HESI MANAGEMENT REVIEW
What is the duty of the nurse as delegator if the delegatee has limited knowledge and ability to perform a task? A.Provide guidance. B.Observe and motivate. C.Explain what is to be done. D.Establish mutual expectations.
A.Provide guidance. If the delegatee has limited knowledge and ability to perform a task, the delegator should provide guidance. The delegator is expected to observe and monitor the task performed by the delegatee to ensure he or she has the ability and willingness to establish a relationship and accomplish work. The RN explains the task and how to execute it if the situation involves a new task and the relationship is ongoing. If the delegatee is new to the workplace, but has the ability and willingness to perform a task, the delegator should establish mutual expectations and conditions of performance in order to establish a good relationship.
The nurse leader finds that a client with a severe vitamin B12 deficiency is extremely fatigued and tends to fall. Which theory does the student nurse think that the nurse leader would find appropriate for prioritizing the need of the client? A.Role theory B.Maslow's theory C.Complexity theory D.Situational leadership theory
B. Maslow's theory Maslow's theory prioritizes the needs of the client and, if applying Maslow's theory, the nurse leader would provide for safety needs of the client first. Role theory is associated with an appreciable framework for the development and evaluation of staff. Complexity theory explains that change is an ongoing experience through which a system is adjusted. Situational leadership theory analyzes an individual's knowledge and the work-related task before delegation.
Which healthcare settings are appropriate for delegating care according to the functional model of nursing? Select all that apply. A.Hospice units B.Emergency units C.Inpatient facilities D.Ambulatory clinics E.Acute care agencies
B,D In the functional method, each healthcare provider knows the expectation of his or her assigned role and completes tasks quickly and effectively. This model works well in emergency situations and ambulatory clinics. Hospice settings are not suitable for this type of care, because in hospice care the client requires chronic and continuous care. Inpatient care settings are not suitable for the use of the functional model of care delivery because these settings need acute care and continuous care by careful monitoring. Acute care agencies are not suitable for the functional model because acute and more specific individualized care is required.
During an interview for a nurse manager position, the panel asks the nurse about the primary role of a leader. Which answer provided by the nurse would be most appropriate? A."To inspire followers" B."To provide training to the followers" C."To share views about the task with the followers" D."To increase the feeling of self-worth in the followers"
A. "To inspire followers"
Which delegatee requires little guidance from the delegator? A.Delegatee who is familiar with the task but not the client B.Delegatee who has experience but is unfamiliar with the task C.Delegatee who has little experience but has willingness to do the task D.Delegatee who is very familiar with the client but has a lack of ability to do the task
A.Delegatee who is familiar with the task but not the client A delegatee who has experience and is familiar with the task requires less guidance and support from the delegator as he or she has the ability to accomplish the task. A delegatee who has work experience may have ability but requires guidance as he or she is new to the delegated task. A delegatee who shows willingness to do the task but has little experience requires supervision. A delegatee who is familiar with the client but has a lack of ability to do the task requires supervision or guidance.
The unlicensed assistive personnel (UAP) assigned to the 7:00 AM shift has not been coming to work until 8:00 AM. Nursing care is delayed, and assignments are started late. What is the most effective action by the charge nurse/team leader? A.Discuss the issue with a friend from another unit. B.Remind the UAP of the expected start time. C.Report the problem to the Human Resources department. D.Document the information and discuss it with the UAP.
D. Document the information and discuss it with the UAP. Documentation is the best initial response; documentation should include both the missed time and the effect on client care. Discussing the issue with a friend from another unit is not a professional response to the problem. Reminding the unlicensed assistive personnel (UAP) of the expected start time may be helpful, but will not effectively address the issue if the problem continues. Reporting the event to the Human Resources department may be a later response to the problem.
The nurse leader, while teaching a group of nurse leaders, references an approach of evidence-driven consciousness to be applied in the nursing practice. What is the main concern of the nurse leader? 1 About managing emotions Correct 2 About the safety of the clients 3 About the focus on emergence 4 About focus on efficiency and cost
B.About the safety of the clients The phrase "evidence-driven approach" mainly shows a concern about the safety of clients. The management of emotions could be associated with emotional intelligence. The concern about the focus on emergence may be executed through the use of phrases such as "think outside the box." The focus on efficiency and cost may not be signified though the phrase "evidence-driven approach."
What are the responsibilities of the nurse as a leader? Select all that apply. A.Being accountable for financial matters B.Encouraging the direct care nurses to provide input into decisions C.Identifying charge nurses who have a potential to become managers D.Being responsible for the selection, hiring, and orientation of employees E.Ensuring that day-to-day activities of the staff are correctly planned and executed
B,E The nurse leader should encourage the direct care nurses to provide input into the decisions being made. A proper plan should be executed by the nurse leader that ensures day-to-day activities of the staff are correctly planned and executed. A nurse manager has financial accountability. The process of selection, recruitment, and orientation of employees requires the attention of a nurse manager. The nurse leader may identify charge nurses who have a potential to become managers, but this is not one of the direct responsibilities of the nurse leader.
A nurse encourages employees to implement a Magnet Recognition Program in the organization. The nurses think beyond their own personal needs and are clear about the group outcomes. Which leadership quality according to Gardner's tasks is reflected in the activity of the nurse? 1 Developing trust 2 Serving as a symbol Correct 3 Representing the group Incorrect 4 Achieving workable unit
C.Representing the group According to Gardner's Tasks of Leadership, encouraging employees to implement a Magnet Recognition Program shows that the nurse is representing the group. Trust develops when leaders are clear when providing direction and refrain from misdirecting others in their thinking and actions. The leader may serve as a symbol by becoming involved in public relations events, for example. The nurse as leader can achieve workable unity between and among parties by avoiding, diminishing, or resolving conflicts.
The registered nurse (RN) is evaluating the student nurse in the aspect of leadership qualities. Which behaviors of the student nurse express emotional intelligence in leadership? Select all that apply. A.Supporting the team B.Motivating the other nurse C.Following the rules of organization D. Showing proficiency in technical skills Using skills to expand social networks
A,B,D Supporting the team describes the interpersonal competence which is a characteristic of emotional intelligence of leadership. Motivating others promotes emotional self-control and using skills to expand social networks describe the handling of relationships. To follow the rules of organization and expertise in technical skills are the nursing professional aspects.
Which nursing actions indicate effective implementation of systems thinking theory principle with respect to "thinking of the Big Picture"? Select all that apply. 1 Focusing on the needs of all the residents in a long-term care facility 2 Knowing about the complications of emergency department overcrowding in an urban setting 3 Focusing on analyzing morale, working relationships, team work, and the number of clients 4 Identifying and understanding the relationships of clients, families, communities, and local economies 5 Recognizing the long-term effects of actions on the organization or client care
1,2 Focusing on the needs of all residents in a long-term care facility and knowing about the complications of emergency department overcrowding in an urban setting are actions that indicate effective implementation of the "Big Picture" principle by helping the nurse envision his/her work beyond the immediate tasks. Focusing on analyzing morale, working relationships, team work, and the number of clients indicates effective implementation of "Using Measurable versus Nonmeasurable Data Systems" principle of systems thinking theory. Identifying and understanding the relationships of clients, families, communities, and local economies indicates effective implementation of "Recognizing the Dynamic, Complex, and Interdependent Nature of Systems" principle. Recognizing the long-term effects of actions on the organization or client care indicates the "Balancing Short-Term and Long-Term Objectives" principle of systems thinking theory
Who would the registered nurse state is accountable for establishing systems to communicate competency requirements related to delegation? A.Registered nurse (RN) B.Chief nursing officer (CNO) C.Licensed practical nurse (LPN) D.Unlicensed assistive personnel (UAP)
B.Chief nursing officer (CNO) CNOs are accountable for establishing systems to communicate competency related to delegation. The registered nurse delegates the task to LPN and UAP. In delegation, the RN implements in clinical practice to improve the safety and quality of client care. LPNs provide direct care to the client. UAP provide direct care to the client under the supervision of the registered nurse who retains accountability for client care outcomes.
What principal components are associated with a nurse's time management skill? Select all that apply. A. Autonomy B.Goal setting C.Priority setting D.Interruption control E.Right communication
B.Goal setting C.Priority setting D.Interruption control Goal setting, priority setting, and interruption control forms the principal components of time management. Autonomy is an important component in the decision-making process. Right communication is considered one of the rights of delegation.
The nurse leader arranges a meeting with the staff members to learn how satisfied they are with their jobs. Which approach by the nurse leader would outline effective leadership? Select all that apply. 1 Seeking feedback from the team 2 Allotting work schedules to the team 3 Penalizing the team for poor performance 4 Motivating the team to reach the desired goals 5 Asking the team to participate in decision making
1,4,5 Seeking feedback from the team will help the team members in reaching the organizational goals and a shared vision. The most important leadership quality is to motivate the team members in such a way that they are satisfied with their jobs and helped in reaching their goals. Asking team members to participate in decision making will improve their job satisfaction. Allotting the work schedules and penalizing team members for poor performance are the duties of a nurse manager.
Which questions should the nurse consider to assess and ensure delegation to the right person? Select all that apply. 1 Is the prospective delegatee a willing and able employee? 2 Does the delegatee understand the directions and expected results of the task? 3 Does the delegatee understand how, what, and when to report to the delegator? 4 Is it clear that the delegatee will provide feedback related to the task when appropriate? 5 Does the delegatee have the knowledge and experience to perform the specific task safely?
1,5 The right delegatee is chosen on the basis of the person's willingness and ability. The nurse should assess the knowledge and experience of the prospective delegatee to perform the specific task safely and fulfill the expected outcomes. Right direction and documentation are assessed by the delegatee's ability to understand the directions and expected results of the task. It can also be assessed on the basis of the delegatee's understanding of how, what, and when to report to the delegator. The right supervision is providing feedback to the delegatee, related to the task, when appropriate.
Case management is being implemented in a major city hospital. What should the manager include when instructing the nursing staff about this care delivery method? Select all that apply. A."The case manager advocates for the client and family." B."The case manager identifies outcomes and coordinates care activities." C."Case managers help control the costs for high-risk, high-cost client populations." D."Identifying tasks that can be performed by other care providers is just one activity." E."Case management includes the client, family, and all healthcare provider involvement."
A, D, E Educating the staff of other departments about the case manager's role and responsibilities will increase the effectiveness of the case-management process. This education should include explain how the case manager serves as an advocate for the client and the family. The case-management model of care delivery streamlines costs for high-risk, high-cost client populations and seeks the active involvement of the client, the family, and healthcare professionals. Identifying outcomes and coordinating care activities and identifying tasks that can be performed by other care providers are functions of the nurse manager in client-focused care.
What are the elements integrated into delegacy? Select all that apply. A. Stability B. Leadership C.Clinical Practice D. Critical Thinking E. Communication
A. Stability D. Critical Thinking The four elements that foster effective delegation decisions are safety, critical thinking, stability, and time. Leadership, critical thinking, communication, and clinical practice are the competency skills of a charge nurse.
The registered nurse (RN) assigns a task to a licensed practical nurse (LPN) to take care of a client admitted with severe burns. Which tasks are being performed by the LPN in this situation? Select all that apply. A.Performing hygiene tasks B.Monitoring the heart rate C.Evaluating the medical reports D.Monitoring the blood pressure E.Administering the oral medication
B,D,E The licensed practical nurse monitors the heart rate, monitors blood pressure, and administers oral medications. Hygienic tasks are performed by the unlicensed assistive personnel. Evaluating medical reports is performed by the RN, not by the LPN.
The Joint Commission is surveying an organization's nursing care. Which question is the surveyor most likely to ask regarding right supervision when delegating? A."Do you inform the delegatee the proper way of providing results?" B."Do you monitor and evaluate the client's condition appropriately?" C."Do you maintain open lines of communication with the delegatee?" D."Do you provide clear and concise directions to the delegatee before delegating the task?"
B."Do you monitor and evaluate the client's condition appropriately?" Monitoring and evaluating clients' conditions should be performed by the delegator. This falls under right of supervision of delegation. Assessing the delegatee's knowledge regarding the importance of providing results falls under right communication of delegation. Maintaining open lines of communication with the delegatee and providing clear and concise directions to the delegatee falls under right communication of delegation.
Which statement of the nurse is true regarding Hersey's Situational Leadership Model? A.The situational leadership model cannot be applied to real work-related situations. B.The situational leadership model provides a solid foundation for delegation decisions. C.The situational leadership model does not relate to the behavior of the delegatee during delegation. D.The situational leadership model contends that managers should not behave differently on different occasions.
B.The situational leadership model provides a solid foundation for delegation decisions. Hersey's Situational Leadership Model describes the ability to diagnose the performance, competence, and commitment of others to be flexible and to collaborate for performance. Therefore, it provides a solid foundation for delegation decisions. Hersey's Situational Leadership Model can be applied to real work-related situations. Hersey's Situational Leadership Model relates to the behavior of the delegatee during delegation. The situational leadership model contends that managers need to behave differently on different occasions.
The registered nurse is teaching a nursing student the qualities of a leader for effectively managing conflicts. Which statement by the nursing student indicates the need for further teaching? A."I will provide a forum for open discussion." B."I will ask the staff or clients to learn from the situation." C."I will immediately resume efforts to resolve the conflict if initial efforts fail." D."I will motivate followers to use skills and resources for dispute resolution."
C."I will immediately resume efforts to resolve the conflict if initial efforts fail." The effective approach toward managing conflicts as a leader is to provide a "cooling off" period before reconvening if the resolution fails. If the nurse reconvenes the parties immediately after initially failing to find a resolution, it may not help the nurse manage the conflict properly. Providing a forum for discussion will help in eliciting feedback before and after negotiations. Working with staff or clients after the conflict to learn from the situation may help prevent a similar kind of conflict in the future. Motivating others to implement skills and resources for dispute resolution is an effective way to manage conflicts.
While supervising the LPN's technique with medication administration, the nurse manager sees the LPN beginning to dispense an incorrect dose. How should the nurse manager respond initially? A. By telling the LPN that an error has been made B.By informing the nursing supervisor that the LPN is unsafe C.By questioning the dosage in the hope that the LPN will identify the error D.By pointing out the error just before the LPN begins to administer the medication
C.By questioning the dosage in the hope that the LPN will identify the error Because the nurse is supervising, not evaluating, the LPN, questioning the dosage rather than pointing out the error is a positive approach that will allow the LPN to grow and help foster a supportive working relationship. Telling the LPN that an error has been made is not the initial intervention; this may become necessary if the LPN does not identify the error without being told. Informing the nursing supervisor is inappropriate and premature. Waiting until just before administration of the incorrect dose puts the client at risk.
Which theory states that leaders act as change catalysts and innovators? A.Role theory B.Trait theory C.Quantum theory D.McGregor's Theory X
C.Quantum theory Quantum theory states that leaders must embrace uncertainty and understand behaviors before changing them. Therefore quantum leaders represent change catalysts and innovators. Role theory is a collection of concepts that predict circumstances under which certain type behaviors are expected. Trait theory is a leadership theory in which leadership traits such as a certain set of physical and emotional characteristics are innate and cannot be learned. McGregor's Theory X describes the workforce motivation by assuming that people basically do not like their work and must be coerced by their manager to perform.
What is the main motto of the Hersey's 2006 model? A.Information decay B.Information salience C.Situational leadership D.Individual accountability
C.Situational leadership Hersey's 2006 model provides a solid foundation for delegation decisions. The main motto of this model is situational leadership. The core competencies of a situational leader are the ability to diagnose the performance, competence, and commitment of others; to be flexible; and to partner for performance. Anthony and Vidal describe characteristics of communication that interfere with the delegation process, such as information decay. They also describe information salience, or the quality, meaning, and clarity of the information. Ana mentioned individual accountability, the expectation of accountability and responsibility in 2011, specifically referencing delegation
The charge nurse is assigning client care to oncoming staff. The new nurse on the unit expresses an inability to care for the assigned client and is requesting to be reassigned. What should the delegator do in this situation? A.Provide little guidance to the delegatee B.Evaluate the ability and willingness of the delegate. C.Understand the delegatee's motivation in the situation. D.Understand the kind of support needed to accomplish the task.
C.Understand the delegatee's motivation in the situation. An inability to care for the assigned client shows inability and/or unwillingness in the new nurse. The delegator needs to understand the delegatee's motivation related to the situation and should use selling leadership style, which leads to a supportive relationship. Little guidance should be provided to the delegatee when he or she has high ability and willingness to perform the task delegated efficiently. When a new team begins to work together, the delegator should evaluate the ability and willingness of the delegatee. In the application of practice before delegation, the delegator needs to understand the kind of support to be given to accomplish the task.
A registered nurse (RN) in charge of a mental health unit has two additional staff members: a licensed practical nurse (LPN) and a nursing assistant (NA). The unit has 20 clients, with one client on constant observation for acute suicidality. What should the nurse in charge do when making the daily assignments? A.Administer medications and assign the LPN to maintain observation of the suicidal client and the NA to provide client care. B.Maintain constant observation of the suicidal client and assign the LPN to administer medications and the NA to provide client care. C.Perform client care and administrative duties and assign the NA to administer medications and the LPN to maintain observation of the suicidal client. D.Provide client care and administrative duties and assign the LPN to administer medications and the NA to maintain constant observation of the suicidal client.
D.Provide client care and administrative duties and assign the LPN to administer medications and the NA to maintain constant observation of the suicidal client. Assigning the LPN to administer medications utilizes the LPN's skills; providing constant observation of a client is within the role of NAs and frees the RN to perform client care and administrative duties. Administering medications will keep the RN from performing administrative duties; having the LPN perform direct client observation will underutilize the abilities of the LPN. Providing suicide observation will prevent the RN from performing required administrative duties. Having an NA administer medications is illegal in many states. NAs are not educated about the actions and side effects of medications.
