Leadership final

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Leadership final
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  1. An operational budget accounts for which of the following?
    Income and expenses associated with daily activity within an organization
  2. Revenue can be generated through which of the following?
    Billable patient services
  3. Cost centers are used to do which of the following?
    Track financial data within a department or unit.
  4. Track financial data within a department or unit.
    Generate revenue and control expenses within a pro- jected framework.
  5. Productivity can be measured by which of the following?
    Volume of services delivered
  6. Revenue and expenses are typically tracked using which of the following tools?
    Operational budget
  7. Identify which of the following are indirect expenses.
    Gas, electric, phones
  8. Which of the following should be reviewed immediately after an operational budget has been put into place?
    Budget monitoring
  9. Examples of capital budget items are which of the following?
    • MRI Scanner
    • Mammogram equipment
    • Brain scanner
  10. What types of indicators are typically displayed on dash- boards in hospital settings? Select all that apply.
    • Patient satisfaction
    • Financial performance
    • Quality performance
    • Staff satisfaction 
    • Patient outcomes
  11. Patient classification systems measure nursing workload needed to care for patients. The higher the patient’s acuity, the more care is required by the patient. Which of the fol-lowing statements is a weakness of classification systems?
    Patient classification data are useful in predicting the required staffing for the next shift and for justifying nursing hours provided.
  12. If your full-time staff members receive four weeks of vacation and 10 days of sick time per year, how many productive hours would each FTE work in that year if they utilized all of their benefited time?
    1,840 productive hours
  13. Patient outcomes are the result of many variables, one being the model of care delivery that is utilized. From the following scenarios, select which is the worst fit between patient needs and the care delivery model.
    Medical intensive care patients being cared for in a team nursing model
  14. When calculating paid nonproductive time, the nurse manager considers
    all hours that are paid but not worked on the assigned unit.
  15. The most important variable that affects staffing patterns and schedules should be which of the following?
    Delivering safe, quality patient care
  16. The medical-surgical unit provides 200 hours of care daily to 20 patients. Their NHPPD is which of the following?
    10
  17. Benchmarking is which of the following?
    A comparison of productivity data for similar nursing units
  18. Informatics supports staffing by doing which of the following?
    Organizing data from multiple sources into information for taking action
  19. In developing a staffing plan for your unit, which of the following considerations would you include? Select all that apply.
    Data from census and staffing from the past quarter

    Presence of a mini-pharmacy on your unit that stocks medications

    Your hospital is located in Modesto, California. 

    The scope of practice for nursing assistive personnel on your unit
  20. Which of the following would you take into account when developing a staffing schedule starting next week and running for six weeks? Select all that apply.
    Susan took four vacation days last month and has three days scheduled this month.

    Tim comes out of nursing orientation next week.

    There is scheduled maintenance on the water system for rooms 201–207 next week.

    You have 22 nurses with over 10 years experience on the unit.
  21. When a nurse considers delegating a task, what five rights should be utilized?
    Right task, right circumstance, right person, right direction/communication, right supervision
  22. Right task, right circumstance, right person, right direction/communication, right supervision
    Sit with a patient who was recently diagnosed with Crohn’s disease who is crying.
  23. The staff working on the unit includes four RNs, two LPNs, and an NAP for 25 patients. What assignment is the most appropriate for one of the LPNs?
    Pass medications to a group of patients.
  24. What is the most appropriate task for the RN to delegate to the NAP?
    Administer a soap suds enema to a patient who has requested it for constipation.
  25. What parts of the nursing process cannot be delegated to a NAP? Select all that apply.
    • Assessment
    • Nursing diagnosis
    • Planning
    • Evaluation
  26. The charge nurse working with an RN, an LPN, and a NAP is very busy with the group of patients on the unit. One patient’s intravenous line has just infiltrated, a practitioner is on the phone waiting for a nurse’s response, a patient wants to be discharged, and the NAP has just reported an elevated temperature on a new surgical patient. Who should be assigned to restart the intravenous line?
    RN
  27. A new graduate nurse is assigned a patient who is two days postoperative who has had a colostomy. The patient has an order to have a nasogastric tube inserted immediately. The new graduate has never inserted this type of tube in a patient. How should the new graduate nurse proceed in this situation?
    Ask an experienced RN for assistance with the procedure.
  28. When a nurse considers delegating a task, which of the fol-lowing are cultural phenomena that should be considered?
    • Communication
    • Space
    • Social organization
    • Environmental control
    • Biological variations
  29. Who is responsible for educating the health care team in an organization on the policies, practices, and laws of delegation?
    Health care organization
  30. When a nurse asks another nurse to observe his or her group of patients while at lunch, and one patient falls out of bed, which nurse is responsible?
    The actions of both nurses will be reviewed.
  31. Shared governance is described as which of the following?
    An allocation of control, power, or authority among mutually interested, vested parties
  32. The five levels of a clinical promotion ladder built on Benner’s theoretical framework include all but which of the following?
    Orientee
  33. The principles of whole-systems shared governance include which of the following? Select all that apply.
    • Partnership
    • Accountability
    • Ownership
    • Equity
  34. In developing a unit-based performance improvement plan, which of the following areas should be considered? Select all that apply.
    • Service
    • Cost
    • Outcomes
    • Clinical quality
    • Access
  35. A learning organization promotes professional practice through encouragement of personal mastery, team learn-ing, and which of the following?
    Awareness of our mental models
  36. Transforming Care at the Bedside (TCAB) is a performance improvement process whose distinguishing factor is that it focuses on which of the following?
    Ideas for performance improvement come from staff at the bedside.
  37. Relationship-based care is a framework that includes the dimensions of leadership, patient care delivery, teamwork, resource-driven practice, and which of the following? Select all that apply.
    • Professional nursing practice 
    • Outcome measurement
  38. In situational leadership, the development of the follower is accomplished by the leader adjusting their leadership style as the follower grows. Leadership styles include coaching, directing, delegating, and which of the following?
    Supporting
  39. A professional portfolio that is reviewed periodically as a registered nurse journeys through a clinical ladder could include a copy of the nurse’s resume, license, and which of the following? Select all that apply.
    • Exemplars
    • CEU certificates
    • Publications
  40. The strategic planning process includes values clarification defining the mission, a SWOT analysis, and which of the following?
    A vision statement
  41. The nurse has just finished the change of shift report. Which patient should the nurse assess first?
    A patient with asthma who had difficulty breathing during the prior shift.
  42. The staff RN’s assignment on the 7 a.m. to 3 p.m. shift includes a newly admitted patient with pneumonia who has arrived on the unit, a new postoperative surgical patient requesting pain medication, and a patient diag-nosed with nephrolithiasis who is complaining of nausea. What should the nurse do first after shift report?
    Assess the newly admitted pneumonia patient.
  43. The nurse has been assigned to a medical-surgical unit on a stormy day. Three of the staff can’t make it in to work, and no other staff is available. How will the nurse proceed? Select all that apply.
    Prioritize care so that all patients get safe care

    Quickly make rounds on all assigned patients to assess needs.

    Decide on desired outcome
  44. The nurse has just completed listening to morning report. Which patient will the nurse see first?
    The patient with a sickle cell crisis and an infiltrated IV.
  45. A new graduate RN organizing her assignment asks the charge nurse, “Of the list of patients assigned to me, who do you think I should assess first?” What is the best response the charge nurse could make?
    “I would assess the patient who is having respiratory distress first.”
  46. Of the following new patients, who should be assessed first by the nurse?
    A patient with a diagnosis of alcohol abuse with impending delirium tremens (DTs).
  47. The nurse has just come on duty and finished hearing morning report. Which patient will the nurse see first?
    The patient who is receiving continuous IV Heparin per pump.
  48. A nurse can enhance personal productivity by doing which of the following? Select all that apply.
    Analyzing time, getting up an hour early, and delegating unwanted tasks.

    E. Controlling unwanted distractions such as texts, e-mails, and unplanned phone calls.

    F. Using downtime by having reading and writing materials available.
  49. You have received report on the following patients. Who would you make patient care rounds on first?
    Patient who is severely allergic to peanuts who just ate potato chips fried in peanut oil.
  50. Who would you make rounds on second?

    A. Patient who is concerned that he has had no bowel movement for two days.
    B. Patient who has suffered several acute asthmatic attacks within the last 24 hours.
    C. Patient who is now comfortable but has had several episodes of breakthrough pain since yesterday.
    D. Patient who is severely allergic to peanuts who just ate potato chips fried in peanut oil.
    Patient who has suffered several acute asthmatic attacks within the last 24 hours.
  51. You are a new graduate on the unit, and your preceptor has asked you to demonstrate an insulin injection to your patient. The primary learning style you will utilize when the patient does his return demonstration is which of the following?

    A. Visual learning
    B. Auditory learning
    C. Kinesthetic learning
    D. Logical learning
    Kinesthetic learning
  52. Referring to Gagne’s nine events of instruction (Table 19-10), a nurse has just instructed her asthmatic patient on the use of an inhaler. One event the nurse can utilize to evaluate the patient’s skill is which of the following?

    A. Ask the patient to watch the nurse demonstrate the skill again.
    B. Have the patient demonstrate the use of the inhaler.
    C. Document the education session on the patient’s chart.
    D. Provide the patient with a lecture on asthma.
    Have the patient demonstrate the use of the inhaler.
  53. The nurse has just instructed the patient on stroke management as part of discharge planning for home. The patient states, “I don’t feel I am ready to go home so soon. I am scared.” What should the nurse say next?

    A. Tell the patient to call the rehabilitation nurse every hour for reassurance.
    B. Ask the patient in a calm, reassuring voice to verbalize his/her concerns.
    C. Review the stroke education information again in a loud, emphatic voice.
    D. Stand over the patient without eye contact and ask the patient to verbalize his concerns.
    Ask the patient in a calm, reassuring voice to verbalize his/her concerns.
  54. The major goal of education is to spread and share knowl-edge as well as which of the following?

    A. Enable student learning
    B. Utilize group learning
    C. Change behavior
    D. Learn new behavior
    C. Change behavior
    (this multiple choice question has been scrambled)
  55. Utilizing a fact sheet such as the one on VAP (ventilator-associated pneumonia), the nurse’s instruction should include which of the following?

    A. VAP is not a common occurrence in the ICU.
    B. VAP is an inflammation of the lining of the heart.
    C. A loved one should be flat in bed at all times.
    D. Hand washing is a measure to prevent VAP.
    D. Hand washing is a measure to prevent VAP.
    (this multiple choice question has been scrambled)
  56. 6. Evaluating the effectiveness of an education event can be accomplished by which of the following? Select all that apply.

    _____ A. Noting a change in the learner’s behavior
    _____ B. Having the patient complete a written test
    _____ C. Using the teach back method
    _____ D. Asking the patient if they have understood
    _____ E. Observing the patient do a return demonstration
    • _____ A. Noting a change in the learner’s behavior 
    • _____ B. Having the patient complete a written test 
    • _____ C. Using the teach back method
    • _____ E. Observing the patient do a return demonstration
  57. 7. The nurse is an important component in patient educa-tion because of which of the following?
    A. Ability to comfort others
    B. Caring attitude
    C. Knowledge and expertise
    D. Professional appearance
    C. Knowledge and expertise
    (this multiple choice question has been scrambled)
  58. 8. Which learning domain involves changes in the learners’ feelings and beliefs?

    A. Reflective domain
    B. Affective domain
    C. Cognitive domain
    D. Psychomotor domain
    B. Affective domain
    (this multiple choice question has been scrambled)
  59. 9. Which of the following forms of analysis is concerned with the situation that created the need for education and with the conditions under which education will occur?
    A. Learner analysis
    B. Context learning
    C. Design analysis
    D. Content learning
    B. Context learning
    (this multiple choice question has been scrambled)
  60. Which of the following behaviors may indicate that your patient has low health literacy? Select all that apply.

    _____ A. Opening up pill bottles to identify the pills
    _____ B. Signing a consent form after reading all of the front page
    _____ C. Refusing to fill out a form and saying, “I’m too tired to read.”
    _____ D. Responding when asked about why he takes a medication, “I take it because the doctor told me to!”
    _____ E. Becoming angry about nurses asking “too many questions.”
    _____ F. Patient responds, “I’ll read it later.”
    • _____ A. Opening up pill bottles to identify the pills 
    • _____ C. Refusing to fill out a form and saying, “I’m too tired to read.” 
    • _____ D. Responding when asked about why he takes a medication, “I take it because the doctor told me to!” 
    • _____ E. Becoming angry about nurses asking “too many questions.” 
    • _____ F. Patient responds, “I’ll read it later.”
  61. The primary focus of the Joint Commission is which of the following?

    A. Remaining within the proposed budget
    B. Providing employment opportunities
    C. Safe, high-quality patient care
    D. Providing a structure for collaboration among employees
    A. Remaining within the proposed budget
    (this multiple choice question has been scrambled)
  62. The current goal of quality improvement initiatives is which of the following?

    A. Improving response time to care requirements
    B. Reviewing past breeches of clinical practices
    C. Developing strategies to promote ongoing and future health care practices
    D. Involving the consumer in the decision-making process
    C. Developing strategies to promote ongoing and future health care practices
    (this multiple choice question has been scrambled)
  63. Following a sentinel event, which step would be initiated first?

    A. Taking corrective action on personnel
    B. No action required
    C. Reporting the event to legislative authorities
    D. Immediate investigation
    D. Immediate investigation
    (this multiple choice question has been scrambled)
  64. A process reflecting the situation, background, assessment, recommendation, and response (SBARR) results in which of the following?

    A. Procedures that promote and enhance data collection strategies
    B. Improved organizational reporting requirements to licensing bodies
    C. Communication that promotes situational awareness and timely interventions for patients
    D. Increased governmental funding
    Communication that promotes situational awareness and timely interventions for patients
  65. Which of the following describes the benchmarking process?

    A. Reviewing your own unit’s data for opportunities
    B. Collecting data on an individual patient
    C. Reviewing data in the literature
    D. Comparing your data to that of other organizations to identify improvement opportunities
    Comparing your data to that of other organizations to identify improvement opportunities
  66. Identifying QI opportunities in the health care arena is the responsibility of which group?

    A. All health care personnel
    B. Practitioners
    C. Patients
    D. Administration
    A. All health care personnel
    (this multiple choice question has been scrambled)
  67. Standardizing a process has which of the following effects? It:

    A. advocates for the same care for everyone, without consideration for individual differences.
    B. removes unwanted variation from a work process, decreasing risk for error.
    C. increases complexity, because it is hard to communicate the standard to everyone.
    D. removes all chance of error.
    B. removes unwanted variation from a work process, decreasing risk for error.
    (this multiple choice question has been scrambled)
  68. What tool could be used to track a change in a process?

    A. Time series chart
    B. Pie chart
    C. Flowchart
    D. Histogram
    A. Time series chart
    (this multiple choice question has been scrambled)
  69. A well-functioning team demonstrates which of the follow-ing characteristics? Select all that apply.

    _____ A. Clarity about each member’s role
    _____ B. A shared plan to achieve a goal
    _____ C. Effective communication practices
    _____ D. Cost of each clinical procedure
    _____ E. Understanding the vision of the organization
    • _____ A. Clarity about each member’s role 
    • _____ B. A shared plan to achieve a goal 
    • _____ C. Effective communication practices
    • _____ E. Understanding the vision of the organization
  70. Cost of care decreases with quality improvement initiatives such as which of the following? Select all that apply.

    _____ A. Standardizing care delivery work processes
    _____ B. Applying evidence-based principles
    _____ C. Improving patient care outcomes
    _____ D. Maintaining continuous quality improvement surveillance
    _____ E. Benchmarking with other health care organizations
    • _____ A. Standardizing care delivery work processes 
    • _____ B. Applying evidence-based principles 
    • _____ C. Improving patient care outcomes 
    • _____ D. Maintaining continuous quality improvement surveillance
    • _____ E. Benchmarking with other health care organizations
  71. To participate effectively in the use of EBNP, nurses should do which of the following? Select all that apply.
    _____ A. Participate in the development, use, and evaluation of practice guidelines
    _____ B. Read and analyze outcomes of research studies
    _____ C. Involve themselves in everyday patient care and nursing practice
    _____ D. Attend professional nursing conferences on evidence based practice
    _____ E. Utilize evidence-based outcomes to provide cost-effective care
    • _____ A. Participate in the development, use, and evaluation of practice guidelines 
    • _____ B. Read and analyze outcomes of research studies 
    • _____ C. Involve themselves in everyday patient care and nursing practice 
    • _____ D. Attend professional nursing conferences on evidence based practice 
    • _____ E. Utilize evidence-based outcomes to provide cost-effective care
  72. Why is it important for nurses to recognize and value patient-focused outcome indicators?

    A. To achieve safe, quality, cost-effective care for patients in daily practice
    B. To realize that individual nursing practice styles directly affect the rates at which patients recover
    C. To prevent development of unnecessary complica-tions and injury
    D. All of the above
    D. All of the above
  73. Which of the following are examples of national evidence-based practice guidelines?

    A. JC accreditation standards
    B. Hospital policy on how to staff a nursing unit
    C. Hospital procedure on how to insert a catheter
    D. AHRQ pressure ulcer treatment guidelines
    D. AHRQ pressure ulcer treatment guidelines
    (this multiple choice question has been scrambled)
  74. Which organization released two landmark reports on health care safety and quality, entitled To Err Is Human and Crossing the Quality Chasm ?

    A. Institute of Medicine
    B. Joint Commission
    C. Agency for Healthcare Research and Quality
    D. The Leapfrog Group
    A. Institute of Medicine
    (this multiple choice question has been scrambled)
  75. Which of the following statements are true about the PDSA Cycle? Select all that apply.

    _____ A. It provides a framework to think about how to apply evidence-based knowledge, facili-tating ability to make changes in individual patient care.
    _____ B. It is a process that can be applied to a system or an individual.
    _____ C. It is a process that can be used to test hunches, theories, and ideas about patient care, resulting in actual changes that result in improvement.
    _____ D. It is a process only utilized for individual patients.
    _____ E. It is a multidisciplinary process involving all members of the health care team.
    • _____ A. It provides a framework to think about how to apply evidence-based knowledge, facili-tating ability to make changes in individual patient care. 
    • _____ B. It is a process that can be applied to a system or an individual. 
    • _____ C. It is a process that can be used to test hunches, theories, and ideas about patient care, resulting in actual changes that result in improvement
    • _____ E. It is a multidisciplinary process involving all members of the health care team.
  76. Which of the following is an example of a component of the planning phase of the PDSA Cycle?

    A. Initiation of a multidisciplinary conference to discuss reduction in patient falls
    B. Evaluation of patient progress after implementation of a new pressure relief device
    C. Revision of a current pain documentation flow sheet
    D. Implementation of a skin care protocol for bariatric patients
    A. Initiation of a multidisciplinary conference to discuss reduction in patient falls
    (this multiple choice question has been scrambled)
  77. A source of data used to modify or adapt patient care may include which of the following?

    A. A patient’s concerns, preferences, and changing clini-cal condition
    B. Study results of a pressure ulcer prevalence survey
    C. The Web site for the Institute for Healthcare Improvement (IHI)
    D. All of the above
    D. All of the above
  78. Which organization revised its Social Policy Statement to include statements about the evaluation of the effective-ness of care in relation to identified outcomes and the use of evidence to improve care?

    A. IHI
    B. JC
    C. AHRQ
    D. ANA
    B. JC
    (this multiple choice question has been scrambled)
  79. 9. The continuous process of measuring products, service, and practices against the toughest competitors or those customers recognized as industry leaders is referred to as which of the following?

    A. Process evaluation
    B. Quality improvement
    C. Cost analysis
    D. Benchmarking
    D. Benchmarking
    (this multiple choice question has been scrambled)
  80. The PDSA Cycle by Langley, et al., begins with what question?

    A. What change can we make that will result in an improvement?
    B. What are we trying to accomplish?
    C. How will we know that change is an improvement?
    D. What have we learned from this process up to this point?
    B. What are we trying to accomplish?
    (this multiple choice question has been scrambled)
  81. A nurse needs to assist a patient in walking down the hall twice daily as part of the patient’s postoperative activities. It is the middle of the afternoon, and the patient is asleep. The nurse would like to allow the patient to sleep, because the patient was awake a majority of the night. However, if the nurse does not ambulate the patient now, it is possible that the rest of the nurse’s afternoon activities will prevent her from returning to the patient to ambulate before the end of her shift. The nurse must decide whether to ambulate the patient now. What is the next step of the decision-making process?

    A. Determine the outcome or goal that is desired.
    B. Generate alternatives and determine benefits and con-sequences of each.
    C. Evaluate the decision.
    D. Make the decision.
    A. Determine the outcome or goal that is desired.
    (this multiple choice question has been scrambled)
  82. A nurse is asked to participate on a committee to interview and assist in making selections of staff in conjunction with the nurse manager. An applicant is interviewed, and the committee is discussing her qualifications. A committee member states, “If we hire her, then we will have all of our positions filled and no one will get any overtime.” A discus-sion ensues about the consequences of no overtime, and the committee determines that they shouldn’t hire the nurse. What dysfunctional characteristic of group decision making may be going on in this group?

    A. Groupthink
    B. Consensus
    C. Stereotyping outsiders
    D. Group believes it is invincible
    A. Groupthink
    (this multiple choice question has been scrambled)
  83. A nursing assistant approaches the RN to tell her that her patient care assignment is too difficult of a patient load. She will be unable to complete all of her work, which is unusual for this assistant. She asks the RN if she will review the assignments to see if a more equitable assignment can be made. The RN makes rounds on the patients and reviews patient acuities as well as other nursing assistant assignments. Which step of the problem-solving process is the RN performing?

    A. Gathering and analyzing data
    B. Generating alternatives
    C. Selecting an action
    D. Identifying the problem
    B. Generating alternatives
    (this multiple choice question has been scrambled)
  84. A nurse manager decides to form a task force to identify reasons and solutions for patient dissatisfaction on your unit. What are the advantages of forming this task force? Select all that apply.
    _____ A. The decisions will be made more quickly.
    _____ B. Higher-quality decisions will be made due to more solutions being generated.
    _____ C. Acceptance of the decision is more likely.
    _____ D. There is access to a larger resource base.
    _____ E. There is less likely to be conflict during the decision-making process.
    _____ F. This will help to promote ownership of the problem.
    • _____ B. Higher-quality decisions will be made due to more solutions being generated.
    • _____ C. Acceptance of the decision is more likely. 
    • _____ D. There is access to a larger resource base. 

    _____ F. This will help to promote ownership of the problem.
  85. A new nurse is trying to set her goals for the next five years. She plans to eventually become an acute care nurse practitioner in the ICU setting. She knows she needs to become more experienced, obtain appropriate certification, go back to school, and take the practitioner exam. She would like to see a visual of the time it will take her to realistically accomplish those goals. She should use which of the following?

    A. Gantt chart
    B. Problem-solving process
    C. Decision grid
    D. Decision tree
    A. Gantt chart
    (this multiple choice question has been scrambled)
  86. A task force designed to examine solutions for low patient satisfaction in an emergency has decided to write their ideas down, present their ideas to the task force, discuss the ideas, and then vote on the ideas. This is an example of which group process?

    A. Delphi technique
    B. Problem-solving process
    C. Consensus building
    D. Nominal group technique
    D. Nominal group technique
    (this multiple choice question has been scrambled)
  87. Your friend tells you that the nurse manager over the pediatrics unit, where you wanted to work, is a “terrible” nurse manager. Because of this information, you decide to pursue employment elsewhere. Making this decision might have involved which of the following?

    A. Assigning inaccurate probabilities to alternatives
    B. Making a decision to justify a previous decision
    C. Being comfortable with the status quo
    D. Making a decision based upon the first available information
    D. Making a decision based upon the first available information
    (this multiple choice question has been scrambled)
  88. A nurse needs to determine whether she should work over-time next week for two shifts. The nurse is having difficulty deciding, because she will miss her child’s program if she works but feels the extra income might be worth it. She also believes it will be beneficial to work because the manager might give her preference for time off in the next pay period. Also, the nurse will miss a continuing education program she has been wanting to attend if she works overtime. The nurse could make the best decision by using which of the following?

    A. Gantt chart
    B. Decision-making grid
    C. Group consensus
    D. PERT diagram
    B. Decision-making grid
    (this multiple choice question has been scrambled)
  89. A nurse has finished her shift and is on her way home from her job. She is mulling over the activities of the day and thinks about the teaching she completed with a patient who has diabetes. The nurse decides that the patient had some difficulty understanding the insulin injections because she (the nurse) did not explain the differences in the two types of insulin in terms the patient could under-stand. The nurse decides that next time she will use more nonmedical terms in her explanations. This is an example of which of the following?

    A. Critical thinking
    B. Decision making
    C. Intuitive thinking
    D. Reflective thinking
    D. Reflective thinking
    (this multiple choice question has been scrambled)
  90. Today’s health care consumers are taking a more active role in their treatment decisions. The nurse’s confidence in critical thinking helps to empower patients in this endeavor. What are some strategies the nurse can employ that help with critical thinking and decision making? Select all that apply.

    _____ A. Base decisions on the way things were always done in the past.
    _____ B. Avoid procrastination; make decisions as you go along rather than let them accumulate.
    _____ C. Consider all those affected by the decision.
    _____ D. Make snap decisions; always “go with your gut.”
    _____ E. Make only those decisions that are yours to make.
    _____ F. Trust your intuition, then also consider other ways of thinking.
    • _____ B. Avoid procrastination; make decisions as you go along rather than let them accumulate. 
    • _____ C. Consider all those affected by the decision
    • _____ E. Make only those decisions that are yours to make.
    • _____ F. Trust your intuition, then also consider other ways of thinking.
  91. You are given a written order by a provider to administer an unusually large dose of pain medicine to your patient. In this situation, which of the following is an appropriate nursing action?

    A. Refuse to administer the medication, and move on to another patient.
    B. Speak with the provider about your concerns, and clarify whether the medication dose is accurate.
    C. Administer the medication because it was ordered by a provider.
    D. Select a dose that you feel comfortable with, and administer that dose.
    B. Speak with the provider about your concerns, and clarify whether the medication dose is accurate.
    (this multiple choice question has been scrambled)
  92. A practitioner has ordered you to discharge Mr. Jones from the hospital, despite a new temperature of 102.0°F (38.8°C). The practitioner refuses to talk with you about the patient. In this situation, which of the following is an appropriate nursing action?

    A. Administer an antipyretic medication, and discharge the patient.
    B. Discharge the patient, and tell the patient to take Tylenol when he gets home.
    C. Discharge the patient with instructions to call 911 if he has any problems.
    D. Do not discharge the patient until you have discussed the matter with your nursing manager and are satisfied regarding patient safety.
    D. Do not discharge the patient until you have discussed the matter with your nursing manager and are satisfied regarding patient safety.
    (this multiple choice question has been scrambled)
  93. A practitioner has issued a Do Not Resuscitate (DNR) order for your patient, a fifty-five-year-old man with cancer. You spoke with the patient this morning, and he clearly wishes to be resuscitated in the event that he stops breathing. What is the most appropriate course of action?

    A. Contact the medical licensing board to complain about the practitioner.
    B. Ignore the patient’s wishes because the practitioner ordered the DNR.
    C. Attempt to talk the patient into agreeing to the DNR.
    D. Consult your hospital’s policies and procedures, speak to the practitioner, and discuss the matter with your nurse manager.
    D. Consult your hospital’s policies and procedures, speak to the practitioner, and discuss the matter with your nurse manager.
    (this multiple choice question has been scrambled)
  94. The Health Insurance Portability and Accountability Act (HIPAA) protects which of the following?

    A. A patient’s right to be insured, regardless of employ-ment status or ability to pay
    B. The hospital’s right to disclose protected health information
    C. The nurse’s right to health insurance
    D. The confidentiality of certain protected health information
    D. The confidentiality of certain protected health information
    (this multiple choice question has been scrambled)
  95. Which of the following elements is not necessary for a nurse to be found negligent in a court of law?

    A. The nurse’s intention to be negligent
    B. Physical, emotional, or financial harm to the patient
    C. A breach of that duty or obligation
    D. A duty or obligation for the nurse to act in a particular way
    A. The nurse’s intention to be negligent
    (this multiple choice question has been scrambled)
  96. Which type of law authorizes state boards to enact rules that govern the practice of nursing?

    A. State law
    B. Federal law
    C. Criminal law
    D. Common law
    A. State law
    (this multiple choice question has been scrambled)
  97. You are a new nurse working on a medical-surgical unit. One of your patients, an elderly woman, has an advanced directive that requests that no CPR be done in the event that she stops breathing. One day she stops breathing, and someone on your unit calls a “code” and begins resuscita-tive efforts. You go along with the team and help to resus-citate the patient. She regains a pulse but never regains consciousness. She is now ventilator dependent, and her family is very angry with you and the staff. Which of the following is a potential legal action you will face?

    A. Criminal recklessness
    B. Revoked nursing license
    C. Violation of patient privacy
    D. Battery
    D. Battery
    (this multiple choice question has been scrambled)
  98. 8. Which of the following is not an essential element of a Good Samaritan law?

    A. The health care worker is rendering care without pay.
    B. The care provided did not recklessly or intentionally cause injury or harm to the injured party.
    C. The health care worker is concerned about the safety of the victims.
    D. The care is rendered in an emergency situation.
    C. The health care worker is concerned about the safety of the victims.
    (this multiple choice question has been scrambled)
  99. 9. Some of the situations in which a nurse could be accused of false imprisonment are which of the following? Select all that apply.

    _____ A. Inappropriate use of chemical restraints
    _____ B. Inappropriate use of physical restraints
    _____ C. Restraining a competent person
    _____ D. Failure to follow the institutions policies regarding the type and frequency of restraints
    _____ E. Using restraints in an emergency situation to protect the patient from harm
    • _____ A. Inappropriate use of chemical restraints
    • _____ B. Inappropriate use of physical restraints 
    • _____ C. Restraining a competent person 
    • _____ D. Failure to follow the institutions policies regarding the type and frequency of restraints
  100. The goal of a risk management program in an institution is to do which of the following? Select all that apply.
    _____ A. Identify and correct systemic problems in the facility
    _____ B. Identify when better orientation is needed for staff
    _____ C. Identify issues with equipment and staffing
    _____ D. Punish the person responsible for the error
    _____ E. Reduce legal and financial liability for the institution
    _____ F. Reduce the number of errors made in patient care
    • _____ A. Identify and correct systemic problems in the facility 
    • _____ B. Identify when better orientation is needed for staff 
    • _____ C. Identify issues with equipment and staffing 
    • _____ E. Reduce legal and financial liability for the institution
    • _____ F. Reduce the number of errors made in patient care
  101. Stephanie, the Gen X night shift charge nurse, is requesting more time off than any other charge nurse. What reason for this best represents her generation? She does which of the following?

    A. Wants to increase her leisure time to balance with work
    B. Seeks to be rewarded for time spent at work
    C. Prefers to work the day shift and is hoping for a schedule change
    D. Believes that there are other nurses just as capable to fill her role
    A. Wants to increase her leisure time to balance with work
    (this multiple choice question has been scrambled)
  102. Nurses may fail to meet spiritual needs because of which of the following?

    A. Lack of compassion
    B. Lack of chaplains in the care area
    C. Lack of understanding of the patient’s spiritual beliefs
    D. Lack of knowledge regarding the patient’s illness
    C. Lack of understanding of the patient’s spiritual beliefs
    (this multiple choice question has been scrambled)
  103. During orientation to work on a new unit, the nurse experiences a sense of isolation from his preceptors. Which of the following actions will best increase his socialization into the preceptor group? The nurse should do which of the following?

    A. Study the differences between his values and his preceptor group’s values
    B. Request that his orientation be increased for two more weeks
    C. Ask as many questions as he can
    D. Arrive late for duty frequently
    A. Study the differences between his values and his preceptor group’s values
    (this multiple choice question has been scrambled)
  104. An organization’s workplace culture reflects which of the following?

    A. The cultural affiliations of the staff
    B. The culture of its preceptors
    C. The values and beliefs of the organization
    D. The religion practiced by the hospital’s leadership group
    C. The values and beliefs of the organization
    (this multiple choice question has been scrambled)
  105. The Veteran or Silent Generation may do which of the following?

    A. Value working primarily for the challenge
    B. Use the Internet daily as a part of their life
    C. Value working as one’s duty
    D. Have a speak-your-mind philosophy
    C. Value working as one’s duty
    (this multiple choice question has been scrambled)
  106. Strategies to improve cultural competency skills include which of the following? Select all that apply.

    _____ A. Participation in continuing education offerings about culturally congruent care
    _____ B. Development of culturally competent approaches to care
    _____ C. Talking with patients about their cultural views on health care
    _____ D. Assessing your own skill level and seeking improvements
    _____ E. Talking with staff and colleagues about their cultural views on health
    _____ F. Identifying and reducing ethnocentric bias
    • _____ A. Participation in continuing education offerings about culturally congruent care 
    • _____ B. Development of culturally competent approaches to care 
    • _____ C. Talking with patients about their cultural views on health care 
    • _____ D. Assessing your own skill level and seeking improvements 
    • _____ E. Talking with staff and colleagues about their cultural views on health 
    • _____ F. Identifying and reducing ethnocentric bias
  107. Causes of health care disparities include which of the following? Select all that apply.

    _____ A. Patient health behaviors
    _____ B. Conscious bias
    _____ C. Institutional discrimination
    _____ D. Unconscious bias
    _____ E. Culturally specific provider rapport
    _____ F. Biological variation
    • _____ A. Patient health behaviors 
    • _____ B. Conscious bias 
    • _____ C. Institutional discrimination 
    • _____ D. Unconscious bias 
    • _____ E. Culturally specific provider rapport 
    • _____ F. Biological variation
  108. After shift report, the nurse is preparing to enter the room of patient, Guadalupe González. While reviewing the patient’s chart, the nurse notes that the patient is listed as of “Hispanic/Latino origin.” What is the best way for the nurse to determine which culture Mrs. González identifies with?

    A. Determine her culture by her hair color and skin complexion
    B. Ask the patient which culture she identifies with
    C. Determine her culture by her accent
    D. Determine her culture by her body shape and size
    B. Ask the patient which culture she identifies with
    (this multiple choice question has been scrambled)
  109. A spiritual assessment includes which of the following? Select all that apply.

    _____ A. Prayer needs
    _____ B. Affiliations with religious communities
    _____ C. Medicinal regimes
    _____ D. Coping mechanisms
    _____ E. Pastoral care visits
    • _____ A. Prayer needs 
    • _____ B. Affiliations with religious communities 

    • _____ D. Coping mechanisms 
    • _____ E. Pastoral care visits
  110. A practicing Muslim nurse requests to wear her hijab while on duty. Which of the following actions would be most appropriate?

    A. Review the organization’s dress policy
    B. Decline the request
    C. Advocate for modification of the organization’s dress code
    D. Make the accommodation
    A. Review the organization’s dress policy
    (this multiple choice question has been scrambled)

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