377 leadership final

A nurse discovers that a client was administered an antihypertensive medication in error. Identify the appropriate sequence of steps that the nurse should take using the following actions. A: Call the provider B: Check vital signs C: Notify the risk manager D: Complete an incident report E: Instruct the client to remain in bed until further notice

1 - B: Check vital signs 2- E: Instruct the client to remain in bed until further notice 3 - A: Call the provider 4 - D: Complete an incident report 5 - C: Notify the risk manager

A nurse manager is providing information about the audit process to members of the nursing team. Which of the following information should the nurse manager include? (select all that apply) A: A structure audit that evaluates the setting and resources available to provide care B: An outcome audit evaluates the results of the nursing care provided C: A root cause analysis is indicated when a sentinel event occurs D: Retrospective audits are conducted while the client is receiving care E: After data collection is completed, it is compared to a benchmark

A: A structure audit that evaluates the setting and resources available to provide care B: An outcome audit evaluates the results of the nursing care provided C: A root cause analysis is indicated when a sentinel event occurs E: After data collection is completed, it is compared to a benchmark

A nurse witnesses an assistive personnel they are supervising reprimanding a client for not using the urinal properly. The AP threatens to put a diaper on the client if the urinal is not used more carefully next time. Which of the following torts is the AP committing? A: Assault B: Battery C: False imprisonment D: Invasion of privacy

A: Assault

A nurse is hired to replace a staff member who has resigned. After working on the unit for several weeks, the nurse notices that the unit manager does not intervene when there is conflict between team members, even when it escalates. Which of the following conflict resolution strategies is the unit manager demonstrating? A: Avoidance B: Smoothing C: Cooperating D: Negotiating

A: Avoidance

A nurse is assisting with the discharge planning for a client. Which of the following should the nurse take? (select all) A: Determine the clients need for home medical equipment B: Provide a list of all the medications the client received in the facility C: Obtain printed instruction for medication self-administration D: Provide the family with a list of community agencies that can provide assistance E: Discuss the importance of attending follow-up appointments

A: Determine the clients need for home medical equipment C: Obtain printed instruction for medication self-administration D: Provide the family with a list of community agencies that can provide assistance E: Discuss the importance of attending follow-up appointments

A nurse is planning safety interventions at a new clinic. Which of the following interventions should the nurse include? A: Have staff who will be performing x-rays wear dosimeters B: Provide both latex and non-latex gloves for employees C: Place sharps containers outside client rooms D: Provide electrical tape for staff to repair frayed cords

A: Have staff who will be performing x-rays wear dosimeters

A home health nurse is assessing the safety of a client's home. The nurse should identify which of the following factors as increasing the client's risk for falls? (select all) A: History of a previous fall B: Reduced vision C: Impaired memory D: Takes rosuvastatin E: Uses a night light F: Kyphosis

A: History of a previous fall B: Reduced vision C: Impaired memory F: Kyphosis

An RN on a medical-surgical unit is making assignments at the beginning of the shift. Which of the following tasks should the nurse delegate to the LPN? A: Obtain vital signs for a client who is 2 hour post-procedure following a cardiac catheterization B: Administer a unit of packed red blood cells (RBCs) to a client who has cancer C: Instruct a client who is scheduled for discharge in the performance of wound care D: Develop a plan of care for a newly admitted client who has pneumonia

A: Obtain vital signs for a client who is 2 hour post-procedure following a cardiac catheterization

A nurse manager is observing the actions of a nurse they are supervising. Which of the following actions by the nurse requires the nurse manager to intervene (select all that apply) A: Reviewing the health care record of a client assigned to another nurse B: Making a copy of a client's most current laboratory results for the provider during rounds C: Providing information about a client's condition to hospital clergy D: Discussing a client's condition over the phone with an individual who has provided the client's information code E: Participating in walking rounds that involve the exchange of client related information outside of clients' rooms

A: Reviewing the health care record of a client assigned to another nurse B: Making a copy of a client's most current laboratory results for the provider during rounds C: Providing information about a client's condition to hospital clergy E: Participating in walking rounds that involve the exchange of client related information outside of clients' rooms

A nurse on an acute care unit is caring for a client following a total hip arthroplasty. The client is confused, moving the affected leg into positions that could dislocate the new hip joint, and repeated attempting to get out of bed. After determining that restraint application is indicated, which of the following actions should the nurse take? (select all) A: Secure the restraint to the frame of the bed B: Get a prescription for restraints from the provider C: Have a family member sign the consent for restraints D: Tie the restraint to the side rail using a double knot E: Ensure that only one finger can be inserted between the restraint and the client

A: Secure the restraint to the frame of the bed B: Get a prescription for restraints from the provider C: Have a family member sign the consent for restraints

A nurse manager is developing an orientation plan for newly licensed nurses. Which of the following information should the manager include in the plan? (select all that apply) A: Skill proficiency B: Assignment to a preceptor C: Budgetary principles D: Computerized charting E: Socialization into unit culture

A: Skill proficiency B: Assignment to a preceptor D: Computerized charting E: Socialization into unit culture

A nurse is serving as a preceptor to a newly licensed nurse and is explaining the role of a nurse as an advocate. Which of the following situations illustrates the advocacy role? (select all that apply) A: Verifying that a client understands what is done during a cardiac catheterization B: Discussing treatment options for a terminal diagnosis C: Informing members of the health care team that a client has a DNR status D: Reporting that a health team member on the previous shift did not provide care as prescribed E: Assisting a client to make a decision about their care based on the nurse's recommendations

A: Verifying that a client understands what is done during a cardiac catheterization C: Informing members of the health care team that a client has a DNR status D: Reporting that a health team member on the previous shift did not provide care as prescribed

A nurse on a sixth-floor medical surgical unit is advised that a severe weather alert code has been activated. Which of the following actions should the nurse take? (Select all that apply.) A. Draw window shades and close drapes as protection against shattering glass. B. Move beds of nonambulatory clients away from windows. C. Relocate ambulatory clients into the hallways. D. Use the elevators to move clients to lower levels. E. Turn the radio on for severe weather warnings

B. Move beds of nonambulatory clients away from windows. C. Relocate ambulatory clients into the hallways. E. Turn the radio on for severe weather warnings

A community experiences an outbreak of meningitis, and hospital beds are urgently needed. Which of the following clients should the nurse recommend for discharge? A: A client newly admitted with angina and a history of myocardial infarction 1 year ago B: A client who was preadmitted for rotator cuff surgery and has diabetes mellitus type 2 C: A client admitted the day before with pneumonia and dehydration D: A client who has a fractured hip and is scheduled for total hip replacement the next day

B: A client who was preadmitted for rotator cuff surgery and has diabetes mellitus type 2

Which do you address first? (medical unit) A: Administer daily statin drug B: Administer prn nebulizer treatment C: Administer q4 hour IV antibiotics D: Take q shift vitals

B: Administer prn nebulizer treatment

A nurse is preparing to transfer a client who is 72 hours postoperative to a long term care facility. Which of the following information should the nurse include in the transfer report? (Select all that apply) A: Type of anesthesia used B: Advance directive status C: Vital signs on day of admission D: Medical diagnosis E: Need for specific equipment

B: Advance directive status D: Medical diagnosis E: Need for specific equipment

Which do you address first? (Nursing Home) A: BP of 170/80 in patient with known hypertension B: BP of 170/80 in patient with no history of hypertension C: Administer morning insulin to type 1 diabetic D: Administer daily oral anti-coagulant drug

B: BP of 170/80 in patient with no history of hypertension

A nurse is caring for a client who has chest pain. The client says, "I am going home immediately." Which of the following actions should the nurse take? (select all) A: Notify the client's family of their intent to leave the facility B: Document the client's intent to leave the facility against medical advice C: Explain to the client the risks if they choose to leave D: Ask the client to sign a form relinquishing responsibility of the facility E: Prevent the client from leaving the facility until the provider arrives.

B: Document the client's intent to leave the facility against medical advice C: Explain to the client the risks if they choose to leave D: Ask the client to sign a form relinquishing responsibility of the facility

A newly licensed nurse is preparing to insert an IV catheter in a client. Which of the following sources should the nurse use to review the procedure and the standard at which it should be performed? A: Website B: Institutional policy and procedure manual C: More experienced nurse D: State nurse practice acts

B: Institutional policy and procedure manual

A nurse is discussing disaster planning with the board members of a hospital. Which of the following individuals should the nurse expect to request extra supplies and staffing for the facility? A: Incident commander B: Medical command physician C: Triage officer D: Media liaison

B: Medical command physician

A nurse who has just assumed the role of unit manager is examining the skills necessary for interprofessional collaboration. Which of the following actions support the nurse's interprofessional collaboration (select all that apply) A: Use aggressive communication when address the team B: Recognize the knowledge and skills of each member of the team C: Ensure that a nurse is assigned to serve as the group facilitator for all interprofessional meetings D: Encourage the client and family to participate in the team meeting E: Support team member requests for referral

B: Recognize the knowledge and skills of each member of the team D: Encourage the client and family to participate in the team meeting E: Support team member requests for referral

A nurse is observing a newly licensed nurse and an assistive personnel (AP) pull a client up in bed using a drawsheet. Which of the following actions byt he newly licensed nurse indicated an understanding of this technique? A: The nurse stands with both feet together B: The nurse uses their body weight to counter the client's weight C: The nurse's feet are facing inward toward the center of the bed D: The nurse rotates the waist while pulling the client upward

B: The nurse uses their body weight to counter the client's weight

A case manager is discussing critical pathways with a group of newly hired nurses. Which of the following statements indicates understanding? A: The time to fill out the pathways often increases the cost of care B: The pathway shows an estimate of the number of days the client will be hospitalized C: Deviance from the pathway is a sign of improved quality D: The pathway include information about the clients history

B: The pathway shows an estimate of the number of days the client will be hospitalized

Which do you do first? (ED patient) A: Apply pressure to non-pulsating bleeding foot B: Obtain EKG C: Administer bag-valve mask ventilation D: Administer aspirin for c/o chest pain

C: Administer bag-valve mask ventilation

A LPN ending their shift reports to the RN that a newly hired AP has not calculated the intake and output for several clients. Which of the following actions should the RN take? A: Complete an incident report B: Delegate this task to the LPN C: Ask the AP if they need assistance D: Notify the nurse manager

C: Ask the AP if they need assistance

A nurse is caring for a client who is scheduled for surgery. The client hands the nurse information about advance directives and states, "Here, I don't need this. I am too young to worry about life-sustaining measures and what I want done for me." Which of the following actions should the nurse take? A: Return the papers to admitting department with a note stating that the client does not wish to address the issue at this time B: Explain to the client that you never know what can happen during surgery and to fill the papers out just in case C: Contact a client representative to talk with the client and offer additional information about the purpose of advanced directives D: Instruct the client that surgery cannot be conducted unless the advance directives form are completes

C: Contact a client representative to talk with the client and offer additional information about the purpose of advanced directives

A nurse is participating in a quality improvement study of a procedure frequently performed on the unit. Which of the following information will provide data regarding the efficacy of the procedure? A: Frequency with which procedure is performed B: Client satisfaction with performance of procedure C: Incidence of complications related to procedure D: Accurate documentation of how procedure was performed

C: Incidence of complications related to procedure

A nurse manager is explaining the use of incident report to a group of nurses in an orientation program. Which of the following information should the nurse manager include? (select all that apply) A: A description of the incident should be documented in the client's health care record B: The client should sign as a witness on the incident report C: Incident reports include a description of the incident and actions taken D: A copy of the incident report should be placed in the client's health care record E: The risk management department investigates the incident

C: Incident reports include a description of the incident and actions taken E: The risk management department investigates the incident

A nurse enters the room of a client and finds the client lying on the floor. Which of the following actions should the nurse take first? A: Call the provider B: Ask a staff member for assistance getting the client back in bed C: Inspect the client for injuries D: Instruct the client to ask for help if they need to get out of bed.

C: Inspect the client for injuries

A nurse is reviewing the hospital's fire safety policies and procedures with newly hired assistive personnel. The nurse is describing what to do when there is a fire in a client's trash can. Which of the following information should the nurse include? (select all) A: The first step is to pull the alarm B: Use a class C fire extinguisher to put out the fire C: Instruct ambulatory clients to evacuate to a safe place D: Pull the pin on the fire extinguisher prior to use E: Close all doors

C: Instruct ambulatory clients to evacuate to a safe place D: Pull the pin on the fire extinguisher prior to use E: Close all doors

A nurse is caring for a child who is being treated in the emergency department following a head contusion from a fall. History reveals that the child lives at home with one parent. The provider's discharge instructions include waking the child every hour to assess for indications of a possible health injury. In which of the following situations should the nurse intervene and attempt to prevent discharge? A: The parent states that they do not have insurance or money for a follow up visit B: The child states, "My head hurts and I want to go home" C: The nurse smells alcohol on the parent's breath D: The parent verbalizes fear about taking the child home and requests they be kept overnight

C: The nurse smells alcohol on the parent's breath

A nurse is caring for a client who is medically unstable. The client's adult child informs the nurse that the client has a DNR prescription with the primary care provider. Which of the following actions should the nurse take? A: Assume the client does not want to be resuscitated, and take no action if they experience cardiac arrest B: Write a note of the front of the provider prescription sheet asking that a DNR be re-prescribed C: Write a DNR prescription in the client's medical record D: Call the provider to verify the existence of an active DNR prescription

D: Call the provider to verify the existence of an active DNR prescription

Which do you address first? (Post Op Unit) A: Heart rate monitor sounding B: Pt request to use restroom C: Report from tech: patient fasting glucose of 79 D: Client is respiratory arrest

D: Client is respiratory arrest

A nurse manager is providing information to the nurses on the unit about ensuring client rights. Which of the following regulations outlines the rights of individuals in health care settings? A: American Nurse Association Code of Ethics B: HIPAA C: Patient Self-Determination Act D: Patient Care Partnership

D: Patient Care Partnership

True or False: Critical thinking is an automatic process that requires no effort or discipline to practice

False

True or False: Confrontation is most often the least effective approach to handling conflict in the workplace.

False It is the MOST EFFECTIVE approach

True or False: A "Do Not Resuscitate" order on a patient's record is a long-term advanced directive document that is valid across all settings until the patient changes their mind.

False Not long term or transferable

True or False: Positive patient outcomes in the United States are directly correlated with the dollars spent on care (based on average cost per person).

False Paying more and not having better outcomes

True or False: According to the Fair Labor Standards Act, overtime is defined as work over 8 consecutive hours in a single 24 hour period.

False Some organizations go by this standard but it is not mandated

Lewin's Force-field model for change can be applied to budgeting and/or staffing issues faced in nursing settings.

True

National Patient Safety Goals are established by the Joint Commission for Health Care Organizations (JCAHO) annually for hospitals and outpatient care settings.

True

True or False: A nurse manager may delegate participation on a quality team to a staff nurse while retaining accountability for unit performance specific to the quality initiative.

True

True or False: A patient has the right to refuse life-sustaining care.

True

True or False: An astute nurse manager may identify antecedents to conflict prior to conflict occurring and take steps to avoid negative situations.

True

True or False: Communication is essential for effective supervision within the "5 Rights of Delegation"

True

True or False: While decision-making doesn't require a problem to be present, problem-solving requires decisions to be made

True

True or false: A team's initial work should include setting aside time to establish how conflict will be managed.

True

True or false: Authenticity in qualitative research examines how the investigators portray an accurate range of realities of the study informants.

True

True or false: Concurrent mixed methods research involves collection of quantitative and qualitative data during the same period of time.

True

True or false: Errors in care that lead to patient complications/death can not be considered unavoidable without investigation of contributing factors.

True

True or false: One challenge associated with interprofessional team work is recognizing the differences in culture among the team members.

True

True or false: One of the current National Patient Safety Goals addresses use and response to alarms on medical equipment.

True

True or false: Prioritization in the Emergency Department may often be guided by determining if a problem is systemic or local in nature.

True

True or false: Professional decision making occurs in a process that can be considered as similar to the nursing process.

True

True or false: Profit is defined as the amount of revenue collected minus the cost of providing service.

True

True or false: The Capital Budget consists of expenses related to items purchased for use of greater than one year and/or cost over $500.

True

True or false: The central focus of interprofessional teams is patient-centered care.

True

True or false: Two quiz scores will be dropped when calculating the final course grade.

True

True or false: When a registered nurse delegates a task to an unlicensed nursing assistant, he/she retains accountability for the correct completion of the task and the outcomes associated with it.

True

An FTE is a mathematical calculation based on 40 hours (or 36 if 12 hour shifts) of work over one week (7 consecutive days) being "full time".

True 40/40 = 1.0 FTE

True or False: Business skills are a nurse management competency

True Budgeting

True or False: Controlling is a management function associated with budget responsibilities.

True Comparing actual vs projected

True or False: Communication patterns have a direct connection to promoting client safety

True QSEN

True or False: A living will can be created once and presented during multiple hospitalizations to guide health decision-making

True Unlike DNR orders, a living will is in effect until the person revokes it. DNR orders must be established for every hospital stay and expire at discharge. (May also be used in home care and long term care settings).

Total quality management aims to prevent avoidable safety issues through organizational commitment at all levels.

True Total quality management focus is commitment

The primary concern for trustworthiness of qualitative research pertains to: a. How credible and dependable the reported findings may be considered b. Deciding how to apply the research to your patient population c. Whether the author's credentials are sufficient to provide expertise on the subject d. Correct statistical analysis and reporting of p-values

a) How credible and dependable the reported findings may be considered Yes, this is the intended outcome of evaluating trustworthiness of qualitative research

When delegating a task and an LPN and tech are both available, what considerations guide delegation decisions? (Choose all that apply) a) Right task: sterile vs clean technique b)Right person: training and policy/procedure support delegation c) Right supervision: RN must have time to observe completion of the task d) Right circumstances: patient stability and expected out come of task e) Right communication: LPN or tech must know what/when to report to RN once task is completed.

a) Right task: sterile vs clean technique b)Right person: training and policy/procedure support delegation d) Right circumstances: patient stability and expected out come of task e) Right communication: LPN or tech must know what/when to report to RN once task is completed. Right supervision refers to giving clear instructions, providing feedback and intervening if needed.

Which of the follow is true regarding use of restraints? (Choose all that apply) a) The maximum amount of time restraints can be ordered is 24 consecutive hours b) You must be able to insert two fingers between the restraint and person's extremity c) Neuro checks are required every 2 hours or as needed d) Secure to a non-movable part of the bed e) Offer food and fluids during restraint

a) The maximum amount of time restraints can be ordered is 24 consecutive hours b) You must be able to insert two fingers between the restraint and person's extremity c) Neuro checks are required every 2 hours or as needed e) Offer food and fluids during restraint

Which one of the following is an example of the "right supervision/evaluation"? a)Assessing a patient's neuro status after a tech reports a blood glucose of 70. b)Making a delegation decision based on the patient's current stability. c)Reviewing a new tech's competency checklist at the beginning of the shift. d)Instructing a tech on how to assist a patient with eating related to the patient's swallowing precautions.

a)Assessing a patient's neuro status after a tech reports a blood glucose of 70.

Which of the following are factors related to determining which nursing care delivery model is most appropriate? (Select all that apply) a)Complexity of nursing actions required b) Availability of human resources (licensed nurses, techs) c) Location of supportive services (nutrition, housekeeping, pharmacy) d) Size and layout of patient care unit

a)Complexity of nursing actions required b) Availability of human resources (licensed nurses, techs) c) Location of supportive services (nutrition, housekeeping, pharmacy) d) Size and layout of patient care unit

A qualitative study states in the methods section that researchers met with informants following data analysis and verified they had correctly interpreted the meaning of statements made during interviews. This practice is known as: a)Member checking b)Disconfirming evidence c)Negative case analysis d)Second guessing

a)Member checking a)This may be done at any point during data collection, following coding, or identifying themes and developing findings.

Which of the following leadership theories is characterized by: staff knowledge of desired outcomes; confidence in decision-making; works well in a rapidly changing environment? a)Quantum b)Transactional c)Transformational d)Servant

a)Quantum a) Employees are trained, empowered, and know the expected outcomes. Decisions made based on policies, critical thinking, and availability of information.

An emotionally intelligent leader demonstrates which of the following? a)Uses perceived emotions of self and others to plan communication. b)Makes decisions based on the state of emotional turmoil among staff. c)Communicates unpopular news immediately in order to use strong emotion to convey message. d)Reserves communication until emotional state of all staff is balanced.

a)Uses perceived emotions of self and others to plan communication. Practice of awareness of self and others emotions with planning to accommodate anticipated emotional responses Uses strength of relationships in leadership

Which of the following statements is an example of servant leadership style: Select one: a. A manager considers how a change that must be made will impact each employee and speaks with them about how he/she can help the employee make the transition b. A manager informs employees via email that a change is being made in the unit staffing model with the effective date; no negotiation of the new plan is possible c. A manager makes the decision not to implement a change that has been mandated from higher level administration because it will negatively affect too many of his/her employees d. A manager has staff vote on the best solution for a change in staffing of the nursing unit

a. A manager considers how a change that must be made will impact each employee and speaks with them about how he/she can help the employee make the transition Yes; this demonstrates the manager's desire to care for each employee's needs related to the changes

Effective coaching occurs: Select one: a. As a proactive step in employee development focusing on future performance b. Right after challenging situations to draw attention to what could have been done differently c. Only among entire teams of employees, such as during staff meetings d. When an employee's performance is not at the required level

a. As a proactive step in employee development focusing on future performance Yes; coaching focuses on future performance for success

Effective strategies for managing resistance to change include: Select one: a. Close, frequent communication with those who exhibit resistance to the change b. Rallying supporters of the change against those who exhibit resistance c. An autocratic approach that includes confrontation and exercise of power d. Suspending the change process until resistors can be removed from the organization

a. Close, frequent communication with those who exhibit resistance to the change Yes; keeping resistors informed and listening to their input can be an effective strategy for reducing resistance

Method triangulation refers to: a. Collecting data in more than one way b. Asking the same question three times to verify the subject's accuracy c. Using at least three different methods to conduct a study d. Using three data points to determine an average score

a. Collecting data in more than one way Yes - this gives opportunity to evaluate differences that could be noted among themes in data and helps verify data is correct.

A zero-based budget process is: Select one: a. Created using a "blank sheet" - no figures from previous years are in the template to begin with b. Created using the previous year's budget as a template - adjustments are made to the previous year's figures to create the new budget c. Used only when an organization is new and has no history d. None of the above

a. Created using a "blank sheet" - no figures from previous years are in the template to begin with zero based=no figures

Which is true of a "Durable Power of Attorney for Healthcare"? Select one: a. Designates another person to act on the patient's behalf if the patient cannot speak for him/herself b. States the patient's specific and detailed wishes for life support/sustaining measures if he/she cannot speak c. States the patient's financial representative for paying healthcare related bills following death d. None of the above

a. Designates another person to act on the patient's behalf if the patient cannot speak for him/herself

A nursing care delivery model that includes dietary, environmental services and complementary therapies fits best within which of the following: Select one: a. Evolving models b. Primary nursing model c. Total patient care model d. Functional nursing model

a. Evolving models Yes; evolving care models incorporate all patient care services

Which of the following is not a component of the definition of a team? Select one: a. Individual contributions are more valued than group decision-making b. Work collaboratively toward goals c. A leader maintains function d. The team is stronger than the members

a. Individual contributions are more valued than group decision-making Yes; the value of teams is the interaction of the members and the interdependence on each other to reach decisions

Nursing care delivery models supporting patient-centered care embrace which of the following: Select one: a. Nursing, environmental services and complementary therapies work together as a unit b. Patients choose which nurses will care for them c. Patients deciding which health insurance to select d. All disciplines meeting at the bedside to make all care decisions for the patient

a. Nursing, environmental services and complementary therapies work together as a unit Yes; focusing on all aspects of the patient's needs puts them at the center of all activity planning and delivery evolving nursing care model

The research question: "How do fifth graders in underserved urban settings interpret the importance of physical activity to their health?" is most likely what kind of research question? Select one: a. Qualitative b. quantitative

a. Qualitative Yes; this is most likely a meaning question answered with qualitative methods

Which of the following is an example of a retrospective quality audit? Select one: a. Review of ED EMR's to determine if aspirin was given within the specified time frame for patients presenting with chest pain. b. Observing and documenting staff handwashing practice in the ED for two weeks c. Predicting how many antibiotics will be prescribed for ED patients based on staff handwashing compliance d. None of the above

a. Review of ED EMR's to determine if aspirin was given within the specified time frame for patients presenting with chest pain. Yes; reviewing records after care was rendered is a retrospective audit activity

A "service line" structure in a healthcare organization is best demonstrated in which of the following: Select one: a. Staff from multiple disciplines managed in units to promote specialized service focus b. Nursing services are organized under a single department c. A mix of several different structures are used to achieve specific goals d. Nursing and medical service operate in different departments with parallel management structures

a. Staff from multiple disciplines managed in units to promote specialized service focus Yes; all staff serving a specific specialty are in a single department and have more highly specific training based on the patient population characteristics specialized service is the key for this structure

Transferability refers to: a. The ability to apply the findings of research to other similar populations b. The ability to re-create a research study with a different group of participants c. The transfer of participants from a qualitative study to a quantitative study d. The act of transferring qualitative data into quantitative data

a. The ability to apply the findings of research to other similar populations Yes - the more the design and results of a study can be applied to populations beyond the original study group the more transferable the findings of the study are

Authority is: Select one: a. The right to do something b. The obligation to do something c. Accepting ownership of results d. All of the above

a. The right to do something given either hierarchical or legally

According to Rogers, which of the following is true: Select one: a. There is a logical order in which steps toward change occur b. The process of change has a single direction, requiring completion of the process before making adjustments c. Unfreezing is the phase of change when new behaviors have been fully established d. None of the above

a. There is a logical order in which steps toward change occur Yes; the logical order in which people consider change and move toward change occurs in a sequence of steps; it is possible for it to reverse at times.

Characteristics of effective/healthy communication in the healthcare workplace include which of the following: Select one: a. They are contextual (take timing, environment, and circumstances into account) b. They are static (structured for consistency so that they are identical each time) c. They are directive (delivered to provide one way instructions to patients, families, etc) d. None of the above

a. They are contextual (take timing, environment, and circumstances into account) Yes; planning is necessary in many cases to promote effective professional communication contextual, irreversible, dynamic

Barriers to effective communication should be identified and addressed in health care settings because: Select one: a. They can have a direct impact on patient safety and outcomes b. They are necessary to clarify the boundaries within interprofessional communication c. Authority and chain of command are preserved through strict hierarchies d. All choices are correct

a. They can have a direct impact on patient safety and outcomes Yes; tools to facilitate effective communication related to patient safety are widely used QSEN

Assignment is: Select one: a. Transfer of authority, accountability and responsibility b. Transfer of authority and responsibility, but retain accountability c. The same as accountability d. None of the above

a. Transfer of authority, accountability and responsibility done by nurse manager or charge nurse

A nurse manager is planning the implementation of a new bed upgrade on a med-surg floor. When planning using the Lewin's force-field model of change, what stage is the nurse using by preparing the unit for the renovation with education about the needed change and a timeline of when and how the project is going to take place? Select one: a. Unfreezing b. Planning c. Moving d. Refreezing

a. Unfreezing Yes; unfreezing is the preparatory phase for change

The practice of triangulation within qualitative research refers to: Select one: a. Using more than one method or person to obtain or analyze data b. Verifying trustworthiness of a research report c. Applying at least three different approaches to recruiting research subjects d. Always applying mixed methods to research questions

a. Using more than one method or person to obtain or analyze data

What type of budget process would allow for using excess revenue from one month of the year to offset larger than projected costs in another month? Select one: a. Variable b. Cost-based c. Fixed d. All of the above

a. Variable Yes; a variable budget has some allowances to move budgeted amounts within the year

The nurse's communication with an occupational therapist regarding a patient's ability to transfer from bed to wheelchair best illustrates what communication function? a)Collaboration b)Continuity of care c)Discharge planning d)Patient handoff

b)Continuity of care

In which phase of qualitative research would "method triangulation" support the strength of the research findings? a)Research team selection - choosing individuals who have experience with the topic. b)Data collection - conducting interviews and making observations of informants. c)Coding and analysis - using competing theories to identify themes from data. d)Meeting with informants and discussing findings to confirm correct interpretation of meanings.

b)Data collection - conducting interviews and making observations of informants. a)Using multiple methods to obtain data provides more opportunity to correctly identify codes and themes.

Which of the following is true about "benchmarks" in Quality Management programs? a)Reflects the desired client response to care/treatment b)Goals set to determine level outcome indicators should be met c)Pertains to the setting where care/treatment is provided d)Examines how care is provided based on policies and procedures

b)Goals set to determine level outcome indicators should be met May be internally or externally set; also referred to as thresholds

Which of the following may be delegated to an LPN but not a patient care technician? a)Obtain blood glucose measurements using a finger-pick technique and glucometer. b)Sterile dressing change to a surgical wound. c)Insert foley catheter in pre-op unit. d)Evaluate the effectiveness of pre-discharge teaching.

b)Sterile dressing change to a surgical wound.

Which of the following communication practices is most supportive of client safety? Select one: a. Referral to home health services for physical therapy upon hospital discharge b. "Time out" prior to beginning surgical procedure in the operating room (patient undergoing general anesthesia) c. Scheduling a follow up appointment for the client's post-op visit d. Documentation in EMAR of who client will be living with upon hospital discharge

b. "Time out" prior to beginning surgical procedure in the operating room (patient undergoing general anesthesia) Yes; there is an immediate and high level of risk related to wrong patient, wrong procedure, wrong location when patient is sedated and cannot speak up

Detailed note-taking during observations of data within a qualitative study most supports which of the following: a. Triangulation b. Accurate interpretation of results c. Proof that the study was conducted well d. Protection from allegations of bias

b. Accurate interpretation of results Yes; the open-ended nature of the data in qualitative research calls for detailed notes that can be interpreted by researchers when identification of themes is conducted.

Which of the following would produce the most variety of qualitative data? a. A multiple choice paper and pencil questionnaire b. An interview that uses open-ended questions c. Asking participants to rate something on a 1-10 scale d. A telephone survey where the informant uses telephone buttons to answer questions.

b. An interview that uses open-ended questions Yes - an infinite variety of responses may be possible with this method

The Transtheoretical Theory of Change (Prochaska & DiClemente) is founded on the premise that: Select one: a. Change is possible regardless of the readiness of the person b. Change requires progression through phases of readiness to be successful and sustainable c. Readiness for change is uniform and occurs the same way for all individuals d. All of the above

b. Change requires progression through phases of readiness to be successful and sustainable Yes; attaining "maintenance" is the goal for this model of change

Which of the following is not a component required for Informed Consent to exist? Select one: a. Notification of risks associated with the procedure b. Guarantee of success if the patient's underlying health is intact c. Notification of alternative treatments available d. Risks involved with electing not to receive procedure

b. Guarantee of success if the patient's underlying health is intact There is never guarantee of success provided related to procedural consent

Which of the following is a difference in modern interprofessional practice from past practice? Select one: a. Physicians typically over estimate the amount of collaboration that occurs b. Nurses are team members as opposed to performing nursing work alongside of other professionals c. It is important for each profession to complete disciplinary work with higher priority than to spend time communicating with other disciplines d. None of the above; there are no identifiable differences

b. Nurses are team members as opposed to performing nursing work alongside of other professionals Yes; the importance of interprofessional collaboration is founded in evidence that patient outcomes are better

According to the National Council of State Boards of Nursing, the primary goal of proper delegation by registered nurses is to: Select one: a. Protect the registered nurse's license from being revoked for poor practice b. Protect the public c. Assure that organizational policies are adhered to d. Prevent lawsuits for malpractice

b. Protect the public Yes; the Venn diagram of the inputs to delegation processes focus on protecting the public through best nursing practice

An advantage of mixed-methods research is: a. An investigator can decide which data is more useful to report b. Quantitative analysis may be performed to test a hypothesis derived from initial qualitative findings c. It is more likely to be published in evidence-based journals d. Can be used when the investigator doesn't have a specific research problem in mind.

b. Quantitative analysis may be performed to test a hypothesis derived from initial qualitative findings Yes. Qualitative research data often leads to questions that can be measured in quantitative ways, giving more depth to the understanding of a research question.

Satisficing decisions are best suited for: Select one: a. Situations that require lengthy planning and preparation b. Situations that require prompt, basic solutions that meet minimum standards c. Problem solving for long term solutions to organizational problems d. Problem solving when circumstances require outcomes that are optimal every time, meeting the most rigorous standards

b. Situations that require prompt, basic solutions that meet minimum standards Yes; such as triage settings or temporary staffing crises

The Institute of Medicine report "The Future of Nursing" indicates all of the following changes must occur except: Select one: a. Nurses must be able to practice to the full extent of knowledge and education b. The NCLEX exam must be replaced with a different type of licensure testing c. Nurses must possess higher levels of education than in the past d. Nurses must be full partners in health care delivery

b. The NCLEX exam must be replaced with a different type of licensure testing Yes; this is not one of the recommendations made by the report.

Latent conflict exists when: Select one: a. At least one person in a relationship is aware that there is a difference of opinion regarding a common issue. b. The antecedents for conflict are present but no one feels the presence of conflict yet. c. Two or more people in relationship are acutely aware of conflict and take action to resolve it. d. None of the above

b. The antecedents for conflict are present but no one feels the presence of conflict yet. Yes; this is the definition of latent conflict

If a nursing assistant does not follow through in reporting back to the registered nurse as directed that a patient who had a urinary catheter inserted did not produce at least 250cc of urine in 4 hours, who is accountable for the patient's outcome (pain, discomfort, increased blood pressure, etc?) Select one: a. The nursing assistant alone b. The registered nurse alone c. Both the nursing assistant and the registered nurse d. None of the above

b. The registered nurse alone

The cost of employee turnover includes: Select one: a. Concern for lawsuits arising from improper termination b. Time and other resources invested in extensive training/residency programs c. Poor manager performance d. None of the above

b. Time and other resources invested in extensive training/residency programs Yes; the time and resources to orient both experienced and new employees is high

Delegation involves: Select one: a. Transfer of authority, accountability and responsibility b. Transfer of authority and responsibility, but retain accountability c. The same as accountability d. All of the above

b. Transfer of authority and responsibility, but retain accountability

A nurse manager must inform staff of change in the way scheduling will be handled. The manager informs each staff member individually of the change, asking what her can do to minimize the stress for each person involved. What leadership theory is most likely being used? a) emotional b) transformational c) servant d) transactional

c) servant consideration for EACH member of the staff with planning ahead of time to help each person adjust

An LPN reports to an RN that a newly hired tech did not calculate intake and output for her patients. What is the best action for the RN to take? a)Complete an incident report. b)Delegate the task to the LPN c)Ask the tech if they need assistance d)Notify the nurse manager

c)Ask the tech if they need assistance This is an opportunity to immediately determine training needs and provide instruction.

Accountability is: Select one: a. The right to do something b. An obligation to do something c. Accepting ownership of results d. None of the above

c. Accepting ownership of results even if responsibility is delegated to someone else, accountability means you retain ownership of the results

Managers who effectively use feedback: Select one: a. Schedule meetings with employees every six months to discuss performance b. Record observations and place in employee files just before evaluation time. c. Communicate with employees frequently and immediately following challenging situations d. Keep logs of employee problems to present during evaluation

c. Communicate with employees frequently and immediately following challenging situations Yes; the best time for effective feedback is as close to the performance activity as possible.

Effective teams have which combination of the following? Select one: a. Power, leadership, goals & end point b. Norms, morals, representation & democracy c. Communication, leadership, norms & roles d. None of the above

c. Communication, leadership, norms & roles Not always power, representation and democracy also not mentioned in slides

Which of the following best represents the nurse manager function of controlling? Select one: a. Coordinating patient care assignments b. Matching the number of staff to the patient census c. Comparing actual monthly unit expenses to the budgeted expenses d. Establishing goals for staff development programs

c. Comparing actual monthly unit expenses to the budgeted expenses Yes; budget management is the controlling function

The salary portion of the operating budget includes all of the following except: Select one: a. Costs associated with employee health insurance coverage b. Anticipated cost of staffing to cover employee sick time c. Furniture for the nurse's station d. Anticipated levels of needed overtime due to staff retirements

c. Furniture for the nurse's station Yes; this is not a salary budget component

Which of the following would be considered indirect costs for a nursing unit? Select one: a. Nursing salaries b. Purchase of IV catheter insertion kits c. Maintenance fees for printers d. Overtime salary costs

c. Maintenance fees for printers Yes; while printing is essential to support nursing services, it is not directly related to care delivery

The demand for quality is considered a change influencing the cost of health care because of which of the following: Select one: a. Clients trust that health care providers will always do the right thing b. It is directly related to which insurance plans clients can choose c. Medical errors not only decrease quality but involve costs related to lawsuits, malpractice, and efforts to improve quality. d. Government bodies have not had an interest in quality of healthcare

c. Medical errors not only decrease quality but involve costs related to lawsuits, malpractice, and efforts to improve quality. Medical errors not only decrease quality but involve costs related to lawsuits, malpractice, and efforts to improve quality.

Progressive discipline for performance appraisal involves: Select one: a. Employment continuation decisions made on a single incident of a policy infraction b. Repeated verbal discussions with an employee regarding problematic performance just prior to termination c. Multiple discussions of performance with an employee that addresses specific goals for achieving acceptable performance and increasing severity of consequences for repeated non-adherence d. All of the above

c. Multiple discussions of performance with an employee that addresses specific goals for achieving acceptable performance and increasing severity of consequences for repeated non-adherence Yes; this describes the progressive nature of discipline

Which of the following is an example of an outcome indicator for quality improvement activities? Select one: a. Consistent handwashing among clinical providers b. Verification of proper sterilization of resuable surgical instruments c. Post-operative infection rates remain below acceptable threshold established by benchmarks d. Consistently accurate documentation of "time out" prior to surgical procedures

c. Post-operative infection rates remain below acceptable threshold established by benchmarks Yes; patient infections related to a common procedure (such as surgery) would be an outcome of care and therefore outcome indicator others are more process related

Which of the following statements is true: Select one: a. Registered nurses can only delegate tasks any untrained person is capable of completing b. Registered nurses can delegate any task as long as he/she can directly observe completion of the task c. Registered nurses can delegate tasks, but no part of the nursing process d. Registered nurses can delegate any task that an unlicensed nursing assistant who is a nursing student has completed in his/her clinical education

c. Registered nurses can delegate tasks, but no part of the nursing process Yes; tasks contributing information/assessment data can be delegated but not the function of assessment

The National Patient Safety Goal that addresses medication safety addresses which of the following: Select one: a. Checking expiration dates on liquids b. Giving insulin from multiple dose vials to more than one patient c. Taking extra care with patients who take medication to thin their blood. d. Handwashing before administering oral medications.

c. Taking extra care with patients who take medication to thin their blood. Yes; NPSG 3 specifically identifies safety related to care of patients on blood thinning medications.

Which of the following is an important consideration when making a decision to delegate or not: Select one: a. Understanding the level of evidence needed b. The patient's ability to recognize the anticipated outcome c. The complexity of the task and predictability of the outcome d. How mature the person being delegated to is

c. The complexity of the task and predictability of the outcome

The "5 Rights of Delegation" do NOT include: Select one: a. The right follow up communication regarding task completion and patient response b. The right person is chosen to complete the task based on his/her skills c. The right documentation of who was assigned to complete a task d. The right direction is given to the person the task is being delegated to

c. The right documentation of who was assigned to complete a task

Overtime is defined by the United States Government as: Select one: a. Any time worked over the employee's usually scheduled number of hours in a month b. Incentive for working overnight if an employee is usually scheduled during the day. c. Time worked over 40 hours in a 7 consecutive-day week d. Defined only by organizational policy; there is no Federal Government definition.

c. Time worked over 40 hours in a 7 consecutive-day week

The use of triangulation during data collection in qualitative research is best described as: a. Three investigators review transcripts of interviews to confirm themes b. Placing data into a three column table to search for themes c. Using more than one investigator to make observations of informant behavior in the research setting d. Having at least three investigators agree upon the methods for data collection

c. Using more than one investigator to make observations of informant behavior in the research setting

A leader who is most comfortable with a Laissez-faire style is likely to handle a patient complaint about nursing care by doing which of the following: Select one: a. Present the problem to the entire staff group to obtain input on solutions b. Confront all nursing staff together and give one-way direction to change a practice. c. Wait to see what happens; these things always work themselves out d. Have a one-on-one conversation with the nurse involved right away to get their perspective on the issue.

c. Wait to see what happens; these things always work themselves out Yes; avoiding action and hoping a problem will resolve itself is a hallmark of Lassez-faire style

Delegating a task to an unlicensed patient care tech is permissible when: Select one: a. The RN fully retains control of the nursing process through exercising supervision of task completion (right supervision) b. The tech has been trained and competency-evaluated in task performance (right person) c. There is a high degree of predictability for the outcome of task completion (right circumstances) d. All of the above

c. all of the above

What of the following has the highest priority for nursing intervention? a)Type I diabetic patient with fasting glucose of 89; has not had am insulin yet. b)Patient with oxygen saturation of 89% on 2L oxygen via nasal cannula. c)Post knee-replacement patient with capillary refill of > 4 seconds on operative extremity with noted cyanosis of foot. d) Patient on telemetry with ECG changes; potassium level 2.8.

d) Patient on telemetry with ECG changes; potassium level 2.8. Prioritize actual before potential Medical emergency may be imminent

The "right circumstance" is demonstrated in which of the following? a)RN delegates obtaining "every 4 hour vital signs" to tech for all patients. b)RN observes tech ambulating a post-op patient and provides feedback on IV line management. c)A newly hired RN reviews the policy and procedure manual and tech job descriptions to support delegation decisions. d)A newly hired RN assesses each assigned patient before delegating ambulation of post-op patients to tech.

d)A newly hired RN assesses each assigned patient before delegating ambulation of post-op patients to tech.

Which of the following is not a prioritization model? a)Survival potential b)Assessment/data collection (nursing process) c)Acute vs chronic d)Documentation policies

d)Documentation policies While documentation policies guide organization of work and time management they are not used to prioritize patient care

When used to evaluate qualitative research, Lincoln and Guba's Framework guides us in determining which of the following: a)Reliability of the findings reported based on the statistical methods applied to analyze the data. b)Sufficient diversity of the sample selection process. c)Adequate preparation of research team in qualitative methods. d)Trustworthiness of the results reported.

d)Trustworthiness of the results reported. Credibility, Dependability, Confirmability, Transferability and Authenticity should be addressed in reports of qualitative research. These elements allow the reader to make a judgement about the trustworthiness of the value of the results.

The nurse's role in obtaining Informed Consent is: a)Describe to patient the expected benefit of the procedure. b)Describe the amount of pain, potential for harm and discomfort expected. c)Identify who may possibly participate in the procedure (residents, physician-assistants, medical students). d)Witness the patient's signature and ensuring the patient understands the description of the procedure provided by the physician.

d)Witness the patient's signature and ensuring the patient understands the description of the procedure provided by the physician. Nurses should only reinforce what the provider has already told the patient for informed consent to be obtained. Nurses should NOT be the first health professional the patient has discussed a procedure with.

The nurse employed in a long-term care facility is planning assignments for the clients on a nursing unit. The nurse needs to assign four clients and has a licensed practical (vocational) nurse and three unlicensed assistive personnel (UAP) on a nursing team. Which client would the nurse most appropriately assign to the licensed practical nurse? Select one: a. A client who requires a bed bath b. An older client requiring frequent ambulation c. A client who requires hourly vital sign measurements d. A client requiring abdominal wound irrigations and dressing changes every 3 hours

d. A client requiring abdominal wound irrigations and dressing changes every 3 hours These technical nursing skills fall within the LPN's scope of practice

The operation of organizations is best described as guided by: Select one: a. Beliefs, attitudes and shared values that form an organizational culture b. A statement of what the organization wants to become c. A statement of why the organization exists d. All answers are correct

d. All answers are correct each contributes to the organizations foundation for existence

It is important to plan communication for many professional interactions because: Select one: a. Efficiency is required based on available time to complete work b. Much communication nurses engage in professionally is goal-oriented c. Client-centered care requires knowing the individual's needs and ability to learn/understand the message being delivered d. All choices are correct

d. All choices are correct

Using evidence to inform nursing practice and guide clinical decisions requires: Select one: a. Understanding the level of evidence needed b. Ability to recognize what population(s) evidence applies to c. Use of only reliable sources of evidence d. All choices are correct

d. All choices are correct

A patient who desires to leave "AMA" (against medical advice) needs to know which of the following: Select one: a. Risks associated with not receiving planned care b. His/her health insurance may not cover services received if leaves AMA c. A form must be signed (or expressly refused) verifying the decision to leave AMA d. All of the above

d. All of the above

An example of professional communication related to safety is: Select one: a. Using consistent "checklist" style processes such as SBAR b. The ability to understand and effectively hold conversations with other health disciplines (such as therapies, physicians, social workers.) c. The ability to ask and answer questions during changes in patient care delivery settings d. All of the above

d. All of the above

Changes in the healthcare system over the past 20 years can be attributed to: Select one: a. Technology has become a central factor in care provision b. Rising costs c. Patient safety is viewed as within the control of health providers d. All of the above

d. All of the above

Which of the following are tactics that could be used by an employer to support low levels of absenteeism? Select one: a. Low-cost health promotion programs for employees b. On-site child care c. Financial support for continuing education/attainment of advanced degrees/certifications d. All of the above

d. All of the above

Critical thinking involves which of the following: Select one: a. Self direction b. Self discipline c. Self correction d. All of the above

d. All of the above key - self oriented

Organizations with flat (wide) organizational structures most likely have which of the following characteristics Select one: a. Management and administration makes all decisions and passes these back down the lines of authority to employees. b. Multiple layers of authority in decision-making resulting in slow, methodical and consistent operations at all times. c. Mostly low-knowledge workers who rely upon managers to communicate specific and detailed directives for decision-making to employees d. Employees have autonomy within their roles to make decisions that best suit individual situations

d. Employees have autonomy within their roles to make decisions that best suit individual situations flat organizations tend to give power/autonomy for decision making to employees performing hands on work ex: Nursing

Which of the following is most likely a permanent team? Select one: a. Mother-infant quality improvement team focusing on effectiveness of a new fetal monitoring strap that has been recently implemented. b. Emergency Department patient satisfaction team addressing physician complaints regarding accuracy of patient triage c. Planning committee for celebration of Nurse's Week throughout the organization's offsite locations. d. Interprofessional quality team that monitors all Incident and Accident Reports on a monthly basis

d. Interprofessional quality team that monitors all Incident and Accident Reports on a monthly basis This is a process that is ongoing in healthcare organizations and most likely a permanent team

SBAR is an acronym for: Select one: a. Supplying background and resolution b. Supervision, barriers, accommodations and reassurance c. Situation backed around the record d. Situation, background, assessment and recommendation

d. Situation, background, assessment and recommendation

When a conflict is present and a team member uses a resolution tactic that involves building up the other(s) point of view, downplays differences, and focuses on areas of agreement, the tactic is most likely called: Select one: a. Withdrawal b. Negotiation c. Accommodating d. Smoothing

d. Smoothing "Making it not sound as bad"

The primary purpose of a budget is: Select one: a. To restrict overspending within the unit b. To establish limits on staffing c. To list each item that will be used to provide care during the year d. To ensure that resources are available to achieve organizational objectives

d. To ensure that resources are available to achieve organizational objectives

Which of the following concepts are true of the Lewin Force Field theory of change? Select one: a. Assessment is the first step in preparing for change b. A process that is in the "frozen" state cannot be changed. c. Moving toward change is the initial action step d. Unfreezing of a process must occur before moving can occur

d. Unfreezing of a process must occur before moving can occur

Leadership can best be defined as: Select one: a. Directing others based on authority granted by job description b. Representing a nursing unit at organizational meetings c. Completing tasks that support organizational goals d. Using interpersonal skills to influence others; creates followership

d. Using interpersonal skills to influence others; creates followership both formal and informal leaders share this quality not as important for manager vs leader

Effective nursing care delivery models must consider: Select one: a. Effective time management and organization of workload b. Competency of team members c. Individual client needs d. All of the above

d. all of the above