Leadership Exam 2

An experienced LPN is working under the supervision of the RN. The LPN is providing nursing care for a patient who has a respiratory problem. Which activities should the RN delegate to the experienced LPN? Select all that apply.

-Auscultate breath sounds. -Administer medications via metered-dose inhaler (MIDI).

Implicit bias affects our understanding in an unconscious manner. A person's ability to recognize these biases can improve communication with patients and colleagues alike. Which of the following statements is true about implicit bias?

-Implicit bias forms during a lifetime. -Implicit bias can influence clinical decision making and treatment. -Implicit bias contributes to an individual's social behavior.

When should a new graduate consider taking on management responsibilities

After developing clinical expertise

Scientific management focuses on:

Efficiency

George S. has just become a nurse manager in a long-term care facility. He knows he has a lot to learn--what should he tell his staff?

That he is still learning, too, and values their input

A respiratory therapist performs suctioning on a patient with a closed head injury who has a tracheostomy. Afterward, the NAP obtains vital signs. The nurse should communicate that the NAP needs to report which vital sign value or values immediately? Select all that apply.

Tympanic temperature of 101.4°F (38.6°C)

Which of the following is a major reason why newly licensed nurses resign?

Unsupportive management

A nurse is assigned to care for the following patients. Which patient should the nurse assess first?

A 50-year-old with asthma who complains of shortness of breath after using a bronchodilator

Effective nurse managers have: Select all that apply.

-Leadership capabilities -Clinical expertise -Business sense -Budgeting savvy

Which of the following issues may be addressed in a collective bargaining agreement?

-Shift differentials -Safe working environment -Grievance procedures

Servant leadership focuses on:

Creating a supportive work environment

Nursing management and the nursing union are having differences on several issues. There may be a need for negotiation. Which of the following is a serious disadvantage to using collective bargaining to resolve this conflict?

Creating an adversarial relationship between staff and management

Differences in status and authority within the health-care team can generate conflict. What is the most common cause of conflict?

Disrespect and incivility

The EMR has many advantages compared with paper charting. It helps track data through time and can help monitor things such as preventative care in primary care practices. Jane is the office nurse in a local practice. She is meeting a new patient for the very first time who informs her that he was recently hospitalized. Jane pulls up the patient's EMR and sees no information regarding his recent hospital stay. How could this have happened?

EMRs are usually practice or hospital specific, so the patient's information would not be accessible to Jane.

Florence has two team members who continually criticize each other despite being told to stop. Which approach is the most appropriate for this situation?

Engage in problem resolution.

Theory Y emphasizes:

Guidance, development, and reward

ISBARR provides a framework for communicating critical client information. ISBARR is an acronym for:

Introduce, Situation, Background, Assess, Recommend, Readback

Bedside shift report is one of the things that Jane reviews at the staff meeting. She stresses the way she would prefer the report to start. Which of these would be the least important to share with the oncoming nurse?

Introducing the client and his or her diagnosis to the oncoming nurse

You are working on the trauma unit today, and your new patient with a femur fracture complains of leg pain and seems a little diaphoretic and short of breath. You assess the patient and prepare to contact the surgeon. In preparation for contacting the physician, you:

Jot down notes about the situation as it is presented to you, review the patient's history, focus your assessment, and determine what you need for the patient.

Jane is a new nurse manager who will be holding her first staff meeting tomorrow. She has learned that the staff members have not been following important patient care policies. What is the most important communication skill that she should use at the meeting?

Listening

What is the difference between management and leadership?

Management is an assigned position.

A nurse is caring for a patient who is diagnosed with coronary artery disease and sleep apnea. Which action should the nurse delegate to the NAP?

Remind the patient to sleep on his side instead of his back.

The purpose of learning how to negotiate conflict is to:

Resolve conflicts more effectively

The hospital has recently reorganized; therefore, several departments were closed. The patient census on the unit has increased. The staff have always had a strong team spirit, but the nurse manager knows that workflow changes can cause conflict. What can the nurse manager do to reduce the possibility of conflict among her team?

-Monitor the quality of patient care. -Ensure that supplies and equipment are readily available. -Assess the equity of nursing assignments.

As Jane speaks with the team, she learns why the staff members have had difficulty following policies. Which of these would be considered barriers to effective communication?

-The charge nurse is unavailable to help the nurses when they have questions about policies. -Some staff are afraid to ask particular charge nurses for help for fear of retribution. -The use of acronyms is confusing to staff members who are new to the unit.

An assistant nurse manager is making assignments for the next shift. Which patient should the assistant nurse manager assigns to a nurse with 6 months of experience and who has been floated from the surgical unit to the medical unit?

A 72-year-old who needs teaching about the use of incentive spirometry

What is brainwriting?

A strategy to encourage the free flow of ideas

If an informal negotiation session becomes too highly emotional, what should the nurse manager do?

Deal with the feelings first.

Mara Z. wants to become a nurse manager. She has been offered an opportunity to take a nursing management course. Which topic is most important for her to learn?

Managing people

The patient with COPD has a nursing diagnosis of Ineffective Breathing Pattern. Which appropriate action to delegate to the experienced LPN under your supervision?

Observe how well the patient performs pursed-lip breathing.

Who is responsible for accepting, transcribing, and implementing physician orders?

Professional nurse

The nursing assistant tells a nurse that a patient who is receiving oxygen at a flow rate of 6 L/min by nasal cannula is complaining of nasal passage discomfort. What intervention should the nurse suggest to improve the patient's comfort for this problem?

Suggest that the patient's oxygen be humidified.

A nurse is helping an NAP provide a bed bath to a comatose patient who is incontinent. Which of the following actions requires the nurse to intervene?

The nursing assistant answers the phone while wearing gloves.

What is the most desirable result of a problem resolution?

Win-win

Nursing and respiratory departments both experienced job cuts. The nurse manager notices that members of his staff are having more trouble getting a fast response from a respiratory therapist. What source of conflict is probably operating here?

Work intensification

TJC attributes 80% of all medical errors to:

Poor hand-off communication

A nurse is caring for a patient who has a pulmonary embolus. The patient is receiving anticoagulation with IV heparin. What instructions should the nurse give the NAP who will help the patient with activities of daily living? Select all that apply.

-Use a lift sheet when moving and positioning the patient in bed. -Use an electric razor when shaving the patient each day. -Use a soft-bristled toothbrush or tooth sponge for oral care. -Be sure the patient's footwear has a non-slip sole when the patient ambulates.

Social media is commonly used to update friends and groups on things we have going on in our lives. Health-care organizations routinely use social media to promote medical facts, services, and recognitions. What is important for nurses to remember when deciding to post something work related on a social media site?

Nurses should never post protected health information on a social media site.

A nurse is caring for a patient who has chronic obstructive pulmonary disease (COPD) and is 2 days postoperative after a laparoscopic cholecystectomy. Which intervention for airway management should the nurse delegate to an NAP?

Assisting the patient to sit up on the side of the bed

Informational aspects of a nurse manager's job include:

Being a spokesperson