Exam 1

Question 1

Define Leadership

Answer 1

: “…an interactive process that provides needed guidance and direction” Giddens (2013)

Question 2

Define managing

Answer 2

…the ability to plan, direct, control, and evaluate others in situations where the outcomes are known or preestablished, where one or more ways of performing have been agreed upon based upon evidence, where feedback and communication is shared to improve clinical processes and outcomes, and where sustained relationships advance consistency of purpose.

Question 3

Define followership

Answer 3

each group member contributes optimally in tandem with other group members to achieve clinical or organization outcomes.*

Not passive direction taking, rather, behaviors that model collaboration, influence, and action with leader or manager

Question 4

Can leaders be formal or informal?

Answer 4

• Can be formal or Informal- Some are designated as leaders (managers) while others are seen as leaders (experienced staff nurses)

Question 5

• Can be fluid- The “expert” or leader can change depending on the situation

Answer 5

• Float nurse /behavioral team

* Everyday leadership video

Question 6

What does Emotional Intelligence have to do with leadership?

Answer 6

possessing social skills, interpersonal competence, psychological maturity, and emotional awareness

Question 7

5 Domains proposed by Goleman:

Answer 7

1. Self-awareness (understand your emotions)
   2. Self-regulation (manage your emotions)
   3. Motivating yourself
   4. Being empathetic (understanding the emotions of others)
   5. Social skills (managing relationships with others)

Question 8

Self-Awareness

Answer 8

ü Emotional awareness: become familiar with your emotions and how they affect you and others
ü Accurate self-assessment: strive to know your strengths and weaknesses
ü Self-confidence: build your self esteem and confidence by focusing on your strengths and capabilities

Question 9

Self-Regulation/Managing Emotions

Answer 9

ü Practice emotional regulation “train your brain”
ü Foster trust in those around you by showing that your responses to them are calm, measured, and respectful
ü Avoid passive-aggressive responses and drama
ü Important for Nurses and Leaders to do as we deal with many complex and emotional situations

Question 10

Motivating Self

Answer 10

Focus on achievable goals
ü Practice delayed gratification
ü Maintain a positive and optimistic attitude, even in the face of challenges

Question 11

Being Empathetic:

Answer 11

ü Valuing differences in perspective
ü Showing sensitivity to the experiences of others in ways that demonstrate the ability to understand another’s perspective on a situation
ü Engrained in what we do as nurses

Question 12

Social Skills/Relationships

Answer 12

ü Collaboration and cooperation: share your knowledge and work to build the abilities of yourself and others
ü Communication: Be available to listen attentively
ü Feedback: constructive, not blaming or shaming
ü Conflict management: Diffuse conflict by seeking to understand the perspective of others

Question 13

What is Lateral Violence?

Answer 13

• Put simply, lateral violence is bullying. The American Nurses Association (ANA) defines bullying as “repeated, unwanted harmful actions intended to humiliate, offend and cause distress in the recipient.” These actions include intimidating behavior, name-calling, making faces behind someone’s back, or threatening. But often, lateral violence is more covert. When a nurse or other team member routinely speaks to you with exaggerated impatience, refuses to answer valid questions, provides misinformation, sets you up to fail, uses condescending language, spreads rumors, or questions your judgment constantly (especially in front of others), this is bullying.

Question 14

Leadership Styles

Answer 14

1. Laissez-faire
2. Autocratic
3. Democratic
4. Transformational

Question 15

What is a delegator

Answer 15

Delegator: One who delegates a nursing responsibility. A delegator may be an APRN, RN, or LPN/LVN (where state law allows).

Question 16

“OARS” is a patient communication tool used in motivational interviewing and stands for which of the following?

Answer 16

• Open ended questions, affirmation, reflection, summary

Question 17

The nurse is caring for the assigned clients for the day. The nurse fulfills the need of three of four clients, and owing to time constraints is unable to fulfill the needs of the fourth client. Which ethical principle has the nurse violated?

Answer 17

Justice

Question 18

The nurse understands that several areas need to be explored in order to conduct a culturally sensitive assessment related to end-of-life care. Which answer IS NOT pertinent?

Amount and type of accepted intervention

The nurse’s beliefs on death and dying

Communication about death

Financial support for client care

Answer 18

Amount and type of accepted intervention

The nurse’s beliefs on death and dying

Communication about death

Financial support for client care

All of these areas except for financial support are relevant. The nurse must examine his/her own beliefs regarding death and dying so that cultural bias can be controlled.

Question 19

The charge nurse is planning the assignment for the day. What factors should the nurse remain mindful of when planning the assignments? (Select all that apply)

1. the acuity level of the clients
2. specific requests from the staff
3. the clustering of the rooms on the unit
4. the number of anticipated client discharges
5. client needs and workers’ needs and abilities

Answer 19

1. the acuity level of the clients

5. client needs and workers’ needs and abilities

Question 20

A nurse is preparing an in-service program about delegation. Which of the following elements should she identify when presenting the 5 rights of delegation? (Select all that apply)

a. right client
b. right supervision and evaluation
c. right direction and communication
d. right time
e. right circumstances

Answer 20

b. right supervision and evaluation
c. right direction and communication
e. right circumstances

ATI Fundamentals ch 6

Question 21

An RN on a medical-surgical unit is making assignments at the beginning of the shift. Which of the following tasks should the nurse delegate to the PN?

a. obtain vital signs for a client who is 2 hr postprocedure following a cardiac catheterization
b. administer a unit of packed red blood cells (RBCs) to a client who has cancer
c. instruct a client who is scheduled for discharge in the performance of wound care
d. develop a plan of care for a newly admitted client who has pneumonia

Answer 21

a. obtain vital signs for a client who is 2 hr postprocedure following a cardiac catheterization

ATI Leadership and Management

Question 22

The registered nurse is planning the client assignments for the day. Which is the most appropriate assignment for an unlicensed assistive personnel (UAP)?

1. A client requiring a colostomy irrigation
2. A client receiving continuous tube feedings
3. A client who requires urine specimen collection
4. A client with difficulty swallowing food and fluids

Answer 22

3. A client who requires urine specimen collection

• colostomy irrigations and tube feedings are not performed by UAPs because these are invasive procedures
• the client with difficulty swallowing is at risk for aspiration

NCLEX ch 7

Question 23

The nurse employed at a long-term care facility is planning assignments for the clients on a nursing unit. The nurse needs to assign four clients and has a licensed practical (vocational) nurse and 3 unlicensed assistive personnel (UAP) on a nursing team. Which client would the nurse most appropriately assign to the licensed practical (vocational) nurse?

1. A client who requires a bed bath
2. An older client requiring frequent ambulation
3. A client who requires hourly vital sign measurements
4. A client requiring abdominal wound irrigations and dressing changes every 3 hours

Answer 23

4. A client requiring abdominal wound irrigations and dressing changes every 3 hours
   - bed bath, assisting with ambulation, and vital signs can all be performed by UAPs

NCLEX ch 7

Question 24

Which of the following tasks should the charge nurse delegate to an experienced LPN working on the adult medical unit?

1. Teaching a client about the preprocedure preparation for a gastric endoscopy
2. Inserting an NG tube for gastric acid analysis
3. Administering IV midazolam hydrochloride during endoscopy
4. Developing a nursing care plan for a client having a cystoscopy

Answer 24

2. Inserting an NG tube for gastric acid analysis

• NG tube insertion is included in LPN education and is an appropriate task for an experienced LPN
• the other options are part of the RN scope of practice

Critical Thinking textbook

Question 25

A nurse on a medical-surgical unit has received change-of-shift report and will care for four clients. Which of the following client's needs should the nurse assign to an assistive personnel (AP)? 1. Feeding a client who was admitted 24 hr ago with aspiration pneumonia 2. Reinforcing teaching with a client who is learning to walk using a quad cane 3. Reapplying a condom catheter for a client who has urinary incontinence 4. Applying a sterile dressing to a pressure ulcer

Answer 25

3. Reapplying a condom catheter for a client who has urinary incontinence - client with pneumonia is at risk for aspiration so it is inappropriate to delegate the feeding to an AP - reinforcing teaching and sterile dresses are within the scope of practice of PNs and RNs ATI Fundamentals ch 6

Question 26

A nurse manager of a medical-surgical unit is assigning care responsibilities for the oncoming shift. A client is awaiting transfer back to the unit from the PACU following thoracic surgery. To which of the following staff members should the nurse assign this client? 1. Charge nurse 2. RN 3. Practical nurse (PN) 4. Assistive personnel (AP)

Answer 26

2. RN - a client returning from surgery requires an RN's assessment and establishment of a plan of care, especially if the client is potentially unstable ATI Fundamentals ch 6

Question 27

An RN is making assignments for a practical nurse (PN) at the beginning of the shift. Which of the following assignments should the PN question? 1. Assisting a client who is 24-hr postoperative to use an incentive spirometer 2. Collecting a clean-catch urine specimen from a client who has a wound infection 3. Providing nasopharyngeal suctioning for a client who has pneumonia 4. Teaching a client who has asthma how to use a metered-dose inhaler

Answer 27

4. Teaching a client who has asthma how to use a metered-dose inhaler - the RN is responsible for primary teaching, the PN may only reinforce teaching - the other options are within the scope of practice of a PN ATI Fundamentals ch 6

Question 28

A nurse is acquainting a group of newly licensed nurses with the roles of the various members of the health care team they will encounter on a medical-surgical unit. When she gives examples of the types of tasks certified nursing assistants (CNAs) may perform, which of the following client activities should she include? Select all that apply: 1. Bathing 2. Ambulating 3. Toileting 4. Determining pain level 5. Measuring vital signs

Answer 28

1. Bathing 2. Ambulating 3. Toileting 4. Measuring vital signs -determining pain level is a task that requires the assessment skills of licensed personnel, it is outside the scope of practice of a CNA ATI Fundamentals ch 2

Question 29

A registered nurse (RN) is providing care to a patient who had abdominal surgery 2 days ago. Which task is appropriate to delegate to the nursing assistant? 1. Helping the patient ambulate in the hall 2. Changing surgical wound dressing 3. Irrigating the nasogastric tube 4. Providing brochures to the patient on health diet

Answer 29

1. Helping the patient ambulate in the hall Fundamentals text ch 21

Question 30

Which task is appropriate for a registered nurse (RN) to delegate to a nursing assistant? 1. Explaining to the patient the preoperative preparation before the surgery in the morning 2. Administering the ordered antibiotic to the patient before surgery 3. Obtaining the patient's signature on the surgical informed consent 4. Helping the patient to the bathroom before leaving for the operating room

Answer 30

4. Helping the patient to the bathroom before leaving for the operating room Fundamentals text ch 21

Question 31

Which of the following skills can be delegated to nursing assistive personnel (NAP)? (Select all that apply.) 1. Nasotracheal suctioning 2. Oropharyngeal suctioning of a stable patient 3. Suctioning a new artificial airway 4. Permanent tracheostomy tube suctioning 5. Care of an endotracheal tube (ETT)

Answer 31

2. Oropharyngeal suctioning of a stable patient 4. Permanent tracheostomy tube suctioning Fundamentals text ch 41

Question 32

The nurse would delegate which of the following to nursing assistive personnel (NAP)? (Select all that apply.) 1. Repositioning and retaping a patient's nasogastric tube 2. Performing glucose monitoring every 6 hours on a patient 3. Documenting PO intake on a patient who is on a calorie count for 72 hours 4. Administering enteral feeding bolus after tube placement has been verified 5. Hanging a new bag of enteral feeding

Answer 32

2. Performing glucose monitoring every 6 hours on a patient 3. Documenting PO intake on a patient who is on a calorie count for 72 hours Fundamentals text ch 45

Question 33

The unit is very busy and short staffed. What could the RN delegate to the unlicensed assistive personnel (UAP)? 1. Administer antihypertensive meds to stable patients 2. Obtain orthostatic BP readings for older patients 3. Check BP readings for the patient receiving IV sodium nitroprusside 4. Teach about home BP monitoring and use of automatic BP monitoring equipment

Answer 33

2. Obtain orthostatic BP readings for older patients - UAPs can't administer meds - pt on sodium nitroprusside is having a hypertensive crisis, needs an RN - only RNs can do the teaching about at-home BP MS workbook ch 32

Question 34

Which intervention should the nurse delegate to the licensed practical nurse (LPN) when caring for a pt following an acute stroke? a. assess the pt's neurological status b. assess the pt's gag reflex before beginning feeding c. administer ordered antihypertensives and platelet inhibitors d. teach the pt's caregivers strategies to minimize unilateral neglect

Answer 34

c. administer ordered antihypertensives and platelet inhibitors MS workbook ch 57

Question 35

Who is responsible for educating the health care team in an organization on the policies, practices, and laws of delegation? a. American Nurses Association b. National Council of State Boards of Nurses c. health care organization d. the state

Answer 35

c. health care organization Leadership and Management

Question 36

The nurse has become incredibly busy with discharging 2 pts and expecting a new pt any second. The following are tasks that need to be completed right away. What task can the nurse delegate to an NAP to help out with managing the nurse's time with pts? a. remove sutures from an incision and apply dressing to the pt's left wrist b. provide tracheostomy care to the pt c. sit with a pt who was recently diagnosed with Crohn's disease and is crying d. transport a pt to x-ray on a cardiac monitor

Answer 36

c. sit with a pt who was recently diagnosed with Crohn's disease and is crying Leadership and Management

Question 37

The staff working on the unit includes 4 RNs, 2 LPNs, and an NAP for 25 pts. What assignment is most appropriate for one of the LPNs? a. gather data about a newly admitted pt b. pass medications to a group of pts c. pass water to all of the pts on the unit d. obtain a urine sample from a Foley catheter on a pt who is not assigned to the LPN

Answer 37

b. pass medications to a group of pts Leadership and Management

Question 38

What is the most appropriate task for the RN to delegate to the NAP? a. silence the IV pump until the RN arrives b. notify the family of a pt who has died c. administer a soap spuds enema to a pt who has requested it for constipation d. reinforce teaching to a pt who has had an above the knee amputation

Answer 38

c. administer a soap spuds enema to a pt who has requested it for constipation Leadership and Management

Question 39

The charge nurse working with an RN, LPN, and a NAP is very busy with the group of pts on the unit. One pt's intravenous line has just infiltrated, a practitioner is on the phone waiting for a nurse's response, a pt wants to be discharged, and the NAP has just reported an elevated temperature on a new surgical pt. Who should be assigned to restart the intravenous line? a. LPN b. NAP c. RN d. charge nurse

Answer 39

c. RN Leadership and Management

Question 40

A new graduate nurse is assigned a pt who is 2 days postoperative who has had a colostomy. The pt has an order to have an NG tube inserted immediately. The new graduate has never inserted this type of tube in a pt. How should the new graduate nurse proceed in this situation? a. delegate the task to a NAP b. read over the procedure and then insert the tube c. notify the practitioner of the new graduate's inexperience d. ask an experienced RN for assistance with the procedure

Answer 40

d. ask an experienced RN for assistance with the procedure Leadership and Management

Question 41

A patient with an acute peptic ulcer and major blood loss requires an immediate transfusion with packed red blood cells. Which task is appropriate for the registered nurse (RN) to delegate to unlicensed assistive personnel (UAP)? a. Confirm the IV solution is 0.9% saline. b. Obtain the vital signs before the transfusion is initiated. c. Monitor the patient for shortness of breath and back pain. d. Double check the patient identity and verify the blood product.

Answer 41

b. Obtain the vital signs before the transfusion is initiated. MS ch 30

Question 42

When caring for a patient with Alzheimer's disease, which task could be delegated to the LPN/LVN on the team? a. Administer enteral feedings via a gastrostomy tube. b. Teach patient and caregivers memory enhancement aids. c. Use bed alarms and frequent monitoring to decrease fall risk. d. Make referrals for community services such as adult day care.

Answer 42

a. Administer enteral feedings via a gastrostomy tube. MS ch 59

Question 43

When creating an assignment for a team consisting of an RN, 1 LPN, and 2 UAPs, which is the best client for the LPN? 1. a client requiring frequent temperature checks 2. a client requiring assistance with ambulation every 4 hrs 3. a client on a mechanical ventilator requiring frequent assessment and sunctioning 4. a client with a spinal cord injury requiring urinary catheterization every 6 hrs

Answer 43

4. a client with a spinal cord injury requiring urinary catheterization every 6 hrs - UAPs can do temperature checks and ambulation - the pt on the mechanical ventilator requiring frequent assessment and suctioning should be more appropriately cared for by the RN - urinary catheterization is within LPN's scope of practice NCLEX

Question 44

A nurse is delegation the ambulation of a client who had knee arthroplasty 5 days ago to an AP. Which of the following information should the nurse share with the AP? (Select all that apply) a. the roommate ambulates independently b. the client ambulates with his slippers on over his antiembolic stockings c. the client uses a front-wheeled walker when ambulating d. the client had pain medication 30 min ago e. the client is allergic to codeine f. the client ate 50% of his breakfast this morning

Answer 44

b. the client ambulates with his slippers on over his antiembolic stockings c. the client uses a front-wheeled walker when ambulating d. the client had pain medication 30 min ago ATI Fundamentals

Question 45

When a nurse considers delegating a task, what 5 rights should be utilized? a. right pt, right chart, right physician, right results, right information b. right person, right pt, right task, right documentation, right time frame c. right task, right circumstance, right person, right direction/communication, right supervision d. right room, right time, right person, right documentation, right directions c. right task, right circumstance, right person, right direction/communication, right supervision Leadership and Management Nice work! You just studied 30 terms! Now up your study game with Learn mode. Try Learn mode Study with Flashcards again 30/30

Answer 45

c. right task, right circumstance, right person, right direction/communication, right supervision Leadership and Management

Question 46

(1)  General nursing procedures. An R.N. shall utilize the nursing process in the execution of general nursing procedures in the maintenance of health, prevention of illness or care of the ill. The nursing process consists of the steps of assessment, planning, intervention and evaluation. This standard is met through performance of each of the following steps of the nursing process: • (a) Assessment. Assessment is the systematic and continual collection and analysis of data about the health status of a patient culminating in the formulation of a nursing diagnosis. • (b) Planning. Planning is developing a nursing plan of care for a patient which includes goals and priorities derived from the nursing diagnosis. • (c) Intervention. Intervention is the nursing action to implement the plan of care by directly administering care or by directing and supervising nursing acts delegated to L.P.N.'s or less skilled assistants.* • (d) Evaluation. Evaluation is the determination of a patient's progress or lack of progress toward goal achievement which may lead to modification of the nursing diagnosis

Answer 46

• (c) Intervention. Intervention is the nursing action to implement the plan of care by directly administering care or by directing and supervising nursing acts delegated to L.P.N.'s or less skilled assistants.*