Leadership ATI 2016 - Flashcards

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delegation/supervision

answer

*5 rights* 1. task 2. circumstance 3. person 4. direction and communication 5. supervision and evaluation -based on individual client needs, facility policies and job descriptions, state NPA, professional standards -consider the individual's education, training, and experience -RNs can delegate to: ;;other RNs ;;LPNs ;;APs

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delegating to AP

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-ADLs -bathing -grooming -dressing -toileting -ambulating -feeding without swallowing precautions -positioning -bed making -VS for stable clients -specimen collection -I;O ;;follow facility policies and stage practice guidelines

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right task

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repetitive, requires little supervision, and relatively noninvasive right task: AP to assist pt with bedpan and pneumonia wrong task: delegate AP to administer a nebilizer to a pt with pneumonia

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right circumstance

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-assess health status and complexity of care required by the client -match the complexity of care demands to the skill level of the health care team -consider workload right circustance: delegate to AP to measure VS on stable pt wrong: delegate AP to measure VS on pt who is post-op and received naloxone to reverse respiratory depression

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right person

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-assess and verify competency of the health care team member ;;within scope of practice and necessary competence and training -continual performance reviews right: delegate a LPN to adminster enteral to a client who has a head injury wrong: delegate an AP to adminster enteral feedings to a client who has a head injury

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right direction/communication

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-data that needs to be collected -method and time line for reporting (when to report concerns/findings right: delegate an AP to assist in room X with (something very specific) before X amount of time wrong: delegate an AP to assist with (something nonspecific) in room x

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right supervision/evaluation

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-directly or indirectly -clear directions and expectations -monitor performance -provide feedback -intervene if necessary -evaluate and identify needs for quality improvement activities right: delegate the ambulation of the client and provide positive feedback to the AP after completion of task wrong: delegate the ambulation of a client to an AP without supervision to determine the need for intervntion and failing to provide feedback to the AP

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delegating to LPN

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-monitoring client findings as input for the RNs ongoing assessment of the client -reinforcing client teaching from a standardized care plan -performing tracheostomy care and suction -perform uncomplicated wound care -checking NG tube patency -administering enteral feedings -inserting urinary catheter -administering medications ;;not IV meds

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responding to inappropriate delegation

answer

*DO NOT DELEGATE*: -nursing process -client education -tasks that require clinical judgement to LPNs or APs *CONSIDER*: -predictability of outcome -potential for harm -complexity of care -need for problem solving and innovation -level of interaction with the client

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when a nurse receives an unsafe assignment

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-bring the assignment to the attention of the scheduling/charge nurse and negotiate a new assignment -if unresolved take it up chain of command -file a written protest to the assignment ;;assignment despite objection ;;document of practice situations -failure to accept the assignment without following the proper channels can be considered client abandonment

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inappropriate use of restraints

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*assualt*: threatening to place a NG tube in a pt who is refusing to eat *battery*: restraining a pt and administering an injection against his wishes *false imprisonment*: using restraints on a competent client to prevent his leaving the health care facility

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reporting information to the provider (ch. 2)

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should be fostered to create a climate of mutual respect and collaborative practice *-assessment data integral to changes in client status -recommendations for changes in the plan of care -clarification of prescriptions* *Qualities*: -good communication -assertiveness -conflict negotiation skills -leadership skills -professional presence -decision-making and critical thinking

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Decision-making styles: *decisive*

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the team uses a minimum amount of data and generates one option

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Decision-making styles: *flexible*

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the team uses a limited amount of data and generates several options

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Decision-making styles: *Hierarchical*

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the team uses a large amount of data and generates one option

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Decision-making styles: *integrative*

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the team uses a large amount of data and generates several options

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breach of confidentiality (ch. 3)

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-nurses who disclose client information to an unauthorized person can be liable for invasion of privacy, defamation, or slander -*HIPAA rights of pts* ;;client is able to obtain a copy of their medical record and to submit requests to amend erroneous or incomplete information ;;a requirement for health care and insurance providers to provide written information about how medical information is used and how it is shared with other entities -->permission must be obtained before information is shared >>the pt has the right to privacy and confidentiality

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*components of privacy rule*

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-only healthcare team members directly responsible for the client's care are allowed access to the patients records. >>nurses may not share information with other clients or staff not involved in the patient care -clients have a right to read and obtain a copy fo their medical record, and agency policy should be followed when the client requests to read or have a copy of the record -no part of the client record can be copied except for authorized exchange of documents between health care institutions >>transfer from a hospital to an extended care facility >>exchange of documents between a general practitioner and a specialist during a consult -client records must be kept in a secure area to prevent inappropriate access to information -client information may not be disclosed to unauthorized individuals, including family members who request it and individuals who call on the phone >>many hospitals use a code system in which information is only disclosed to individuals who can provide the code >>nurses should ask any individual inquiring about a client's health status for the code and disclose information only when that code is -communication should only take place in a private setting where it can not be overheard by unauthorized people ;;change of shift reports are to be done at the bedside as long as the patient does not have a roommate and no unsolicited visitors are present ;;*DO NOT* use: -->walking rounds or taped rounds

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referral for home oxygen therapy (ch. 2)

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-begin discharge planning upon the client's admission -evaluate the client/family competencies in relation to home care prior to discharge -involve the client and family in care planning -discharge referrals are based on client needs in relation to actual and potential problems and can be facilitated with the assistance of social services, especially if there is a need for: >>specialized equipment: -->cane, walker, wheelchair, grab bars in bathroom >>specialized therapies

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time management (p. 7)

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*WASTERS*: -documenting at end of shift -making repeated trips to the supply room for equipment -providing care as opportunity arises regardless of other responsibilities -missing equipment when preparing to perform a procedure -being reluctant to delegate or underdelegate -not asking for help when needed or truing to procide all client care independently

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time savers (p. 7)

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-documenting throughout shift -group activities -estimate time needed and plan accordingly -plan non-essential tasks -delegate -complete one task before beginning a second

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client's rights

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-right to be respectful, considerate, and competent care -right to participate fully in the decision-making process -right to accept, refuse, or request modification in the plan of care

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advocacy

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the nurse supports the client in the decisions she makes about her own health care

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responsibility

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the nurse upholds obligations

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accountability

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the nurse answers for personal actions

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confidentiality

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the nurse protects the privacy of the client and her health care information

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quality monitoring tools

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-

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transformation leadership

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gives group members responsibilities that will enhance their professional development

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participative leadership

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*democratic* -serves as a resource person and facilitator and is non-directive -guides staff toward reaching an objective and shares responsibilities with the staff -allows creativity and development of many strategies

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autocratic

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direct and issues commands necessary for *emergency situations* -makes decisions idependently and then notifies the staff of the decisions made -maintains a high degree of control over the staff and allows little freedom of staff members

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laissez-faire

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demonstrates a non-productive approach -exerts little or no leadership and control -

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moral leadership

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involves honesty and fairness under any circumstances

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mandated reporter

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children or older adult clients who are being abused or neglected

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employees that are resistant to change

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realize that if the nurse who must implement the change are not invested in the change process, resistance to change is likely. -problematic when the change is unplanned or imposed by outside forces -resistant staff nurse has likely rejected the change for reasons such as habit, fear of the unknown, and lack of time to learn something new -a meeting between the nurse manager and the staff nurse will allow an open forum for the staff nurse to verbalize the reasons for reluctance to adopt the new policy

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HIPAA

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prohibits disclosing

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6 Essential Components of Leadership

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Knowledge Self-Awareness Communication Energy Goals Action

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5 Phases of the Management Process

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Planning Organizing Staffing Directing Controlling

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3 Management Styles

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Autocratic Laissez-Faire Democratic

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Which is the most effective management style?

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democratic

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Which style of management does the manager not participate in, rather they delegate to the staff to solve the problem?

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laissez-faire

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Which style of management does the manager allow staff to participate in making decisions/unit changes?

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Democratic

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Which style of management is the best for emergency situations?

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Autocratic

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Which style of management makes decisions for staff without their input?

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Autocratic

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Which style of management allows staff to work out conflicts on their own?

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Laissez-faire

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Which style of management is the most time consuming?

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Democratic

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Which style of management puts emphasis on teamwork?

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Democratic

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5 types of power

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Reward Coercive Legitimate Referent Expert

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Which type of power has the ability to control resources?

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Reward

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Which type of power has the ability to inflict aversive outcomes or punishment?

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Coercive

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Which type of power is based on one's position?

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Legitimate

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Which type of power is based on attractive characteristics?

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Referent

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Which type of power is based on expertise or knowledge?

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Expert

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List 10 reportable incidents

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client injury unanticipated client death malfunction of equipment unanticipated adverse reactions inability to meet client needs unethical, illegal, or incompetent practice client/family complaint about care toxic spills, fires, &/or other environmental emergencies violent behavior by client/family loss of pregnancy

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when a professional provides expert advise in a particular area & determines what treatment or services are needed it is called a _________

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consultation

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when a formal request for a special service by another care provider so the client can access special care identified it is called a _______

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referral

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AMA

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If a patient leaves AMA one of the best things you can do is make sure they have a follow-up appointment. This way you are hoping they will continue getting care and the services they need.

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Great Leader

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One point to remember about a great leader is that they usually go by their intuition or gut instinct to make their decisions.

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Consent

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If you are having a patient sign a pre-op form. You are only witnessing that they signed the form, NOT that they understand the procedure. If the patient makes a statement about the procedure that is incorrect, it is then YOUR responsibility to call the physician and have he/she come explain it.

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Nurses First Responsibility

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Nurses first responsibility if to their patients, which sometimes puts you in the middle of a conflict between what the patient wants and what the physician feels is best.

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Abuse

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All healthcare providers are responsible to report any type of abuse.

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Medication Error

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has to be reported and incident report filed. You need to report it to the charge nurse or supervisor and they will help you, but it is your responsibility to make sure the report is written and it is reported.

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Performance Evaluation

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your signature on the evaluation only means you have read it. It doesn't mean you agree with what is stated.

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Chemical Impairment

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When confronted the employee is usually defensive and denies allocations, but it is extremely important that the unit manager confront any suspected employee immediately. Most nurses steal drugs from their place of employment

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Authoritarian

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Strong control is maintained over the work group. Others are motivated by coercion. Others are directed with commands. Communication flows downward. Decision making does not involve others. Emphasis is on difference in status ("I" and "you"). Criticism is punitive

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Democratic

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Less control is maintained. Economic and ego awards are used to motivate. Others are directed through suggestions and guidance. Communication flows up and down. Decision making involves others. Emphasis is on "we" rather than "I" and "you". Criticism is constructive

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Laissez-faire

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Is permissive, with little or no control. Motivates by support when requested by the group or individuals. Provides little or no direction. Uses upward and downward communication between members of the group. Disperses decision making throughout the group. Places emphasis on the group. Does not criticize

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Advocacy

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Helping others to grow and self-actualize. Nurses must advocate for: Themselves, Their clients, Their subordinates, Their profession. Goals of the Advocate: To inform, To enhance autonomy, To respect the decisions of others.

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Ethical Dilemas

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Most difficult. Being forced to choose between two or more undesirable alternatives

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Critical Thinking

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Definition: "the mental process of actively and skillfully conceptualizing, applying, analyzing, synthesizing, and evaluating information to reach an answer or conclusion." More complex than problem solving or decision making. Involves higher-order reasoning and evaluation. Includes both a cognitive and affective component: Insight, Intuition, Empathy, Willingness to take action

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Study of Ethics

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The systematic study of what a person's conduct and actions should be with regard to self, other human beings, and the environment. A system of moral conduct and principles that guide a person's actions. The study of what a person's life and relationships should be.

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Transactional Leader

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Focuses on management tasks. Is a caretaker. Uses trade-offs to meet goals. Does not identify shared values. Examines causes. Uses contingency reward

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Transformational leader

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Identifies common values. Is committed. Inspires others with vision. Has long-term vision. Looks at effects. Empowers others

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Standard

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Predetermined level of excellence that serves as a guide for practice. Have distinguishing characteristics: Predetermined, Established by authority, Communicated to and accepted by the people affected by them.

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Quality control: know the steps

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1. The criterion or standard is determined. 2. Information is collected to determine whether the standard has been met. 3. Educational or corrective action is taken if the criterion has not been met.

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Benchmarking

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The process of measuring products, practices, and services against best-performing organizations.

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A nurse receives a change-of-shift report at 0700 for an assigned caseload of clients. Number the following clients in the order in which they should be seen. A client who has been receiving a blood transfusion since 0400 A client who has an every 4 hr PRN analgesic prescription and who last received pain medication at 0430 A client who is scheduled for a colonoscopy at 1130 and whose informed consent needs to be verified A client who needs rapid onset insulin before the breakfast trays arrive A client who is being discharged today and needs reinforcement of teaching regarding dressing changes.

answer

1. client who has been receiving a blood transfusion since 0400 2. A client who needs rapid onset of insulin before the breakfast trays arrive 3. a client who has an every 4 hr PRN analgesic prescription and who last received pain medication at 0430 4. a client who is scheduled for a colonoscopy at 1130 and whose informed consent needs to be verified 5. a client who is being discharged today and needs reinforcement of teaching regarding dressing changes

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An older adult client who is on fall precautions is found lying on the floor of his hospital room. Which of the following actions is most appropriate for the nurse to take first? A. Call the client's provider. B. Ask a staff member for assistance getting the client back in bed. C. Inspect the client for injuries. D. Ask the client why he got out of bed without assistance.

answer

C

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A nurse is preparing to initiate IV therapy for a client who has a prescription for morphine 10 mg IV bolus. Using time management principles, which of the following actions should the nurse take first? A. Mentally envision the procedure when collecting supplies. B. Enter the room and perform hand hygiene. C. Eject excessive medication from the prefilled syringe D. Explain the procedure to the client

answer

A

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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 LPN? A. Obtaining vital signs for a client who is 2 hr postprocedure following a cardiac catheterization B. Administering a unit of packed red blood cells (RBCs) C. Instructing a client in the performance of wound care D. Developing a plan of care for a newly admitted client

answer

A

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An LPN ending her shift reports to the RN that a newly hired assistive personnel has not calculated the intake and output for several clients. Which of the following actions should the RN take? A. Complete an incident report. B. Delegate this task to the LPN. C. Ask the AP if assistance is needed to complete the I;O records. D. Notify the nurse manager

answer

C

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A nurse manager is developing an orientation plan for newly licensed nurses. Which of the following should the manger include in the plan? (Select all that apply.) A. Skill proficiency B. Assignment to a preceptor C. Budgetary principles D. Computerized charting E. Socialization into unit culture F. Facility policies and procedures

answer

A B D E F

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A nurse manager is providing information about the audit process to members of the nursing team. Which of the following statements should the nurse manager include? (Select all that apply.) A. A structure audit evaluates the setting and resources available to provide care. B. An outcome audit evaluates the results of the nursing care provided. C. A root cause analysis is indicated when a sentinel event occurs. D. Retrospective audits are conducted while the client is receiving care. E. After data collection is completed, it is compared to a benchmark

answer

A B C E

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A nurse is participating in a quality improvement study of a procedure frequently performed on the unit. Which of the following will provide the most relevant information regarding the efficacy of the procedure? A. Frequency with which procedure is performed B. Client satisfaction with performance of procedure C. Incidence of complications related to procedure D. Accurate documentation of how procedure was performed

answer

C

question

A nurse is hired to replace a staff member who has resigned. After working on the unit for several weeks, the nurse notices that the unit manager does not intervene when there is conflict between team members, even when it escalates. Which of the following conflict resolution strategies is the unit manager demonstrating? A. Avoidance B. Smoothing C. Cooperating D. Negotiating

answer

A

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A nurse has received a performance appraisal from the unit manager. Which of the following actions by the unit manager requires intervention? A. The evaluation was conducted in the unit manager's office. B. Data that was collected for the previous 12 months was presented. C. Verbal concerns provided by a staff member were incorporated into the data. D. The nurse was asked to review the performance appraisal tool and complete a self-evaluation.

answer

C

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A nurse is preparing to transfer an older adult client who is 72 hr postoperative from a surgical procedure to a long-term care facility. Which of the following should the nurse include in the transfer report? (Select all that apply). A. Type of anesthesia used B. The client's advance directives status C. The client's vital signs on day of admission D. The client's medical diagnosis E. Need for special equipment

answer

B D E

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A nurse is participating in an interprofessional conference for a client who has a recent C6 spinal cord injury. The client worked as a construction worker prior to his injury. Which of the following members of the interprofessional team should also participate in planning care for this client? (Select all that apply). A. Physical therapy B. Speech therapy C. Occupational therapist D. Psychologist E. Vocational counselor

answer

A C D E

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A nurse manager is working with a committee of nurses whose task is to update the policies for new employee orientation. The nurse manager directs the team to collect as much data as possible and recommend several options. Which of the following decision-making styles is being demonstrated by the nurse manager? A. Decisive B. Flexible C. Hierarchical D. Integrative

answer

D

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A nurse who has just assumed the role of unit manger is examining her skills in interprofessional collaboration. Which of the following actions support interprofessional collaboration? (Select all that apply.) A. Use aggressive communication when addressing the team. B. Recognize the knowledge and skills of each member of the team. C. Ensure that a nurse is assigned to serve as the group facilitator for all interdisciplinary meetings. D. Encourage the client and family to participate in the team meeting. E. Support team member requests for referral.

answer

B D E

question

A nurse on a telemetry unit is caring for a client who was admitted 2 hr ago and has chest pain. The client becomes angry and tells the nurse that there is nothing wrong with him and that he is going home immediately. The nurse should base her actions on which of the following? (Select all that apply.) A. The nurse should notify the risk manager immediately. B. In the event the client leaves the hospital without a discharge order, the nurse should document that the client left the facility "against medical advice" (AMA). C. It is the nurse's responsibility to explain to the client the risks involved if he chooses to leave. D. Most facilities have a form that clients are asked to sign if they leave the facility prior to discharge. E. A nurse who tries to prevent a client from leaving the hospital may be faced with legal charges.

answer

B C D E

question

A nurse manger is observing the actions of a nurse she is supervising. Which of the following actions by the nurse requires the nurse manager to intervene? (Select all that apply.) A. Reviewing the health care record of a client assigned to another nurse B. Making a copy of a client's most current laboratory results for the provider during rounds C. Providing information about a client's condition to hospital clergy D. Discussing a client's condition over the phone with an individual who has provided the client's information code E. Participating in walking rounds that involve the exchange of client-related information outside clients' rooms

answer

A B C E

question

A nurse is caring for a client who is being prepared for surgery. The client hands the nurse information about advance directives and states, "Here, I don't need this. I am too young to worry about life-sustaining measures and what I want done for me." Which of the following actions should the nurse take? A. Return the papers to the admitting department with a note stating that the client does not wish to address the issue at this time. B. Explain to the client that you never know what can happen during surgery and that he should fill the papers out "just in case." C. Contact a client representative to talk with the client and offer additional information about the purpose of advance directives. D. Inform the client that surgery cannot be conducted unless he completes the advance directives forms.

answer

C

question

A nurse is serving as a preceptor to a newly licensed nurse and is explaining the role of the nurse as advocate. Which of the following situations illustrates the advocacy role? (Select all that apply.) A. Verifying that a client understands what is done during a cardiac catheterization B. Discussing treatment options for a terminal diagnosis C. Informing members of the health care team that a client has do-not-resuscitate status D. Reporting that a health team member on the previous shift did not provide care as prescribed E. Assisting a client to make a decision about his care based on the nurse's recommendations

answer

A C D

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A nurse manager is providing information to the nurses on the unit about ensuring client rights. Which of the following outlines the rights of individuals in health care settings? A. American Nurses Association Code of Ethics B. HIPAA C. Patient Self-Determination Act D. Patient Care Partnership

answer

D

question

A nurse is reviewing a client's health care record and discovers that the client's do-not-resuscitate (DNR) order has expired. The client's condition is not stable. Which of the following actions should the nurse take? A. Assume that the client does not want to be resuscitated, and take no action if she experiences cardiac arrest. B. Write a note on the front of the provider order sheet asking that the DNR order be reordered. C. Anticipate that CPR will be instituted if the client goes into cardiopulmonary arrest. D. Call the provider to determine whether the order should be immediately reinstated.

answer

D

question

A toddler is being treated in the emergency department following a head contusion from a fall. History reveals the toddler lives at home with only her mother. The provider's discharge instructions include waking the child up every hour during the night to assess for indications of a possible head injury. In which of the following situations should the nurse intervene and attempt to prevent discharge? A. The mother states she does not have insurance or money for a follow-up visit. B. The child states her head hurts and she wants to go home. C. The nurse smells alcohol on the mother's breath. D. The mother verbalizes fear about taking the child home and requests she be kept overnight.

answer

C

question

A newly licensed nurse is preparing to insert an IV catheter in a client. Which of the following sources should the nurse use to review the procedure and the standard at which it should be performed? A. Web site B. Institutional policy and procedure manual C. More experienced nurse D. State nurse practice act

answer

B

question

A nurse witnesses an assistive personnel (AP) under her supervision reprimanding a client for not using the urinal properly. The AP threatens to put a diaper on the client if he does not use the urinal more carefully next time. Which of the following torts is the AP committing? A. Assault B. Battery C. False imprisonment D. Invasion of privacy

answer

A

question

A home health nurse is assessing the safety of a client's home. Which of the following factors may increase the client's risk for falls? (Select all that apply.) A. History of a previous fall B. Reduced vision C. Impaired memory D. Takes rosuvastatin (Crestor) E. Wears house slippers F. Kyphosis

answer

A B C E F

question

A client is brought back to the unit after a total hip arthroplasty. The client is confused, is moving his leg into positions that could dislocate the new hip joint, and he repeatedly attempts to get out of bed. Which of the following actions should the nurse take? (Select all that apply.) A. Apply arm and leg restraints immediately. B. Get an order from the provider. C. Have a family member sign the consent for restraints. D. Use a square knot to secure the restraints to the bed frame. E. Ensure that only one finger can be inserted between the restraint and the client

answer

A B C

question

A nurse is observing a newly licensed nurse and an assistive personnel (AP) pull a client up in bed using a drawsheet. Which of the following actions by the newly licensed nurse indicates a need for further education? A. The nurse spreads his legs apart. B. The nurse uses his body weight to counter the client's weight. C. The nurse's feet are facing inward, toward the center of the bed. D. The nurse uses the muscles in his arms to lift the client off the bed using the drawsheet.

answer

C

question

An assistive personnel (AP) reports that a client's finger-stick blood glucose reading 30 min before lunch is 58 mg/dL. The client's morning finger-stick blood glucose was 285 mg/dL. The client is asymptomatic for hypoglycemia, and his next dose of insulin is scheduled to be administered at this time. Which of the following actions should the nurse take first? A. Recalibrate the glucometer, and recheck the client's blood glucose. B. Have the laboratory draw a stat serum glucose. C. Inform the AP to give the client 120 mL of orange juice. D. Administer insulin as prescribed.

answer

A

question

A staff nurse is reviewing the hospital's fire safety policies and procedures with newly hired assistive personnel. The nurse is describing what to do when there is a fire in a client's trash can. Which of the following statements should the nurse include? (Select all that apply.) A. The first step is to pull the alarm. B. Use a Class C fire extinguisher to put out the fire. C. Instruct ambulatory clients to evacuate to a safe place. D. Pull the pin on the fire extinguisher prior to use. E. Close all doors.

answer

C D E

question

A nurse discovers that a client was administered an antihypertensive medication in error. Number the following actions in the appropriate sequence that the nurse should follow. A. Call the client's provider. B. Monitor the client's vital signs. C. Notify the risk manager. D. Complete an incident report. E. Instruct the client to remain in bed until further notice.

answer

1. Monitor the client's vital signs. 2. Instruct the client to remain in bed until further notice. 3. Call the client's provider. 4. Complete an incident report. 5. Notify the risk manager.

question

A nurse manager is explaining the use of incident reports to a group of nurses in an orientation program. Which of the following statements should the nurse manager include? (Select all that apply.) A. A description of the incident should be documented in the client's health care record. B. Incident reports should not be shared with the client. C. Incident reports include a description of the incident and actions taken. D. A copy of the incident report should be placed in the client's health care record. E. The risk management department investigates the incident.

answer

A B C E

question

An individual approaches the door of the maternal newborn unit, states that he is the uncle of a newborn, and asks to be admitted to the unit. Which of the following actions should the nurse take? A. Admit the individual after he provides the mother's full name and the date and time of the infant's birth. B. Call security to remove the individual from the area. C. Instruct the individual to obtain the access code from the family and then return. D. Call a Code Pink because the man could be attempting to abduct the infant

answer

C

question

A community experiences an outbreak of meningitis, and hospital beds are urgently needed. Which of the following clients should the nurse recommend for discharge? A. 58-year-old man admitted this morning with angina and a history of a coronary artery bypass grafting (CABG) 1 year ago B. 50-year-old adult with type 2 diabetes mellitus being admitted for rotator cuff surgery C. 70-year-old adult admitted yesterday with pneumonia and dehydration D. 65-year-old woman who fell and broke her hip and is scheduled for total hip replacement tomorrow

answer

B

question

A nurse on a sixth-floor medical surgical unit is advised that a severe weather alert code has been activated. Which of the following actions should the nurse take? (Select all that apply.) A. Draw window shades and close drapes as protection against shattering glass. B. Move beds of nonambulatory clients away from windows. C. Relocate ambulatory clients into the hallways. D. Use the elevators to move clients to lower levels. E. Turn the radio on for severe weather warnings

answer

A B C E

question

Factors that influence healthcare planning

answer

1. Value vs. volume 2. Revenue Management vs Cost Management 3. Physician Integration 4. Population Health 5. Illness care vs. Wellness care 6. Complementary and Alternative medicine 7. Intraprofessional collaboration 8. Patient centered care 9. EHR - portability of health information 10. Expert networks 11. Robotics 12. Biomechatronics 13. Biometrics 14. Point of Care Testing 15. Home Care (Telehealth) 16. Internet 17. Increased demand for RNs 18. Aging workforce 19. Improving economy 20. Nursing Education

question

Time Management Pinciples

answer

Making optimal use of available time: Prioritizing duties, Managing and controlling crises, Reducing stress and Balancing work and personal life

question

time wasters

answer

1. Technology - find balance 2. Socializing a. Don't make self overly accessible b. Interrupt to encourage directness c. Avoid promoting socialization d. Be brief e. Schedule long-winded pests 3. Paper-work Overload 4. Poor filing system

question

strategic planning process

answer

Examines purpose, mission, philosophy and goals in the context of its external environment - SWOT Analysis and Balanced Scorecard Management Process: 1. Clearly defined purpose 2. Establish consistent, realistic goals and objectives 3. Identify stakeholders 4. Communicate goals and objectives 5. Sense of ownership 6. Strategies for goal achievement 7. Effective use of resources 8. Method of measuring progress 9. Informed change as needed 10. Consensus about organizational direction

question

change strategies

answer

1. Rational-empirical strategies 2. Normative-reeducative strategies 3. Power-coercive strategies

question

barries to change

answer

needs to be Expected and Factors influencing: a. Personal values b. Educational levels c. Sociocultural background d. Experience with change e. Risk taking propensity/Life history

question

the goals of healthcare reform

answer

Provide universal access to healthcare for Americans Control the rising costs of healthcare Regulate the private insurance industry through things like state-based private exchanges - an online marketplace that brings together state-approved insurance plans from multiple companies so consumers can shop for individual insurance plans Improve the quality of healthcare Make healthcare choices more consumer friendly and easier to understand.

question

budgeting

answer

Budget - financial plan including estimated expenses and income for a period of time. Types: a. Fixed expenses - do not vary with volume b. Variable expenses - vary with volume c. Controllable expenses - controlled by manager d. Non-controllable expenses - no control by manager i. Additional Budget Terminology Display 10.2,p. 206-207

question

NCHPPD

answer

NCH/PPD = Nursing hours worked in 24 hours/ patient census

question

Career development

answer

1. Reduces employee attrition 2. Provides equal employment opportunity 3. Improves use of personnel 4. Improves quality of work life 5. Improves competitiveness of the organization 6. Avoids obsolescence/builds new skills 7. Promotes EBP!!!!!

question

the hiring process

answer

1. Interviewing 2. Selection 3.Placement 4. Indoctrination (Display 15.6, p. 355) a. Planned guided adjustment of an employee to the organization and the work environment

question

nursing shortage

answer

Caused By: Changes in reimbursements, Quality and safety movement and National and local economics Typically a nursing shortage increases with robust economy, decreases with receding economy

question

nursing turnover

answer

Benefits: Fresh thinking and Reduces groupthink Costs: Human resources, Recruitment fees, Use of travel nurses/agency nurses, Overtime, Lost productivity and Training time and expense

question

interviewing

answer

Purpose is Determination of applicant's suitability for the position, Applicant determines if they want to work for the organization and Maintaining respect and goodwill regardless of the outcome. Types of interviews: Unstructured, Semi-structured, Structured

question

staff education

answer

Benefits: Employee competence and productivity are unit level issues and Socialization is a unit level issue Difficulties: Role ambiguity between education staff and manager, Limited accountability for quality and outcomes of activities and Lack of cost-effective evaluation Overcoming: Clear communication and follow up - understanding of accountability, Input from nursing unit if education is not administered by nursing, Educational advisory committe, and Track cost and benefit of each program

question

transition to practice

answer

i. Internships ii. Residencies iii. Fellowships

question

role development

answer

Cost-effective way to increase productivity, Training: Providing employees with the knowledge and skills to perform a specific duty of a job, Evaluation of training needs: Ask, Watch,and Education. Global development of employees

question

staffing mandates

answer

Pro's: Protect patients and nurses, Increase patient safety, Improved patient outcomes Con's: Band-aid cure for quality of care issues caused by nursing shortage, Numbers ? quality, Don't account for acuity, Costs keep employers from responding to market forces and innovations

question

staff selection

answer

including IOM 80/20 recommendation

question

creating a motivating climate

answer

1. Understand employee values 2. Devise a reward system that is consistent 3. Recognize each worker as uniquely motivated and act on those differences 4. Generational differences 5. Positive reinforcement 6. Consistency 7. Predictable and spontaneous

question

communication - individual, group and organizational

answer

INDIVIDUAL: 1. Assertive communication- Use of "I" statements, Verbal and nonverbal message are congruent, Conveying a message that insists on being heard AND Respectful of the receiver 2. Passive communication - Silence when the person has a message 3. Aggressive communication - Direct and hostile 4. Passive-aggressive communication - Aggressive message delivered in a passive way GROUP: Forming - Relationships formed, expectations defined, directions given. Storming - Competition and attempts to establish individual identities. Norming - Establish rules and design work. Performing - Work gets done. Termination or closure ORGANIZATIONAL: 1. Assess organizational communication 2. Understand structure and who will be affected by decisions: Formal networks AND Informal networks 3. Communication is a two way channel 4. Must be clear, simple and precise 5. Seek feedback regarding accurate reception of message 6. Use multiple communication methods for important messages 7. Don't overwhelm people with unnecessary information

question

group roles

answer

a. Initiator b. Information seeker c. Information giver d. Opinion seeker e. Elaborator f. Coordinator g. Orienter h. Evaluator i. Energizer j. Procedural technician k. Recorder

question

HIPAA

answer

Communication, Confidentiality and HIPAA 1. Legitimate professional need to know 2. Meaningful use HIPPA violation to tell someone where another patient is if they do not have authorization to know this information. Be careful where you are talking about patients and who might overhear you say something.

question

Delegation

answer

Strategies for Successful Delegation: 1. Plan ahead 2. Match the task to the education and skill level of the person 3. Select capable people 4. Communicate goals clearly 5. Empower the delegate 6. Set deadlines and monitor progress 7. Monitor the role and provide guidance 8. Evaluate performance 9. Reward accomplishment

question

conflict

answer

1. Internal or external discord that results from differences in ideas, values, or feelings between two or more people. 2. Can occur when there are differences in economic and professional values and with competition among professionals 3. Other sources: scarce resources, restructuring and poorly defined role expectations 4. Conflict can produce growth or destruction depending on how it is managed 5. Some level of conflict in an organization is desirable; optimum level unknown

question

unionization

answer

to organize into a labor union; bring into or incorporate in a labor union. Current conditions in health care invite unionization.

question

incivility

answer

rude or unsociable speech or behavior. an impolite or offensive comment.

question

bullying

answer

use superior strength or influence to intimidate (someone), typically to force him or her to do what one wants.

question

aggression

answer

hostile or violent behavior or attitudes toward another; readiness to attack or confront. the action of attacking without provocation, especially in beginning a quarrel or war. forceful and sometimes overly assertive pursuit of one's aims and interests.

question

LPN delegation

answer

monitoring client findings (as input to the RN's ongoing assessment of the client) reinforcement of client teaching from a standard car plan tracheostomy care suctioning checking nasogastric tube patency administration of enteral feeding insertion of a urinary catheter medication administration (exlcuidng intravenous medications in several states)

question

AP delegation

answer

activities of daily living (ADLs) -bathing -grooming -dressing -toileting -ambulating -feeding (without swallowing precautions) -positioning -bed making specimen collection intake and output (I&O) vital sign (on stable clients)

question

Living will

answer

what are the patient's wishes. Care is provided to keep the patient comfortable. Clarify patients concern's or wishes

question

Time management

answer

important to help new RN's with time management and encourage them not to leave big tasks to the end of the shift.

question

informed consent

answer

signed component by a competent adult

question

implied consent

answer

consent when client with complies with instructions provided by the nurse

question

Patient has question about a procedure

answer

it is your responsibility to inform physician.

question

Incident report

answer

notify charge nurse/supervisor, write report, does not go in the patients chart.

question

Restraints

answer

if there is not an order you have to remove them immediately

question

Medication error

answer

incident report has to be written

question

Not able to contact physician

answer

report to supervisor after 30 minutes.

question

Medication error

answer

incident report has to be written

question

individuals who can grant consent for another person

answer

parent of a minor legal guardian court specified representative spouse of closest available individual who has durable power of attorney for HC (emancipated minors can provide for themselves)

question

Client role in informed consent

answer

client must: give it voluntarily be competent and of legal age or be emancipated receive sufficient information to make a decision based on an informed understanding of what is expected

question

nurse role in informed consent

answer

witness ensure the provider gave the necessary info ensure the client understood and is competent have the client sign notify provider if client has more questions or does not understand documenting: reinforcement of info originally given by provider, questions from client were forwarded to provider, use of an interpreter

question

advance directive

answer

communicates clients wishes regarding end of life care if client cannot do so 2 components: living will ; durable power of attorney

question

discharging in an emergency

answer

ambulatory clients requiring minimal care go first clients requiring assistance are next clients who are unstable or require nursing care should not be discharged

question

What type of strategy is being used during collaboration, mediation and negotiation?

answer

All three are conflict resolution strategies

question

A nurse manager is presenting an in-service about preventing readmission of clients due to complications after joint replacement surgery. Which leadership task is the nurse performing?

answer

Advocacy: The nurse acts as an advocate by promoting and protecting safety for staff and clients by providing information that allows staff to act autonomously.

question

The RN has assigned an LPN to perform routine wound irrigation, is this appropriate?

answer

Routine wound irrigation is in an LPN's scope of practice..in addition LPN's can reinforce teaching, but the initial teaching must be completed by the RN. FYI. LPNS can administer enteral feedings.

question

Why do nurse case managers use critical pathways in the planning of patient care?

answer

They are used to implement evidence-based strategies for patients with a common diagnosis to promote cost-effective care.

question

Is it appropriate for a nurse manager to assign LPN's to initiate care to class II (yellow tag) patients?

answer

No - Class II clients require treatment within 30min - 2 hours. These patients also need an initial assessment which is not with an LPN's scope of practice. LPN's are allowed to provide care for class III (green tag) patients who have non-urgent and minor injuries.

question

Why should a nurse report a postoperative patient who has a urine output of 20 ml/hr?

answer

it is important to report because the patient is at risk for acute kidney injury

question

True/false. A family member of a client can have the living will overturned in some cases.

answer

true..family members have the right to question the mental capacity at the time a living will was completed

question

what do you do if a client is refusing surgery and is leaving against medical advise (what is the first thing)

answer

Inform the client about the risks she may encounter by leaving the facility

question

What should the nurse do if a client's IV infused over 6 hr instead of 8 hr

answer

fill out an incident report

question

a client who has developed slurred speech should be assessed first because...

answer

this may indicate a CVA--which means that this pt is unstable and should be assesssed first

question

Collaboration is ____

answer

a conflict resolution strategy

question

What is an important follow up for a patient who is on warfarin?

answer

schedule follow-up tests for PT and INR

question

Chlamydia should be

answer

reported to state health department

question

a patient who has been vomiting x 3 days is at highest risk for

answer

potassium imbalance

question

What are the rights of a nursing home patient?

answer

right to be treated w/ dignity and respect. Right to refuse medicaitons. right to leave regardless of provider recommendations. right to be fully informed of their health conditions.

question

Patients who have restraints must have

answer

a provider prescription in the medical record for the restraints

question

Restraints

answer

Nursing Interventions for restraints Implement non-pharmacological measures such as a distraction, frequent observation, or diversion Prior to application, review manufacturers instructions for correct application. Notify health care provider immediately when restraints are implemented. Remove the restraints and assess client q 2 hrs. Assess neuro vascular and neuro sensory status q 2 hrs. Leave the restraint loose enough to prevent injury. Always tie the restraint loose enough to prevent injury. Always tie the restraint to the bed frame Reassess the need for continued use.

question

In an emergency triage crisis...LPN's can care for which clients?

answer

green tag (class III)..these are non-urgent minor injuries

question

what is advocacy?

answer

Advocacy refers to nurses role in supporting clients by ensuring that they are properly informed, that their rights are respected and that they are receiving the proper level of care.

question

Situations in which nurses may need to advocate for clients:

answer

End of life decisions Access to health care Protection of client privacy Informed consent Substandard practice

question

Is collaboration a win-win solution

answer

YES -It is a form of conflict resolution resulting in a win-win for both pt and health care team

question

this is a conflict resolution strategy where one party attempts to ____ another party by trying to satisfy the other party. Often used to maintain or preserve a peaceful work environment.

answer

smoothing

question

admissions can only be performed by

answer

RN's

question

Can LPN's collect a sterile specimen from a wound?

answer

yyes

question

Airborne precautions require:

answer

Private room Masks and respiratory protection Negative pressure airflow exchange in the room of at least 6 to 12 exchanges per hour. Examples: Measles, varicella, Turburculosis

question

Droplet precautions require:

answer

Private room with other clients with same disease Masks ex.: Pneumonia, Influenza,rubella, mumps, meningococcal pneumonia

question

Contact precautions

answer

Private room w/ same pts Gloves and gowns worn ex. Respiratory syncytial virus (RSV), wound infections (MRSA), herpes simplex, impetigo, scabies,active herpes simplex lesions

question

Advance directives

answer

The purpose of advance directives is to communicate a client's wishes regarding end-of-life care should the client become unable to do so. The Patient Self-Determination Act (PSDA) requires that all clients admitted to a health care facility be asked if they have advance directives

question

DNR

answer

Unless a "do not resuscitate" (DNR) or "allow natural death" (AND) order is written, the nurse initiates cardiopulmonary resuscitation (CPR) when the client has no pulse or respirations. The written order for a DNR or AND must be placed in the client's medical record. The provider consults the client and the family prior to administering a DNR or AND.

question

Nursing interventions for radiation seeds

answer

Private room, sign on door (radiation exposure), Visitors can't stay more than 30 min and must stay 6 ft away, wear badge that records amt of radiation exposure

question

smoothing

answer

-one party attempts to "smooth" the other party, decreasing the emotional component of the conflict -often used to preserve or maintain a peaceful work environment -the focus may be on what is agreed upon, leaving conflict largely unresolved -usually a lose-lose situation

question

What are examples of things that require an incident report?

answer

medication errors, procedure/treatment errors, equipment-related injuries/errors, needlestix, client falls/injuries, visitor injuries, threat made to client or staff, loss of property (dentures...)

question

what are examples of unintentional torts?

answer

negligence (didn't implement safety precautions) or malpractice (medication error)

question

What is required for a patient to sign their own informed consent

answer

They must be a competent adult who is capable for understanding the information and must be fully able to communicate in return with the provider (an interpretor must be available in a language barrier situation)

question

the quality improvement process begins with

answer

identification of standards and outcome indicators based on evidence.

question

what are benchmarks?

answer

goals that are set to determine at what level the outcome indicators should be met (for example a specific percentage)

question

what is the PSDA?

answer

The Patient Self-Determination Act (PSDA) stipulates that on admission to a health care facility, all clients must be informed of their right to accept or refuse care. Competent adults have the right to refuse treatment, including the right to leave a health care facility. The Patient Self-Determination Act (PSDA) requires that all clients admitted to a health care facility be asked if they have advance directives.

question

An assertive approach..

answer

required that the nurse manager take some direct action to help resolve the situation. -Assertive behavior involved discusing a situation directly with the person(s) involved.

question

Lithium carbonate toxicity

answer

Poor coordination is an advanced sypmtome of lithium carbonate toxicity. Mental confusion and coarse tremors are also associated with lithium levels of 1.5-2.0 mEq/L. This is the PRIORITY

question

Planning

answer

The actual writing of an expected outcome is done in the planning phase of the nursing care plan. During panning, the nurse establishes goals and outcomes for the client and selects the interventions that will help achieve those goals and outcomes. Planning also involves setting care priorities.

question

Evaluation

answer

Evaluation is the portion of the nursing process where the nurse uses critical thinking skills to determine whether application of the nursing process and implementation of the treatment plan have resulted in an improvement in the client's status.

question

Analyzing

answer

Analysis/diagnosis is the portion of the nursing process where the nurse uses critical thinking skills to identify the client's health status or problems, interpret data, reach a nursing judgment about the client's health status and coping mechanisms, and provide direction for nursing care.

question

Assessment

answer

Assessment is the portion of the nursing process where the nurse uses critical thinking skills to collect subjective and objective data about the client to help plan the appropriate interventions.

question

What does an incident report contain?

answer

The incident report should contain the client's name, age, and diagnosis. The report should contain a factual description of the incident, any injuries experienced by those involved, and the outcome of the situation

question

Who can give tracheostomy care?

answer

An RN may delegate the task of performing tracheostomy suctioning for a client who is stable or whose tracheostomy is not new to the LPN. This task is within their scope of practice.

question

What CAN NOT be delegated by the RN?

answer

RNs cannot delegate the nursing process, client education, or tasks that require nursing judgment to LPNs.

question

Hospice care

answer

Hospice care is only appropriate for ac client who has at terminal illness who has less than a 6-month life expectancy.

question

Adult day care

answer

Adult day care personnel can provide constant assistance with ADLs while the family member is at work; the client can live at home during the night and evening hours.

question

An assisted-living facility

answer

Clients have to be able to perform ADLs to be in an assisted living situation.

question

What does informed consent imply?

answer

That the client has all the information necessary to decide on treatment. It is the client's agreement for the health care team to proceed with the specified treatment based on awareness of risks, benefits, other treatment options, and the expected outcomes of refusing the treatment.

question

palliative care

answer

aims to keep the client comfortable without aggressive therapy. It is focused on managing symptoms, not on curing the disease.

question

What happens if you have a medication error that causes hypotension? What do you do?

answer

-take vitals -make sure the client calls for assistance before getting out of bed. -notify the provider -complete an incident report -notify risk manager

question

veracity

answer

the principle of veracity refers to telling the truth. This situation describes the nurse truthfully informing the client about the diagnosis.

question

case management model

answer

collaboration between disciplines to create a multidisciplinary care plan for each client

question

compartment syndrome

answer

tingling, numbness, pallor, paresthesia, and pain.

question

When is informed consent not needed?

answer

In general, there are two situations in which informed consent of an adult client is not needed. One is when an emergency is present and delaying treatment for the purpose of obtaining informed consent would result in injury or death to the client. The second is when the client waives the right to give informed consent. Option 1 will delay emergency treatment, and option 2 is inappropriate. Although option 4 may be pursued, it is not the best action.

question

living will

answer

Living wills, also known as natural death acts in some states, are required to be in writing and signed by the client. The client's signature must be witnessed by specified individuals or notarized. Laws and guidelines regarding living wills vary from state to state, and it is the responsibility of the nurse to know the laws. Many states prohibit any employee, including the nurse of a facility where the client is receiving care, from being a witness.

question

Defamation

answer

Defamation is a false communication or a careless disregard for the truth that causes damage to someone's reputation, either in writing (libel) or verbally (slander). An assault occurs when a person puts another person in fear of a harmful or an offensive contact. Negligence involves the actions of professionals that fall below the standard of care for a specific professional group.

question

What happens if a nurse questions a HCP prescription?

answer

If the HCP writes a prescription that requires clarification, the nurse's responsibility is to contact the HCP. If there is no resolution regarding the prescription because the HCP cannot be located or because the prescription remains as it was written after talking with the HCP, the nurse should contact the nurse manager or nursing supervisor for further clarification as to what the next step should be. Under no circumstances should the nurse proceed to carry out the prescription until obtaining clarification.

question

Types of leadership

answer

The autocratic leader is focused, maintains strong control, makes decisions, and addresses all problems. The autocrat dominates the group and commands, rather than seeks suggestions or input. In this situation, the manager addresses a problem (quality improvement) with the staff, designs a plan without input, and wants all problems reported directly back to her. A situational leader will use a combination of styles, depending on the needs of the group and the tasks to be achieved. The situational leader would work with the group to validate that the information that the leader gained as a new employee was accurate and that a problem existed. Then, the leader would take the time to get to know the group and determine which approach to change (if needed) would work best according to the needs of the group and the nature and substance of the change that was required. A democratic leader is participative and would likely meet with each staff person individually to determine the staff member's perception of the problem. The democratic leader would also speak with the staff about any issues and ask the staff for input with developing a plan. A laissez-faire leader is passive and nondirective. The laissez-faire leader would state what the problem was and inform the staff that the staff needed to come up with a plan to "fix it."

question

What CAN LPN's do?

answer

LPNs may reinforce teaching, give PO meds, and perform some higher level skills like dressing changes or suctioning, but should not be assigned the care of unstable patients.

question

What CAN AP's do?

answer

They can take vital signs, perform ADLs and range of motion exercises. They can also give enemas, obtain urine specimens, and perform blood glucose monitoring. They cannot perform higher level skills unless they have special certificates.

question

Botulism toxin

answer

-symptoms: ptosis, dysphagia, descending paralysis, difficulty breathing. -Botulinum toxin can be absorbed through the GI or respiratory tract, but not through the skin. it is highly toxic.

question

Pneumonic plauge

answer

-usually presents with fever, weakness and rapid on set pneumonia with shortness of breath, cough, chest pain, and sometimes bloody sputum. Nausea and abdominal pain may occur. Without early intervention, pneumonic plague will usually cause respiratory failure, shock, and rapid death.

question

Inhalation Antrhax

answer

-occurs when a person inhales spores that are aerosolized, though it may be transmitted cutaneously as well if they come in direct contact with the spores.

question

manager confronts a nurse with smell of alcohol on her breath. which action to take?

answer

set up formal meeting within 24 hr

question

client requests pain med. nurse fulfills a promise to return with med in 15 min. nurse demonstrates which ethical principle

answer

fidelity

question

adverse effects after a new med. which communication tool for complication

answer

SBAR

question

urgent care nurse pain assessment not to policy. take which action

answer

report this issue to the nurse manager

question

potassium 3.2, been paging provider for 1hr to report. which intervention next

answer

notify nursing supervisor

question

assign AP which task

answer

suction a clients trach

question

informed consent prior to

answer

receiving moderate sedation

question

pt has dnr. AP understands when states...

answer

"i will call for the clients nurse to come to the room if i cannot detect a pulse"

question

charge nurse orienting new nurse. understands when..

answer

"after i finish with the printout of my assignment i will put it in the shredder

question

nurse planning DC for stroke. which intervention

answer

advise client to install grab bars in her bathroom at home

question

frayed cord of infusion pump. take which action

answer

Report the pump...

question

long term facility transferring to acute care facility. include what info in paper work

answer

list of current medications

question

charge nurse supervising several clients which require intervention

answer

studen tnurse photocopying...

question

nurse caring for four clients. which priority

answer

client with PVD and absent pulse

question

staff not answering call light promplty

answer

ask the client to verbalize his expectations

question

planning care for client who has dementia

answer

placing client in a room near the nurses station

question

UTI quality improvement

answer

establish best practice guidelines for reducing the incidence of UTIs

question

AP qualified

answer

review the APs skill competency checklist

question

change of shift 4 clients

answer

miss graves needs pain reassed

question

tubal ligation, uncertain

answer

discuss the clients feelings about the procedure

question

committee for discharge

answer

determine goals and objectives

question

mental health mechanical restraints

answer

i should request the provider to examine the client within 1 hour of applying mechanical restraints

question

arguing about restock

answer

i would like for you to approach the ap to resolve the problem

question

time management skills

answer

groups tasks that are in the same location

question

no ortho experience

answer

client who had a right above knee amp 24 hr ago

question

safe use of wheelchair

answer

raise footplates before transferring

question

external disaster plan activated

answer

identify stable patients for transfer to surg unit

question

smoke from wastebasket

answer

transported client to hallway

question

charge managing conflict...

answer

you always complete your work on time and do a great job.....

question

caring following stem cell

answer

place clients in positive pressure airflow rooms

question

decrease rate of pressure ulcers

answer

compare data from clients records regarding skin integrity

question

sterile dressing change

answer

the nurse places the sterile package with the top flap opening away from her

question

reflects intrapersonal conflict

answer

im not sure whether i want to apply for unit manager or start a family

question

delegating unit short staffed. wound irrigation

answer

assign procedure to LPN

question

outpatient surgery gave consent

answer

ask the client to explain the procedure that is being performed

question

joint repacement surgery

answer

advocacy

question

planning daily work priority

answer

assign client care to staff

question

discharged with post op infection, PICC

answer

ensure that home infusion therapy has been arranged

question

nurse receiving report on four clients

answer

Potassium 6.5

question

difficulty buttoning her clothes

answer

occupational therapy

question

morning lab results, exhibit

answer

obtain a cap blood glucose reading

question

nurse has arrived late

answer

issue informal verbal give nurse formal suspend without pay terminate employement

question

clinical pathway following hip arthroplasty

answer

length of clients stay

question

abdominal pain admitted

answer

completing the clients initial admin assessment

question

18 yr old rhabdomyosarcoma

answer

the nurse states i can gather info about palliative care

question

client rights understanding of teacing

answer

clients on mental health unit can refuse meds

question

ER perfomring triage after MVC

answer

arm contusions and asym thoracic movement

question

delegate to ap

answer

measuring I&O

question

staff looking atEMR for celeb

answer

remind staff this is a breach of confidentiality

question

COPD receiving oxygen

answer

an office chair oxygen tank on floor throw rug over vinyl

question

restraints to combative

answer

quick release tie to secure restraint

question

2 hr postop following chole

answer

recheck the clients BP

question

right direction of communication

answer

tell me what time the client in 205 voids for the first time after cath removal

question

four clients who's priority

answer

adult client femur fracture SOB

question

poor attendence

answer

explore reasons staff are not attending

question

breast cancer otions

answer

lets talk about benefits of each

question

VAP

answer

notify quality improvement team

question

cancer and vomits blood

answer

mop the floors with a bleach solution

question

advance directives

answer

this means i have outlines my wishes for med treatments

question

community health clinic communicable diseases. nationally infection disease

answer

chlamydia

question

What do you do if a prescription is unclear

answer

Whenever a prescription is unclear or the dose is questionable, the nurse should contact the provider for clarification

question

When to seek assistance from the charge nurse

answer

Seek assistance from the charge nurse when client care may require emergency medical interventions that are outside of the nurse's scope of practice

question

Functional nursing model

answer

assign specific tasks to staff

question

total client care model

answer

assign a nurse to complete total care of a client

question

what do you document

answer

only document objective findings

question

do you ever chart in advance

answer

NO! don't ever chart in advance

question

what to observe when you have an interpreter and are talking with a client

answer

observe the client's nonverbal behavior during the session with an interpreter

question

What is risk management

answer

Is a planned method to identify, analyze, and evaluate risks, followed by a plan for reducing the frequency of accident and injuries.

question

What kind of incidents need to be reported

answer

Accidental omission of prescribed therapies, circumstances that led to injury, client falls, medication administration errors, needle stick injuries

question

5 rights of delegating

answer

Right task, right circumstance, right person, right communication, and the right supervision

question

When can't a client give informed consent

answer

a client can't give informed consent under the influence of narcotics

question

what is an indicator of the need of home health care

answer

a new health care problem that requires continued teaching and hands on care is an indicator for home health care

question

deontological theory

answer

focuses on human dignity as an underlying principle

question

team nursing

answer

when assigning a team to care for a group of clients based on client location within the unit

question

Unfreezing stage of change

answer

the nurse should communicate to staff about the need for change during the unfreezing stage of change

question

how should the nurse contribute to the development of a new policy

answer

the nurse should collect data from peer reviewed journals or evidence based practice

question

getting work done through others

answer

management

question

the ability of an individual to influence the behavior of others

answer

leadership

question

this type of leader empowers folowers to assume responsibility for a communal vision, and personal development is a secondary outcome

answer

transformational leader

question

this type of leader focuses on immediate problems, maintaining the status quo and using rewards to motivate followers

answer

transactional leader

question

Most managers can be categorized into the floowing three styles:

answer

authoritative, democratic, laissez faire

question

Authoritative, democratic or laissez faire? Work output by staff is usually high- good for crisis situations and bureaucratic settings

answer

authoritative

question

Authoritative, democratic or laissez faire? makes decisions for the group, motivation by coercion

answer

authoritative

question

Authoritative, democratic or laissez faire? work output by the staff is usually of good quality- good when cooperation and collaboration is necessary

answer

democratic

question

Authoritative, democratic or laissez faire? includes the group when decisions are made, motivation by supporting staff achievements

answer

democratic

question

Authoritative, democratic or laissez faire? makes very few decisions and does little planning, motivation largely the responsibility of individual staff members

answer

laissez faire

question

Authoritative, democratic or laissez faire? work output is low unless an informal leader evolves from teh group

answer

laissez faire

question

the five major management functions are:

answer

planning, organizing, staffing, directing, controlling

question

The four skills necessary for nurses to provide nursing care in an efficient and safe manner: (4)

answer

critical thinking, decision making, prioritization, and time management

question

process of transferring the authority, accountability, and responsibility of a client care task to soemone else

answer

assigning

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