Sherpath - Chapter 21: Managing Patient Care

To whom would the nurse delegate the task of evaluating the patient's response to a narcotic pain medication?

Another RN

Which task can the RN safely delegate to the AP?

Assisting the patient with morning hygiene

Which element of the leadership quality of decision-making gives the registered nurse the legitimate power to give commands and make final decisions specific to a given position?

Authority

Which element of leadership involves the freedom of choice?

Autonomy

When was the primary nursing model of care adopted?

During the 1970s

Building an empowered nursing team starts with the nurse executive. Which responsibility lies with the nurse executive in this process?

Establishing a philosophy for nursing staff to provide quality nursing care

Which member of the nursing team is most likely to use transformational leadership for team development?

Nurse manager

Which nursing care delivery model improved RN accountability but is rarely used today because of high costs?

Primary nursing

When unit staffing includes AP, which scenario is characteristic?

The RN is accountable for the tasks delegated to the AP

The AP have been trained in measuring blood pressure. The RN delegates the duty of measuring blood pressure to the AP. Which statement is true about the RN's delegating skills.

The nurse has followed the principle of right task

Which is an appropriate task for the nurse to delegate to a nursing assistant?

Toileting a patient on a bladder-training regimen

Which nursing interventions delegated by the nurse to the nursing assistant are inappropriate?

"Could you please help me find out the problem with this patient? He is developing severe chest pain."

Which factor is essential to a philosophy of care? Select all that apply. Management of patient care Selection of proper interventions Selection of the management structure Selection of a nursing care delivery model Knowledge of roles and responsibilities of a nurse

- Selection of a nursing care delivery model - Selection of the management structure

While administering medications, a nurse realizes that she has given the wrong dose of medication to a patient. She completes an incident report and notifies the patient's health care provider. Which characteristic is the nurse demonstrating?

Accountability

The RN is caring for a patient with hypertension and finds that the caregiver is unknowingly giving the patient high-sodium food. The RN asks a dietitian to help educate the patient and caregiver. Which leadership skill is the RN using?

Authority Rationale: Authority refers to a formal legitimate power to make final decisions that are specific to a given position; the nurse is exercising his/her authority to request the help of a dietician. Autonomy is the freedom of choice to make decisions about a patient's specific care plans.

The nurse is learning about a decentralized nursing unit that supports decision-making. Which element of decision-making would the nurse practice? Select all that apply. Authority Autonomy Negligence Dependence Responsibility

Authority Autonomy Responsibility

The nurses on the unit developed a system for self-scheduling of work shifts. This is an example of which characteristic?

Autonomy

Which statement describes accountability?

Being answerable for one's actions

The hospital nursing staff is competent and motivated and receives consistently high patient satisfaction scores. Which is responsible for this achievement?

Decentralized decision-making Rationale: Decision-making at the level of staff members in an organization is called decentralized decision-making. It allows the managers and staff more active involvement in shaping and determining the success of the health care organization, which increases staff competency and motivation.

The nurse is assessing a patient's wound and using data to determine a plan of care. Which leadership skill is the nurse exhibiting?

Evaluation

Which responsibility is that of a nurse administrator?

Maintains professional satisfaction of the staff Rationale: The nurse administrator has a critical role in maintaining healthy communication and professional satisfaction among staff members. The nursing manager has the responsibility of conducting regular patient rounds, using transformational leadership to empower the staff, and estabilshing the unit performance plan.

A nurse manager has which responsibility?

Making rounds with the provider Rationale: The manager should make rounds with the health care provider to check the health of the patients and the quality of care provided. The nurse manager is responsible for recruiting new nursing staff, not physicians. The nurse executive deals with the cost-effectiveness of the care plan and established structure that helps achieve organizational goals.

Which task is appropriate for the nurse to delegate to the assistive personnel (AP)?

Obtain and record vital signs

Which nursing model focuses on improving the accountability of nursing for patient outcomes?

Primary nursing

A RN delegates the duty of oral care of a patient to one of the APs. The RN provides instructions for the procedure and supervises the assistant when the procedure is being done. Which right of delegation is the nurse applying?

Right supervision

Which nursing care delivery model involved the registered nurse (RN) providing direct patient care with the help of assistive personnel (AP)?

Team nursing

Which statement is true about the primary nursing model?

The model allows lateral communication from nurse to nurse

A nurse is having a positive effect on the team and contributing to better teamwork and satisfaction. Which model is the nurse using?

Transactional leadership Rationale: Transactional leadership has a positive effect on the team by contributing to better teamwork and satisfaction. Team nursing and primary nursing are traditional models of nursing care delivery.

The nurse is assessing a patient who has diarrhea. While inserting the intravenous catheter, the nurse asks the nursing assistant to help stabilize the patient's hand. What type of clinical care coordination is the nurse following?

Use of resources

Which quality is desired in an entry-level nurse? Select all that apply. An understanding of the environment of care The ability to provide care single-handedly Respect for the rights, beliefs, and values of patients Knowledge of the roles and responsibilities of a nurse The ability to lead management of patient care as needed

- An understanding of the environment of care - Respect for the rights, beliefs, and values of patients - Knowledge of the roles and responsibilities of a nurse

Which characteristic describes that of an effective team? Select all that apply. Different purposes Effective communication Trust The ability to keep feedback to oneself Effective conflict management

- Effective communication - Trust - Effective conflict management

Which nursing care delivery model delivers health care services with high-quality and cost-effective care?

Case management

Which factor is important during clinical care coordination? Select all that apply. Evaluation Use of resources Interruption control Time management Organizational skills

Evaluation Use of resources Time management Organizational skills

Which statement is true regarding responsibility?

It reflects a person's ownership

A nurse must help a hospitalized patient with diabetes eat; the health care provider has also requested a urine sample. Which leadership element would the nurse use in this situation?

Organizational skills

The nurse collects the supplies for the dressing change for the patient in bed 1 and signs out the capillary blood glucose monitoring equipment to test the glucose of the patient in bed 2 before walking down the hall to the room. Which attribute is the nurse displaying?

Organizational skills

The nurse leader is providing feedback to the AP after the assigned task has been completed. Which action can the nurse leader take while providing feedback to improve confidence levels in AP?

Performing the session in a private place

Which statement by the nursing student indicates effective learning regarding a characteristic of an effective leader? Select all that apply. "A leader is a role model for the staff." "A leader is an effective communicator." "A leader is consistent in managing conflict." "A leader avoids a participatory approach to decision-making." "A leader may not be competent in all aspects of delivery of care."

- "A leader is a role model for the staff." - "A leader is an effective communicator." - "A leader is consistent in managing conflict."

The head nurse is delegating responsibilities to her staff. Which order would be given to the nurse manager? Select all that apply. "Conduct regular staff meetings." "Make rounds with health care providers." "Submit staffing schedules for the unit." "Provide care to the patients using a holistic approach." "Participate in the development of nursing policies and procedures."

- "Conduct regular staff meetings." - "Make rounds with health care providers." - "Submit staffing schedules for the unit."

Which characteristic should the nurse possess to be an effective leader? Select all that apply Set objectives and guide the staff Maintain a neutral approach in decision-making Be consistent in managing conflict Delegate work appropriately Display impassivity toward others to avoid discrimination

- Set objectives and guide the staff - Be consistent in managing conflict - Delegate work appropriately

Which strategy improves staff communication in a health care team? Select all that apply. Staff meetings Newsletters Standing orders Protocol Minutes of meetings

- Staff meetings - Newsletters - Minutes of meetings

Which characteristic of team nursing holds true? Select all that apply. The RN works directly with the patient and family The RN assumes responsibility for the caseload of patients The RN leads the team of other nurses and nursing assistants The team leader develops patient care plans and coordinates with team members The team members provide direct patient care under supervision of the RN

- The RN leads the team of other nurses and nursing assistants - The team leader develops patient care plans and coordinates with team members - The team members provide direct patient care under supervision of the RN

A nursing director has planned to change the nursing care delivery model of the hospital from a team nursing model to a total patient care model because of the increase in the number of RNs working at the hospital. Which order would be given to incorporate the new model? Select all that apply. The RN leads the team of other RNs The RNs should plan care RNs can delegate care to subordinates One primary RN should assume responsibility of the caseload of patients The RN works directly with patients, families, and health care team members

- The RNs should plan care - RNs can delegate care to subordinates - The RN works directly with patients, families, and health care team members

Which statement describes a disadvantage of the total patient care model? Select all that apply The team leader needs to take time to delegate work, which may be time consuming. There is a lack of collaboration with other health care team members. The associate nurse is unable to change the care plan without discussing it with the primary nurse. A greater number of RNs are needed to provide care Continuity of care is a problem if the RN is unable to communicate patient needs.

- A greater number of RNs are needed to provide care - Continuity of care is a problem if the RN is unable to communicate patient needs. Rationale: The total patient care model requires a greater number of RNs to provide the care. This results in increased costs, making the model less cost effective. Continuity of care is a problem if the RN is unable to communicate the patient's needs. The total patient care model does not have a lack of collaboration; rather the model allows a high degree of collaboration with other health care team members.

Which quality is desired in an entry-level nurse? Select all that apply. An understanding of the environment of care The ability to provide care single-handedly Respect for the rights, beliefs, and values of patients Knowledge of the roles and responsibilities of a nurse The ability to lead management of patient care as needed

- An understanding of the environment of care - Respect for the rights, beliefs, and values of patients - Knowledge of the roles and responsibilities of a nurse

Which responsibility is that of a nurse manager? Select all that apply Conduct routine nursing staff evaluations Prepare the care plan for the patients Interview and hire new nursing employees Conduct rounds to solve patient and caregiver complaints Provide psychological support to patients and family members

- Conduct routine nursing staff evaluations - Interview and hire new nursing employees - Conduct rounds to solve patient and caregiver complaints Rationale: Nurse managers aren't always involved in direct patient care. They aren't responsible for preparing nursing care plans or providing psychological support to patients and family.

Which activity indicates that the new nurse manager has a good understanding of his/her role and responsibility? Select all that apply. Conducts routine staff evaluations Provides direct care to patients Establishes interprofessional committees Monitors professional nursing standards Recommends new equipment for the unit

- Conducts routine staff evaluations - Establishes interprofessional committees - Monitors professional nursing standards - Recommends new equipment for the unit

Which duty would a case manager perform? Select all that apply. Prescribe medicines to the patient in the doctor's absence Coordinate acute care of the patient in the hospital Supervise the care delivered by other staff Actively coordinate patient discharge planning Provide alternative therapies to the patient

- Coordinate acute care of the patient in the hospital - Supervise the care delivered by other staff - Actively coordinate patient discharge planning

Which action indicates that the nursing student displays an understanding of accountable nursing care? Select all that apply. Suspend care after discharge Exhibit a commitment to providing excellent patient care. Inform patients about ways to improve self-care Deny responsibility for patient care outcomes. Check with the patient about his or her health status after discharge.

- Exhibit a commitment to providing excellent patient care. - Inform patients about ways to improve self-care - Check with the patient about his or her health status after discharge.

Which principle is included in time management? Select all that apply Goal setting Time analysis Priority setting Interruption control Clinical decision-making

- Goal setting - Time analysis - Priority setting - Interruption control

A group of RNs in a 75-bed, pediatric health care agency are planning to apply for Magnet status for the hospital. One of the nurses proposes decentralizing the care-managing process to improve the nursing management system. Which advantage of decentralized management may have led the nurse to propose this concept? Select all that apply. It makes the RNs the decision-makers It keeps all the managers and staff members actively involved. It facilitates a greater collaborative effort for patient care. It limits the work of the APs. The nursing staff are highly motivated in this system of management.

- It keeps all the managers and staff members actively involved. - It facilitates a greater collaborative effort for patient care. - The nursing staff are highly motivated in this system of management.

A nurse manager would have which responsibility? Select all that apply Seeking guidance Learning to lead a team Assuming accountability Providing staff education Solving problems in the clinic

- Learning to lead a team - Providing staff education

Which tip would help the RN appropriately delegate patient care to AP? Select all that apply. Listen attentively to the AP Communicate clearly with the AP Let the AP perform tasks independently Assign tasks a little higher than the AP's skills Assess the knowledge and skills of the AP

- Listen attentively to the AP - Communicate clearly with the AP - Assess the knowledge and skills of the AP

Which characteristic does the primary nursing care delivery model exhibit? Select all that apply. One primary RN assumes the responsibility for a caseload of patients Team members provide direct patient care under the supervision of an RN The same RN provides care for a group of patients during their entire stay in the agency There is hierarchical communication from charge nurse to charge nurse The RN assesses the patient, develops the plan of care, and delivers appropriate nursing interventions

- One primary RN assumes the responsibility for a caseload of patients - The same RN provides care for a group of patients during their entire stay in the agency - The RN assesses the patient, develops the plan of care, and delivers appropriate nursing interventions

Which factor is essential to a philosophy of care? Select all that apply. Management of patient care Selection of proper interventions Selection of the management structure Selection of a nursing care delivery model Knowledge of roles and responsibilities of a nurse

- Selection of the management structure - Selection of a nursing care delivery model

The nurse, who has experience working in a non-Magnet hospital, has found a new job in a Magnet hospital. Which difference would the nurse expect to find in the new hospital? Select all that apply. The staff feels valued There is increased job satisfaction There is increased dependence on other staff members Solo work is preferred to working in a team It empowers nurses to be innovative

- The staff feels valued - There is increased job satisfaction - It empowers nurses to be innovative

Which type of care management approach coordinates and link health care services to patients and their families while streamlining costs and maintaining quality?

Case management