QSEN Teamwork EAQ
The registered nurse is evaluating the statements made by a student nurse after teaching ways to make appropriate delegation decisions. Which statement made by the student nurse indicates a need for correction?
"The delegator should recheck and redo the work of the delegatee."
What advice is appropriate for a growing child to prevent obesity?
"You should eat small meals throughout the day." "You should drink fewer sweetened beverages every day." "You should watch television for less than 2 hours every day."
The registered nurse (RN) is teaching a newly hired nurse how to communicate with a delegatee while delegating a task. Which statements made by the newly hired nurse indicate effective learning?
"I will share the information using electronic media." "I will provide an opportunity to clarify the information." "I will keep the information simple."
A registered nurse (RN) delegates the task of foot care for a client to an unlicensed nursing personnel (UNP). The UNP is skillful and willing to perform the given task, but was recently hired and is unfamiliar with the client's condition. What should the RN do in this situation?
Establish mutual expectations and conditions.
Which statement best describes a fundamental aspect of the clinical nurse leader (CNL)?
Evaluates care for evidence-based approaches
Which statement is true regarding leadership theories?
Expectancy theory states that leaders should provide specific feedback about positive performance.
Which behavior of the delegator with respect to the work delegated to a delegatee is characterized as "selling" according to the Hershey's Model?
Explaining or persuading
During change of shift report the night nurse indicates that a client cannot tolerate the prescribed intermittent tube feedings. Which action should the receiving nurse take first?
Gather more data from the night nurse about the technique used
A client says, "None of the medications will work on me because I am away from my holy land." What course of action should the nurse take to comply with teamwork and collaboration competency according to the Quality and Safety Education for Nurses (QSEN)?
Approach the agency chaplain to discuss the spiritual needs of the client
Which action should the nurse take when caring for clients through a Community-Based Care Transition Program (CCTP)?
Contacting the client and physician through a conference call line to discuss medication issues
Which nurse has the following authorizations: change plans whenever necessary; function as part of the interprofessional team by communicating, planning, and implementing care directly to the client; and assess the cohort risks?
Clinical Nurse Leader
Which are considered as nurse competencies within the synergy model of care delivery?
Collaboration Clinical Judgement Cultural Competency
The senior nurse finds that a novice nurse is mainly emphasizing leadership activities in a healthcare facility. Which action of the senior nurse indicates effective leading ability?
Encouraging and developing the leadership of the new nurse
The registered nurse delegates the tasks related to caring for a client who has undergone surgery. What are the benefits of delegation in this situation?
Increased efficiency Improved quality of client care Increased professional skills of the unlicensed assistive personnel
A nurse is planning to negotiate with the supervisor in order to achieve a better work environment. Which actions are appropriate in this context?
Making tradeoffs Asking for a more desirable schedule
A nurse delegator assigns work to a delegatee who has the ability and willingness to do the work but the relationship between the delegator and delegatee is relatively new. How is the delegator's behavior described according to Hersey's Model?
Participating
The registered nurse (RN) who delegates work to a newly hired licensed practical nurse (LPN) says, "Please tell me how you will go about performing this procedure, and I will share my expectations with you." Which behavior strategy of Hersey's model is being applied?
Participating
A healthcare team is caring for a client who underwent kidney transplantation. Which task is most suitable to be delegated to a licensed practical nurse (LPN) to provide effective client care?
Recording vital signs Placing the urinary catheter
Which statements by a nurse indicate that the organization has no formalized mechanism for nurse input into organizational decision making?
"I think my supervisor is not fit for that role." "What would they do if I quit my job right now?" "I can fill out an official complaint about my head nurse."
Which statement of the nurse is true regarding Hersey's Situational Leadership Model? 1. The situational leadership model cannot be applied to real work-related situations. 2. The situational leadership model provides a solid foundation for delegation decisions. 3. The situational leadership model does not relate to the behavior of the delegatee during delegation. 4. The situational leadership model contends that managers should not behave differently on different occasions.
2 .
Which actions of the nurse exhibit transactional leadership?
Meeting the targets within the deadline Working according to organizational rules Correcting the errors in a reactive manner
Which statement is true regarding delegation?
Open lines of communication must occur between delegator and delegatee. Delegation occurs only when at least two people are involved in a mutual work situation. Delegation involves sharing activities with other appropriate authority to accomplish the work.
A worried parent informs the nurse, "My 6-year-old is otherwise healthy but still wets the bed at night." The nurse is teaching the parent necessary steps to manage the child's nocturnal enuresis. Which statement made by the parent indicates effective learning?
"I should avoid giving my child fruit juice after 4:00 pm." "I should encourage my child to drink lots of water during the day." "I should wake my child at the same time every night to use the bathroom."
The care delivery committee is considering client-focused care units for a 300-bed community hospital. What cost information should the committee prepare to help the hospital's board of directors make this decision? 1. Training charge nurses 2. Redesigning all care areas 3. Cross-training support personnel 4. Hiring additional nurse managers 5. Hiring an all registered nurse staff
2,3
Which healthcare team member is responsible for the coordination and assignments of client care?
Charge nurse
Which auditory test is appropriate for infants?
Behavioral audiometry
A nurse manager determines that one of the nurses in the intensive care unit may be experiencing burnout. What can the nurse manager do to help this nurse begin to confront the problem?
Help the nurse identify personal responses to daily stresses on the job.
What is the key element of success for a nurse manager as a leader?
Including the direct care nurses in decision making
Which topic should the nurse include in the anticipatory guidance provided to the parents of a 7-year-old client during a scheduled health maintenance visit?
Increase of Allergies
Who functions as a liaison between team leaders and other healthcare providers?
Charge Nurse
Who is accountable for the ongoing evaluation of a client's care?
Registered Nurse
While having a group discussion in an organization, one of the team members criticizes an idea of another team member. Which strategy should the leader apply to resolve the issue?
Brainstorming
The nurse is managing a client who underwent cardiac bypass surgery. Which healthcare member can be safely delegated the task of monitoring electrocardiography?
Cross-trained technician
The nurse manager asks the staff nurse to participate in creating new guidelines for providing services to the client. Which management strategy is utilized by the nurse manager?
Empowerment of staff
What developmental skills does a preschooler exhibit?
Specific reasoning Increased curiosity Magical thinking
A nurse leader is caring for a client during their entire stay in the hospital. Which nursing model is this nurse following?
Primary Nursing
What is the main motto of the Hersey's 2006 model? Information decay Information salience Situational leadership Individual accountability
Situational Leadership
The registered nurse is caring for a client suffering from skin infections. The nurse delegates the client care tasks to the health care team. Which task delegated is correct as per guidelines?
Topical administration of medication by the licensed practical nurse (LPN)
The registered nurse delegates the care of a client in the immediate postoperative period to the patient care associate (PCA). Which tasks performed are in the scope of practice of the PCA?
Feeding the client Assisting the client with bathing
The registered nurse assigns a task to a newly hired licensed practical nurse (LPN) to monitor a client's blood pressure. Which is relevant to the delegator in this situation?
Requires more guidance
A health care organization is planning to implement differentiated nursing practice. What should be prepared prior to implementing this care delivery system?
Salary ranges Position descriptions Expected competencies Degree of participation in decision-making
The charge nurse is teaching the newly-hired registered nurse (RN) about delegating tasks to unlicensed nursing personnel (UNPs). Which statement made by the newly hired RN indicates the need for further teaching?
"I should assist the staff in sorting out and articulating values."
The leader is teaching a nursing student about systems theory. Which statement by the student nurse indicates the need for further teaching? .
"Systems theory accounts for unpredictability." "Systems theory focuses on the effect of random events."
According to chaos theory, which statement from the nurse executive indicates having the qualities of a manager?
"I will take risks willingly." "I will use creativity and flexibility." "I will experiment with new ideas in a situation."
Which statement is true regarding leadership? 1. Having the title of chief executive officer indicates a good leader. 2. Leadership is an earned honor and an action-oriented responsibility. 3. Playing an administrative role can automatically place the title of leader on an individual. 4. Strengthening the mission of an organization purely depends on the leader himself or herself.
2
A client has been prescribed chlorpromazine for the management of positive symptoms of schizophrenia. What is the nurse's response when the client reports difficulty sustaining an erection?
Consulting with the primary healthcare provider regarding alternative medication therapies
Which of the nurse's statements are true regarding delegation?
Delegation improves client care outcomes when used effectively. Delegation is a complex process
The chief operating officer conducts an interview for the position of nurse leader and asks about Kotter's eight-step model. Which attribute cited by the nurse relating to helping build the momentum is correct?
Forming a powerful coalition
While a client is being given intravenous magnesium sulfate therapy for preeclampsia, it is essential for the nurse to monitor the client's deep tendon reflexes. What reason does the nurse give to the client to explain why this is done?
Identifies the potential for respiratory depression
The client with methicillin-resistant staphylococcus aureus (MRSA) is admitted to the medical unit. Which of the following tasks should be performed by the registered nurse?
Initiating intravenous (IV) antibiotic therapy
A nursing assistant is working with a delegator. Which action of the nursing assistant may negatively affect client care management?
Performing the same tasks as the delegator
Which internal factors affect the decision-making process of a leader?
Values Interest Knowledge
A nurse leader has resolved a conflict within the team. Which further action of the nurse leader prevents the same conflict in the future?
Working with the team members after the conflict
In a healthcare unit, there are 30 clients and the charge nurse delegates the healthcare team for providing client care. Which statements made by the delegator would indicate care responsibilities are assigned to unlicensed assistive personnel (UAP)?
"Note the oxygen saturation reading." "Check whether the client is taking fluids." "Ensure that the client has time for uninterrupted sleep."
The leader has planned to assist staff in order to achieve workplace unity. Which of Gardner's tasks would the leader apply in practice?
Assisting clients to accomplish optimal functioning
A nurse in the postpartum unit must complete several interventions before a client's discharge from the hospital. The nurse plans to delegate some of the tasks to an unlicensed health care worker. Which activity must be performed by the nurse?
Comparing the identification bands of mother and infant
The registered nurse is teaching the student nurse about the concepts of delegation. Which response given by the student nurse indicates the need for further teaching?
Delegation is the transfer of accountability while retaining responsibility.
A delegator, working in collaboration with a delegatee, allots responsibilities and explains the various procedures and techniques needed to accomplish the task. Which action is the delegator performing, according to the Hersey model?
Explaining and Persuading
A resident primary healthcare provider in the birthing unit asks the nurse to prepare for a vaginal examination on a client with a low-lying placenta who is in early labor. What is the priority nursing action at this time?
Explaining why a vaginal examination should not be performed
The nursing manger previously assured the staff nurse that she would have flexibility regarding work shifts and agrees when the staff nurse requested different shift work than usual. Which principle does the nursing leader follow in this situation?
Fidelity
The nurse leader sent a team of followers to conduct a community health session. The session was completed successfully. Which action of the nurse indicates leadership quality?
Giving rewards to the followers responsible for the success
What type of relationship between the nurse delegator and delegatee causes the nurse delegator to use the leadership behavior of telling?
Limited
Which task can the registered nurse safely delegate to the unlicensed assistive personnel (UAP) while caring for a client with gastroesophageal reflex disease?
Positioning the bed
A group of bomb blast victims needs to be transported to the hospital immediately. Which staff members of an emergency unit are most appropriate to handle this situation?
Prehospital care providers
Which actions would the nurse describe as defining the role of a senior leader? .
Providing resources Defining procedures for immediate response to errors
Which behavior of the nurse as a leader indicates Gardner's task of renewing at an executive level?
Providing self-care to enhance the ability to care for clients, families, staff, and the organization
The postpartum nurse is providing care to four maternal/infant couplets who have all delivered within the past 24 hours. After receiving the handoff report from the off-going nurse, which client is a priority for the nurse to see first?
The term infant with a transcutaneous bilirubin reading of 8.6 mg/dL (90 mcmol/L)
Which healthcare professional would the nurse know is held accountable for the tasks performed by the patient care associate (PCA)?
RN
The direct care nurse wishes to improve her understanding of the steady-state career style in order to get promoted as the nurse leader. On which quality attributes would the nurse want to focus?
Rewarding competence and tenure
Which qualities of a nurse leader can move the organization in a forward direction to continue delivering the best possible care?
Supporting the followers effectively Nurturing the followers with right knowledge and direction
Which member of the healthcare team, when using the team nursing approach, is responsible for prioritizing client care?
Team Leader
A registered nurse as a leader is teaching novice leadership skills to a newly appointed leader. Which statements made by the new leader indicate effective learning?
"I should resolve conflict." "I should deal with difficult people." "I should learn how to work in groups."
The hospital administration promotes a nurse leader to the role of nurse manager and provides the opportunity to participate in a quality improvement plan. Which statements made by the new nurse manager indicate there is a need for revising the responsibilities in the quality improvement plan?
"I will build infrastructure and remove the barriers for improvement." "I will implement the systems for internal and external reporting of information." "I will define the procedures for immediate responses to errors that involve care."
Which questions related to decision making for delegation are appropriate according to the delegation right of "right circumstance"?
Are the equipment and resources available to complete the task? Does the delegatee have appropriate supervision to complete the task?
Which aspects of organizations does the nurse consider during the decision-making process?
Laws, Policies, Standards
The nurse has accepted a position as a navigator. What should the nurse expect to learn during training for this role?
Learning ways to work through the health systems Strategies to teach clients about disease, including prevention and treatment Assessing barriers that clients have encountered while attempting to receive care Helping clients cope with delays in receiving treatment until barriers are overcome
Upon assessment the nurse discovers a client with heart failure has crackles in lower lung fields and dyspnea. Upon notifying the primary healthcare provider, the provider prescribes intravenous (IV) normal saline at 200 mL/hr and furosemide 120 mg orally stat. Which action should the nurse take next?
Question the choice of solution, the amount to be given, and the dose of furosemide that has been prescribed.
A staff nurse is requesting that the nurse leader be her preceptor in the emergency department. Which source of power is effective in this situation?
Referent Power
Which task is achieved by the delegator when he or she engages in self-care to enhance his or her ability to care for the healthcare team?
Renewing
A client is admitted to the medical unit with pulmonary edema. The registered nurse admits the client, writes a plan, and assigns the work to another registered nurse (RN). Which factors are transferable in this case?
Responsibility Accountability
The leader nurse noticed that a staff nurse is unable to meet the responsibilities assigned, though the staff nurse is aware of the working requirements. What is the staff nurse experiencing?
Role Conflict
While supervising a smallpox vaccination program, a nurse manager observes a nurse cleansing the arm of a client with an alcohol swab before giving the vaccination. What should the nurse manager's first reaction be?
Stop the nurse from giving the vaccination.
During a status meeting for a research project, the project leader asks the team members for feedback. What leadership theory is represented by the action of the leader?
Style theory
The registered nurse, while teaching a group of nursing students about the characteristics of a good team player, states, "A good team player should work with determination and refuse to stop until the goal has been accomplished." Which characteristic is the registered nurse describing?
Tenacity
A nurse is caring for a client who is being given intravenous magnesium sulfate to treat preeclampsia. Which effect alerts the nurse to notify the primary healthcare provider?
Urine output of less than 100mL in 4 hours
Which task can be delegated to the licensed vocational nurse (LVN)?
Administering oral hypoglycemic agents Administering intramuscular medications
The nurse as a leader assists multidisciplinary leaders to achieve optimal functioning to benefit client care delivery. Which Gardner's task is the nurse applying?
Achieving workable unity
What type of delivery method is used when the nurse provides care to the same client for the entire work period?
Case Method
Which beliefs may be associated with a registered nurse's failure to delegate tasks?
Delegation is too time consuming. More energy is required to delegate others. The registered nurse will not receive credit for total client care.
A group of clients is admitted with mass fatalities in the emergency unit. Which emergency medical service agency offers service for this condition?
Disaster Mortuary Operational Response Teams (DMORT)
Which charge-nurse remark would be expected in a care area that is using team nursing as a care delivery method?
"Have you discussed this client care issue with your team leader?"
While interviewing a nurse for the position of leader, the chief executive officer of a healthcare facility asks "How will you develop political skills in your team?" Which answers provided by the nurse most likely will result in an offer for the position?
"I will encourage their active memberships in the state nurses' association." "I will encourage their participation in Nurse Lobby Day."
What birth weight in a neonate indicates that the infant is a very low birth weight (VLBW) infant?
1300 g
A nurse manager works on a unit where the nursing staff members are uncomfortable taking care of clients from cultures that are different from their own. How should the nurse manager address this situation? 1. Assign articles about various cultures so that they can become more knowledgeable. 2. Relocate the nurses to units where they will not have to care for clients from a variety of cultures. 3. Rotate the nurses' assignments so they have an equal opportunity to care for clients from other cultures 4. Plan a workshop that offers opportunities to learn about the cultures they might encounter while at work.
4
The nurse leader conducts an education session for the nursing staff regarding case management. Which statement made by the nursing staff indicates they do not understand the role of case management? 1. It increases the hospital profits by providing the optimal client care." 2. "It manages the client care by managing the client care environment." 3. "It promotes the appropriate use of hospital personnel and resources." 4. It represents that primary health prevention is managed by a single case manager."
4
Which statement is true related to the role of the registered nurse in active delegation? 1. To provide direct care to a client 2. perform the task on behalf of a delegatee 3. perform certain functions as the healthcare provider 4. Direct an unlicensed practical nurse to perform certain tasks
4
Which task must a nurse leader undertake to lead a healthcare culture? 1. Serving as a coach or a guide 2. Maintaining a good relationship with the team 3. Working to solve process problems with the team 4. Empowering staff to be continuous learners and risk takers
4
A 36-year-old primigravida is receiving treatment for preeclampsia at 29 weeks' gestation. In light of the latest information on the client's record, which nursing intervention is of the highest importance at this time? 1. Assessing the fetal heart rate for tachycardia 2. Promoting adequate urine output by offering oral fluids 3. Monitoring respiratory status and ascertaining that calcium gluconate is at the bedside 4. Notifying the primary healthcare provider regarding the epigastric pain, headache, and blurred vision
4. Notifying the primary healthcare provider regarding the epigastric pain, headache, and blurred vision
Which members of the healthcare team are under dependent status when a task is delegated by the registered nurse (RN)?
Client attendant Licensed vocational nurse (LVN)
Which behaviors indicate that a care provider is functioning as a primary nurse?
Completes the client's plan of care Coordinates care needs with ancillary staff Discusses approaches to improve care responses
Hospital management has replaced some equipment to provide more effective treatment. The nurse, as a leader, wants the team to support and implement this change successfully. Which actions of the nurse leader are effective in this situation?
Conducting a dialogue with the team members Encouraging the team members to develop new skills Encouraging the team members to increase competency in different areas
Which delegatee requires little guidance from the delegator?
Delegatee who is familiar with the task but not the client
The unlicensed healthcare worker assigned to the 7:00 am shift has not been coming to work until 8:00 am. Nursing care is delayed, and assignments are started late. What is the most appropriate action by the charge nurse/team leader?
Document the information before discussing it with the unlicensed healthcare worker.
The case manager notes that a client's hospitalization is being prolonged for one day because of an unexpected adverse medication reaction. What action should the case manager take?
Document the reaction as a variance.
While caring for a client with diabetes, the registered nurse delegates the task of administering oral medications to the licensed practitioner nurse (LPN), but the LPN is reluctant to take the assignment. What should be the most appropriate response of the registered nurse in this situation?
Evaluate the reason for the behavior.
Which generation of nursing professionals, being exposed to both terrorism and natural disasters, should be key members for disaster planning initiatives?
Generation Y
A nurse manager is selecting direct care nurses for a client-care project. The manager asks a direct care nurse about treatment priorities. Which answer provided by the direct care nurse would be appropriate?
I will give preference to the problems that have the greatest urgency.
Which statement made by a nurse indicates being an effective community opinion leader?
I will try to build a society that treats males and females equally
A healthcare team is caring for clients after a fire. The charge nurse delegates different tasks to the healthcare team according to the functional model of nursing. Which team member is eligible and accessible to provide oral medications to any clients?
Licensed practical nurse
Which actions in the delegation process represent accountability?
Monitor Client Care Seeing the outcome report
The nurse is attending a city commission meeting being held to discuss using a community park to build a museum. How should the nurse advocate as a community opinion leader to help maintain a health conscious society?
Oppose building the museum
While providing feedback to nurse practitioners, the registered nurse uses the extinction approach to handle negative behaviors. Which theory of leadership is the registered nurse applying in this scenario?
Organizational behavior modification (OB Mod) theory
Before assigning a task, the registered nurse makes sure that the prospective delegatee is willing to complete the task. Which delegation right does this situation reference?
Person
Which member of the healthcare team would the nurse claim performs functions through passive delegation?
Pharmacist
Which motivator factors to inspire work performance are in accordance with the two-factor theory?
Recognition Achievement
Which hospital care setting is most appropriate for a case manager to perform tasks as a delegatee?
Rehabilitative care
The nurse, as a leader, takes care of himself or herself to promote the nurse's ability to care for the staff. Which of Gardner's tasks of leadership is the nurse applying in practice?
Renewing
Which component of delegation is considered a "two way process"?
Responsibility
Which action on the part of the nurse constitutes transactional leadership?
Rewarding the licensed practitioner nurse for high performance
The registered nurse assesses if an unlicensed assistive personnel (UAP) new to the unit is capable of carrying out a task. Which principle of delegation does this illustrate?
Right Person
The registered nurse (RN) is teaching a newly hired nurse about delegating tasks to the healthcare team. When asked what the rights of delegation are, which right listed by the hired nurse indicates the need for further teaching?
Right drug name
A pregnant client has class II cardiac disease. To best plan the client's care, what does the nurse anticipate for the client?
Should be hospitalized if there is evidence of cardiac decompensation
Which activities should the nurse suggest to the parents of a latchkey school-age client to decrease loneliness?
Suggesting that the parents get the child a pet Calling the child if the parent will be late coming home Helping the child talk about his or her feelings about being alone after school
A patient care associate (PCA) is delegated a task that can be completed in 2 hours. The PCA has limited knowledge and willingness regarding that particular task. Which leadership style should be implemented by the delegator in this situation?
Telling
After caring for a client who underwent a cesarean section, the delegatee failed to report results and findings of vital signs to the delegator due to improper understanding. Which action of the delegator is the reason for the delegatee's failure?
Unclear directions to the delegatee
The charge nurse is assigning client care to oncoming staff. The new nurse on the unit expresses an inability to care for the assigned client and is requesting to be reassigned. What should the delegator do in this situation?
Understand the delegatee's motivation in the situation.
Which action of the leader signifies the implementation phase of the nursing process to teaching?
Sequencing different tasks
Which statement is correct regarding delegation?
Delegation involves two people—delegator and delegatee—with the transfer of authority to perform the task. The delegator retains accountability for the outcome of the task delegated. The delegatee holds responsibility but not accountability for the task. Assignment involves the transfer of both responsibility and accountability of the work to the delegatee. Principles of delegation outline what nurses need to know and do in relation to completing the task
The nurse is caring for a client admitted with fluid overload. Which tasks are most appropriate to be delegated to the patient care associate?
Document Vital Signs Documenting Urine output Repositioning patient ever 2 hours
What is the role of unlicensed assistive personnel in intravenous (IV) therapy for a client?
Monitor clinical manifestations
The nurse as a leader teaches staff about organizational disciplines to support change and evolution. Which statement of the nurse is relevant in the context of maintaining self-awareness and using reflection?
Personal mastery fosters openness in the face of change
The nurse as a leader in the healthcare setting is studying how the communities and cultures that make up society relate to healthcare delivery. Which aspect of systems thinking theory of leadership is the nurse applying in this situation?
Recognizing the dynamic, complex, and interdependent nature of systems
A nurse manager receives a complaint from a client that a particular staff member had been rude when providing care. The nurse, rather than punishing the staff member, listens to his or her side of the story and then talks to the client to clarify the misunderstanding. Which leadership theory is reflected in this scenario?
Situational-contingency theory
Which characteristics of a licensed practical nurse should be considered before delegation of tasks?
Critical thinking Diagnostic reasoning Synthesizing information
Which nurse would be the best to create clinical pathways for joint replacement surgeries in an environment that supports differentiated nursing practice?
Nurse with a master's degree who case managed clients in an orthopedic care center
The nurse manager finds that there is an increased infection rate in the unit due to an increased number of client visitors. The nurse believes that a change in the visitor policy could help reduce the infection rates. The leader is initiating an open dialogue about external and internal realities among the team members. Which attribute of Kotter's eight-step model is involved in this action by the nurse manager?
Creating Urgency
Which assets of the nurse as a licensed health care professional help in planning effective nursing care?
Critical thinking Diagnostic reasoning Ability to synthesize information
A nurse leader is promoting dialogue within the team successfully. Which actions of the nurse leader are responsible for this success?
Serving as a facilitator Encouraging the sharing of ideas Reacting to changed proposals honestly
Which personnel should the nurse state are responsible for deciding the number, acuity, and resources needed for clients during a disaster?
Medical command physician
While assigning a task, the registered nurse finds that one of the delegatees is not competent to hold the current position. Which strategy does the nurse follow for managing this issue during delegation? Attacking the delegate verbally Doing the task himself or herself Adjusting the quality of client care Lowering the expectations temporarily
Lower Expectations Temporarily
Which internal factors should be considered while implementing any change in an organization?
Number of staff Leader competency Nurse education level
The nurse leader teaches student nurses about ways of making care visible. During a follow up visit, the leader observes the nurse holding the client's hand after finding him or her anxious before radiation therapy. Which communication skill applied by the student nurse shows effective learning?
Showing nonverbal care
The nurse as a leader provides feedback to a recently recruited student nurse after checking performance reports that show a disregard for the Organizational Behavior Modification (OB Mod) theory. Which activity of a student nurse would the nurse leader mention during the feedback session?
Discussing the past mistakes of a subordinate
The nurse leader is representing the nursing unit and the values and beliefs of the organization to staff members. Which leadership task does the nurse's behavior indicate according to Gardner's tasks of leadership?
Serving as a symbol in a management position
After surgery to repair a retinal detachment, an older adult client is transferred to the postanesthesia care unit with the affected eye patched. During the first four hours after surgery, the nurse should plan to notify the primary healthcare provider if the client reports which information?
Sharp pain in the affected eye
Which questions should the delegator assess to determine the right task? 1. Is the task legally appropriate to delegate?" 2. Is the environment conducive to completing the task safely?" 3. Does the delegator provide clear and concise directions for the task?" 4. Is the task appropriate to delegate based on institutional policies and procedures?" 5. Does the delegatee have the knowledge and experience to perform the specific task safely?"
1,4
Which question does the registered nurse recognize as related to the right of circumstance when delegating?
"Is the delegation appropriate to the situation?"
A nurse leader is setting priorities for achieving success by using the simplest and fastest method of communication. Which rules and responsibilities does the nurse fulfill by this action?
Maintaining Balance
The nurse delegates the tasks of caring for a postpartum client. During assessment, the nurse observes an infection in the client caused by lack of hygiene. Which member of the health care team is most likely responsible for the client's condition?
RN UAP
A client with a history of ulcerative colitis is admitted to the hospital because of severe rectal bleeding. The client engages in angry outbursts and places excessive demands on the staff. One day an unlicensed healthcare worker tells the nurse, "I've had it. I am not putting up with that behavior. I'm not going in there again." What is the best response by the nurse? 1. You need to try to be patient. The client is going through a lot right now." 2. I'll talk with the client. Maybe I can figure out the best way for us to handle this." 3.Just ignore it and get on with your work. I'll assign someone else to take a turn." 4. The client's frightened and taking it out on the staff. Let's think of approaches we can take."
4
The registered nurse (RN) is evaluating the student nurse in the aspect of leadership qualities. Which behaviors of the student nurse express emotional intelligence in leadership?
Supporting the team Motivating the other nurses Using skills to expand social networks
During an interview for the position of manager in the healthcare industry, the candidate is asked about the important qualities of a successful manager. Which responses would be appropriate?
"A successful manager should take risks." "A successful manager should tolerate uncertainty." "A successful manager should experiment with ideas for a unique situation."
A registered nurse (RN) delegates the task of oral care of a client with stomatitis, to an unlicensed assistive personnel (UAP). Which instruction should be given by the RN to the UAP?
"Be certain to use mouthwash containing sodium bicarbonate with the client."
At a staff meeting, while discussing the return of one of the staff nurses from a drug rehabilitation program, one nurse states, "I don't know why we are wasting time on this. We all know that addicts go back to using drugs as soon as the pressure increases." What is the nurse manager's best response?
"It's important for us to share our feelings about staff members with problems."
The nurse leader teaches the student nurse about the quality assurance (QA) process. Which statement made by the student nurse indicates ineffective learning?
"The major task is staff development."
The registered nurse is instructing the student nurse regarding the gross anatomy and physiology of the kidneys prior to client examination. Which statement made by the student nurse indicates the nurse needs to intervene?
"The right kidney is a little longer and narrower than the left kidney."
In a long-term care facility, the care tasks for a client who is suffering with liver disease are being delegated. Which statement made by the delegator indicates the responsibility for the tasks is with the registered nurse?
"You will assess alleviation of the client's symptoms." "You will be monitoring the client care on an hourly basis." "You will admit the client to the intensive care unit (ICU) if her condition deteriorates."
A client with a history of three spontaneous abortions is now at 16 weeks' gestation and attending the high-risk prenatal clinic. She expresses concerns about remaining at home during this pregnancy. Which questions will elicit responses most helpful to the nurse developing the client's plan of care? 1. "Do you have a support system available to help you?" 2. Have you been told about the status of your pregnancy?" 3. "Do you know the causes related to spontaneous abortions?" 4. "Are you aware of how a healthy lifestyle affects a pregnancy?" 5. What are the characteristics of an impending spontaneous abortion?
1,2
What are the desired attributes of the nurse as a leader? 1. Identifying the needs of followers 2. Avoiding the use of personal intuition over facts 3. Motivating others assertively towards the objective 4. Focusing on a single option to accomplish the objective 5. Using a critical thinking approach while making a decision
1,3,5
Which is the essential nursing skill for the triage process in the emergency department? 1. Evaluating care 2. Setting priorities 3. Formulating diagnoses 4. Implementing interventions
2
Which actions should be completed by the manager of a group of nursing case managers? 1. study the current licensed to unlicensed staffing ratio. 2. Discuss revision of position descriptions for cross-trained staff. 3. Analyze status of clients' movement through clinical pathways. 4. Match clinical pathway actions with expected diagnostic-related grouping activities. 5. Coordinating communication among all departments in the organization.
3,4,5
Which factors should be assessed to determine the level of followers' readiness according to Hersey's model?
Ability Willingness
The nurse leader, while teaching a group of nurse leaders, references an approach of evidence-driven consciousness to be applied in the nursing practice. What is the main concern of the nurse leader?
About the safety of the clients
The nurse as a leader explains ethical principles to the student nurse. Which example does the leader give for autonomy?
Accepting the client's wish to donate his/her organs after death
Under a leader, a team of followers has failed to achieve success in conducting research. What does an effective leader do in this situation?
Accepts failure and gains experience from it
The nurse observes a dispute between staff members due to differences in perspective concerning nursing practices. Which approaches of the nurse as a leader would be appropriate in building up negotiation "loop-backs" to resolve the conflict?
Allowing a cooling-off period if the resolution fails Informing of the full consequences of failing to resolve the issues
Which interventions are in the scope of a licensed practical nurse (LPN)?
Ambulating the client Assisting the client with bathing Administering intramuscular medications
The healthcare unit reviews the evaluation report of a newly promoted nurse leader and rates the performance as excellent. At which qualities did the nurse excel?
Charting new paths that lead to progress Demonstrating positive feelings in the workplace
Which system thinking theory principle is involved when the nurse considers the decision of a client to terminate clinical treatment?
Balancing short-term and long-term objectives
The nurse leader performs his or her own honest appraisals on a regular basis and feels good about the job. Which rule is the nurse leader implementing by this action?
Building Self Confidence
A nurse manager wants to change the protocol of preoperative teaching to include aspects of deep breathing and infection control measures. Which strategies should the nurse implement to support this change?
Developing new skills and competency required for implementing the change Making modifications in preoperative teachings to support the change initiative Reducing the negative influences of late adopters from the group implementing the change
Which action is specific to the role of a nurse leader or manager in the area of clinical research?
Facilitating the application of research findings in practice
A 15-year-old client tells a school nurse, "I have this awful pain during my periods—it never stops." What should the nurse encourage her to do?
Have a gynecologic examination.
Which action of the clinical nurse is consistent with Gardner's task of "achieving work unity"?
Helping clients accomplish optimal functioning
Which action makes a nurse manager also a nurse leader?
Helping employees reach the highest level of their potential excellence
A nurse is caring for a group of clients who are being considered for treatment with a negative pressure wound treatment device. Which condition will cause the nurse to discuss this prescription with the primary healthcare provider?
Hip wound with slight bleeding
What is the most important information the nurse and the rapid response team must keep in mind when caring for a client who had a cardiac arrest?
How long the client was anoxic
The registered nurse (RN) delegates the collection of respiratory rate data to a licensed practical nurse (LPN) for a client who is experiencing severe dehydration and whose condition is unstable. The LPN reports the data to the RN. The RN rechecks the data and finds that the report no longer reflects the patient's current condition. Which characteristic of communication has interfered with the delegation process?
Information decay
The registered nurse (RN) is caring for a client with epilepsy. Which tasks delegated by the registered nurse (RN) to the assistive personnel indicates active delegation?
Instructing the licensed practical nurse (LPN) to monitor the vital signs Instructing the unlicensed assistive personnel (UAP) to reposition the client Instructing the unlicensed assistive personnel (UAP) to place the oxygen mask
The nurse is assessing a 12-hour-old newborn. Which clinical finding should be reported to the health care provider in a timely manner?
Jaundice
Which individual is categorized as one who would be considered as "dependent status"?
LPN
While caring for a client with arthritis, the delegator gave the task of administering medication intramuscularly to the client to another healthcare team member. Which healthcare team member is most appropriate to perform the task?
LPN
The nurse is assisting the registered nurse with delegation decisions regarding management of a client with shortness of breath. Which action by the nurse indicates a need for correction?
Providing constructive feedback about client care management
A client who was in an accident is admitted to the hospital. Which decision making approach by the nurse leader indicates the 'satisficing' approach?
Providing preliminary care to the client
Which right of delegation would the nurse describe as most instrumental in shaping quality and safety outcomes according to Anthony and Vidal?
Right communication and direction
Which application would the registered nurse state is related to the trait theory in practice?
To develop assertiveness
The nurse is giving unlicensed assistive personnel (UAP) strategies to care for a 2-year-old child admitted to the hospital with severe diarrhea. Which strategies should the nurse provide?
Weighing the child at the same time every day
A delegator working in a rural setting has to handle a task of managing care for clients in that area. Which crucial step should the delegator take to develop a productive strategy in delegating tasks to a delegatee?
Understanding the capabilities of the delegatee
Which healthcare professionals would the nurse say work under active delegation?
Licensed practical nurse (LPN) administering oral medications as delegated by the registered nurse (RN) Unlicensed nursing practitioner (UNP) maintaining oral hygiene of the clients as delegated by the registered nurse
The nurse leader arranges a meeting with the staff members to learn how satisfied they are with their jobs. Which approach by the nurse leader would outline effective leadership?
Seeking feedback from the team Motivating the team to reach the desired goals Asking the team to participate in decision making
A nurse educator is presenting information about the nursing process to a class of nursing students. What definition of the nursing process should be included in the presentation?
Sequence of steps used to meet the client's needs
A primary nurse managing client case records finds that the discharge teaching plan for a client is inadequate. The nurse consults other team nurses and formulates a better teaching plan. Which element of the decision making process is the nurse exercising?
Authority
A client requires emergency cardiac surgery. The leader nurse wants to make the client aware of the situation and wants the client to decide what should be done. Which ethical model does the leader nurse follow here?
Autonomy Model
How can the lines of communication be improved in a healthcare organization during the process of delegation?
By appreciating and valuing each other's cultural perspectives
A medical-surgical unit is expecting a large volume of client admissions after a train derailment. Which member of the nursing care team will prioritize care for the unit?
Charge Nurse
The nurse observes bleeding into the subgaleal compartment upon reviewing a child's magnetic resonance imaging (MRI) results. What other conditions should the nurse evaluate for in the child?
Decreased platelet levels Decreased hematocrit levels
The nurse leader finds that a client with a severe vitamin B12 deficiency is extremely fatigued and tends to fall. Which theory does the student nurse think that the nurse leader would find appropriate for prioritizing the need of the client?
Maslow's Theory
Which group discussion technique involves a large number of respondents who may be participating in the discussion remotely?
Delphi Technique
A nurse is determining which tasks to delegate. Which actions should a registered nurse perform while caring for a client in traction?
Determining correct body alignment Assessing complications associated with immobility Teaching the client about range-of-motion (ROM) exercises
The nursing leader is giving a demo on using computerized provider order entry (CPOE) to a newly hired nurse for automatic dose calculation. The nurse leader observed that the staff nurse was not concentrating on the instructions and seemed distressed. After completing the demo, the nurse leader asked the staff nurse to operate the CPOE, but the nurse misused the system. Which communication barrier does the nurse leader suspect to be the reason?
Emotions and personality
A nurse leader wants to communicate and explain changes to hospital rules to team members. Which approaches should the nurse leader follow for effective communication?
Explaining the reason behind the change Providing the opportunity for dialogue and feedback Giving information that addresses the listener's self-interest
What are the desirable actions of the nurse as a transformational leader?
Fostering a shared vision Providing coaching and mentoring
A client has a femoropopliteal bypass graft. The nurse assesses vital signs, and the client's blood pressure is 200/110 mm Hg. The nurse notifies the surgeon. What is the rationale for the nurse's action?
Graft is leaking
Which activity performed by the registered nurse (RN) indicates effective supervision of the delegatee?
Guiding the delegatee while he or she is performing the task
Which health care provider would best help a homeless client receive needed medication for a communicable disease?
Navigator
What characteristics should be included when devising care plans for use with the total client care delivery system?
Holistic Continuous Client-centered Comprehensive
The nurse is teaching a nursing student how to care for a client who underwent stereotactic radiosurgery for a pituitary adenoma. Which statement made by the student indicates effective learning?
I will monitor serum osmolarity
Which are the organizational outcomes of transformational leadership? .
Increased loyalty Increased commitment Increased performance
The transformational leader demonstrates charismatic behavior and the careful consideration of the value of every individual in the organization. What might be the expected organizational outcomes with this type of leadership?
Increased loyalty Increased performance
A direct care nurse has great skill in teaching clients different self-care activities and is sought out by colleagues to teach their clients. Which power does the nurse possess?
Information power
While caring for a client, the registered nurse (RN) needs the assistance of a licensed practical nurse (LPN). The RN feels that the LPN requires supervision as the LPN has previously only worked in a physician's office. Which action by the RN would help diminish any negative feelings the LPN might have about being supervised?
Initiating a conversation about the new role and functions of the LPN
A direct care nurse performs exceedingly well on a cancer project. As a result, the managerial team decides to promote the nurse to a managerial position. Which actions by the nurse would justify the decision of the panel? .
Inspiring new ideas Establishing short-term goals Demonstrating positive feelings Maximizing results from existing resources
The registered nurse is teaching a group of nursing students about leadership principles. Which statement made by a nursing student indicates the need for further teaching?
"A leader has a formal position."
The nurse leader is teaching a student nurse about the modifications in the patient-focused care model. Which statement made by student nurse indicates ineffective learning?
"It requires a technician to provide client care."
Which among the Five Rights of Delegation is the cornerstone of delegation?
"Right communication and direction"
A client with burns tells the nurse that the primary healthcare provider stated that skin grafts would be required. The client asks when the procedure will be performed. Which response by the nurse is most appropriate initially?
"Tell me what your primary healthcare provider said about the graft procedure."
The registered nurse is evaluating the statements made by a student nurse after teaching about the delegation communication template. Which statement made by the student nurse indicates a need for correction?
"The delegation communication template should include only the work that is to be delegated."
Which of these clients can be provided care safely by unlicensed nursing personnel?
A client who is stable A client who is recovering
Which emergency response team is involved in emotional recovery of victims after a disaster?
American Red Cross
The leader teaches the student nurse about STAMP (staring, tone and volume of voice, anxiety, mumbling, pacing) assessment. During the session, the leader mentions rapid speech and dilated pupils. What component is responsible for these two conditions?
Anxiety
A nurse in the prenatal clinic is assessing a woman at 34 weeks' gestation. The client's blood pressure is 166/100 mm Hg and her urine is +3 for protein. She states that she has a severe headache and occasional blurred vision. Her baseline blood pressure was 100/62 mm Hg. What is the priority nursing action?
Arranging transportation to the hospital
The registered nurse is caring for an elderly client who is admitted with severe asthma. Which task delegated by the nurse is most suitable to be performed by the client attendant?
Assisting the client during nebulization
Two hours after a 1-year-old child with acute laryngitis is admitted to the hospital, the nurse observes increases in the child's respiratory and cardiac rates, increased restlessness, and substernal and intercostal retractions. What action should the nurse take immediately?
Calling the healthcare provider to report the child's respiratory status
Which members of the health care team have dependent status under the registered nurse? Unit secretary Certified nursing aide Licensed practical nurse Licensed vocational nurse Unlicensed nursing personnel
Certified nursing aide Licensed practical nurse Licensed vocational nurse Unlicensed nursing personnel
Which nursing model includes a registered nurse (RN) paired with technical assistance?
Co-primary Nursing Model
The hospital management is planning a study that compares the benefits and harms of a particular method to the benefits and harms of alternative methods when treating clients with chronic disorders. Which approach does the nurse manager follow to improve client care?
Comparative Effectiveness Research
The hospital management wants to prevent post-traumatic stress in the nursing staff. Which implemented strategies will be ineffective in pursuing this goal?
Encouraging the staff to work for more than 12 hours per day
The nurse is relating to and inspiring the client who has a psychiatric disorder to achieve the client outcomes. Which of Gardner's leadership tasks is reflected in the nurse's actions?
Motivating
Which are the core roles for an advanced practice registered nurse (APRN)?
NP CNS CNM CRNA
Which principle of systems thinking theory involves the nurse focusing on the needs of all residents in a long-term care facility?
Thinking of the big picture
A registered nurse is teaching a student nurse about the functions and utilization of trauma centers. Which statement of the student nurse indicates effective learning?
"Clients requiring stabilization with major injuries should be sent to a level III trauma center."
After a hysterosalpingo-oophorectomy, a client wants to know whether it would be wise for her to take hormones right away to prevent symptoms of menopause. What is the nurse's most appropriate response?
"Discuss this with your primary healthcare provider because it is important to verbalize your concerns."
Which question asked by a nurse leader establishes and maintains a human rapport with staff?
"How are your children?"
A pharmacy technician arrives on the nursing unit to deliver opioids and, following hospital protocol, asks the nurse to receive the medications. The nurse is assisting a confused and unsteady client back to the client's room. How should the nurse respond to the technician?
"I can't receive them right now. Please wait a few minutes or come back."
Which statement would most likely be made by a client who is receiving care through the functional method?
"I have to wait until the medication nurse is available for a pain pill."
The registered nurse (RN) is teaching a student nurse about taking a current history from a client who is suspected to have a neurologic disorder. Which statement made by the student nurse indicates the RN needs to follow up?
"I should ask the client about insomnia." "I should ask the client about diabetes mellitus."
What should the manager take into consideration when identifying a delivery model for client care? 1. Budget 2. Unit objectives 3. Staff preference 4. Client population 5. Organizational goals
1,2,4,5
When assigning a task, the delegator should understand the delegatee's personal values and align them with the organizational values. Which task can be achieved from this delegation?
Affirming
A nurse is helping a client determine and articulate personal values about health problems. The nurse also explains the effect of these problems on lifestyle adjustments. Which Gardner's task of leadership is the nurse leader applying?
Affirming values
The nurse is seeking a position as a clinical nurse leader in a major city hospital. What should the nurse prepare to do in order to secure this type of nursing role?
Pass the certification exam Complete a master's degree in nursing
A staff member is planning to start a new job but is worried about the impact it might have on future growth opportunities. The nurse leader is helping the staff member understand all the implications. Which ethical principle is the nurse manager as a leader following?
Paternalism
The nurse manager is planning to assign an unlicensed healthcare worker to care for clients. What care can be delegated on a medical-surgical unit to an unlicensed healthcare worker?
Performing a bed bath for a client on bed rest Assisting a client who has patient-controlled analgesia (PCA) to the bathroom
The nurse manager appointed a registered nurse (RN) to provide hospice care for a client and explained the tasks to be performed. Which tasks has the nurse manager delegated to the RN?
Providing total client care Teaching the client and family members Teaching the client about personal hygiene
It is determined that a staff nurse has a drug abuse problem. What approach to the staff nurse's addiction should be taken as an initial intervention?
Referred to the employee assistance program
The nurse leader teaches about attributes that all change agents possess. Which attribute of a change agent is the key to self-support through challenges?
Sense of humor
Which model of ethics considers broad social issues and involves accountability to the overall institution?
Social Justice model
The nurse with limited clinical experience is preparing a delegation communication template. Which action by the nurse indicates the need for correction?
Specifying that no extra time is allotted to report data
Which element creates an integrative process that fosters effective delegation decisions by the registered nurse?
Stability
What are the elements integrated into delegacy? Stability Leadership Clinical Practice Critical Thinking Communication
Stability Critical Thinking
The student nurse is assisting the registered nurse (RN) in collecting feedback from superiors and peers. The questions they are asking address comments to the RN about his or her work quality that affects the environment and overall productivity. Which theory does the student nurse think the RN is applying practically as a leader?
Style Theory
Which activity performed by the registered nurse (RN) indicates effective delegation?
Supervising and monitoring the licensed practical nurse (LPN) about the different activities
After resolution of a conflict, the nurse leader encourages a team member who was involved in the conflict. To be an effective leader, which action should the nurse leader avoid
Telling the team member that he or she will get legal punishment for conflicts in the future
The registered nurse is delegating a task to a newly hired unlicensed nursing personnel (UNP) and feels that the UNP requires explanation. Why does the RN feel the need to provide explanation?
The UNP is familiar with the ongoing process but the task is new.
A registered nurse delegates the task of administering oral antibiotics for a client with diabetes. Which statements are true in this scenario?
The registered nurse (RN) is accountable for the delegatee's work. The licensed practical nurse (LPN) should report to the RN once the task is completed. The licensed practical nurse (LPN) can be held responsible for any failure in administration of oral medication.
Which description by the nurse is a correct explanation of delegation?
The transfer of responsibility for the performance of an activity
What are the overall purposes of delegation?
To achieve nursing goals To improve client outcomes
The nurse leader has implemented a change in documentation of nursing care. The nurse leader finds that the licensed practitioner nurse (LPN) is resistant to change and is not participating in the change process. Which approach made by the nurse leader would be appropriate in dealing with the LPN?
To confront the LPN and encourage verbalization of feelings regarding the change
After a bomb blast in a city, why would the federal government send the Medical Reserve Corps (MRC) to the site? To provide advanced Disaster Life Support training To establish first aid stations or special-needs shelters To establish fully functional field surgical facilities to victims To provide medical equipment sufficient for 72 hours to victims
To establish first aid stations or special needs shelters
Which example would the nurse consider to be a part of systems thinking theory?
To focus on the needs of all residents in a long-term care facility
What is the key idea of role theory in nurse leadership?
To understand behavior in certain circumstances To collect concepts that predict the actors' performance in a given role
The nurse leader is working on resolving conflicts between team members. Which action indicates that the nurse is involved in constructive conflict?
Making use of authentic communication
The nurse manager is assisting the nursing staff with planning, priority setting, and decision making. Which Gardner's task of leading is being applied in this practice?
Managing
While serving as a leader, the nurse assists the client with planning, priority setting, and decision making. Which of Gardner's leadership tasks is the nurse putting into practice?
Managing
Which roles require the nurse to prioritize when implementing a primary nursing model of client care? Manger Advocate Decision Maker Team Leader Care Coordinator
Manger Advocate Decision Maker Care Coordinator
The registered nurse, as a leader, is teaching about leadership roles to a group of nurse practitioners. Which statement made by a nurse practitioner indicates effective learning?
"I should use experience and knowledge to judge reasonable risks."
The registered nurse is teaching a nursing student about interventions that reduce the risk of pressure ulcers in a client. Which statements made by the nursing student indicate effective learning?
"I will elevate the head of the client's bed to 30 degrees." "I will instruct the client to take baths in lukewarm water." "I will ensure that the client's fluid intake is 2000 to 3000 mL/day."
The nurse manager shares experiences faced during the journey to leadership with other staff members. Which statement made by the nurse appropriately describes the barriers faced during the leadership journey?
"It requires time commitment." "The title doesn't guarantee good leadership."
After assigning a specific task, the registered nurse observes that the delegatee is unable to perform the task accurately. What will be the appropriate statement of the registered nurse in this situation?
"Just follow my steps and you can do it."
The nurse manager is teaching newly assigned delegators about the limitations of delegation. Which statements made by the delegators indicate effective teaching?
"Personal hygiene activities can be delegated to unlicensed assistive personnel (UAP)." "Administration of oral medication can be delegated to the licensed practical nurse (LPN)." "Tasks related to caring for clients in a hospice care setting can be delegated to licensed vocational nurses (LVNs)."
A newly promoted nurse manager is studying the critical factors that are needed to be an effective leader according to situational-contingency theory. Which statement by the nurse manager indicates the need for further study?
"The leader should provide specific feedback for positive performance." "The leader should elicit feedback from peers, followers, and higher authority."
The registered nurse (RN) and unlicensed assistive personnel (UAP) have been working together for two years. Which statement made by the RN would be appropriate after delegating a task to the UAP?
"You know what to do and when to report."
The registered nurse orders unlicensed nursing personnel (UNP) to check blood oxygen saturation levels every 6 hours and to report the results regularly. Which activity is the registered nurse performing in this situation? 1. Active Delegation 2. Passive Delegation 3. Individual accountability 4. Organizational Accountability
1
What would the nurse describe as the challenges of delegation? 1. Limited resources 2. More staff availability 3. Larger geographic area 4. Care for vulnerable populations 5. Deciding if delegating is time-saving
1,3,4
A client is hospitalized with a brain injury and a skull fracture. The registered nurse is delegating tasks to the healthcare team. Which member of the healthcare team is suitable to provide client care? 1. Charge nurse 2. Chief nursing officer 3. Licensed practical nurse 4. Newly hired registered nurse 5. Unlicensed nursing professional
1,4
A client is admitted to the emergency department following a motor vehicle accident. The client's wounds are extensive. Which healthcare team member is best suited to care for this client in the emergency ward? 1. Charge Nurse 2. Registered Nurse 3. LPN 4. Unlicensed nursing personnel
2
How should a student nurse be trained for implementing delegation in practice? 1. By reinforcing delegation to the student nurse only during academics 2. By interacting with highly qualified, clinically experienced nursing mentors 3. By improving didactic content by theoretically educating the student nurse 4. By considering the student nurse's opinions for the master delegation decisions
2
What are the roles and responsibilities of a senior nurse leader while implementing strategies for improving the quality of the organization? 1. Participating actively in the quality improvement activities 2. Setting priorities for staff effectiveness and client health outcomes 3. Providing support systems for staff who have been involved in a sentinel event 4. Building infrastructure, providing resources, and removing barriers for improvement 5. Meeting regularly with staff to monitor their progress and help them improve their work
2,3,4
What does Hersey's situational leadership model describe about ability and willingness? 1. Willingness relates to knowledge and skills in a specific situation. 2. An individual's ability does not change from one moment to the next. 3. An individual's willingness can fluctuate from one moment to another. 4. Ability relates to the individual's attitude and commitment towards a specific situation. 5. Ability and willingness need to be assessed to determine the level of the follower's readiness.
2,3,5,
An elderly client with periods of confusion underwent surgery and requires assistance for feeding. To which healthcare professional should the registered nurse delegate the task? 1. Charge nurse 2. Nurse manager 3. Licensed practical nurse 4. Unlicensed assistive personnel (UAP)
3
A nurse manager asks for extra help from other nurses in the unit. In exchange, the nurse manager ensures special care for the parent of a staff nurse who is currently a client in the hospital. Which behavior does the nurse manager exhibit? 1. Supportive 2. Inspirational 3. Quid pro quo 4. Management by exception
3.
A nurse providing care in a hospital witnesses a client's spouse shaking the client vigorously because the client has had an episode of incontinence. Because of the suspicion of physical abuse, legally the nurse should discuss the concerns with which party? 1. The client 2. The client's spouse 3. The client's primary healthcare provider 4. Adult Protective Services
4. Adult Protective Services
What entity outlined the principles of delegation for registered nurses?
ANA
Which quality of the nursing assistant should be known by the delegator when assigning a task?
Ability
A client with hypoglycemia is admitted to the hospital. Which duties can the registered nurse (RN) safely delegate to the licensed practical nurse (LPN)?
Administering oral medications Administering intramuscular medications
In which environments is the functional model of care most likely to be utilized?
Ambulatory clinics Extended care facilities
The nurse is a member of the critical incident stress management unit that looks to meet the psychosocial needs of first responders after a mass casualty incident. Which action by the nurse is appropriate when conducting a session?
Arranging Group Discussions
Which conservation exercises should the nurse include in the assessment process of a child who is 6 years of age?
Asking the child to compare the mass of two balls Asking the child to compare the length of pencils Asking the child to compare the number of marbles
A hospital is planning to implement the functional model of nursing. Which action performed by a nurse leader would be effective under this model?
Assigning individual duties to different nurses and nursing students for different tasks
The client reports a "fluttering in my chest." The nurse analyzes the client's heart rhythm and notices that there are three P waves for each QRS complex. The waves have a sawtooth appearance. The atrial rate is 240 beats per minute, but the ventricular rate is only 80 beats per minute. The nurse notifies the primary healthcare provider for which rhythm?
Atrial flutter
The care delivery committee is determining whether primary nursing would be appropriate to implement in a 500-bed acute care hospital. Which information would support the selection of another care delivery approach?
Average length of stay per client is 42 hours. Average experience of registered nurses is 16 months. Budget for salaries 120% over estimates for the last fiscal quarter.
The registered nurse is assigning work to four delegatees. Which delegatee most likely has a limited relationship with the delegator?
B check bp every morning
The nurse, as a leader, is planning to provide information about personal hygiene to a group of clients. Which communication methods should the nurse use to talk to the clients?
Being sensitive to nonverbal communication Providing the opportunity for dialogue and feedback Presenting information that addresses the listener's self-interest
When a client with cancer reaches an incurable last stage, the nurse explains the situation to the client and calls the client's family members to provide support. Which need of the client does the nurse prioritize here?
Belonging need
How does a nurse leader effectively implement change in an organization?
By using personal and professional skills
The senior manager reviews the performance of the transformational leader on the basis of the feedback given by the nurse leader's team. Which statements describe the attributes of a transformational leader?
Charismatic Motivational Individualized consideration
Which health care professional is accountable for establishing systems to assess and communicate competency requirements related to delegation?
Chief nursing officers
Before assigning a task, the registered nurse makes sure that the delegation process is appropriate to the situation. To which delegation right does this situation refer?
Circumstance
A nurse reviews the medication charts of four clients. Which medication prescription will cause the nurse to notify the primary healthcare provider?
Client A has acromegaly, which is a result of increased growth hormone production. This condition should be treated with octreotide and lanreotide instead of conivaptan; conivaptan is used to treat SIADH. The treatment of Cushing's syndrome involves the administration of aminoglutethimide. SIADH is treated with vasopressin receptor antagonists such as tolvaptan. Pheochromocytoma is treated with adrenergic blockers such as phenoxybenzamine.
The registered nurse is interviewing for a management position and wants to present a powerful image. What can the nurse focus on when preparing for the interview?
Conveying positive body language Appearing well groomed and well dressed Showing confidence in work and abilities
What aspect of total client care needs to be taken into consideration if used on a 24-bed care area? Cost of Nurses Training Needs Documentation Time Commitment
Cost of Nurses
A 20-year-old developmentally challenged woman is a resident in a group home. She has had four abortions in the past 2 years, and the agency supervisor recommends that she be sterilized. It is obvious that the client is unable to exercise informed consent for sterilization. The nurse understands that the procedure cannot be performed without legal consent from whom?
Court-appointed individual or group
The registered nurse is delegating tasks for nursing assistants caring for a client who requires more attention. Which element should be considered when selecting the suitable nursing assistant for delegation of a task?
Critical thinking
The nurse leader states, "The people in rural America dress and act differently from those in urban centers." What concept describes this statement?
Cultural Marginality
A client with mild preeclampsia is admitted to the high-risk prenatal unit because of a progressive increase in her blood pressure. The nurse reviews the primary healthcare provider's prescriptions. Which prescriptions does the nurse expect to receive for this client?
Daily weight Side lying bed rest Deep tendon Reflexes
The registered nurse (RN) delegates obtaining and recording a client's pulse every 30 minutes. During the last hour, the licensed practical nurse (LPN) fails to report the client's elevated heart rate to the RN. Which factor best explains the situation?
Decayed Information
The registered nurse (RN) is caring for a client who is currently hospitalized for a stroke. What is the most effective professional management strategy for the RN to improve the safety and quality of client care? Delegation Leadership Supervision Assignment
Delegation
What are the three strategies that the nurse can perform while assisting other nurses in making delegation decisions?
Doing, Asking, Offering
A nurse discusses the type of anesthesia that will be used for a vaginal birth with a client who has class I cardiac disease. Which type of block is most appropriate for this client?
Epidural
The registered nurse (RN) is caring for a client who underwent knee surgery. Which activity delegated to the novice unlicensed assistive personnel (UAP) in the immediate postoperative period would be most appropriate to achieve an effective care outcome?
Feeding the client with fluids
The nurse leader monitors the direct care nurse administering pain medication to the client. The leader tells the client "I will come back in 30 minutes to check your pain level." Which right of the client does the leader fulfill if the leader returns within 30 minutes?
Fidelity
A nurse leader has prepared an objective for strategic planning. Which point indicates that the nurse possesses the ability to write objectives clearly and concisely?
Inclusion of the timeline and deadline
The nurse is teaching a group of nursing students about case management. What should the nurse explain as being the goal of case management?
Integrate care with cost-effective approaches.
What is one strategy that will improve client outcomes, communication, and collaboration between all health care providers?
Interprofessional education
The nursing manager is preparing a schedule for delegating appropriate tasks to different health care team members. Which health care team member can be delegated the task of administering oral medications?
Licensed practical nurse Licensed vocational nurse
The nurse leader asks the team members not to talk to each other while writing their ideas for solving a predefined problem. Which type of group decision-making style does the nurse leader follow?
Nominal Group technique
A senior nurse is teaching about leadership qualities to a new nurse. Which action of the new nurse represents his or her leadership quality?
Organizing a group of colleagues to address organizational problems
A registered nurse (RN) in charge of a mental health unit has two additional staff members: a licensed practical nurse (LPN) and a nursing assistant (NA). The unit has 20 clients, with one client on constant observation for acute suicidality. What should the nurse in charge do when making the daily assignments?
Provide client care and administrative duties and assign the LPN to administer medications and the NA to maintain constant observation of the suicidal client.
What tasks should the nurse perform as a leader to increase productivity?
Provide information and direction related to meeting unit productivity goals. Prepare a staffing plan that balances the organizational directives with unit needs. Provide coaching and mentoring to the staff.
A nurse is providing education to a coworker who is caring for a client who is scheduled to have a thoracentesis for a pleural effusion. Which information will be appropriate for the nurse to include?
Rapid removal of large amounts of fluid may precipitate cardiovascular collapse
A healthcare team is delegated the task of assisting a client with bathing. Which member of the healthcare team is responsible and accountable for this aspect of client care?
Registered Nurse
The nurse manager orders the direct care nurse to assist in providing tertiary care to a client. Which type of treatment would the direct care nurse be involved in?
Rehabilitation
Which delivery system was developed to provide care through others as an adaptation to functional nursing?
Team
While delegating a task, the registered nurse says to the delegatee, "Please tell me how you go about performing this procedure, and I will share with you my perspective about how frequently and under what conditions we need to communicate with and report to each other." What does this indicate?
The delegatee and delegator are creating mutual expectations.
While delegating a specific task, the registered nurse says to the delegatee, "It is important that you measure the client's blood pressure every 15 minutes." What does this situation indicate?
The delegator is providing more guidance.
The nurse as a leader is using a transactional leadership style. Which effect on followers often results from this style of leadership?
The followers will correct errors in a reactive manner.
According to style theory of leadership, which is an action of a nurse leader?
Using feedback from superiors to measure own performance
A client who sustained serious burns now has a stress ulcer. Which clinical indicators of shock should the nurse immediately report to the primary healthcare provider?
Weakness Diaphoresis Tachycardia Cold extremities
When does delegation become more challenging?
When the client is pregnant When school children are receiving care
A registered nurse distributes a task to four healthcare professionals. When are both accountability and responsibility transferred to the healthcare professional?
When the task is given to another registered nurse (RN)
A nurse is conducting a health campaign in a school. During the health campaign, the nurse finds that the school management has replaced the registered nurse (RN) with a trained clerk. What should the nurse, as a community opinion leader, do?
Write a letter to a local newspaper editor opposing the decision of the school board
The senior nurse advises a newly promoted nurse concerning various aspects of the leadership role. Which advice by the senior nurse would the newly promoted nurse most likely consider as leading by example?
"Try to be a participant in political activity in the local community."
After the completion of training under the newly appointed transactional leader, the nurse manager intends to judge the performance of the new leader through interaction with the staff. What type of statements would the manager expect to receive when asking about the outcome of training?
"We fulfill the task to avoid punishment." "We are paid only after our work is satisfactorily completed." "We tend to minimize errors; otherwise, it gets corrected in a reactive manner."
Which comment by a team leader exemplifies team nursing the way it was intended?
"(Registered Nurse 1), check all of the intravenous (IV) sites and give the IV medications."
The registered nurse is evaluating a group of student nurses after teaching how leaders should maintain balance. Which statement by a student nurse indicates effective learning?
"A good strategy for retaining control is to get control over communication."
A nurse manager agrees to mentor a newly recruited nurse who wishes to develop leadership qualities. Which statements hold true about this mentor relationship? 1. The mentor should serve as a role model. 2. The mentor should not expect anything in return 3. The mentor should be geographically close. 4. The mentor should provide advice whenever necessary. 5. The mentor should give appropriate feedback to promote improvement.
1,4,5
