Professional Nurse 2 Exam 2

Honest Mistakes

Accidents and errors that are inevitable in healthcare.

- Elderspeak - Gossiping - Bullying - Horizontal violence

What are examples of incivility?

- Knowledge - Attitudes - Performance

What are the core tenets of Team STEPPS?

Thorough and accurate documentation

What is the best defense a nurse has in a court of law?

C. Yellow-green drainage on the surgical incision

A nurse is assessing a client who is 48 hr postoperative following abdominal surgery. Which of the following findings should the nurse report to the provider? A. Blood pressure 102/66 mm Hg B. Straw-colored urine from an indwelling urinary catheter C. Yellow-green drainage on the surgical incision D. Respiratory rate 18/min

B. Fetal HR

A nurse is assisting a provider with an amniotomy on a client who is in labor. Which of the following is the priority nursing assessment following the procedure? A. Color of amniotic fluid B. Fetal HR C. Uterine contraction pattern D. Odor of amniotic fluid

A. Collecting a stool specimen C. Measuring oral intake D. Providing postmortem care

A nurse is caring for a group of clients on a medical-surgical unit. Which of the following tasks should the nurse delegate to an assistive personnel (AP)? (SATA) A. Collecting a stool specimen B. Providing instructions about using a spirometer C. Measuring oral intake D. Providing postmortem care E. Changing a sterile dressing

C. Identify the problem.

A nurse manager has recently become aware of a conflict between the pharmacy and the staff nurses regarding sending and receiving medications. Which of the following actions should the nurse take first to resolve the conflict? A. Implement a resolution. B. Brainstorm solutions. C. Identify the problem. D. Evaluate the results.

A. "Let's talk about your concerns about the new policy."

A nurse manager hears a staff nurse on the unit speak openly about her dislike of a recent policy change regarding client care. When discussing the issue with the nurse, which of the following statements by the nurse manager is appropriate? A. "Let's talk about your concerns about the new policy." B. "Why didn't you voice your concerns before the new policy was implemented?" C. "Being open to change is an expectation of the nurses who work on this unit." D. "You should support this policy change because it was based on evidence-based practice."

Non-Verbal Communication

Communicating without the use of words.

Intercultural Communication

Communication that occurs in interactions between people who are culturally different.

Persuasion

Conscious intent by one individual to modify the thoughts or behaviors of others.

Persuasion

Convincing a patient to follow their treatment plan and comply with recommended lifestyle changes would be an example of?

A. Incivility B. Incivility C. Incivility D. Civility E. Incivility F. Civility

Determine whether the following behaviors display civility or incivility? A. Passive or direct aggression B. Creating nicknames C. Sarcasm, gossiping, or verbal insults D. Referring to patients and coworkers by preferred name E. Displaying favoritism F. Mutual respect

State Boards of Nursing

Establishes and administers state nurse practice acts.

Negligence

Failure to act as a reasonable professional would have under similar circumstances.

Malpractice

Negligence on the part of the healthcare professional..

Bargaining

Offering to pick up a coworker's Thanksgiving shift if they take your shift this weekend would be an example of?

Interprofessional Communication

Open communication among interdisciplinary teams of health care professionals.

Civility

Politeness or courtesy in speech and behavior that communicates respect for others and facilitates successful communication.

Undiscussables

Risks that are seen but not addressed and are intentional.

Incivility

Rude or disruptive behavior that can progress to disruption, bullying, and violence.

Interpersonal Communication

The exchange of thoughts, feelings, and beliefs between two or more people.

Delegation

The opportunity to transfer duties or tasks to other members of the healthcare team that is beneficial for the patient and delegator.

Bargaining

To make a series of offers and counteroffers about what each party will do, give, receive, etc., until an agreement is reached and to the satisfaction of all.

1. Clear 2. Concise 3. Complete 4. Correct information

What are the 4 C's of delegation?

1. Define the problem 2. Gather information 3. Determine the overall goal 4. Develop solutions 5. Consider the consequences 6. Make a decision 7. Implement and evaluate the solution

What are the 7 steps of problem solving?

- Communication - Leadership - Situational Monitoring - Mutual Support

What are the basic skills of Team STEPPS?

1. Right task 2. Right circumstance 3. Right person 4. Right communication 5. Right supervision

What are the five rights of delegation?

1. Define your goal 2. Master your stories 3. Gather all relevant information 4. Move to action

What are the four basic steps of conflict resolution?

1. Nurse assumed care for the patient 2. Nurse breached the duty of care/failed to meet the standards of care 3. Failure of the nurse to meet standard of care was the cause of injury 4. The injury is proved

What are the four elements that must be proven in order to make a malpractice case?

1. Define what is the practice of professional nursing 2. Sets the minimum educational qualifications and requirements for licensure 3. Determines the legal titles and abbreviations nurses may use 4. Provides for disciplinary action of licensees for certain causes

What are the four functions of the nurse practice act?

1. The delegate must be trained, validated, and competent. 2. Cannot delegate tasks that require nursing judgement or critical thinking. 3. Must own delegating authority. 4. Delegated task must be within the scope of practice.

What are the four parts of delegation criteria?

Describe the situation or behavior Express how you feel Suggest alternatives Consequences should be stated

What are the four parts of the DESC method?

1. Analyze data and related evidence 2. Ascertain the meaning of the data and evidence 3. Apply knowledge to a clinical situation 4. Determine client outcomes desired and/or achieved as indicated by EBP

What are the four ways in which a nurse uses clinical judgement?

- Systemic over local (life over limb) - Acute over chronic - Actual over potential problems - Emergencies and complications over expected findings

What are the principles of prioritization in nursing?

1. Recognize cues 2. Analyze cues 3. Prioritize hypothesis 4. Generate solutions 5. Take actions 6. Evaluate outcomes

What are the six functions of the clinical judgement model?

I am concerned I am uncomfortable This is a safety issue

What are the three parts of the CUS method?

1. Dangerous shortcuts 2. Concerns about incompetence 3. Concerns about disrespect

What are the three undiscussables?

Top Tier: Self-determination Second Tier: Institutional Policies and Procedures Third Tier: Nurse Practice Act, Rules and Regulations Foundation: Scope and Standards of Nursing Practice, Code of Ethics, Specialty Certification

What are the tiers of the professional nursing practice regulation model?

1. Omission: not doing something that should have been done 2. Commission: doing something that shouldn't have been done

What are the two ways in which malpractice can occur?

- Avoid elder speak - Use "you" rather than "we"

What are ways that nurses can promote civility when caring for patients?

Critical Urgent Routine Extra

What does the priority-setting framework CURE stand for?

A. Maintain a safe positive learning environment

What is a nurse leaders' role when bullying or incivility occurs? A. Maintain a safe positive learning environment B. Avoid calling attention to negative behavior C. Tell both parties to deal with the issue outside class D. Take a side in the conflict

D. I am concerned about the patient's rep rate of 10 and lethargy

Which statement best describes the "situation" in SBAR? A. Patient was admitted this morning and received morphine an hour ago. B. Would you like to order naloxone and oxygen? C. Patient had a resp rate of 16 and was alert prior to naloxone. D. I am concerned about the patient's rep rate of 10 and lethargy.

A. I noticed you have been late for work twice this week

A nurse manager plans to speak with a staff nurse who has been late for work several times. Which initial statement would best avoid creating defensiveness? A. I noticed you have been late for work twice this week. B. You are letting your team down when you come into work late. C. You have to be on time for work. D. If you can't show up on time, you can't work here.

D. Bargaining

A nurse should identify the following patient statement as which type of communication "I will only take my morning medication if I can have a Coca-Cola with it." A. Negotiation B. Non-verbal C. Persuasion D. Bargaining

C. Prescribe a blood pressure medication for the patient.

A physician has asked the registered nurse to do the following tasks. Which of these tasks is out of the registered nurses' scope of practice? A. Insert an IV. B. Administer acetaminophen 500mg PO for pain. C. Prescribe a blood pressure medication for the patient. D. Give a CHG bath to the patient.

Clinical Judgement

A reflective and reasoning process that uses all available data and extensive knowledge to form a clinical conclusion.

D. Discharging a patient

An RN on a medical-surgical unit is making assignments at the beginning of the shift. Which of the following tasks should the nurse NOT delegate to the LPN? A. Performing tracheostomy care B. Inserting a urinary catheter C. Administering medications D. Discharging a patient

Shared Governance

A decision making tool that promotes empowerment and autonomous decision making.

Call- Out

A communication strategy that is used to communicate important or critical information.

Negotiation

Dialogical discussion between two or more parties to arrive at an agreement about an issue.

Situational Monitoring

Process of actively scanning and assessing situational elements to gain information or understanding or to maintain awareness to support functioning of the team.

D. The client who has a blood glucose level of 50 mg/dL and complains of blurred vision.

The RN has received the client assignment for the day. Which would the nurse assess first? A. The client who has a nasogastric tube attached to intermittent suction B. The client who needs to receive sub-q insulin before breakfast C. The client who is 2 days post-op and is complaining of incision pain D. The client who has a blood glucose level of 50 mg/dL and complains of blurred vision.

Mutual Support

The ability to anticipate and support other team members' needs through accurate knowledge about their responsibilities and workload.

B. Method & timeline for reporting, including when to report concerns/findings C. Client-specific instructions

Which of following statements best fit the correct direction/communication right of delegation? Select all that apply? A. Assess & verify competency of the health care team member B. Method & timeline for reporting, including when to report concerns/findings C. Client-specific instructions D. Delegating tasks to appropriate team member based on standards of practice

A. Right direction and communication C. Right task D. Right circumstance

Which of the following are parts of the five rights of delegation? Select all that apply. A. Right direction and communication B. Right policy C. Right task D. Right circumstance E. Right licensure

C. Undiscussable

An OR nurse observes a scrub tech break sterile field. The scrub tech ignores it and continues their work. Which communication breakdown does this best describe? A. An honest mistake B. Non violent communication C. Undiscussable D. Open communication

DESC

A constructive communication approach used for managing and resolving conflict.

Pilot Projects

A decision making tool that involves a trial to try out a solution alternative on a small or restricted basis.

C. A client who has a prescription for irrigation of an indwelling urinary catheter

A charge nurse on a medical-surgical unit is making client assignments for the oncoming shift. Which of the following clients should the charge nurse assign to LPN? A. A client who requires an updated plan of care following a diagnosis of cancer B. A client who is postoperative following a total hip replacement and requires discharge teaching C. A client who has a prescription for irrigation of an indwelling urinary catheter D. A client who has just arrived from PACU and requires head-to-toe assessment

Check-Back

A communication strategy that is used to ensure that information conveyed by the sender is understood by the receiver as intended.

A. Determines what actions the nurse can perform under their licensure. B. Ensures patient safety and improves quality of care. D. Maintains professional standards.

A student nurse is reviewing the nursing scope of practice. What is considered the purpose of the nursing scope of practice? Select all that apply. A. Determines what actions the nurse can perform under their licensure. B. Ensures patient safety and improves quality of care C. Allows everyone with licensure (NA, LPN, RN, etc.) to perform the same duties. D. Maintains professional standards

Tanner's Clinical Judgment Model

Decision making model that focusses on noticing patient cues, interpreting and responding to them and then reflecting on the course of action.

Negotation

Discussion of salary increase with your manager or HR team would be an example of?

Scope of Practice

Each discipline in an interdisciplinary team has a set of skills they can practice for their specific profession.

A. Decreased job satisfaction B. Preventable errors in patient care

Effects of incivility in the workplace include: (select all that apply) A. Decreased job satisfaction B. Preventable errors in patient care C. Decreased turnover D. Improved interprofessional collaboration

Licensure Compact

Intended to allow RNs to more easily practice across state lines - can use home state license to practice in a compact state.