A new graduate nurse is employed in a small community hospital. The nurse notices practices which seem to be very physician driven and that patients have
... [Show More] little input into their care. Families are seen as a nuisance rather than as partners in potential care provision. What is the best approach for the new nurse to use for improving care in this setting?
a)Do nothing. They are too new to the organization to make change.
b)Share with the physician the recommendations from various IOM reports.
c)Share with their team members what they know about the aims of providing health care.
d)Report the team members to the chief nursing officer who is unlikely to know the lack of details on this unit.
C
Mr. Grandion was admitted to a rehabilitation center after discharge from a hospital. He has not walked in the 5 days while he was hospitalized and is provided a wheelchair. Dining with other residents is expected, and staffing is limited on a holiday weekend. What is the best strategy to ensure Mr. Grandion has sufficient nutrition and exercise?
a)Tell Mr. Grandion to stay in bed and someone will bring a tray to his room because the staff can't get him to the dining room in time for dinner
b)Assist Mr. Grandion into his wheelchair and remind him that in 2 hours he must be in the dining room if he wishes to eat.
c)Request help from another unit before dinner and indicate the nature of help needed.
d)Order a life device to transfer Mr. Grandion from his bed to the wheelchair.
c
When entering the postoperative care unit, the nurse manager notices that the temporary agency nurse has incorrectly entered the rate of infusion for the patient's vasopressor medication, and the arterial line blood pressure has a reading of 76/40 mmHg. After discontinuing the intravenous medication infusion, what is the nurse manager's next intervention?
a)Notify the nurse in charge of the unit.
b)Ask if there is an assigned resource nurse to serve as mentor for the temporary nurse.
c)Ask if there are standing orders for interventions for hypotension.
d)Ask if the temporary nurse has had an orientation to the unit.
C
An incident report of the incident described in the previous question needs to be completed. What is the appropriate wording to be included in the incident report?
a)"Patient was noted to have a low arterial blood pressure (76/40), and the vasopressor medication was discontinued."
b)"Patient's vasopressor medication was infusing at a higher rate than ordered and the medication was discontinued when the patient's blood pressure dropped to 76/40."
c)"Nurse M.J. started the vasopressor medication, the patient subsequently was noted to have a blood pressure reading of 76/40, the medication was discontinued, and the physician was also notified."
d)"Patient receiving vasopressor medication intravenously, blood pressure noted to be 76/40, and intravenous infusion discontinued. Physician notified and orders received for 500 mL normal saline administered for hypotension."
D
The nurse is needing to provide information for Foley catheter insertion to a patient in the patient's primary language. Which action would the nurse follow for the best outcome in this situation?
a) Assume the process of translating "word for word" is sufficient when a treatment is ordered for a culturally diverse patient.
b) Request an English-speaking family member to provide the translation to the patient about the treatment.
c) Create a cross-cultural semantic or word equivalency vocabulary list for the nursing unit to use with patient.
D. Request a healthcare professional translator to translate verbally the source language to the target language with the patient regarding the procedure.
D
A new nurse works on a busy medical-surgical unit. While the charge nurse keeps the unit organized and running smoothly, the nurse notices that another experienced nurse is the nurse to whom most of the other nurses ask questions and seek information. How does the new nurse view this experienced nurse?
a)A formal leader
b)A positional leader
c)An official leader
d)An informal leader
D
A new nurse sees a flyer for a workshop on healthcare relationship building and recognizes that relationship building with those in current leadership positions is challenging for her. She decides to attend. By making the decision to attend what is the new nurse demonstrating?
a)Social awareness
b)Self management
c)Strengths-based learning
d)Personal leadership
B
Emotional intelligence (EI) is a quality critical to the development of a new leader. This trait should inspire those who follow a leader whom demonstrates high levels of EI. What is the BEST example which illustrates emotional intelligence?
a) Manager who conducts rounds on unit, makes eye contact with team members, and generally makes time to hear about the issues of the day.
b) Manager holds meetings at the nurses station to be able to respond to emergencies and phone calls yet is rarely seen in scrubs helping at the bedside.
c) Manager who holds team accountable. However, she interrupts people frequently at meetings and raises voice when disagrees with them.
d) Manager writes down thoughts and puts them in an e-mail, often very late at night, for her team or colleagues to read. She expects others to respond to them by the first meeting of the day. She frequently reschedules meetings for personal reasons yet gives others a hard time for similar requests for absences.
a
What is the BEST way that nurse leaders can reduce stress on the job?
a) Delegate to others who are unlicensed, whenever possible.
b) Support a professional practice model and learn to "let go."
c) Be available 24/7 so the staff feel supported.
d) Post the Employee Assistance Hotline in the staff lounge.
B
A very close relationship exists between stress management and time management. What is the best way to define time management?
a) "Going with the flow" so that unexpected events don't have a negative impact on the plans for the day
b) Using tools and principles to engage others in low-priority needs and objectives in order that the leader may occupy self with high-priority needs
c) Using tools, techniques, and principles to achieve personal and professional goals
d) Doing things that matter to others, such as supervisors, subordinates, and peers
C
Two employees disagree about who should work on Christmas Day. The bottom line is that one employee will have to work, and the schedule must be posted tomorrow. What is the best method for the nurse manager to assist in the conflict between the nurses?
a) Use your position of power to resolve the conflict. You decide who will work Christmas Day.
b) Rely on centralized staffing to resolve the issue.
c) Try to arrange a compromise. Have one employee work the first half of the shift and have the other work the second half
d) Meet with both employees at the same time. Engage them in the problem-solving process.
D
During bedside rounds, a surgeon turns to the charge nurse and says, "The poor nursing care has caused this wound to become infected. Can't nurses at this hospital do anything right?" What is the appropriate response by the charge nurse?
a) "The nursing care on this unit has received awards and certainly is not the problem."
b) "Let's first decide what to do for Mrs. Johnson and then step into the hall and talk further about your concerns."
c) "It is inappropriate to talk to me that way. I will report this to my supervisor."
d) Would you like to change the antibiotic Mrs. Johnson is receiving?"
b
Nurses were long viewed by physicians, legislators, the media, and others as powerless because nurses:
a)declined to participate in political activities in the earliest years of the profession in the United States.
b)as women were subject to control by medicine and other paternalistic groups; women had limited legal rights in late 19th-century America.
c)and nursing leaders in the mid-20th century did not wish to be viewed by those outside of nursing as pushy or demanding.
were subject to nursing practice acts that limited their ability to take political action.
B
When caring for a patient who had a hip replacement that morning, a nurse is providing what level of care?
a)Primary
b)Secondary
c)Tertiary
d)Essential
B
To maximize the coordination of care, provide seamless transitions, and improve quality of care, organizations are increasingly turning to which organizational structure?
a)Academic medical centers
b)Public health institutions
c)Accountable care organizations
d)Proprietary, investor-owned organizations
C
What is the most effective strategy for an organization to take in order to maximize authority and accountability for all aspects of nursing practice in the nurses responsible for the delivery of care?
a)Position management and administrative levels to coordinate and facilitate the work of the practicing nurses.
b)Define in specific detail the daily activities of frontline nurses.
c)Have nurses report directly to physicians.
Develop multidisciplinary teams of care providers.
A
What is the most important role of the nurse manager in case management?
a)Provide supportive therapy during the grieving process.
b)Provide education to patients regarding upcoming surgery.
c)Serve as a communication link between all providers of care.
Perform a psycho-social assessment of the patient and his family.
C
The nurse manager on a skilled nursing unit notices that the number of patient falls in the unit has increased over the past year, resulting in a fall rate that is below the projected target rate for this unit. What is the BEST evidenced-based method to approach the fall rate on the unit?
a)Increase the number of total nursing hours on the unit.
b)Institute a safety restraint policy.
c)Purchase side rails that are easy to raise and lower.
Place patients at risk for falls close to the nursing station.
A [Show Less]