bleeding c. A patient who needs preoperative teaching for bowel resection surgery d. A patient who needs central line insertion for chemotherapy
B
Which of the following is true of management activities: a) Inspiring a vision is a management function. b) Management is focused on task accomplishment. c) Management is more focused on human relationships. d) Management is more important than leadership.
B
Relationship management is a key leadership skill because: A) Being liked by staff makes it easier to get things done. B) Patient care requires a high degree of interdependence on other care providers. C) Transferring negative moods to staff can decrease productivity. D). Helping staff cope with change is important.
B) Patient care requires a high degree of interdependence on other care providers.
During a staff meeting, a group of RNs has complained that medications are not arriving to the unit in a timely manner. The nurse manager suggests that the group resolve this issue through the development and work of a multidisciplinary team led by one of these RNs. This scenario demonstrates: a) adaptation. b) empowerment c) flexibility d) relationship management.
B) empowerment. - the nurse leader is giving authority (empowering) the group of RNs to resolve the issue
The nurse in charge of a nursing unit is asked to select the hospitalized clients who can be discharged so that hospital beds can be made available for victims of a community disaster. Which clients can be safely discharged? Select all that apply. a. A client with chest pain b. A client with a Holter monitor c. A client receiving oral antibiotics d. A client experiencing sinus rhythm e. A client newly diagnosed with atrial fibrillation
B,C,D
The nurse has made an error in documentation of the dose administered of an opioid pain medication in the client's record. The nurse draws 1 mg from the vial and another registered nurse (RN) witnesses wasting of the remaining 1 mg. When scanning the medication, the nurse entered into the medication administration record (MAR) that 2 mg of hydromorphone was administered instead of the actual dose administered, which was 1 mg. The nurse should take which action(s) to correct the error in the MAR? Select all that apply. a. Complete and file an occurrence report. b. Right-click on the entry and modify it to reflect the correct information. c. Document the correct information and end with the nurse's signature and title. d. Obtain a cosignature from the RN who witnessed the waste of the remaining 1 mg. e. Document in a nurse's note in the client's record detailing the corrected information.
B,C,D,E
Which of the following definitions apply to management? (Select all that apply.) A). It is a process of inspiring people to accomplish goals through support and confidence building B) It is the process of coordination and integration of resources to accomplish specific goals. C) It includes the activities of planning, organizing, coordinating, directing, and controlling. D) It is a process of planning and directing human effort to achieve established objectives. E) It is the directing of the organizations' money, facilities, and supplies to achieve results.
B,C,D,E
Great leaders possess four essential skills identify two statements that describe those skills. (Select all that apply) a) Great leaders possess popularity to establish followers to engage. b) Great leaders possess a sense of integrity with a distinctive and compelling vocal tone to engage others in shared meaning. c) Great leaders are visible, set examples, and share responsibility. d) Great leaders possess a combination of hardiness and the ability to grasp context, called adaptive capacity.
B,D
How should nurses provide effective nursing care to clients from different cultural backgrounds? A.) By advising clients that some cultural practices may be harmful to health. B.) By providing care that fits the clients' cultural beliefs. C.) By strictly adhering to organization policies regarding nursing care. D.) By ignoring the cultural aspect and focusing on the medical aspect of care.
B.) By providing care that fits the clients' cultural beliefs.
What are the qualities of an effective leader? Select all that apply. A.) Born with the right qualities B.) Elicit a vision from people C.) Bring out the best in people D.) Incites discipline and obedience E.) Inspire people to bring the vision into reality
B.) Elicit a vision from people C.) Bring out the best in people E.) Inspire people to bring the vision into reality
. A nurse is caring for an elderly patient who was admitted after sustaining a fall at home. When creating a care plan for the patient, she requests that the doctor order a home health visit to assess for home safety and medication compliance. In addition, the nurse is concerned about the nutrition of the patient and requests a dietitian evaluation. The nurse is demonstrating which of the following leadership skills: a) Care provider b) Business principles c) Care coordination d) Change management
C
4.) Managers may or may not be leaders; however, managers do all of the following EXCEPT: a) Build a culture of teamwork. b)Collaborate and translate direction into action, warning the team of potential barriers to the vision. c)Avoid addressing complexity so that the staff does not worry and change may occur anyway. d) Organize, plan, control, and solve problems.
C
A client is brought to the emergency department by emergency medical services (EMS) after being hit by a car. The name of the client is unknown, and the client has sustained a severe head injury, multiple fractures, and is unconscious. An emergency craniotomy is required. Regarding informed consent for the surgical procedure, which is the best action? a. Obtain a court order for the surgical procedure b. Ask the EMS team to sign the informed consent c. Transport the victim to the operating room for surgery d. Call the police to identify the client and locate the family
C
A client with a diagnosis of sickle cell crisis is being admitted to the hospital. The nurse anticipates that which priority intervention will be prescribed? a. Laboratory studies b. Genetic counseling c. Oxygen administration d. Electrolyte replacement therapy
C
A nurse cares for clients during a community-wide disaster drill. Once of the clients asks, "Why are the individuals with black tags not receiving any care?" How should the nurse respond? a. To do the greatest good for the greatest number of people, it is necessary to sacrifice some. b. Not everyone will survive a disaster, so it is best to identify those people early and move on. c. In a disaster, extensive resources are not used for one person at the expense of many others. d. With black tags, volunteers can identify those who are dying and can give them comfort care.
C
A nurse educator at the local hospital is conducting an orientation sessions for nurses newly employed at the hospital. The nurse educator informs new nurses that the policy of the hospital requires that nurses "float" to other nursing departments when client census is high on other units. The nurse educator advises the nurses that if the situation arises and the nurse is unfamiliar with the unit in which the nurse must float to do which of the following: A. Refuse to float B. Call the nurse educator C. Report to the unit and identify tasks that can be safely performed within your scope of practice D.Call the nurse supervisor
C
A patient with a diagnosis of sleep apnea has a problem with sleep deprivation related to a disrupted sleep cycle. Which action should the nurse delegate to the unlicensed assistive personnel (UAP)? a. Discussing weight-loss strategies such as diet and exercise with the patient b. Teaching the patient how to set up the bilevel positive airway pressure (BiPAP) machine before sleeping c. Reminding the patient to sleep on his side instead of his back d. Administering modafinil to promote daytime wakefulness
C
In an effort to improve glycemic control of hospitalized patients, a hospital puts together a team of doctors, nurse managers, nurses, and pharmacists. The goal of the group is to implement a standardized glycemic management protocol to be used throughout the hospital. This type of a team is an example of a: a. Primary work team b. Leadership team c. Ad hoc team d. Dysfunctional team
C
Leadership is best defined as: a) an interpersonal process of participating by encouraging fellowship. b) delegation of authority and responsibility and the coordination of activities. c) inspiring people to accomplish goals through support and confidence building. d) the integration of resources through planning, organizing, and directing.
C
Nurses agree to be advocates for their patients. Practice of advocacy calls for the nurse to: a. Seek out the nursing supervisor in conflicting situations b. Work to understand the law as it applies to the client's clinical condition c. Assess the client's point of view and prepare to articulate this point of view d. Document all clinical changes in the medical record in a timely manner
C
The nurse from a medical unit is called to assist with care for clients coming into the hospital emergency department during an external disaster. Using principles of triage during a disaster, the nurse should attend to the client with which problem first? A. Fractured tibia B. Penetrating abdominal injury C. Bright red bleeding from a neck wound D. Open massive head injury in deep coma
C
The nurse manager calls a meeting of unit staff members to discuss ways to improve the timeliness of patient discharge. The nurse manager and group decide that the use of an admit/discharge nurse would help improve patient flow. This is an example of what kind of decision procedure? a. Autocratic b. Consultative c. Joint d. Delegated
C
The nurse who works on the night shift enters the medication room and finds a co-worker with a tourniquet wrapped around the upper arm. The co-worker is about to insert a needle, attached to a syringe containing clear liquid, in the antecubital area. Which is the most appropriate action by the nurse? A.)Call the Police B.) Call Security C.) Call the Nursing Supervisor D.) Lock the coworker in the med-room until help is obtains
C
The RN is caring for a client with tuberculosis who is on airborne isolation precautions. The RN can delegate which tasks to the UAP? Select all that apply. a. Alert the x-ray department about the airborne isolation precautions. b. Explain to the patient why they must wear a mask during transport to another department. c. Post signs for airborne isolation precautions on the patient's door and stock the equipment necessary. d. Remind visitors to wear a respirator mask and to keep the door closed while in the patient's room. e. Talk to the family about the reasons for airborne precautions.
C,D
5.) A nursing instructor delivers a lecture to nursing students regarding the topic of client rights and asks a nursing student to identify a situation that represents invasion of client privacy. Which situation indicates an understanding of a violation of this client right? a) Performing a procedure without consent b) Threatening to give a client a medication c) Telling the client that he or she cannot leave the hospital d) Observing care provided to the client without the client's permission
D
A client arrives at the ED after suffering multiple injuries from a head-on car collision. Which of the following assessment should take the highest priority to take? a. Unequal pupils b. Irregular pulse c. Ecchymosis in the flank area d. A deviated trachea
D
A nurse is field-triaging clients after an industrial accident. Which client condition should the nurse triage with a red tag? a. Dislocated right hip and an open fracture of the right lower leg b. Large contusion to the forehead and a bloody nose c. Closed fracture of the right clavicle and arm numbness d. Multiple fractured ribs and shortness of breath
D
A nurse is field-triaging clients after and industrial accident. Which client condition should the nurse triage with a red tag? a. Dislocated right hip and an open fracture of the right lower leg. b. Large contusion to the forehead and a bloody nose c. Closed fracture of the right clavicle and arm numbness d. Multiple fractures ribs and shortness of breath
D
After a change of shift, you are assigned to care for the following patients. Which patient should you assess first? a. A 60-year old patient on a ventilator for whom a sterile sputum specimen must be sent to the lab b. A 55-year old with COPD and a pulse oximetry reading from the previous shift of 90% saturation c. A 70-year old with pneumonia who needs to be started on IV antibiotics d. A 50-year old with asthma who complains of shortness of breath after using a bronchodilator
D
An 87-year-old woman is brought to the emergency department for treatment of a fractured arm. On assessment, the nurse notes old and new ecchymotic areas on the client's chest and legs and asks the client how the bruises were sustained. The client, although reluctant, tells the nurse in confidence that her son frequently hits her if supper is not prepared on time when he arrives home from work. What is the most appropriate nursing response? a. "Oh really I will discuss this situation with your son" b. "Let's talk about the ways you can manage your time to prevent this from happening" c. "Do you have any friends that can help you out until you resolve these important issues with your son?" d. "As a nurse, I am legally bound to report abuse. I will stay with you while you give the report and help find a safe place for you to stay.
D
An emergency department (ED) charge nurse prepares to receive clients from a mass casualty within the community. What is the role of this nurse during the event? a. Ask ED staff to discharge clients from the medical-surgical units in order to make room for critically injured victims. b. Call additional medical-surgical and critical care nursing staff to come to the hospital to assist when victims are brought in. c. Inform the incident commander at the mass casualty scene about how many victims may be handled by the ED. d. Direct medical-surgical and critical care nurses to assist with clients currently in the ED while emergency staff prepare to receive the mass casualty victims.
D
The nurse employed in an emergency department is assigned to triage clients coming to the emergency department for treatment on the evening shift. The nurse should assign priority to which client? a. A client complaining of muscle aches, a headache, and history of seizures b. A client who twisted her ankle when rollerblading and is requesting medication for pain c. A client with a minor laceration on the index finger sustained while cutting an eggplant d. A client with chest pain who states that he just ate pizza that was made with a very spicy sauce
D
The nurse has made an error in a narrative documentation of an assessment finding on a client and obtains the client's record to correct the error. The nurse should take which action to correct the error? A. Documenting a late entry into the client's record B. Trying to erase the error for space to write in the correct data C. Using whiteout to delete the error to write in the correct data D. Drawing one line through the error, initialing and dating, and then documenting the correct information.
D
The nurse is assigned to care for four clients. In planning client rounds, which client should the nurse assess first? a. A postoperative client preparing for discharge with a new medication b. A client requiring daily dressing changes of a recent surgical incision c. A client scheduled for a chest x-ray after insertion of a nasogastric tube d. A client with asthma who requested a breathing treatment during the previous shift
D
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, which of the following basic rules was she talking about? a. Listening actively b. Being compassionate c. Being flexible d. Committing to resolution
D
Which of the following statements regarding communication is not true? a. Communication is an essential skill for leaders. b. Effective communication can motivate and engage others. c. Poor communication affects care coordination. d. Communication is easy to measure.
D
Which statement is true regarding Kotter's model of change? a. It is a theory that involves nurse-to-nurse communication. b. It centers on conflict management. c. Patients are barriers to transformational processes. d. The vision of change should be communicated to employees.
D
Which statement regarding leadership and management is false? A). Leadership focuses on people while management focuses on systems and structures. B) Both leadership and management processes seek to accomplish goals. C)Strategies used to accomplish goals may be different in leadership and management. D)Leadership and management have discrete skill sets.
D) Leadership and management have discrete skill sets. - they aren't all discrete sets; there are overlapping skills between the two
Which action demonstrates a situational leadership style by the nurse manager? A.) The nurse manager delegates tasks to each team member. B.) The nurse manager allows team members to work without supervision. C.) The nurse manager invites team members to provide input about a unit problem. D.) The nurse manager quickly delegates activities to team members during an emergency situation.
D.) The nurse manager quickly delegates activities to team members during an emergency situation.