leadership finals test banks

A nurse-manager has been asked to write an article for the newspaper addressing a health care issue of local concern. Which statement demonstrates the nurse's understanding of the appropriate way to respond to such a request? Select all that apply. a. "I'll include the latest data on the subject." b. "When will you need to have the final draft of my article?" c. "Are you comfortable with me focusing on three key points related to this topic?" d. "That isn't my field of expertise but I will contact a peer with that knowledge." e. "Working with the media is outside my scope of practice, but I'll recommend you to someone else."

a. "I'll include the latest data on the subject." b. "When will you need to have the final draft of my article?" c. "Are you comfortable with me focusing on three key points related to this topic?" d. "That isn't my field of expertise but I will contact a peer with that knowledge."

The principle of autonomy would have the greatest bearing on what clinical situation? a. A client is discussing a do-not-resuscitate order with the care team. b. A client is unable to afford the treatment that carries the best chance for a cure. c. A nurse is considering whether to report a colleague's rough treatment of a client. d. The nurse is caring for two clients in pain and must choose whom to treat first.

a. A client is discussing a do-not-resuscitate order with the care team.

Which nurse could face discipline for committing an intentional tort? Select all that apply. a. A nurse who slapped a client when the client became verbally abusive b. A nurse who applied restraints to a client as a punitive measure c. A nurse who increased a client's analgesia dosage without a prescription d. A nurse who neglected to supervise a client, leading to a fall e. A nurse who threatened an elderly client when the client did not participate in care

a. A nurse who slapped a client when the client became verbally abusive b. A nurse who applied restraints to a client as a punitive measure e. A nurse who threatened an elderly client when the client did not participate in care

A nurse is practicing in a challenging environment where ethical and moral issues must often be dealt with. Which statement describes how moral uncertainty occurs? a. An individual is unsure which moral principles or values apply and may even be uncertain as to what the moral problem is. b. An individual knows the right thing to do, but organizational constraints make it difficult to take the right course of action. c. An individual witnesses the immoral act of another but feels powerless to stop it. d. An individual is forced to choose between two or more undesirable alternatives.

a. An individual is unsure which moral principles or values apply and may even be uncertain as to what the moral problem is.

A registered nurse has admitted to the manager that she obtained her license on false pretenses and that she never actually graduated from a nursing education program. What is most likely to take place next? a. An investigation by the board of nursing b. A civil lawsuit by the health care facility c. Criminal charges d. A fine levied by the jurisdiction where the event took place

a. An investigation by the board of nursing

In which situation would a nurse be justified in overriding a client's right to confidentiality? a. An older adult client discloses to the nurse that her son occasionally hits her. b. A client states that he does not want to know the results of his recent diagnostic test. c. A client does not want her husband to know that she is a client on the unit. d. A teenage client asks the nurse not to tell her parents that she is pregnant.

a. An older adult client discloses to the nurse that her son occasionally hits her.

Which nursing intervention demonstrates attention to the nursing values central to client advocacy? Select all that apply. a. Assuring clients that their wishes will be respected regarding the care they receive b. Reassuring clients that they will always make the right decisions c. Identifying clients' religious dietary practices when discussing a prescribed diet d. Answering clients' questions regarding the alternatives to proposed procedures e. Suggesting to clients that a social services consult would help with discharge needs

a. Assuring clients that their wishes will be respected regarding the care they receive c. Identifying clients' religious dietary practices when discussing a prescribed diet d. Answering clients' questions regarding the alternatives to proposed procedures e. Suggesting to clients that a social services consult would help with discharge needs

A nurse is preparing for a television interview to address an aspect of health care. What actions should the nurse perform? Select all that apply. a. Being focused on key points b. Introducing statistics that support the key points c. Repeating key points several times during the interview d. Providing background material related to the key points e. Using technical vocabulary to ensure precise communication

a. Being focused on key points b. Introducing statistics that support the key points c. Repeating key points several times during the interview d. Providing background material related to the key points

A nurse is facing a malpractice suit after an incident where a client received the wrong dose of medication. Which elements must be present to prove malpractice? Select all that apply. a. Breach of duty b. Presence of injury c. Ability to foresee harm d. Causal relationship between inadequate care and injury e. Intent to cause harm

a. Breach of duty b. Presence of injury c. Ability to foresee harm d. Causal relationship between inadequate care and injury

Which leadership role is most closely associated with advocacy? a. Creating a climate where advocacy and its associated risk taking are valued b. Giving subordinates and clients adequate information to make informed decisions c. Ensuring that the workplace environment is safe d. Seeking appropriate consultation when advocacy results in intrapersonal or interpersonal conflict

a. Creating a climate where advocacy and its associated risk taking are valued

A nurse-manager can implement workplace advocacy and subordinate advocacy by performing what actions? Select all that apply. a. Creating an atmosphere that is free of violence or the threat of violence b. Providing education about injury prevention and safety c. Making efforts to ensure that nurses have reasonable and predictable work schedules d. Including nurses in the decisions that must be made at the facility e. Encouraging clients to provide feedback about the care they provide when they are discharged

a. Creating an atmosphere that is free of violence or the threat of violence b. Providing education about injury prevention and safety c. Making efforts to ensure that nurses have reasonable and predictable work schedules d. Including nurses in the decisions that must be made at the facility

A new nurse-manager has committed to modeling the leadership roles associated with applying ethics in the workplace. What is the manager's best action? a. Demonstrate self-awareness about their own beliefs, morals, and values. b. Ensure that individual rights are always prioritized over collective rights. c. Delegate ethical decision making to staff nurses whenever possible. d. Ensure nurses are responsible for scrutinizing each other's behavior to monitor for ethical violations.

a. Demonstrate self-awareness about their own beliefs, morals, and values.

Which statement is true regarding criminal law cases in the context of nursing? Select all that apply. a. Incarceration is a likely consequence of being found guilty of a criminal offense. b. Intentionally giving an overdose of a potent narcotic is a criminal offense. c. A guilty verdict requires evidence beyond a reasonable doubt. d. Most malpractice cases are tried in criminal court. e. A serious, inadvertent drug error is likely to bring criminal charges.

a. Incarceration is a likely consequence of being found guilty of a criminal offense. b. Intentionally giving an overdose of a potent narcotic is a criminal offense. c. A guilty verdict requires evidence beyond a reasonable doubt.

A nurse-manager is overseeing the care of a client who is taking a passive role in their care. How should the nurse begin to act in the role of an advocate? a. Inform the client of their rights and ensure they have sufficient information b. Teach the client the benefits of taking an active and assertive role in their care c. Assess the size and quality of the client's social support network d. Role-play with the client in order to teach assertiveness skills

a. Inform the client of their rights and ensure they have sufficient information

What initiative is most likely to promote open communication between clients and practitioners? a. Involving health care consumers as active members of the health care team b. Promoting the creation of cultures of client safety in health care organizations c. Establishing a federal leadership locus for advocacy of client safety and health care quality d. Building an evidence-based information and technology system that impacts client safety

a. Involving health care consumers as active members of the health care team

Which statements concerning autonomy are true? Select all that apply. a. It is a form of personal liberty b. Its legal equivalent is self-determination c. It is based on a person's right to make a choice d. It supports the process of progressive employee discipline e. It overrides paternalism but not beneficence

a. It is a form of personal liberty b. Its legal equivalent is self-determination c. It is based on a person's right to make a choice d. It supports the process of progressive employee discipline

Which characteristics associated with being a client of the health care system increase the need for advocacy? Select all that apply. a. Loss of physical freedom as a result of extended hospitalizations b. Decreased independence due to physical or psychosocial limitations c. Loss of legal rights due to being a client in a health care facility d. Physical or psychosocial limitations negatively impacting autonomy e. Increased vulnerability due to impaired communication

a. Loss of physical freedom as a result of extended hospitalizations b. Decreased independence due to physical or psychosocial limitations d. Physical or psychosocial limitations negatively impacting autonomy e. Increased vulnerability due to impaired communication

A nurse-manager is focusing on management controlling functions that are associated with quality control. What task best addresses this goal? a. Periodically evaluating the unit's mission and philosophy b. Creating the daily client care assignments to distribute workload evenly c. Contributing to the development of the annual budget d. Distributing staffing policies related to the choice of vacation time

a. Periodically evaluating the unit's mission and philosophy

A nurse is reviewing the provisions of legislation that relates to nursing practice in the jurisdiction where the nurse provides care. The nurse should identify what primary purpose of this legislation? a. Protecting clients' rights and safety b. Organizing the overall structure of the health care system c. Promoting a unique role for nursing in promoting wellness d. Ensuring nurses provide care that is ethical and moral

a. Protecting clients' rights and safety

Which activity best demonstrates a nursing-unit manager's attention to ANA standards for ethics required of that position? a. Refers complex dilemmas to the institution's ethics board b. Terminates a staff member for absenteeism c. Assures staff and clients that unit decisions are ethically sound d. Maintains current licensure

a. Refers complex dilemmas to the institution's ethics board

A nurse is concerned about the implications of a new piece of legislation that is being debated by lawmakers. The nurse has decided to draft a letter to a legislator and should do what actions? Select all that apply. a. Self-identify as a constituent in the first paragraph. b. State the reason for writing in the second paragraph. c. Sign the letter and include contact information. d. Address the legislator by his or her title. e. Hand deliver the letter to the legislator's office, if possible.

a. Self-identify as a constituent in the first paragraph. c. Sign the letter and include contact information. d. Address the legislator by his or her title.

The nurse-manager of a hospital unit has set a goal of increasing client advocacy. What activities are likely to help the manager attain this goal? Select all that apply. a. Staffing the unit with a sufficient number of care providers b. Orienting staff on the safe use of a new mechanical lift c. Providing an in-service on culturally meeting clients' end-of-life needs d. Arranging for a client to have a meeting with a member of the financial office e. Organizing an equitable system for distributing vacation time to staff

a. Staffing the unit with a sufficient number of care providers b. Orienting staff on the safe use of a new mechanical lift c. Providing an in-service on culturally meeting clients' end-of-life needs d. Arranging for a client to have a meeting with a member of the financial office

A state Nurse Practice Act is an example of which source of law? a. Statute b. Constitution c. Administrative d. Judicial

a. Statute

The manager of a community health center is committed to acting as an advocate. What action by the manager best promotes this goal? a. Taking prompt action when working conditions appear unsafe b. Seeking formal and informal interactions with the media c. Communicating a vision that advocacy is something highly valued in the organization d. Pushing for the creation of a binding, national Bill of Rights for Patients

a. Taking prompt action when working conditions appear unsafe

4. A preoperative admitting nurse witnessed a client sign an operative consent form. The nurse then cosigned the same document as a witness. The client suffered an injury during surgery and names the nurse in the suit because the nurse witnessed the consent form. What is the most likely outcome? a. The nurse is not likely liable because the signature only specifies that the nurse witnessed the client signing the consent form. b. The nurse is likely not liable because surgery is beyond the nurse's scope of practice. c. The nurse may be liable because cosigning the consent form makes the nurse an equal member of the surgical team. d. The nurse is liable because cosigning the consent form confirms that the client fully understood the risks of surgery.

a. The nurse is not likely liable because the signature only specifies that the nurse witnessed the client signing the consent form.

A nurse was navigating a difficult situation that involved an ethical dilemma. Which factors should be considered when assessing the quality of the nurse's ethical problem-solving process? Select all that apply. a. The outcomes of the process b. The process that was used to arrive at a decision c. The number of alternatives that the nurse initially generated d. The process the nurse used for data gathering e. Precedents in the organization involving similar situations

a. The outcomes of the process b. The process that was used to arrive at a decision c. The number of alternatives that the nurse initially generated

Which statement is true regarding political action committees (PACs)? a. They attempt to persuade legislators to vote in a particular way. b. They are composed of volunteers who are interested in politics. c. Their focus is usually on defeating specific pieces of legislature. d. They appear to have less influence on lawmakers than in the past.

a. They attempt to persuade legislators to vote in a particular way.

A nurse has applied the MORAL decision-making model to a situation that involved an ethical dilemma. The nurse should complete the process by: a. evaluating the effectiveness of the decision-making process. b. reaffirming the nurse's relationships with stakeholders. c. disseminating the results of the process to other nurses. d. leading the implementation plan.

a. evaluating the effectiveness of the decision-making process.

A nurse is facing a malpractice suit after a client was injured in a fall. When establishing whether the nurse committed a breach of duty, the court will consult with: a. other nurses who practice in similar settings and specialties. b. members of public who have been treated in similar care settings. c. the administrators of the health facility where the fall occurred. d. medical experts from the same area of specialty.

a. other nurses who practice in similar settings and specialties.

Which of the following would be considered sentinel events that should be reported to The Joint Commission? Select all that apply. a. A client with ischemic heart disease dies of a myocardial infarction. b. A client with dementia falls and suffers a hip fracture while trying to walk to the bathroom. c. A client files a formal complaint about the inattention of staff while he was in the hospital. d. A client experiences nephrotoxicity and requires dialysis because of a medication error. e. A client experiences a transfusion reaction after receiving the wrong type of packed red blood cells.

b. A client with dementia falls and suffers a hip fracture while trying to walk to the bathroom. d. A client experiences nephrotoxicity and requires dialysis because of a medication error. e. A client experiences a transfusion reaction after receiving the wrong type of packed red blood cells.

The nurse-manager oversees the care of several dozen nurses. With which nurse should the manager review the provisions of the Health Insurance Portability and Accountability Act (HIPAA)? a. A nurse who has discussed a client's status with a physician over the telephone b. A nurse who confirmed a new client's admission to the unit to a relative who telephoned c. A nurse who completed a client's documentation outside of the client's room d. A nurse who has initiated contact with a social worker to discuss a client's discharge planning

b. A nurse who confirmed a new client's admission to the unit to a relative who telephoned

In which situations does the nurse-manager have a legal responsibility for reporting? Select all that apply. a. A nurse had to work 2 hours overtime because another nurse failed to report for a shift. b. A nursing assistant has reported a suspected incident of elder abuse. c. A nurse is suspected of providing substandard medical care. d. A pediatric client reports physical abuse in the home. e. There is a confirmed case of a reportable infectious disease.

b. A nursing assistant has reported a suspected incident of elder abuse. c. A nurse is suspected of providing substandard medical care. d. A pediatric client reports physical abuse in the home. e. There is a confirmed case of a reportable infectious disease.

Which action should the nurse prioritize when trying to prevent malpractice claims? a. Always carrying a personal liability insurance policy b. Always functioning within the scope of the Nursing Practice Act c. Asking for assistance when engaged in complicated procedures d. Devoting time to establishing an effective nurse-client relationship

b. Always functioning within the scope of the Nursing Practice Act

For which client would right to die laws most likely apply? a. An adult client with major depression b. An adult client who has a terminal diagnosis c. A client who lives with intractable pain d. A client who has expressed suicidal ideation

b. An adult client who has a terminal diagnosis

A charge nurse has discovered that a medication error was made on the previous shift. What is the nurse's best action? a. Share that information with the charge nurse on the previous shift. b. Document the incident and follow it up as per hospital policy. c. Write a memo to the nurse who made the error requesting an incident report be written. d. Document in the client's chart that an incident report will be completed.

b. Document the incident and follow it up as per hospital policy.

A nurse has recognized that many older adult clients on the unit do not receive enough nutrition because they are unable to feed themselves independently. What action by a manager would be most likely to resolve the nurse's moral distress? a. Acknowledging and validating the nurse's observation b. Hiring more nursing assistants to help feed these clients c. Arranging to have the clients' diets changed so they are more nutrient-dense d. Providing a reference so the nurse can seek new employment

b. Hiring more nursing assistants to help feed these clients

A nurse-manager is applying the MORAL decision-making model to a decision around a client's plan of care. The manager has engaged all the necessary stakeholders and collected as much data about the situation as possible. What should the manager do next? a. Assess the client's values and beliefs. b. Identify as many alternatives as possible. c. Choose the option that best aligns with ethical principles. d. Arrange to meet with the institution's ethics board.

b. Identify as many alternatives as possible.

Which statement best describes the impact that the concept of respondeat superior has on the issue of nursing liability? a. It allows for equal liability among physicians, nurses, and health care organizations. b. It supports the sharing of blame among all involved sources of health care services. c. It encourages legal intervention when health care is thought to be substandard. d. It implies that the institution is responsible for errors, not the employee.

b. It supports the sharing of blame among all involved sources of health care services.

What is the best reason that nurse-managers have an ongoing responsibility to be aware of legislation affecting nursing practice? a. Laws are created by people who are not nurses. b. Laws are fluid and subject to change. c. Awareness will help ensure ethical practice. d. Awareness is included in nursing standards of practice.

b. Laws are fluid and subject to change.

A nurse-manager has learned that there is conflict between a nonresponsive client's family members about the best plan of care. The manager recognizes the complex ethics of this situation. What is the manager's best action? a. Base a decision on the most recent precedent in the organization. b. Make contact with the hospital's ethics committee. c. Refer the family to the hospital's spiritual care service. d. Ask an impartial staff member to mediate.

b. Make contact with the hospital's ethics committee.

A nurse has repeatedly witnessed a physician being dismissive of clients' reports of pain and anxiety. The nurse recognizes that the best action would be to address this behavior with the physician, but the nurse strongly suspects that these concerns would be dismissed. What phenomenon is this nurse experiencing? a. Moral conflict b. Moral outrage c. Ethical relativism d. Ethical universalism

b. Moral outrage

High-achieving nursing students were found to have studied in small groups, attended class 100% of the time, took frequent rest breaks during study sessions, and ate a balanced diet for 1 week before the examination. What type of audit provided data about the students' preparation? a. Structure b. Process c. Outcome d. Concurrent

b. Process

A nurse-manager is reviewing the provisions of the Consumer Bill of Rights and Responsibilities (Patient's Bill of Rights) with a group of new nurses. The manager should address what goals of this legislation? Select all that apply. a. Ensuring every client has access to quality and affordable health care b. Promoting strong relationships between clients and health care providers c. Promoting clear communication between members of the health care team d. Helping clients feel confident in the health care system e. Assisting clients with understanding the provisions of their health insurance

b. Promoting strong relationships between clients and health care providers d. Helping clients feel confident in the health care system

A nurse has been hired to manage a busy medical-surgical unit. What actions should the nurse-manager perform to ensure compliance with legal issues? Select all that apply. a. Develop a vision for the organization's future and communicate this vision. b. Remain current on all institutional policies and procedures. c. Delegate with consideration to appropriate scopes of practice. d. Require physical proof of appropriate professional licensure. e. Ensure that client-nurse ratios do not exceed 3:1.

b. Remain current on all institutional policies and procedures. c. Delegate with consideration to appropriate scopes of practice. d. Require physical proof of appropriate professional licensure.

Which are the common areas requiring nurse-client advocacy? Select all that apply. a. Maintaining current licensure b. Securing client informed consents c. Preventing medication errors d. Facilitating access to health care services e. Promoting respect for client dignity and cultural values

b. Securing client informed consents c. Preventing medication errors d. Facilitating access to health care services e. Promoting respect for client dignity and cultural values

Two registered nurses have disagreed about their scope of practice regarding medication administration. What resource should the nurses consult? a. The attorney general's office b. The Nurse Practice Act c. The nursing standards of practice d. The code of ethics

b. The Nurse Practice Act

A nurse is off duty, in the community, and witnesses an adult suddenly collapse. The individual appears to be unconscious. How should the nurse apply Good Samaritan laws to this situation? a. The nurse should intervene because of the legal obligation to do so. b. The nurse is not required to intervene, even though intervening is an ethical act. c. The nurse should attempt to contact emergency services before intervening. d. The nurse should attempt to determine if the individual has an advance directive before intervening.

b. The nurse is not required to intervene, even though intervening is an ethical act.

A nurse is integrating the code of ethics when making a decision about the best response to a challenging situation. What information will the nurse be able to obtain from this document? a. Legal guidelines to help the nurse make an ethical decision b. The principles that are most valued in nursing practice c. A model that will guide the nurse to make an ethical decision d. Guidelines that will help the nurse clarify his or her own values

b. The principles that are most valued in nursing practice

The policies in a long-term care facility specify that immobile residents should be repositioned at least every 2 hours. Despite this, it is well known that many residents endure long periods without being repositioned. How should the nurse best interpret this situation? a. It is necessary for the nurses at the facility to review the code of ethics. b. There is a need for actions to address this theory-practice-ethics gap. c. The nurses at the facility are experiencing intrapersonal conflict that affects their practice. d. The nurses at the facility should apply the MORAL decision-making model to address this.

b. There is a need for actions to address this theory-practice-ethics gap.

A nurse is admitting a client to the health care facility who is in the late stages of pancreatic cancer. In order to comply with the terms of the Patient Self-Determination Act (PSDA), the nurse should: a. ensure that the client clearly understands each treatment option. b. determine whether the client has established an advance directive. c. document that the client's family has been included in care planning. d. assess the client's expectations for recovery.

b. determine whether the client has established an advance directive.

A nurse is admitting a new client who is facing a serious health problem. The nurse can best apply the skills of advocacy when working with this client by: a. seeking opportunities to demonstrate professionalism. b. engaging closely and genuinely with the client and family. c. making decisions for the client and family in order to lessen their responsibilities. d. providing evidence-based care.

b. engaging closely and genuinely with the client and family.

A nurse has been asked to stay after a shift and work overtime because three nurses have called in sick. The nurse is reluctant to work the overtime because of a social commitment. Duty-based reasoning would dictate that the nurse: a. carefully weighs the effect of the decision on workplace relationships b. works overtime because of the responsibility owed to clients c. bases the decision on recent precedents in the health care organization d. contacts the three nurses to remind them of their obligations

b. works overtime because of the responsibility owed to clients

A client has provided informed consent for surgery and is being assessed by the nurse. What statement by the client should prompt the nurse to contact the surgeon? a. "Why am I not allowed to eat and drink before the surgery?" b. "How long do you think I'll stay in the recovery room?" c. "Do you think this surgery is actually safe and necessary?" d. "What is the difference between a surgeon and an anesthesiologist?"

c. "Do you think this surgery is actually safe and necessary?"

A nurse has been caring for a medical client for several shifts and the client has expressed frustration with his slow recovery. At the beginning of the shift, the client states to the nurse, "That's it. I want to read what they've written in my chart." What is the nurse's best response? a. "Certainly. I'll go and get it for you." b. "You'll have to get permission to do so, but I'll definitely pass on your request to the care team." c. "It sounds like you might have some questions about your health and your care. Can we talk about that?" d. "That's definitely within your rights, but you'll likely find that it's difficult to understand because of medical jargon."

c. "It sounds like you might have some questions about your health and your care. Can we talk about that?"

A nurse is distressed by some of the examples of substandard care in the workplace and is considering whistleblowing. What is the nurse's best initial action? a. Seek contacts in the local media. b. Inform the manager of the nurse's intent. c. Carefully consider the possible ramifications of whistleblowing. d. Hire an attorney to assist with the whistleblowing process.

c. Carefully consider the possible ramifications of whistleblowing.

A nurse has applied for a management position in a new organization. How can the manager best prevent intrapersonal conflict related to ethical issues in this role? a. Determine whether nurses in the organization are required to follow a code of ethics. b. Identify a mentor in the organization who maintains high ethical standards. c. Clarify their own values and beliefs and compare to those of the organization. d. Become familiar with the Nurse Practice Act in the jurisdiction where the organization is located.

c. Clarify their own values and beliefs and compare to those of the organization.

A nurse feels strongly that a proposed piece of legislation would be contrary to the interests of clients. How can the nurse most effectively oppose this legislation? a. Address the issue on social media sites as often as possible. b. Send e-mails to legislators' offices expressing concerns. c. Collaborate with a group of professionals who feel the same way. d. Contact media outlets and ask to be interviewed.

c. Collaborate with a group of professionals who feel the same way.

What task will best allow a health care organization to benchmark its performance? a. Comparing its performance on key indicators to its performance the previous year b. Setting ambitious but realistic goals for the coming year c. Comparing the organization's performance with that of best performing institutions d. Seeking input from clients and families about the organization's performance

c. Comparing the organization's performance with that of best performing institutions

A client is preparing to be discharged from the health care facility and has told the nurse that he would like to read his medical record. What is the nurse's best initial action? a. Arrange for the medical record to be provided to the client. b. Inform the client that this request will be communicated to the facility's ethics committee. c. Confirm the facility's policy around providing medical records to clients. d. Check whether this provision is included in the jurisdiction's Nurse Practice Act.

c. Confirm the facility's policy around providing medical records to clients.

A novice nurse-manager is a member of a team that will oversee quality control in a health care organization. What action should the nurse and the other members of the team perform first? a. Take corrective action to address standards that are known to be challenging. b. Collect the essential data that will give a general overview of performance data. c. Determine the specific criteria and standards by which quality will be measured. d. Assign tasks between the team members to address identified standards.

c. Determine the specific criteria and standards by which quality will be measured.

What action by the manager of a community health center best demonstrates workplace advocacy? a. Phoning the home of a nurse who has called in sick to confirm that the nurse is genuinely ill b. Asking clients to provide feedback on the care that they have received in their homes c. Ensuring nurses have all the personal protective equipment they need to perform home visits d. Assigning a different nurse to a client who had personality differences with his original nurse

c. Ensuring nurses have all the personal protective equipment they need to perform home visits

A nurse is being sued for malpractice after a client completed suicide on the medical-surgical unit. The nurse's attorney has pointed out that the client had no history of suicide attempts, had no history of mental illness, and denied suicidality on the standard intake assessment. This argument calls into question what component of a malpractice suit? a. Breach of duty b. Failure to meet standard of care c. Foreseeability of harm d. A causal relationship

c. Foreseeability of harm

A nurse is applying the MORAL decision-making model to a dilemma involving a colleague's possible dishonesty in documentation. What is the nurse's initial action? a. Perform a critical self-reflection of the nurse's own morals and values b. Think of as many alternatives as possible c. Gather as much information about the situation as possible d. Engage the colleague in the decision-making process

c. Gather as much information about the situation as possible

An interdisciplinary team is considering whether to apply the principle of paternalism in the care of a client. What question should guide the team's decision? a. Does the client have strong social or family support? b. What is the client's most likely prognosis? c. Is the client competent to make decisions? d. What interventions are in the client's best interest?

c. Is the client competent to make decisions?

Which is a true statement regarding TQM? a. It is based on the premise that an organization knows what is best for the consumer. b. Its guiding purpose is to save an organization's money. c. It recognizes that the customer is the focal element on which production and service depend. d. It assumes that inspection and removal of errors lead to the delivery of quality services.

c. It recognizes that the customer is the focal element on which production and service depend.

A nurse failed to supervise a confused client, and the client fell while transferring to the bathroom. The client was unharmed, but the client's family has launched a malpractice suit, citing the nurse's breach of duty. What is the most likely outcome of this case? a. The outcome will depend on the extent to which the client was responsible for the incident. b. It will likely be successful, provided the family can prove the event was reasonably foreseeable. c. It will likely be unsuccessful because the client was not injured. d. The outcome will depend on how the nurse's actions compare to the established standard of care.

c. It will likely be unsuccessful because the client was not injured.

Which statement is correct regarding the distinction between legal and ethical obligations in decision making? a. Ethical controls are clearer and philosophically impartial. b. Ethical controls are much clearer and individualized. c. Legal controls are clearer and philosophically impartial. d. Legal controls are much less clear and individualized.

c. Legal controls are clearer and philosophically impartial.

Thirty-eight percent of the people who attended a smoking cessation clinic were not smoking 1 year after completing treatment. What type of audit provided this type of data? a. Structure b. Process c. Outcome d. Concurrent

c. Outcome

Which ethical principle is demonstrated when an adult child is legally given the right to make medical decisions for a cognitively impaired parent? a. Justice b. Fidelity c. Paternalism d. Beneficence

c. Paternalism

What role has The Joint Commission assumed in ensuring quality at the organizational level? a. Establishing clinical practice guidelines b. Reducing diagnosis-related group reimbursement levels c. Standardizing clinical outcome data collection d. Assessing monetary fines for organizations that fail to meet standards

c. Standardizing clinical outcome data collection

A nurse-manager is overseeing an organization that uses the Nursing Minimum Data Set (NMDS). What will the use of the NMDS achieve? a. Comparing the quality of nursing care and medical care with reference to standardized data b. Identifying minimal levels of quality necessary for nurses to maintain licensure c. Standardizing the collection of nursing data for use by multiple users d. Identify only "nursing-sensitive" client outcome measures

c. Standardizing the collection of nursing data for use by multiple users

A health care provider prescribes a medical procedure that the staff nurse has reason to believe will harm the client. Which principle should guide the nurse's choice of action? a. The staff nurse cannot be held legally liable for any harm to the client if the procedure is carried out with due care. b. The nurse may lose their license by refusing to carry out the procedure. c. The nurse can be held legally liable for any harm if the procedure is carried out without questioning it. d. Liability rests with the health care provider, not the nurse.

c. The nurse can be held legally liable for any harm if the procedure is carried out without questioning it.

The nurse at a long-term care facility became frustrated with a client who has dementia and is unable to be redirected from wandering. The nurse applied restraints to keep the client in bed during a night shift despite there being no order to do so. How should this nurse's actions be best interpreted? a. The nurse is guilty of malpractice. b. The nurse's action is permissible if it was in the client's best interest. c. The nurse could face charges of false imprisonment. d. The nurse's action may be grounds for an assault charge.

c. The nurse could face charges of false imprisonment.

Which statements accurately describe the implications of a Good Samaritan law for a registered nurse? Select all that apply. a. A nurse has a legal responsibility to provide emergency services. b. Such laws are universally worded so as to minimize differences between jurisdictions. c. To be protected, nurses must provide care that is within their legal scope of practice. d. A nurse who provided out-of-scope care is not protected by the Good Samaritan law. e. A nurse can be held responsible for a person's injuries if the nurse does not intervene.

c. To be protected, nurses must provide care that is within their legal scope of practice. d. A nurse who provided out-of-scope care is not protected by the Good Samaritan law.

A nurse is deeply concerned about a proposed piece of legislation. Which action will best influence a local legislator who will be voting on the legislation? a. Signing an online petition b. Phoning the legislator's office repeatedly c. Writing a succinct, personalized letter to the legislator d. Forwarding the legislator online articles that are related to the legislation

c. Writing a succinct, personalized letter to the legislator

When applying the principles of advocacy, a nurse-manager should: a. defer to a leader whenever possible because advocacy is primarily a leadership function. b. prioritize the needs of subordinates over the needs of the organization. c. balance the need to advocate for several different individuals, groups, and organizations. d. recognize that advocacy can only be provided for individuals, not groups or organizations.

c. balance the need to advocate for several different individuals, groups, and organizations.

A novice nurse can reduce the likelihood of being sued for malpractice by: a. beginning his or her career in a lower acuity setting. b. avoiding performing interventions without a witness present. c. establishing positive, therapeutic relationships with clients and families. d. engaging in lifelong learning.

c. establishing positive, therapeutic relationships with clients and families.

A care team is working with a client who has mental illness and has been deemed a threat to self and others. It may be justified to take away the client's right to: a. justice. b. confidentiality. c. self-determination. d. beneficence.

c. self-determination.

A nurse made a medication error that injured a hospital client. The nurse's attorney has cited the concept of respondeat superior during the trial. This argument would focus on: a. the resources that were available to the nurse. b. the intent of the nurse's actions. c. the hospital's responsibility for the injury. d. the provisions of the nurse's malpractice insurance.

c. the hospital's responsibility for the injury.

A nurse-manager is discussing a proposed change in practice with the interdisciplinary team. What question by the manager best reflects a utilitarian perspective? a. "Have we asked clients and families what they think?" b. "Does our code of ethics address this?" c. "Are the benefits greater than the risks?" d. "How many people will this benefit?"

d. "How many people will this benefit?"

What statement by a nurse most clearly demonstrates an intuitionist framework for ethical decision making? a. "I'll make the best decision if I choose the option that comes to mind first rather than overanalyzing the situation." b. "I'm trying to think of as many different options as I can rather than focusing on those that look most attractive." c. "It's important that I consider the effect of my decision on the organization, not just the people who are directly involved." d. "I've got to look at this situation on the basis of its unique characteristics, not by comparing it to other situations."

d. "I've got to look at this situation on the basis of its unique characteristics, not by comparing it to other situations."

For which client are the provisions of the Patient Self-Determination Act (PSDA) most likely to be significant? a. A client who has recently been diagnosed with HIV b. A client whose neonate has just died of sudden infant death syndrome (SIDS) c. A client whose reduced ability to perform activities of daily living (ADLs) has required an admission to long-term care d. A client who has just experienced an ischemic stroke and whose prognosis is poor

d. A client who has just experienced an ischemic stroke and whose prognosis is poor

The Genetic Information Nondiscrimination Act (GINA) protects which individual from discrimination? a. A client who has chosen genetic testing for her child b. A client who has received gene therapy c. A client who has been diagnosed with a health disorder that has a genetic component d. A client who is known to have a genetic predisposition to a disease

d. A client who is known to have a genetic predisposition to a disease

Which nurse is experiencing moral distress? a. A nurse witnesses a colleague using a racial slur in a conversation with another nurse. b. The children of a terminally ill client do not want the client's prognosis communicated to the client. c. A nurse knows that a colleague called in sick to work because the colleague had a social engagement. d. A heavy workload prevents a nurse from providing the care that each client requires.

d. A heavy workload prevents a nurse from providing the care that each client requires.

The nurse is faced with a situation that requires ethical decision making. What statement should guide the nurse's action? a. Outcomes are the main criterion for evaluating ethical decision making. b. Only desirable alternatives should be identified when solving ethical dilemmas. c. Critical ethical decisions should be made quickly so the situation does not worsen. d. Accepting some ambiguity and uncertainty is a part of ethical decision making.

d. Accepting some ambiguity and uncertainty is a part of ethical decision making

A client has been diagnosed with a degenerative neurologic disease and has expressed interest in physician-assisted suicide. How should the nurse best advocate in this situation? a. Document the client's statements verbatim in the medical record as a resource for the care team. b. Clearly explain the moral and ethical implications of physician-assisted suicide. c. Implement interventions that directly address the client's fear and anxiety. d. Ask the client and family questions that help them identify and explore their values and beliefs.

d. Ask the client and family questions that help them identify and explore their values and beliefs.

A nurse-manager is working with colleagues to update the policies and procedures at a health care facility. To ensure that the policies align with the provisions of Title VII, the team should focus on what aspect of care? a. Falls prevention b. Timely and accurate documentation c. Relationships between practical and registered nurses d. Avoiding discrimination against clients

d. Avoiding discrimination against clients

A nurse is involved in a challenging clinical situation which requires the nurse to consider many people's interests. How can the nurse best implement Standard VII of the American Nurses Association (ANA) Scope and Standards of Practice? a. Allow the client to read the documentation about the situation. b. Seek legal advice promptly. c. Advocate for the organization's interests above those of individuals. d. Carefully consider the ethical aspects of the situation.

d. Carefully consider the ethical aspects of the situation.

A nurse is working with a client who has a terminal diagnosis and who is facing difficult decisions around end-of-life care. How can the nurse best advocate for this client? a. Teach the client how to make an effective decision. b. Offer to facilitate a referral to social work or spiritual care. c. Arrange for the client to meet an individual who has faced the same decision. d. Ensure the client receives all the necessary information to make an informed choice.

d. Ensure the client receives all the necessary information to make an informed choice.

A nurse is applying the ethical principle of justice when providing care for clients. What action best exemplifies this principle? a. Meeting continuing education requirements for license renewal b. Prioritizing actions that will benefit the largest number of clients c. Respecting clients' rights to make decisions about their care d. Ensuring that time and resources are distributed equitable to clients

d. Ensuring that time and resources are distributed equitable to clients

Even after a lengthy discussion concerning the ramifications, a client wants to leave the hospital against medical advice (AMA). What should the nurse do in the role of a client advocate? a. Instruct the client to wait until morning to leave the hospital. b. Ask family members to help talk the client out of the decision. c. Encourage the client to leave and assist with the transition. d. Make sure the client has appropriate follow-up appointments.

d. Make sure the client has appropriate follow-up appointments.

Which statement is true concerning political action of nurses? a. Political action is often contrary to codes of ethics. b. Political action mainly takes place through the American Nurses Association (ANA). c. Nurses' primary focus is to speak about consumer health-related issues. d. Nurses have not yet recognized the full potential of political activity.

d. Nurses have not yet recognized the full potential of political activity.

An RN is a supervisor in an organization that has total quality management (TQM) as the basis for its organizational goals and objectives for quality control. How should the RN practice TQM on the unit? a. Encourage colleagues to create vision and mission statements. b. Develop a quota system for number of clients cared for. c. Explain to the staff that "if it's not broke, don't fix it." d. Promote teamwork rather than individual accomplishments.

d. Promote teamwork rather than individual accomplishments.

A nurse is facing an ethical dilemma about whether to report a colleague's offensive comment, an action which is likely to jeopardize their relationship. What is a characteristic of this nurse's ethical dilemma? a. The dilemma can be solved by applying empirical data b. The situation involves a breach of the law c. The dilemma has no realistic solution d. The situation involves two or more undesirable alternatives

d. The situation involves two or more undesirable alternatives

The only treatment alternative left for a client diagnosed with advanced cancer is a rare, highly experimental bone marrow transfusion with a 10% success rate. Some individuals are arguing that the high cost of the procedure could be better spent providing well-baby screening for 2,000 residents in the service area. What ethical principle is most directly involved in this situation? a. Unethical conduct b. Maleficence c. Paternalism d. Utility

d. Utility

Which statement best describes ethics? a. How our lives are led in day-to-day circumstances b. How people make decisions based on legal consequences c. The conflict, power, and interdependency associated with the way we live d. What our conduct and actions should be regarding what is right and good

d. What our conduct and actions should be regarding what is right a good

Which strategy best demonstrates an understanding of the manager's role as an advocate for their subordinates? a. Posting a copy of the code of ethics in the staff room b. Addressing an employee's high rate of absenteeism c. Establishing friendships with as many of the nurses as possible d. Working with primary care providers to expand standing nursing orders

d. Working with primary care providers to expand standing nursing orders

A nurse has become dismayed at repeated instances of false documentation in the health care organization. The nurse has become aware that documentation has been altered so that acts of negligence appear to be accidents. When preparing to blow the whistle on this behavior, the nurse should: a. attempt to edit the false documentation so that it is more accurate. b. resign from the health care facility to reduce the risk of retaliation. c. seek permission from the nurse's immediate supervisor and head of the organization. d. carefully document any prior attempts to address the issue with supervisors.

d. carefully document any prior attempts to address the issue with supervisors.

A nurse has accepted a new position as the manager at an ambulatory clinic. The nurse can best model subordinate advocacy in this new position by: a. abolishing formal performance reviews. b. increasing the number of part-time employees and reducing the number of full-time employees. c. adopting a laissez-faire leadership style. d. encouraging employees to participate in decision making.

d. encouraging employees to participate in decision making.

The managers of a hospital unit have been approached by a nurse educator who wants to conduct research into a particular nursing intervention. In order to ensure that the rights of clients who may participate are protected, the managers should: a. ask the hospital ethics committee to approve or deny the application. b. discuss the educator's values, beliefs, and ethics. c. compare the study methodology to the code of ethics. d. refer the educator to the institutional review board (IRB).

d. refer the educator to the institutional review board (IRB).