Leadership Final

An incident of sexual harassment as identified by the EEOC is: (SELECT ALL THAT APPLY) 1. Telling jokes about sexual identity issues 2. Separate restrooms 3. Providing coffee and doughnuts to the nursing staff 4. Demanding a daily kiss for writing a favorable evaluation

1. Telling jokes about sexual identity issues 4. Demanding a daily kiss for writing a favorable evaluation

Transformational nursing leaders have the ability to: 1. Increase the negativity of the team 2. Work best alone 3. Define the group's mission and communicate that mission to others 4. Pay close attention to the weaknesses and shortcomings of others

3. Define the group's mission and communicate that mission to others Rationales: Transformational leaders help their teams define their mission and see how their work helps them achieve their mission

New graduates usually experience a "honeymoon" period at their first job, which is characterized by: 1. Extreme criticism from colleagues 2. Long hours and low pay 3. Feeling undervalued 4. Excitement about the new position

4. Excitement about the new position

ATI BOOK chapter 3

Professional responsibilities

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? a) Assisting the patient to sit up on the side of the bed b) Instructing the patient to cough effectively c)Teaching the patient to use incentive spirometry d) Auscultating breath sounds every 4 hours

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

A nurse manager is developing an orientation plan for newly licensed nurses. Which of the following information should the manager include in the plan? (Select all that apply) a. skill proficiency b. assignment to a preceptor c. budgetary principles d. computerized charting e. socialization into unit culture f. facility policies and procedures

a. skill proficiency b. assignment to a preceptor d. computerized charting e. socialization into unit culture f. facility policies and procedures

TJC attributes 80% of all medical errors to: a. Poor hygiene and hand washing b. Poor hand-off communication c. Poor work environment d. Lack of care

b. Poor hand-off communication

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? a)Discuss weight-loss strategies such as diet and exercise with the patient. b) Teach the patient how to set up the CPAP machine before sleeping. c) Remind the patient to sleep on his side instead of his back. d) administer modafi nil (Provigil) to promote daytime wakefulness

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

ATI book: chapter 2 coordinating client care

coordinating client care

A nurse is assigned to care for the following patients. Which patient should the nurse assess fi rst? a)A 60-year-old patient on a ventilator for whom a sterile sputum specimen must be sent to the laboratory b) A 55-year-old with COPD and a pulse oximetry reading from the previous shift of 90% saturation c) A 70-year-old with pneumonia who needs to be started on IV antibiotics d) A 50-year-old with asthma who complains of shortness of breath after using a bronchodilator

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

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

A. Have staff who will be performing x-rays wears dosimeters

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

B. "The pathway shows an estimate of the number of days the client will be hospitalized." *Critical pathways often reduce the cost of care by streamlining care services. Critical pathways are specific to a client diagnosis and show the average length of stay a client with the diagnosis type will have. Deviances from the pathway require documentation of explanation, because it usually indicates the client is not progressing at the expected rate. Critical pathways include a projection of treatments the client will receive

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

B. A client who was preadmitted for rotator cuff surgery and has diabetes mellitus type 2 (a)Recognize that a client who has angina is at risk for a cardiac event. Do not recommend this client for discharge because the client is unstable. (b)Identify that a client that is stable and their condition can be managed at home with surgery rescheduled. This meets the criteria of first discharging clients who are ambulatory and require minimal care(c) Recognize that a client who has dehydration and active infection requires ongoing nursing care. Do not recommend this client for discharge because the client is unstable(d) Recognize that a client who has hip fracture is unstable and at risk for further damage to the hip. If the client were 1 day or more postoperative, discharging the client to a tertiary facility might have been possible

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

C. Ask the AP if they need assistance *An incident report is indicated when a critical incident has occurred. It is not necessary to complete an incident report in this situation. Do not redelegate this task. Find out what the AP knows about performing the task and provide education for the AP if indicated. The RN is capable of handling the situation. It is not necessary to notify the nurse manager.

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

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

Which of the following represents the "S" in a SWOT analysis? 1. Flexibility 2. Difficulty adapting to change 3. Nursing shortage 4. Competition among health-care facilities

1. Flexibility

What is an important contribution of the nursing specialty organizations? 1. Setting standards for specialty practice 2. Improving nursing's image on television 3. Supporting the associate's degree in nursing education 4. Providing collective bargaining agreements

1. Setting standards for specialty practice

A common ergonomic occupational-related risk in the health-care environment is 1. Indoor air pollution 2. Active shooters 3. Nosocomial infection 4. Back injuries

4. Back injuries Back injuries are a very common ergonomic risk in health care

An emotionally intelligent nurse leader: 1. Seeks the emotional support of others 2. Cannot juggle multiple demands 3. Works alone without help 4. Welcomes constructive criticism

4. Welcomes constructive criticism Rationales: Emotionally intelligent leaders welcome criticism that is constructive and acknowledge other team members' perspectives

A unit team leader who fails to provide direction to his or her nursing care team is a(n): 1. Democratic leader 2. Laissez-faire leader 3. Autocratic leader 4. Situational leader

Answer: 2. Laissez-faire leader Rationales: Laissez-faire leaders are passive, inactive leaders who would not provide direction

A nurse is preparing to transfer a client who is 72 hr postoperative to a long-term care facility. Which of the following information should the nurse include in the transfer report? (SELECT ALL THAT APPLY.) A. Type of anesthesia used B. Advance directives status C. Vital signs on day of admission D. Medical diagnosis E. Need for specific equipment

B. Advance directives status D. Medical diagnosis E. Need for specific equipment

An effective leader will have: Select all that apply. 1. Courage and integrity 2. A critical mind-set 3. The ability to set priorities 4. The ability to provide feedback

1. Courage and integrity 2. A critical mind-set 3. The ability to set priorities 4. The ability to provide feedback Rationales: 1. Integrity and courage are qualities of an effective leader 2. Thinking critically is a behavior of effective leaders 3. Setting priorities is another behavior of effective leaders 4. Skillful communication includes providing constructive feedback

A nursing student is graduating in 3 months. The student is looking for a position. Where should the student begin the search? (SELECT ALL THAT APPLY) 1. Health-care organizations 2. Online job boards 3. National Council of State Boards of Nursing 4. American Association of Colleges of Nursing 5. Recommendations from peers and professionals

1. Health-care organizations 2. Online job boards 5. Recommendations from peers and professionals

Which of the following characterize the transition from nursing student to practicing nurse?(SELECT ALL THAT APPLY) 1. Increased number of assigned patients 2. Higher productivity expectations for the student compared with the practicing nurse 3. Greater emphasis on efficiency in practice 4. Shorter hours, fewer workdays back to back in practice

1. Increased number of assigned patients 3. Greater emphasis on efficiency in practice

Which of the following is a macro-level change? 1. Shift in medicare payment policies 2. Change in shift differentials 3. Opening a new unit 4. Changing visiting hours

1. Shift in medicare payment policies

You are a new nurse. The hospital where you work is committed to providing safe, high-quality care. Which of the following activities would let you know that your organization is committed to improving patient safety? 1. The hospital has a good catch program for staff who recognize errors and near misses 2. The hospital subscribes to TJC safety publications 3. The hospital measures performance every month, monitors quality indicators, and regularly reports on quality 4. All of the above

1. The hospital has a good catch program for staff who recognize errors and near misses The good catch program is a strategy designed to identify system improvement opportunities aimed at reducing risk or harm to patients by staff reporting errors or near misses without fear of punishment or reprisal

Which of the following is unique to a professional standard of decision making? Select all that apply. 1. Weighs benefits and risks when making a decision 2. Analyze and examines choices more independently 3. Concentrate thinking 4. Anticipate when to make choices without others' assistance

1. Weighs benefits and risks when making a decision 2. Analyze and examines choices more independently Rationales:Professional behaviours include accountability and sound decision-making abilities 1. Professionals look at risks and benefits before making a deccision 2. They analyze choices in order to make sound decisions 3. Concrete thinking is literal and focuses on the physical world.

A nurse is providing care to a patient whose family has previously sued another hospital and 2 physicians. Under which ethical principle should the nurse practice? 1. justice 2. veracity 3. autonomy 4. nonmaleficence

1. justice

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? 1. managing people 2. manage the units budget 3. planning for the future 4. redesigning the units workflow

1. managing people

A nursing student who is graduating in a few weeks is preparing a résumé. What should the nursing student highlight FIRST? (SELECT ALL THAT APPLY) 1. Family status 2. Educational degrees 3. Community service 4. Employment experience 5. Leadership experiences in school

2. Educational degrees 4. Employment experience

When should a new graduate consider taking on management responsibilities? 1. as soon as they are offered 2. after developing clinical expertise 3. after 15 years on the job 4. before developing leadership expertise

2. after developing clinical expertise

A patient asks a nurse if he must agree to the health provider's treatment plan. The nurse asks the patient about his concerns. Which ethical principle is the nurse applying in this situation? (select all): 1. beneficence 2. autonomy 3. veracity 4. Justice

2. autonomy

A colleague tells you, "I'm so burned out, I think it's time for me to resign." What can you tell your colleague? 1. "You probably need a break from work. Why don't you ask for a 6-month leave of absence?" 2. "Why don't you apply for a position at our rival hospital?" 3. "Tell me how you take care of yourself and what you like about your work." 4. "We're all burned out. Welcome to the club."

3. "Tell me how you take care of yourself and what you like about your work."

Autocratic leaders: 1. Postpone decision making as long as possible 2. Share leadership with members of the team 3. Give orders and make decisions without consulting the team 4. Encourage creativity when problem solving

3. Give orders and make decisions without consulting the team Autocratic leaders frequently give orders and make decisions without consulting with team members

What type of resistance to a change is the hardest to overcome? 1. The resistance that comes from inertia: "We always do it this way." 2. Active resistance to changing a preferred procedure 3. Passive resistance to an unpopular change 4. Resistance based upon fear of losing one's job

4. Resistance based upon fear of losing one's job Resistance based on the fear of losing one's job is the most difficult type of resistance to overcome because the person perceives that there is a threat to his or her way of life, which the person will guard at all costs. The individual does not feel that he or she can speak freely without jeopardizing his or her job, so although the individual disagrees with the change, he or she keeps silent to stay employed

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

A. Secure the restraint to the frame of the bed B. Get a prescription for restrains from the provider C. Have a family member sign the consent for restraints *Secure the restraint to a movable part of the bed frame. Obtain a prescription from the provider as soon as possible, typically within 1 hr. Most agencies encourage informed consent for restraints. Instruct the family on the purpose of, alternatives to, and requirements for restraints. A quick-release knot must be used to secure the restraint. The distance between the restraint and the client should be two finger widths.

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

A. A structure audit evaluates the setting and resources available to provide care B. An outcome audit evaluates the results of the nurse care provided C. A root cause analysis is indicated when a sentinel event occurs E. After data collection is completed, it is compared to a benchmark *A structure audit evaluates the setting in which care is provided and includes resources (equipment and staffing levels). An outcome audit evaluates the effectiveness of nursing care. It should include observable data (infection rates among clients). A root cause analysis is indicated when a sentinel event occurs. A sentinel event is a serious problem (injury or death of a client). Immediate investigation of the problem is indicated. The health care team can use root cause analysis to study the problem and take measures to prevent recurrence. Retrospective audits are conducted when the client is no longer receiving care. The benchmark is set at the beginning of the process and then it is compared to the data after collection is completed

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

A. Assault *Assault is conduct that makes a person fear they will be harmed. Battery is physical contact without a person's consent. False imprisonment is restraining a person against their will. It includes the use of physical or chemical restraints, and refusing to allow a client to leave a facility. Invasion of privacy is the unauthorized release of a client's private information

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

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

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

A. have staff who will be performing x-rays wear dosimeters

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

B. Check vital signs E. Instruct the client to remain in bed until further notice A. Call the provider D. Complete an incident report C. Notify the risk manager

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

B. Institutional policy and procedure manual

An assistant nurse manager is making assignments for the next shift. Which patient should the assistant nurse manager assign to a nurse with 6 months of experience and who has been floated from the surgical unit to the medical unit?A. A 58 year old on airborne precautions for TBB. A 68 year old who just returned form bronchoscopy and biopsy C. A 69 year old with COPD who is ventilator dependent D. A 72 year old who needs teaching about the use of incentive spirometry

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

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

D. Patient Care Partnership

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

D. Patient Care Partnership *The American Nurses Association Code of Ethics provides nurses with a set of standards for nursing practice. The Privacy Rule of HIPAA ensures client privacy and confidentiality. The Patient Self-Determination Act is federal legislation that requires that all clients admitted to a health care facility be asked whether they have advance directives. The Patient Care Partnership is a document that addresses client's right when receiving care

ATI BOOK: chapter 5

Facility protocols

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

Incidence of complications related to procedure *The frequency with which the procedure is performed is important. The team can take the frequency in which the procedure is performed under consideration in the planning process, but this information does not address the efficacy of the procedure. The team should take client satisfaction under consideration in the planning process, but this information does not address the efficacy of the procedure. The incidence of complications related to the procedure is an outcome measure directly related to the efficacy of the procedure. The team can take accuracy of documentation under consideration in the plannig process, but this information does not address the efficacy of the procedure

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

Introduce, situation, background, assess, recommend, readback

ATI BOOK- chapter 4

Maintaining a safe environment

ATI BOOK: Chapter 1

Managing client care

An assistant nurse manager is making assignments for the next shift. Which patient should the assistant nurse manager assign to a nurse with 6 months of experience and who has been floated from the surgical unit to the medical unit? a) A 58-year-old on airborne precautions for tuberculosis (TB) b) A 68-year-old who just returned from bronchoscopy and biopsy c) A 69-year-old with COPD who is ventilator dependent d) A 72-year-old who needs teaching about the use of incentive spirometry

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

An experienced LPN/LVN, under the supervision of the team leader RN, is providing nursing care for a patient with a respiratory problem. Which actions are appropriate to the scope of practice of an experienced LPN/LVN? SELECT ALL THAT APPLY. 1) Auscultating breath sounds. 2) Administering medications via metered-dose inhaler (MDI). 3) Completing in-depth admission assessment. 4) Checking oxygen saturation using pulse oximetry. 5) Developing the nursing care plan. 6) Evaluation the patient's technique for using MDIs.

1) Auscultating breath sounds. 2) Administering medications via metered-dose inhaler (MDI).

Which of the following is a current concern related to the nursing profession? 1. Aging of the nursing workforce 2. Oversupply of nurses versus decreasing demand for nursing care 3. Emphasis on evidence-based practices 4. Expansion of EHR use into the community

1. Aging of the nursing workforce

Effective nurse leaders: Select all that apply 1. Are also good followers 2. Effectively work together with shared goals 3. Never act on their ideas 4. Have master's degrees

1. Are also good followers 2. Effectively work together with shared goals Rationales: 1. Every leader is at times a follower 2. Effective leaders work with their team on shared goals

Enhancing the quality of work life can be achieved by: 1. Encouraging critical thinking and new ideas 2. Discouraging a working relationship with one's peers 3. Being negative 4. Endangering a client's health or safety

1. Encouraging critical thinking and new ideas

Burnout at work can be identified best by: 1. Expressions of frustration and powerlessness 2. Fatigue and refusal to work double shifts 3. Allergic reactions 4. A preference for efficiency

1. Expressions of frustration and powerlessness

An effective way to help a diverse staff work together is to: 1. Provide equal opportunities for advancement 2. Pretend there are no cultural differences 3. Promote uniformity in communication styles 4. Establish an English-only policy institution-wide

1. Provide equal opportunities for advancement

A nursing student is preparing a résumé to send to prospective employers. What qualities should the nursing student emphasize? (SELECT ALL THAT APPLY) 1. Responsibility and accountability 2. Integrity 3. Interpersonal skills 4. Social skills 5. Family values

1. Responsibility and accountability 2. Integrity 3. Interpersonal skills

Professional accountability serves the following purpose: Select all that apply. 1. To provide a basis for ethical decision making 2. To respect the decision of the client 3. To maintain standards of health 4. To evaluate new professional practices and reassess existing ones 5. To belong to a professional organization

1. To provide a basis for ethical decision making 2. To respect the decision of the client 3. To maintain standards of health 4. To evaluate new professional practices and reassess existing ones Rationales: 1. To provide a basis for ethical decison making is a characteristic of professional accountability 2. To respect the decision of the client is a characteristic of professional accountability 3. To maintain standards of health is a characteristic of professional accountability 4. To evaluate new professional practices and reassess existing ones in a characteristic of professional accountability 5. Belonging to a professional organization demonstrates commitment to the profession, not necessarily accountability

Effective nurse managers have (select all): 1. leadership capabilities 2. clinical expertise 3. business sense 4. budgeting savvy

1. leadership capabilities 2. clinical expertise 3. business sense 4. budgeting savvy

A patient is transported to the ED by rescue after being involved in a motor vehicle accident. The patient is alert and oriented but keeps stating he is having trouble breathing. O2 is started but the patient is showing signs of dyspnea. The patient suddenly develops respiratory arrest and dies. During the resuscitation process, it is discovered that the nurse failed to open the correct oxygen valve. The family sues the hospital and the nurse for 1. malpractice 2. negligence 3. nonmaleficence 4. equipment failure

1. malpractice

When is it most appropriate to dictate (order) change? 1. When the change is very complicated 2. In an emergency 3. When resistance is very high 4. If the change is unimportant

2. In an emergency In an emergency, there is little time for discussion or debate around taking action. In this situation, it is appropriate for someone in authority to take charge and dictate how the department will proceed. This is most common during life-threatening events such as a Code Blue, a fire, or a natural disaster

The purpose of QI is to continuously improve the capability of everyone involved to provide safe, high-quality patient care. What is important to know about the QI process? 1. It is independent of teamwork 2. It is a data-driven approach to improving process 3. Common safety indicators are not used to evaluate quality of care 4Opportunities for QI are selected by organization leadership

2. It is a data-driven approach to improving process

Effective followers are those who are: 1. Passive employees 2. Skilled and self-directed employees 3. Less valuable employees 4. Employees who are never supportive of new ideas

2. Skilled and self-directed employees Rationales: The most effective followers are not only competent but self-directed

When conducting a SWOT analysis, the "T" represents: 1. Time spent in education 2. Threats to obtaining a position 3. Terminal degree expectations 4. Talking points for the interview

2. Threats to obtaining a position

What is the difference between management and leadership? 1. management focuses on budget 2. management is an assigned position 3. leadership is not concerned with getting work done 4. leadership is more focused on people

2. management is an assigned position

George S. has become a nurse manager in a long-term care facility. He knows he has a lot to learn- what should he tell his staff? 1. nothing, he should pretend he has expertise 2. that he is still learning and values their input 3. that the staff needs to manage themselves 4. how little he know about management

2. that he is still learning and values their input

An important competency that nurse leaders need to develop in order to lead effectively is the: 1. Ability to be firm and inflexible 2. Ability to be close-minded and to ignore negative feedback 3. Ability to communicate effectively with others 4. Ability to follow orders without questioning them

3. Ability to communicate effectively with others Rationales: 1. Inflexibility is not a leadership competency. In fact, it impedes a leadership effectiveness 2. Leaders who ignore negative feedback may lose opportunities to improve their leadership effectiveness 3. Ability to communicate effectively with other people is one of the three competencies identified by Hersey and Campbell 4. Nurse leaders need to be critical thinkers. There are times when they are obligated as caring professionals to question directions, requests, or medical orders

What can the new graduate do to make a successful transition from student to practicing nurse? 1. Try to maintain one's student identity. 2. Move into nursing management as soon as possible. 3. Learn about the organization as a whole as well as about your assigned unit. 4. Focus on the stress of making this difficult transition.

3. Learn about the organization as a whole as well as about your assigned unit.

A democratic nurse lader consistently works to: 1. Move the group toward the leader's goals 2. Make little or no attempt to move the group 3. Share leadership with the group 4. Dampen creativity

3. Share leadership with the group Rationales: Democratic or participative leaders are characterized by their inclusion of team members in important decisions

Your new organization is committed to quality patient care. Which of these are considered characteristics of quality health care? 1. The nurses use evidence-based research to guide care delivery 2. The nurses are respectful and responsive to their clients' individual preferences 3. The nurses perform an independent double check when administering chemotherapy medication 4. All of the above

4. All of the above

Organizational culture is best defined as: 1. The stated vision and mission of an organization 2. Policies and procedures 3. The type of decor that was chosen for the facility 4. An enduring set of shared values and beliefs

4. An enduring set of shared values and beliefs

A new nurse manager has observed several instances of horizontal violence between staff members on her unit, primarily verbal abuse and malicious gossip. What should she do? 1. Ignore it because it is not physical violence and will not hurt anyone. 2. Model this bullying behavior so that staff can see how it affects people. 3. Keep a log of observed bullying behavior to discuss during the employees' annual evaluation. 4. Confront the bullying behavior and discuss strategies for responding to it.

4. Confront the bullying behavior and discuss strategies for responding to it.

How can you increase your staff's receptivity to an important change in procedures? 1. Assign the new procedure to the newest staff member 2.Apologize for making their work more complicated 3. Provide them with a booklet on preparing for change 4. Give them time to learn the new procedure

4. Give them time to learn the new procedure

Which of the following demonstrates a nurse as advocating for a patient? The nurse: 1. Calls a nursing supervisor in conflicting situations 2. reviews and understands the law as it applies to the clients clinical condition 3. documents all clinical changes in the medical record in a timely manner 4. assesses the clients point of view and prepares to articulate this point of view

4. assesses the clients point of view and prepares to articulate this point of view

An RN has asked an LPN (licensed practical nurse) to trim the toenails of a diabetic patient. The LPN trims them too short, which results in a toe amputation from infection. The patient files a lawsuit against the hospital, the RN, and the LPN. What might all 3 be found guilty of? 1. unintentional tort 2. intentional tort 3. negligence 4. malpractice

4. malpractice

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

A. A description of the incident should be documented in the client's health care record C. Incident reports include a description of the incident and actions taken E. The risk management department investigates the incident *Document a factual description of the event in the client's health care record. Do not inform the client or individual involved that an incident report has been filed. Incident reports are for facility quality assurance. In addition to providing an accurate description of the event, also document the actions taken following the event. Do not place the incident report in the client's health care record in order to shield it from discovery in the event of a lawsuit. Expect a risk manager to investigate all incidents as part of the agency's quality assurance program

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

A. Determine the client's need for home medical equipment C. Obtain printed instructions for medication self-administration D. Provide the family with a list of community agencies that can provide assistance E. Discuss the importance of attending follow-up appointments *Provide the client a list of currently prescribed medications so that the client can continue to take the correct medications at home

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

A. History of a previous fall B. Reduced vision C. Impaired memory F. Kyphosis *A client who has had a previous fall is at an increased risk for another fall. Reduced vision increases the client' risk for tripping over equipment and furniture. A client who has impaired memory is at an increased risk for falls due to not asking for help with ambulation or ADLs. Rosuvastatin does not place the client at risk for falls. The use of night lights and adequate lighting decreases the risk for falls. Kyphosis, which is a type of curvature of the spine, alters the client's posture and center of balance and can place the client at risk for falls.

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

A. Obtain vital signs for a client who is 2 hr postprocedure following a cardiac catheterization *It is within the scope of practice of the PN to monitor a client who is postprocedure for a cardiac catherization, because this client is considered stable.

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

A. Reviewing the health care record of a client assigned to another nurse B. Making a copy of a client's most current laboratory results for the provider during rounds C. Providing information about a client's condition to hospital clergy E. Participating in walking rounds that involve the exchange of client-related information outside client's rooms *To maintain confidentiality, client information is disseminated on a need-to-know basis only. A nurse who is not assigned to care for a client should not access the client's information. Paper copies of confidential information create a risk for breach of confidentiality. It is inappropriate to share this information with the hospital clergy. The nurse can share information with an individual who has been provided the information code. Sharing information in the hallway where it can be overheard by others can result in a breach of confidentiality

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

A. Skill proficiency B. Assignment to a preceptor D. Computerized charting E. Socialization into unit culture F. Facility policies and procedures *The purpose of orientation is to assist the newly licensed nurse to transition from the role of student to the role of employee and licensed nurse. Include evaluation of skill proficiency and provide instruction as indicated. Include assignment of a preceptor to ease the transition of the newly licensed nurse. Include computerized charting, which is an essential skill for the newly licensed nurse. Include socialization to the unit as a way to ease the transition of the newly licensed nurse. Include information about facility policies and procedures, which is essential information for the newly licensed nurse. Budgetary principles are an administrative skill that is usually the responsibility of the unit manager.

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

A. Verifying that a client understands what is done during a cardiac catherization C. Informing members of the health care team that a client has do-not-resuscitate status D. Reporting that a health team member on the previous shift did not provide care as prescribed *Ensuring that the client has given informed consent illustrates nurse advocacy. Discussing treatment options is not within the scope of practice of the nurse. Ensuring that the client's care is consistent with their DNR status illustrates nurse advocacy. Ensuring that all clients receive proper care illustrates nurse advocacy. Assisting a client to make decisions about their care based on nurse recommendations is appropriate. The nurse should support the client in making their own decisions.

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

A. Verifying that a client understands what is done during a cardiac catheterization C. Informing members of the health care team that a client has do-not-resuscitate status E. Assisting a client to make a decision about his care based on the nurse's recommendations

A new nurse manager plans to implement a new scheduling process. This was met with resistance from the staff who were very happy with the current scheduling process. How can the nurse manager lower their resistance to this change? 1. Tell the staff that their concerns about the new schedule are unfounded and plan to post the new schedule 2. Share information about the new schedule and discuss its impact on the unit 3. Post the schedule and deal with staff on an individual basis 4. Ask the staff to come up with an alternative for the nurse manager's consideration

Answer: 2 Sharing information about the new scheduling process and how it can benefit the staff offers them time to learn about the new process and possibly have input into the proposed change

You are participating in a clinical care coordination conference for a patient with terminal cancer. You talk with your colleagues about using the nursing code of ethics for professional registered nurses to guide care decisions. A non-nursing colleague asks about this code. Which of the following statements best describes this code? 1. Improves communication between the nurse and the patient 2. Protects the patient's right of autonomy 3. ensures identical care to all patients 4. Acts as a guide for professional behaviours in giving patient care

Answer: 4. Acts as a guide for professional behaviours in giving patient care Rationales: 1. Although good communication is expected, it is not considered an "ethical code."2. Protecting autonomy is part of the ethical code. 3. All individuals are entitled to equitable care; however, nursing care is patient-centered, so care, although equitable, may not be identical4. Codes of ethics provide guidelines for appropriate professional behaviours and guide practice

The NCLEX for nurses is exactly the same in every state in the United States. The examination: 1. Gaurantees safe nursing care for all patients 2. Ensures standard nursing care for all patines 3. Ensures that honest and ethical care is provided 4. Provides a minimal standard or knowledge for a registered nurse in practice

Answer: 4. Provides a minimal standard or knowledge for a registered nurse in practice Rationales: 1. The exam ensures minimally safe practice 2. Standards of care are designated by evidence-based practice 3. Honest and ethical care is expected and guided by the Code of Ethics 4. The NCLEX exam ensures that the registered nurse has achieved the minimum knowledge and skills necessary to enter practice

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

Avoidance *The goal in resolving conflict is a win-win situation. The unit manager is using an ineffective strategy, avoidance to deal with this conflict. Although the unit manager is aware of the conflict, they are not attempting to resolve it. The goal in resolving conflict is a win-win solution. When smoothing is used, one person attempts to "smooth" the other party and/or point out areas in which the parties agree. This is typically a lose-lose solution. When cooperating is used, one party allows the party to win. This is a lose-win solution. When negotiating is used, each party gives up something. If one party gives up more than the other, this can become a win-lose solution.

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

B. Advance directives status D. Medical diagnosis E. Need for specific equipment *The receiving nurse and facility do not need to know the type of anesthesia used in order to provide care or address the client's current needs. Communicate the client's advance directive status as part of client advocacy. The receiving nurse and facility do not need to know admission vital signs in order to provide care or address the client's current needs. However, provide the most recent set of vital signs in the report. Communicate the client's medical diagnosis in order to provide care and address the client's current needs. Communicate the client's need for specific equipment so the facility can provide appropriate care

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

B. Document the client's intent to leave the facility against medical advice (AMA) C. Explain to the client the risks involved if they choose to leave D. Ask the client to sign a form relinquishing responsibility of the facility *Notifying the client's family without the client's permission violates the client's right to confidentiality. Notify the client's provider. When documenting a discharge, document the type of discharge, including an AMA discharge. The nurse is legally responsible to warn the client of the risks involved in leaving the hospital against medical advice. Clients who leave the hospital prior to a prescribed discharge are asked to sign a form to provide legal protection for the hospital. A nurse who tries to prevent a client from leaving the hospital by any action (threatening them or refusing to give them their clothes) can be charged with assault, battery, and false imprisonment

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

B. Institutional policy and procedure manual *A website might not provide information that is consistent with institutional policy. The institutional policy and procedure manual will provide instructions on how to perform the procedure that is consistent with established standards. This is the resource that should be used. A more experienced nurse on the unit might not perform the procedure according to the policy and procedure manual. The nurse practice act identifies scope of practice and other aspects of the law, but it does not set standards for performance of a procedure

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

B. Medical command physician *Expect the incident commander to manage the incident and key leaders within the facility. Expect the medical command physician to oversee use of resources (equipment and personnel.) Expect the triage officer to prioritize the treatment of incoming clients. Expect the media liaison to communicate with members of the media and press on behalf of the facility

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

B. Recognize the knowledge & skills of each member of the team D. Encourage the client & family to participate in the team meeting E. Support team member requests for referral *The nurse should use assertive skills when communicating with the interprofessional team. The nurse should recognize that each member of the team has specific skills to contribute to the collaboration process. A nurse can serve as the facilitator. However, this role can be assumed by any member of the team. Collaboration should occur among the client, family, and interprofessional team. The nurse should support suggestions for referrals to link clients to appropriate resources.

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

B. The nurse uses their body weight to counter the client's weight *When pulling a client up in bed, spread both legs apart to create a wide base of support. Use body weight to counter the client's weight to make pulling easier. Both feet should point at the head of the bed instead of the center of the bed. Avoid rotating and twisting while moving clients to prevent injury

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

C. Contact a client representative to talk with the client and offer additional information about the purpose of advance directives *(a)The nurse should advocate for the client by ensuring that the client understands the purpose of advance directives. *(b)This response is nontherapeutic and can cause the client to be anxious about the surgery.*(c)Seeking the assistance of a client representative to provide information to the client is an appropriate action*(d) This statement is untrue and is a barrier to therapeutic communication

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

C. Inspect the client for injuries *The first action to take using the nursing process is to assess the client in order to determine which interventions the client will need

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

C. Instruct ambulatory clients to evacuate to a safe place D. Pull the pin on the fire extinguisher prior to use E. Close all doors *When a fire occurs in client's room, the first step to take is to remove or evacuate the client from the room. Know the RACE sequence; rescue the client, pull the alarm, confine the fire, and then extinguish the fire. Class A fire extinguishers are used for paper, wood, and cloth. Ambulatory clients can walk by themselves to a safe place. The fire extinguisher PASS sequence is pull the pin, aim at the base of the fire, squeeze the lever, and sweep the fire extinguisher from side to side. The employee should close all doors to contain the fire.

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

C. The nurse smells alcohol on the parent's breath *Lack of insurance does not warrant a delay in discharge, but it can indicate the need for referral for social services to assist with client needs. The child's report of pain is an expected finding. It would be unsafe to discharge a child who requires hourly monitoring with a parent who might be chemically impaired. Fear verbalized by the parent does not warrant denial in discharge. The nurse should alleviate the parent's fears by providing education about how to monitor the child and provide phone numbers for use.

A nurse is reviewing a client's health care record and discovers that the client's do-not-resuscitate (DNR) prescription has expired. The client's condition is not stable. Which of the following actions should the nurse take?A. Assume that the client does not want to be resuscitated, and take no action if they experience cardiac arrest. B. Write a note on the front of the provider prescription sheet asking that the DNR be represcribed C. Anticipate that CPR will be instituted if the client goes into cardiopulmonary arrest D. Call the provider to determine whether the prescription should be immediately reinstated

D. Call the provider to determine whether the prescription should be immediately reinstated *Without a current DNR prescription. the nurse must initiate emergency resuscitation, which most likely is not consistent with the client's wishes. Writing a note on the prescription sheet will likely result in a delay in resolving the problem. Immediately call the provider to determine whether the prescription should be reinstated. This is the action to take to be sure that the client's wishes are carried out

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

a. a description of the incident should be documented in the client's health care record. c. incident reports include a description of the incident and actions taken. E. the risk management department investigates the incident. Rationales: a. CORRECT: the nurse should document a factual description of the event in the client's health care record. B. the nurse should not inform the client or individual involved that an incident report has been filed. incident reports are for facility quality assurance. c. CORRECT: in addition to providing an accurate description of the event, the nurse also should document the actions taken following the event. D. the nurse should not place the incident report in the client's health care record in order to shield it from discovery in the event of a lawsuit. E. CORRECT: the nurse should expect a risk manager to investigate all incidents as part of the agency's quality assurance program.