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N 108 Nursing Transition > Chapter Three > Flashcards

Chapter Three Flashcards

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1
Q

Concepts Related to Nursing Management

A

Leadership Styles
Democratic
Autocratic
Laissez-faire

Leadership Approaches
Transformational 
Situational 
Emotional intelligence 
Cultural influences
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2
Q

Leadership Style Democratic

A

Internally motivated
Desire to be included ion goal setting
A more participative role in the decision-making process

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3
Q

Leadership Style Autocratic

A

Authoritarianleadership

The individual has the control over all decisions and little input from group members.

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4
Q

Leadership Style Laissez-faire

A

This leader believes that people excel when they are left alone to respond to their responsibilities and obligations in their own ways.

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5
Q

Leadership Styles

A

Democratic: Internally motivated and want to be included in setting goals and making decisions.
Autocratic: Externally motivated, group movement requires an authority figure who has the power. This leader makes all the decisions and uses coercion and punishment to influence behavior.
Laissez-faire: Internally motivated, needs to be left alone to make decisions the leader provides no direction or facilitation.

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6
Q

Situational Leadership

A
  1. Identify the Most Important Tasks or Priorities2. Diagnose the Readiness Level of the Followers 3. Decide the Matching Leadership Style
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7
Q

Leadership Approaches Emotional intelligence

A 
Self-awareness 
Self-regulation 
Social skills 
Empathy 
Motivation
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8
Q

Leadership Approaches

A

Transformational: Creates valuable & positive changes, develops future leaders; leads with a vision, strong convictions, & engages with the group to ensure their commitment..
Situational: Depending on the situation a varying of leadership/management is required.
Emotional intelligence: Identify emotions in self and others & use this insight to guide thoughtful actions
Cultural influences: Recognizing cultural influences of leadership
Transitioning to decision maker

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9
Q

5 essential steps in Conflict Management

A
  1. Identify the source of the conflict
  2. Looking beyond the incident
  3. Resolution
  4. Solution is identified
  5. Agreement
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10
Q

Cognitive Rehearsal .

A

The Joint Commission (2019), encourages cognitive rehearsal as a method against bullying.
In utilizing this method, the employee is taught about lateral violence in nursing practice and the use of cognitive rehearsal.
This allowed nurses to depersonalize, which allowed them to ask questions, learn, and confront the offender. Although confrontation can be difficult, it resolved the conflict in the lateral violence behavior.

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11
Q

Nursing JudgmentClinical

A

Nursing (clinical) judgment is the application of information based on actual observation of a patient combined with subjective and objective data that lead to a conclusion. Nursing judgment involves problem solving, decision making, and critical thinking. Working as a member developing a critical/clinical pathway

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12
Q

Delegation

A

The American Nurses Association (ANA) and the National Council of State Boards of Nursing (NCSBN) acknowledge that delegation is a skill that must be taught and practiced for nurses to be proficient in using it in the delivery of nursing care.

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13
Q

Agency for Healthcare Research & Quality (AHRQ)

A 
5 key principles 
Team Structure
 Communication 
Leadership
Situation Monitoring 
Mutual Support
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14
Q

TeamSTEPPS Key Principles

A

Situation Monitoring: Process of actively scanning and assessing situational elements to gain information or understanding, or to maintain awareness to support team functioning
Mutual Support: Ability to anticipate and support team members’ needs through accurate knowledge about their responsibilities and workload

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15
Q

An elderly client wants to return home after her hip replacement. The family wants her to go to a nursing home. Acting as a client advocate, the nurse

A

A) Informs the family that the client has a right to decide on her own.
B) Asks the physician to discharge the client to home.
C) Suggests the client hire a lawyer to protect her rights.
D) Helps the client and family communicate their views to each other.

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16
Q

A nurse working in the Emergency Department is asked to care for an openly gay client with AIDS. The nurse tells her supervisor that caring for the client is against her religious beliefs, and asks if she must take the assignment. Does this nurse have a moral obligation to care for the client?

A

A. No, because the client’s behavior caused him to contract AIDS
B. Yes, unless the risk exceeds the responsibility
C. No, the nurse does not have to violate religious beliefs
D. Yes, but the nurse should hide her negative feelings

17
Q

A fully alert and competent 89-year-old client is in end-stage liver disease. The client says, “I’m ready to die,” and refuses to take food or fluids. The family urges the client to allow the nurse to insert a feeding tube. What is the nurse’s moral responsibility?

A

A. The nurse should obtain an order for a feeding tube.
B. The nurse should encourage the client to reconsider the decision.
C. The nurse should honor the client’s decision.
D. The nurse must consider that the hospital can be sued if she honors the client’s request.

18
Q

A client with cancer has decided against further treatment. Which nursing action would be most helpful?

A

A. Making sure the client has accurate information and understands the consequences of the decision
B. Informing the client’s wife, and encouraging her to talk to the client and intervene, if necessary
C. Accepting the decision and making no comments to the client
D. Talking to the client and trying to persuade the client to think about reversing the decision

19
Q

A 43 year-old client with end stage ovarian cancer is admitted to the hospital with a bowel obstruction. The client in a tremendous amount of pain, states, “please give me enough morphine to kill me.” The nurse’s best response would be:

A

A. “I can’t give you an overdose, but once you are discharged, you can do anything that you want.”
B. “I can see that you are in a lot of pain. Let me rub your back too.”
C. “I am trying to understand what you are saying. D. Describe the pain, where is it? How intense is the pain? What do you normally do for this type of pain?”
“All right, I can give you a little extra medication.”

20
Q

The client is being involuntarily committed to the psychiatric unit after threatening to kill his spouse and children. The involuntary commitment is an example of what bioethical principle?

A

A. Fidelity
B. Autonomy
C. Beneficence
D. Veracity

21
Q

An ethical dilemma exists due to the difference of opinions regarding performing surgery for a premature infant. The facility/agency’s ethics committee has met and all members were given the information required to make a decision. What is the next step in the reasoning process?

A

A. Every one examines his/her own values
B. A statement is developed describing the dilemma
C. All possible solutions are listed
D. A solution is negotiated.

22
Q

The Nurse has determined that a client does not understand the implications of a surgical procedure scheduled for the next day. The nurse will not ask the client to sign the informed consent form until the surgeon provides further explanations, and the client verbalizes understanding. The professional nursing ethical principle applicable in this situation is

A

A. Autonomy
B. Confidentiality
C. Fidelity
D. Veracity

23
Q

When patients are denied access to experimental and possibly beneficial new or investigational drugs, which two ethical principles are violated?

A

A. Justice and beneficence
B. Justice and respect for autonomy
C. Beneficence and nonmaleficence
D. Beneficence and respect for autonomy

24
Q

The day staff nurse suspects that clients are more frequently restrained on the night shift when a particular nurse is scheduled. What is the day nurse’s responsibility?

A

A. Review the records of restrained clients to determine if the restraints were warranted.
B. Discuss her concerns with the clients who were restrained.
C. Discuss her concerns with the nurse manager.
D. Monitor the situation for 1 month to try to establish a pattern of behavior.

25
Q

You are acting as preceptor for a newly-graduated RN during her second week of orientation. You would assign the new RN under your supervision to provide nursing care to which patients? (Select all that apply.)

A

A. 38-year-old with moderate persistent asthma awaiting discharge
B. 63-year-old with a tracheostomy needing tracheos­tomy care every shift
C. 56-year-old with lung cancer who has just under­gone left lower lobectomy
D. 49-year-old just admitted with a new diagnosis of esophageal cancer
E. 76-year-old newly diagnosed with type 2 diabetes

26
Q

A patient has chronic obstructive pulmonary disease (COPD). Which intervention for airway management should you delegate to the medical assistant?

A

A. Assisting the patient to sit up on the side of the bed
B. Instructing the patient to cough effectively
C. Teaching the patient to use incentive spirometry
D. Auscultating breath sounds every 4 hours

27
Q

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

A

A. Observing how well the patient performs pursed-lip breathing
B. Planning a nursing care regimen that gradually increases activity tolerance
C. Assisting the patient with basic activities of daily living (ADLs)
D. Consulting with the physical therapy department about reconditioning exercises

28
Q

The patient with COPD tells the PCA that he did not get his annual flu shot this year and has not had a pneumonia vaccination. You would be sure to instruct the PCA to report which vital sign value?

A

A. Blood pressure of 152/84 mm Hg
B. Respiratory rate of 27 breaths/min
C. Heart rate of 92 beats/min
D. Oral temperature of 101.2° F (38.4° C)

29
Q

You are responsible for the care of a postoperative patient with a thoracotomy. The patient has been given the nursing diagnosis of Activity Intolerance.Which action should you delegate to the PCA?

A

A. Instructing the patient to alternate rest and activity periods
B. Encouraging, monitoring, and recording nutri­tional intake
C. Monitoring cardiorespiratory response to activity
D. Planning activities for periods when the patient has the most energy

30
Q

You are supervising a nursing student who is providing care for a thoracotomy patient with a chest tube. What finding would you clearly instruct the nursing student to notify you about immediately?

A

A. Chest tube drainage of 10 to 15 mL/hr
B. Continuous bubbling in the water-seal chamber
C. Reports of pain at the chest tube site
D. Chest tube dressing dated yesterday

31
Q

You are initiating a nursing care plan for a patient with pneumonia. Which intervention for cough enhancement should you delegate to the PCA?

A

A. Teaching the patient about the importance of adequate fluid intake and hydration
B. Assisting the patient to a sitting position with nee c flexed, shoulders relaxed, and knees flexed
C. Reminding the patient to use an incentive spirom­eter every 1 to 2 hours while awake
D. Encouraging the patient to take a deep breath, hold it for 2 seconds, then cough two or three times in succession

32
Q

Which intervention for a patient with a pulmonary embolus could be delegated to the LPN/LVN on your patient care team?

A

A. Evaluating the patient’s reports of chest pain
B. Monitoring laboratory values for changes in oxygenation
C. Assessing for symptoms of respiratory failure
D. Auscultating the lungs for crackles

33
Q

A patient with a pulmonary embolus is receiving anticoagulation with IV heparin. What instructions would you give the UAP who will help the patient with ADLs? (Select all that apply.)

A

A. Use a lift sheet when moving and positioning the patient in bed.
B. Use an electric razor when shaving the patient each day.
C. Use a soft-bristled toothbrush or tooth sponge for oral care.
D. Use a rectal thermometer to obtain a more accurate body temperature.
E. Be sure the patient’s footwear has a firm sole when the patient ambulates.

34
Q

You are assigned to provide nursing care for a patient receiving mechanical ventilation. Which action should you delegate to an experienced PCA?

A

A. Assessing the patient’s respiratory status every 4 hours
B. Taking vital signs and pulse oximetry readings every 4 hours
C. Checking the ventilator settings to make sure they are as prescribed
D. Observing whether the patient’s tube needs suctioning every 2 hours

N 108 Nursing Transition (4 decks)

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