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Leadership HESI Practice Questions and answers latest updated
The nurse calls a surgeon about a male client who is having abdominal pain after a bowel resection. He received hydromorphone 2 hours ago and is now reques... [Show More] ting additional pain medication. Vital signs include temperature 97.8 F, HR 112bpm, RR 24pm, and BP is 98/62 mmHg, which is lower from previous reading one hour ago. The client has a history of chronic atrial fibrillation and takes clopidogrel, which was continued until one day prior to surgery. The Nurse recommends that surgeon see the client immediately to evaluate the situation. What information makes this report complete? The abdomen is rigid, tender to touch, and distended A nurse is preparing to transfer a client from the emergency department to a medical-surgical unit using the SBAR communication tool. Which of the following information should the nurse include in the background portion of the report? A prescribed consultation The client's vital signs The client's name The client's code status The client's vital signs A nurse is doing telephone triage at the clinic office. Which client is most acute and should be scheduled for the first available appointment? A 21-year-old with a history of kidney transplant. Today the client complains of flu-like symptoms with a fever of 100.4°F The nurse is calling for an older adult who was admitted with a urinary tract infection and is now exhibiting signs of severe inflammatory response syndrome (SIRS). Which collaborative care goals should the nurse include in the plan of care? Decrease blood pressure Reduce white blood cell count Body temperature within normal limits Negative urine culture Incision free of exudate Reduce white blood cell count Body temperature within normal limits Negative urine culture Pt came off the PCA pump an hour ago and put on PO analgesic and he in a room with another patient and he was fussing and demanding the PCA back. Nurse was on the phone with the surgeon, what does she say to implement the recommendation of SBAR acronym? Ask can pt PCA be reinitiated for 12 hours When meeting with the client and the family, which nursing interventions demonstrate the nurse's role of collaborator of care? Coordinating and educating about multidisciplinary services It is most important to schedule a multi-disciplinary team meeting to discuss which client? A woman who is pregnant with twins and whose due date is one week away. A 2 year old who contracted Hep A while at a local daycare center A business executive admitted with Gullain-Barre syndrome who has residual numbness in lower extremities An elderly client admitted through ED with a broken hip whose blood glucose is 400 mg/dl An elderly client admitted through ED with a broken hip whose blood glucose is 400 mg/dl The charge nurse on a surgical unit is assessing the morning lab work on four clients. Which client's lab finding should be reported to HCP immediately? A client scheduled for an elective transurethral resection of prostate that has an aPTT of 80 seconds An elderly client in end-stage renal disease who has a creatinine level of 2.4 mg/dL and BUN of 84 mg/dL An adolescent who had an emergency appendectomy yesterday and has a WBC of 12,000 mm3 A client scheduled for an elective transurethral resection of prostate that has an aPTT of 80 seconds (i think we picked this one) An elderly client in end-stage renal disease who has a creatinine level of 2.4 mg/dL and BUN of 84 mg/dL When triaging emergency-room clients, which client should the nurse assess first? A female client with severe right lower abdominal pain who is febrile and vomiting The nurse working on a medical unit is assigned to care for four clients. Which client should the nurse assess first? A client who is quadriplegic and is complaining of severe headache After receiving report, which client should the nurse assess first? A client with O2 sat of 70% following bronchodilator therapy The nurse is caring for several clients on the telemetry unit. Which client should the nurse assess first? A client who is demonstrating: NSR and complaining of chest pain After receiving morning report on an acute care unit, which client should the nurse assess first? A client sitting close to the nurse's station who has been restrained for the past 6 hours After receiving report on an inpatient acute care unit, which client should the nurse assess first? A client with a bowel obstruction due to a valvula's who is experiencing abdominal rigidity A nurse working the 7 am-to-3 pm shift is reviewing the records of him/her assigned clients. Which client should the nurse assess first? A client scheduled for hemodialysis at 10 am A client scheduled for a nuclear scanning procedure at 10 am A client scheduled for contrast computed tomography (CT) at noon A client scheduled for hydrotherapy for treatment of a burn injury at 10:30 am A client scheduled for hemodialysis at 10 am A client in the intensive care unit needs to be transferred to the medical unit to make room for a client who is being admitted from the emergency department. Which client is best for the charge nurse to transfer? A client with: Chronic emphysema that has an arterial blood gas PaO2 of 75mmHg (norm= 80-100mmHg) After lumbar puncture, what position should the client be positioned in? The client should be placed in supine position for 4 to 12 hours as prescribed Nurse determines that an IV vesicant chemotherapy infusion is infiltrated. What should he/she do? Apply COLD compress You use warm for non-vesicant but for vesicant you use cold to constrict the blood vessels and stop it from going into tissues more Also you want to raise the extremity if infiltration happens Also vesicants should always run through a pump Some vesicants have antidotes, so it is important to notify HCP right away so it can be ordered and administered if applicable Which nurse's behavior is a breech of patient confidentiality according to HIPAA regulations? Nurse takes home a daily report sheet with information on the team's client While the registered nurse is appearing to take the vital signs of a newly admitted client who has a medical diagnosis of congestive heart failure. A practical nurse enters the client's room and reports to the RN that another client just pulled out his central venous catheter and the unlicensed assistive personnel is in the room with the client. The RN knows that the newly admitted client is to receive a stat dose of oral anti-anxiety medications. How should the RN assign the needed care? The RN should provide care for the client who removed the central venous catheter while the PN administers a stat medication and the UAP obtains the newly admitted client's vital signs Fire alarm is going off, what does the charge nurse tell the nurses to do? Keep clients in rooms with doors closed A fire is reported in the kitchen on the first floor of a three-floor community Hospital, and the operator notifies the charge nurse on the third floor to start evacuation procedures. What intervention should the charge nurse implement? Instruct the nursing staff to evacuate ambulatory clients to the nearest fire exits At 2 a.m. the nurse phones the health-care provider to request a PRN medication for a client who is unable to sleep. The health-care provider is awakened, and gives the nurse a prescription for 4 times the normal dosage. When questioned by the nurse, the health-care provider responds in a sleepy voice "yeah okay" and hangs up the phone. What action should the nurse take first? Call HCP back and report that the dosage described is 4 times the normal dose The practical nurse caring for a client with acute congestive heart failure and pitting edema tells the charge nurse that a verbal prescription was obtained from the health-care provider for 1000 mL D5 % normal saline to be administered over 4 hours. What action should the charge nurse take? Clarify the prescription with the HCP A nurse is assisting a primary health care provider in assessing a hospitalized client. During the assessment, the primary health care provider is paged to report to the recovery room. The primary health care provider leaves the client's bedside after giving the nurse a verbal prescription to change the solution and rate of the intravenous (IV) fluid being administered. What is the appropriate nursing action in this situation? Asking the PCP to write the prescription in the client's chart before leaving the nursing unit A primary health care provider repeatedly asks a nurse to write his verbal prescriptions in his clients' charts after he makes his rounds. The nurse is uncomfortable with writing the prescriptions and explains this to the physician, but the primary health care provider tells the nurse that she will be reported if she does not write the prescriptions. How should the nurse manage this conflict? Discuss issue with nurse manager A practical nurse (PN) is reluctant to use new blood glucose monitoring equipment despite having attended the mandatory in-service about the equipment. What action is best for the charge nurse to take? Observe the PN while he uses the new equipment A registered nurse (RN) is planning assignments for five clients on the nursing unit. The team includes a licensed practical nurse (LPN) and a nursing assistant. Which clients should the nurse assign to the LPN? Select all that apply. A client who is confused and requires assistance with a shower A client requiring a bed bath and frequent ambulation with a cane A client who must be accompanied to physical therapy twice during the shift A client with a colostomy who requires reinforcement regarding the procedure for irrigation A client with diabetes mellitus who requires the administration of regular insulin in accordance with a sliding dosage scale every 4 hours A client with a colostomy who requires reinforcement regarding the procedure for irrigation A client with diabetes mellitus who requires the administration of regular insulin in accordance with a sliding dosage scale every 4 hours The nurse assigns collection of the sputum specimen to the unlicensed assistive personnel (UAP). Before delegating this task to the UAP, which action is most important for the nurse to implement? Determine if the UAP has received training to collect sputum specimen The registered nurse is gathering supplies to assist a healthcare provider with a bedside thoracentesis when the ER nurse calls to report on a client with unstable angina that must be admitted immediately. A practical nurse (PN) and unlicensed assisted personnel (UAP) are available to assist the RN. How should the RN assign the necessary nursing actions? Assign PN to assist with the thoracentesis while the nurse obtains report and the UAP prepares the room for the new admission An unlicensed assistive personnel UAP who is working on a skilled nursing unit is diagnosed with hepatitis A HVA. Two weeks later, a nurse complains of headache, nausea, anorexia, arthralgia, and low-grade fever. What action should the nurse-manager take next? Refer the nurse to the employee health clinic for serological testing An unlicensed assistive personnel UAP who is working on a skilled nursing unit is diagnosed with hepatitis A HVA. Two weeks later, a nurse complains of headache, nausea, anorexia, arthralgia, and low-grade fever. What action should the nurse-manager take next? Refer the nurse to the employee health clinic for serological testing After receiving morning report on an acute care unit, which client should the nurse assess first? A client sitting close to the nurses' station who has been restrained for the past six hours What should UAP notify nurse about when putting SCD on legs? Report any change in color in client's feet or legs A nurse is planning client assignments for the day. Which of the following assignments is the least appropriate for the nursing assistant? Assisting a client with dysphagia to eat A client has a prescription for 20 units of Novolin 70/30 insulin to be administered subcutaneously. The pharmacy has provided a vial of Novolin N insulin in a vial of Novolin R insulin. What action should the nurse implement? Notify the pharmacy that the incorrect insulin has been delivered to the unit Client is admitted and within chart there is a DNR Confirm current resuscitation wishes with client and family The nurse is giving change-of-shift report for four clients in the emergency center and reports the client with a terminal disease has a living will and a "Do not resuscitate" (DNR) order on file. Which client fits the criteria for a terminal illness? 2-year-old child with esophageal burns from drinking drain cleaner who now has a gastrostomy tube. 76-year-old female client with Alzheimer's disease who is pacing the halls and trying to "go home." 52-year-old male client who had a partial lobectomy and on a ventilator on the 2 postoperative day. 43-year-old male with amyotrophic lateral sclerosis who is refusing artificial nutrition or hydration. 43-year-old male with amyotrophic lateral sclerosis who is refusing artificial nutrition or hydration. A primary health care provider informs a nurse that the husband of an unconscious client with terminal cancer will not grant permission for a do-not-resuscitate (DNR) order. The primary health care provider tells the nurse to perform a "slow code" and let the client "rest in peace" if she stops breathing. How should the nurse respond? Telling the physician that "slow codes" aren't acceptable A 51-year-old client with amyotrophic lateral sclerosis (Lou Gehrig's disease) is admitted to the hospital because his condition is deteriorating. The client tells the nurse that he wants a do-not-resuscitate (DNR) order. What is the most appropriate action by the nurse? The DNR request should be discussed with the provider, who will write the order Nursing diagnosis within plan of care for Heart Failure? Impaired gas exchange Leukemia Precautions Maintain private isolation if client is infectious A client with leukemia is being considered for a bone marrow transplant. The healthcare team is discussing the risks and benefits of this treatment and other possible treatments with the goal of inflicting the least possible harm on the client. Which principle of healthcare ethics is the team practicing? Non maleficence Making assignments for the day, which info provided during change of shift report is most important for the charge nurse to consider? Elderly female client who refuses to be cared for by a male nurse To facilitate the initiation of a new fall prevention program, which action should the nurse manager implement? Involve the staff in developing interventions for the program Pertussis Precautions Pertussis is spread by respiratory droplets Ensure staff follow droplet precautions (including wearing a surgical mask) during close contact with cases A nurse in a clinic is reviewing laboratory reports for a group of clients. Which of the following diseases should the nurse report to the state health department? Pertussis Needs Assess Equipment Determine if other units can use equipment Young adult woman with brain tumor refuses further treatment, die by natural causes; HCP does not agree and refuses...What action should be taken by nurse? Initiate a review of the situation by the hospital's ethics committee The charge nurse needs to determine if an additional nurse should be called to help staff in the unit for the next shift. Which information is most important for the charge nurse to consider when making this decision? The acuity level of the clients on the unit Several family members are visiting a client who had a myocardial infarction 4 days ago. The unlicensed assistive personnel (UAP) inform the nurse that one of the visitors is lying on the client's bed. What action should the nurse implement? Explain that the client has the right to have a visitor lie on the bed To help prevent litigation by dissatisfied clients, which objective is most important to include in the orientation classes for staff nurses? New nursing staff members will: Discuss how to handle complaints from the client and/or their families The practical nurse reports that a client with a DVT was mistakenly given heparin in addition to the prescribed warfarin. Which priority action should the nurse take? Monitor for signs of bleeding The healthcare provider prescribes an oral medication to be given daily for 3 days. However, medication was also given on the fourth day. Which intervention is most important for the charge nurse to implement? Evaluate client for symptoms of drug interaction New policy to prevent med errors Examine med admin data to determine use of new procedure Med error occurred filled out incident report, called doctor, notified manager...This is an example of Emotional intelligence Med Error Action Assess pt, incident report, notify doctor, document amount prescribed and dosage given (do not place incident report in chart or make any reference to it in patient's medical record) The nurse assigns collection of sputum specimen to a UAP. Before delegating this task to the UAP, which action is most important to the nurse to implement? Determine if the UAP received training to collect sputum specimen A nurse has delegated several nursing tasks to staff members. What is the nurse's primary responsibility after delegation of these tasks? Following up with each staff member regarding the performance of the task and the outcomes r/t implementation of the task The RN is assigned to care for 4 surgical clients. After receiving report, which client should the nurse see first? The client who is: Three days postoperative resection, receiving transfusion of packed RBCs The nurses caring for a group of clients on a surgical unit. What action should the nurse implement first? Determine if the client scheduled for surgery is prepared to go to the operating room In assigning client care to an RN and a licensed practical nurse, it is most important to assign which client to the RN? A client who is: Exhibiting signs of Addison's crisis after corticosteroids were discontinued A registered nurse (RN) is planning client assignments for the day. Which of the following clients should the RN assign to the nursing assistant? A client who needs frequent ambulation with a walker A registered nurse (RN) is planning client assignments for the day. Which clients should the nurse assign to a nursing assistant (assistive personnel)? Select all that apply. A client with a permanent tracheostomy A client requiring a gastrostomy tube dressing change A client who requires transport to the radiology department in a wheelchair A client with a Foley catheter for whom a 24-hour urine collection is in progress A client who underwent surgery an hour earlier and has a nasogastric tube and a Foley catheter A client who requires transport to the radiology department in a wheelchair A client with a Foley catheter for whom a 24-hour urine collection is in progress The nurse is working at a diabetic clinic with a PN. Which nurse care is best to assign to PN? Assess cause of nausea and vomiting for past 2 days Describe meaning of hgb a1c result of 9.9% Observe first attempt at self-administration of insulin Perform dressing change stage 2 ankle ulcer Perform dressing change stage 2 ankle ulcer The home health nurse is planning care for a client with diabetes. Which task can the nurse delegate to the unlicensed assistive personnel (UAP)? Assist with bathing and other activities of daily living The nurse is planning a diabetes education course for a group of clients newly diagnosed with diabetes mellitus. Which collaborative approach is the best use of interdisciplinary team members? Invite the dietician to discuss the timing of meals and snacks An older woman with end-stage heart disease is hospitalized for severe heart failure. She is alert, oriented, and requests that no heroic measures are implemented if her breathing stops. What actions should the nurse take first? Discuss with the client her meaning of heroic measures. Obtain a DNR. Set up a family conference to discuss the client. Consult the palliative care team about the client's care. Discuss with the client her meaning of heroic measures. An older female client signed a living will document two years ago that requested no heroic measures be taken on her behalf. Today she is admitted 6 hours after the onset of left hemiplegia, left-sided neglect, and hemianopsia. When the neurologist asks the client if she wants to be ventilated, she responds, "If it will help." The daughter asks the nurse what the family should do because the ventilator places her frail mother at risk for other complications and is contrary to her mother's original request, which was executed when she was healthy. What information is best for the nurse to provide? The family should be guided to support the client's current decision about the ventilato [Show Less]
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Leadership HESI Questions and answers graded A content
Which actions should be completed by the manager of a group of nursing case managers? (SATA) - Study the current licensed to unlicensed staffing ration -... [Show More] Discuss revision of position descriptions for cross trained staff - Analyze status of clients movements through clinical pathways - Match clinical pathway actions with expected diagnostic related grouping activities - Coordinating communication among all departments in the organization - Analyze status of clients movement through clinical pathways - Match clinical pathway actions with expected diagnostic related grouping activities - Coordinate communication among all departments in the organization Case management is being implemented in a major city hospital. What should the manager include when instructing the nursing staff about this care delivery method? (SATA) - The case manager advocates for the client and family - The case manager identifies outcomes and coordinates care activities - Case managers help control the costs for high-risk, high cost client populations - Identifying tasks that can be performed by other care providers is just one activity - Case management includes the client, family and all health care provider involvement - The case manager advocates for the client and family - Case managers help control the costs for high-risk, high-cost client populations - Case management includes the client, family and all health care involvement What term began to be used in the 1960's to describe case management? - process control - risk management - quality improvement - utilization management - utilization management The count of hydrocodone is incorrect. After several mins of searching the medication cart and medication records, no explanation is found. Who should the primary nurse notify about the discrepancy? - nursing unit manager - hospital administrator - quality control manager - healthcare provider prescribing the med - Nursing unit manager The nurse leader conducts an education session for the nursing staff regarding case management. Which statement made by the nursing staff indicates they do NOT understand the role of case management? - It increases hospital profits by providing the optimal client care - it manages the client are by managing the client care environment - it promotes the appropriate use of hospital personnel and resources - It represents that primary health prevention is managed by a single case manager - it represents that primary health prevention is managed by a single case manager (Case management represents an interdisciplinary health care delivery system, but not the primary health prevention that is managed by a single case manager ) During an interview for the position of manager in the health care industry, the candidate is asked about the important qualities of a successful manager. Which response would be appropriate? (SATA) - A successful manager should take risks - A successful manager should tolerate uncertainty - A successful manager should show willingness to lead and follow peers - A successful manager should experiment with ideas for a unique situation - A successful manager should exert power for communication through different channels - A successful manager should take risks - A successful manager should tolerate uncertainty - A successful manager should experiment with ideas for a unique situation A nurse manager determines which nurses on the unit will care for patients for the upcoming shift. Which element of the health care system is the manager practicing? - Delegation - Leadership - Supervision - Assignment - Assignment A nursing student is listing the nursing manager's role in the hospital setting. Which roles listed by the nursing student are accurate? (SATA) - The nursing manager coordinates the activities of the nursing staff in delivering nursing care - The nursing manager uses appropriate leadership styles to create a nursing environment for clients and staff - The nursing manager investigates ways to improve nursing care and further define and expand the scope of nursing practice - The nursing manager establishes an environment for collaborative care to provide safe and quality care with a positive client outcome - The nursing manager provides independent care to women during pregnancy, labor and delivery and also provides care to the newborn - The nursing manager coordinates the activities of the nursing staff in delivering nursing care - The nursing manager uses appropriate leadership styles to create a nursing environment for clients and staff - The nursing manager establishes an environment for collaborative care to provide safe and quality care with a positive client outcome In a mass casualty situation, which is the facility-level organizational model for disaster management used by hospital or long term care facilities? - Emergency operations center (EOC) - Hospital incident command system (HICS) - National incident management system (NIMS) - Federal Emergency Management Agency (FEMA) - Hospital incident command system (HICS) The nurse would consider which disaster management plan to be most applicable if an earthquake hits a metropolitan area, causing death and injuries? - recruitment of additional healthcare personnel - evacuation and relocation from the disaster site - activation of the facilities emergency management plan - collaboration of multiple agencies and health care facilities - Development of policies and procedures for managing these events - Activation of the facility's emergency management plan - Collaboration of multiple agencies and healthcare facilities Which action makes a nurse manager also a leader? - implementing best management skills when hiring employees - having financial accountability associated with the organization - screening effectively to select the right employees for the organization - helping employees reach the highest level of their potential excellence - Helping employees reach the highest level of their potential excellence What qualities does the the professional nurse require to lead, manage and follow in a team? - being insensitive - impeding relationships - exercising self awareness - motivating self and others - managing emotions in self and others - exercising self awareness - motivating self and others - managing emotions in self and others The nurse manager is delegating tasks to the healthcare team to care for a client who underwent brain surgery. Which individuals on the team share accountability during delegation? (SATA) - attendant - nurse manager - certified tech - healthcare provider - UAP - Health care provider - nurse manager The nurse leader as a manager makes a decision regarding the method of documentation that benefits the nursing team. Which type of decision-making style does the nurse leader utilize? - Autocratic - informative - paternalistic - shared decision making - paternalistic (The nurse manager is making a decision based on what is best for the nursing team) The nurse leader suffers from headaches, HTN and GI probelms. Which affirmative statement by the leader reflects an appropriate way to manage stress? - I will avoid protein - I will plan a vacation - I will get enough sleep - I will participate in support groups - I will get enough sleep The nurse manager asks the staff nurse to participate in creating new guidelines for providing services to the client. Which management strategy utilized by the nurse manager? - insubordination - use of expert power - empowerment of staff - management by exception - empowerment of staff What are the responsibilities of the nurse as a leader? (SATA) - being accountable for financial matters - encouraging the direct care nurses to provide input into decisions - Identifying charge nurses who have a potential to become managers - being responsible for the selection, hiring and orientation of employees - ensuring the day to day activities of the staff are correctly planned and executed - Encouraging the direct care nurses to provide input into decisions - ensuring that day to day activities of the staff are correctly planned and executed The unit manager comes to work obviously intoxicated. Which action is the staff nurse ethically obligated to take? - call the security guard - tell the nurse manager to go home - have the supervisor validate the observation - offer the nurse manager a large cup of coffee - have the supervisor validate the observation (Call the supervisor and have them confirm the suspicion and handle the situation) Which intervention is a part of the response phase of disaster planning? - stabilize the community - limiting the impact of disaster - implementing the disaster plan - evaluate the events of disaster management - implement the disaster plan [Show Less]
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Evolve HESI Leadership/Management questions and answers latest updated
Which actions of the nurse exhibit transactional leadership? Select all that apply. 1 Motivating or inspiring the employees 2 Meeting the targets withi... [Show More] n the deadline 3 Working according to organizational rules 4 Correcting the errors in a reactive manner 5 Increasing the employee commitment of an organization 2, 3, 4 The characteristics of transactional leadership include valuing the orders and structures of an organization. The nurse who exhibits transactional leadership will meet the targets within the deadline given by the organization. The nurse will also follow the rules of an organization and will correct the errors of an employee in a reactive manner. Motivating or inspiring the employees and increasing employee commitment are the characteristics of transformational leadership. The unit nurse manager comes to work obviously intoxicated. Which action is the staff nurse ethically obligated to take? 1 Call the security guard. 2 Tell the nurse manager to go home. 3 Have the supervisor validate the observation. 4 Offer the nurse manager a large cup of coffee 3 Have the supervisor validate the observation. The staff nurse should call the hospital supervisor to confirm and handle the problem. The security guard has no authority in this situation. Although sending the nurse manager home removes the nurse manager from the clinical setting, this action misses an opportunity for documenting the situation and the nurse manager is in no condition to drive safely. Drinking coffee does not make a person less intoxicated. Which aspects are considered when determining the willingness of a nursing assistant before delegating a task? Select all that apply. 1 Ability 2 Attitude 3 Personality 4 Confidence 5 Commitment 2, 4, 5 An individual's willingness is related to attitude, confidence, and commitment. Ability is related to knowledge and skills in a specific situation. Personality characteristics can influence the effectiveness of the delegator. Which performance appraisal method is used by nurse managers to measure the performance of the nurse both qualitatively and quantitatively? 1 Narrative method 2 Critical incidents method 3 Graphic rating scale form 4 Behaviorally anchored rating scales 4 The behaviorally anchored rating scale is a performance appraisal method that provides an overview of nursing standards by determining performance both qualitatively and quantitatively. The narrative method requires a manager to write a statement about the nurse's performance. The critical incidents type is a performance appraisal method in which a manager keeps a written record of positive and negative performance. The graphic rating scale form is a performance appraisal checklist on which a manager rates the nurse's performance on a continuum such as excellent, good, average, and poor. The healthcare team is caring for clients in an emergency department. How soon should the clients triaged as an emergency severity index-3 (ESI-3) be seen by the physician according to the five level triage system? 1 Immediately 2 Within 1 hour 3 Could be delayed 4 Within 10 minutes 2 Within 1 hour The clients triaged as an ESI-3 should be seen by the physician within an hour. The clients with life-threatening problems are triaged as ESI-1, and they should be provided with immediate care. The care of the clients in ESI-4 and ESI-5 can be delayed for some time because the condition of the clients in this level is stable. Clients with major injuries are triaged as an ESI-2 and require treatment within 10 minutes. Which question does the registered nurse recognize as related to the right of circumstance when delegating? 1 "Is the delegation appropriate to the situation?" 2 "Is the task within the delegatee's scope of practice?" 3 "Is the prospective delegate a willing and able employee?" 4 "Is the delegator able to monitor and evaluate the client appropriately?" 1 "Is the delegation appropriate to the situation?" The question, "Is the delegation appropriate to the situation?" is related to right circumstance. The question, "Is the task within the delegatee's scope of practice?" is related to right task. The question, "Is the prospective delegate a willing and able employee?" is related to right person. The question, "Is the delegator able to monitor and evaluate the client appropriately?" is related to right supervision. Which factors does the registered nurse consider in the decision to delegate process? Select all that apply. 1 Evaluation 2 Nursing judgment 3 Predictability of outcomes 4 Pervasive functions of assessment 5 Complexity of the task to be performed 3, 5 Two factors responsible for the decision to delegate process are predictability of outcomes and complexity of the task to be performed. Evaluation, nursing judgment, and pervasive functions are not factors in the decision to delegate process. Under a leader, a team of followers has failed to achieve success in conducting research. What does an effective leader do in this situation? 1 Criticizes the team members for failure 2 Provides excuses for the negative outcome 3 Refuses to take the responsibility for failure 4 Accepts failure and gains experience from it 4 Accepts failure and gains experience from it An effective leader should accept the failure and gain experience from it to avoid repetition of the same errors. The effective leader should counsel and motivate the team members for future success and should not criticize them. Making excuses for the negative outcome is not the correct action of the effective leader. The effective leader should take responsibility for the failure and the growth he or she will gain from it. The nursing manager wants to implement transformational leadership qualities. Which actions best describe this style of leadership? Select all that apply. 1 Providing intellectual stimulation 2 Intervening only when problems exist 3 Performing experiments with system redesign 4 Using motivator factors to inspire work performance 5 Monitoring performance and taking action to correct 1, 3, 4 Transformational leaders provide intellectual stimulation and encourage follower creativity. They experiment with systems redesign, empower staff, create enthusiasm for practice, and promote scholarship of practice in client care. They use motivator factors liberally to inspire work performance. Intervening only when problems exist is a behavior related to transactional leadership. Monitoring performance and taking corrective action is a transactional leadership quality. Which component of delegation is defined as the ability to perform duties in a specific role? 1 Authority 2 Supervision 3 Responsibility 4 Accountability 1 Authority is the ability to perform duties in a specific role. Supervision is the provision of guidance and oversight of a delegated task. Responsibility refers to reliability, dependability, and obligation to accomplish work. Accountability involves determining whether the actions are appropriate and providing a detailed explanation of what has occurred. The healthcare team is caring for a client with neutropenia. Which task is delegated to unlicensed assistive personnel? 1 Administering antibiotics 2 Assisting with personal hygiene 3 Monitoring for signs and symptoms of infection 4 Teaching the client and caregivers about how to avoid infection 2 Unlicensed assistive personnel assisting with the client's personal hygiene. The licensed practical nurse administers antibiotics. Monitoring for signs and symptoms is performed by the licensed practical nurse. The registered nurse teaches the client and caregivers how to avoid infection. A client's serum potassium level has increased to 5.8 mEq/L (5.8 mmol/L). What action should the nurse implement first? 1 Call the laboratory to repeat the test. 2 Take vital signs and notify the healthcare provider. 3 Inform the cardiac arrest team to place them on alert. 4 Take an electrocardiogram and have lidocaine available. 2 Vital signs monitor cardiorespiratory status; hyperkalemia causes cardiac dysrhythmias. The healthcare provider should be notified because medical intervention may be necessary. A repeat laboratory test will take time and probably reaffirm the original results; the client needs immediate attention. The cardiac arrest team is always on alert and will respond when called for a cardiac arrest. Taking an electrocardiogram and having lidocaine available are insufficient interventions. The nurse has accepted a position as a navigator. What should the nurse expect to learn during training for this role? Select all that apply. 1 Approaches to reduce the cost of health care 2 Learning ways to work through the health systems 3 Strategies to teach clients about disease, including prevention and treatment 4 Assessing barriers that clients have encountered while attempting to receive care 5 Helping clients cope with delays in receiving treatment until barriers are overcome 2, 3, 4, 5 Navigators are responsible for overcoming health system barriers, providing health education about diseases from prevention to treatment, addressing barriers to care, and providing psychosocial support. These are the areas the nurse should expect to focus on when being trained in the role. Learning approaches to reduce the cost of health care would be appropriate for a case manager to learn. What aspect of total client care needs to be taken into consideration if used on a 24-bed care area? 1 Cost of nurses 2 Training needs 3 Documentation 4 Time commitment 1 Cost of nurses Since total client care is provided by a registered nurse (RN) it can be very expensive and not realistic to use a highly skilled and extremely knowledgeable professional nurse to provide all the care required in a unit of 24 clients. There are no particular issues with training, documentation, or time commitment with total client care. For which situations would total client care be an appropriate delivery system? Select all that apply. 1 Client scheduled for lithotripsy for renal calculi 2 Client with an endotracheal tube for pulmonary sepsis 3 Client recovering from cardiovascular bypass graft surgery 4 Client recovering from the placement of a cerebrospinal fluid shunt 5 Client transferring to a rehabilitation unit after total hip replacement surgery 2, 3, 4 Total client care is used in critical care settings where one nurse provides total care to one or two critically ill clients. The client with an endotracheal tube for pulmonary sepsis and the client recovering from cardiovascular bypass graft surgery are considered acutely ill and will be receiving care in a critical care area. The client recovering from cranial surgery to place a cerebrospinal fluid shunt would be appropriate for total client care. Total client care would not be an ideal care approach for the client scheduled for lithotripsy or the client being transferred to a rehabilitation unit. Which intervention should the charge nurse perform to manage a task when the unlicensed nursing personal (UNP) is lacking competence? 1 Provide constructive feedback and assign another task. 2 Provide open vocal feedback and withdraw the UNP from task. 3 Provide additional support and temporarily lower expectations. 4 Provide accountability to the organization and undergo training again. 3 Provide additional support and temporarily lower expectations. The charge nurse should manage a task by temporarily lowering expectations and providing additional support to an unlicensed nursing personal (UNP) who is lacking competence. This strategy allows the UNP to build on strengths, minimize weaknesses, and gain confidence. Providing constructive feedback and assigning another task may not improve the strategy of the UNP and may affect the productivity of the new task. Withdrawing the UNP from the task and providing open vocal feedback may weaken the working relationship and the UNP may lose confidence or become frustrated. The charge nurse should be aware of accountability to the organization in case of a failure of the delegation, but assigning the UNP for further training may lead to high risk for legal liability. Which statement would most likely be made by a client who is receiving care through the functional method? 1 "My nurse's name is Amy." 2 "Susan will be caring for me until 7 pm." 3 "I have to wait until the medication nurse is available for a pain pill." 4 "Barbara coordinated all of my care but I might receive the care from other nurses." 3 "I have to wait until the medication nurse is available for a pain pill." In the functional method, staff are assigned tasks according to scope of practice. In this approach a medication nurse will be identified. Knowing the nurse's name would more likely be a characteristic of team or primary nursing. Knowing which nurse will provide care for a specific period of time would indicate the case approach to care. Knowing which nurse coordinated the care that might be provided by others would more likely indicate primary nursing or case management. Which constructive aspects of conflict does the nurse leader identify? Select all that apply. 1 Polarizes groups 2 Releases pent-up emotions 3 Promotes ineffective communication 4 Helps individuals grow personally 5 Builds cohesiveness among people 2, 4, 5 Conflict serves as a release for pent-up emotion, anxiety, and stress. It helps individuals to grow personally and apply what they learn to future situations. It helps to build cohesiveness among people sharing the conflict, celebrating in its settlement and learning more about each other. It polarizes groups so they increase internal cohesiveness and reduce intergroup cooperation; this is a destructive aspect of conflict. Authentic communication is an aspect of conflict but not improbable communication. When does delegation become more challenging? Select all that apply. 1 When the client is stable 2 When the client is pregnant 3 When the geographic area is small 4 When the resources are abundant 5 When school children are receiving care 2 When the client is pregnant, 5 When school children are receiving care The delegation process becomes more challenging when vulnerable populations such as pregnant women and school children are receiving care. Delegation can be safely and successfully carried out in the stable client. Delegation can be accomplished successfully when the geographical area is small and resources are abundant. A client reports severe pain 2 days after surgery. After assessing the characteristics of the pain, which initial action should the nurse take next? 1 Encourage rest. 2 Obtain vital signs. 3 Administer the prescribed analgesic. 4 Document the client's pain response. 2 Obtain vital signs. Immediately before administration of an analgesic, an assessment of vital signs is necessary to determine whether any contraindications to the medication exist (e.g., hypotension, respirations ≤12 breaths/min). Pain prevents both psychological and physiologic rest. Before administration of an analgesic, the nurse must check the healthcare provider's prescription, the time of the last administration, and the client's vital signs. A complete assessment, including vital signs, should be done before documenting the client's pain response. A nurse leader, along with the team, is caring for a client who is scheduled for colonoscopy. Which delegated task requires the leader's supervision? 1 Assisting the client with an enema 2 Assisting the client with bathing 3 Assisting the client with feeding 4 Assisting the client with ambulating 1 Assisting the client with an enema A client who is scheduled for colonoscopy requires having the gastrointestinal tract emptied, mainly the colon. Before undergoing this procedure the client is assisted with an enema and other laxatives to expel all bowel contents present in the gastrointestinal tract. A nurse leader should supervise this procedure, as an inadequately emptied colon may cause complications. Assisting the client with bathing, feeding, and ambulating are easy tasks and may not require supervision. Which comment by a team leader exemplifies team nursing the way it was intended? 1 "(Unlicensed assistive personnel), I need you to measure all vital signs." 2 "(Registered Nurse 1), check all of the intravenous (IV) sites and give the IV medications." 3 "(Licensed Practical Nurse), you pass all of the oral medications to the clients today." 4 "(Registered Nurse 2), Mr. Jones has a foot wound, two IV meds, and needs morning insulin." 2 "(Registered Nurse 1), check all of the intravenous (IV) sites and give the IV medications." The team leader must have excellent communication skills, delegation, and effective decision-making abilities to provide a working "team" environment for members. When the team leader is not prepared for this role, the team method becomes a miniature version of the functional method. The assignment given to RN 1 takes the nurse's experience and skills into consideration and exemplifies team nursing. The statements made to the UAP, LPN, and RN 2 exemplify functional nursing. The registered nurse finds that two nursing students are arguing with each other. Which action by the registered nurse best represents a leadership quality? 1 Complaining to management and asking the students to go outside 2 Letting them continue arguing until they resolve the matter themselves 3 Assessing the condition and strategizing to resolve the matter by reducing the difference 4 Asking the reason for their argument and reprimanding them for having the argument in the hospital 3 Visioning is required by an efficient leader to engage others to assess the current reality. This skill includes determining and specifying a desired end-point state and then strategizing to reduce the differences. Letting them continue arguing and waiting until they resolve the matter may allow the argument to escalate. Complaining to management would pass off responsibility for a resolution and would not indicate leadership. Reprimanding the nurses may stop the argument, but would not be a constructive approach. [Show Less]
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Management & Leadership HESI questions answers latest updated
The nurse is preparing assignments for the day shift. It is most important that the client with which diagnosis and description is assigned to a registered... [Show More] nurse? A. Menorrhagia: 24 hours post vaginal hysterectomy B. Myocardial infarction: 4-days post infarction, transferred from ICU yesterday C. Depression: Admitted during the night, following a suicide attempt with an overdose of Tylenol D. Pneumonia: A 4-year old who is receiving IV antibiotics C. Depression: Admitted during the night, following a suicide attempt with an overdose of Tylenol During report, the charge nurse informs a nurse that she must work on another unit. The nurse begins to sigh deeply and tosses about her belongings as she is preparing to leave, making it known that she is very unhappy about having to "float." What is the best immediate action for the charge nurse to take? A. Continue with report, and talk to the nurse about the incident at a later time B. Ask the nurse to call the supervisor to see if she can be reassigned C. Stop report and remind the nurse that all staff must "float" at some time D. In the presence of other staff members, inform the nurse that her behavior is inappropriate A. Continue with report, and talk to the nurse about the incident at a later time A 15-year-old sexually active girl diagnosed with pelvic inflammatory disease (PID) is admitted to the hospital with a temperature of 101.6F and a purulent vaginal discharge. She has no insurance and tells the nurse she enjoys small children. Which room should the nurse assign this client? A. A semi-private room with a 4-year-old girl who is currently receiving chemotherapy B. A semi-private room with an older adolescent girl who had surgery yesterday C. A room close to the nurse's station D. A private room D. A private room The registered nurse (RN) and unlicensed assistive personnel (UAP) are working together to provide care for a bedfast client needing total care, medications, and Foley catheter irrigation. How should the RN assign the client's care? A. UAP: Personal care, catheter irrigation, I&O. RN: Medications B. UAP: Personal care. RN: Medications, catheter irrigation, I&O C. UAP: Catheter irrigation, I&O. RN: Medications. Both provide personal care. D. UAP: Personal care, I&O. RN: Catheter irrigation, medications. D. UAP: Personal care, I&O. RN: Catheter irrigation, medications. The charge nurse assigns the care of a client with diabetes who has hyperglycemia to a practical nurse (RN). In supervising the PN, what is the charge nurse's most important action? A. Decide which sliding scale insulin dose should be administered B. Obtain the blood sugar results via skin puncture and glucometer C. Notify the healthcare provider of the daily serum glucose results D. Confer with the PN about any manifestations the client is exhibiting D. Confer with the PN about any manifestations the client is exhibiting A registered nurse (RN) is caring for several clients on a progressive care "step-down" unit. After assessing the clients, which clerical tasks should the nurse assign to a UAP? A. Chart pulse oximeter readings and type of breath sounds auscultated in the medical record. B. Record the presence of blood-tinged urine and the hourly Foley output on the flow sheet. C. Document the type and amount of drainage on a new surgical dressing in the progress note. D. Transcribe vital signs from a unit worksheet to the individual graphic page in the client charts. D. Transcribe vital signs from a unit worksheet to the individual graphic page in the client charts. Which situation requires intervention by the nurse who is caring for a terminally ill client in a hospital? A. The case manager notifies the family that the critical pathway requires transfer to a hospice facility. B. The case manager notifies the social worker of the client's financial needs related to hospice care C. The social worker describes the client's feelings of grief to the spiritual counselor D. The social worker provides information about long-term care facilities to the client A. The case manager notifies the family that the critical pathway requires transfer to a hospice facility. The UAP reports morning vital signs to the primary nurse. Which client should the nurse assist first? The client who is: A. diagnosed with myxedema with a temperature of 96.8F B. one-day postoperative abdominal surgery with a pulse of 104 beats/minute C. diagnosed with hypertension and has a blood pressure of 154/94 mmHg D. diagnosed with pneumonia and has a respiratory rate of 26 breaths/minute D. diagnosed with pneumonia and has a respiratory rate of 26 breaths/minute A female client is receiving an enteral feeding via nasogastric feeding tube. The daughter reports to the charge nurse that her mother is coughing vigorously and sounds congested. Which staff member should the charge nurse ask to check on the client? A. Registered nurse (RN) who is admitting a new postoperative client to the unit B. Practical nurse (PN) who is giving routine medications C. Practical nurse (PN) who is talking with anxious family members D. Registered nurse (RN) who is entering nursing notes at the computer D. Registered nurse (RN) who is entering nursing notes at the computer The charge nurse, along with two registered nurses (RN), one practical nurse (PN), and one UAP is working in an emergency department. What activity should be assigned to the UAP? A. Monitor a client with mid-sternal chest pain, nausea, and vomiting B. Give instructions to the EMS about a patient being transferred to a nursing home C. Transport a client diagnosed with septicemia to the medical unit D. Obtain the history from a female client who presents in early labor C. Transport a client diagnosed with septicemia to the medical unit The charge nurse working in a long-term care facility is informed by the LPN that a client's son is unhappy with the care his mother is receiving. What action should the nurse take first? A. Ask the family member to come to the nurses' station to discuss the concerns B. Provide the son with a complaint form and ask him to describe the situation C. Discuss with the LPN the son's concerns about his mother's care D. Notify the administrator of the long-term care facility about the son's discontent C. Discuss with the LPN the son's concerns about his mother's care When the charge nurse is making assignments, which tasks can be assigned to a UAP? A. Perform a dressing change, oral suctioning, and admission of a client to the unit B. Time contractions, determine fetal heart rate, and administer an enema to a client in early labor C. Take vital signs, give a cleansing enema, and apply soft restraints to an older client D. Irrigate a naso-gastric tube, collect a stool specimen, and measure intake and output C. Take vital signs, give a cleansing enema, and apply soft restraints to an older client The charge nurse is assigning a room for a newly-admitted client, diagnosed with acute Pneumocystitis carinii pneumonia, secondary to acquired immunodeficiency syndrome (AIDS). Which room would be best to assign to this client? A. A private room fully equipped with an outside air ventilation system B. A semi-private room shared with a bed-ridden elder who would enjoy the company C. A semi-private room with a bed available nearest to the bathroom D. A semi-private room that does not have a client in the other bed at this time D. A semi-private room that does not have a client in the other bed at this time A nurse who works in an acute minor illness clinic returns form lunch and finds several clients who need attention. Which client should the nurse attend to first? A. A 10-year-old with asthma who is responding well to nebulizer treatments B. A three-week-old infant who is nursing and was brought in because he had a fever C. A 4-year-old receiving intravenous fluid for dehydration whose IV fluid bag is empty D. A 6-year-old with Down syndrome who has been coughing productively C. A 4-year-old receiving intravenous fluid for dehydration whose IV fluid bag is empty The nurse is designing a program to control nosocomial infections on a geriatric unit of an acute care hospital. What strategy should be included in this plan? A. Do not allow those with influence to be admitted to the unit B. Require that all clients receive a pneumonia vaccine prior to admission C. Ensure that sterile technique is followed when changing surgical dressings D. Encourage clients to drink water to prevent urinary tract infections C. Ensure that sterile technique is followed when changing surgical dressings The charge nurse working the 3 to 11 shift of a 24-bed medical unit in a large acute care hospital is making assignments. Currently, there are 20 clients on the unit and 4 admissions are scheduled to arrive during the shift. Besides the charge nurse, the staff consists of two experienced practical nurses (PN) and one unlicensed assistive personnel (UAP) who has worked on the unit for 10 years. Taking into consideration the acuity of each client, which distribution of clients is the best assignment for the nurse to make? A. 10 clients and 2 admissions to each of the PNs. Have the UAP take all vital signs and collect all I&Os. B. 10 clients to each of the PNs. Have the UAP take vital signs. The charge nurse takes the 4 new admissions. C. 8 clients to each of the PNs, 4 clients to the charge nurse, and the 4 admissions to the UAP. D. 8 clients to each of the PNs, 4 admissions to the charge nurse, and 4 low-acuity clients to the UAP. B. 10 clients to each of the PNs. Have the UAP take vital signs. The charge nurse takes the 4 new admissions. An emergency room anticipates an influx of injured clients from a large motor vehicle collision on a major freeway. Which client should the triage nurse send to the trauma staff for immediate intervention? A. A young adult male with a suspected closed head injury who has no respirations despite having his airway repositioned by the emergency medical team. B. An adult with a suspected intraabdominal bleed who was not breathing on arrival, but is currently responding since repositioning the airway C. A teenager with a suspected fractured leg who's respirations are 26 breaths/minute, capillary refill D. A young adult with a facial laceration that is controlled by pressure and whose respiratory rate, capillary refill, and ability to follow commands are WNL B. An adult with a suspected intraabdominal bleed who was not breathing on arrival, but is currently responding since repositioning the airway Which pediatric client requires immediate intervention by the nurse? A. A 2-year-old with a twenty-four hour urine output of 500mL B. A 3-year-old with several episodes of nocturnal enuresis C. A 4-year-old with an easily palpable bladder and frequency D. A 5-year-old with diuresis following furosemide (Lasix) administration C. A 4-year-old with an easily palpable bladder and frequency The nurse is caring for 4 clients on an orthopedic floor: 2 clients with total hip replacements, one client with total knee replacement, and one client with a fractured femur who is in skeletal traction. Which nursing task should the nurse delegate to the UAP? A. Adjust the setting on the continuous passive motion machine (CPM) B. Clean the skeletal traction insertion sites while performing a.m. care C. Assist the client to ambulate for the first time after surgery D. Change the linens for the client with skeletal traction D. Change the linens for the client with skeletal traction The nurse is giving change-of-shift report for four clients in the emergency center and reports the client with a terminal disease has a living will and a "Do not resuscitate" (DNR) order on file. Which client fits the criteria for a terminal illness? A. 2-year-old child with esophageal burns from drinking drain cleaner who now has a gastrostomy tube B. 76-year-old female client with Alzheimer's disease who is pacing the halls and trying to "go home." C. 52-year-old male client who had a partial lobectomy and on a ventilator on the 2 postoperative day D. 43-year-old male with amyotrophic lateral sclerosis who is refusing artificial nutrition or hydration D. 43-year-old male with amyotrophic lateral sclerosis who is refusing artificial nutrition or hydration The nurse manager is talking to a new nurse who is thinking about resining before orientation to the unit is over. The nurse-manager explains that reality shock after graduation is common. Which explanation should the nurse-manager use to best describe reality shock to the new nurse? A. A realization that practice and education are not the same B. A series of experiences to become an experienced nurse C. A period of role adjustment from school into the work force D. A phase that new nurses go through before changing jobs C. A period of role adjustment from school into the work force Which task should the nurse delegate to the UAP? A. Accompany the healthcare provider during client visits B. Determine a client's response to pain C. Observe a client's central venous catheter site D. Feed a client with minimal dysphagia D. Feed a client with minimal dysphagia The nurse receives report in the emergency center for four clients. Which client should the nurse assess first? A. A screaming child with a compounding fracture of the wrist B. A diabetic client with a laceration on the sole of the foot C. A client experiencing shortness of breath and dyspnea D. A geriatric client with many new and old bruises noted C. A client experiencing shortness of breath and dyspnea [Show Less]
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Leadership HESI Questions and answers graded A+
An RN distributes a task to four healthcare professionals. When are both accountability and responsibility transferred to the healthcare professional? - w... [Show More] hen the task is given to another RN (when the RN gives a task to another RN, the task can be assigned but not delegated ) Which component is the ability to preform duties in a specific role? - authority The nurse leader monitors the direct care nurse administering pain medication to a client. The leader tells the client "i will be back in 30 mins to assess your pain level". Which right of the client does the leader fulfill if the leader returns within 30 mins. - Fidelity Clients with which tag are referred to as "walking wounded" when managing a disaster? - green Which delegation actions may be performed by the UAP while caring for a client? - asking the client to wear footwear when walking - asking the client to wash hands before eating meals Which action would the nurse think should be excluded to prevent staff from having PTSD during a mass casualty assessment? - to work continuously without breaks (this can increase stress) Which drawback indicates an improper follow-through on the part of the delegatee? - failure to report results and findings Which internal factors affect the decision making process of a leader? - values, interests, knowledge When assessing an obese client, a nurse observes dehiscence of the abdominal surgical wound with evisceration. The nurse places the client in the low-fowler position with the knees slightly bent and encourages the client to lie still. What is the next nursing action? - Cover the wound with a sterile towel moistened with normal saline Which interventions are in the scope of a UAP? - ambulating the client - assisting with the client bathing - Recording vitals Which amount of time is appropriate for a nurse to spend triaging each client during a mass casualty incident? - less than 15 seconds Which action is specific to the role of a nurse leader or manager in the area of clinical research? - facilitating the application of research findings in practice The geographic location of a community makes it vulnerable to storms. The community health nurse teaches the community about safety measures to be taken during the storm. Which phase of disaster management is this action? - preparedness Which task can be delegated to the LPN? - administering oral hypoglycemic agents - administering IM medications A nurse leader is caring for a client during their entire stay in the hospital. Which nursing model is the nurse following? - primary nursing model What does the nurse understand to be the role of EMTs in emergency nursing after a disaster? - to monitor vital signs What qualities does the professional nurse require to lead, manage, and follow in a team? - exercising self-awareness - motivating self or others - managing emotions in self and others The nurse is caring for a client with severe menstrual cramps and bleeding. Which task is appropriate to be delegated to the LPN? - administration of oral analgesics Which strategy of the nurse leader regarding the quality improvement (QI) process requires revising? - focus is on correcting errors The nurse is caring for a client with trauma in the emergency unit. Which action should the nurse preform as the highest priority? - provide adequate oxygen supply (ABC) Which clients would the nurse consider to require a high intensity of resources to provide effective care? - client with respiratory distress (this is life threatening) Which task is achieved by the delegator when he or she engages in self-care to enhance his or her ability to care for the health care team? - renewing What are major issues identified by the nurse leader as reasons for increased union activity? - low wages - mandatory overtime requirement - absence of reporting unsafe work environments Which responsibility of the nurse manager differs from the responsibilities of a nurse leader? - planning the budgets What is the duty of the nurse as delegator if the delegatee has limited knowledge and ability to preform a task? - provide guidance What is an expectation of a primary nurse? - coordinate all aspects of a clients care Which nursing care delivery system works well in emergency situations that necessitate prioritization of care? - functional nursing ( each care provider knows the expectations of the assigned role and completes the tasks quickly and efficiently ) The nurse leader is teaching the staff that health care providers continuously strives to work effectively within the cultural context of a client. Which cultural principle is the nurse leader explaining? - cultural competence A client reports smoke coming from a utility room on the nursing unit. What is the initial action the nurse should take? remove anyone who is in immediate danger *RACE: Remove any clients from danger, activate fire alarm, contain fire by closing windows and doors, extinguish the fire The nurse is caring for four clients on a medical unit. Which client should the nurse see first? - client with chest pain Which health care team member is familiar with all the needs of the individual clients? - the charge RN (charge nurse is involved in the coordination and assignment of care to individual clients ) What type of delivery method is used when the nurse provides care to the same client for the entire work period? - case method A nurse recieves a shift report on four adult clients who are between the ages of 25-55. Which client should the nurse assess first? - female client on warfarin with an INR of 7.5 ( Normal INR is between 2-3) Which actions can the mentor take to develop effective leadership qualities in the aspiring leader? - modeling behavior - giving timely feedback - providing appropriate advice Which activity indicates improper follow-through on the part of the delegatee? - failure to report results Who is the designated delegator? - nurse manager Who would the RN state is accountable for establishing systems to communicate competency requirements related to delegation? Chief nursing officer (CNO) (they are accountable for establishing systems to communicate competency related to delegation) Which skills would be essential for an effective nurse manager to develop and improve collaboration with others? - flexibility - ability to listen to others - ability to share information and ideas A group of clients injured in a cyclone are admitted to the ER. The hospital management wants to caution people living in those areas through radio and news to notify other healthcare facilities. Which personnel would the nurse consider are appropriate in this situation? - public information officer Which action by the nurse leader is indicative of transactional leadership? motivating the self-interest of the employees by offering external rewards (Transactional leadership relies on the power of organizational position and formal authority to reward and punish performances) Which nursing process includes tasks that can be delegated? - implementation During an external disaster, which member of the hospital command system has the authority to rapidly expand hospital capacity and ensure the availability of medical supplies to the nurse as a function of an emergency response plan? - hospital incident commander (this is a physician or administrator who assumes overall leadership for implementing the emergency response plan) Which injuries would likely be given a green tag after a disaster? - strains - sprains - abrasions What are qualities of an effective leader? - elicit a vision from people - bring out the best in people - inspire people to bring the vision into reality Which personnel can determine priorities for treatment in an emergency response plan? - triage officer Which personnel should the nurse state are responsible for deciding number, acuity and resources needed for clients during a disaster? - medical command physician ( they have the authority to decide the number, acuity and resources needed for clients during a disaster) The nurse on the cardiac unit has received the shift report from the outgoing nurse. Which client should the nurse assess first? a) The client who has just been brought to the unit from the ED with no report of complaints b) The client who received pain meds 30 mins ago for chest pain that was a level 3 on a 1-10 scale c) The client who had a cardiac cath in the morning and has palpable pedal pulses bilaterally d) The client who has been turning on the call light frequently and stating her care has been neglected a) The client who has just been brought to the unit from the ED with no reports of complaints The client may or may not be stable, they need to be assessed to see what brought the client into the ED to begin with The nurse on the cardiac unit is preparing to administer medications after receiving the morning change of shift report. Which medication should the nurse administer first? a) The cardiac glycoside to the client who has an apical pulse of 58 b) The loop diuretic to a client with a serum K+ level of 3.2 mEq/L c) antidysrhythmic to the client in v-fib d) the calcium channel blocker who has a blood pressure of 110/68 c) The antidysrhythmic to the client in v-fib this is life threatening The nurse has finished receiving the morning change of shift report. Which client should the nurse assess first? a) The client diagnosed with arterial occlusive disease who has intermittent claudication b) The client on strict bed rest who is complaining of calf pain and has a reddened calf c) The client who complains of low back pain when lying supine in bed d) The client who is upset because the food doesnt taste good and is cold all the time b) The client on strict bed rest who is complaining of calf pain and has a reddened calf Could be a DVT The nurse is working with an LPN and a UAP to care for a group of clients. Which nursing task should not be delegated or assigned? a) the routine oral meds for a client b) the bed baths and oral care c) Evaluating a clients progress d) transporting the client to dialysis c) Evaluating the client care The nurse is caring for clients on a medical unit. Which tasks should the nurse implement first? a) change the abdominal surgical dressing for a client who has ambulated in the hall b) discuss the correct method of placing montgomery straps on the client with the UAP c) Assess the male client who called the desk to say he is nauseated and just vomited d) Place a call to the extended care facility to give the report on a discharged patient c) Assess the client who called the desk to say he is nauseated and just vomited Which is essential for ensuring disaster readiness in a community? a) Trauma system b) state govt c) federal govt d) emergency response system a) Trauma system The nurse forgets to administer lasix, the client later experiences pulmonary edema. This constitutes negligence how? a) purposeful failure to preform a healthcare procedure b) Unintentional failure to preform a healthcare procedure c) act of substituting a medication for the one prescribed d) failure to follow a healthcare provider prescription b) Unintentional failure to preform a healthcare procedure A nurse finds a patient dizzy and drowsy. Which type of need would the nurse prioritize according the Maslows heirarchy of needs? a) safety b) belonging c) self-esteem d) self-actualization a) safety A patient with a history of chronic heart failure is admitted with severe SOB and cough. Which action should the nurse preform first? a) auscultate the abdomen b) check the capillary refill c) auscultate the lungs d) assess LOC c) auscultate the lungs What should the nurse consider when obtaining an informed consent from a 17 year old male? a) whether the client is allowed to give consent b) That the client cannot make informed decisions about healthcare c) If the client is able to give consent without the parents there d) the inability to choose between alternatives when asked to consent a) whether the client is allowed to give consent Grandparents stop by the nursery and offer to take the newborn to the mothers room. What is the best response by the nurse? a) "I'll get your grandchild. You must be very excited" b) "Show me your ID. I need to see it before I can give you the baby" c) "Please go on to see your daughter. Ill bring the child" d) "Only the mother can ask to see the child. Have her call us to bring the child" c) Please go on to see your daughter, Ill bring the child Which personnel can determine priorities for treatment in an emergency response? a) Triage officer b) Public information officer c) Medical command officer d) Hospital incident commander a) Triage officer After a nurse assigns a task to an LPN, which of the following should the nurse do? a) assume the task was done b) follow up with the LPN c) ask the charge nurse to check up on her d) document that the task was done b) follow up with the LPN What is the appropriate statement that describes the focus of Managers and leaders? a) the process and strategies look similar with different goals b) The manager focuses on people and the leader focuses on systems and structures c) The leader focuses on people and the manager focuses on systems and structures d) management and leadership are different c) The leader focuses on people and the manager focuses on systems and structures [Show Less]
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Leadership Hesi 2, questions and answers graded
Finding a client sitting on the floor, nurse calls for help from UAP Get a BP cuff Assigning a UAP to assist client with personal care Prescribed ... [Show More] activity level Charge nurse developing guidelines for a coronary care unit The scope of of practice from the American nurses association Which patient should be assigned to a nurse that is floated from maternity unit Post op hysterectomy There has been a major disaster. Triage nurse should give which patient priority Cut over the Eye Delegate to LPN Dressing change Move which patient to medical surgical unit Patient with ABNL liver levels One open bed in ICU but reserved for patient coming from PACU with respiratory problems, what to do Take patient to ICU and arrange for respiratory patient to stay in PACU UAP giving complete bath-which patient is more concern Patient with dyspnea (SOB when lying flat) ER nurse getting moved to L&D, what patient should leader assign Patient with episiotomy infection DNR Notify the family Against medical Advice (AMA)with and IV RN removes IV, sign the document AMA form Prescriptions-telephone repeat order back to doctor to make sure it is correct Assign UAP hygiene, feeding, ADLS, ROM, ambulation Malpractice negligence by professional personnel Ex: buring client with hot heating pad, ignoring s/s of bleeding, giving wrong medication Assignments-new grad graduate nurse supervised by RN, what pt to give? Infusing antibiotic or choosing catheter port Unsafe nurse after nurse goes through rehab she can do her job regularly critical lab value potassium 2.5 is critical lo 6 it critical hi Fibromyalgia assistance provide uninterrupted sleep and refer to pain specialist MRSA room assigned private room, contact isolation Cultural Native American POC Know rules for Immunization permission Priority care Management Ethical Assign least care to UAP Clients rights to give Informed consent is based on which ethical principle Autonomy Consent to treat dont need consent Conflict resolution-nurses Ask the nurses to meet with the nurse manager to identify ways of working CPR effectiveness NGT Irrigation-assignment RN must irrigate UAP using a hand sanitzers that is alcohol for 2 minutes tell that hand sanitizer use is less charge nurse developing the nursing guidelines for a coronary care unit The Scope of Standards of Practice from the American Nurses Association nurse-manager is preparing an annual budget for the unit. Nursing salaries should be included in which component of the budget Operating budget reporting blood glucose results to the nurse the LPN says the glucometer was not calibrated prior to use because the report given by the night shift staff ran late Advise the LPN of the implications involved by not calibrating the glucometer Risk management: pt fell while using some equipment charge nurse trying to find out what happened- hospital polices New RN to Unit Assignment best client to assign is client 4 days post MI Incorrect Delegation LVN/LPN to remove staples from abdominal wound Client in labor, you call the provider and he has slurred words, loud noise in background, and seems intoxicated contact the healthcare provider's associate, not the medical director nurse-manager of a perinatal units is notified that one client from the medical-surgical unit needs to be transferred to make room for new admissions A 35-year-old with lupus erythematosus What action should the nurse implement first when delegating nursing activities to an unlicensed assistive personnel (UAP) Evaluate the experience of the UAP [Show Less]
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Leadership & Management HESI Questions and answers latest updated
Rn is planning assignments for 5 clients on the nursing unit. the team includes a LPN and a nursing assistant. which clients should the nurse assign to the... [Show More] LPN? 1. a client w/ a colostomy who requires reinforcement regarding the procedure for irrigation 2. a pt w/ DM who requires the administration or regular insulin in accordance w/ a sliding dosage scale every 4 hrs A client scheduled for surgery tells the nurse that he signed an informed consent for the surgical procedure but was never told about the risks of the surgery. The nurse serves as the client's advocate by: calling surgeon and asking that the risks be explained to the client A nurse is preparing the client assignments for the day. One of the nurses on the team has just learned that she is pregnant. Which client does the nurse refrain from assigning to the pregnant team member? a client w/ a solid sealed cervical radiation implant A RN is supervising a nursing assistant ambulating a client with right-sided weakness. The RN would conclude that the nursing assistant is performing the procedure incorrectly after observing that the nursing assistant: stands behind the client A RN is watching as a new LPN administer an IM injection in a client's deltoid muscle. the RN determines that the LPN is performing the procedure correctly if the LPN: administers the injection 2 in below the acromion process The nurse is preparing client assignments for the day. Which client should the nurse assign to a nursing assistant? unconscious pt who requires oral care A RN who has a LPN and a nursing assistant on the nursing team is planning client assignments for the day. Which client should the RN assign to the LPN? a pt receiving oxygen who requires frequent pulse oximetry monitoring and resp treatments A nurse has delegated several nursing tasks to staff members. The nurse's primary responsibility after the delegation of the tasks is to: follow up with each staff member regarding the performance of the task and the outcomes r/t implementation of the task A nurse is planning the client assignments for the shift. Which of the following clients should the nurse assign to the nursing assistant? a client who needs frequent ambulation with a walker A nurse employed at a hospital is asked by a nurse manager to review the organizational chart. The nurse reviews the chart so that he will: be familiar with the organizations line of authority A nurse leader in a med-surg unit overhears the nursing staff openly discussing a client and stating that the client is "uncooperative and a real pain to care for." the nurse leader would most appropriately manage this issue by: discourage the judgemental comments a nurse educator describes the standards of care formulated by the american nurse association to a group of new nursing graduates hired by the hospital. which of the following are accurate descriptions of these standards of care 1. define professional practice 2. have some similarity to policies & procedures 3. are authoritative statements that describe a common or acceptable level of client care or performance the nurse educator, discussing care maps, asks the graduate nurse whether she understands how a care map is used. which response indicates understanding care map outlines the day-to day expected outcomes of care and the outcomes anticipated at discharge the unit secretary says to the nurse "i read in mr. gage's medical record that he has gonorrhea." how should the nurse respond to the secretary we cant discuss a clients medical condition during the program, a crew from a local television station arrives to film the proceedings because the station is publicizing a series on hospital services. the nurse conducting the program should explain to the television crew that videotaping is not allowed a nurse manager discusses staff empowerment with the nursing team. the nurse manager explains that staff empowerment fosters the growth of others so that they are less dependent on the leader which notes in a client's record indicated an unexpected outcome and the need for follow-up? pt w/ a central venous catheter has a temp of 100.6 an ed nurse is performing an assessment of a client who has sustained circumferential burns of both legs. what should the nurse assess first peripheral pulses which situation is an example of the use of evidence based practice in the delivery of client care ... a client whose right leg is in skeletal traction complains of pain in the leg. which action should the nurse take first ... in which situation is the nurse upholding the ethical principle of fidelity ... A nurse, newly employed by a home health agency, is told that the organization's decision-making process is centralized. the nurse determines that this means that the authority to make decisions is vested in a few individuals, such as the board of directors a client with cancer is transported to the radiology departement for a bone scan to determine whether the cancer has metastasized to bone. while the client is in the radiology department the clients wife arrives and asks what test is being performed. the nurse should tell the wife she will have to discuss the prescribed test with the client After initial rounds, which client will the RN plan to care for first? a pt who is scheduled for surgery at 1 pm Rn is uncomfortable with writing prescriptions and explains this to the DR, but the DR tells the nurse that she will be reported if she does not write the prescriptions. how should the nurse manage this conflict? discussing the situation w/ the nurse manager a negligent act using clean gloves to change a gastrostomy tube dressing beneficence RN administers an immunization to a child even though it may cause discomfort float nurse to ICU is angry with the assignment ask the nurse manager of the ICU to discuss the assignment Which clients should be assigned to a nursing assistant? 1. pt who requires transport to the radiology department 2. pt w/ a foley catheter for whom a 24 hr urine collection is in progress change of shift report should include needs and priorities of care current diagnosis results of lab studies conducted that day pt response to tx implemented that day DM is having a hard time drawing the insulin into syringe bc he cant see the markings on the syringe. refer him to home care new nurse needs help w time management if documents task completion & client info at the end of the day difficulty holding utensils while eating occupational therapy client wants a DNR. the nurse should tell him that DNR request should be discussed w/ physician, who will write the order [Show Less]
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Leadership & Management HESI Practice questions and answers
Newly hired UAP expresses fear to collect a sputum from HIV patient Determine the UAP's knowledge about HIV transmission. RN, PN, UAP are working a... [Show More] s a team The UAP obtains an oxygen saturation level while RN reports finding to the health care provider. The most immediate follow-up An UAP is assigned to check a client for fecal impaction. Nurse receives a prescription over the telephone Administer a nebulizer breathing treatment. Patient uses the call system alarm Ask a coworker to respond to the client whose call bell is alarming. Emergency room, who to take care first A female client with severe right lower abdominal pain who is febrile and vomiting. No heroic measures Give detailed report to accepting nurse. Evaluate cardiac monitor system Organize a committee of ICU nurses to identify potential problems of the new monitoring system. Client has reported feeling of being constipated Assist the client to drink warm prune juice. Sequential compression devices Report any change in color in the client's feet or legs. Respiratory therapist cross-trained avoiding HIV positive client Provide the employee with feedback about the observed behavior. Medication error remains unchanged Examine medication administration data to determine use of new policy by nursing staff. Increase of nurse-to-patient ratio by 25% Disseminate factual information to all nursing staff to avoid misinformation and rumors. Respiratory rate decreases 14/ min -> 6/ min -> 4/min The decision regarding when to call the health care provider Glucometer checks post 2 days consistently 50-60 mg/dl higher Evaluate calibration of glucometer in use per manufacturer guidelines. Receptionist is responsible for taking client calls. Who to call back first? Casted right leg has a funny feeling tingling sensation. Two clients in one room. One client has MRSA the other one neutropenia. What intervention should the nurse implement? Transfer client with neutropenia to a private room. Signed witnessed DNR Confirm current resuscitation wishes with client and family hospice nurse end of life care MUCOUS MEMBRANE MOIST old client to rn (going to give to most experienced nurse) 72 YEAR OLD WITH DM 1 4 clients, iv infusing CEFTATRIAXONE IN 5% DEXTROSE uap, colostomy record amount charge nurse, rn, pn cardiac cath, no pedal pulses .Charge nurse takes over for nurse on break, which client checked first 40 ml dark colored urine UAP stuck in palm by needle with Hep -wash hands with soap and water Assess first -coronary syndrome with increasing SOB New clinical documentation -Need to discuss new clinical documentation that helps save lifes and require one more document PCA to PO. BP increases 120/72 to 150/90. Additional questions/comments to HCP -can PCA be reinitiated Most immediate, intervention by nurse Pneumothorax with 80 SpO2% Intervention best to delegate to LPN Duragesic Morning lab, follow-up first BNP assay, MI with SOB 1000 UAP to assemble nephrostomy tube -change bag to leg bag Women health fair, PN helping RN -assist with bone density prep Warrants immediate attention -female with RLQ pain in abd, febrile and vomiting Delegated to UAP` apply abdominal binder Multidisplinary team -elderly man with BGL 400 Assess first -constipation [Show Less]
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Hesi Leadership Exit Exam Version 2 questions and answers
1.A nurse is performing telephone triage at the clinic office. Which client has the most acute problem and should be scheduled for the first available appo... [Show More] intment? A 21 year old with a history of a kidney transplant. Today the client reports flu-like symptoms with a fever of 100.4 F (38 C) 2.The nurse is admitting a woman who has an arteriovenous (AV) fistula in her right arm that is used for hemodialysis. She missed her last hemodialysis session and is experiencing shortness of breath and an irregular heartbeat. Which action should the nurse assign to the UPA who is working with the nurse? Measure Vital Signs 3.The nurse should assess the client with which problem first? Paresthesia secondary to an arterial occlusion 4.A young adult client with a brain tumor refuses further treatment and requests to be allowed to die a natural death. The healthcare provides does not agree with the client's decision and refuses to write do-not-resuscitate instructions. Which action should the nurse take? Initiate a review of the situation by the hospital's ethics committee. 5.A healthcare provider notifies the nurse that new prescriptions have been written for a client. Which is the 1st action the nurse should implement? Read all of the new prescriptions for the client written by the provider 6.The nurse is observing the staff provide care to a client with acquired immune deficiency syndrome Unlicensed assistive personnel wearing a mask to take client's blood pressure. 7.The nurse caring for a client with bacterial meningitis is preparing report for the oncoming nurse. It is most important to include which assessment finding in the report? Increasing Pulse Pressure 8.The charge nurse notices that a respiratory therapist who has been cross-trained to work as a phlebotomist and unlicensed assistive personnel (UAP) seems to be avoiding HIV positive clients Provide the employee with feedback about observed behavior 9.The nursing supervisor sends an unlicensed assistant personnel ( UAP) to a medical unit to replace an absent UAP. When delegating the task of obtaining client's blood sugar levels using a glucometer, which action is most important for the nurse to implement? Observe the UAP obtain a fingerstick glucose level using the glucometer. 10.The nurse manager conducts regular audits of patient care medication records and notices that the amount of narcotic pain medications administered during the evening shift on a postsurgical unit Conduct a closer examination of staff nurse's distribution of pain medication from evening shift 11.The smell of cigarette smoke is coming from a client's bathroom. Which action should the nurse Educate the client about the hospital smoking policy. 12.The practical nurse (PN) reports to the charge nurse that the transparent dressing covering a single lumen central venous catheter inserted in the subclavian vein of a client has come loose and the insertion site is inflamed. Which action should the charge nurse implement? Confirm the findings of the PN while securing the transparent dressing and notify the healthcare provider. 13.At 0200 the nurse phones the healthcare provider to request a PRN medication for a client who is unable to sleep. The healthcare provider is awakened and gives the nurse a prescription for four times the normal dosage. When questioned by the nurse, the healthcare provider responds in a sleepy Call the healthcare or back, and report that the dosage prescribed is our times the normal dosage. 14.The charge nurse notices that a female practical nurse (PN), who has a long work history on the unit and is a valued employee, seems tired and slow to respond verbally during the change of shift report. One hour later the charge nurse overhears the PN telling an unlicensed assistive personnel (UAP) that she took a sleeping pill 4 hours ago and she is still feeling its effects. Which action should the charge nurse take? Send the PN to the employee health center for a urine drug Screen 15.It is most important to assign which client to a registered nurse rather than a practical nurse? After ambulating, a postoperative client grimaces and reports incisional pain at a "9" on a point scale. 16.After receiving a change of shift report for clients on a medical surgical unit, which task should the nurse Apply hydrocolloid dressings to venous 17.The charge nurse observes unlicensed assistive personnel (UAP) and a nurse arguing at the nurse's station. What action is best for the charge nurse to implement? Inform both individuals that their behavior is inappropriate in a work setting 18.A male client with metastatic lung cancer has requested that "no heroic measures" are used to extend his life, so the healthcare provider prescribes transferring the client to the palliative care Ensure the prescriptions or transfer include the client's end-of-life choice. 19.The charge nurse observes that a client with a nasogastric tube applied to low intermittent suction is drinking a glass of water immediately after the unlicensed assistive personnel (UAP) left the room. What is the best initial action for the charge nurse to take. Remove the glass of water and speak to the UAP. 20.The nurse hears a newly employed unlicensed assistive personnel (UAP) who is working in a long-term care facility calling the adult residents "honey" and "dearie." What is the best action for the nurse to take? Meet with the UAP to discuss respectful client care strategies. 21.The charge nurse is providing instructions to unlicensed assistive personnel (UAP) who will be assisting with the care of a client who has a hiatal hernia. Which instruction should the charge provide the UPA? Elevate the head of the bed before the client begins to eat 22.A nurse (RN), practical nurse (PN), and unlicensed assistive personnel (UAP) are working as a team to provide care for an acutely ill client requiring immediate bedside insertion of a chest tube. Which assignment is best use of each persons skills? The UAP obtains oxygen saturation level while the RN reports findings to the healthcare provider 23.The nurse is caring for a group of clients with the help of an experienced unlicensed assistive personnel UAP . Several specimens need to be collected and sent to the lab. Wich specimen collection can the nurse delegate to the UAP? Urine from indwelling catheter. Fecal drainage sample. 24.The nurse observes that a practical nurse (PN) charted that wound care was performed on a client. However, the nurse's assessment indicates that the date on the dressing is 2 days old, and the dressing does not appear to have been changed since the date noted. Which is the best initial intervention Consult with the PN about the discrepancy 25.After reviewing the morning laboratory findings for four clients, which client should the nurse follow-up The BNP assay for a client with shortness of breath after a MI increases to 1000 pg/mL. 26.After receiving morning report on an acute care unit, which client should the nurse assess first? A client sitting close to the nurse's station who has been restrained the past six hours 27.An older woman with a long history of hypertension is transferred from a long-term care facility to the hospital intensive care unit because of an exacerbation of heart failure (HF). She has a signed and witnessed "do not resuscitate" from in her record. Which action should the nurse take? Confirm current resuscitation wishes with client and family. [Show Less]
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HESI Exit Exam - Leadership & Management, questions and answers
By what authority may RNs delegate nursing care to others? State Nurse Practice Act A UAP may perform care that falls within which component of the... [Show More] nursing process? Implementation Which type of communication is necessary to implement a democratic leadership style? Assertive communication skills What are the five rights of delegation? A. Right task B. Right circumstance C. Right person D. Right direction or communication E. Right supervision Which of the following tasks can be delegated to a UAP? A) Inserting a Foley catheter B) Measuring and recording the client's output through a Foley C) Teaching a client how to care for a catheter after discharge D) Assessing the symptoms of a urinary tract infection A) Is a sterile invasive procedure and should not be delegated to a UAP *B) Falls within the implementation phase of the nursing process and does not require nursing judgment. Evaluation of the I&O must be done by the nurse C) Client teaching requires the abilities of a nurse and should not be delegated. The USP may be instructed to report anything unusual that is observed and any symptoms reported by the client, but this does not replace assessment by the nurse D) Assessment must be performed by the nurse and should not be delegated. The UAP may be instructed to report anything unusual that is observed or any symptoms reported by the client, but this does not replace assessment by the nurse. What are the essential steps of effective supervision? Direction, evaluation, and follow-up Which of the following is an example of assertive communication? A) "You need to improve the way you spend your time so that all of your care gets performed." B) "I've noticed that many of your clients did not get their care today." A) This is an aggressive communication, which causes anger, hostility, and defensive attitude. B) Assertive communication begins with "I" rather than "You" and clearly states the problem. What are common signs of substance (nurse substance abuse)? Common signs of substance (nurse substance abuse) are clients complaining that pain medication foes not relieve pain when administered by a certain nurse, frequent inaccuracies of controlled medication counts for a specific nurse, and client reports not taking pain medication but several doses are signed out for that client. Describe common characteristics of incivility/bullying among nurses. Common characteristics of incivility/bullying are refusing to work with others, yelling or cursing at peers, making degrading comments, and verbal abuse. Workplace violence contributes to high staff turnover rate and decline in client care. HESI Hint #1 Motivation comes from within an individual. A nurse leader can provide an environment that will promote motivation through positive feedback, respect, and seeking input. Look for responses that demonstrate these behaviors. HESI Hint #2 NCLEX-RN questions often include examples of nursing intervention that do or do not demonstrate the skills and characteristics of the nurse manager - act as a liaison between clients and others - engage in conflict resolution as needed with staff - plan overall strategies to address client problems - review management outcomes - identify roles/responsibilities of health care team members - supervise care provided by others - serve as resource person to other staff HESI Hint #3 Assertive communication starts with "I need" rather than with "You must" HESI Hint #4 Delegating to the right person requires that the nurse be aware of the qualifications of the delegatee: appropriate education, training, skills, experience, and demonstrated and documented competence HESI Hint #5 Remember the nursing process: Assessments, analysis, diagnosis, planning, and evaluation (any activity requiring nursing judgment) may not be delegated to a UAP. Delegated activities fall within the implementation phase of the nursing process HESI Hint #6 UAP generally do not perform invasive or sterile procedures HESI Hint #7 RNs should give clear instructions--be specific, communicating the objectives of the delegated task and the expected results. Remember that even though a task may be delegated under law and facility policy, you, the nurse, are responsible for its outcome HESI Hint #8 The RN is accountable for adhering to the 3 basic aspects of supervision (direction/guidance, evaluation/monitoring, follow-up) when delegating to other health care personnel, such as LPNs, graduate nurses unexperienced nurses, student nurses, and UAP HESI Hint #9 Priorities often center on which client the nurse should assess first. Ask yourself the following questions: Which client is the most critically ill and unstable? Which client is most likely to experience a significant change in condition? Which client requires assessment by an RN? HESI Hint #10 The nurse manager must analyze all the desired outcomes involved when assigning rooms for clients or assigning client care responsibilities. For example, a client with an infection should not be assigned to share a room with a surgical or immunocompromised client. A nurse's client care management should be based on the nurse's abilities, the individual client's needs, and the needs of the entire group of assigned clients. Safety and infection control are high priorities HESI Hint #11 Change causes anxiety. An effective nurse change agent uses problem-solving skills to recognize factors such as anxiety that contribute to resistance to change and uses decision making and interpersonal skills to overcome that resistance. Intervention that demonstrate these skills include seeking input, showing respect, valuing opinions, and building trust. HESI Hint #12 The Interprofessional Education Collaborative Expert Panel (PEC) recommended development of four core competencies for interprofessional collaborative practice. Those competency domains among health care professionals include: 1) values/ethics for interprofessional practice; 2) roles/responsibilities; 3) interprofessional communication; and 4) teams and teamwork [Show Less]
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