Book Questions Final

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A nurse leader new to the organization has a transactional leadership style. The staff members who work with this leader are aware that what is the leader's focus? 1. The goals of the organization 2. The goals of the nursing unit 3. The welfare of the staff of the nursing unit 4. The satisfaction of the individual patients

A nurse manager is educating a staff nurse with regard to the five rights of delegation. Which statement by the staff nurse indicates that additional training is needed with regard to right supervision or evaluation? 1. Once a task has been delegated, the nurse is absolved of responsibility. 2. Nurses should provide feedback relative to task completion. 3. It is important to provide clear directions relative to task delegation. 4. Performance of the delegated task should be monitored.

A nurse working on a medical-surgical unit is trying to integrate services of the informatics department to help improve patient outcomes.Which person would the nurse contact in order to develop an understanding of how the computer system would work? 1)Network engineer 2)Clinical analyst 3)Clinical systems educator 4)Chief nursing information officer

A nursing student who is going to graduate from a Bachelor of Science Nursing (BSN) program is preparing a résumé. What fact should the nurse pay attention to when preparing the document? 1. Most employers who read résumés spend little time reviewing the document. 2. All activities should be included in the document regardless of whether they relate to the job position. 3. The document should be presented in a comprehensive narrative format. 4. Language style used is not important.

A registered nurse (RN) refuses to delegate any patient care tasks to other members of the nursing unit staff preferring to complete all tasks herself. What type of delegation practice would this demonstrate? 1. Underdelegation 2. Effective delegation 3. Overdelegation 4. Recognition of right person

A worker on the nursing unit has become increasingly frustrated with the work environment and is becoming more aggressive with the rest of the staff. How would this be classified according to the National Institute for Occupational Safety and Health (NIOSH)? 1. Type 3 2. Type 1 3. Type 2 4. Type 4

In terms of traditional care models, what is the primary difference between total patient care and functional nursing? 1. Inclusion of ancillary personnel to complete patient care tasks 2. Type of clinical setting 3. Educational background 4. Length of shift

In the clinical setting, the hospital organization has changed to a different electronic health record (EHR) system after reviewing several different types of available systems. Of what type of change is this an example? 1. Planned change 2. Unplanned change 3. Innovation 4. Crisis resolution

Nonlicensed staff members (unlicensed assistive personnel [UAP]) have asked for a meeting with the nurse manager as they are unhappy with how some of the nursing staff (Registered Nurse [RN]) has been delegating tasks with regard to patient care. Which statement if made by a nonlicensed staff member would indicate that additional instruction is needed for the nursing staff with regard to effective delegation principles? 1. "The RN told me that I couldn't obtain a urine specimen from a patient." 2. "I was told by the RN that I had to wait until the order was written in the patient's chart before I could act on it." 3. "The RN told me that I should wait until after lunch before I gave the patient AM care as the patient had just been medicated for pain." 4. "The RN told me that I had to change all of the bed linen for the patients before I went home at the end of the shift."

Nurse managers know that what category of worker in a health-care organization is employed more than any other? 1. Nursing 2. Maintenance 3. Dietary 4. Environmental/housekeeping

The nurse is aware that human factors engineering is utilized to accomplish what goal? 1. Decrease errors in nursing care. 2. Ensure that there is adequate staffing on a nursing unit. 3. Determine if the nursing unit is an optimal healing environment. 4. Design more efficient ways for nurses to provide patient care.

The nurse leader is beginning a quality improvement (QI) project on the nursing unit and is aware that what is most important to the ultimate success of the project? 1. All members of the nursing unit are involved in the project. 2. Registered nurses implement the project. 3. Nursing assistants are used to collect data. 4. The nurse leader is ultimately responsible for the success of the project.

The nurse leader is responsible for patients on six different units in the acute care facility, including the newborn nursery and the intensive care unit. In which nursing unit would the nurse leader face potential liability? 1. The newborn nursery has to admit 10 babies from labor and delivery and only 7 cribs have been cleaned completely and released back to the nursery. The nurse leader tells the nurses to clean the necessary number of cribs themselves and the housekeeping staff will finish the cleaning in the morning. 2. The medical-surgical unit experiences a patient fall related to a patient neglecting to use the call button to ask for assistance. 3. The intensive care unit experienced a patient injury after an experienced nurse administered the incorrect medication. 4. The orthopedic unit had a patient who became septic and had to be moved to the intensive care unit because a nursing assistant, employed by the facility for 15 years, forgot to check the patient's vital signs as ordered.

The nurse manager has encouraged the nurses to provide patients on the unit any toiletries that are needed but to determine if the patient needs these supplies before providing them. Which one of the Institute of Medicine's Six Aims for Health Care in the 21st Century is the nurse manager using? 1. Efficient 2. Equitable 3. Patient-centered 4. Effective

The nurse manager in a for-profit health-care facility explains to a new staff nurse that the profits from care are used in what capacity? 1. Pay for a new magnetic resonance imaging (MRI) machine 2. Increase the pay for all staff members 3. Provide for extra services for patients 4. Give bonuses to executives of the facility

The nurse manager is involved in strategic planning and knows that what is the reason for this process to be instituted? 1. Strategic planning defines the future of the organization 2. Strategic planning reflects the image of the future the organization plans to create. 3. Strategic planning reflects the attitudes, ideas, and convictions of the organization. 4. Strategic planning reflects the direction in which the organization intends to head.

The nurse manager is involved in strategic planning and knows that what is the reason for this process to be instituted? 1. Strategic planning defines the future of the organization. 2. Strategic planning reflects the image of the future the organization plans to create. 3. Strategic planning reflects the attitudes, ideas, and convictions of the organization. 4. Strategic planning reflects the direction in which the organization intends to head.

The nurse manager is preparing to discuss safety improvement at a unit meeting and will stress that what is a key aspect to error prevention? 1. Avoiding automatic actions 2. Asking a nurse with many years of experience to complete the procedure 3. Having the charge nurse confirm procedure policy prior to completing any procedure 4. Making each staff member an expert in a different procedure

What would be considered to be a key component of the budgeting process for a nursing unit? 1. To provide cost-effective care 2. Efficiency independent of quality 3. Keeping costs contained independent of quality 4. Maintaining cost and quality at minimum levels

Which action would not represent the process of collaboration in the clinical setting? 1. Nursing staff on the unit working together to problem solve including only full-time staff and not part-time staff 2. Staff on the surgical unit working together to prevent nosocomial infections by promoting hand hygiene throughout the hospital 3. Dietary and food service management team members working together to promote healthy dietary choices for individuals who eat in the hospital cafeteria 4. Staff nurses on a unit discussing how best to prevent falls on the medical unit

Which characteristic is always included when considering making changes in any type of nursing setting? 1. It is often met with resistance. 2. It does not lead to conflict. 3. As long as stakeholders are vested in the process, there will be no problems with implementation. 4. All changes lead to improved outcomes.

Which characteristic is included in the American Nurses Association (ANA) Nurses' Bill of Rights? 1. To function as a patient/client advocate without fear of retribution 2. Compensation for clinical practice is based solely on the fiscal budget of the employer 3. Practice setting safety addresses patient/client only 4. Negotiation for conditions of employment is not included as a basic right

Which characteristic is not attributed to Emerging Change Theories? 1. Linear in nature 2. Inherent complexity 3. Exhibit flexibility 4. Focus on innovation

Which clinical environment is reporting an increased need for nursing staff? 1. Ambulatory care 2. Obstetrical units 3. Intensive care units 4. Medical-surgical units

Which percentage represents the amount of time nurse leaders and managers spend in helping to resolve conflicts within the clinical setting according to clinical research? 1. Approximately 25% 2. Varies between 50% and 100% 3. 99% 4. Less than 10%

Which statement is accurate with regard to leading and managing teams? 1. Management personnel do not always have to assume team leadership positions. 2. There is no need for reminders as long as an agenda has been provided. 3. Meetings must be held face to face in order to be effective. 4. Keeping members of the team focused is based on individual accountability.

Which term can also be used to describe teamwork? 1. Interprofessional collaborative practice 2. Individual decision making 3. Maintaining individual autonomy 4. Individual problem solving

A patient is going to a new health-care provider. Which documentation system would contain his or her medical record files and be brought by the patient to the scheduled office visit? 1. Personal health record (PHR) 2. Electronic medical record (EMR) 3. Electronic health record (EHR) 4. The patient does not have access to this type of information.

1 (Any patient can have access to his or her individual health records by establishing a personal health record (PHR) in which personal health information is stored and updated by the individual. The EMR is an electronic health record used by an individual organization with respect to an individual patient. The EHR is an electronic health record used by multiple organizations in a shared format with respect to an individual patient. With regard to accessing information, any patient when going to a new provider can request records from a previous provider and/or health-care organization by signing an authorization form.)

A nurse is taking care of a patient whose health information has been requested by a consulting physician during a phone conversation. In providing that health information to the consulting physician, which option would help prevent health information from being distributed to others in consideration of the Health Insurance Portability and Accountability Act (HIPAA)? 1. Use encryption methods to send requested health information. 2. Have health-care workers acknowledge a privacy disclosure statement each time they log into a medical record in the clinical setting. 3. Send patient data via e-mail. 4. Restrict chart access for patients on unit only to nursing staff.

1 (As the consulting physician is part of the team taking care of the patient, he or she should have access to all relevant information in order to provide appropriate care. Thus, the nurse should use encryption methods to send requested health information. It would not be appropriate to send via e-mail, unless the system was encrypted. Having the health-care worker attest to a privacy disclosure statement at the time of each log-in would not provide a mechanism of action for appropriate transfer of information. Only those nursing staff who are taking care of the individual patient should have access to the medical chart.)

Nurses on the unit are trying to find out if there is a correlation between hospital admissions for community acquired pneumonia (CAP) and noncompliance with pneumonia vaccinations. Which action would lead to information that might help support the nurses' hypothesis? 1. Data mining 2. Database 3. Data interface 4. Demographic data related to gender

1 (Data mining refers to extracting patient information to help identify patterns and trend results. If an association is found with the retrieved data, then the hypothesis will be supported. If no association is found, then the nurses would have to look at other factors. A database is considered a repository of information, but the process of data mining would examine specific characteristics rather than look at the entire dataset. Data interface looks at examination of data points across systems. Knowledge of gender in and of itself will not provide information related to vaccination status and as such would not help to support the hypothesis.)

A health-care provider uses the computerized provider order entry (CPOE) system to initiate a medication order for a patient. Which option is not included in the CPOE for the medication? 1. Medication barcode 2. Identification of allergies 3. Notification of pharmacy department 4. Transcription of name of medication

1 (Medication barcode refers to the administration process whereby the clinician scans both the patient's identification bracelet in conjunction with barcodes on the medication to help assist in the verification of the five rights of medication administration. Identification of allergies is contained within the CPOE system, along with notification of pharmacy (and other interdisciplinary departments) along with transcription of name of the medication.)

Nursing students are working together in a clinical simulation activity and being monitored by nursing faculty. Which statements if observed by nursing faculty during a clinical simulation activity with nursing students would require the nursing faculty member to intervene? Select all that apply. 1. "What do you think you are doing?" 2. "I really thought you took nursing school more seriously." 3. "What you did is so stupid that all I can do is sit here and laugh." 4. "Do you need any help?' 5. "Can you provide me with some more information?"

1, 2, 3

What hallmarks help to support a healthy work environment based on American Association of Colleges of Nursing (AACN)? Select all that apply. 1. Empowerment of nurses 2. Focusing on clinical advancement through educational programs 3. Fostering of collaborative relationships 4. Limiting use of technology interfaces 5. Focusing on medical executives

1, 2, 3

When comparing traditional change theories and models, which statements are accurate with regard to when to apply specific models? Select all that apply. 1. Force-field model when problem solving 2. Eight-stage process when rapid change is required for learning organizations 3. Force-field model when planned change is anticipated 4. Innovation-decision making when implementing technological changes 5. Phases of change when organizational change is warranted

1, 2, 3

Which activities would be included in the assessment phase of budget planning? Select all that apply. 1. Estimating cost of supplies 2. Determining workload 3. Gathering relevant data 4. Comparing actual versus projected results 5. Starting once the budget has been implemented

1, 2, 3

Which aspects are included in how nurses develop nursing judgment? Select all that apply. 1. Academic experience 2. Use of experience to help form an opinion 3. Analysis of information to help arrive at a decision 4. Leadership style 5. Level of administrative experience as opposed to being a staff nurse

1, 2, 3

What components should be included in an agenda for a meeting? Select all that apply. 1. Time and date of the meeting 2. Topics to be presented 3. Individuals who will be providing information 4. Phone numbers of all participant members 5. Time allotted to each topic

1, 2, 3, 5

A nurse who is endeavoring to increase emotional intelligence knows that what are the core components necessary to the development of this leadership characteristic? Select all that apply. 1. Empathy 2. Motivation 3. Intellectual skills 4. Leadership 5. Self-awareness

1, 2, 5

According to Benner's novice-to-expert theory, which statements are false? Select all that apply. 1. Proficient nurses have the largest amount of clinical experience. 2. Competent nurses have at least 10 years of clinical experience. 3. Competent nurses are able to identify priorities based on their established plan of care. 4. Advanced beginners need to be mentored in the clinical setting. 5. An experienced nurse does not become a novice when transferring to another clinical unit in which he or she has no experience.

1, 2, 5

In order to achieve a well-functioning information system within a health-care setting,which element should be included? Select all that apply. 1)Information is stored at the individual level. 2)Information is stored at the organizational level. 3)Specific specialty designed systems allow for better integration of services. 4)Customization of systems can only be achieved when using a home-grown system. 5)Financial systems are included in administrative systems.

1, 2, 5

Which criteria should a nurse use to evaluate online websites for accuracy with regard to providing health information to the public? Select all that apply. 1. Assess the sites for relative strengths and weaknesses. 2. Make sure that there is a physician documented as providing the information. 3. Evaluate websites for use of credible information supported by evidence-based practice. 4. Websites that require a paid subscription typically provide more accurate information. 5. Websites that are updated regularly provide more accurate information.

1, 3 (When trying to determine if a website is providing accurate information to the public, it is important for the nurse to assess sites for their relative strengths and weaknesses while at the same time looking to make sure that the information provided is based on evidence-based practice. Whether or not a physician provides information in itself may not indicate that the information is accurate. Whether a website required a paid subscription similarly does not mean that the information provided is accurate. Last, updating websites on a regular basis also does not mean that the information provided is accurate.)

The nurse educator is preparing a group of registered nursing students for graduation and licensure and completes a discussion of the professional values. The students identify which values as part of the five core professional values for nurses? Select all that apply. 1. Integrity 2. Beneficence 3. Human dignity 4. Altruism 5. Veracity

1, 3, 4

The nurse leader has implemented a quality improvement (QI) project and realizes what elements are required for the project to be successful? Select all that apply. 1. Reliable quality improvement tools 2. Object of the project kept confidential 3. Clarification of the scope of the problem 4. Continuous evaluation of performance 5. Nursing unit development of its own QI model

1, 3, 4

Which actions should not be delegated to a licensed vocational nurse (LPN) on a medical unit in a hospital setting by a registered nurse (RN)? Select all that apply. 1. Initiating a blood transfusion 2. Inserting a urinary catheter 3. Administering chemotherapy infusion 4. Completing initial admission assessment 5. Performing post-operative dressing changes

1, 3, 4

Which components are included in a résumé? Select all that apply. 1. Contact information for the applicant 2. A listing of personal friends résumé 3. A listing of educational degrees 4. Related work history 5. Personal preferences related to job description

1, 3, 4

Which information is consistent with the chaos theory of change? Select all that apply. 1. It is nonlinear. 2. It contains formed matter. 3. It may also be referred to as the "butterfly effect." 4. It reflects randomness. 5. It can be predicted.

1, 3, 4

Which members would be included in an interprofessional team approach in the clinical setting? Select all that apply. 1. Selected members from different departments throughout the hospital 2. All of the nurses who work full time at the facility 3. Both licensed and nonlicensed employees who work in the hospital setting 4. A collection of individuals who work in the hospital and/or community of interest who are considered to be stakeholders 5. Nursing staff and community health department

1, 3, 4

Which statements are accurate with regard to team building? Select all that apply. 1. All nurses should participate in a collaborative manner. 2. Nurse managers must participate as team leaders in order to be effective. 3. Team building is an effective way to increase productivity. 4. Team building is an effective way to decrease costs. 5. Team leaders should not provide direction and allow for individual team member growth.

1, 3, 4

The nurse manager is working to create a culture of safety and is aware that which characteristics are fundamental to designing processes for high-reliability organizations? Select all that apply. 1. Sensitivity to operations 2. Desire to simplify 3. Preoccupation with failure 4. Creation of expertise 5. Resilience

1, 3, 5

What factors would help to contribute to nurses being injured during delivery of client care? Select all that apply. 1. Implementation of manual lifting 2. Two-person lift 3. One-person lift 4. Hook-and-toss method 5. Discontinuing "no lift" policy

1, 3, 5

Which examples represent improper use of delegation in the clinical setting by a registered nurse (RN), licensed practical nurse (LPN), or unlicensed assistive personnel (UAP)? Select all that apply. 1. UAP delegating a task to a LPN 2. RN delegating a task to a UAP or a LPN 3. LPN delegating a task to a RN 4. RN delegating a task to a RN 5. UAP delegating a task to a RN

1, 3, 5

Which statements describe differences between licensure and certification? Select all that apply. 1. Certification is based on meeting additional criteria as opposed to licensure, which is based on meeting minimal competency. 2. In order to become licensed, one must meet certification standards. 3. The licensure period typically lasts longer than certification periods. 4. Licensure represents general knowledge, whereas certification represents specialized knowledge. 5. Licensure is renewable as long as criteria are met, whereas certification is not renewable.

1, 4

A nurse manager has to submit requests for the capital budget for the medical-surgical unit. Which considerations should the nurse manager include when planning the capital budget? Select all that apply. 1. Recommendations from unit staff 2. Items that cost less than $500 3. Items that you anticipate with a performance life of 1 year 4. Financial implications relative to buying versus leasing 5. Projected maintenance costs for the item

1, 4, 5

The director of nursing has decided to begin a quality improvement program, and staff members with what skills should be included on the initial committee to ensure the success of this program? Select all that apply. 1. Have experience in working with interdisciplinary teams 2. Have experience in error justification 3. Have experience in providing efficient care 4. Have experience in performing self-assessment 5. Have experience in designing and testing interventions to change a care process

1, 4, 5

The director of nursing is encouraging the nurse managers to begin seeking Magnet status for the facility and knows that this status is associated with what positive outcomes for both nurses and patients? Select all that apply. 1. Increased patient satisfaction 2. Decreased morbidity with static mortality rates 3. Decreased numbers of peripheral intravenous infiltrations 4. More nursing autonomy 5. Decreased nurse burnout

1, 4, 5

A new nurse working on a medical-surgical unit needs some assistance with working within the electronic documentation system. Which individuals would the nurse contact in order to develop to help with application of this system in the context of delivery of care? Select all that apply. 1. Super user: Expert 2. Clinical analyst 3. Network engineer 4. Super user: Shift 5. Super user: Unit

1, 4, 5 (A super user is a designated individual within the organization who has been given additional training with the technology system and as such can help staff with adaptation to delivery of care. One common model utilized in clinical settings is to have three levels of super users—expert, shift, and unit—available to working nurses for assistance. A clinical analyst would provide information relative to design, testing, and implementation of the system. A network engineer would be needed if there were technical issues.)

When using an electronic documentation system in the clinical environment, which situations should the nurse anticipate will occur? Select all that apply. 1. Planned downtime 2. Rolling power outages 3. Unable to access information once a shift 4. Periodic compromise of backup system 5. System maintenance

1, 5 (It is reasonable to expect that with all electronic documentation systems in the clinical environment, there will be some planned downtime for specific upgrades or enhancement to the system. Additionally, when using any electronic documentation system, one should anticipate that scheduled system maintenance will occur. The nurse would not anticipate that there would be rolling power outages or that he or she would not be able to access information once a shift as the system operates in real time. Additionally, the nurse would not anticipate that there would be periodic compromise of existing backup systems.)

A nurse leader is explaining the process of appreciative inquiry to a group of nurses who hope to use this process in bringing change to their nursing unit. The leader shares that what are stages of appreciative inquiry? Select all that apply. 1. Discovery 2. Dreaming 3. Dramatics 4. Design 5. Destiny

1,2,4,5 Discovery is the first stage, and its goal is to identify what works best. Dreaming is the second stage or envisioning and encourages staff members to imagine a future based on the positives identified during discovery. Design is the third stage, and the focus is to design the ideal and identify the structure and processes necessary to make the dream a reality. Destiny is the last stage, and it is used to determine how to create the identified characteristics. Dramatics is not a stage found in any part of critical thinking, decision making, or appreciative inquiry.

The nurse manager has determined that patient care on the nursing unit would be more efficient if a different nursing model was used and plans to use what tool for decision making that gives the manager the opportunity to look at more than one feasible alternative? 1. Decision-making grid 2. DECIDE model 3. SWOT analysis 4. Shared decision making

1. A decision-making grid analysis is one of the simplest tools a nurse manager can use especially if the decision involves more than one feasible alternative. The DECIDE model helps the nurse manager avoid jumping to conclusions before all information is collected and analyzed. A SWOT analysis helps the nurse manager identify strengths and weaknesses of the staff and helps identifies areas of improvement and opportunities for facilitating positive change. The shared decision-making model is not an actual tool for decision making but an actual decision-making process.

The nurse leaders of a large acute care facility have decided to implement shared decision making on each nursing unit and expect to see what result? 1. Improved retention of nurses 2. More nurses applying for leadership positions 3. Decreased nurse-to-patient ratio 4. Elimination of medication errors

1. Shared decision making has shown to have a positive effect on nurse recruitment and retention. There is no evidence that shared decision making leads to an increased number of nurses applying for leadership positions. Shared decision making does not increase staffing, which would lead to a decreased nurse-to-patient ratio, but it helps to utilize nursing staff in a better fashion and leads to increased patient satisfaction. Shared decision making leads to a decrease in adverse effects, not an elimination of medication errors.

The nurse manager knows that what is the first step in the critical thinking process? 1. Reflection 2. Judgment 3. Evaluation 4. Criticism

1. There are four elements required for critical thinking and sound decisions, and it begins with reflection as the nurse leader thinks back or reflects on the area that needs correction or change. Judgment, evaluation, and criticism are all parts of the critical thinking process, but it begins with reflection.

A new chief operating executive believes that patients will receive better care and be more satisfied in a unit that is specific to their disorder. A nurse manager heads a unit that has functioned for the last 10 years as a general medical-surgical unit but will now become a specialty unit for patients with chronic respiratory issues. What is the nurse manager's priority responsibility during this transition? 1. Assist the staff to feel more comfortable in their new roles. 2. Ensure that the patients receive safe care by qualified staff. 3. Survey the patients daily to determine if needs are being met. 4. Hold briefings daily with the staff to determine common problem areas.

A nurse is aspiring to move from a staff nurse's position to a leadership and management role. What activity would be most helpful to this nurse in achievement of this goal? 1. Complete a leadership survey. 2. Enroll in a graduate leadership program. 3. Read a leadership book. 4. Request a change in position weekly from the charge nurse.

A nurse leader has begun to look for a new position in a different health-care organization because the present organization is a closed system. The nurse leader is aware that this system has led to what issue on the nursing unit? 1. The nurse leader has had to be open to new ideas. 2. The nurse leader had difficulty recognizing the nursing unit was a part of the whole organization. 3. The nurse leader did not like the flexibility required as part of this type of system. 4. The nurse leader was not prepared for the self-renewing, self-organizing aspect of the nursing unit.

A nurse seeking to advance to a leadership position within the health-care organization has become the mentee of a nurse manager. What is the primary responsibility of the mentee in this relationship? 1. Follow the mentor in all activities. 2. Work to dialogue with other nurse leaders and managers. 3. Request a monthly meeting with the mentor to discuss leadership attainment. 4. Ask the mentor to place the mentee in a minor leadership position.

A nurse who has been licensed for 2 years is now seeking employment at a different facility. Which option would the nurse consider to be a priority with regard to potential employment at this other facility? 1. Number of beds in the hospital facility 2. Understanding of the nursing job description being offered 3. Whether the hospital is considered to be a teaching facility 4. Whether the hospital has achieved Magnet status

A patient is changing health-care providers and wants to take his medical record with him.He has a significant medical history with several comorbidities and frequent hospitalizations at several hospitals in his geographic area.What would the patient do based on this circumstance? 1)Access his electronic medical record (EMR)and print out copies to take with him when he has his initial meeting with his new health-care provider. 2)Provide information from his personal health record (PHR). 3)Attempt to directly access his electronic health record (EHR)to obtain information. 4)Gather information from his EMR that will provide information about all of his hospitalizations in different health-care settings as it provides a comprehensive overview of his medical history.

A physician has ordered a rectal suppository to be administered to a 25-year-old male patient. The registered nurse (RN) delegates this task to the licensed practical nurse (LPN). The LPN would prefer not to complete this task. The RN tells the nurse manager about this issue. How would the nurse manager interpret this refusal by the LPN to perform a delegated task? 1. Underdelegation 2. Possibility of a delegate-related barrier 3. Overdelegation 4. Possibility of a delegator-related barrier

A registered nurse (RN) is working on a medical-surgical care unit with a five-patient assignment. Helping the RN with completion of direct and nondirect tasks is an unlicensed assistive personnel (UAP). Based on this information, what type of patient care model is being implemented? 1. Primary 2. Integrated 3. Nonclinical 4. Team

A registered nurse (RN) is working on a medical-surgical unit functioning as a team leader for five patients with a licensed practical nurse (LPN) and a certified nurse's aide (CNA). Which action should not be delegated to the CNA? 1. Positioning the patient for comfort by raising the head of the bed 2. Performing a pain assessment 3. Assisting the patient with transfer from bed to chair 4. Offering the patient fluids

A staff nurse has been caring for a patient with chronic obstructive pulmonary disease (COPD) through repeated hospitalizations and his condition continues to get worse despite multiple treatments. The patient states he is ready to die and wants the doctor to make him a DNR (do not resuscitate). The doctor refuses to write the order and instead insists that there is a chance the patient will improve and have some quality of life. The nurse notifies the head of the hospital ethics committee about the situation and knows the doctor will most likely be very upset by this development. What has the nurse displayed by doing this? 1. Moral distress 2. Moral courage 3. Moral uncertainty 4. Moral trepidation

Based on Benner's novice to expert model, which nurse would best serve as a preceptor for a new graduate nurse who is starting the orientation process on a medical-surgical unit and has no prior clinical experience other than nursing school clinical experience? 1. Charge nurse on the unit with 20 years of experience on that unit 2. Nurse who has just gotten off orientation but has been a nurse for about 5 years 3. Nurse who has worked on the unit for 10 years with a varied clinical background including medical-surgical, pediatrics, and obstetrics 4. Nurse who recently transferred from a different unit in the facility with 15 years of experience in the areas of critical care and medical-surgical settings

In a hospital setting, there appears to be conflict between the hospital's administrative personnel regarding hospital performance objectives. What type of conflict could be applied to this situation? 1. Intrapersonal 2. Organizational 3. Interpersonal 4. Intergroup

In terms of regulation, which statement is accurate with regard to unlicensed assistive personnel (UAPs)? 1. Consistent state regulation of responsibilities 2. May or may not be regulated by a state board of nursing 3. Can perform tasks in the absence of delegation 4. Has a nursing license

In which step of the budget process are variances reported? 1. Assessment 2. Implementing 3. Diagnosis 4. Planning

Nurses in the emergency room (ER) are complaining about how the medical-surgical unit nurses are responding to them when patients are being transported to the floor. The ER nurses state that the medical-surgical nurses do not want to do their job at times. The medical-surgical unit nurses state that the ER nurses always bring the patients near change of shift. What type of conflict is represented by this situation? 1. Interpersonal 2. Intergroup 3. Organizational 4. Intrapersonal

Staff nurses in response to a suggested change on the unit have displayed no resistance and are embracing the change. Which example of change strategy is represented by this scenario? 1. Normative-reeducative 2. Empirical-rational 3. Power-coercive 4. Anticipated due to peer pressure

Team members are becoming disillusioned with the group performance. The members of the team indicate that they have no input into the decision-making process. Which statement if provided by team members would account for their disillusionment? 1. Times and dates for the meetings are provided in advance. 2. An agenda is provided at the start of the meeting. 3. At the start of the meeting, the team leader provides an overview of stated goals. 4. The meeting ends with a summary of what transpired during the session.

The director of nurses has implemented a new salary scale that does not take into account the educational level of the nurse. The director of nurses may have violated which ethical principle? 1. Beneficence 2. Justice 3. Fidelity 4. Veracity

The director of nursing at an acute care facility is aware that safety issues must be continually addressed because what percentage of patients globally experience a preventable adverse event? 1. 5% 2. 10% 3. 15% 4. 20%

The nurse has just come on shift after receiving initial report and one of the patients is requesting pain medication.In order for a nurse to administer this medication to a patient using the electronic medication administration record (eMAR),which application must be in place? 1)Completion of full shift nursing assessment in patient's medical record 2)Computerized provider order entry (CPOE)noted in chart for pain medication 3)Using one patient identifier for confirmation 4)Access to the patient portal

The nurse leader believes that a mentorship program for new nursing graduates would benefit the organization in what way? 1. New nurses will require no supervision after the mentorship program is completed. 2. Mentorship leads to new nurses remaining with the organization longer than those nurses who did not engage in a mentorship program. 3. The nurse who completes the mentorship program will understand better how to care for patients without assistance. 4. Engaging in a mentorship program helps that individual to work longer hours without fatigue.

The nurse leader is supervising the entire acute care facility and is notified that many employees have called in sick related to an outbreak of influenza. The nurse leader sends a registered nurse who works on a transitional care unit to the emergency department to provide care. In what area could this nurse potentially experience liability? 1. Failure to warn 2. Inappropriate assigning of staff and failure to supervise 3. Negligent retention practices 4. Unsafe staffing

The nurse manager in a not-for-profit health-care facility is aware that what issue may arise due to the funding for this type of organization? 1. The care provided to patients is of lower quality than the care given in for-profit health-care organizations 2. There is a possibility that staff must be reduced because of decreased available funds. 3. The health-care organization will move all inpatient to outpatient care 4. If available funds are reduced, managers will be let go and each unit will run itself.

The nurse manager in a not-for-profit health-care facility is aware that what issue may arise due to the funding for this type of organization? 1. The care provided to patients is of lower quality than the care given in for-profit health-care organizations. 2. There is a possibility that staff must be reduced because of decreased available funds. 3. The health-care organization will move all inpatient to outpatient care. 4. If available funds are reduced, managers will be let go and each unit will run itself.

The nurse manager is working to establish a culture of safety and has encouraged the staff to use the CUS communication system. Which statement by a staff nurse indicates the proper use of this system? 1. "I know that this procedure has resulted in an error before but I believe that I can complete it without making any mistakes." 2. "I don't feel comfortable beginning this procedure. An event occurred the last time it was completed." 3. "I think this procedure should become the focus of a study, but I believe it can still be used while it is being reviewed." 4. "All procedures are safe as long as the nurse performing the procedure knows exactly what to do."

The nurse manager recognizes that health-care organizations have been slow to accept the principles of quality improvement for what reason? 1. Health-care organizations had programs comparable to quality improvement. 2. Health-care organizations did not have sufficient infrastructure. 3. Health-care organizations do not produce a product and therefore do not require quality improvement. 4. Health-care organizations are considered low-risk organizations and have little need of quality improvement.

The nurse manager recognizes that what is fostered at all levels in a decentralized health-care organization? 1. Authority to hire and fire 2. Feelings of autonomy 3. Ability to make changes at all levels 4. Top-to-bottom communication

The nurse manager, using the Institute of Medicine's Ten Rules for Health-care Delivery in the 21st Century, knows that the policies and procedures should be based on what? 1. Education of the staff nurses 2. Research concerning best practices 3. Education of the nurse manager 4. Collective years of experience of the staff nurses

The nurse student is aware that what feature is now a part of the newest nursing leadership theories? 1. Self-discipline 2. Flexibility 3. Motivation 4. Visionary

What statement best represents an authentic relationship? 1. Observing for deficits while promoting strength 2. Assuming that both you and others are working at the best possible level 3. Words are not consistent with demonstrated actions 4. Promoting self-empowerment

When calculating break-even quantity, which information is needed? 1. Total cost divided by units of service 2. Fixed costs divided by variable costs per patient 3. Measure of the input provided by the output 4. Deviation from the projected budget

Which aspect of change takes place in the refreezing stage of Lewin's Force-Field Model? 1. Determination that change is needed 2. Achievement of equilibrium 3. Exhibiting motivation to change 4. Gathering of information occurs

Which behavioral action by a charge nurse would indicate an example of destructive feedback if observed in a clinical setting relative to a nurse's performance? 1. Offering the nurse a set of sterile gloves upon witnessing that the gloves that the nurse is wearing to perform a procedure have a tear 2. Telling the nurse that you have never seen anyone do that in all your years of nursing experience in front of a patient 3. Asking the nurse to provide more detailed information related to the patient's pain assessment 4. Telling the nurse that she is getting the next admission to the floor

Which employment option would be most beneficial for a new graduate nurse who has just passed state boards and is newly licensed as a registered nurse? 1. Orientation training lasting 30 days for a position in an ambulatory care surgical unit 2. Medical-surgical unit with orientation training lasting 6 months inclusive of self-review and core competencies 3. Intensive care unit preceptorship lasting 60 days 4. Orthopedic unit with no structured orientation process 5. Medical oncology unit with orientation lasting 6 weeks with no assigned preceptor

Which information is represented by the framed question, "why" of change? 1. Participant stakeholders 2. Rationale 3. Timing 4. Technique

Which information should not be included in a cover letter? 1. Should serve as an introduction 2. Quotes from references 3. Reason why you are applying for the position 4. Brief summary of qualifications

Which method would a nurse leader use in order to sustain team synergy? 1. Allow participant team members to direct topics 2. Avoid calling numerous meetings if not warranted to stated goals 3. Do not provide an agenda until the team meets to discuss concerns 4. Do not provide a stated purpose for the meeting

Which nursing care model's primary focus is on reducing the cost of nursing care while at the same time looking to improve productivity? 1. Primary 2. Partnership 3. Patient-focused 4. Team

Which patient activity could be performed by either a registered nurse (RN) or a licensed practical nurse (LPN) or delegated as a task even if there is an unlicensed assistive personnel (UAP) present on the unit? 1. Initiation of blood transfusion 2. Tracheostomy care 3. Assisting a patient with feeding 4. Obtaining daily weight

Which self-care area is included in helping nurses to limit fatigue in the clinical setting? 1. Educational 2. Spiritual 3. Flexible 4. Individual

Which situation provides an example of the right circumstances as defined by the five Rights of Delegation? 1. Completion of the task does not require nursing judgment 2. Assessing needs of the population in the context of available resources 3. Identifying competency level 4. Providing correct information to a patient

Which statement best reflects the concept of accountability with regard to delegation of tasks? 1. Nursing state practice acts do not require nurses to be held accountable for their actions. 2. Accountability exists at both nursing and organizational levels. 3. An organization's obligation to accountability is based on its ability to offer quality care regardless of nurse staffing. 4. The competency of the nurse is not considered as being relevant to accountability.

Which statement describes an example of an intraprofessional team with regard to nursing in the clinical setting? 1. Nurses who work in the emergency room department 2. All nurses who work in the facility at both staff and supervisory levels 3. Entire hospital staff composed of nurses and ancillary team members 4. Chief nursing officer (CNO) of the facility and medical staff

Which statement indicates the primary purpose for Nurse Residency programs? 1. To decrease the stress level for new graduates 2. To provide a transition program that leads to competent practice 3. To allow for new nurses to learn basic information 4. To provide continuing education credits for initial licensure

Which statement is accurate with regard to the Phases of Change Model? 1. Change always occurs in a comprehensive manner. 2. Communication and feedback are critical elements. 3. Time does not affect potential for change. 4. Realistic goals are often not achieved.

Which statement is correct with regard to scope of practice for both registered nurses (RNs) and licensed vocational/practical nurses (LVNs and LPNs)? 1. Work under the direction of the RN in the clinical setting 2. Passed a national licensing exam 3. Administer all medications to patients in the clinical setting 4. Graduated from an accredited nursing program

Which statement is inaccurate with regard to work-related injuries and illness? 1. Health-care workers are more likely to experience work-related injuries and illness. 2. Stress does not play a role in work-related injuries and illness. 3. Musculoskeletal complaints are typically seen. 4. Working overtime appears to lead to more work-related injuries and illness.

Which statement provides an accurate description of backup behavior? 1. Understand how other team members behave during group interactions. 2. Ability to shift assignments during periods of high workload 3. Assessing team performance 4. Develop a common understanding of the environment.

Which statement reflects the difference between a preceptor and a mentor? 1. Preceptors provide a lifelong learning relationship, whereas mentors provide shorter-term learning relationships. 2. Mentors do not have to be nurses but preceptors do. 3. A mentoring relationship exists only at the beginning graduate nurse level, whereas preceptors occur across experience levels. 4. It is the type of communication pattern that is maintained.

he nursing unit is asking for a new Hoyer lift to be used to assist staff in the transfer of patients in the clinical setting. Which type of budget request would be needed to obtain this piece of equipment? 1. Personnel budget 2. Capital budget 3. Personal budget 4. Would be considered as a variable request

There has been a violation of the Health Insurance Portability and Accountability Act (HIPAA) in the hospital setting. The nurse understands that violation of HIPAA would cause legal action at which level? 1. State 2. Federal 3. Regional 4. Hospital

2 (HIPAA law is initiated at the federal level, not at the state or regional level. While this action may have occurred in the hospital setting, legal action is taken at the federal level.)

With regard to the concept of meaningful use, which statement is accurate? 1. Completion of eight core functions according to the Institute of Medicine guidelines 2. Completion of three stages is regulated by Centers for Medicare and Medicaid Services (CMS) 3. Certification by representatives of The Joint Commission that standards have been met 4. Compliance with Institute of Medicine guidelines

2 (Meaningful use is a regulatory requirement that has financial implications for reimbursement of services. It is part of the CMS Quality Incentive program and consists of meeting established standards in three phases: data capture and sharing, advanced clinical processes, and improved outcomes. Completion of eight core functions by the IOM refers to electronic health records. Certification of compliance with meeting The Joint Commission standards addresses the entire health-care organization. Compliance with IOM as an organization does not relate to meaningful use.)

Which option would represent a method that can be used to maintain data security when using the electronic medical record system in the clinical setting by a staff nurse on a medical-surgical unit? 1. Utilize a password that contains the nurse's last name. 2. Use a random generator to come up with an access code. 3. Use the same password while employed at the hospital. 4. Keep logged in on the computer throughout the shift as long as a screen saver is in place.

2 (Use of a randomly generated password will help to promote and maintain data security. Using a password that contains one's available personal information such as his or her last name can be considered as being easy to break or re-create. Keeping the same password while employed at the hospital cannot be done as most institutions enforce a mandatory password change at established intervals. Keeping logged in on the computer throughout the shift can lead to a security breach if someone else has access to an already logged-in screen regardless of whether or not a screen saver is used.)

A nurse manager has begun to use transformational leadership theory and knows that this theory uses what aims of the Institute of Medicine (IOM)? Select all that apply. 1. Nurse-centered 2. Efficient 3. Timely 4. Safe 5. Inexpensive

2, 3, 4

In a corrective plan of action, which violations would warrant documenting a written reprimand? Select all that apply. 1. First 2. Second 3. Third 4. Fourth 5. All violation classes

2, 3, 4

The nurse leader is developing a quality improvement (QI) project for the nursing unit and knows that what characteristics are necessary to determine the priority of the issue to be investigated? Select all that apply. 1. Failure in performance is known to occur infrequently. 2. The problem itself occurs frequently. 3. The problem has at some time caused serious consequences to health. 4. The problem has caused issues that are costly. 5. The problem may be very difficult to fix.

2, 3, 4

The nurse manager is responsible for designing a new pediatric oncology unit and plans to ensure that it is designed with a culture of safety. The nurse manager is aware that this culture of safety requires what necessary principles to accomplish this task? Select all that apply. 1. Patient safety must be the responsibility of the unit leadership team. 2. Work processes are to be simplified. 3. Train all members of the nursing unit to work as a team. 4. Redesign work processes to prevent accidents. 5. Discourage the use of simulation and focus on actual patient care.

2, 3, 4

Which behaviors if utilized by nurse managers would help to establish change in the clinical environment? Select all that apply. 1. Rewarding consistent actions at the expense of anticipated change 2. Helping to build trust 3. Instilling confidence 4. Anticipating that change is inevitable 5. Not allowing staff to transfer off unit

2, 3, 4

Which measures are included in the Registered Nurse Safe Staffing Act of 2015? Select all that apply. 1. Nurses can be floated to units based on patient/patient need. 2. Hospitals must provide unit orientation to nurses for which they have not been trained prior to the nurse being assigned to work on that unit. 3. Hospitals must take into account the level of educational preparation that the nurse has in determination of making staffing assignments. 4. Hospitals must have an established procedure for handling complaints relative to nurse staffing. 5. Hospitals do not have to have nursing input with regard to nurse staffing if they accept Medicare reimbursement.

2, 3, 4

Which statements are true with regard to continuing education (CE) credit requirements for registered nurses? Select all that apply. 1. CEs are not required once the nurse has achieved licensure. 2. CE requirements may vary from state to state. 3. It is the individual nurse's responsibility to continue to take CEs. 4. CEs are limited in how they are presented. 5. CEs courses are accredited.

2, 3, 5

According to Benner's novice-to-expert theory, which statements are true? Select all that apply. 1. A nursing student is considered to be an advanced beginner. 2. Proficient nurses look at the entire picture rather than individual elements. 3. Competent nurses use intuition and reflective practice. 4. A new graduate would not be categorized as a novice nurse. 5. Competent nurses use checklists to differentiate tasks.

2, 4

The nurse manager is working to ensure that the Institute of Medicine's Ten Rules for Health-care Delivery in the 21st Century are in place on the medical-surgical unit by using which rules? Select all that apply. 1. The patient may gain information after asking permission for records. 2. Health-care professionals are to be transparent in all activities. 3. Waste is controlled by budget cuts and rationing of services. 4. The patient is the source of control over his or her own care. 5. Health-care professionals anticipate needs of the patient.

2, 4, 5

What standards help to support a healthy work environment based on the American Association of Critical Care Nurses? Select all that apply. 1. Closed-ended communication 2. Adequate staffing 3. Standards established that are independent 4. True collaboration 5. Authentic leadership

2, 4, 5

Which statements reflect accurate information related to the concept of productivity? Select all that apply. 1. It is not affected by output or input. 2. It should be a blend of efficiency and safety. 3. It is determined only by input. 4. It has to be monitored to be determined. 5. Input refers to resources used.

2, 4, 5

The nurse manager is beginning the process of integrating evidence into a clinical skill and plans to use the PICOT approach. Place in order the steps of the PICOT technique. 1. Nurses evaluate relevant studies to determine their validity, reliability, and applicability. 2. Nurses incorporate evidence using their expertise and the patient's preferences to implement care. 3. Nurses collect the best evidence relevant to the identified question. 4. Nurses evaluate the practice decision. 5. Nurses identify the clinical question.

2, 5, 4, 1, 3

The nurse manager believes that critical thinking when used to make decisions involving patient care is the ability to think in a systematic and logical manner and involves being open to questioning and reflecting on the reasoning process used to ensure safe nursing practice and is basing this definition on what group or individual? 1. Ignatavicius 2. Masters 3. Alfaro-LeFevre 4. AACN

2. Masters believes that critical thinking for clinical decision making is the ability to think in a systematic or logical manner. Ignatavicius states that critical thinking is a purposeful, outcome-directed thinking that is based on a body of scientific knowledge that is derived from research and other courses of evidence. Alfaro-LeFevre states that critical thinking is a deliberate, purposeful, and informed outcome-focused thinking that requires careful identification of key problems, issues, and risks involved. The American Association of Colleges of Nursing (AACN) states that critical thinking underlies decision making and involves the process of questioning, analyzing, synthesizing, interpreting, inferring, using inductive and deductive reasoning, and using intuition and creativity.

The nurse manager has decided to begin a shared decision-making model on the nursing unit and knows that individual staff nurses will receive what benefit from this decision? 1. Sense of entitlement 2. Sense of empowerment 3. Sense of inquiry 4. Sense of intellect

2. Shared decision making gives the nurses engaged in this process a sense of empowerment, because the nurses are given the opportunity to assist in making the decisions involving the provision of effective patient care and also in the operation of the unit. It does not provide a sense of entitlement, inquiry, or intellect.

The nurse manager has been evaluating the nursing unit's strengths and weaknesses in an effort to ensure that the unit continues to improve its safety practices and is using what cognitive skill of the critical thinking process in this exercise? 1. Interpretation 2. Self-regulation 3. Analysis 4. Evaluation

2. The cognitive skill of self-regulation is the process of examining one's practice for strengths and weaknesses and promoting continuous improvement. Interpretation is clarifying data and circumstances to determine meaning and significance. Analysis is determining a problem or issues based on assessment data, and evaluation is determining whether expected outcomes have or have not been met.

A group of nurse managers are reviewing a new job description for a staff nurse on a medical-surgical unit. Which observation if found would indicate that the job description needs revision with regard to delegation? 1. Delineation of roles and responsibilities 2. A listing of tasks that the nurse can complete 3. No mention of the nursing position authority 4. Listing of minimum qualifications for the nursing position

A group of nurses are discussing safe patient handling and mobility on the nursing unit in relation to nurses sustaining musculoskeletal disorders (MSDs). Which statement made by one of the nurses would indicate that additional training was needed? 1. The most common occurrence for MSDs is when nurses are transferring, lifting, or repositioning patients/clients. 2. It is important to maintain body principles when repositioning a patient/client. 3. If done properly, no nursing action will result in acquiring an MSD. 4. Use of body mechanics while required does not mean that a nurse will not get an MSD.

A new nurse leader has adopted a laissez-faire style of leadership that may result in what characteristics of those who report to this leader? 1. Team members may be very good at time management but poor on job satisfaction. 2. The staff may be very knowledgeable but have a lack of focus on the job at hand. 3. Team members experience disagreements among themselves. 4. Productivity is high with low job satisfaction.

A nurse has worked for over 20 years in the clinical practice setting and is experiencing considerable back pain at the present time. Questions asked by the health-care provider focus on how the nurse implemented lifting actions during the course of her career. The nurse stated that she "used safe body principles throughout her career." Based on this information, what does the health-care provider suspect might account for the nurse's physical complaints? 1. Undiagnosed scoliosis 2. Improper use of body mechanics 3. Microinjuries to the spine over time 4. Unaware of ergonomic principles as they apply to body mechanics

A nurse is assisting a patient with reviewing an explanation of benefits (EOMB)in relationship to insurance reimbursement.The patient has a history of Diabetes,Type 1 and went to the physician for an office visit.In order to determine which code reflects the office visit,what would the nurse examine? 1)Discrete data 2)ICD (International Classification of Diseases) 3)CPT (Current Procedural Terminology) 4)Data sets

A nurse is looking on the unit for an infusion pump to use for the patient. How would the nurse manager classify this nurse activity? 1. Value care 2. Necessary care 3. Non-value added care 4. Indirect care

A nurse is reviewing her annual performance appraisal from her direct supervisor (Unit Nurse Manager) and does not agree with some of the information documented on the form. How should the nurse respond to this noted disagreement? 1. Sign the form as indicated and then talk to the chief nursing officer of the facility. 2. Do not sign the form and ask for a copy so that you can bring it home to discuss it with your family. 3. Discuss your concerns with your direct supervisor and make noted comments on the form stating that you disagree and then sign the form. 4. Sign the form indicating that you agree because there are no designated restrictions on your role on the unit and this is just personally motivated.

A nursing student is required to take a nursing leadership course and questions why this type of course is necessary when the initial primary role of the graduate nurse is to perform bedside patient care. What is the nurse educator's best response to this student? 1. "It is a part of the curriculum that is required by all state boards of nursing." 2. "Though new graduates begin at the bedside, most take on leadership positions within the first 6 months of employment." 3. "Leadership competencies are required even at the bedside to help in navigating the evolving health-care landscape." 4. "All nurses report to someone, so you have to understand leadership so you know who you report to."

A patient dies as the result of a wound infection. When the family sues the hospital and the nurses involved in this patient's care, it is discovered that wound care was only charted three times despite a twice daily order from the health-care provider. What category of nursing practice will be the focus of the resulting lawsuit? 1. Failure to act as a patient advocate 2. Failure to assess and monitor 3. Failure to document 4. Failure to communicate

A registered nurse (RN) delegated specimen collection to an unlicensed assistive personnel (UAP) for a patient who had a urine analysis ordered by the physician. The UAP did not obtain the specimen. When checking the patient's chart later in the shift, the RN noticed that there was no documentation that a urine specimen was collected. The RN asked the UAP to provide an explanation for why the specimen was not obtained. The UAP told the RN that she was going to obtain the specimen from the patient after lunch. Which stated action would correlate with the delegation right of right communication? 1. The RN followed up later in the shift checking the patient's chart for documentation of the specimen collection. 2. The RN delegated the task to the UAP. 3. The UAP told the RN that she was going to obtain the specimen from the patient after lunch. 4. The RN monitored the task completion process.

An experienced nurse is applying for a new job position, and an interview has been scheduled. What priority information should the experienced nurse use to help prepare for the upcoming interview? 1. Review of the hospital's website 2. Whether the hospital has achieved Magnet status 3. Review of organization's mission, values, and goals 4. Type of staffing pattern utilized by the facility

Based on current clinical research, which statement represents support for promoting adequate staffing? 1. Adequate staffing places little demand on the budgeting of nursing units. 2. Staffing practices are unrelated to nursing fatigue. 3. Adequate staffing helps to promote both patient and nurse satisfaction. 4. Staffing patterns do not affect hospital infection rate

Despite best efforts, it has been decided that a nurse is to be terminated based on several recorded action plans without noted improvement or correction of incidents. The nurse manager and the chief nursing officer of the facility are in agreement that the employee meets the criteria for termination. Which department in the facility should also be included in review of the termination procedure? 1. Hospital Ethics Committee 2. Medical staff 3. Human Resources 4. Clinical Nurse Educator

Even though nursing is not considered to be revenue generating in terms of health care, how is revenue projected on a nursing unit? 1. Viewed as being separate from the room charge 2. Determined by patient satisfaction 3. Based on average daily census or number of procedures done 4. Related to the number of nurses in the facility

In order to establish "meaningful use" with regard to providing health-care services,what would the nurse expect that the physician must do? 1)Sign all electronic health-care records for their respective patients. 2)Document that improved health outcomes are met while reducing overall fees and reimbursement. 3)Complete all required elements defined by the Centers for Medicare and Medicaid Services (CMS). 4)Reduce patient fees for services provided in order to increase access to medical care for patients.

Nurses are aware that the Quality and Safety Education in Nursing (QSEN) competency, Teamwork and Collaboration, requires what specific type of collaboration? 1. Multidisciplinary 2. Interdisciplinary 3. Interprofessional 4. Customized care

The charge nurse on the unit is getting ready to prepare staffing and assignments for the upcoming shift. The charge nurse reviews the following information: number of patients on the unit, corresponding patient acuity, and present level of staffing pattern. What type of process is the charge nurse implementing to make this decision? 1. Nursing assessment 2. Evidence-based practice 3. Patient classification system 4. Budgeting

The director of nursing at the county health department is aware that which ethical theory is most commonly used by nurses in public health agencies? 1. Deontology 2. Principlism 3. Utilitarianism 4. Principle of duty

The director of nursing is implementing a quality improvement project for the emergency department and knows that what is the first step in this process? 1. Construction of a monitoring system 2. Formulation of criteria and standards 3. Determination of what activity to monitor 4. Data collection

The nurse is aware that the optimal healing environment, which is a component of the Patient-Centered Care Quality and Safety Education in Nursing (QSEN) competency, is designed to assist the patient in what way? 1. Has enough room for family members 2. Provides for privacy 3. Helps the patient heal himself or herself 4. Ensures a pleasant hospital experience

The nurse leader is to talk to a staff nurse who is suspected of consuming alcohol during the lunch break. The nurse leader confronts the nurse privately and asks about the smell of alcohol on the nurse's breath. The nurse responds that it is just mouthwash that was used after eating onions at lunch. What is the best action for the nurse leader at this time? 1. Send the nurse home. 2. Terminate the nurse's employment. 3. Send the nurse for a drug screening. 4. Stay with the nurse until the end of the shift.

The nurse leader is using general systems theory to assist in implementing changes on the nursing unit and knows that what nursing activities are considered throughput? 1. Nursing skills 2. Nursing education 3. Nursing management of care 4. Nursing beliefs

The nurse leader is using the plan-do-study-act (PDSA) cycle for the unit's quality improvement project and knows that this comes from what quality improvement model? 1. Six Sigma Model 2. Lean Model 3. Institute for Healthcare Improvement (IHI) Model 4. Donabedian Model

The nurse manager has decided to use the strategies of the Institute of Medicine (IOM), To Err Is Human, to improve health care on the nursing unit. The nurse has identified that patient safety, practice consistent with current medical knowledge, and what other strategy must be implemented in this endeavor? 1. Work in interdisciplinary teams. 2. Work in intradisciplinary teams. 3. Meet the expectations of the patient. 4. Meet the expectations of the nurses.

The nurse manager has just been informed that a patient received a medication intravenously that should have only been administered as an intramuscular injection. The patient suffered a respiratory arrest and is being transferred to the intensive care unit. The nurse manager is aware that this is known as what type of error? 1. Near miss 2. Error of omission 3. Sentinel event 4. Lapse

The nurse manager is aware that what aspect of leadership relates to the ability to make a promise, keep it, and carry through on that promise? 1. Compassion 2. Confidence 3. Connectedness 4. Commitment

The nurse manager is conducting a SWOT analysis as a part of a strategic planning process and arranges for the new electronic health record being used on the nursing unit to be featured in the local newspaper. The nurse manager knows that this corresponds to what part of the SWOT analysis? 1. Strengths 2. Weaknesses 3. Opportunities 4. Threats

The nurse manager is evaluating several nurses who have expressed an interest in leadership activities and knows that the nurse who demonstrates which type of followership has the most potential for a leadership role? 1. Standing by 2. Doing following 3. Resisting following 4. Passive follower

The nurse manager is observing an experienced nurse who is new to the unit perform a dressing change. The experienced nurse is using sterile gauze, but the orders for the dressing change indicate that it is a clean dressing change. The time to complete the procedure was under 5 minutes. The patient tolerated the procedure without complaints. How would the nurse manager interpret this situation? 1. The experienced nurse is demonstrating decreased productivity. 2. The patient was satisfied with the demonstrated task. 3. The experienced nurse is not demonstrating efficiency. 4. The experienced nurse can teach other nurses how to do the dressing.

The nurse manager is planning a change to the nursing unit that requires all patients to receive health promotion education but knows that this may be difficult for what reason? 1. The regulations of the Patient Protection and Affordable Care Act of 2010 2. The need to focus on health promotion and disease prevention 3. Focus of financial rewards for providing health care to the sick 4. The shift from a traditional to a futuristic planning approach

The nurse manager is providing a performance appraisal to one of the nurses on the unit who has not received a very good evaluation. The nurse manager is offering constructive criticism to help the nurse gain insight into how improvement can be made. Which action by the nurse manager would be included in a performance appraisal? 1. Telling the nurse that it would be helpful if when talking to other staff members on the unit, the nurse used a lower tone of voice 2. Inquiring about the nurse's family members before starting to discuss the performance appraisal 3. Focusing on aspects of the job description where improvement is needed 4. Telling the nurse that it would be better to only share comments/concerns with management

The nurse manager observes that the nursing staff on the unit starts the process of assigned group work with regard to reviewing unit protocols by introducing members. Which part of the team development process is represented by this observation? 1. Norming 2. Storming 3. Forming 4. Adjourning

The nurse manager reports directly to the director of nursing and knows that this defines what type of command? 1. Span of command 2. Chain of command 3. Unity of command 4. Organizational structure

What action would help to promote workforce sustainability in a hospital setting? 1. Nurse managers hiring new employees to fill positions regardless of whether they have clinical experience 2. Allowing nursing staff to work overtime 3. Facilitating an open communication pattern 4. Nurse managers maintaining fiscal responsibility in budget planning

What component is not included in the SMART technique acronym? 1. Specific 2. Realistic 3. Talented 4. Measureable

What elements are included in the hallmarks of a professional nursing practice environment? 1. Minimal staffing patterns 2. Nursing staff members who have limited input 3. A formal program for performance improvement 4. Limited accountability but with increased responsibility

What type of nursing activity is noted when a registered nurse (RN) administers medication to a patient who is experiencing nausea? 1. Value-added nondirect care 2. Necessary care 3. Value-added direct care 4. Non-value added care

Which aspects of the budget are not within a nurse manager's control? 1. Staffing assignment 2. Staffing pattern 3. Patient acuity 4. Cost of supplies

Which behavioral action if observed by a nurse leader would indicate effective coaching style? 1. Providing constant feedback 2. Keeping a low profile while looking toward inner self-reflection 3. Acknowledging a job that is well done 4. Focusing only on achievement of personal gain

Which certification degree represents an acute care nurse practitioner? 1. Adult health clinical nurse specialist 2. Informatics nursing 3. Adult psychiatry, mental health 4. Nurse executive—advanced

Which is an example of a fixed expense in a budget for a nursing unit? 1. Medications 2. Supplies 3. Administrative salaries 4. Salaries for nursing staff

Which observation if noted on a performance evaluation would require that the supervisor speak with the nurse in order to promote a healthy work environment? 1. Works an overtime shift once every few months 2. Follows policies and procedures 3. Refuses to take breaks while working shifts 4. Takes more time to document using the electronic documentation system compared to other more experienced nurses

Which situation if observed would warrant immediate action by the nurse manager? 1. Staff nurse asks for additional clarification from the physician related to a written order. 2. Unit secretary asks the nurses to answer the unit phone when she is busy. 3. Unit secretary draws caricature images of nursing staff with sarcastic comments. 4. Two nurses who work days are switching their days for the last 2 weeks of the schedule.

Which situation would take priority when reviewing the nursing unit budget for the past year? 1. No increase in productivity rate 2. Increasing patient/patient satisfaction 3. Increase in reported staffing variance 4. Change in several of the manufacturers related to products and supplies

Which statement best describes what is meant by the term "third-aged nurses"? 1. Refers to individuals who already had a professional career and then went back to school to obtain a nursing license and pursue a nursing career 2. Nurses who have three academic degrees 3. A nurse who is within the age group of 50 to 70 years 4. Nurses who work three 12-hour shifts to satisfy their work week requirement

Which statement by a nursing staff member indicates that incivility has occurred on the nursing unit? 1. "I wish that I didn't have to take that assignment." 2. "I always end up staying late to complete my documentation and that makes me upset." 3. "They seem to keep hiring the same type of people here, those who don't want to work and then I have to keep doing their job." 4. "I respect my nurse manager but I don't like her as a person."

Which statement is accurate with regard to the concept of competence as applied to nursing practice? 1. Competence is not considered to be an outcome. 2. Competence is a static variable. 3. Nurses must continue to maintain competence following graduation from nursing school. 4. Once competence is assessed, it is achieved and does not need to be re-evaluated.

Which task should not be delegated to a licensed vocational nurse (LVN) by a registered nurse (RN) who is working with a LVN and unlicensed assistive personal (UAP) as part of the team? 1. Performing oral hygiene for a patient who has oral ulcerations 2. Feeding a patient with dysphagia 3. Transferring a patient from the bed to a chair 4. Monitoring a blood transfusion

Which theme is not included in the initiative, Transforming Care at the Bedside (TCAB) model? 1. Safe care 2. Vitality and teamwork 3. Limited value 4. Transformational leadership

Which topic area is not addressed in a nursing delivery care model? 1. Responsibility for decision making relative to patient care 2. Handling of patient care communication 3. Financial ability to provide services 4. Length of time a patient decision remains in effect

Who is a key stakeholder that is a critical part of the informatics team when attempting to implement an electronic documentation system? 1)Physician or health-care provider 2)A super user who is an expert 3)A super user who is a shift expert 4)IT support

A patient is reviewing an explanation of benefits (EOMB) in relationship to insurance reimbursement for a medical evaluation in which he had an incision and drainage procedure performed for an infected abscess as a complication of diabetes. Which code would represent the incision and drainage procedure? 1. Discrete data 2. ICD (International Classification of Diseases) 3. CPT (Current Procedural Terminology) 4. Data sets

3 (A procedural code relative to the incision and drainage procedure would be reflected by a CPT code. An ICD code would indicate information relative to the medical diagnosis. Discrete data reflect patient information that can be used for interpretation, analysis, and trending of data. Data sets refer to a collection of data entries that help to provide a framework for statistical analysis.)

How would one explain the underlying framework of nursing informatics? 1. Nursing science and philosophical beliefs 2. Informational technology assisting nurses to obtain information relative to patient care 3. Combination of sciences from different disciplines such as nursing, computer, information, and information technology to provide information so as to support and effect change in nursing practice 4. Utilization of electronic documentation in the clinical setting 5. Helps to promote use of computer technology

3 (Combination of sciences from different disciplines such as nursing, computer, information, and information technology to provide information so as to support and effect change in nursing practice is the correct answer. Understand that by integrating various components from different disciplines, nursing informatics integrates this information and applications to benefit problem solving and decision making in the clinical environment. Although nursing science is included, philosophical beliefs are associated with philosophy. The application of informational technology does provide information, but this is one aspect of the discipline of nursing informatics. Nursing informatics provides information and approaches to affect nursing practice, not just individual patient care. Utilization of electronic documentation in the clinical setting is an aspect of communication. Helping to promote use of computer technology can be perceived as a secondary benefit of applying nursing informatics, but it does not describe the underlying framework.)

Which is an example of discrete data that could be used by nurses in the research process? 1. Narrative text describing patient's clinical response to pain medication 2. Client's noted response as to why he or she was admitted to the hospital 3. Documented patient weight 4. Documented history and physical by health-care provider

3 (Discrete data can be pulled from a data repository, such as a number or category, and as such is easy to retrieve and then analyze. Narrative text information is much harder to retrieve and analyze in terms of quantitative measurement.)

A nurse is admitting a patient to the hospital with congestive heart failure (CHF) using an electronic documentation system. While entering assessment data, pop-up windows are appearing asking for additional information. How would the nurse respond to this situation? 1. Continue to chart information, then close pop-up window and sign off note. 2. Close the pop-up window and disable pop-up blockers from the system. 3. Respond to the pop-up by providing the additional information that is required. 4. Close out of the system and then sign back in to the patient's chart.

3 (Electronic medical record systems (EMRs) are designed with rules and alerts that serve as prompts or reminders to provide specific information related to a diagnosis or clinical admission. Therefore, it is important to respond appropriately and provide the requested information. Although the nurse may be able to continue charting, closing the pop-up window and signing off without providing the requested information is not reasonable documentation even if the note is signed. Closing the pop-up window and disabling pop-up blockers from the system would interfere with the system management of the EMRs. As rules and alerts typically come up as prompts in a new window, the nurse should not anticipate this as being a computer error. Thus, there is no need to close out of the system and then sign back in to the patient's chart.)

Which option is not included in an electronic medication record (eMAR)? 1. List of medications that the patient has been prescribed 2. Times for medication administration 3. Client history and physical 4. Notation of clinical response to medication

3 (The patient's history and physical are not included in the eMAR system. A list of medications that have been prescribed for the patient are included as well as times for medication administration. Additionally, there is a place to document medication administration along with space to note clinical response to medication.)

Which information should be included in a nurse's self-appraisal? Select all that apply. 1. A listing of personal hobbies 2. Salary 3. A review of goal statements 4. Accomplishments achieved during the last year 5. Peer feedback received

3, 4, 5

The nurse manager has determined that the nursing unit should see a reduction in medication errors by 50% and knows that this decision equates to what part of the nursing process? 1. Assessment 2. Diagnosis 3. Outcomes identification 4. Planning

3. The nurse leader has determined that the nursing unit's medication error rate should be reduced by 50%, which corresponds to the outcomes identification step of the nursing process. Assessment involves data collection, diagnosis is the identification of an issue or problem, and planning is the determination of the steps needed to achieve the intended outcome.

The nurse manager knows that which nurse on the medical-surgical unit will be the best at using intuitive thinking? 1. The nurse who graduated from nursing school 6 months ago and has worked on the unit for 3 months. 2. The nurse who just started working on the unit but has worked on a pediatric unit for 2 years. 3. The nurse who worked in the intensive care unit for 1 year and has worked on this unit for 4 months. 4. The nurse who worked in a long-term care facility for 6 years and has worked on this unit for 6 months.

3. Expert nurses use intuitive understanding of a patient's situation based on previous knowledge, experiences, and pattern recognition. The nurse who has a year of intensive care experience has more previous knowledge, experience, or pattern recognition of medical-surgical patients than does the nurse with 2 years of pediatric experience, 6 years of long-term care experience, and especially the new graduate nurse.

The nurse leader manages a nursing unit that has a preponderance of nurses who have graduated from nursing school within the last 12 months and knows that what type of thinking will provide the best guidance to the nursing staff? 1. Reactive 2. Intuitive 3. Reflective 4. Automatic

3. Nurse leaders and managers who use reflective thinking provide to staff guidance that creates a sense of trust and safety on the unit. Reactive thinking can also be known as automatic thinking and is a knee-jerk reaction to a situation and leads to poor nursing practice. Nurse leaders use intuitive thinking as they deal with day-to-day unit-level situations. Dealing with many new graduates on a unit requires reflective thinking.

The nurse manager is holding a unit meeting and asks each staff member to share one thing that the individual believes works best on the unit. What technique is the nurse manager using in this meeting? 1. Critical thinking 2. Shared decision making 3. Appreciative inquiry 4. Reflective thinking

3. The nurse manager is using appreciative inquiry, which is a collaborative process that engages staff in a healthy exchange of knowledge to solve problems, which avoids focusing on the negatives and shifts the perspective to what works best for the organization. It is not strictly a critical thinking or shared decision-making model, and reflective thinking is the use of one's own personal experiences and knowledge to help with self-improvement.

A group of nurses are discussing unit policies and procedures. Based on a consensus of opinion, the nurses suggest minimal changes in the near future. What type of future is demonstrated by this statement? 1. Preferable 2. Plausible 3. Possible 4. Probable

A nurse is reviewing a chart in which a medication error occurred as part of a performance improvement (PI) evaluation. Which notation if observed would indicate a potential contributory factor to the incident based on the concept of nurse fatigue? 1. Clinical response to antibiotic oral medication given by the nurse was not documented. 2. The physician's order was signed off. 3. The pain assessment profile prior to medication being administered was noted as 9 out of 10. 4. The nurse who had administered the medication was working his third shift in a row, which was considered to be an overtime shift.

A nurse manager attempts to resolve conflict on the unit between staff members by bringing all sides to the table to have a discussion. What type of conflict management strategy is being displayed? 1. Accommodating 2. Competing 3. Avoidance 4. Collaborating

A nurse manager is planning to take on the responsibility for a nursing unit that specializes in tertiary care. The nurse manager knows that this unit will be responsible for the care of what type of patients? 1. Those who are giving birth 2. Those who are being treated for pneumonia 3. Those who are seeking treatment for a knee strain 4. Those who had a knee replacement and are receiving rehabilitation

A staff nurse approached the director of nursing to discuss steps that would be helpful in moving to an administrative position. The director of nursing told the staff nurse not to consider leadership because this nurse was not a "born leader." What leadership theory is the director of nursing using to make this judgement? 1. Behavioral theory 2. Situational leadership theory 3. Contingency leadership theory 4. Great Man theory

According to clinical research findings, with what is a lower registered nurse (RN) skill mix associated? 1. Increased productivity 2. Fewer patient complications 3. Increased efficiency 4. Poorer time management

An experienced nurse on the medical-surgical unit has a pattern of making rude statements about her co-workers. These repeated statements have become part of the unit culture. How would the nurse manager who has observed these interactions categorize this type of behavior in terms of violence? 1. Hearsay 2. Nurse to patient 3. Vertical 4. Horizontal

How many minutes is equivalent to one credit of continuing education credit? 1. 25 2. 60 3. It varies from state to state. 4. 50

In order to promote clinical competencies for the new graduate nurse, which orientation strategy would be most beneficial? 1. Didactic work in a classroom setting with other new hospital staff recruits 2. Taking a computer training class on the hospital's electronic health record system with a designated staff super user 3. Working closely with other new graduate nurses to develop collegiality and professional identity 4. Working with an experienced nurse in a mentor relationship as part of orientation training

Nursing management has been tasked with building a new team to address methods that can be used to promote health education in the clinical setting. Members of the previous team were all from the same nursing unit in the hospital. What action should nursing management take in order to build the new team? 1. Maintain the same member composition 2. Limit the time allowed for the team to report 3. Assign individual work to team members and use self-report as the basis for teamwork 4. Invite more diverse membership

The nurse is admitting a patient who has community acquired pneumonia (CAP).While documenting the patient's history in the medical record,the nurse encounters prompts for further information relative to the medical diagnosis.What is this an example of? 1)Data mining 2)Standardization of language 3)Alert 4)Activation of a rule

The nurse leader as a part of the patient-centered care Quality Safety Education in Nursing (QSEN) competency has encouraged all nurses to be advocates for their patients. The nurse leader knows that this concept is understood when the nurses demonstrate which action? 1. Patients state they believe they have access to information and resources and have the opportunity to learn and grow. 2. Patients state that they have all the supports necessary to manage their own disease. 3. Patients state they have the ability to read, understand, and act on information about their diseases. 4. Patients state that the nursing staff knew about their desires and allowed them to make their own decisions.

The nurse leader is working with a team to develop a more effective admission assessment process. Which team member is an example of one who participates in the team by "standing by"? 1. A team member who often works with team members who are new to the team and helps to mentor them in his or her role 2. A team member who appears to function against the goals set up by the team leader 3. A team member who is flexible and ready to make any needed changes 4. A team member who requires detailed instructions concerning the leader's expectations

The nurse manager has implemented a series of changes in the nursing unit that are intended to improve safety and will use which tool to determine if the change has been effective? 1. Fishbone diagram 2. Histogram 3. Pareto chart 4. Run chart

The nurse manager is working with a staff nurse who committed a medication error that led to the patient requiring surgery. The nurse manager expects this staff nurse to experience what type of reaction? 1. Termination of employment 2. No noticeable reaction 3. Extreme joking 4. Avoidance of other staff

The nurse manager of a busy medical-surgical unit has received an anonymous note that one of the unit's LPNs has routinely been documenting care that has not been given. What is the best action of this nurse manager concerning this situation? 1. Immediately report the LPN to the state board of nursing. 2. Question each RN about the anonymous note. 3. Ask the LPN if the anonymous note is true. 4. Check the LPN's documentation after observing the LPN.

The nurse understands that improvement of safety in nursing is dependent on evidence-based practice and which element of the safety competency? 1. Resilience 2. Human factors engineering 3. High-reliability organizations 4. Standardized protocols

There was a violent incident on the medical-surgical unit that occurred between a staff worker and the worker's spouse. How would this be classified according to the National Institute for Occupational Safety and Health (NIOSH)? 1. Type 1 2. Type 2 3. Type 3 4. Type 4

What is the first step that nurses should take in integrating evidence-based practice on a nursing unit? 1. Research how other nursing units have implemented evidence-based nursing. 2. Ensure that the evidence is relevant to the specific nursing unit. 3. Evaluate the effectiveness of the evidence to patient care. 4. Determine which clinical problem is to be researched.

Which action if used by a nurse manager would lead to increased conflict in the clinical setting? 1. Assessment of needs versus wants 2. Reminding staff that every member should be treated with respect 3. Emphasizing the importance of listening 4. Using statements that focus on the individual performing the behavior indicating "we" or "you"

Which action would help to promote a nurse in becoming a skilled communicator? 1. Limit reflective practices and focus on present interaction. 2. Focus on individual thoughts and beliefs. 3. Believe that all conversations contain credible information. 4. Become more candid.

Which budgeting method uses projections based on the current year's budget multiplied by a predetermined amount to arrive at a new budget proposal? 1. Zero-based 2. Performance 3. Operational 4. Flat percentage

Which description best supports the "M" in the TEEAMS approach? 1. Recognition of individual team members 2. Showing excitement about the team's work 3. Promotion of an engaging work environment 4. Holding team members accountable

Which factors play an important role in being able to academically prepare students to become future nurses? 1. Increase in available clinical sites combined with an increase in nursing school enrollment 2. Increased enrollment in graduate nursing programs and preceptors 3. Decreased student's interest to pursue a nursing degree along with decreased classroom space 4. Decreased number of nursing faculty and limited budget

Which observation if made by a registered nurse (RN) who is working with a licensed practical nurse (LPN) and an unlicensed assistive personnel (UAP) would require immediate intervention based on the delegation process? 1. UAP was transferring a patient out of bed who was 2 days postoperative laparoscopic surgery 2. LPN was administering oral pain medication following performing a pain assessment 3. LPN was monitoring a blood transfusion 4. UAP was providing information to a patient who was just placed on isolation relative to neutropenic precautions

Which of these factors are included in the "TEEAMS" approach? 1. Time, evidence-based practice, efficiency, accountability, mutual respect, and support 2. Temperament, efficiency, environment, autonomy, model, and support 3. Task, enthusiasm, efficiency, authority, management, and support 4. Time, empowerment, enthusiasm, appreciation, management, and support

Which type of traditional care model is most similar to the total patient care model? 1. Functional 2. Team 3. Bedside 4. Primary

You are interviewing a nurse who arrives at the interview using a walker as an assistive device for ambulation. Which question if asked would be construed as violating the American with Disabilities Act of 1990? 1. "Can you perform the duties listed on the job description without accommodation?" 2. "Do you need me to repeat the question?" 3. "Do you think that you can do this job?" 4. "Do you have a disability?"

The staff nurses from an orthopedic surgery unit are dissatisfied with the admission process of a patient following surgery. The nurses state that there may be four to five admissions within a 1-hour period as they are discharged from the postanesthesia recovery unit. With many patients arriving at the same time, the staff does not feel able to give the patients the close assessment they deserve and complete the admission process. The director of nursing suggests that these nurses observe the system that the women's health unit uses for the multiple admissions that happen at the same time due to deliveries and female surgeries. What problem-solving technique is the director of nursing using? 1. Critical thinking 2. Shared decision making 3. DECIDE model 4. Appreciative inquiry

4. Appreciative inquiry is a problem-solving strategy that capitalizes on the positive characteristics of an outcome by valuing and building on them. It is a collaborative process that engages a healthy exchange of knowledge to solve problems and innovate change. Critical thinking is a directed thinking process that imposes intellectual standards on the elements of thought. Appreciative inquiry is a comparison and collaborative process that allows one unit to look to what another unit is doing and learn from that unit. Shared decision making is the inclusion of staff nurses in decision making related to patient care and work methods at the unit and organizational level. Appreciative inquiry is problem solving by investigating something within the organization that works the way you are seeking. The DECIDE model is a decision-making model that helps to ensure that all steps of decision making are addressed. It is not the same as appreciative inquiry.

The nurse from the postanesthesia care unit (PACU) is giving report to the unit nurse at the bedside of a patient who just had surgery for a total hip replacement. Approximately 20 minutes after the patient's admission to the unit, the patient experiences a period of respiratory depression that was later attributed to medication received in the PACU. What error that occurred during the nurse-to-nurse handover may have contributed to this patient's problem? a. The PACU nurse was giving report while helping to transfer the patient into bed. b. The PACU nurse arrived with the patient 15 minutes later than was expected. c. The unit was not available for the nurse-to-nurse handover for 5 minutes after the PACU nurse arrives. d. The unit nurse was familiar with the patient from previous hospitalizations.

The nurse leader is working to improve communication on the nursing unit and knows that effective communication requires an articulate sharing of ideas and what other important element? a. The nurse manager must understand the audience for which the message is intended. b. The staff on the nursing unit must agree with the ideas of the nurse manager. c. The nurse manager must ensure that the ideas presented are important to the staff of the nursing unit. d. The staff on the nursing unit must have person-to-person contact for the communication to be received.

The nurse manager is aware that SBAR may be used in what nonclinical issues? a. Staffing levels b. Nursing pay levels c. Nursing clinical ladder issues d. Required continuing education

The nurse manager is aware that preventable medical errors are associated with what communication failure? a. Lack of interprofessional communication b. Lack of upward communication c. Lack of intraprofessional communication d. Lack of downward communication

The nurse manager is aware that what element of communication is essential to the transmission of relational information? a. feedback b. nonverbal communication c. responding d. receiving

The nurse manager is preparing to institute the use of SBAR for interprofessional communication. The nurse manager has based this decision on what benefits to this tool? Select all that apply. a. Assertive dialogue between professionals b. Most essential information delivery c. Safer delivery of patient care d. Decreased continuity of patient care e. Increased time spent in interprofessional communication

a, b, c

The nurse manager is aware that what communication is considered verbal? Select all that apply. a. E-mail message b. Facebook post c. Facial grimace d. Telephone message e. Arms and legs crossed

a, b, d

The nurse manager is planning to use the DECIDE model to assist in improving nursing staff self-scheduling and is explaining the use of this tool by comparing it to the nursing process and knows that the ECI of the model corresponds to what parts of the nursing process? Select all that apply. 1. Assessment 2. Diagnosis 3. Identification of outcomes 4. Planning 5. Evaluation

all In the DECIDE model, E stands for establish the criteria, C is for consider the alternatives, I is for identify the best alternatives, and these correspond to diagnosis and identification of outcomes in the nursing process.

The nurse is communicating to the health-care provider the patient's current medications, allergies, vital signs, and current laboratory values and is using which section of SBAR in giving this information? a. Situation b. Background c. Assessment d. Recommendation

The nurse manager plans to implement which communication strategy that has been found to reduce errors and improve patient safety while increasing patient satisfaction? a. TeamSTEPPS b. Interprofessional team rounding c. Diagonal communication d. Oral report in the conference room

The nurse manager is using the Principles of Collaborative Relationships: Effective Communication by the American Nurses Association (ANA) to improve communication on the nursing unit and knows that these principles require the staff nurses to use what communication practices? Select all that apply. a. Speak to multiple persons about the issue. b. Use active listening techniques. c. Keep the environment close and private. d. Ensure accuracy in the information transmitted. e. Know the purpose of the message transmitted.

b, d, e

The nurse manager would suggest what communication tool to assist staff nurses in organizing and prioritizing information prior to communicating with the health-care provider? a. Interprofessional team rounding b. TeamSTEPPS c. SBAR d. Call-out

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