Leadership Management - Delegating

A nursing graduate is attending an agency orientation regarding the nursing model of practice implemented in the health care facility. The nurse is told that the nursing model is a team nursing approach. The nurse understands that planning care delivery will be based on which characteristic of this type of nursing model of practice?
1. A task approach method is used to provide care to clients.
2. Managed care concepts and tools are used in providing client care.
3. A single registered nurse is responsible for providing care to a group of clients.
4. A registered nurse leads nursing personnel in providing care to a group of clients.

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 collections
4. A client with difficulty swallowing food and fluids

A new unit nurse manager is holding her first staff meeting. The manager greets the staff and comments that she has been employed to bring about quality improvement. The manager provides a plan that she developed and a list of tasks and activities for which each staff member must volunteer to perform. In addition, she instructs staff members to report any problems directly to her. What type of leader and manager approach do the new manager's characteristics suggest?
1. Autocratic
2. Situational
3. Democratic
4. Laissez-faire

The nurse employed in 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 three 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

The nurse should use which guidelines to plan delegation and assignment-making activities? Select all that apply.
1. Ensuring client safety
2. 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

The nurse is giving a report to an unlicensed assistive personnel (UAP) who will be caring for a client who has hand restraints (safety devices). The nurse instructs the UAP to check the skin integrity of the restrained hands how frequently?
1. Every 2 hours
2. Every 3 hours
3. Every 4 hours
4. Every 30 minutes

The nurse manager is planning the clinical assignments for the day. Which staff members can be assigned to care for a client with herpes zoster? Select all that apply.
1. The nurse who never had roseola
2. The nurse who never had mumps
3. The nurse who never had chickenpox
4. The nurse who never had German measles
5. The nurse who never received the varicella-zoster vaccine

When making assignments to a team consisting of a registered nurse (RN), one licensed practical nurse (LPN), and two unlicensed assistive personnel (UAP), which is the best client for the LPN?
1. A client requiring frequent temperature checks
2. A client requiring assistance with ambulation every 4 hours
3. A client on a mechanical ventilator requiring frequent assessment and suctioning
4. A client with a spinal cord injury requiring urinary catheterization every 6 hours as prescribed

The registered nurse (RN) is planning assignments for the clients on a nursing unit. The RN needs to assign four clients and has one RN, a licensed practical (vocational) nurse, and two unlicensed assistive personnel (UAPs) on a nursing team. Which client would the nurse most appropriately assign to the licensed practical (vocational) nurse?
1. The client who requires a 24-hour urine collection
2. A client with an abdominal wound requiring frequent wound irrigations
3. An older client requiring assistance with a bed bath and frequent ambulation
4. A client on a mechanical ventilator requiring frequent assessment and suctioning

The nurse manager attends a conference, and the topic of discussion is leadership styles. The nurse is seeking a leadership style that will empower staff to achieve excellence. Which leadership style should the nurse select to achieve this goal?
1. Autocratic
2. Situational
3. Democratic
4. Laissez-faire

The nurse is caring for a client with acute glomerulonephritis. The nurse instructs the unlicensed assistive personnel (UAP) to implement which action when caring for the client?
1. Ambulate the client frequently.
2. Encourage a diet that is high in protein.
3. Remove the water pitcher from the bedside.
4. Monitor the client's temperature every 2 hours.

The registered nurse is planning the client assignments for the day. Which is the most appropriate assignment for the unlicensed assistive personnel (UAP)?
1. A client scheduled to receive a blood transfusion
2. A new diabetes mellitus client scheduled for discharge
3. A client with bladder cancer who will be receiving chemotherapy
4. A client on bed rest who requires range-of-motion (ROM) exercises every 4 hours

The nurse is planning the client assignments for a group of clients and has a licensed practical nurse (LPN) and an unlicensed assistive personnel on the nursing team. Of the following clients, which would the nurse most appropriately assign to the LPN?
1. A client with stable heart failure who has early-stage Alzheimer's disease
2. A client who is scheduled for an electrocardiogram and a chest x-ray examination
3. A client who was treated for dehydration and is weak and needs assistance with bathing
4. A client with emphysema who is receiving oxygen at 2 L/minute by nasal cannula and becomes dyspneic on exertion

The nurse educator presents an in-service training session on case management to nurses on the clinical unit. During the presentation the nurse educator clarifies that what is a characteristic of case management?
1. Requires that one nurse take care of one client
2. Promotes appropriate use of hospital personnel
3. Requires a case manager who plans the care for all of the clients
4. Uses a team approach, but one nurse supervises all of the other employees

The nurse attends an educational conference on leadership styles. A colleague at the conference who is employed at a large trauma center states that the leadership style at the trauma center is task oriented and directive. The nurse recognizes that what type of leadership style is used at the trauma center?
1. Autocratic
2. Situational
3. Democratic
4. Laissez-faire

Laptop computers have been purchased by a community hospital to be used in the nursing units for documentation. The nurse educator at the hospital plans in-service educational sessions regarding the use of the computers and the new documentation system. The nurse educator anticipates some resistance to the use of the computers and should plan to best deal with this difficulty by doing what?
1. Ignoring the resistance
2. Discarding all paper-type documentation forms
3. Demanding that the nurses use the new computer system
4. Allowing the nurses extra time to work with the new computer system

The registered nurse (RN) is planning client assignments and cannot take a client assignment today. Two unlicensed assistive personnel (UAP) and a licensed practical nurse (LPN) also are assigned to the unit. Which client should the RN most appropriately assign to the LPN?
1. A client requiring frequent ambulation
2. A client scheduled for a cardiac catheterization
3. A client requiring range-of-motion (ROM) exercises
4. A client with a 24-hour urine collection who is on strict bed rest

As a home health case manager, the nurse functions as a coordinator of client care. The nurse understands that in this role he or she will perform which function?
1. Organize, manage, and balance health care services needed for the client.
2. Report daily to all members of the client's health care team to advise them of the plans.
3. Plan weekly meetings with all persons involved in the care of this client to assess status.
4. Conduct daily teaching sessions for the client and significant others about the case management process.

The registered nurse (RN) has provided instructions to a licensed practical nurse (LPN) regarding administering enemas to a client scheduled for a barium enema. The RN has instructed the LPN to administer enemas until they are clear. The LPN tells the RN that three enemas were administered and that the returns are still not clear. What should the RN instruct the LPN to do?
1. Administer one more enema.
2. Stop administering the enemas.
3. Continue to administer enemas until the solution is clear.
4. Wait for 1 hour and then continue administering the enemas.

A client with diabetes mellitus is admitted to the hospital for cataract surgery. Which task can be delegated to the unlicensed assistive personnel (UAP)?
1. Assist the client in ambulating in the hallway.
2. Listen to the client express his frustration or loss.
3. Instruct the client on how to apply the eye drops.
4. Review hand washing and hygiene practices with the client.

A registered nurse (RN) is observing a licensed practical nurse (LPN) preparing a client for treatment with a continuous passive motion (CPM) machine. Which observation by the RN would indicate that the LPN is performing an incorrect action?
1. The LPN keeps the client's knee at the hinged joint of the machine.
2. The LPN assesses the client for pressure areas at the knee and the groin.
3. The LPN places the client's knee in a slightly externally rotated position.
4. The LPN checks the degree of extension and flexion and the speed of the CPM machine according to the health care provider's (HCP) prescriptions.

The nurse is planning the client assignments for the shift. Which client should the nurse assign to the unlicensed assistive personnel?
1. A client requiring dressing changes
2. A client requiring frequent ambulation
3. A client on a bowel management program requiring rectal suppositories and a daily enema
4. A client with diabetes mellitus requiring daily insulin and reinforcement of dietary measures

A registered nurse is delegating activities to the nursing staff. Which activity is least appropriate for the unlicensed assistive personnel (UAP)?
1. Collecting a urine specimen from a client
2. Obtaining frequent oral temperatures on a client
3. Accompanying a man being discharged to his transportation to home
4. Assisting a postcardiac catheterization client who needs to lie flat to eat lunch

The registered nurse (RN) directs the licensed practical nurse (LPN) to assist with the care of a client who has a sacral ulcer. Which is the most appropriate activity for the RN to delegate to the LPN?
1. Place the client in a side-lying position.
2. Initiate wound care protocol for standardized ulcer care.
3. Meet with the wound specialist to identify measures to improve healing.
4. Determine which treatments would best meet the healing needs of the client.

The nurse has recently been assigned to manage a pulmonary progressive unit at a large urban hospital. The nurse's leadership style is participative, with the belief that all staff members assist in decision making and the development of the unit's goals. Which leadership style is the nurse implementing?
1. Autocratic
2. Democratic
3. Situational
4. Laissez faire

The registered nurse is planning client assignments for the day. Which is the most appropriate assignment for the unlicensed assistive personnel (UAP)?
1. A client scheduled to receive a blood transfusion
2. A client with bladder cancer who will be receiving chemotherapy
3. A client newly diagnosed with diabetes mellitus scheduled for discharge
4. A client on bed rest who requires range-of-motion (ROM) exercises every 4 hours

The nurse is preparing the client assignment. Which should be assigned to a licensed practical nurse (LPN)?
1. A client who requires teaching about an insulin pump
2. Completing an admission assessment on a newly admitted client
3. Administration of a new oral medication to a client with Alzheimer's disease
4. An assessment of a client whose pulse oximetry reading is 85% and is having difficulty breathing

The nurse is rearranging the client assignments after several discharges and admissions occurred. Which tasks can be assigned to the unlicensed assistive personnel (UAP)? Select all that apply.
1. Cleaning a client's dentures
2. Ambulating a postoperative client
3. Taking 4:00 pm vital signs on clients
4. Giving medications left by the nurse for the client to take
5. Assisting a client with a urinary drainage catheter into a chair
6. Obtaining a catheterized urinalysis and taking it to the laboratory

The registered nurse (RN) is planning her client assignments for the day. She has a licensed practical nurse and an unlicensed assistive personnel (UAP) on her team. Which task would the RN delegate to the UAP?
1. Empty a client's urinary catheter bag.
2. Instruct a client on his new diabetic diet.
3. Teach a client how to check her blood glucose.
4. Evaluate a newly admitted client's home medications.

The nurse is delegating the morning hygienic care of a man to the unlicensed assistive personnel (UAP). In reviewing the assigned tasks, the nurse should instruct the UAP to use an electric razor for which client?
1. The client with severe pain related to osteoporosis
2. The client with hypokalemia related to diuretic therapy
3. The client with thrombocytopenia related to chemotherapy
4. The client with an elevated white blood cell count related to infection

The nurse is planning the client assignments for the day. Which clients can be safely assigned to the unlicensed assistive personnel (UAP)? Select all that apply.
1. The client receiving a heparin infusion
2. The client receiving a blood transfusion
3. The client receiving continuous oxygen at 2 L/min
4. The client recovering from Guillain-Barré syndrome
5. The client who just returned from surgery for a hip repair
6. The client on isolation for methicillin-resistant Staphylococcus aureus

The nurse is planning the client assignments for the day. Which clients can be safely assigned to the unlicensed assistive personnel (UAP)? Select all that apply.
1. A client needing a bed bath
2. A client needing to ambulate
3. A client needing packed red blood cells
4. A client requiring assistance with feeding
5. A client needing to have vital signs checked
6. A client needing to use the bedside commode

The nurse is responsible for the care of a client who has begun to experience hallucinations more frequently. Which activity in the care of the client can be appropriately delegated to an unlicensed assistive personnel (UAP)?
1. Determining if the client has consistently been medication compliant
2. Discussing the frequency and duration of the hallucinations with the client
3. Providing distraction for the client by engaging him or her in a board game
4. Assisting the client in identifying any new stressors he or she may be experiencing

The nurse is planning the client assignments for the day. Which clients can be safely assigned to the unlicensed assistive personnel (UAP)? Select all that apply.
1. A confused older client who requires feeding
2. A client who requires turning every 2 hours
3. A client admitted with dehydration who is on strict intake and output
4. A client on 3 L of oxygen by nasal cannula and a pulse oximetry reading of 89%
5. A client who experienced a 10-beat run of ventricular tachycardia and hypotension on the previous shift
6. A client 4 days postoperative exploratory laparotomy who requires ambulation in the hallway four times a day

The nurse is planning client assignments for the day. Which clients can be safely assigned to unlicensed assistive personnel (UAP)? Select all that apply.
1. The 60-year-old client who is receiving chemotherapy and is in isolation
2. The 52-year-old client with anemia who is receiving a second unit of blood and needs assessment of vital signs
3. The 48-year-old client newly diagnosed with hyperthyroidism who is in need of teaching regarding medication therapy
4. The 50-year-old, 72-hour postoperative client who is recovering from a total knee replacement and needs assistance with bathing and dressing
5. The 48-hour postoperative client who is recovering from an open reduction and fixation of the right forearm and needs assistance with feeding
6. The newly admitted client with shortness of breath, circumoral cyanosis, and a respiratory rate of 30 breaths per minute who requires an admission assessment

The nurse would instruct the unlicensed assistive personnel (UAP) to use an electric razor for which client?
1. The postoperative client
2. The client with an infection
3. The client taking warfarin (Coumadin)
4. The client taking acetaminophen (Tylenol)

The nurse is developing a client care assignment for a group of unlicensed assistive personnel (UAP). What is the nurse's first step in planning and assigning clients?
1. Determine what skills can be delegated.
2. Determine the years of experience of each UAP.
3. Determine how much supervision is required for each client assigned.
4. Determine how many clients the agency allows to be delegated to each UAP.

The newly appointed vice president for nursing operations has announced that the authority for decision making will be decentralized and distributed throughout the organization. The nurse managers anticipate that the channel of communication and authority will be characterized by which organizational chart?
1. Flat
2. Vertical
3. Circular
4. Horizontal

The graduate nurse is interviewed by the manager of a unit and is told that the manager's leadership style is one of letting the staff nurses make the decisions about the unit's operations. When the interviewee meets with the day nursing staff, the graduate nurse hears examples of unit issues indicating that the manager's approach is laissez-faire. Which question should the graduate nurse ask to confirm her suspicions?
1. "Does the manager facilitate decision making by the group?"
2. "Does the manager maintain control and make all decisions?"
3. "Does the manager assume a passive, nondirective approach?"
4. "Does the manager change style according to the needs of the group?"

A nurse manager meets with the staff nurses and announces that management has developed a new policy and procedure that is significantly different from old practices. Which statement by the nurse manager should reflect the manager's use of legitimate power?
1. "The health care system services a client population that presents particular challenges. The changes made will enhance client safety and reduce errors."
2. "If you don't follow the new policy and procedure, I'll have no choice but to give you a notice about poor performance–which could lead to termination of your employment."
3. "Every manager has the responsibility to see that these new policies and procedures are followed 100% of the time. Please join me in this organization's effort to continue to improve quality care."
4. "You're just going to have to trust me on this one. I was a member of the committee that wrote the policy and procedure, and there are good reasons why the specific nursing actions need to be done this new way."

Which tasks should the registered nurse (RN) delegate to the licensed practical nurse (LPN)? Select all that apply.
1. Assessment
2. Urinary catheterization
3. Endotracheal suctioning
4. Intramuscular medication administration
5. Subcutaneous medication administration
6. Intravenous push medication administration