Li- leadership

Five Rights of Delegation

a) Right Task b) Right Circumstance c) Right Person d) Right Direction/Communication e) Right Supervision/evaulation

Transformational leaders establish a common mission and vision and encourage employees to heighten their level of performance. example:

"We've agreed to provide excellent client care and brainstormed the steps we will take to meet our objectives."

Bureaucratic leaders are not open to creativity and want everyone to follow the established rules and guidelines. example:

"I appreciate your suggestion, but each of you will wash your hands before exiting a client's room."

An AP tells a charge nurse that it is unfair that they have to take care of all the clients who are in continent. Which of the following responses should the charge nurse make?

"I delegate tasks to personnel based on their job descriptions." This response addresses the AP's concerns and provides clear information about the charge nurse's responsibility when delegating tasks.

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leader types-fyi

-autocratic: makes decisions without consultation, issues orders or gives direction, and controls the members of the group through the use of rewards or punishments -free-rein: leaves members free to decide what, how, and when to act, offering no guidance -participative: seeks input from group members and gives them an active role in decision-making -social behavior: focus upon building and maintaining positive, productive relationships among group members -task behavior: directs the attention and activity of a group towards a specified goal -transactional: based on power relationships that relies on reward and punishment to achieve its ends -transformational: based on mutual respect and stewardship rather than on control -emergent: emerges as a leader during the group's deliberations

a nurse is precepting a newly licensed nurse and suggests using the IDEAL method to structure the client's discharge planning. the client's caregiver is also in the room. which of the following statements made by the newly licensed nurse demonstrates the correct the use of the IDEAL methods

-i will include the client and caregivers in the discharge discussion

What are the six steps for EBP?

1-Ask a clinical questions 2-Collecte the most relevant and best evidence 3-Critically appraise the evidence you gather 4-Integrate all evidence with your clinical expertise, patient preferences, and values 5-Evaluate the practice decision or change 6-Communicate the results of the change (Pnuemonic- Always Come Clean In Every Clinical)

A nurse is preparing a presentation on the regulation of nursing practice. Place the hierarchy of the regulation of practice in the correct order, beginning with the highest level.

1. Nursing regulatory board (each state has a BON) 2. nurse practice act (Each BON determines laws of practice) 3. organization policies and procedures 4. individual self regulation

Shared governance is a leadership structure that encourages group collaboration to make shared decisions. Being a contributing partner in decisions promotes interprofessional collaboration, professional development and accountability, and improves client outcomes. example:

A group of staff nurses in a clinic work together to recommend new equipment purchases for the unit.

cognitive rehearsal

ATI: a nurse is assigned to care for a client. the client's provider is known to become angry and yell at the nurse. which of the following actions by the nurse demonstrates the use of cognitive rehearsal? -Ans: the nurse mentally practices in advance what to say to the provider. The American Psychological Association (2020) defines cognitive rehearsal as an intellectual therapeutic technique where one envisions or visualizes an overwhelming, or an anxiety-producing situation, and then mentally rehearses different reactions, behaviors, or repeats constructive statements to positively effect coping skills. Much like running a game plan or dance steps in one's head before a performance, cognitive rehearsal is playing a difficult scenario in one's head ahead of time to prepare oneself for constructive action if that scenario happens in reality.

which of the following is a characteristic of situational leadership.

Adjusts quickly to different circumstances. (A situational leader looks at each situation quickly and adjusts strategies based on the circumstances. The situational leader aligns their style to assist in the development and growth of others and the overall effectiveness of the organization. This leader communicates, problem-solves, organizes, and prepares with their employees to accomplish tasks and improve overall efficiencies.)

Aggregated data

Aggregated data over time is the most useful for performance improvement activities in terms of identifying patterns and trends. Data aggregation involves the gathering and collection of data rather than looking at single pieces of data. For example, you may want to aggregate client falls data so you can identify the time of day that most falls occur. Critical incident data relates to only one incident; formative and summative data are collected during and after an educational activity to evaluate its effectiveness.

A nurse is working with an AP in a long term care facility. According to the five rights of delegation, which of the following determinations should the nurse make prior to assignment of tasks? a. whether the AP has consented to the performance of delegated tasks b. the client's willingness to consent to the care of the AP c. whether the task can be more efficiently completed by the nurse d. the degree of supervision that the AP will require to complete the task

Ans: d. the degree of supervision that the AP will require to complete the task Successful delegation involves assigning the right task to the right person under the right circumstance. The person that is to perform the task must be given adequate direction and specification regarding the amount of supervision that will be provided. The right communication of expectations and the right feedback on performance must also be supplied.

A public health nurse is developing a list of recommendations for her supervisor on how to use EBP to improve community outcomes. Which of the following should the nurse recommend as a qualitative research method?

Answer: Phenomenology Rationale: Phenomenology is a qualitative research method that provides additional understanding of participants' experiences with emotional variances, such as grief and hope

confrontation used in conflict management

Confrontation is a conflict management tool in which the nurse manager instructs two parties in conflict to work out their differences on their own(BV). This should involve face-to-face communication, which can be facilitated by the nurse manager

Conflict Resolution Strategies

Avoiding/withdrawing. Smoothing. Competing/coercing. Cooperating/accommodating. Compromising/negotiating. Collaborating.

A charge nurse is delegating tasks to a licensed practical nurse (LPN). Which of the following tasks should the charge nurse delegate to the LPN? (Select all that apply.) A. Provide dietary teaching to a client who has a BMI of 31. B. Obtain vital signs from a client who is 6 hr postoperative. C. Administer a tap-water enema to a client who is preoperative. D. Develop a plan of care for a client who is postoperative from an appendectomy. E. Catheterize a client who has not voided in 6 hr.

BCE

A nurse is discussing nursing roles with a newly licensed nurse. which are roles of the nurse?

Caregiver, Advocate, Change agent note: not the medication dispenser (is the role of pharmacy)

A transformational leader focuses on a person's willingness to change and stimulates them to review current structures and come up with fresh new ways to improve them, such as finding a way to decrease client falls. example

Challenges a nurse to investigate evidence-based approaches to reduce the client fall rate on the unit

A nurse in a community health clinic is caring for four clients who each have a communicable disease. Which of the following conditions is considered a nationally notifiable infectious disease

Chlamydia trachomatis

a nurse is caring for a client who is being transferred to another unit, but the receiving nurse is unavailable to take report. which of the following concepts is being violated that could place the client at risk

Continuity of care The nurse should understand that continuity of care can cause a safety risk of a client when there are numerous hand-off reports completed during a transfer to another unit. The nurse should wait until the other nurse is available for report.

A charge nurse is planning an in-service training session about client advocacy with a group of staff nurses. Which of the following situations should the nurse include as an example of client advocacy? (Select all that apply.) A. Discussing treatment options with a client who was diagnosed with pancreatic cancer B. Notifying the provider when a client has questions about the procedure C. Helping a client make a list of questions to ask the provider D. Clarifying the dosage of a medication prescribed for a client who has impaired liver function E. Carrying out the end-of-life wishes outlined in the living will of an older adult client who has end-stage renal disease

Correct : BCDE Incorrect Answer: A. Discussing treatment options for a client who has pancreatic cancer is outside the scope of practice for a nurse. This is the responsibility of the provider. The provider should discuss treatment options with the client, including risk, benefits, and alternative treatments.

A nurse is admitting a client who has measles. This client should be placed in which of the following types of isolation? A. Airborne B. Contact x Incorrect answer CC. Droplet D. Protective environment

Correct Answer: A. Airborne The nurse should place the client who has measles in airborne isolation. Airborne isolation is used for clients who have infections that can be transmitted through droplets in the air that are smaller than 5 microns. Therefore, the nurse should place the client in a private room that has a negative-pressure airflow with at least 6-12 air exchanges per hour. The nurse should also wear an N95 respirator mask while caring for the client.

A nurse supervisor has requested additional staff for the cardiac surgery unit. While negotiating staffing issues with the CEO, the CEO suddenly asks, "I don't really understand heart physiology. Can you tell me about how the heart works?" Which of the following negotiating tactics does this represent?

Correct Answer: A. Ambiguous questioning The CEO is using an ambiguous (inappropriate) question that is irrelevant to the negotiation. A nurse who is skilled at managing conflict will learn to recognize destructive and dishonest negotiation tactics and remain focused on the negotiation instead of the diversion. This can be difficult if a person of authority is using a dishonest negotiation tactic.

A nurse navigator is assuming the care of a client who has a new diagnosis of cancer and will be living at home with their family. Which of the following tasks is the responsibility of the nurse navigator?

Correct Answer: A. Assist the client and family in finding community resources. It is the responsibility of the nurse navigator to assist the client and family to find community resources. Often, the nurse navigator will work with a social worker who has expertise in this area. The nurse navigator serves as a clinician, care coordinator, educator, and counselor to assist the client and family during the course of an illness.

A charge nurse is preparing assignments for the upcoming shift. Which of the following tasks should the charge nurse delegate to an assistive personnel (AP)? A. Perform a simple dressing change. B. Interpreting a client's blood glucose reading C. Providing advice when speaking to a client's family member on the phone x Incorrect answer DD. Determining the effectiveness of a client's urinary catheter

Correct Answer: A. Perform a simple dressing change. The nurse should identify that the completion of a simple dressing change is within the AP's range of function. Therefore, the charge nurse can delegate this task to an AP. Incorrect Answers: D. Determining the effectiveness of a client's indwelling urinary catheter can involve assessment and evaluation, which are outside the range of function for an AP. Therefore, this task should be delegated to a nurse.

Which type of data is the most useful for identification of patterns and trends when planning performance improvement activities? A. Aggregated data B. Critical incident data C. Formative data D. Summative data

Correct Answer: A. Aggregated data

A nurse is providing teaching to a client who has been newly diagnosed with schizophrenia and is being discharged from an inpatient facility. Which of the following community resources should the nurse include for continued mental health care? A. Partial hospitalization program B. Crisis stabilization units C. Community mental health center D. Primary care provider

Correct Answer: A. Partial hospitalization program The nurse should identify that a client who has been newly diagnosed with schizophrenia and is ready for discharge from an inpatient setting will still require intensive care. Therefore, the nurse should include information about partial hospitalization programs as part of the continuum of care. These programs are designed to assist clients to transition from an inpatient setting. Partial hospitalization programs meet 5 days per week, for about 6 hr per day. note: C is not correct. A client newly diagnosed with schizophrenia and being discharged from an inpatient facility would require a higher level of care to maintain stabilization of their condition. Community mental health centers offer a wide range of outpatient services across the lifespan including medication prescribing, therapy and, in some cases, vocational and residential services.

Which of the following is correct concerning the nursing peer review process?

Correct Answer: C. The performance appraisal should include other evaluation components in addition to the peer review The peer review process is an important part of employee evaluation, as an employee's peers can provide valuable information about one's work performance. The peer review should be based on the employee's work performance, and the results should only be shared with the employee and the manager. A performance appraisal should contain several components of evaluation; the peer review is only one part of the appraisal. note: During a peer review, one colleague may evaluate the performance of another; one colleague is typically not selected to evaluate several others.

A nurse is completing a medication reconciliation with a newly licensed nurse on a client admitted to the unit from the emergency department. Which of the following statements by the newly licensed nurse indicates an understanding of the process?

Correct Answer: B. "The purpose of medication reconciliation is to compare the medications a client is taking with newly prescribed medication." Medication reconciliation includes reviewing an accurate list of all medications the client is taking or should be taking, and comparing that list to new medications the provider has prescribed. This action decreases the risk for medication interactions, errors such as omission, dosing errors, and adverse outcomes. NOTE: The Joint Commission recommends facilities have processes in place for completing medication reconciliation.

A group of nurses on a telemetry unit informs a nurse manager of a need to update the cardiac monitoring system to improve arrhythmia detection. Which of the following responses should the nurse manager make? x Incorrect answer AA. "This purchase will require the completion of a variance analysis." B. "This purchase will need to be addressed in the capital budget plan for the unit." C. "This purchase will result in a reduction in the operating budget." D. "This purchase can be reimbursed by Medicare funds, as clients who use Medicare will benefit from the equipment."

Correct Answer: B. "This purchase will need to be addressed in the capital budget plan for the unit." The capital budget involves planning for spending related to equipment and major purchases that have a long life of use. Incorrect Answers: A. The anticipated purchase of new equipment does not require a variance analysis. Variance analysis is a process that differentiates planned budget results from actual results. C. An operating budget is separate from the budget for large expenditures for equipment or other major purchases. This type of budget reflects expenses that change in response to the volume of service (e.g. supplies, electricity). D. Medicare funds do not reimburse institutions for equipment purchases, even though clients who are receiving Medicare use the equipment.

A nurse is providing teaching about home tracheostomy care to the partner of a client who is to be discharged. When considering cost-effective care, which of the following instructions should the nurse give to the partner? A. Wear clean gloves when suctioning the client's tracheostomy. B. Rinse and dry suction catheters and reuse for up to 24 hr. C. Empty and rinse the suction container in a sink every 24 hr. D. Discard oral suction tubes (Yankauer) after each use.

Correct Answer: B. Rinse and dry suction catheters and reuse for up to 24 hr. In the home setting, suction catheters can be reused for up to 24 hours. Catheters should be flushed between each use utilizing distilled water or recently boiled water and allowed to air dry. Incorrect Answer: A. In the home setting, it is not necessary to wear gloves when performing tracheostomy suctioning. Caregivers should wash hands with soap and water prior to performing the suctioning. C. Suction containers pose a significant infection control risk due to the presence of potential bacteria and viruses in the sections. These containers should be carefully emptied into a toilet bowl and the container should then be carefully cleaned and disinfected. The caregiver should wear a mask and gloves when performing this procedure. D. Oral suction tubes (Yankauer suction tubes) can be used for at least 24 hr if they are carefully cleaned, dried, and stored in a clean, dry area after each use.

A nurse in a community health clinic is planning an in-service staff training session on nationally notifiable infectious conditions. Which of the following conditions should the nurse include in the teaching? A. Clostridioides difficile B. Varicella C. HIV exposure x Incorrect answer DD. Influenza

Correct Answer: B. Varicella The nurse should identify that varicella is a nationally notifiable infectious condition. Incorrect Answers:A. C. difficile is not a nationally notifiable infectious condition. C. HIV infection is a nationally notifiable infectious condition, but HIV exposure is not. D. Influenza is not a nationally notifiable infectious condition, but influenza-associated pediatric mortality is a nationally notifiable infectious condition.

A nurse is caring for a client who is on bed rest and states, "I would prefer not to have all of the side rails on my bed raised." After assessing the client is safe without the four side rails raised, which of the following interventions should the nurse implement?

Correct Answer: C. Leave the side rails down and document this decision as per the client's request. Raising all four side rails can be considered a form of restraint if they restrict the client's ability to get in and out of bed. This client is on bed rest and does not require that level of mobility; however, if the client expresses a wish for the rails to be down, the client's level of consciousness is not impaired, and there is no other specific safety hazard posed by lowering the side rails, the client's request should be respected.

A charge nurse is teaching a group of unit nurses about alternative restraints for clients who are confused and wandering. Which of the following pieces of information should the nurse include in the teaching? x Incorrect answer AA. Distract the client by leaving on the television B. Plan to administer a sedative to the client C. Provide the client with a rocking chair D. Place full-length side rails on the client's bed

Correct Answer: C. Provide the client with a rocking chair The nurse should advise providing the client with a rocking chair to expend some of the client's energy through rocking rather than walking, which leads to wandering. Incorrect Answers:A. The nurse should advise decreasing stimulation by reducing the noise level and dimming the lights.

A home health care nurse is conducting a home hazard assessment. For which of the following findings should the nurse intervene? A. The client's hot water heater temperature is set to 46.1°C (115°F). B. There are 8 steps to enter the client's home. C. The client's household lamps have 40-watt light bulbs installed. D. The bathroom has a handheld shower attachment for bathing

Correct Answer: C. The client's household lamps have 40-watt light bulbs installed. The nurse needs to intervene for low-wattage light bulbs. Inadequate lighting increases the risk of falls and presents a safety hazard for the client. Incorrect Answers:A. The nurse does not need to intervene, as hot-water heater temperatures should be set to a maximum of 49°C (120°F). B. The nurse does not need to intervene for the steps leading into the client's home. The nurse should, however, assess any broken or loose steps and note the security of handrails on both sides of the stairway. D. The nurse does not need to intervene for a handheld shower attachment, as this will assist the client in bathing. The nurse should inspect the tub for a nonstick surface.

A nurse overhears two other nurses discussing a conflict they are having about who should complete certain client-care tasks. The nurses agree that they are tired of the conflict and will let the nurse manager decide who should complete the tasks. The nurse should identify this outcome as which of the following approaches to conflict management? A. Win-win B. Win-lose C. Win-yield D. Lose-lose

Correct Answer: C. Win-yield A win-yield approach involves both parties no longer trying to resolve the conflict. Instead of taking the initiative to end the conflict, they agree to honor whatever the nurse manager decides. Incorrect Answers: A. A win-win strategy is a collaborative approach. There is no power struggle, and both parties work together for a positive outcome that meets a common goal. B. A win-lose strategy involves one party emerging victoriously and the other losing the struggle. If the losing party continues to pursue the situation, it becomes a competing strategy. D. A lose-lose strategy is also an avoidance approach. The two parties abandon the struggle and take no further action, but the conflict remains. In this outcome, no one wins.

digital divide 数字鸿沟：拥有计算机和网络访问权限与没有这些条件的人之间的经济、教育和社会不平等现象。

Correct Answer: C. Reduced access to information technology, such as computers or wireless devices, when compared to others' access

A nurse is following standard policy and procedure for reporting a client who has a communicable disease. Which of the following infections should the nurse plan to report to the CDC? A. Clostridioides difficile B. Candidiasis C. Vancomycin-resistant Staphylococcus aureus D. Trichomoniasis

Correct Answer: C. Vancomycin-resistant Staphylococcus aureus

An Orthodox Jewish client refuses a new prescription for omeprazole capsules for GERD. Which of the following actions is most appropriate for the nurse? A. Advise the client to sprinkle the contents of the capsule on food when using it. B. Consult the healthcare provider for a new medication. x Incorrect answer CC. Tell the client that failure to treat GERD may result in significant negative health consequences. D. Ask the pharmacist if another form of the medication is available.

Correct Answer: D. Ask the pharmacist if another form of the medication is available. Capsule medications are generally coated in collagen from animals, a nonkosher substance that some Orthodox Jewish clients may refuse as unacceptable. In cases where another form of the medication is unavailable, it may be appropriate to consult with the client's rabbi to determine whether or not the dietary restrictions may be relaxed for the client.

Read the following order from a physician. After reading the order, note which of the following nursing actions is most appropriate? "Administer 500 mg ceftriaxone p.o. now and q 6 hrs x 24 hours for infection prevention."

Correct Answer: D. Contact the physician to clarify the order In this situation, the nurse must contact the physician to clarify the order. Ceftriaxone (Rocephin) is only administered in the IV or IM routes, never by mouth.

A nurse manager is implementing a team nursing approach on his unit, hiring licensed practical nurses (LPNs) and assistive personnel (AP) as additional staff. Which of the following actions should the nurse manager take to facilitate acceptance of this change? x Incorrect answer AA. Develop a plan for the change and present it during a staff meeting. B. Explain that this change is a request from the administration and will be carried out. C. Hire new LPNs and APs and gradually integrate them into the staff. D. Introduce the new approach and facilitate the development of a task force to plan implementation.

Correct Answer: D. Introduce the new approach and facilitate the development of a task force to plan implementation. This appropriate approach involves the staff in the planning and will give them a feeling of control over their practice and enhance acceptance of the change. Incorrect Answers: A. This approach to staffing change is authoritarian in nature. Involvement of staff in facilitating the change is more democratic and will enhance acceptance.

A nurse is caring for a client who has been charged with a traffic violation that resulted in injuries to others. After a visit to the victims on the trauma floor, a local police officer visits your unit requesting information about the client. What is the appropriate response by the nurse?

Correct Answer: D. Provide the officer with information regarding the privacy rule restriction according to HIPAA According to HIPAA privacy rules, the RN may provide the following information to a law enforcement officer under six circumstances and subject to specified conditions: 1.as required by law (including court orders, court-ordered warrants, subpoenas) and administrative requests 2. to identify or locate a suspect, fugitive, material witness, or missing person 3. in response to a law enforcement official's request for information about a victim or suspected victim of a crime 4. to alert law enforcement of a person's death, if the covered entity suspects that criminal activity caused the death 5. when a covered entity believes that protected health information is evidence of a crime that occurred on its premises 6. by a covered health care provider in a medical emergency not occurring on its premises, when necessary to inform law enforcement about the commission and nature of a crime, the location of the crime or crime victims, and the perpetrator of the crime.

An unconscious client arrives at the emergency department's trauma center by helicopter after a motorcycle accident in which the client was not wearing a helmet. The client arrives unaccompanied and has no identification on him, and his name and any other identifying information is not known. Due to the severity of his head injury and internal organ injuries, emergency surgery is required. Which of the following is the best next step with regard to obtaining informed consent for the surgeries?

Correct Answer: D. Take the client to surgery without informed consent Informed consent is required for any and all diagnostic, therapeutic or surgical procedures that are complex, invasive or involve any risk of serious injury or death. There are two situations in which informed consent is not required. In a case like this one, where delaying surgery for the purpose of obtaining informed consent can lead to a worse outcome for the client (such as injury or death), informed consent is not required. A second situation in which informed consent would not be required would be if the client signs a waiver stating that they waive their right to informed consent.

A nurse hold a single state nursing license and is preparing to move to another state. For the nurse to apply for reciprocity see which of the following action should the nurse take?

Present a current invalid nursing license, submit an application, pay the fees for a new license note: The nurse is not required to retake any exam, repeat any educational classes, or reapply for specialty nursing certification when applying for a new license.

Which of the following are the roles of a state board of nursing? (Select all that apply.) A. Enforcing the State Practice Act for nurses B. Issuing fines to nursing schools when they breach conduct C. Granting nursing licenses and overseeing licensing exams D. Disciplining nurses who have practiced in an unsafe manner E. Sending delegates to represent nurses statewide at national conferences

Correct Answers: A. Enforcing the State Practice Act for nurses C. Granting nursing licenses and overseeing licensing exams D. Disciplining nurses who have practiced in an unsafe manner The State Board of Nursing in each state is responsible for licensure, discipline, and development of practice standards within the state.

Which of the following describes characteristics of a transformational leader? (Select all that apply.) A. Engaging stakeholders in the leadership process B. Promoting "top down" authority C. Focusing on what others are trying to say D. Commanding expectations rather than asking E. Maintaining high levels of integrity and responsibility

Correct Answers: A. Engaging stakeholders in the leadership process C. Focusing on what others are trying to say E. Maintaining high levels of integrity and responsibility

Which of the following are examples of a nurse case manager's activities? (Select all that apply.) A. Witnessing informed consent B. Measuring and documenting client outcomes C. Transporting the client to and from procedures D. Teaching the client to be an advocate for himself E. Assisting with activities of daily living

Correct Answers: A. Witnessing informed consent B. Measuring and documenting client outcomes D. Teaching the client to be an advocate for himself

Which of the following is most likely utilized by an RN case manager? (Select all that apply) A. Web portal where clients can log in and the RN can answer questions related to nursing information B. Computers programmed to manage and track inventory C. Software for client data entry that integrates with predesigned templates to track care D. Integration of changes in regulations that affect reporting requirements by payer agencies or eligibility for healthcare benefits E. Software that allows se

Correct Answers: C. Software for client data entry that integrates with predesigned templates to track care D. Integration of changes in regulations that affect reporting requirements by payer agencies or eligibility for healthcare benefits E. Software that allows searchable client records for case numbers by diagnosis-related groups or length of stay Case managers track a "caseload" or group of clients. These caseloads require software for entry of client data and integration with templates to track care. Case managers must also stay current with new regulations, including those that affect eligibility for healthcare benefits and reporting requirements of payer agencies. They also keep a database of providers. These elements are integrated into caseload management software that allows the case manager to demonstrate cost-benefit analysis of care and trends by relating client outcomes to cost.

A nurse is discussing leadership styles with a newly licensed nurse. Which of the following characteristics should the nurse identify as describing a bureaucratic leader? (select all)

Decisions are controlled by policies, enforces the rules, inflexible to creative suggestions Uses a variety of strategies based on the circumstances is incorrect. A situational leader looks at each situation and adjusts strategies based on the circumstances.Motivates staff with the use of rewards or punishments is incorrect. Transactional leaders use rewards or punishments to motivate staff.

Mandatory Reporting

Diseases and illnesses that are considered a threat to public health, such as tuberculosis, HIV, and influenza, require mandatory reporting to the health department to track and develop prevention and protection protocols.

sentinel event

Evidence-based practice indicates that, following a sentinel event, the first step the committee should take is to conduct a RCA to identify the underlying cause or causes that led to the medication errors. Other sentinel events identified by The Joint Commission include: • Suicide of client receiving care • Discharge of an infant to incorrect family • Unintended retention of a foreign object in a client following an invasive procedure • Perform invasive procedure on the wrong client or at the wrong site; perform incorrect procedure • Hemolytic transfusion reaction involving administration of wrong blood or blood product • Unanticipated death of a full-term infant

(CLASS) Generational differences team members

Generational differences influence the value system of the members of an interprofessional team and can affect how members function within the team. Generational differences can be challenging for members of a team, but working with individuals from different generations also can bring strength to the team. ● Veterans (Silent Generation, Traditionals): Born 1925 to 1942 ● Baby Boomers: Born 1942 to early 1960s ● Generation X: Born mid-1960s to early 1980s ● Generation Y (Millennial): Born mid-1980s to 2000 ● Generation Z (Homelanders): Born after 200

Which of the following types of communication is informal, distorted, and typically involved three or four individuals?

Grapevine 葡萄藤 Grapevine communication is informal and generally involves three or four people at one time. The message often contains errors as it is communicated because the sender bears little accountability for the message.

A nurse is assisting with teaching a class about HIPAA. Which of the following information should the nurse include? (Select all that apply.)

HIPAA protects the unauthorized release of a client's protected health information is correct. The loss of a provider's cell phone that contains a client's protected health information is considered a data breach is correct. A breach in HIPAA should be reported within 60 days after the breach is discovered is correct. NOTE: HIPAA requires notification of a breach in privacy via an in-person report is incorrect. The health care facility should notify clients about potential breaches of privacy via mail. If a breach is imminent, the facility can notify the client via a phone call.

Grapevine Communication

Informal, haphazard, and random, usually involving small groups

(CLASS)Lewin's change theory

Lewin's change theory is a common model for promoting planned change, which has three stages. ● Unfreezing: Need for change is identified or created. ● Change/Movement: Strategies (driving forces) that overcome resistance to change (restraining forces) are identified and implemented. ● Refreezing: The change is integrated and the system is re-stabilized. Lewin's theory has been adapted into a stages of change model for individual change, with five stages: ● Precontemplation: No intent to change is present or has been considered. ● Contemplation: The individual considers adopting a change. ● Preparation: The individual intends to implement the change in the near future. ● Action: The individual implements the change. ● Maintenance: The individual continues the new behavior without relapse.

PICOT

P: Population I: Intervention C: Comparison O: Outcome T: Time

According to Patricia Benner, which of the following is a characteristic of the advanced beginner nurse?

Performs at an acceptable level. Bases actions on principles. Anticipates outcomes based on experience is incorrect. The proficient nurse anticipates outcomes based on experience. Provides efficient and organized care is incorrect. The competent nurse provides efficient and organized care. Performs at an acceptable level is correct. The advanced beginner nurse performs at an acceptable level. ​Exhibits a high level of proficiency is incorrect. The expert nurse exhibits a high level of proficiency. ​Bases actions on principles and experience is correct. The advanced beginner nurse bases actions on principles and experience.

Which of the following will assist the new graduate nurse with the development of knowledge & skills necessary for the nursing role?

Preceptor NOTE: ​A mentor makes a conscious decision to help an individual attain expert status and further career development, and assists with the development of attitudes and values.

The nurse should identify that which of the following are contributions made by The American Nurses Association (ANA)? (Select all that apply.)

Providing a definition of nursing is correct.Lobbying for whistle blower protection is correct.Providing all registered nurses with competency expectations is correct.

A nurse is teaching a class about searching the internet for research articles to use for evidence-based changes. Which of the following information should the nurse include?

Quackwatch is a website that monitors internet websites for misinformation and credibility. The nurse should instruct students to use resources such as Quackwatch to verify health care information.

The nurse enters the client's room to administer pain medication. The client asks for help to get into a more comfortable position. Place the following actions in the correct order they should be performed by the nurse:

Reposition the client Check the client's name band Ask the client their name Give the medication

A nurse asks a newly hired a P to remove a clients indwelling urinary catheter. Which of the following actions should the nurse take to ensure the AP is qualified to perform this task

Review the AP skill competency checklist A review of the AP's checklist should validate that they have demonstrated the ability to safely perform the procedure. NOTE: Asking an AP if they can perform the task does not provide evidence of competency to perform the task.

A nurse is planning a staff education session regarding biological weapons of mass destruction. Which of the following should he plan to include in the session? (Select all that apply.)

Sarin is incorrect. Sarin is a chemical - rather than a biological - agent of mass destruction .Smallpox is correct. Smallpox is a biological weapon of mass destruction. Anthrax is correct. Anthrax is a biological weapon of mass destruction .Hydrogen cyanide is incorrect. Hydrogen cyanide is a chemical - rather than a biological - agent of mass destruction. Botulism is correct. Botulism is a biological weapon of mass destruction.

A nurse on a MedSurg unit has arrive late to work multiple times over the past several weeks. Identify the sequence the nurse manager should follow when disciplining the employee

Schedule a meeting with the nurse provide a written reprimand temporarily remove the nurse from scheduled shift terminate the nurses employment

CONTINUITY OF CARE

Simply stated, the continuity of care is the well-planned and seamless movement of a client to a different level of care based on their status.(BV). This movement, or transition, to another level of care is based on the identified needs of the client. In some cases a client may be moved to a less intense level of care; in other cases, a client may be moved to a more intense level of care based on the client's changing needs

A nurse is providing client care using the nursing process. The nurse should identify that which of the following standards or guidelines includes this criterion?

Standards of practice

A charge nurse is delegating tasks to a licensed practical nurse (LPN). Which of the following criteria is the priority for the charge nurse to consider when delegating?

State Nurse Practice Act According to evidence-based practice, the nurse should first consider the state Nurse Practice Act, which provides the legal authority for nursing practice. A state's Nurse Practice Act specifies the qualifications and responsibilities of nurses and outlines the specific tasks that nurses can legally perform based upon their educational preparation. Essential Elements of Delegation Criteria Included in Nurse Practice Acts 1. Definition of delegation 2. Tasks that cannot be delegated 3. Description of professional nursing practice 4. Role description and limitations for PNs and AP 5. Degree of supervision required when working with PNs and AP 6. Guidelines for minimizing risks to delegation 7. Inappropriate delegation

A nurse is serving on a committee that is considering the creation of a policy that will allow nurses to insert peripherally inserted central catheter's in the intensive care unit. Which of the following resources should the nurse consult in planning for this policy? National League for Nursing (NLN) American Academy of Nursing (AAN) Agency for Healthcare Research and Quality (AHRQ) State Nurse Practice Act (NPA)

State nurse practice act - The nurse should consult the NPA in this situation because the NPA defines the scope and boundaries of professional nursing practice. The NPA provides guidelines for developing standardized procedures within specific facilities where expanded nursing functions have been approved in collaboration with nurses, providers, and administration. The NLN is a national organization for faculty nurses and leaders in nurse education. It offers faculty development, networking opportunities, testing services, nursing research grants, and public policy initiatives. The AAN is a professional organization that generates, synthesizes, and disseminates nursing knowledge to contribute to health policy and practice for the benefit of the public and the nursing profession in general. The AHRQ is part of the United States Department of Health and Human Services, which supports research and is designed to improve the outcomes and quality of health care.

which of the following agencies provides The Nursing Scope and Standards of Practice?

The American Nurses Association (ANA)

A nurse is educating a group of nurses about the nurse practice act. Which of the following statements should the nurse include?

The NPA contains current laws and regulations for nursing practice, the NPA contain standards and scope of practice, the nurse is responsible to know current roles and responsibilities as defined by the NPA NOTE: The federal government enforces the NPA for each state is incorrect. The state legislature assigns a regulatory body such as the state board of nursing. This regulating body has the authority to enforce the NPA.

Which of the following describes a standard of care?

The level of care nurse provides that is the same for all nurses who have comparable education, competency, and experience. note: Explanatory statements that describe the competent level of care for all nurses to follow in practice. This defines the Standards of Practice, which are explanatory statements describing the competent level of care expected from all nurses.

American Nurses Association (ANA) -fyi

The national professional membership association of nurses that works for the improvement of health standards and the availability of healthcare services, fosters high professional standards for the nursing profession, and advances the economic and general welfare of nurses

Situational Monitoring

The process of continually scanning & assessing what's going on around you to maintain situation awareness ATI: Some of the primary teamwork skills include team structure, communication, leadership, situation monitoring, and mutual support. These skills are used to improve and enhance collaboration and improve client outcomes. Situation monitoring encourages the team to be aware and understand the team's performance and the impact it has on client outcomes.

Transactional Leadership example:

The staff members who complete their online learning courses before the deadline will receive a gift card. (Transactional leaders use rewards or punishments to encourage compliance for an established goal. They communicate specific expectations, focusing on tasks and completion of short-term goals.)

A nurse is assisting with teaching a client about remote patient monitoring (RPM) devices. Which of the following information should the nurse include? (Select all that apply.)

The transfer of data is accomplished using wireless devices .Clients can participant in their health by using RPM. A client's heart rhythm can be transferred using RPM.

Implied consent

Types of consent include implied consent, expressed verbal consent, and written consent. Implied consent is used for routine procedures such as taking vital signs, checking blood glucose, or receiving an intramuscular injection(BV). The client has consented to these routine procedures as the result of their admission. The nurse also tells the client what they are doing before providing care, such as taking vital signs or giving injections. Major invasive procedures, such as surgical procedures, intubation, and diagnostic tests such as an MRI with contrast, require a written expressed consent.

The state Nurse Practice Act

Upon licensure, a nurse will follow the Nurse Practice Act for the state in which they choose to practice. This document states the rules and regulations surrounding the practice of nursing set forth by each state's board of nursing.

A graduate nurse is offered a position in the emergency department upon the granting of initial licensure. Which of the following information should the graduate nurse identify as a requirement during the initial licensure process?

Verification of graduation, criminal background check in certain states, passing score on the NCLEX examination, self disclosure of any substance use in the past five years

Laissez-faire leaders step back and allow staff members the freedom to work independently. example:

You are a smart and highly competent team. I will let you do what you do best."

Nurse Licensure Compact (NLC)

allows RNs LVNS to have one license yet practice in other compact member states

A nurse is assisting with teaching a class about evidence-based protocols established by the CDC to prevent healthcare-associated infections (HAIs). Which of the following infections should the nurse include? Select all that apply

b) catheter-associated urinary tract infection d) central line-associated bloodstream infection e) surgical site infection

A nurse is caring for a client who has a prescription for wrist restraints. Which of the following actions should the nurse take? a) tie the restraints to the siderails on the client's bed b) remove the restraints with each vital sign check c) use the square knot to secure the restraints d) make sure one finger can fit under the restraints

b) remove the restraints with each vital sign check

A charge nurse is evaluating conflict resolution between two staff nurses. Which of the following conflict resolution styles is an example of one nurse putting aside her own goals to satisfy the other nurse? a. avoidance b. accommodation Compromise Collaboration

b. accommodation. Accommodation is when one person puts aside her own goals to satisfy the needs of another person. The nurse is using accommodation in order to resolve the conflict.Avoidance is when one person uses passive behaviors and withdraws from a conflict. Neither individual is able to pursue goals.Compromise is when both individuals give up something to achieve a common goal.Collaboration is when both individuals actively try to find a solution that is acceptable to both parties.

Using quality monitoring tools, a facility committee identifies that clients who have congestive heart failure have an average length of stay that is 5 days instead of the established standard of 3 days. Which of the following steps should the nurse implement next in the quality improvement process? a. educate staff members on shortening the length of stay for these patients b. collect data regarding length of stay for these patients c. determine which actions can be instituted to address this

c. determine which actions can be instituted to address this problem. Further analysis of data will identify factors that contribute to the longer lengths of stay. Identifying actions to shorten the clients' lengths of stay is the next step in the process. collect data regarding length of stay for these clients is incorrect. The data has already been collected regarding the length of stay for this group of clients. Collecting additional data will delay a response to the problem.

A charge nurse on a ped unit is delegating tasks to an AP who is pregnant and reports that she is unsure of her immune status. Which of the following clients should the charge nurse assign to the AP? a. A 9 yr old child who has fifths disease b. A 4 yr old child who has varicella c. A 6 yr old child who has rubella d. A 2 yr old child who has impetigo contagiosa (impetigo)

d. A 2 yr old child who has impetigo contagiosa. This is a safe assignment. If the AP practices universal precautions, there is no risk for contracting impetigo. Impetigo is a superficial skin infection caused by either staphylococcus or streptococcus. A 9-year-old child who has Fifth disease. If the AP has never had Fifth disease, the chance of contracting it is significant. Erythema infectiosum is a communicable disease and has been associated with early fetal loss. There is no immunization for Fifth disease.

process audit 流程审计

examines how nursing care is provide Process audits evaluate the process of how nursing care was provided and determine if the nursing care is consistent with facility policy.d (BV) Incorrect Answers: A. Structure audits evaluate the availability of supplies, such as fire extinguishers. B. Structure audits measure staff ratios. D. Outcome audits measure the outcome of the care provided for specific nursing interventions and include elements such as morbidity, mortality, and length of facility stay

Fifth disease (erythema infectiosum)-FYI

is a childhood disease caused by the human parvovirus. This common community-acquired disease does not usually require treatment, but respiratory isolation is recommended for 7 days following the onset of symptoms. The initial stage of the disease presents as red cheeks that appear to be "slapped" or "slapped cheeks" with circumoral pallor

health literacy

knowledge of health information needed to make good choices about your health

A nurse is preparing a poster describing leadership styles for a unit in-service. Which of the following terms should the nurse use to describe a nurse manager who exerts little control over the decisions made by the charge nurse?

laissez-faire (Under a laissez-faire style of leadership, nurses are given the freedom to work independently to accomplish goals with little control asserted by the nurse manager.)

Root Cause Analysis (RCA)

process that looks backwards at an event to prevent its future occurence The root cause analysis investigates deviations from the standards of care surrounding the event A root cause analysis.(ATI) is a function of quality improvement, the purpose of which is to determine what factors led to a deviation from established standards of care resulting in errors in client care.

Human Flourishing

the nurse providing client care that demonstrates respect for diversity, approaches clients in a holistic and client-centered manner, and uses advocacy to enhance clients' health.

variance report (AKA: incident report or occurrence report)-FYI

tool used by health care facilities to document the occurrence of anything out of the ordinary that results in or has the potential to result in harm to a patient, employee, or visitor;