Exam 2

4. What is the most appropriate assignment for a nurse who has 10 years of experience in a neurological ICU when floated to a pediatric oncology unit? A) A 3-year-old boy with leukemia who has contracted bacterial meningitis B) A 6-year-old boy with osteogenic sarcoma C) An 18-month-old infant postsurgery with a neuroblastoma D) A 14-year-old girl with a pheochromocytoma and adrenalectomy

A 3-year-old boy with leukemia who has contracted bacterial meningitis

5. Select all of the key element(s) that the Pew Commission Final Report identified as key to constructive interpersonal encounters. A) Relationship centered B) Education based C) Culturally sensitive D) Caring E) Evaluated F) Collaborative

A) Relationship centered B) Education based C) Culturally sensitive E) Evaluated

Fill in the blanks with the correct word(s) to complete the following statement: A client's reading comprehension level and ability to follow through on health instructions is called ___________ ___________.

ANS: health; literacy

Fill in the blanks with the correct word(s) to complete the following statement: Based on a task-oriented philosophy, _________ __________ requires each person to perform a specific job that is narrowly defined according to the needs of the unit.

ANS: functional nursing

Fill in the blank with the correct word(s) to complete the following statement: Depending on how it is channeled, expressed, and used, ______________ can be a positive or negative force within the group. ANS: anger

ANS: anger

10. Identify the task that may be delegated to an LPN (LVN) if all of the clients are stable. A) Adding potassium to a bag of D6W that was already hanging B) Developing the nursing diagnosis for a newly admitted client C) Teaching a new diabetic patient how to administer insulin injections D) Turning a client with a CVA every 2 hours

D) Turning a client with a CVA every 2 hours

8. To which individual can the charge nurse delegate the task of completing the history and physical examination for a newly admitted client? A) RN B) LPN C) CNA, level II D) CNA, level III

RN

8. Which statement by a nurse manager during a staff meeting best demonstrates use of an aggressive style of communication? A) "I am the manager and we will do it my way." B) "I'm sorry, but your suggestion was useless to solving the problem." C) "I really don't care; do it the way you think is best." D) "You have made some good points, but I have another suggestion."

A) "I am the manager and we will do it my way."

3. The elderly client is being discharged to a skilled nursing acility. The client asks the nurse if she can choose the facility. The nurse's best response is: A) "I will contact your primary care provider." B) "You need to receive services from a Medicare-certified skilled facility." C) "Medicare clients need to file for Medicaid before admission." D) "Speak to your attorney about becoming your health-care proxy."

A) "I will contact your primary care provider."

15. During a discussion between the nurse manager and a staff registered nurse (RN) about the RN's recent erratic performance on the unit, the RN states, "After my husband announced that he was leaving me, I thought I was dying." Identify the best response by the nurse manager. A) "Tell me how you were feeling." B) "That was a pretty unrealistic way to feel. There are a lot of fish in the sea." C) "Your personal life should not affect the way you perform your job." D) "You didn't die, did you? You seem okay now."

A) "Tell me how you were feeling."

Select all of the elements that are commonly a result of workplace lateral violence. A) A toxic work environment B) Increased self-esteem C) Workplace physical violence D) Psychological pain E) Positive emotions F) Anxiety

A) A toxic work environment C) Workplace physical violence D) Psychological pain F) Anxiety

3. Which behavior would the nurse expect an adult who is the youngest child of several children to display? A) Assertive and competitive B) Organized and directive C) Submissive and quiet D) Angry and hostile

A) Assertive and competitive

18. What is usually considered to be an unfair labor practice? A) Being fired because a physician does not like a nurse's attitude B) Being passed over for a promotion with an explanation of the rationale C) Being assigned to work five weekends in a row when the policy states that nurses will be required to work as needed D) Only being allowed 2 weeks of vacation during the first year of work

A) Being fired because a physician does not like a nurse's attitude

9. A leader who is paternalistic and attempts to include the group's feelings and concerns in making a final decision about how to accomplish a task is best identified as using which approach? A) Benevolent authoritarian B) Democratic C) Laissez-faire D) Dictatorial authoritarian

A) Benevolent authoritarian

12. Identify the element that would be considered a needs motivator or satisfier in Herzberg's motivation hygiene theory. A) Career advancement B) Job security C) Salary D) Status in the organization

A) Career advancement

4. Identify all of the elements that are considered essential to include in an electronic client education tracking system. A) Client control B) Physician input C) Customized to each client D) Continuous tracking E) Successful outcomes

A) Client control C) Customized to each client D) Continuous tracking

11. What is the most serious consequence of bullying and intimidation in the workplace? A) Client safety is jeopardized. B) Nurses quit after a short time, which increases the nursing shortage even more. C) The morale of the workplace becomes very negative. D) Hospital costs increase and reduce the ability to purchase necessary equipment.

A) Client safety is jeopardized.

24. Identify the key element in the fee-for-service model of governance. A) Clients are billed separately for nursing services. B) All clients are billed the same amount for nursing services. C) Nursing care is included in the overall room bill sent to the client. D) A functional nursing model is required to implement fee for service.

A) Clients are billed separately for nursing services.

Select all of the characteristics of followers who are found in the health-care professions. A) Critical of leaders B) Defiant in the face of change C) Believes in the traditional social hierarchy of the institution D) The source of the leader's power E) Avoids identifying themselves as followers F) Can also be leaders

A) Critical of leaders C) Believes in the traditional social hierarchy of the institution D) The source of the leader's power F) Can also be leaders

7. A patient who was just told he has stage four lung cancer blurts out to the nurse, "This can't be happening. I've never smoked. I want a second opinion from somebody who knows what they're talking about!" What is the primary goal for the use of denial by this patient? A) Gives the patient time to adjust to the diagnosis B) Lets the nurse know that he is in charge of the situation C) A second diagnosis may show that he does not have cancer. D) Keeps the physicians at the top of their skills

A) Gives the patient time to adjust to the diagnosis

13. Which is a Joint Commission requirement for client education? A) Hospital staff must act as skilled client educators. B) All clients must receive some type of education during their care. C) Physicians are primarily responsible for client education. D) Documentation of client education must use a flow sheet.

A) Hospital staff must act as skilled client educators.

3. The client inquires about the value of spirituality related to health. Select all of the responses that the nurse should include about spirituality. A) Improves coping skills and social support. B) Is religion and the chaplain needs to be contacted. C) Relieves stress and promotes healing. D) Focuses only on the elderly who are ill. E) Strengthens the immune system. F) Promotes better healthy behaviors.

A) Improves coping skills and social support. C) Relieves stress and promotes healing. E) Strengthens the immune system. F) Promotes better healthy behaviors.

6. What is the primary drawback to using the trait theory of management in developing management skills? A) It does not take into account how the person responds in specific situations. B) A person has to have all of the traits to be an effective manager. C) Only persons with many years of experience can master the required traits. D) It is not reflective of the traits that are required for management.

A) It does not take into account how the person responds in specific situations.

4. Why are interpersonal bonds important in establishing an environment of civility? A) It provides individuals with a feeling that they have a duty to each other B) Individuals are less likely to demonstrate incivility to others they know well C) A close family atmosphere always enhances civility D) People are more likely to overlook individuals imperfections

A) It provides individuals with a feeling that they have a duty to each other

2. A nurse is planning to conduct a disaster preparedness class at a senior citizen center. Select all of the elements regarding the audience that the nurse must consider when planning this class. A) Mobility issues B) Ability to drive a car C) Chronic health-care needs D) Disaster risk awareness

A) Mobility issues B) Ability to drive a car C) Chronic health-care needs D) Disaster risk awareness

1. Select all of the reasons why the older population is living longer. A) New technology B) More availability of prescription drugs C) New facilities for long-term care D) Decrease in salaries and increase in newer equipment

A) New technology B) More availability of prescription drugs C) New facilities for long-term care

Select all of the characteristics of effective managers. A) Optimistic B) Insensitive to negative comments C) Identifies restraining forces D) Distrusts everyone E) Goal directed

A) Optimistic C) Identifies restraining forces E) Goal directed

2. After her first week working on a busy medical-surgical unit, a new charge nurse notes that the individual nurses are highly competent but seem to be unable to function productively as a team. Select the action by the charge nurse that would best facilitate team building among the staff. A) Provide an opportunity for the nurses to express their feelings and emotions. B) Hire more staff members to reduce stress and fatigue from understaffing. C) Allow the staff more input into important policy decision-making. D) Give the staff members more time to adjust to the change in charge nurses.

A) Provide an opportunity for the nurses to express their feelings and emotions.

Select all of the items that constitute barriers to clear communication. A) Retaliation B) Desire for power C) Comfort D) Increased Knowledge E) Preoccupation

A) Retaliation B) Desire for power E) Preoccupation

Select all of the items that constitute barriers to communication with a person displaying difficult behavior. A) Retaliation B) Desire for power C) Comfort D) Increased knowledge E) Preoccupation

A) Retaliation B) Desire for power E) Preoccupation

What is the first action the nurse manager should take when changing a procedure for the distribution of cardiac telemetry units when there are more clients than units available? A) Review the current standards of care. B) Rewrite applicable policies and procedures. C) Designate the most critical clients as the ones to receive the units first. D) Poll the physicians who commonly use telemetry for their opinions.

A) Review the current standards of care.

7. Identify the characteristic that would commonly be found in an individual recognized as a "violator/tormentor"? A) Self-absorption and negative attitudes B) High self-esteem and rigid behavior C) Positive attitudes and codependence D) High energy levels and manipulative behavior

A) Self-absorption and negative attitudes

1. Learning forgiveness is a skill that tends to counteract which of the following childhood survival mechanisms? A) Self-centeredness B) Jealousy C) Hording D) Anxiety

A) Self-centeredness

2. The student nurse asks, "Why is there such an emphasis on spirituality in health care?" Which of the following is the most appropriate response by the nurse preceptor? A) The Joint Commission has a standard of patient care with inclusion of spirituality. B) The American Association of Colleges of Nursing mandates a policy related to spirituality in health care. C) Each hospital establishes its own policy regarding spirituality. D) Spirituality remains at the discretion of the chaplain or pastoral care.

A) The Joint Commission has a standard of patient care with inclusion of spirituality.

5. What may cause some people to make responses that seem inappropriate or overemotional? A) The lack of an opportunity to develop coping skills B) The successful resolution of a crisis situation C) A group response to a minor situation D) A mature attitude developed by resolving past crises

A) The lack of an opportunity to develop coping skills

17. What is the primary reason a nurse should develop learning objectives for all client teaching? A) The nurse clarifies what actions or behaviors are expected. B) It is a requirement by the Joint Commission. C) Learning objectives help the nurse to organize the teaching materials. D) Clients who do not have objectives will learn material poorly.

A) The nurse clarifies what actions or behaviors are expected.

9. When a nurse delegates a task, who is responsible for ensuring that the task was completed as assigned? A) The person to whom the task was delegated B) The physician who ordered the task C) The nurse manager D) The nurse who delegated the task

A) The person to whom the task was delegated

11. When does the encoding process of communication take place? A) The receiver thinks about the information, understands it, and forms an idea based on the message. B) The receiver responds to the message and gives feedback. C) The sender sends the message. D) The message is sent in a way that causes confusion in the receiver.

A) The receiver thinks about the information, understands it, and forms an idea based on the message.

7. What is a major benefit for the elderly who now have easy access to and use of technology such as the Internet and smartphones? A) They have opportunities to obtain screening and treatment that they might not otherwise seek. B) They can reach hospitals and family if they need help. C) They generally are so confused by the technology, they abandon it. D) They now have a new source of entertainment to keep their minds active and delay the effects of dementia.

A) They have opportunities to obtain screening and treatment that they might not otherwise seek.

20. What is the primary role of the Federal Mediation and Conciliation Service? A) To bring both sides together to work out a settlement B) To prevent nurses and other health-care groups from going on strike C) To develop a solution to the conflict that is binding on both sides D) To force management into accepting the employee demands

A) To bring both sides together to work out a settlement

Select all of the items that are found in a good contract. A) Description of the official collective bargaining group B) Statement outlining the objectives of both management and employees C) Description of grievance procedures D) List of all the employees covered by the contract E) List of what is expected of the professional

A) Description of the official collective bargaining group B)Statement outlining the objectives of both management and employees C) Description of grievance procedures E)List of what is expected of the professional

Fill in the blanks with the correct word(s) to complete the following statement: When the ____________ ________________ _______________becomes part of the culture of a unit or institution, it may not even be recognized as bullying.

ANS: bullying; vicious; circle

Fill in the blank with the correct word(s) to complete the following statement: Depending on how it is channeled, expressed, and used, ______________ can be a positive or negative force within the group.

ANS: competition

Fill in the blanks with the correct word(s) to complete the following statement: Most state nurse practice acts do not give delegation authority to _______________ ____________ such as LPNs or unlicensed assistive personnel.

ANS: dependent practitioners

Fill in the blanks with the correct word(s) to complete the following statement: Communicating with people who have __________ behaviors requires a special set of ___________________ skills. ANS: difficult; communication

ANS: difficult; communication

Fill in the blanks with the correct word(s) to complete the following statement: If mediation fails, the Federal Mediation and Conciliation Service may appoint a _______________ _______________ to investigate the conflict and make recommendations.

ANS: fact-finding-panel

19. A client tells the nurse that she has been using a health information website to find information about her illness. Which statement by the client does the nurse need to correct? A) "Some of the websites do not have very accurate information." B) "All of my personal information will be kept secure." C) "I should speak to my physician before using any alternative therapies." D) "Other clients seem to be having the same symptoms that I have."

B) "All of my personal information will be kept secure."

6. An LPN who has been assigned four clients asks the charge nurse which client should be assessed first after report. Which client should the charge nurse suggest be assessed first? A) A 66-year-old man with type 1 diabetes with 4 p.m. blood sugar of 92 B) A 77-year-old man with congestive heart failure who has a potassium level of 3.1 C) A 24-year-old woman with pyelonephritis and a fever of 101.1°F D) A 38-year-old man with 22 percent deep partial thickness burns of the legs and abdomen

B) A 77-year-old man with congestive heart failure who has a potassium level of 3.1

7. Select the most appropriate client for the RN to assign to the CNA. A) A client with difficulty swallowing food and fluids B) A client with constipation who needs tap-water enemas C) A client with a colostomy who requires irrigations D) A client with a percutaneous endoscopic gastrostomy tube who is receiving continuous tube feedings

B) A client with constipation who needs tap-water enemas

18. Learning objectives that address positive attitudes, constructive feelings, and values (ethics) fall into which domain? A) Cognitive B) Affective C) Psychomotor D) Intellectual

B) Affective

12. Identify a communication style that involves interpersonal behaviors that permit people to defend and maintain their legitimate rights in a respectful manner that does not violate the rights of others. A) Submissive B) Assertive C) Aggressive D) Dishonest

B) Assertive

2. During the first day assigned to a medical-surgical unit, a newly CNA is unable to obtain a urine specimen by catheterization. What should the supervising RN do next? A) Confront the CNA about not being honest concerning his or her ability to perform the procedure. B) Assign the CNA to work with a staff RN to observe and learn the skill. C) Recommend that the CNA be fired because the probation period is still in effect. D) Assign only basic care clients to the CNA.

B) Assign the CNA to work with a staff RN to observe and learn the skill.

21. Identify the major differences between followers as individuals and followers as a group. As a group of followers, they: A) Link the leader to their perceptions of what a good leader should be. B) Bring a collection of past experiences and knowledge when considering a leader's abilities. C) Identify themselves as followers in the organizational structure. D) Are not always obedient and compliant.

B) Bring a collection of past experiences and knowledge when considering a leader's abilities.

2. The caring-civility link is best exemplified by which of the following? A) Helping in disasters in foreign countries B) Conducting scholarly research into overcoming health-care disparities C) Accepting criticisms from physicians even though unjustified D) Making nursing assignments based on clients' needs and nurses' skills

B) Conducting scholarly research into overcoming health-care disparities

12. Select the personal characteristic of an RN that would tend to render his or her delegation ineffective. A) Many years of experience in delegation B) Demands perfection of employees C) Feels self-confident in his or her ability as a leader D) Trusts in the abilities of others

B) Demands perfection of employees

8. Select an important principle that guides managers who use the democratic leadership style of management. A) The leader performs the same tasks as the rest of the members of the group. B) Each member of the group respects all of the other members as unique and valuable. C) The members of the group must carry out decisions made by the leader without question. D) The leader must be methodical and able to sift through complicated information.

B) Each member of the group respects all of the other members as unique and valuable.

3. What is a primary tactic that is used by a person displaying persecutor behavior? A) Backstabbing B) Inconsistent behavior C) Leading gossip sessions D) Finger-pointing

B) Inconsistent behavior

10. How does transformational leadership aid in reversing incivility in the work or school environment? A) Nurse leaders learn how to develop plans to deal with incivility when it occurs. B) It acts as a lens through which leaders can reflect and change inequalities. C) It creates a more open channel of communication from workers to leaders. D) It maintains the status quo so that the environment is more predictable, thereby reducing workers' stress levels.

B) It acts as a lens through which leaders can reflect and change inequalities.

8. What role does anger play in communication? A) It is always negative and destructive. B) It can be used positively to produce change. C) It should be held in as a controlled rage. D) It needs to be expressed immediately.

B) It can be used positively to produce change.

10. A leader with a low relationship/low task orientation presents a leadership style that is most similar to which leadership approach? A) Democratic B) Laissez-faire C) Authoritarian D) Benevolent

B) Laissez-faire

Select all of the items that would constitute barriers to effective delegation. A) Decisiveness B) Micromanaging C) Policies that tolerate mistakes D) Management-by-crisis mode E) Confidence in self F) Work overload

B) Micromanaging D) Management-by-crisis mode F) Work overload

18. A newly appointed nurse manager observes that the unit she is supervising functions in a manner that suggests the previous manager used a laissez-faire approach to supervision. Select the practice that indicates that more direction is required in the leadership style. A) The experienced nurses work through lunch breaks. B) Most tasks are being performed by new graduates. C) Nurses from the float pool are assigned to the low acuity clients. D) Staff members are resistant to proposed changes.

B) Most tasks are being performed by new graduates.

9. Identify which of the following results researchers have found not to occur when nurses work multiple back-to-back shifts. A) There is a higher incident of medication errors. B) Nurses have an increased level of satisfaction since their income is increased. C) The quality of client care decreases. D) Long-term fatigue becomes a factor in care giving.

B) Nurses have an increased level of satisfaction since their income is increased.

1. The hospital administration has just notified all the unit managers that the care delivery model is to be changed from team nursing to modular nursing because of budget restraints. Identify the action by the unit managers that is essential to the successful implementation of the modular nursing care model. A) Hire nurses who are self-directed and concerned with consistency of care. B) Obtain the cooperation and input from the respiratory therapy, radiology, dietary, and laboratory departments and other support services. C) Develop total quality management studies to determine risk areas. D) Initiate a training program for ancillary health workers, such as nurse aides and orderlies.

B) Obtain the cooperation and input from the respiratory therapy, radiology, dietary, and laboratory departments and other support services.

5. Which assignment is most appropriate for a CNA floated to the medical-surgical unit from the outpatient clinic? A) Assisting a 72-year-old man 1 day post-cerebrovascular accident with dysphagia to eat lunch B) Obtaining a temperature on a 29-year-old woman with gastrointestinal bleeding during the last 30 minutes of a whole-blood transfusion C) Completing the admission vital signs and assessment on a 44-year-old woman who just returned from the post anesthesia care unit after nephrectomy D) Changing the sterile dressings on a 22-year-old man 2 days after undergoing skin graft for burn injuries

B) Obtaining a temperature on a 29-year-old woman with gastrointestinal bleeding during the last 30 minutes of a whole-blood transfusion

15. Which of the following statements is most accurate about lateral violence? A) It is a new phenomenon for the nursing profession. B) Oppression theory notes that marginalization is a key contributing factor to lateral violence. C) It has not been connected by research to the production of physical symptoms. D) The concept of inappropriate use of coercive power becomes a key element in lateral violence.

B) Oppression theory notes that marginalization is a key contributing factor to lateral violence.

6. What is an example of horizontal violence? A) A student talking back to an instructor in the classroom B) Posting false and derogatory information on FaceBook about a fellow student C) Faculty assigning additional homework when students fall asleep during class D) Keying the car of faculty who are unreasonable and unfair

B) Posting false and derogatory information on FaceBook about a fellow student

17. Identify the most important factor in the initial negotiation of a contract. A) Discussion of the important issues B) Posturing and showmanship C) Resolution of key conflicts D) Lack of willingness to negotiate

B) Posturing and showmanship

23. What is the most important feature of the shared governance model? A) Nursing administration retains most of the power over nurses to better regulate practice. B) Power and authority are transferred to the nursing staff rather than being located primarily in nursing administration. C) Clients are billed for nursing care as a separate item similar to the way they are billed for physician services. D) The nursing staff hierarchy structure is similar to the medical staff structure.

B) Power and authority are transferred to the nursing staff rather than being located primarily in nursing administration.

3. The nurses on the 7 a.m. to 3 p.m. shift have been complaining to the head nurse that the nurses on the 11 p.m. to 7 a.m. shift have not been doing the ordered client daily weights, and the physicians are very upset when they make their early morning rounds. Identify the initial action the head nurse should take to resolve this conflict. A) Post a stern memo that reminds the night shift nurses to do the daily weights. B) Review the daily weight flow sheet. C) Change the time for daily weights to the late morning. D) Hold a meeting with the physicians to discuss their attitudes.

B) Review the daily weight flow sheet.

19. Select a practice that is an indication of failure to bargain in good faith. A) Agreeing to meet at reasonable times B) Sending individuals to negotiate who cannot make binding decisions C) Unwillingness to negotiate on all issues D) Exchanging lists of demands by both sides

B) Sending individuals to negotiate who cannot make binding decisions

1. A registered nurse (RN) is assigned to a step-down coronary care unit with 20 clients in various stages of recovery. What is the primary consideration in assigning the unit staff that includes two RNs, two licensed practical nurses (LPNs), and one certified nursing assistant (CNA)? A) Distance of client rooms from the nurses' station B) Skill level of each staff member C) Staff preferences for specific clients D) Developmental needs of clients

B) Skill level of each staff member

11. What is the primary reason some nurses have difficulty in their role of managing the needs of the elderly or dying client? A) They become very emotional when clients they are caring for die. B) They have an internal conflict in coping with their own fears of death. C) Their education has focused them on keeping clients alive and promoting health. D) Death of a client may indicate that the care they were providing was insufficient.

B) They have an internal conflict in coping with their own fears of death.

13. Which of the following statements is most accurate about individuals who bully other people? A) They obtain their reward when the bullied individual stands up to them. B) They have low self-esteem and poor self-image. C) They use bullying as a form of entertainment. D) Their targets usually are strong-willed and confident, and they use bullying as a way to "bring them down a peg or two."

B) They have low self-esteem and poor self-image.

5. What is the most common finding in states that have invested in home support services? A) They find it very difficult to balance their budgets due to excessive costs. B) They spend much less and reduce the growth rate of long-term institutional care than states that do not make the investment. C) The overall quality of care for the elderly is reduced markedly as compared to states that do not spend a lot of resources on home care. D) Older adults soon become dependent on these services, which reduces their sense of comfort and belonging.

B) They spend much less and reduce the growth rate of long-term institutional care than states that do not make the investment.

4. Identify the characteristics required in a person who is able to resolve difficult crises. A) Has decreased self-esteem and motivation B) Uses newly developed coping skills to resolve future crises C) Views the experience as personally destructive D) Avoids difficult situations in the future

B) Uses newly developed coping skills to resolve future crises

15. Which is an important element for the nurse to remember when conducting a client language assessment? A) Did the client bring an interpreter to the hospital? B) What is the client's fluency in both the primary and secondary languages? C) How long has the client been living in America? D) What cultural health-care practices does the client use on a regular basis?

B) What is the client's fluency in both the primary and secondary languages?

1. Identify an important communication difference between men and women. A) Men have a larger and better-developed vocabulary at an earlier age than women. B) Women prefer the face-to-face communication style. C) Men prefer close proximity when communicating important information. D) Women tend to be more physical when communicating.

B) Women prefer the face-to-face communication style.

6. The best way to establish trust with a client who is displaying difficult behavior is to always: A) show compassion and sympathy to what the client is talking about. B) be honest in answering the client's questions. C) use therapeutic communication skills when talking with the client. D) be judgmental about the client's feelings.

B) be honest in answering the client's questions.

Select all of the elements that may make a person a target for bullying. (SATA) A) Being highly self-confident B) Having a different sexual orientation C) Possessing physical defects D) Defending himself or herself against bullies E) Unintentionally displaying an attitude of timidity F) Being ostracized from the group

B) Having a different sexual orientation C) Possessing physical defects E)Unintentionally displaying an attitude of timidity F) Being ostracized from the group

Select all of the actions that the Nursing Organizations Alliance recommends help build a positive workplace environment and overcome incivility. A) Developing an action plan to immediately stop lateral violence and bullying B) Training leaders competent in cooperation and communication C) Sharing decision-making with all those it will affect D) Developing professional standards including the development and acquisition of an appropriate set of values and an ethical framework in the work environment E) Continuously developing employee skills and clinical knowledge F) Recognizing and rewarding employees' contributions

B) Training leaders competent in cooperation and communication C) Sharing decision-making with all those it will affect E)Continuously developing employee skills and clinical knowledge F)Recognizing and rewarding employees' contributions

16. Select the factor that is most likely to increase a client's motivation to learn. A) A severe illness with the potential to be fatal B) The presence of the client's significant other during teaching session C) A college education D) A high socioeconomic level

C) A college education

6. What function do personal standards fulfill in a person's life? A) Determining a person's sense of right and wrong B) Forming the basis for a code of ethics C) Acting as more specific criteria for behavior D) Determining how a person responds to individual situations

C) Acting as more specific criteria for behavior

9. What is the first step in defusing the spiral of incivility? A) Reflecting on the problem B) Developing a plan to resolve the problem C) Active listening to a fellow worker's accounts of incivility D) Reporting the incident to a superior

C) Active listening to a fellow worker's accounts of incivility

20. During a staff meeting, an elderly physician is very negative and disagrees with any proposals for change, directing belittling statements at the unit manager such as, "No wonder this hospital is such a mess. You generation-X nurses have no commitment to working hard!" How can the unit manager most appropriately deal with this situation? A) Ask the physician to leave the meeting before proceeding. B) Reply to the physician with equally belittling remarks. C) Allow the physician to express his or her opinions, and then ask for input from others at the meeting. D) Walk out of the room and report the physician to the hospital's chief of medicine.

C) Allow the physician to express his or her opinions, and then ask for input from others at the meeting.

14. What was the key evidenced-based finding that resulted from a study conducted in Denver in 1994 that compared the teaching of professional nurses with the teaching conducted by paraprofessional health-care providers in home health-care situations? A) The teaching was comparable between the two groups. B) Paraprofessionals teaching were much more cost effective than registered nurses (RNs). C) Caution should be used in allowing health-care providers other than RNs to make home health-care visits. D) The rates of readmissions were lower for the clients who were taught by paraprofessionals than it was with those taught by RNs.

C) Caution should be used in allowing health-care providers other than RNs to make home health-care visits.

22. Identify the most important element to look for in a good contract. A) Description of the official bargaining group B) Description of the benefits included in the contract, such as wages, overtime pay, and holidays C) Description of what is expected of the professional D) Timeframe for the implementation of the contract

C) Description of what is expected of the professional

11. What is the first step in the delegation process? A) Obtaining permission from the client for another care provider to help with the care B) Instructing the person to whom the task is delegated about the assignment C) Determining the skill level of the person to whom the task is to be delegated D) Allowing the person to observe the RN performing the task before making the assignment

C) Determining the skill level of the person to whom the task is to be delegated

19. Which objective best indicates that a vice president of nursing services has a good understanding of methods to decrease staff turnover rate? A) Postdischarge questionnaires will show increased levels of client satisfaction. B) During the next 6 months, attrition rates will be the national average. C) During the next 3 months, retention rates will increase by 10 percent. D) Nurses will feel more control over their work environment.

C) During the next 3 months, retention rates will increase by 10 percent.

12. Select the element in managed care that has contributed to the need for increased client education. A) Use of the team method of nursing care B) High rates of nosocomial infections C) Emphasis on increased client responsibility for care D) Physician control of the health-care environment

C) Emphasis on increased client responsibility for care

5. The oxygen saturation for a client with acute infective bronchitis drops to 84 percent, and the client develops severe dyspnea. There is a standing order for a handheld nebulizer (HHN) treatment prn (as needed) for shortness of breath. The respiratory therapy department is designated to give all respiratory treatments in the facility. When the nurse calls the respiratory therapist, he states that he has several more treatments to give but he should be there in 10 or 15 minutes. Select the action by the nurse that would be most appropriate at this time. A) Increase the flow rate of the client's oxygen until the respiratory therapist can arrive. B) Call the respiratory therapist back and insist that he come immediately. C) Give the HHN treatment himself or herself. D) Give the client a prescribed prn sedative to reduce anxiety.

C) Give the HHN treatment himself or herself.

2. Which one of the following is a key to understanding people displaying difficult behavior? A) Understanding how they use communication blockers B) Avoiding their sharp vocal barbs C) Identifying what goals they are trying to achieve D) Recognizing that perception is 90 percent of behavior

C) Identifying what goals they are trying to achieve

11. A manager who always achieves the tasks given to him or her, uses verbal putdowns and poor performance evaluations to motivate employees, and expects all orders to be carried out without question is using which style of leadership? A) High relationship/low task B) Low relationship/low task C) Low relationship/high task D) High relationship/high task

C) Low relationship/high task

5. What is one of the major differences between coworkers' difficulty behavior and the difficult behavior displayed by patients? A) Coworkers' behavior is driven by work-oriented goals. B) Patients' difficult behavior is much easier to resolve. C) Patients' difficult behavior usually involves meeting the needs of the lower levels of Maslow's hierarchy of needs. D) Coworkers' difficulty behavior must be addressed directly for best results.

C) Patients' difficult behavior usually involves meeting the needs of the lower levels of Maslow's hierarchy of needs.

What is the underlying principle upon which all definitions of civility are built? A) Good manners B) The Civil Rights Act of 1974 C) Recognizing the importance of all human beings D) The fight against injustice and oppression

C) Recognizing the importance of all human beings

13. Which behavior indicates that a nurse who is forced to confront a conflict situation is using a submissive approach to communication? A) Sets up a one-on-one meeting at a specific time B) Confronts the other person loudly and in front of an audience C) Refers the problem to a supervisor D) Uses the incident as a threat

C) Refers the problem to a supervisor

14. A particularly vocal staff nurse on a busy obstetric unit has been complaining to the other nurses about the unit manager's preferential treatment of the night-shift nurses. Select the action that the unit manager should take to resolve this problem, which best demonstrates the use of the assertive approach to conflict resolution. A) Notes that the vocal staff nurse is not intelligent enough to understand the situation, and disregards her comments as worthless B) Arranges for the transfer of the staff nurse to the night shift C) Sets up a time and place for a one-on-one meeting with the staff nurse D) Waits until there is an opportunity to use the incident to confront the staff nurse in front of his or her colleagues

C) Sets up a time and place for a one-on-one meeting with the staff nurse

22. Which of the following is an effective way of motivating followers in an organization? A) Withholding vacation days until the follower is motivated to comply with the leader B) Assigning the follower the most difficult clients on the unit so that he or she understands their skill levels C) Showing the followers that they are important to the organization D) Selecting the best nurses to receive a special reward that the others do not receive

C) Showing the followers that they are important to the organization

13. Identify the characteristics of a task that is to be delegated that would require it to be assigned to an RN. A) The client is relatively stable. B) The task is routine in nature and follows hospital policies. C) The task requires decision-making to complete it. D) The client requires an assessment at the beginning of the shift.

C) The task requires decision-making to complete it.

4. Identify which of the following statements is most accurate about the vast majority of the elderly. A) They all have chronic diseases and are in assisted-care facilities. B) They make up the single largest expenditure for the federal government budget. C) They are relatively healthy and most manage their chronic conditions at home. D) They have high levels of depression and are usually in bad spirits.

C) They are relatively healthy and most manage their chronic conditions at home.

6. What is the most common result experienced by states that have cut their Medicaid budgets over the past few years? A) State governments have become much smaller. B) Their citizens have become less dependent on free handouts from the government. C) They lost a significant source of income. D) It encourages providers to accept more elderly clients for care.

C) They lost a significant source of income.

14. Identify the item that is not a manifestation of covert lateral violence. A) Making faces behind someone's back B) Whining C) Threatening body language D) Fabrication

C) Threatening body language

9. Identify an important characteristic of informal norms found in most nursing units. A) Expressed clearly so that everyone knows what is expected B) Promulgated through memos C) Unclear but often used for informal evaluation of work behaviors D) Logical and well organized

C) Unclear but often used for informal evaluation of work behaviors

21. What is the most important advantage that a union has over an Student Nurses Association as a bargaining unit for nurses? A) The union has a good understanding of the complex needs of the profession. B) The union has more power as a bargaining unit than an SNA. C) Unions have skilled representatives with much experience in negotiating contracts. D) Hospitals and nursing homes are more afraid of unions than SNAs.

C) Unions have skilled representatives with much experience in negotiating contracts.

16. Extreme bottom-up vertical violence can sometimes manifest itself as: A) using passive-aggressive ways to decrease productivity. B) an environment that remains in a constant state of fear. C) an employee "going postal" and causing physical injury. D) decreased communication.

C) an employee "going postal" and causing physical injury.

20. Which statement by the nurse would best indicate the nurse's use of the shared power concept in client teaching? A) "If you do the procedure just as I showed you, you will not have any infections." B) "The physician wants you to take this medication at the same time every day." C) "Once you get home, you can do whatever you want." D) "Tell me what your greatest concern is about being discharged."

D) "Tell me what your greatest concern is about being discharged."

1. A client asks what the Affordable Care Act is. The nurse's best response is: A) "The law is only for those on Medicare Part D." B) "The law requires that most of the assets be absorbed." C) "The law has been written for those seniors who are under Medicaid." D) "The law has been written for seniors and those of all ages for a positive outcome."

D) "The law has been written for seniors and those of all ages for a positive outcome."

13. A nurse terminates employment without giving the facility the required 2-week notice. One month later, the nurse manager receives a call from the personnel director at a different hospital requesting a reference for this nurse. How can the nurse manager best respond to this request? A) "The nurse was irresponsible and did not give a 2-week notice." B) "The nurse worked here for several months before leaving abruptly." C) "You will be lucky to hire a nurse of his or her caliber." D) "The nurse worked here from November 1, 1993, to April 9, 2002."

D) "The nurse worked here from November 1, 1993, to April 9, 2002."

17. A proposed change in the management structure of the nursing unit is explained during a staff meeting, and several nurses express antagonistic comments about the proposed changes to the nurse manager. Identify the best response by the nurse manager. A) "We need to look at all of the aspects of the proposal even though some of you may not think it is wise." B) "I will not continue with the presentation until the room is quiet." C) "If you cannot hold your comments until the end of the presentation, please leave now." D) "There seems to be some disagreement with the proposal. Let's discuss the good and bad points."

D) "There seems to be some disagreement with the proposal. Let's discuss the good and bad points."

14. Which statement made by a nursing student during a class on delegation indicates that the student needs additional study of the topic? A) "The tasks delegated should have expected and predictable outcomes." B) "The RN who delegates is also responsible for education about the task to be performed." C) "Assessing clients is a task of the RN." D) "When nurses delegate, they are delegating nursing."

D) "When nurses delegate, they are delegating nursing."

16. Which statement by a nurse manager during a staff meeting best demonstrates use of an assertive style of communication? A) "I am the manager and we will do it my way." B) "I'm sorry, but your suggestion was useless to solving the problem." C) "I really don't care; do it the way you think is best." D) "You have made some good points, but I have another suggestion."

D) "You have made some good points, but I have another suggestion."

3. Because of short staffing in the intensive care unit, a labor and delivery nurse is floated to the unit. Identify the most appropriate assignment for this nurse. A) A 36-year-old woman with steroid-induced cardiomyopathy B) An 86-year-old man in cardiogenic shock C) A 3-year-old girl with an accidental overdose of acetaminophen (Tylenol) D) A 23-year-old man with malignant hypertension

D) A 23-year-old man with malignant hypertension

12. Identify the primary role of civility in the nursing profession. A) It allows nurses to practice without fear of retaliation. B) Unit morale is maintained at a high level, increasing productivity. C) Civility is simply an expectation of professional behavior. D) Civility in the profession enables nurses to make caring the focal point of their practice.

D) Civility in the profession enables nurses to make caring the focal point of their practice.

16. A unit manager is preparing the time schedule for the summer holiday season. Approximately one-half of the staff has requested 1 to 2 weeks' vacation. Granting all the requested time will lead to severe staffing shortages. What is the nurse manager's primary consideration in developing this schedule? A) Nurses' satisfaction and work performance B) Establishing good communication with staff members to reduce resentment C) Granting requests by seniority and performance evaluations D) Client safety needs

D) Client safety needs

14. A hospital administrator has decided to turn an underused medical-surgical unit into a rehabilitation unit. What will be necessary to implement this strategic decision? A) Allocate extra money for the staff to work overtime. B) Follow existing policies and procedures used in the rest of the facility. C) Perform a needs assessment and evaluate the data. D) Develop long-term goals and identify key individuals.

D) Develop long-term goals and identify key individuals.

8. When do most health-care expenditures occur in a person's life? A) During and shortly after being born B) During childhood due to the large number of broken bones and traumatic injuries C) As old age sets in due to the development of multiple chronic illnesses D) During the last 6 months of life

D) During the last 6 months of life

10. What result can be anticipated when nurses do not participate in changes in their work environment? A) Feelings that the most qualified individuals will make the best decisions B) A sense of increased security C) Decreased stress levels because they are not required to perform difficult tasks D) Feelings of insecurity

D) Feelings of insecurity

5. What has been identified as a key element to effective education of nursing students A) A feeling of personal safety in the classroom setting B) Low stress levels produced by decreased work assignments C) Permitting students to use cell phones during classes D) High-quality interpersonal relationships between students and teachers

D) High-quality interpersonal relationships between students and teachers

3. Which element increases the likelihood of incivility? A) Using a problem-solving approach B) Using assertive communication C) Internalizing workplace issues D) Increased levels of stress

D) Increased levels of stress

7. Identify what the act of making a decision based on an analysis of the available information is called. A) Bias B) Prejudice C) Stereotyping D) Judgment

D) Judgment

10. What is the best way to increase the motivation to learn in the elderly population? A) Use negative reinforcements when an elderly person does not change behavior appropriately B) Ignore their life experiences so that the learning is not contaminated by misinformation from the past. C) Use the power disparity between the teacher and the client to reinforce basic principles. D) Link positive reinforcement to changes in behavior.

D) Link positive reinforcement to changes in behavior.

7. Identify a typical response for a manager who uses the laissez-faire approach to leadership when faced with a difficult decision. A) Consult with the coworkers on the best way to resolve the problem. B) Make the tough decision by himself or herself and accept the responsibility. C) Appeal to a higher authority to make the decision. D) Postpone making the decision in the hopes that it will resolve itself.

D) Postpone making the decision in the hopes that it will resolve itself.

4. Which of the following goals has the highest priority for the nurse to achieve when helping a patient work through the stages of grief? A) Help the patient work his or her way through the stages of grief until he or she reaches resolution. B) Monitor the patient's emotional expressions for signs of suicide. C) Keep contact sessions with the patient short and to the point. D) Provide the best care possible so that the patient will survive and recover from his or her illness by meeting physiological and safety needs.

D) Provide the best care possible so that the patient will survive and recover from his or her illness by meeting physiological and safety needs.

8. What action would contribute most in preventing experienced nurses from "eating their young"? A) Punishing experienced nurses with extra shifts for displaying incivility to new graduates B) Keeping new graduate nurses segregated as much as possible from hostile experienced nurses until they gain more on-the-job experience C) Providing in-service training sessions for experienced nurses on civility D) Teaching new nurses to be more assertive and to express their opinions without fear

D) Teaching new nurses to be more assertive and to express their opinions without fear

2. Which factor contributes most to an 82-year-old client's understanding of the discharge teaching given by a nurse? A) The client believes he knows all of the information already and is not really paying attention. B) The client asks so many questions that the nurse loses his or her train of thought. C) The nurse attempts to communicate at the client's knowledge level. D) The client believes that asking questions may be perceived as a threat to the nurse's authority.

D) The client believes that asking questions may be perceived as a threat to the nurse's authority.

9. An angry patient says to the nurse, "You're so incompetent, I'd rather have a monkey taking care of me!" What should the nurse keep in mind when dealing with this patient? A) Stopping this type of behavior with a sharp response will keep it from escalating. B) Leaving the room immediately will express the nurse's displeasure with the statement without direct confrontation. C) Reporting this patient's behavior to a superior is the first step in filing a complaint. D) The statement made by the angry patient was not a personal attack on the nurse.

D) The statement made by the angry patient was not a personal attack on the nurse.

17. All of the following are methods faculty can use to overcome academic incivility, except: A) become a catalyst and a change agent in one's own nursing program. B) make civility and cooperation a key element in the vision, mission statement, and outcomes of the program. C) revise the curriculum so that shared values, collegiality, and collaboration are threads that guide students and faculty in the learning process. D) develop and post a list of uncivil behaviors that nursing faculty display.

D) develop and post a list of uncivil behaviors that nursing faculty display.

4. Select the statement by a unit manager to the vice president of nursing during a budget meeting that would be most effective in decreasing the staffing ratio on her unit from one nurse for every nine clients to one nurse for every seven clients. "This proposed change will: A) have a positive effect on the usage of institutional resources." B) better meet current national standards of practice." C) help with the recruitment of new nurses to the facility." D) improve the quality of care for the clients on the unit."

D) improve the quality of care for the clients on the unit."