question

A nurse manager of a 20-bed medical unit finds that 80% of the patients are older adults. She is asked to assess and adapt the unit to better meet the unique needs of the older adult patient. Using complexity principles, what would be the best approach to take in making this change?

answer

1.

question

Engage involved staff at all levels in the decision-making process.

answer

b.

question

A unit manager of a 25-bed medical/surgical area receives a phone call from a nurse who has called in sick five times in the past month. He tells the manager that he very much wants to come to work when scheduled but must often care for his wife, who is undergoing treatment for breast cancer. According to Maslow's need hierarchy theory, what would be the best approach to satisfying the needs of this nurse, other staff, and patients?

answer

2.

question

Work with the nurse, staffing office, and other nurses to arrange his scheduled days off around his wife's treatments.

answer

d.

question

A grievance brought by a staff nurse against the unit manager requires mediation. At the first mediation session, the staff nurse repeatedly calls the unit manager's actions unfair, and the unit manager continues to reiterate the reasons for her actions. What would be the best course of action at this time?

answer

3.

question

Ask each party to examine her own motives and issues in the conflict.

answer

c.

question

At a second negotiation session, the unit manager and staff nurse are unable to reach a resolution. It would now be best to:

answer

4.

question

Turn the dispute over to the director of nursing.

answer

b.

question

The manager of a surgical area has a vision for the future that requires the addition of RN assistants or unlicensed persons to feed, bathe, and walk patients. The RNs on the staff have always practiced in a primary nursing-delivery system and are very resistant to this idea. The best initial strategy in this situation would include:

answer

5.

question

Exploring the values of the RN group in relationship to this change.

answer

a.

question

As the RN charge nurse on the night shift in a small long-term care facility, you've found that there is little turnover among your LPN and nursing assistant (NA) staff members, but they are not very motivated to go beyond their job descriptions in their work. Which of the following strategies might motivate the staff and lead to greater job satisfaction?

answer

6.

question

Allow the LPNs and NAs greater decision-making power within the scope of their positions in the institution.

answer

b.

question

As the nurse manager who wants to increase motivation by providing motivating factors, which action would you select?

answer

7.

question

Implement a model of shared governance.

answer

c.

question

A charge nurse on a busy 40-bed medical/surgical unit is approached by a family member who begins to complain loudly about the quality of care his mother is receiving. His behavior is so disruptive that it is overheard by staff, physicians, and other visitors. The family member rejects any attempt to intervene therapeutically to resolve the issue. He leaves the unit abruptly, and the nurse is left feeling frustrated. Which behavior by the charge nurse best illustrates refined leadership skills in an emotionally intelligent practitioner?

answer

8.

question

Reflect to gain insight into how the situation could be handled differently in the future.

answer

a.

question

The chief nursing officer has asked the staff development coordinator to facilitate the development of a clinical competency program for the facility. While making rounds on the units, the staff development coordinator overhears RN staff complaining that they feel it is insulting to be required to participate in a competency program. Which behavior by the staff development coordinator is most appropriate in this situation?

answer

9.

question

Facilitate a meeting so nurses can articulate their values and concerns about a competency program.

answer

d.

question

As a nurse, you are responsible for teaching ostomy patients self-management skills postoperatively. Mr. Jones is 2 days postoperative after an abdominal perineal resection. In spite of patient-controlled analgesia, Mr. Jones acknowledges inadequate pain relief and rates his pain as an 8, utilizing a 0-to-10 pain scale. When you approach him for teaching, he turns away and closes his eyes. Which approach incorporating Maslow's hierarchy of needs motivational theory is most appropriate in this situation?

answer

10.

question

Intervene to improve his pain management control and return later in the day to reassess his readiness to learn.

answer

b.

question

You overhear a newly graduated RN telling one of your colleagues that leadership and management belong to the unit manager and not to her. As a nursing colleague, your response demonstrates understanding that the perception of the new graduate:

answer

11.

question

Would benefit from further understanding of her role as a professional, whose influence may affect the decision making of patients, colleagues, and other professionals.

answer

b.

question

You walk into Mr. Smith's room and find him yelling at the LPN, Miss Jones. He is obviously very upset and after you speak with him regarding his behavior, you determine that he has not slept for three nights because of unrelieved pain levels. The LPN is very upset with Mr. Smith and calls him an "ugly, old man." You acknowledge her feelings and concerns and then suggest that Mr. Smith's behavior was aggressive, but is related to lack of sleep and to pain. "Can you both, together with Mr. Smith, determine triggers for the pain and effective approaches to controlling his pain?" This approach demonstrates:

answer

12.

question

Leadership behavior.

answer

c.

question

After assessing an older adult patient in long-term care who has been slowly deteriorating for weeks, the nurse manager calls the family and asks them to come in, as the patient is dying. The nurse manager's decision and actions are based on:

answer

13.

question

Tacit knowledge.

answer

d.

question

Chart audits have revealed significant omissions of data that could have legal and funding guidelines. As the unit manager, you meet with the staff to discuss audit findings and to find approaches that will address the gaps in charting and achieve desired goals. This is an example of:

answer

14.

question

Management.

answer

b.

question

A family is keeping vigil at a critically ill patient's bedside. Other, distant family members, not yet able to come, call the unit continuously, asking for updates and wanting to express concern. You speak with the distant family members and suggest that you are going to refer them to the hospital social worker, whose role is to work with such situations. What role are you assuming through this action?

answer

15.

question

Manager

answer

a.

question

In response to the situation in Question 15, you approach the unit manager to apprise her of your concerns that the family dynamics of the patient involved may lead to staff-family and patient-family conflicts. You suggest that the physician may need to discuss the treatment plan with the family. The unit manager advises that he will arrange this discussion. If, after the meeting with family members, this is identified as a desired approach, you support the manager's decision. Your actions indicate that you are acting in what role?

answer

16.

question

Follower

answer

c.

question

You pull staff together to assess a situation in which the family of a seriously ill patient is anxious and is absorbing a great deal of staff time in consultation, discussion, and questioning of treatment decisions. Staff members are becoming distanced from the family. After inviting the concerns of staff, you explain that the organization values patient-centered care and suggest that evidence supports that acting as an advocate and a listener is helpful to families. You ask the staff for ideas as to strategies that are effectively patient-centered in these situations. In this situation, you are taking on which role?

answer

17.

question

Leadership

answer

a.

question

Joan, the nursing unit manager, finds it difficult to work with Thomas, a new graduate. Thomas has many ideas, and his manner of presenting them irks Joan. After reflection and discussion with others, Joan recognizes that she also feels threatened by his behavior. She comes to understand that Thomas is trying to establish his own role on the unit, is not trying to challenge her, and needs guidance, coaching, and affirmation. Joan is demonstrating:

answer

18.

question

Deepening self-awareness.

answer

b.

question

As the head of a nursing program, you consistently invite the ideas of your team about innovations in teaching, community partnerships, and curriculum design and invite participation in decisions. Many of these ideas have been implemented successfully, and your staff members are keen to try on other ideas. You are employing _____ leadership.

answer

19.

question

Transformational

answer

d.

question

As a leader on a rehab unit, you encourage all staff members to see themselves as having a role in decision making and quality care. You see your role as involving particular responsibilities in decision making but not as a hierarchal role. This view of decision making and leadership is consistent with:

answer

20.

question

Complexity theory.

answer

b.

question

You recently acquired a position as a unit manager. During your time on the unit, you have formed a strong social network among your staff, have promoted the development of relationships between your staff and workers in other areas of the organization, and have formed relationships that generate ideas from patient organizations and the local nursing education program. According to complexity theory, you are engaging which principle?

answer

21.

question

Development of networks

answer

c.

question

According to the complexity theory, which of the following should be the focus of measurement?

answer

22.

question

Staff morale and budgets

answer

d.

question

During a staff meeting held to discuss developing a mission statement for the unit, the idea of placing patient needs first is:

answer

23.

question

A leadership tag.

answer

b.

question

A dispute arises between an RN staff member and an LPN over a patient issue. The tension between the two begins to affect other staff members, who are drawn into the conflict; eventually, the team becomes polarized toward either the RN or the LPN. This situation might have been prevented through:

answer

24.

question

Expediency in responding to the initial dispute, once it became apparent that it could not be resolved by the two parties themselves.

answer

a.

question

The unit is shifting from primary nursing to a team model in an effort to contain costs. Staff members are angry and ask for a meeting to discuss the change. After hearing their concerns related to reduction in professional autonomy and care quality, you:

answer

25.

question

Acknowledge the loss.

answer

a.

question

In an effort to control costs and maximize revenues, the Rehabilitation Unit at Cross Hospital reduces the number of its managers and flattens its organizational structure. Within a year, the number of adverse events on the units has doubled. This may be attributable to:

answer

1.

question

Fewer clinical leaders and advocates for necessary resources.

answer

d.

question

Traditional approaches to ensuring patient safety have focused on:

answer

2.

question

Assigning blame.

answer

a.

question

To increase safety in patient care areas of the Valley Hospital, the executive begins by:

answer

3.

question

Consulting with a management expert about staffing schedules.

answer

b.

question

During review of back injuries, it is determined that mechanical lifts and transfer belts are not being properly used. In addressing this concern, the unit manager:

answer

4.

question

After consultation with the staff about the review, orders new lifts to replace older ones that are malfunctioning.

answer

b.

question

Before the IOM report was issued, "To err is human" adverse events were considered:

answer

5.

question

Rare.

answer

b.

question

In complying with Crossing the Quality Chasm, you ensure that:

answer

6.

question

Patients are actively encouraged to make decisions related to care.

answer

a.

question

After consulting with practice environments about quality and safety concerns in health care, the Dean of Health Programs at US University develops:

answer

7.

question

An interdisciplinary program for nurses, pharmacists, and medical practitioners that emphasizes collaborative learning teams.

answer

d.

question

In designing a quality, safe healthcare environment, the primary emphasis needs to be on:

answer

8.

question

The patient.

answer

d.

question

As a patient care advocate, you regularly coach patients as to how to stay safe in health care by educating them about:

answer

9.

question

The need to understand and record all medications being taken.

answer

a.

question

As a nurse manager on the West Surgery Unit, you are interested in increasing patient safety on your unit. Your initial focus is on the two encounters that the Chasm series identified as most likely to generate concerns about patient safety. As a result, you initiate which of the following?

answer

10.

question

Questions on the pre-admission history that specifically explore details of substance use

answer

a.

question

Which philosophical statement would be MOST consistent with that of a learning organization?

answer

11.

question

We believe that change is essential to good service and quality patient care.

answer

d.

question

To achieve nurse-sensitive care standards developed by the NQF, you advocate for which of the following in your health facility?

answer

12.

question

Programming that builds individual nurse competency into smoking cessation

answer

a.

question

You notice that Sally, a student on your unit, is giving information to an anxious young teen, who seems very uncertain about preparation for an upper GI series. After Sally leaves the room, you ask her how she thought her conversation went and:

answer

13.

question

Encourage her to ask the patient if he has questions or concerns about the procedure.

answer

a.

question

The NQF provides a model for advancement of healthcare quality that could be used in healthcare organizations. Using this model might involve councils or committees that dialogue openly regarding quality and:

answer

14.

question

Are interdisciplinary and intersectoral.

answer

b.

question

A survey of safety practices and attitudes at hospital XYZ finds that staff members have concerns about their safety and that of patients. Results from the manager subgroup are likely to be:

answer

15.

question

More positive about safety than staff.

answer

b.

question

As a result of the Joint Commission assessment, a healthcare facility loses it accreditation. What is the primary consequence for this institution?

answer

16.

question

Loss of funding

answer

a.

question

How would you prepare your unit for a Joint Commission visit?

answer

17.

question

Ensure that review of patient outcomes and of responses to outcome data is ongoing.

answer

d.

question

On the basis of a review of increased falls with injury and increased restraint use during evening hours, as the unit manager, you most likely would:

answer

18.

question

Review daytime and evening staffing mixes.

answer

a.

question

The STAR approach to patient safety encourages:

answer

19.

question

Focus and reflection.

answer

a.

question

A logical response to the final step of the STAR Approach to Patient Safety might be to:

answer

20.

question

Seek further learning.

answer

a.

question

The culture of blame and punishment of errors tends to encourage a culture of:

answer

21.

question

Perfectionism.

answer

a.

question

Mary, an 85-year-old patient with cognitive impairment and gross instability, wanders continuously. Lately, she has fallen twice, and the family demands that she be restrained. As the unit manager, you have initiated a least restraint practice. An appropriate action in this situation would be:

answer

22.

question

Initiating a multidisciplinary and family meeting to focus on Mary's needs.

answer

c.

question

A client requires an appendectomy. The surgeon explains the procedure and asks the client to sign the consent. The patient speaks very little English and looks worried. As a nurse, you would:

answer

23.

question

Suggest that an interpreter explain the procedure to the client and answer any questions.

answer

a.

question

As the case manager in a home health service, you are interested in trying the Institute for Healthcare Improvement TCAB project in your service. In considering this application, you need to particularly consider:

answer

24.

question

Applicability of the project to your setting.

answer

b.

question

As the clinical director of 24 employees, you have been asked to explain to staff members why they are not getting a raise this year, even though they have been working short-handed for many months and patient satisfaction scores have never been higher. Because you believe yourself to be a transformational leader, you will approach this problem by:

answer

1.

question

Showing staff members the budget and asking for input about how to cut costs so that raises will be possible in the future.

answer

c.

question

After a newly hired director of nursing has reviewed the hospital's strategic plans, she develops a timeline for achieving those plans. The new leader is:

answer

2.

question

Translating a global document into realistic plans for nursing.

answer

d.

question

A nurse executive is hired to restore a unit's productivity, which has decreased as the result of low staff morale. The nurse executive utilizes which of the following leadership principles?

answer

3.

question

The leader sets the tone, which allows nurses to feel in control of the environment.

answer

a.

question

The director of nursing has been observing staff interactions in a 20-bed coronary care unit. Based on her observations, which of the following staff members is an obvious leader?

answer

4.

question

The staff nurse who persuades other staff members to practice by making evidence-based decisions

answer

d.

question

After being interviewed for the unit manager position, the staff nurse reflects on the interview process. The staff nurse is aware that leadership begins:

answer

5.

question

Within.

answer

a.

question

The nurse manager in the emergency department needs to implement new staffing patterns. As a transformational leader, the nurse manager should:

answer

6.

question

Make staff members think the idea was theirs in the first place.

answer

b.

question

To retain supervisory staff members, the director of nursing develops a mentoring program. The best person to be a mentor for a new supervisor in a leadership position is someone who has:

answer

7.

question

Leadership experience and time to spend communicating with the new supervisor about his or her experiences.

answer

c.

question

Recruiting among the emerging workforce (18- to 35-year-olds) is a challenge for healthcare agencies. Marketing brochures should address the leadership and vision of the healthcare agency. Which of the following workplace environments will attract applicants in the emerging workforce?

answer

8.

question

A nurturing and receptive environment

answer

b.

question

A nurse executive who considers herself a Baby Boomer will have the challenge of convincing the emerging workforce of the necessity of committee meetings. One of the primary reasons that the Baby Boom generation appears to have so many meetings in the work environment is that:

answer

9.

question

They find that the journey to the solution is as important as the solution itself.

answer

b.

question

The hospital administration is discussing the possibility of closing hospital beds in your unit because of a nursing shortage and the increased amount of overtime required to care for patients. As the leader on the unit, which of the following examples best demonstrates your effective leadership style?

answer

10.

question

A group of your staff members goes to the administration to propose closing of a different unit.

answer

c.

question

John is interested in leadership positions within his nursing organization. Although he has been on the same unit for 10 years, he has attended two workshops during that time and has steadfastly refused opportunities to engage in leadership development opportunities or other learning offered as part of the hospital's succession planning strategy. He says that he is interested in a leadership role primarily because it will give him a more stable work schedule and will enable him to spend more time with his family. In coaching John, it would be important to:

answer

11.

question

Encourage him to seek out new experiences and learning that will complement his existing strengths derived from experience and his interest in life-work balance.

answer

d.

question

Becky graduated five years ago and is keenly interested in pursuing leadership opportunities. She has been active in learning about leadership through workshops and Internet research and recently began a graduate degree program with a focus on nursing administration. She has excellent clinical skills and eagerly accepts responsibility for various projects on the unit. Her sarcastic and sometimes aggressive behavior tends to alienate other staff members on the unit. In coaching Becky, you:

answer

12.

question

Suggest that she reflect on situations in which she has had a positive influence and consider how her interactions contributed to the situation.

answer

a.

question

The Sunny Long Term Care Facility has experienced numerous difficulties with staff relationships, despite its success in maintaining financial viability and judicious use of resources. Staff members complain that the primary concerns of the facility include applying policy, saving money, and ensuring that lawsuits are avoided. There is little trust in and involvement of staff members. This facility may be:

answer

13.

question

Overly managed and not well led.

answer

b.

question

While explaining the importance of developing leadership skills among nurses to a group of first year nursing students, Natalie, a nursing unit manager emphasizes that:

answer

14.

question

The public depends on nurses to assume leadership in moving consumer advocacy concerns forward.

answer

d.

question

Which of the following nurses is MOST likely to inspire others to do their best?

answer

15.

question

Jim, RN, has been involved in nursing for several years and is well liked by patients and families. He continually searches for new knowledge and skills, and his sense of humor and optimism are infectious.

answer

b.

question

The new head nurse on G Unit has been the subject of a great deal of discussion and complaining during breaks. She is a competent nurse of tremendous integrity with approximately 30 years' experience. Her predominant method of problem solving and communication is through meetings, which can go over the allotted time. The staff may:

answer

16.

question

Be presenting different generational values and attitudes than the head nurse.

answer

b.

question

The adage "leaders are born and not made" reflects which of the following ideas around leadership?

answer

17.

question

Management can be taught; leadership depends on abilities.

answer

a.

question

Kari, a head nurse on the dialysis unit, has been informed during budget planning meetings that budget cuts are likely. She discusses this at the next unit meeting and tells staff members that unless they do their jobs well, their positions may be terminated, and there will be no replacement. Kari is enacting which management style?

answer

18.

question

Transactional

answer

b.

question

Susan, a new graduate on the dialysis unit (Question 18 above), appears to take Kari's remarks very seriously and works even harder, often volunteering for extra assignments. She also is often in Kari's office, advising of successes with her patients and of the extra effort that she is committing. This behavior suggests that Susan:

answer

19.

question

Knows how to "play the game."

answer

d.

question

The style of leadership that Kari is exhibiting is likely to:

answer

20.

question

Stifle innovative thinking about ways to move out of financial jeopardy.

answer

b.

question

A group of managers is meeting to discuss ideas related to the successful implementation of evidence-based practice on their units. Susan has been asked by the director of care to assume leadership of these discussion groups. After two such sessions, Susan expresses disappointment to her mentor that the group seems disinterested in her ideas and that they are listening to Ken, who has much less experience with leadership. In discussing this with Susan, the mentor understands that leadership:

answer

21.

question

Must be earned.

answer

b.

question

The senior executive praises John for the positive patient evaluations that his unit has received. As an effective leader, John:

answer

22.

question

Points out the contributions of his staff to the outcomes and shares the praise with his staff.

answer

d.

question

During a discussion of concern about approaches used with aggressive patients in the emergency department, several staff members express concern for their safety. It is important for the nurse manager to:

answer

23.

question

Look directly at speakers and acknowledge their comments.

answer

a.

question

In working with Cheryl, her mentor suggests that it is really important for Cheryl to engage in self-appraisal and to know her strengths. This observation is based on an understanding that:

answer

24.

question

There is little external motivation and affirmation in leadership.

answer

c.

question

Role theory has its underpinnings in management theory. Management theories influence managers' leadership styles. Which of the following theories would a nurse manager be most likely to follow when redesigning the staffing schedule?

answer

1.

question

Quantum

answer

d.

question

A nurse manager has worked rapidly to bring the staff to accept changes in the unit's mission, so that downsizing can be avoided. This nurse manager is using quantum leadership by:

answer

2.

question

Determining accurately the direction of change in the institution.

answer

c.

question

The nurse manager, as the leader of the unit's "customer (client) first" initiative, has asked the staff nurses to develop and administer a survey to every client before discharge. In asking the staff nurses to accomplish this task, the nurse manager is demonstrating:

answer

3.

question

Shared leadership.

answer

b.

question

A nurse manager is experiencing considerable conflict among staff members because of weekend staffing coverage. During a called staff meeting, the nurse manager asks the disgruntled staff to meet as a group and determine the best staffing practices. In doing this, the nurse manager is using the concept of collaboration to:

answer

4.

question

Focus all energies of staff members on a win-win strategy.

answer

c.

question

A nurse manager's responsibility for financial management involves making budgetary decisions. Budgets that allow the nurse manager to allocate resources at the unit level allow:

answer

5.

question

Budgetary decision making at the point of service (POS).

answer

d.

question

The nurse manager is anticipating changes on the unit because of managed care. It is up to the manager to "sell" the staff on this care concept. A goal of managed care that the staff must understand is that managed care is:

answer

6.

question

Grounded in business theory.

answer

a.

question

The hospital administrator approves a case management position for a new rehabilitation unit to help reduce costs. In developing the job description, the nurse manager understands that a key element of case management is:

answer

7.

question

Coordination of resources for effective outcomes.

answer

b.

question

In planning a new wing, the nurse manager complies with the workplace safety requirements of the Occupational Safety ; Health Administration (OSHA). Which of the following groups is considered to be at high risk for violence in the workplace?

answer

8.

question

Emergency department staff

answer

c.

question

In orienting a 25-year-old nurse, the unit manager understands that this worker:

answer

9.

question

Likes to solve problems without being given solutions.

answer

d.

question

Nurses on Unit 4 are unhappy and frustrated with their nurse manager. They complain that "nothing is ever good enough for him." These statements suggest that the nurse manager's goals may be:

answer

10.

question

Unrealistic.

answer

b.

question

While interviewing for a nurse manager position, Ann is asked to give an example of a situation in which she demonstrated leadership. Which of the following examples exemplifies leadership?

answer

11.

question

Through research and investigation of best practice and practice-based evidence, she proposed a change to management of incontinence in elderly patients.

answer

a.

question

Budgeting and protection of revenues is a function of:

answer

12.

question

Management.

answer

b.

question

Which of the following is not important in a positive work environment, as defined by the AONE?

answer

13.

question

Challenge and striving for excellence

answer

d.

question

As a manager with a high percentage of young professionals, you increase job satisfaction among this young staff by:

answer

14.

question

Establishing opportunities to self-schedule.

answer

d.

question

A nurse manager in a hospital is deeply concerned that senior administration makes decisions about budgetary directions that affect staffing and other resources without sharing the rationale for changes or demonstrating concern as to how these changes may affect patients or staff. She says she does not feel respected and is emotionally tired as a result. This situation represents:

answer

15.

question

Quantum leadership.

answer

d.

question

As a nurse manager, you identify that a shift in nursing care models might increase patient and staff satisfaction and avoid downsizing. Administration is reluctant to adopt this approach because downsizing is seen as critical to reduction of costs. To leverage your ideas, you:

answer

16.

question

Identify influential members of your nurse manager group with similar ideas and request an opportunity to meet with administration to discuss options.

answer

d.

question

During staff meetings, you make it a regular practice to encourage shared problem solving and to recognize those who go beyond basic roles and responsibilities to contribute to a positive team environment and to quality patient care. This practice exemplifies:

answer

17.

question

Values-based management.

answer

a.

question

The successful integration of informatics into healthcare settings is key to:

answer

18.

question

Quality decision making and processes related to management of resources.

answer

a.

question

As a nurse manager, you embrace the usefulness of resources such as Smart Bed. This behavior is important to:

answer

19.

question

Encouragement of staff utilization of technology.

answer

d.

question

A manager who is concerned with ensuring that patients on her surgical unit have the necessary information to make informed choices is:

answer

20.

question

Demonstrating respect for patient rights.

answer

b.

question

The nurse manager plays a unique role in institutional management in that the nurse manager:

answer

21.

question

Models professional nursing behavior.

answer

b.

question

In developing an orientation program, the hospital educator breaks essential organizational information down into chunks, which she develops as online modules. This is an application of which of Drucker's functions of management?

answer

22.

question

Organization of activities into manageable tasks

answer

d.

question

Nancy is a staff nurse who works on a rehabilitation unit. Nancy tells you that the assistants are experiencing difficulty with the new lift and wonders what your thoughts on organizing an in-service would be. Nancy is exhibiting which trait of a follower?

answer

23.

question

Assumes responsibility for identifying a safety concern and concedes authority for solution to you

answer

d.

question

The manager in the coronary care unit believes that the most important ethical considerations in performance evaluations are that they include the employee's good qualities and that they give positive direction for professional growth. This belief is an example of:

answer

1.

question

Nonmaleficence.

answer

d.

question

A staff nurse in the area that you manage has excelled in the delivery of client education. You are considering implementing a new job description that would broaden her opportunity to teach client and orient new staff members to the value of client education. The ethical principle that you are most directly reinforcing is:

answer

2.

question

Paternalism.

answer

c.

question

A client refuses a simple procedure that you believe is in the client's best interest. The two ethical principles that are directly in conflict in such a situation are:

answer

3.

question

Autonomy and beneficence.

answer

c.

question

An applicant in a wheelchair is applying for the position of receptionist in an outpatient clinic. The nurse manager understands that the Americans with Disabilities Act of 1990 requires that employers:

answer

4.

question

Make reasonable accommodations for persons who are disabled.

answer

a.

question

A staff nurse who was fired for reporting client abuse to the appropriate state agency files a whistleblower lawsuit against the former employer. Reasons that the court would use in upholding a valid whistleblower suit claiming retaliation include that the nurse:

answer

5.

question

Had previously reported the complaint, in writing, to hospital administration.

answer

a.

question

In keeping with standards of The Joint Commission (TJC), the nurse manager organizes an orientation for new staff members. As part of the orientation, the nurse manager reviews the employee handbook. Employers may be bound to statements in the employee handbook:

answer

6.

question

Based on the employee's or the employer's expectations.

answer

c.

question

To reduce the incidence of falls in a skilled nursing unit, the nurse manager contacts the risk manager. Risk management is a process that attempts to identify potential hazards and:

answer

7.

question

Eliminate these risks before anyone else is harmed.

answer

b.

question

One means of ensuring that nurses floated to other patient care areas in healthcare organizations are qualified to work in those areas is:

answer

8.

question

Cross-educating staff members to other areas of the institution.

answer

b.

question

A colleague asks you to give her your password access so that she can view her partner's healthcare record. This request violates the patient's right to:

answer

9.

question

Privacy.

answer

a.

question

On your nursing unit, you employ LPNs, RNs, and advanced practice nurses. You will need to be familiar with at least:

answer

10.

question

One nursing practice act and a medical act.

answer

d.

question

A nurse on your inpatient psychiatric unit is found to have made sexually explicit remarks toward a patient with a previous history of sexual abuse. The patient sues, claiming malpractice. Which of the following conditions would likely not apply in this situation?

answer

11.

question

Injury

answer

a.

question

As a charge nurse, you counsel your RN staff member that he has satisfied his duty of care by notifying a child's physician of his concerns about deterioration in the child's status at 0330 hours. The physician does not come in. The child dies at 0630 hours. As the charge nurse, you could be held liable for:

answer

12.

question

Professional negligence.

answer

a.

question

The parents of a toddler who dies after being brought to the ER launch a lawsuit, claiming that the failure of nurses to pursue concerns related to their son's deteriorating condition contributed to his death. The senior nurse executive is named in the suit:

answer

13.

question

Under the doctrine of respondeat superior.

answer

b.

question

During a staff shortage, you hire an RN from a temporary agency. The RN administers a wrong IV medication that results in cardiac arrest and a difficult recovery for the patient. Liability in this situation:

answer

14.

question

May depend on the patient's belief regarding the employment relationship.

answer

d.

question

You volunteer at a free community clinic. A 13-year-old girl claims to have been diagnosed with SLE and presents with chlamydia. The team leader at the clinic advises that:

answer

15.

question

Care can be provided as long as consent is voluntary and information about treatment and options is provided.

answer

c.

question

Three gravely ill patients are candidates for the only available bed in the ICU. As the supervisor, you assign the bed to the patient with the best chance of recovery. This decision reflects which of the following ethical principles?

answer

16.

question

Beneficence

answer

a.

question

Which ethical principle is primarily involved in informed consent?

answer

17.

question

Autonomy

answer

b.

question

The principle that requires nurses to uphold a professional code of ethics, to practice within the code of ethics, and to remain competent is which of the following?

answer

18.

question

Fidelity

answer

c.

question

Mr. M. complains to you that one of your staff asked him details about his sexual relationships and financial affairs. He says that these questions were probing and unnecessary to his care, but he felt that if he refused to answer, the nurse would be angry with him and would not provide him with good care. Mr. M.'s statements reflect concern with:

answer

19.

question

Privacy.

answer

a.

question

To satisfy duty of care to a patient, a nurse manager is legally responsible for all except:

answer

20.

question

Supervising the practice of the physician.

answer

d.

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