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Leadership review questions

Your pt is prescribed Benadryl 12.5 mg PO every 6 hours. It is supplied as 12.5 mg/5mL. How many teaspoons would you give the pt?
a. 1 Teaspoon = 5mL
What action by the nursing manager would show transformational leadership?
a. I would like to congratulate everyone on our excellent scores
b. I would like to share a letter from a pt which highlights our mission
c. We will be changing from team nursing to democratic nursing
d. ??
b. I would like to share a letter from a pt which highlights our mission
Your nursing manager recognizes that you are an excellent public speaker and wants you to given an in-service to the staff. What does this promote?
a. Empowerment
You realize that there has been a narcotic error when you are completing the narcotic log. What do you do first?
a. Incident report
b. Speak with the nurse that pulled the narcotic out of the omnicell
c. Contact your manager and have her deal with the problem
d. Prior to speaking with the nurse first
b. Speak with the nurse that pulled the narcotic out of the omnicell
You notice that a GN on your floor appears anxious when dealing with a client, what action would show emotional understanding?
a. Tell the GN that is ok to get anxious when first dealing with some pts
b. Don’t do anything, because its normal for a new GN to be nervous
c. Tell your manager that the GN is nervous around pts
d. Tell the GN that they need to have mental health counseling
a. Tell the GN that is ok to get anxious when first dealing with some pts
What is not included in the cover sheet of a resume?
a. Educational Experience
b. Introduction of yourself
c. Reason for applying
d. Offer of thanks to the reader for taking time to look over the resume
a. Educational Experience
You are getting ready to provide home health care for the day, which client do you assess first?
a. 73 y/o who had inguinal hernia repair 3 days ago
b. 24 y/o who is on bed rest s/p pelvis fracture x 4 days ago
c. 45 y/o who was released from the ED yesterday for ketoacidosis
d. 60 y/o who had (I don’t remember the c/c… but this is not the answer)
c. 45 y/o who was released from the ED yesterday for ketoacidosis
What should you not ask during an initial job interview?
a. When, how, and with whom are job evaluations conducted
b. Who would I directly report too
c. What would you expect of me as an employee
d. What are your sick leave and benefits policies
d. What are your sick leave and benefits policies
You just received report on your (4) pts, what time management protocol do you implement first?
a. Assess your pts and document
b. Assign task and priorities
c. Decide ways to not waste time
d. Decide if you are able to accomplish the tasks at hand
b. Assign task and priorities
You just received report on your pts, using the Rhythm Model for time management, what should you do first?
a. Use critical thinking to reassess your priorities
b. Take time to plan and set tasks
c. Immediately complete your highest priority task
d. ???
b. Take time to plan and set tasks
What should a new inexperienced nurse initially do to manage their time the best?
a. Find the time management that is the best fit for themselves
b. Do what the nurse manager does
c. Set goals, Stay organized, (I don’t remember the 3rd part)
d. ??????
c. Set goals, Stay organized, (I don’t remember the 3rd part)
A lawyer is defending a nurse for negligence; what would he use to defend them?
a. Prove that the nurse did the same thing as another nurse with the same experience would do if they were in the same situation
b. Utilize the level of expertise that the nurse possessed
c. ????
d. ????
a. Prove that the nurse did the same thing as another nurse with the same experience would do if they were in the same situation
What would be considered negligence?
a. Nurse who goes on break during a busy shift
b. Nurse who withholds a snack from a pt with a BGL of 268
c. Patient slips and falls in the hall
d. Nurse immediately removes a dressing to assess the site of an angiocath
c. Patient slips and falls in the hall
A pt who is verbally abusive is placed in (4)-point leather restraints by a nurse, what is nurse guilty of?
a. Negligence
b. Battery
c. Malpractice
d. Assault
b. Battery
A MD tells you to give a med that you know may harm the pt; you tell the MD of your concerns and they state “the pt will be fine and I assume all liability”, which statement is appropriate?
a. The MD said to do it, so give the med and document appropriately
b. Give the med because you can be fired for not following the MD’s order
c. Even though the MD said to give it, the nurse can still be found liable if they give the med
d. ????
c. Even though the MD said to give it, the nurse can still be found liable if they give the med
Administration wants a nurse council in place to assess for the needs of the department, which autocratic action by the nurse manager is appropriate, without encroaching on the needs of the council?
a. Assign a room for the meeting to occur in
b. Assign topics for the council to discuss
c. Assign a leader to be in charge of the council
d. ????
a. Assign a room for the meeting to occur in
Which action is the most appropriate for the nurse manager to utilize when assigned breaks and lunches for her department:
a. Democratic – illicit staff input and preferences when decided the schedule
b. Autocratic – assign breaks and lunches for everyone
c. Lassez-fair – let her employees decide amongst themselves when they will take breaks
d. ????
a. Democratic – illicit staff input and preferences when decided the schedule
What is the best definition of management?
a. Inspires staff
b. Advocates for the mission of administration
c. Socialize
d. ????
b. Advocates for the mission of administration
What type of management is seen in hospital organizations today?
a. Commanding and controlling through hierarchy
b. Decision-making
c. Leading, Organizing, Staffing, Controlling
d. ????
c. Leading, Organizing, Staffing, Controlling
Which action would be the least productive in promoting nursing expertise and development?
a. Having nurses attend interdisciplinary meeting
b. Having nurses attend school for their BSN or MSN
c. Having nurses attend nursing conferences
d. Not allowing nurses to participate in specialized nursing research projects
d. Not allowing nurses to participate in specialized nursing research projects
What does the ANA code of ethics not discuss?
a. Advance directives
b. Amassing Nursing Research and Education
c. Community based healthcare and education
d. Nursing standards
a. Advance directives
What can a nurse not do?
a. Monitor and change medication regiments
b. Give research meds w/ MD order
c. Provide pt education
d. Provide community education
a. Monitor and change medication regiments
A nurse is using a new pump for the first time and give a pt too much fluid, causing HF; the nursing manager determines that what type of law benefits the pt?
a. Criminal
b. Civil
c. Statutory
d. Aministrative
a. Criminal
What type of law would provide monetary compensation for a pt?
a. Criminal
b. Civil
c. Statutory
d. Administrative
b. Civil
A nurse is driving home, comes across a car accident, and provides aid. What does the Good Samaritan Act provide?
A. Nurse can not be charged with gross negligence
B. Nurse can be liable if they do not stop to render aid
C. Nurse must act according to hospital standards of care
D. ????
A. Nurse can not be charged with gross negligence
A nurse is helping at the scene of a multi-vehicle accident; which pt would most likely not receive immediate care?
a. Pt who is unresponsive with a possible broken neck
b. Pt who has a leg fracture and heavy bleeding
c. Child who is confused and wandering around in circles
d. Teenager with multiple abrasions and contusions to the extremities
a. Pt who is unresponsive with a possible broken neck
A client wants to tell the nurse something in private but doesn’t want the nurse to tell anyone, what is the best response by the nurse?
a. I must keep everything you tell me confidential; no matter what the topic is
b. I will only tell someone who must know the information
c. I will have to tell a mental health counselor
d. I will have to tell your spouse????
b. I will only tell someone who must know the information
What should go before the hospital ethics committee?
a. A family and MD are in disagreement about treatment of a severely malformed newborn
b. Nurses are concerned with the care that a MD is providing to a pt
c. Hospital staff want to establish policies for dealing with tough, ethical dilemmas
d. Staff want insight on how to handle a tough case
b. Nurses are concerned with the care that a MD is providing to a pt
What type of values is a nurse showing when they are a “good friend” and “excellent critical thinking skills”:
a. Nursing ethics
b. Moral ethics
c. Ethical ethics
d. Professional ethics
a. Nursing ethics
A pt comes into the ED in status asthmaticus and a face mask is placed on the pt. When the pt goes into respiratory distress and codes, the nurse realizes that they didn’t turn the O2 on; what is the nurse guilty of?
a. Beneficene
b. Nonmaleficence
c. Justice
d. Autonomy
b. Nonmaleficence
***The question pertains to the nurse needing to tell the truth:
a. Fidelity
b. Veracity
c. ????
d. ????
b. Veracity
Your pt is getting ready to head up for exploratory surgery. The pt has been given pain medicine and a mild sedative before you realize that the consents have not been signed. What is the most appropriate next step?
a. Send the pt up; this is considered implied consent
b. Call surgery and tell them that the procedure will need to be rescheduled until the pt can legally sign the consents
c. Have a family member sign the consents
d. Have the pt sign the consents
b. Call surgery and tell them that the procedure will need to be rescheduled until the pt can legally sign the consents
You are taking care of a pt who is competent and terminally ill. The pt has advanced directives that state that she does not want to be revived. Pt’s son states that he doesn’t agree with the pt and that he wants all interventions initiated. What is the nurse managers best response?
a. Since the son is “next of kin”, we will honor his wishes
b. Explain to the patient that the son request that all interventions be initiated
c. Explain to the son that hospital staff will honor this wishes of his mom
d. ????
b. Explain to the patient that the son request that all interventions be initiated
A psychiatrist refuses to treat pts who do not possess insurance and will DC pts who’s insurance refuses to keep paying for treatment; what is this psychiatrist not practicing?
a. Beneficence
b. Autonomy
c. Justice
d. Veracity
c. Justice
There was a question from this paragraph (but I don’t remember what the answer is:
Researching the organizational culture can show you the company’s goals, theories, and missions; Cultural safety can show you the values/attitudes/behaviors that are directed to preventing/minimizing pt harm; Care environments can show you emphasis on staff development, quality of pt care, collegial relationships with physicians, and skilled nurse managers with high levels of leadership ability
There was a question from this paragraph (but I don’t remember what the answer is:
Researching the organizational culture can show you the company’s goals, theories, and missions; Cultural safety can show you the values/attitudes/behaviors that are directed to preventing/minimizing pt harm; Care environments can show you emphasis on staff development, quality of pt care, collegial relationships with physicians, and skilled nurse managers with high levels of leadership ability

What is the “normal” structure in a health-care organization?

a. Hierarchical
b. Decentralizing Planning
c. Organic Structures
d. Decision-making

a. Hierarchical
Why might a manager having difficulty with splitting up their responsibilities?
a. They don’t want to give up any of their power
b. They are short staffed
c. ????
d. ????
a. They don’t want to give up any of their power
Which of the following show nursing malpractice?
a. Nurse fails to give proper education about a child safety seat and a child gets injured
b. ????
c. ????
d. ????
a. Nurse fails to give proper education about a child safety seat and a child gets injured
Math:
Shows you a Med Label: 100mg/5ml
Dose is 100mg
Give: 5ml
Math:
Shows you a Med Label: 100mg/5ml
Dose is 100mg
Give: 5ml
You are the nurse who has been assigned to the following patients s/p MCI; place them in order from highest priority to least:
A. Pt is hemodynamically unstable and responds to pain requires and IV
B. Pt w/ shallow respirations of 8 and needs to be bagged
C. Deep thigh lac with venous that requires direct pressure
D. Arm fx w/ no radial pulse that must be realigned and splinted
***If you go with (B) as being the priority (Airway) then the only possible answers are below:
B, A, C, D (the Paramedic in me says that this is the answer)
B, C, D, A (the RN-Student in me says that this is the answer)
Your patient has a Hgb of 7; what is your first intervention?
Assess LOC (this would established upon initial visual of the patient)
Assess Resp Function
Prepare for immediate transfusion
Call the MD for orders
Assess LOC (this would established upon initial visual of the patient)
Mel says answer is : Assess Resp Function
Psych ward… which pt can an LPN care for?
Pt w/ DTs (progression to seizures/coma/violence; would require IV push Anticonvulsants)
Pt w/ Lithium of 2.0 (0.5 to 1.5 is normal; > 1.5 becomes toxic)
Pt w/ diagnosed w/ schizophrenia Tardive dyskinesia
Pt w/ dementia who is confused and disoriented
Pt w/ dementia who is confused and disoriented (I went with this patient on the test)
You are the manager and you are talking to staff: What is the most important consideration w/ communication (the wording is a little off on this question—but I stick with my answer):
Getting Feedback
Being assertive
Listening to the emotions of your audience
Listening to the emotions of your audience (the only one that involved listening)
Your facility is putting together an EOP plan and are reviewing what is included. Which of the following would be included in a post-incidence response?
Replace resources that were used
Do an immediate critique and then follow up with the responders
Decide when to take the hospital from disaster response to regular operations
Hold drills for the hospital and the community
Do an immediate critique and then follow up with the responders
You’re a home healthcare nurse; which patient would you see first? (this was on our last test as well):
43 y/o who was discharged yesterday from the ED for ketoacidosis
75 y/o who is 3 days post-op for an inguinal hernia repair
25 y/o who is on bed-rest s/p pelvis fracture x 4 days
60 y/o who has a broken leg
43 y/o who was discharged yesterday from the ED for ketoacidosis
You are the nurse manager and you noticed that there have been an increase in med-errors during the night-shift. You decide that this needs to change. You decide to review the policies of the unit and the hospital pertaining to medications; from the initial order to when it is administered to the patient. What type of process is the manager using?
Evidenced Based
Nursing best practice
Continuous Quality Improvement
Autocratic management
Nursing best practice (it’s either this one)
Continuous Quality Improvement (or this one… but I wasn’t able to come to a firm decision)
What would cause you to expect that and infectious disease or biological weapon has been deliberately dispersed into the community (pick all that apply):
Any increase in patients with diseases from a normally healthy community
Unusual amount of hospitalization deaths over the last 72 hours
Cluster of patients that are presenting with the same complaints from the same location
Any increase in patients with diseases from a normally healthy community
Unusual amount of hospitalization deaths over the last 72 hours
Cluster of patients that are presenting with the same complaints from the same location
(I want to say that the last option was an obvious wrong choice… but can’t think of it right now.)
Nuclear power plant accident and patients are starting to arrive at the ED; what is the first step:
Put them in a private room
Use a RAD meter to assess for radiation
Wash out any wounds.
Activate the emergency response plan
ACTIVATE THE EMERGENCY RESPONSE PLAN
19 y/o/f that presents to the ED for initial radiation therapy for thyroid CA. What is your priority intervention?
Pregnancy check
Swallow study
Chest x-ray
Pregnancy check
What task can a UAP do?
Remove a Hemovac Drain
Assist the physician with a physical exam
Evaluating a blood glucose level
***Assist the physician with a physical exam (everything that I am reading says that the UAP can assist the nurse… doesn’t say anything about assisting a physician)***
Remove staples from a minor (I am starting to lean more towards this answer)
You are a RN Manger on the floor and a patient was accidentally given (2) doses of another patient antihypertensive meds (this is a sentinel event). The patient had a brief episode of shock symptoms, but is now stable. What is the priority?
Initiate an investigation immediately
Contact JACHO
Transfer patient to the ICU
Alert hospital administration
Initiate an investigation immediately
Which task can the RN NOT DELEGATE to the UAP?
You are giving a blood transfusion that requires vital signs q 30 mins
One of the questions involved an “assessment” and I went with that
Who is in charge of the hospital response in the event of a disaster?
Incident Command
Security
Medical Director of EMS
Medical Director of the ED
Incident Command
Patient was riding his bike and fell down a mountain trail. The patient has multiple fractures. Patient is brought in my EMS and has a C-COLLAR in place; Respirations are EVEN and NON-LABORED. What would alert the nurse to possible internal bleeding?
Elevated HR
Elevated BP
Mid-thoracic pain
Elevated HR
Kid with a temp of 103 and c/o pain to the site of a spinal tap arrives to your unit. Which order should be completed first?
Rocephin
Tylenol
Test family and siblings
Isolation
Isolation
A cancer patient who is undergoing chemotherapy treatment arrives at the ED s/p vomiting bright, red blood. What is the priority intervention?
Place an 18 ga IV w/ NS.
Call the patients CA MD to find out what antineoplastics they are on
Call the patients doctor for orders
Give the patient an antiemetic
Place an 18 ga IV w/ NS.
Patient presents w/ CP which is the priority nursing intervention:
Give Morphine to lower preload
Assess vitals
Attain MED HX and specifically the events leading up to the CP
Assess and auscultate the chest
Assess and auscultate the chest
You’re a Charge Nurse and a RN from a gen surg has been floated to your neuro floor, which patient should you assign to them?
Patient w/ ALS
Myothenia Gravis
Halo Traction
Can’t remember what the patient was diagnosed with, but the patient had respiratory compromise
Halo Traction (this a med-surg patient and w/o more info, this one should go to the med-surg nurse)
You’re on a Maternity Ward; which patient do you assess first?
Mom’s crying due to the baby not latching
Mom won’t see the child
Pain on urination
Patient who soaked through multiple per-pads during the night
Patient who soaked through multiple per-pads during the night
Which patient do you assess first?
Patient is reporting fever and chills that are (2) hours pre-op
Patient admitted w/ COPD (no complaint)
Patient admitted w/ DM (no complaint)
Patient is reporting fever and chills that are (2) hours pre-op ***(I can’t remember the rest of these… but the patient on top is the only one that had an actual complaint—above and beyond their admitting diagnosis)
It’s 0830 am and your patient has surgery scheduled at 0930 am; what is the priority nursing intervention?
Chart their 0800 assessment
Admin the 9 am meds
Teach the pt something about the procedure
Assess their 0600 lab values
Assess their 0600 lab values (one of the questions had “Complete the pre-op checklist” – but I don’t remember which one… could have been this one)
Which patient do you tell the ED MD to see first?
Patient w/ Expiratory wheezes and a RR 28
Pediatric w/ Bilat wheezes on inspiration and expiration who is drowsy
Toddler who fell from a bed to carpet and hit their head
Pediatric w/ Bilat wheezes on inspiration and expiration who is drowsy
You have been assigned the following (4) patients; which do you assess first?
Adult with Mid-Sternal CP and ABD Pain s/p Large Spicy Meal
Pediatric patient with a 1 inch bleeding lac to their chin s/p fall from bed
Adult with a temp of 102, HA, and myalgia (muscle pain)
Adult who can’t bear weight on their foot s/p running accident (bruising noted on the foot)
Adult with Mid-Sternal CP and ABD Pain s/p Large Spicy Meal (stop eating bad food… *** ***!!!) =o)
You’re in charge and some of your nurses must float to the night shift; what is the best initial action that will help solve the issue?
Ask for volunteers
Assign the least senior
Rotation (everyone must go)
Ask everyone to submit reason why they have to be on either/or shift
Ask for volunteers
Which of the following patients MUST AN RN assess? (wording might be wrong on this):
Hgb of 5.0 s/p surgery
Patient with renal failure has a potassium level of 3.9
Hgb of 5.0 s/p surgery
A new GN is having difficulty with prioritizing patients. The charge nurse tells the GN that prioritization is based on what?
Moslow’s Heiracy of needs
Vorcheks Triad
Nursing Process
Patient statement of illness
Moslow’s Heiracy of needs (this is correct… but need more info)
You hospital has a high rate of in-hospital infections; what does the ANA state to reduce the rates?
Ensure the correct nurse-to-patient ratio is in place
Assign nurses to only infectious patients or non-infectious patients
Ensure the correct nurse-to-patient ratio is in place
A nurse and an LPN are both caring for a CVA patient; what intervention can the LPN be assigned too?
Give patient their first meal
Do an ongoing neurological exam
Swallow study
Administer the anticoagulants via SC route
Administer the anticoagulants via SC route
A patient who is on digoxin and Lasix develops a HA and N/V. What is the priority intervention?
Assess lab values—digoxin toxicity?
Administer antiemetic
Call the MD for orders
Assess lab values—digoxin toxicity?
Type-1 DM patient is found to have a resting BGL of 269 at 0600. It’s now 0730 and his medications are due. Which of the following should the nurse administer:
Administer the correction scale and his scheduled dose of Lantus
Withhold correction scale and give the scheduled dose of Lantus
Review the insulin orders with the MD
Withhold the Lantus, but give the correction scale of insulin
Administer the correction scale and his scheduled dose of Lantus
UAP states patient has a BP of 78/50 via Automatic BP Machine and HR 116; what do you do?
Send UAP to recheck
Assess the patient’s cardiovascular status
Place the patient in trendelenberg
Call the MD
Assess the patient’s cardiovascular status
A nurse wants to fix a problem with medication supply. The nurse writes up a proposal and turns it into management. It is denied. What step in the process did the nurse forget to do?
Unfreezing
Refreezing
Unfreezing (this might not be right)
The charge nurse is making patient assignments. Which patient should they assign to a new GN?
50 y/o w/ CP
75 y/o who is scheduled to have a heart cath
45 y/o with MI
50 y/o with unstable angina
75 y/o who is scheduled to have a heart cath
The first Nightingale School for Nurses was founded when?
a. 1825 c. 1885
b. 1860 d. 1910
b. 1860
Which of the following is not considered to be a nurse-sensitive patient outcome?
a. deep vein thrombosis c. shock
b. pneumonia d. hip fractures
ANS: D
Nurse-sensitive patient outcomes are those that can be impacted directly and indirectly by nursing practice. Some of these nurse-sensitive outcomes are deep vein thrombosis, pneumonia, shock, cardiac arrest, and “failure to rescue”
Which of the following is not considered to be an identified professional value characteristic of a professional?
a. caring c. truth
b. equality d. political awareness
ANS: D
A number of characteristics have been identified and associated with professionals. Some characteristics specifically assigned as professional values include caring, equality, truthfulness, ethics, and nonjudgmental attitude. Professional characteristics concerned with professional behaviors and attributes include: political awareness, self-discipline, time-management skills, appearance, initiative, and effective communication.
A number of resources are available for nurses regarding evidence-based care. Which of the following resources is not a journal source for these practices?
a. Centre for Evidence-Based Nursing
b. Health Affairs
c. Hasting Report
d. Worldviews on Evidence-Based Nursing
ANS: A
Today’s nurses have access to a large variety of resources on evidence-based practice. Some of these that are journal-based include Health Affairs, Hasting Report, Advances in Nursing Science, and Worldviews on Evidence-Based Nursing. Some resources that are not journals, but are Internet or Web-based, include Centre for Evidence-Based Nursing, Sigma Theta Tau, Research Centre for Transcultural Studies in Health, and Cochrane Collaboration
Which of the following does not provide health care ratings or scoring of hospital performance?
a. Health Grades
b. Morningstar
c. Leapfrog Hospital Quality and Safety
d. Department of Health and Human Services’ Hospital Compare site
ANS: B
Several groups and agencies report on health care and hospital quality and performance. Some of these groups include Health Grades, Leapfrog Hospital Quality and Safety, Thomson Reuters, the Department of Health and Human Services’ Hospital Compare site, and U.S. News and World Report. Morningstar is a financial investment-based publication.
The development, provision, and evaluation of multidisciplinary health care services to population groups experiencing increased health risks or disparities, and performed in conjunction with health care consumers and the community as a means of improving the health of the community is called:
a. population-focused nursing practice c. population-based health care practice
b. population-based nursing practice d. population-based care
ANS: C
Population-based health care practice is the development, provision and evaluation of multidisciplinary health care services to population groups experiencing increased health risks or disparities. It is performed in conjunction with health care consumers and the community in order to improve the health of the community and its diverse groups. Population-focused nursing practice is defined by nursing activities that concern all people and reflects responsibility to and for the people. Population-based nursing practice is defined as the practice of nursing in which the primary concern of care is to improve the health status of vulnerable or at-risk population groups within a community by employing health promotion and disease prevention across the health continuum. Population-based care requires active partnership of both providers and recipients of care.
Vulnerable populations are groups of people that are subgroups of a community with certain characteristics. Which of the following is not necessarily one of the criteria for vulnerable population groups?
a. powerless c. enfranchised
b. marginalized d. experiencing health disparities
ANS: C
Vulnerable population groups are subgroups of communities whose common experiences meet certain criteria which categorize them as being vulnerable. These criteria include being powerless, marginalized, disenfranchised (not enfranchised), and experiencing health disparities.
Variables that increase or decrease the probability of illness or death and that can be modified are called:
a. health determinants c. vulnerable population groups
b. underserved d. health risk factors
ANS: D
Health risk factors are variables that increase or decrease the probability of illness or death. Health risk factors may be modifiable. Health determinants are variables that include biological, psychological, environmental, and health system factors that may cause changes in the health status of individuals, families, groups, communities, or populations. Vulnerable population groups are subgroups of a community who are powerless, marginalized, or disenfranchised and are experiencing health disparities. The underserved are those people who have not received adequate medical care services.
One goal of population-based health care is to:
a. maintain access to health care services
b. maintain quality of health care services
c. reduce health care disparities
d. increase health care delivery costs
ANS: C
The goals of population-based health care include: 1) reduction of health disparities among different population groups, 2) improvement of access to health care services, 3) improvement of quality of health care services, and 4) reduction of health care delivery costs.
At least 50% of the Joint Commission’s accreditation standards for hospitals and other health care facilities were written to align with whose conditions for participation?
a. HIPAA c. Medicare
b. IOM d. Leapfrog
ANS: C
When the Joint Commission designed their accreditation standards for hospitals, they aligned as many as 50% of these standards with criteria from Medicare’s conditions for participation for hospitals and other health care facilities. These criteria set forth by Medicare are requirements for reimbursement for these health care facilities.
Which of the following chapters from the Joint Commission’s hospital accreditation manual does not fall under the category of patient-focused functions?
a. provision of care, treatment, and services
b. medication management
c. nursing services
d. ethics, rights, and responsibilities
ANS: C
The Joint Commission’s standards for hospital accreditation have identified a number of different chapters that can be categorized into two groups: patient-focused functions and organization-focused functions. The identified patient-focused functions are: 1) provision of care, treatment, and services; 2) medication management, 3) ethics, rights, and responsibilities, and 4) surveillance, prevention, and control of infections. Organization-focused functions are: 1) nursing services, 2) medical staff, 3) management of information, 4) management of human resources, 5) management of the environment of care, 6) leadership, and 7) improving organization performance.
Which nursing theorist was responsible for Human Becoming theory?
a. Nightingale c. Neuman
b. Parse d. Peplau
ANS: B
Rosemarie Rizzo Parse is the theorist responsible for Human Becoming theory. The key concepts of this theory are centered on three ideas: 1) structuring (cocreating reality through language of valuing and imaging), 2) cocreating (rhythmical patterns of relating), and 3) cotranscending (unique ways of originating the process of transforming). Florence Nightingale was responsible for Environmental theory (1859). Betty Neuman was responsible for Systems Model (1972/1995), and Hildegard Peplau was responsible for Interpersonal Process theory (1952).
Public Law 93-360 on Collective Bargaining identified certain characteristics that relate to professions. Which of the following is one of these characteristics?
a. varied work environments c. work has social value
b. autonomous practice d. existence of a code of ethics
ANS: A
A number of different groups and entities have identified characteristics of what constitutes a profession. Some of these characteristics are, according to Public Law 93-360 on Collective Bargaining: varied work environments, predominately intellectual work, requires discretion and judgment, and requires advanced instruction and study. Bixler and Bixler (1959) included autonomous practice, growing body of knowledge, education takes place in higher education institutions, and service above personal gain. Pavalko (1971) noted the following additions to the characteristics of a profession: work has social value, existence of a code of ethics, group identity and subculture, and autonomy.
Under the National Prevention Strategy there are seven priority areas. Under the area of injury- and violence-free living what is one of the targeted areas?
a. mandated car seat laws c. reporting laws for abuse
b. School-based physical education d. preventing drug abuse
ANS: A
The Community Preventive Services has identified seven priority areas as strategy for prevention nationwide. Under the area of injury- and violence-free living one targeted area is mandated laws for car seats for children. The other priority areas are tobacco-free living, preventing drug abuse, healthy eating, active living, reproductive and sexual health, and mental and emotional well-being.
One example of a population-based public health intervention program is the social marketing: college campus initiative. This program targeted:
a. offering condoms at health centers
b. increased use of helmets for campus bikers
c. weight loss programs
d. preventative health screening
ANS: B
According to Ludwig, Bucholz, and Clarke (2005), an example of a population-based public health intervention defined under social marketing is a “grateful head” theme used to increase helmet use on a college campus. This example is defined under the individual/family level of practice. The other choices are not listed as examples of public health intervention programs.
One characteristic of a profession is that it has a peer review of its practice. This is attributed to:
a. Flexner c. Manthey
b. Pavalko d. Public Law 93-360
ANS: C
Manthey (2002) described the characteristics of a profession as those that have a peer review of practice, there is an identification with a professional organization as a standard setter, there is autonomy of decision making, and there is an identifiable body of knowledge that can be attributed via formal education.
The Johns Hopkins Nursing Evidence-based Practice Model is based on the initials PET. These initials stand for:
a. problem, evidence, transmission
b. practice question, evidence, transmission
c. problem, evidence, translation
d. practice question, evidence, transition
ANS: D
PET in the Johns Hopkins Evidence-based Practice Model stands for the three steps in the process: practice question, evidence, and translation. The model progresses through 18 steps from the asking of the question needing an answer to the dissemination of the knowledge when the answer is identified.
Outcomes provide evidence about benefits, risks, and results of treatments so individuals can:
a. make informed decisions c. seek specialty care
b. seek high quality care d. find the best hospital
ANS: A
Evidence-based practice uses evidence-based resources to guide the development of appropriate strategies to deliver quality, cost-effective care. Outcomes provide evidence so individuals can make informed decisions and choices to improve their quality of life.
Which of the following are correct regarding criteria that constitute a profession? Select all that apply.
a. the body of specialized knowledge is continually developed and evaluated through research
b. members are self-organizing and collectively assume responsibilities of establishing standards for education in practice
c. the privilege to practice is granted only after the individual has completed a standardized program of specified education and has demonstrated the ability to meet the standards of practice
d. professional status is achieved when an occupation involves a unique practice and its members declare it one
ANS: A, B, C
While there are different views and opinions regarding what constitutes an occupation and a profession, there are a number of elements that are in general agreement concerning professions. Some of these include 1) the body of specialized knowledge is continually developed and evaluated through research, 2) members are self-organizing and collectively assume responsibilities of establishing standards for education in practice, 3) the privilege to practice is granted only after the individual has completed a standardized program of specified education and has demonstrated the ability to meet the standards of practice, and 4) professional status is achieved when an occupation involves a unique practice that carries with it individual responsibility and is based on theoretical knowledge (not is declared one when its members declare it to be one).
According to Pavlko, which of the following are characteristics of a profession? Select all that apply.
a. work has social value c. autonomy of decision making
b. service to the public d. growing body of knowledge
ANS: A, B, D
According to Flexnor, some of the characteristics of a profession are there is a service to the public, there is autonomy, there is a commitment to the profession, work has social value, and there is the existence of a code of ethics. Autonomy of decision making is attributed to Manthey.
Professional values of nursing include which of the following? Select all that apply.
a. caring c. self-evaluation
b. justice d. human dignity
ANS: A, B, D
The professional values of nursing include caring, altruism, equality, freedom, justice, truth, ethics, human dignity, and nonjudgmental. Self-evaluation is one of the professional behaviors and attributes.
Which nursing theorist is responsible for the theory of self-care deficit?
a. Rogers c. Roy
b. Orem d. Orlando
ANS: B
Orem is responsible for the self-care deficit theory. Rogers is responsible for the science of unitary beings. Roy is responsible for the adaptation model. Orlando is responsible for the nursing process theory.
The National Prevention Strategy includes all of the following except:
a. healthy and safe communities c. smoking cessation programs
b. elimination of health disparities d. community preventative services
ANS: C
The purpose of the National Prevention Strategy is to increase the number of Americans who are healthy at every stage of life. The four facets of this strategy include healthy and safe community environments, to empower people, to eliminate health disparities, and to provide clinical and community preventative services.
One external force that influences health care is financial incentives that reward superior performance. An implication for management in this area would be:
a. an increased diverse workforce c. increased disease prevention
b. increased demand for primary care d. redesign of patient delivery
ANS: D
Management implications that occur from the external force of financial incentives that reward superior performance include the need for increased efficiency, productivity and quality, the redesign of patient care delivery and the development of strategic alliances that add value. An increased diverse workforce comes under the external force of an increased ethnic and cultural diversity of the population. Increased demand for primary care comes under the force of the aging population and associated increase in chronic illness.
Asking the question, did our services meet the greatest unmet health needs of the community? when evaluating a population-based nursing program determines:
a. quality c. cost
b. access d. equity
ANS: A
Evaluating programs of population-based nursing practice involves evaluating quality, access, cost, and equity. When evaluating quality, some questions to ask are as follows: Did our services meet the greatest unmet health needs of the community? Did their health status improve? Were their health risks reduced?
Sentinel events have been found to be linked to:
a. poor quality care c. preventable errors
b. ineffective team communication d. autonomy of health professionals
ANS: B
Sentinel events, medical errors, and patient care quality have been linked to ineffective team communication in the hospital. Outside the hospital there is an increased concern that communication and lack of coordination of care result in preventable readmissions to the hospital.
Which of these time management strategies does not belong?
a. outcome delivery c. focus on priorities
b. analysis of time cost and use d. visualization of the big picture
ANS: A
Some basic time management strategies include: outcome orientation (not delivery), an analysis of the cost of the use of time, a focus upon priorities, and the ability to visualize the big picture.
Which of the following is a characteristic of effective shift planning?
a. getting the job done in the least amount of time
b. nobody died
c. everybody showed up for work
d. evaluation of optimal and reasonable outcomes
ANS: D
Effective shift planning involves deciding what goals or outcomes are to be achieved. Identifying optimal outcomes (best possible objectives) as well as reasonable outcomes (realistic objectives given the available resources at hand), and evaluating progress made toward these outcomes during and at the end of shift are qualities that lead to effective planning during one’s shift. Often enough, nurses do not allow themselves permission to do less-than-optimal work, but sometimes, due to circumstances beyond their control (e.g., being short staffed), achieving reasonable goals is the best that can be expected.
Related common-sense tools that may help one to use time in the most effective and productive manner possible are collectively called:
a. the Pareto Principle c. shift planning
b. time management d. effective leadership
ANS: B
A definition of time management is “a set of related common-sense tools that helps you to use your time in the most effective and productive way possible” (MindTools, 2006a). The Pareto Principle concerns the concept that 20% of focused efforts results in 80% of outcome results. Shift planning deals with the organization and prioritization of patient care and tasks per shift. While the use of time management skills is a quality of effective leadership, it encompasses a variety of other attributes and qualities, such as management skills, knowledge of leadership techniques, theory, and practice.
The Pareto Principle is:
a. 80% of outcome results come from 20% of focused efforts
b. a way to record your activities over a period of time to see how your time is spent
c. 20% of focused efforts equals 20% of outcome results
d. 80% of focused efforts results in 80% of focused time
ANS: A
The Pareto Principle is based upon the prioritization of work through such measures as managing one’s time effectively. The basic premise is that 20% of focused efforts result in 80% of outcome results.
A time management tool that may benefit nurses when determining how their time is spent is:
a. shift assignments c. shift action plan
b. nursing chart d. activity log
ANS: D
The activity log is a time management tool by which behaviors are logged consistently over a period of time to determine how time is spent. Nursing charts, shift action plans, and shift assignments are all good methods for organizing time and tasks.
When organizing tasks, categorizing them according to patient needs/conditions is an effective means of triaging patient care. Which of the following does not belong?
a. life-threatening or potentially life-threatening conditions
b. activities essential for patient safety
c. activities essential to the plan of care
d. activities essential to the hospital/organizational regulation
ANS: D
Prioritizing care is one way that nurses have of organizing their patient care duties. Tasks related to life-threatening or potentially life-threatening conditions (e.g., assessing a patient’s ABCs) are always the top priority. Patient safety concerns come second (e.g., availability of crash carts, equipment to help prevent falls or injury). The third area of patient care duties relates to the plan of care and patient comfort, education (e.g., pain medication, patient positioning, diabetes education).
Which of the following is not necessarily a concern addressed in shift action plans?
a. resources c. task completion due dates and times
b. optimal outcomes d. guidelines for task completion
ANS: B
A number of concerns can be addressed in shift action plans. Some of these include: 1) understanding the big picture (e.g., staffing issues, number of patients, environmental concerns), 2) task completion due dates and times (e.g., time frame for accomplishment of tasks), 3) understanding the priorities (e.g., emergency equipment checks, identification of patients who are at greatest risk for life-threatening complications, 4) reasonable outcomes (e.g., those that are realistic to accomplish, not optimal outcomes), and 5) resources (e.g., staff available to do the work).
Procrastination, inability to say no, management by crisis, haste, indecisiveness, interrupting telephone calls, socialization, and complaining are all examples of:
a. mistakes c. time wasters
b. errors d. new nurses
ANS: C
Marquis and Huston (2009) identified five criteria that contribute to wasting time and hindering the achievement of outcomes. These five criteria are: 1) procrastination, 2) inability to delegate, 3) inability to say no, 4) management by crisis or haste, and 5) indecisiveness. Sullivan and Decker (2009) added interrupting telephone calls and socialization to this list. Reed and Pettigrew (2006) also added complaining to this rather lengthy list.
A number of traps that nurses can fall into related to prioritization have been described by Vacarro (2007). Which of the following is not a potential trap described by Vacarro?
a. doing what hits first c. relying on misguided judgment
b. the path of least resistance d. completing tasks by default
ANS: C
Vacarro (2007) identified five potential traps of prioritizing that nurses need to be aware of and avoid. These potential traps are: 1) doing what hits first, 2) taking the path of least resistance, 3) responding to the “squeaky wheel,” 4) completing tasks, and 5) relying on misguided inspiration.
Providing assistance during a patient transfer is an example of which type of prioritization?
a. first priority: life-threatening or potentially life-threatening
b. second priority: activities essential to safety
c. third priority: activities essential to the plan of care
d. fourth priority: activities essential to the patient’s well-being
ANS: B
Second-priority activities pertain to safety issues. Assisting in the transfer of a patient is one way of providing safe care for both the patient and the nurse. First-priority activities are related to conditions that are life-threatening or potentially life-threatening, such as having IV access and the continuous monitoring of vital signs for critical patients. Third-priority activities are directly related to the plan of care, such as medications, nutrition, and ambulation. The fourth “priority phase” is not generally used in nursing.
Three ways to create time are:
a. delegating, getting up one hour earlier, and eliminating tasks that waste time
b. getting up one hour earlier, eliminating tasks that have value, and delegating
c. going to bed one hour earlier, delegating, and hiring people to do work
d. eliminating tasks that add no value, taking a nap during the day, and hiring people to do work
ANS: A
Three major ways to create more time are: 1) delegating work to others, getting up one hour earlier (this can potentially free up two weeks per year of extra time), 2) hiring someone else to do work (hiring people to do boring tasks), and 3) eliminating those chores that add no value (not those that have value).
_____ reminds us to focus our efforts on the most important activities to maximize the results that we get.
a. The Joint Commission c. Pareto principle
b. Organizational mission d. Nursing process
ANS: C
The Pareto principle reminds us that it is important to focus our efforts on activities that can maximize the results that we get. It also states that 20% of focused efforts can result in 80% of results (Pareto principle, 2008).
In Heindrich, Chow, Skiercynski, and Lu (2008) study of how nurses use their time, what percentage of time was spent giving direct care?
a. 14% c. 21%
b. 18% d. 54%
ANS: A
In the study conducted by Heindrich, Chow, Skierczyski, and Lu (2008) it was found that 14% of nurse’s time was spent in care coordination and direct patient care. Nonproductive personal time accounted for 6%, non-nursing practices accounted for 13%, and documentation accounted for 25%.
When a nurse monitors a patient’s ABCs, the nurse is working under which nursing time management priority?
a. fourth priority c. second priority
b. third priority d. first priority
ANS: D
First-priority activities pertain to life-threatening or potentially life-threatening conditions and are the highest level for prioritization of nursing tasks. These tasks include assessment, monitoring, and intervention (per the prescribed treatment plan) of the patient’s ABCs (airway-breathing-circulation). Second-priority activities include those that are essential to the patient’s safety, such as providing assistance during patient transfers. Third-priority activities are concerned with comfort and teaching. There is no fourth priority noted.
Nurse Q has started her walking rounds at the beginning of her shift. She just entered Mr. K’s room and has found him sitting on the floor smiling up at her. Mr. K says that he is not hurt, just merely “slipped out of bed” while “hunting for quail,” and needs some help getting back into bed. Mr. K is a very large and overweight man. Which nursing task priority does this activity/task encompass?
a. first priority c. third priority
b. second priority d. fourth priority
ANS: B
Second-priority nursing tasks pertain to safety issues. When Nurse Q discovered Mr. K sitting on the floor during her beginning-of-shift walking rounds, it was apparent that this was a safety issue, particularly since this patient also appears to be somewhat confused regarding where he is and why (e.g., the hunting quail comment), and additional assistance would be required to return this patient to bed. First-priority tasks are related to essential ABCs and monitoring of life-threatening or potentially life-threatening conditions. Third-priority tasks concern comfort and teaching. There is no fourth category.
Reed and Pettigrew (2006) identified some additional time wasters that may contribute to a lack of outcome achievement by nurses during their shifts. Which of the following is not one of these identified time wasters?
a. complaining c. enthusiasm
b. perfectionism d. disorganization
ANS: C
A number of time wasters that can inhibit nurses from accomplishing their planned outcomes have been identified. Reed and Pettigrew (2006) added three time wasters to an already lengthy list. These are: complaining, perfectionism, and disorganization
If a nurse added the benefits received as an employee, their salary would increase by:
a. 10%-20% c. 10%-40%
b. 15%-45% d. 15%-30%
ANS: D
Analysis of nursing time use is an important step in developing a plan to effectively use time. Nurses often undervalue their time. Benefits are frequently forgotten, but they add 15%-30% of the nurses’ salary. That means if a nurse is making $26 per hour, benefits would increase the salary by $3.90-$7.25 per hour.
If a nurse keeps an activity log and realizes the activities have not achieved the desired outcomes, the nurse should:
a. define the most energetic time of day
b. evaluate how many activities are on the list
c. evaluate what type of activities are on the list
d. go to the gym daily to increase energy levels
ANS: A
An activity log is a time management tool that can assist the nurse in determining how both personal and professional time is used. The activity log should be used for several days. Behavior should not be modified while keeping the log. If the activities have not achieved the desired outcomes, the nurse needs to change activities and focus on priorities. The nurse should start by noticing the most energetic time of day.
The nurse should schedule time for proper rest, exercise, and nutrition to allow for:
a. quantity time c. creativity
b. quality time d. priorities
ANS: B
When completing an activity log the nurse needs to focus on priorities. This starts by noticing the nurse’s high-energy times and low-energy times. Scheduling time for proper rest, exercise, and nutrition allows for quality time.
To plan effective use of time nurses must:
a. think of their own needs c. review the big picture
b. always be available to help d. review their daily assignment
ANS: C
To plan effective use of time, nurses must understand the big picture and decide on priority outcomes. This starts by reviewing the big picture. No nurse works in isolation. Nurses should know what is expected of their coworkers, what is happening on the other shifts, and what is happening in the agency and the community.
The study by Hendrich, Chow, Skierczynski, and Lu (2008) found that nurses spend 6% of their time:
a. coordinating care c. assessing patients
b. delegating tasks d. being nonproductive
ANS: D
In the study by Hendrich, Chow, Skiercznski, and Lu conducted in 2008, it was found that nurses waste 6% of their time on nonproductive personal time. Assessment and vital signs take up 5% of nurses’ time. Patient care activities utilize 14% of nurses’ time. Care coordination takes up another 14%.
When determining which patient has the priority to be assessed first, the nurse should always evaluate the patient who is:
a. unstable c. on the ventilator
b. having pain d. receiving blood
ANS: A
According to Maslow, always assess physiological needs first. The patients who have the highest priority to be assessed are those that are unstable. The first priority is the ABCs, but patients can become unstable at any time and for many reasons.
A patient who requires to be placed in contact isolation would be said to be in the ___ priority of care.
a. third c. first
b. second d. fourth
ANS: B
Safety is the second priority on Maslow’s level of human needs. Safety includes protecting patients, staff, and visitors from harm. This would include patients who need to be placed in isolation, no matter if it is contact, droplet, or airborne. The first priority is for unstable patients with physiological needs, and the third priority is for comfort and healing. There is no fourth level.
The third level of priority according to Maslow includes patients who:
a. remain unstable c. need hourly monitoring
b. are stable and predictable d. the nursing assistant can care for
ANS: B
In Maslow’s third level of priorities patients who are stable and predictable are included. These patients may need pain relief and healing following an uncomplicated surgery, they may need teaching about their care, disease, or it is management, or they may need to increase strength and provide their ADLs. Any patient who is unstable and/or needs hourly monitoring should be included in the first priority. The nursing assistant does not function independently to provide care.
Which of the following are some useful suggestions that nurses should consider for balancing their time among school, family, and work? Select all that apply.
a. get organized c. address stress
b. look for a good fit d. solicit support from family and friends
ANS: A, B, C, D
The University of Illinois at Chicago has identified a number of tips and suggestions for nurses who want to balance their school, family, and work lives. Some of these suggestions are: look for a good fit (look for a program that fits your needs), invite your employer on board, find out about tuition assistance, get organized, address stress, communicate with friends and family, make the most of student resources, and most of all: be kind to yourself.
Maloney (2012) noted some key aspects of time management. The key aspects include which of the following? Select all that apply.
a. analysis of how time is currently used
b. assessment of time distractions
c. requires self-examination of what pursuits are really important
d. time must be calculated to fit a diverse staff
ANS: A, B, C
Maloney (2012) identified some key characteristics of time management. Some of these characteristics are: 1) analysis of how time is currently used, 2) assessment of time distractions, and 3) requires self-examination of what pursuits are really important.
Which of the following are areas that should be considered when making shift staffing assignments? Select all that apply.
a. patient needs c. agency organizational systems
b. end-of-shift outcome achievement d. staffing
ANS: A, C, D
When making shift assignments, it is important for nurses to consider these three items: patient needs, agency organizational systems, and staffing. While the end-of-shift outcome achievement is important, this is assessed at the end of the shift, not at the beginning while assignments are being assigned.
Ways to address and reduce stress while going to school and working includes which of the following? Select all that apply.
a. take active breaks c. reach out
b. discuss your goals d. have fun
ANS: A, C, D
Addressing the stress that is bound to come from having a job and going to school is important so that pressure does not build and cause conflict. Take active breaks. Get up and take a walk. It may be just up and down the stairs or outside to see the sunshine, but changing perspective is important. Reach out. Do not underestimate your needs for social interaction. Have fun. You cannot work 24-7 without becoming burned out.
Just as there are certain components that should be included in cover letters, there are also those that should not be used. Which of the following is not correct regarding what should not be included in cover letters?
a. name signed in nonblack ink or blue ink
b. repeating information
c. nonindented paragraphs
d. more than one page in length
ANS: C
Some elements that should not be included when formatting a cover letter are: signature in any color other than black ink, repeating information, indented paragraphs, and more than one page in length.
There are a variety of methods that can be used in planning and implementing an effective job search. Which of the following is not usually a productive method to use for job searches?
a. networking through family, friends, and acquaintances
b. reviewing positions listed on hospitals Websites
c. attending job fairs
d. showing up at as many hospitals as you can and asking for a job
ANS: D
There are a number of effective methods that you can incorporate into your plan for implementing a job search. Some of these include: 1) networking through family, friends, and acquaintances, 2) reviewing positions listed in the newspaper (also via Internet searches, recruitment agencies, and Websites), and 3) attending a job fair. Showing up at as many hospitals as you can and asking for a job is not a productive means of job searching, even though one may stumble upon a position inadvertently. It is best to do a preliminary search and research any targeted facilities before contacting them.
Qualities of a good resume include all of the following except:
a. highlights your experiences c. provides your credentials
b. highlights your skills d. detailed and specific
ANS: D
Good resumes include a variety of specific elements that make them good. Some of these elements are; skills and experiences are highlighted, credentials are provided, and they are brief and specific (not detailed or long).
When should the STAR format be used in interviews?
a. when recalling behaviors in specific situations
b. as an initial format for starting an interview dialogue
c. to enhance strengths and weaknesses
d. when discussing goals and values
The STAR format, when used in interviews, can be beneficial to help nurses remember details and behaviors associated with specific situations. The acronym STAR stands for: Specifics (what occurred), Task (the problem or issue), Action (what you did), and Result (result of the action).
Some illegal questions may come up during interviews. Which of the following is not an illegal question area?
a. citizenship c. cultural heritage
b. career goals d. medical history
ANS: B
Not all questions asked during interview situations are legal. Some illegal questions that may come up concern: citizenship, cultural heritage, medical history, age, membership in any social or political organizations, family characteristics, gender preference, and sexual orientation. Legally acceptable questions include: your reason for applying for the job, career goals, any problems you foresee, and your strengths and weaknesses.
Some of these questions may be asked during an interview situation. Which of the following do you not need to answer?
a. Why do you want to work here? c. What are your strengths?
b. What would your references say? d. Do you have childcare arrangements
ANS: D
Questions concerning family relationships, such as your marital status or children, cannot legally be asked during interviews. Other topics that are not considered legal include: questions related to your membership in social organizations, political or sexual orientation, cultural heritage, or health and medical history.
A variety of performance feedback mechanisms and tools exist. Which of the following is not a performance feedback mechanism a new nurse may encounter?
a. 365-degree feedback c. formal performance feedback
b. preceptor feedback d. informal performance feedback
ANS: A
Performance feedback can take many forms. Some formats that new nurses may encounter are: 360-degree feedback (not 365-degree feedback), preceptor feedback (feedback from one’s preceptor during the orientation period), formal performance feedback (regular formalized performance evaluation to maintain accreditation), and informal performance feedback (feedback from nurses and other professionals you work with).
Which is generally not part of the new nurses’ orientation?
a. validation of CPR
b. human resource policies
c. specific requirements for certain units
d. policies related to medication administration
ANS: C
General orientation usually includes information and skills measurement that all nurses new to the organization and facility need to know, regardless of their unit. Some examples of this are: validation of CPR, human resource policies, policies related to medication administration, opportunities to hear from representatives of various departments, and patient safety (Joint Commission) concerns. Requirements specific to a certain unit are provided during the unit orientation process.
Why is a cover letter important?
a. it can be one of your first marketing strategies
b. it is a good way to get your “foot in the door”
c. it can be used to detail your accomplishments
d. it can be used in lieu of a resume
ANS: A
Cover letters are one of the first opportunities you have to present yourself to a potential employer. They are good marketing and advertising techniques, and should be worded very carefully and precisely.
Several components are vital for an effective cover letter. Which of the following is one of these components?
a. one page in length c. one to two pages in length
b. detailed commercial about yourself d. general salutations are usually best
ANS: A
A cover letter is a type of marketing and advertising strategy used when presenting oneself to a potential employer. They should be no longer than one page in length and provide a brief (not detailed) commercial about you. They should be specifically addressed to one person, not a company or a general salutation.
A new hire would expect to receive information on _____ during a unit-specific orientation.
a. benefits c. patient safety standards
b. IV pumps d. CPR
ANS: B
Unit-specific orientation focuses upon information and competencies that a new nurse or new hire needs to safely care for the diagnoses and ages of the patients on the assigned unit. Some elements in this type of unit-specific orientation include: unit specific policies and procedures including IV pump usage, and acquisition and use of paperwork needed for new admissions and discharges. Benefits, CPR validation, and patient safety standards are generally covered during the general orientation
Including personal attributes in your résumé that illustrate your abilities as an effective team player, continuous learner, and consistent performer will show potential employers that you may be a good fit for their organization. Which of the following is not a correct attribute?
a. attention to detail c. reliability in attendance and punctuality
b. seeking out learning opportunities d. resistance in resolving conflict
ANS: D
Personal attributes that highlight one’s capabilities in certain positive employment skills enhance a job seeker’s potential. Some of these positive attributes include: attention to detail, seeking out learning opportunities, reliability in attendance and punctuality, being a team player performing therapeutic nursing interventions, providing a safe and comfortable environment for patient, and demonstrating resilience (not resistance) in resolving conflict.
Utilizing the example of the unit-specific competency tool for the Emergency Department, there are a number of skills that are specific to any new nurse. Which of the following is not necessarily correct?
a. monitor data so that I am up to date on evidence-based care for my patients
b. network primarily with other nurses
c. participate in professional committees at work
d. communicate pride in being a nurse
ANS: B
The unit-specific competency tool example for the Emergency Room provided in the text offers a number of useful skills and critical-thinking concepts that are valuable for new nurses. Some of these include: 1) monitoring data so that I am up to date on evidence-based care for my patients, 2) network primarily with other professionals (not only nurses), 3) participate in professional committees at work, 4) communicate pride in being a nurse, 5) monitor data so that my patients are complication-free and have no nurse-sensitive outcomes, and 6) give and receive professional respect to the health care team.
The conflict between a new graduate’s expectations and the reality of the first nursing position is known as
a. honeymoon period c. resolution phase
b. recovery phase d. reality shock
ANS: D
In 1974 Kramer identified “reality shock.” Reality shock is described as a conflict between the new graduate’s expectations and the reality of the first nursing position. The honeymoon period, the resolution phase, and the recovery phase are not part of reality shock, but they are part of Kramer’s description of the transitions new nurses pass through.
One reason for the exit examination is to demonstrate
a. strengths and weaknesses c. proficiency for getting a job
b. a great GPA d. reduce anxiety for NCLEX
ANS: A
Many nursing programs administer an examination to students at the completion of their nursing program. New graduates who examine their feedback from such an examination have important information regarding their strengths and weaknesses that can help them focus their review for the NCLEX. Taking an exit exam will not help the students reduce their anxiety nor will it help the graduate get a new job.
Successful test performance requires
a. nursing knowledge, test taking strategies, and rest before testing
b. test-taking strategies, anxiety management, and memorization
c. nursing knowledge, test-taking strategies, and anxiety management
d. anxiety management, nursing knowledge, and confidence
ANS: C
Successful test performance requires nursing knowledge, anxiety management, and test-taking skills. Knowledge of the test content is the first critical element. The second element of success is anxiety management, and test-taking skills are the final element. Confidence will help as it demonstrates readiness to test, but it is not one of the three critical elements. Graduates need critical-thinking skills, not memorization to be successful.
When answering NCLEX test questions
a. assume you can give perfect care c. rely on answers from a previous test
b. rely on your clinical experience d. assume you have unlimited time
ANS: A
When taking the NCLEX examination, the graduate should answer questions by assuming you are able to give perfect care “by the book.” Do not let your personal clinical experience direct you to choose a test answer that is less than high-quality care. Assume you have plenty of staffing, plenty of time, and all the necessary equipment for any possible test question choices. The NCLEX examination is a timed exam, so there is no unlimited time.
When presented with a difficult test question, one strategy that can be used is
a. PSDA c. FOCUS
b. ARKO d. CAT
ANS: B
When you are presented with a difficult test question, you can use the ARKO strategy to help answer the question: A – the test question asking you to take Action or no Action; R – Reword the question; K – identify any Key words in the question stem; O – review and eliminate Options. PSDA and FOCUS are types of quality improvement methodology, and CAT is computer adaptive technology which is the type of NCLEX examination.
There are several predictors of performance on the NCLEX-RN examination. Some of these predictors include which of the following? Select all that apply.
a. GPA in science c. ACT score
b. confidence in one’s abilities d. absence of emotional distress
ANS: A, C, D
A number of predictors of performance on the NCLEX-RN exam have been identified. Some of these factors include ACT score, absence of emotional distress, verbal SAT score, high school rank and grade point average, undergraduate nursing program GPA, GPA in science and nursing theory courses, competency in American English language, reasonable family responsibilities or demands, and critical thinking competency.
Anxiety can disrupt even the most prepared test takers. Which of the following are some good strategies for anxiety reduction that nurses preparing for the NCLEX-RN exam might consider? Select all that apply.
a. guided imagery c. relaxation exercises
b. breathing exercises d. fasting
ANS: A, B, C
Visualization and relaxation techniques can be used to help reduce test anxiety related to the NCLEX-RN examination. Some of these are: guided imagery, breathing exercises, and relaxation exercises. While fasting may provide a temporary relief of anxiety due to its association with meditation, the body needs nutrition when exerting the amount of energy and concentration required for test taking.
It is important for nurses to recognize key characteristics of good preceptors. Which of the following are some of these key characteristics of successful and effective preceptors? Select all that apply.
a. assertive/aggressive in clinical expertise
b. clinically prepared
c. enjoy teaching
d. committed to the role
ANS: B, C, D
Nurses are generally assigned the role as preceptor due to their expertise, experience, and knowledge of the unit and facility. Some important characteristics of effective preceptors include: clinically prepared/experienced, enjoy teaching, committed to the role as preceptor, familiar with the organization’s policies and procedures, and willing to share knowledge and model behaviors with their orientees. Being assertive or aggressive related to clinical experience may make a preceptor difficult to work with for new nurses, and this type of behavior is not conducive to effective precepting or for successful orientation
The 360-degree feedback tool can help the nurse evaluate performance. Some aspects of the 360-degree feedback evaluation tool include which of the following? Select all that apply.
a. potentially provides a broader and more balanced assessment
b. is time-consuming
c. does not include patient interviews or assessments
d. includes peer reviews
ANS: A, B, D
The 360-degree evaluation tool is used by some health care organizations. This tool allows for a more comprehensive and broader assessment of an individual by a variety of people. Some other aspects of this evaluation tool include: peer reviews, evaluation by the nurse’s immediate supervisor, patient interviews, and it is time-consuming, yet it yields valuable information from a number of different sources
Which of the following are some of the actions and behaviors which can necessitate corrective action? Select all that apply.
a. excessive absenteeism
b. failing to comply with policies or procedures
c. inability to complete assignments in a timely manner
d. a union complaint
ANS: A, B, C
Behaviors that result in corrective action can be categorized into developmental needs or failure to follow policies and procedures. The nurse’s inability to complete assignments in a timely manner reflects on the nurse’s potential need for coaching and guidance in time management from their manager or supervisor (developmental needs). Excessive absenteeism is a form of failing to comply with policies and procedures that necessitates disciplinary corrective action. A union compliant does not necessarily require corrective action unless it occurs as a result of a corrective or disciplinary action, such as a verbal warning.
Nurse T is a new graduate who has been working on the medical-surgical unit for three months. When asked to take extra shifts or to rotate shifts, she is more than willing to do this. Lately, she has begun to wonder if she is sleep-deprived at work. Some negative effects of sleep deprivation are listed below. Which of the following is not correct?
a. difficulty remembering and concentrating
b. increased risk of motor vehicle accidents
c. increased risk of medical errors
d. a period of 24 hours of wakefulness is equivalent to a 0.001% blood alcohol level
ANS: D
Nurses are particularly susceptible to sleep deprivation due to the nature of their jobs and the caring aspect of their profession. Some negative effects of sleep deprivation that nurses need to be aware of include: 1) difficulty remembering and concentrating, 2) increased risk of motor vehicle accidents, 3) increased risk of medical errors, and 4) the fact that a period of 24 hours of wakefulness is equivalent to a 0.10% (not 0.001%) blood alcohol level.
Nurse V has been working on the same oncology unit for the past ten years. Lately, her coworkers have noticed that she seems to be having trouble processing information and making decisions when caring for her patients. When asked if she needs any help, she flatly denies that anything is wrong and states that she has been doing things this way for ten years and sees no reason to change. Nurse V is having difficulties in which area of health?
a. professional c. intellectual
b. social d. spiritual
ANS: C
Intellectual health consists of the information and knowledge that one accumulates and the ability to think. Intellectually, healthy people are able to clearly process information, make decisions, learn from experience, and are open to new ideas. In the situation noted above, Nurse V is having difficulty processing information, making decisions, and being open to new ideas or thoughts, which are all signs of poor intellectual health. Sometimes other stressors, such as sleep deprivation (physical health) or excessive worrying (emotional health), can result in these types of symptoms, but neither physical nor emotional health is listed as a choice above.
A number of safeguards have arisen as a means of preventing occupational hazards. An example of one of these preventive measures for environmental agents is:
a. use personal protection equipment
b. assess the work area for the amount of noise
c. develop standards of care for handling hazardous agents
d. be aware of bioterrorist alerts
ANS: D
A variety of safeguards and standards exist to aid in the prevention of workplace injury and occupational hazards. Some of these measures that relate to environmental agents include: 1) be aware of bioterrorist alert plans, 2) develop a violence reduction plan, 3) rotate shifts clockwise (day to night), 4) assess for dangerous chemicals in your workplace, and 5) determine whether Occupational Health and Safety Administration (OSHA) standards are in place. Using personal protection equipment is an example of a safeguard for infectious agents. Assessing the workplace for the amount of noise is an example of a physical agent safeguard, and developing standards of care for handling hazardous agents is an example of a chemical safeguard.
Statistical data from 2008 noted that the average age of nurses was:
a. 30.8 c. 52.1
b. 34.2 d. 46.0
ANS: D
The average age of nurses, according to 2008 statistical data, was noted to be 46 years. The average age at graduation for recent RN graduates was noted to be 30.8 years.
“Application of knowledge, interpersonal decision making, and psychomotor skills” is a definition of:
a. clinical ladder c. certification
b. nursing competency d. licensure
ANS: B
The National Council of State Boards of Nursing (2011) has defined professional nursing competency as the application of knowledge, interpersonal decision making, and psychomotor skills expected for the practice role within the context of public health, safety, and welfare. Clinical ladders are used as career advancement tools to offer nurses’ opportunities to seek promotion via a specific pathway.
How many career ladder stages are included in the Colorado Differentiated Practice Model?
a. 4 c. 5
b. 3 d. 8
ANS: A
The Colorado Differentiated Practice Model is based on the work by Benner (1984) and includes four stages. Stage I is considered to be the entry or learning stage. Stage II is represented by individuals who competently demonstrate acceptable performance adapting to constraints of time and resource. Stage III consists of proficient individuals, and Stage IV is defined by individuals who are considered to be experts
A nurse who functions proficiently in her area of specialization is considered to be in which stage of the Colorado Differentiated Practice Model clinical ladder?
a. Stage I c. Stage III
b. Stage II d. Stage IV
A nurse who functions proficiently is considered to be in Stage III of the Colorado Differentiated Practice Model clinical ladder. A nurse in Stage IV is considered to be an expert. A nurse in Stage I is considered to be at the entry or learning level, and a nurse who is at Stage II is considered to be competent and demonstrates acceptable performance.
Which of the following is not considered to be one of the six areas or elements that make up health?
a. spiritual health c. professional health
b. social health d. nursing health
ANS: D
Health has been discussed as a series of different elements that overlap and contribute to the overall well-being of an individual. Six areas or elements of health that have been identified are: 1) spiritual health, 2) social health, 3) professional health, 4) emotional health, 5) intellectual health, and 6) physical health
The Colorado Differentiated Practice Model for Nursing has four weighted components. Of the four to be evaluated which one carries the most weight?
a. competency statements c. institutional goals
b. skills d. professional activities
ANS: A
The Colorado Differentiated Practice Model for Nursing has a separate clinical ladder for the six preparatory backgrounds. The framework for each educational ladder has four weighted elements. These include competency statements (60%), skills (10%), institutional goals (15%), and professional activities (15%).
A skill the nurse can develop to help combat anger is
a. accommodation c. silence
b. resilience d. compromise
ANS: B
One way of coping with anger is to prevent its development. Resilience is the ability to cope with and adapt to adversity (McAllister & McKinnon 2009). It is a desired quality to have in the stress-filled environment of health care. Evidence is growing that resilience is a skill that can be learned. Silence will only promote anger. Accommodation is a way of managing conflict which is a passive response that gives in to others’ needs rather than acknowledging one’s own. Compromise is another way of managing conflict. This technique allows individuals to give and take to reach an agreement.
Working without adequate sleep can lead to long-term consequences of
a. cardiovascular disease c. migraine headaches
b. spiritual distress d. impaired relationships
ANS: A
Nurses often consider fatigue as a normal part of the job, and often do not associate between working excessive hours and impaired health. Working without adequate sleep between shifts can lead to negative chronic health effects, including cardiovascular disease, metabolic syndrome, diabetes, obesity, decreased immune function, and an increased risk of cancer. In respect to job performance and safety to patients, sleep deprivation has been documented as increasing the risk of medical errors (Institute of Medicine [IOM], 2006).
Some reasons for sleep deprivation that are specific to nurses are listed below. Which of the following are some of these reasons? Select all that apply.
a. working the night shift
b. rotating shifts
c. working 10- to 12-hour shifts repeatedly
d. ongoing thoughts about family and social pressures
ANS: A, B, C
Some reasons and behaviors that contribute to sleep deprivation that are specific to nurses are: 1) working the night shift (may be difficult to sleep for long periods of time during the day), 2) rotating shifts (rotating shifts does not usually provide enough time to adjust to the new schedule; hence this can contribute to a loss of sleep), 3) working 10- to 12-hour shifts repeatedly (this does not allow for much time between shifts for sleeping), and 4) ongoing thoughts about patients and activities at work (not thoughts about family and social pressures, as these are not specific to nurses).
A number of occupational health hazards exist that nurses are susceptible to. There are four primary categories of these occupational health hazards. These categories include which of the following? Select all that apply.
a. infectious agents c. workplace violence agents
b. physical agents d. chemical agents
ANS: A, B, D
The four categories of occupational health hazards are: 1) infectious agents (e.g., HIV, hepatitis), 2) physical agents (e.g., radiation, noise), 3) environmental agents (e.g., poor air quality), and 4) chemical agents (e.g., ethyl oxide, glutaraldehyde).
Which of the following workplace strategies can nurses use to help prevent fatigue? Select all that apply.
ANS: B, C, D
There are a number of tips to help nurses prevent fatigue in the workplace. Some of these include: 1) getting adequate sleep, 2) taking an uninterrupted 15-minute break every four hours, 3) rotating shift work clockwise when possible—days, evenings, nights (not staying up for 24 hours when switching from day to night shift as this can be the equivalent of a blood alcohol level of 0.10%), and 4) sharing a ride home or using public transportation. Other suggestions are: joining a safety committee at work, trying to build in a sanctioned short nap when working the night shift, and adequate nutrition and exercise.
Which of the following guidelines are correct for BMI interpretations, set forth by the National Institutes of Health? Select all that apply.
a. 40 and above is obese c. 18.5 to 24.9 is optimal health
b. 25 to 39.9 is overweight d. below 18.5 is considered underweight
ANS: C, D
The National Institutes of Health (NIH) established guidelines for use when interpreting BMI (body mass index). These four guidelines are: 1) 30 and above is considered obese, 2) 25 to 29.9 is overweight, 3) 18.5 to 24.9 is optimal health, and 4) below 18.5 is considered to be underweight.
1. The role of the manager includes:
A) Interpersonal, informational, and decisional actions
B) Extroverted personality, hidden agenda, and personal gain
C) Introversion, asking questions, and inability to take action
D) Extreme prejudice, being unknowledgeable, and being uncaring
A
Interpersonal, informational, and decisional actions
2. Sally meets with all the staff to get input on the governance of the unit. Her management style is most likely:
A) Autocratic
B) Participative
C) Directive
D) Permissive
B
Participative
3. During a code Sue begins giving orders to the staff. Her management style at this time is:
A) Nondirective
B) Permissive
C) Controlling
D) Participative
C
Controlling
4. An example of a human relations-oriented manager is one who:
A) Motivates employees to work to their highest potential
B) Uses control rather than guidance
C) Assumes close supervision over staff development
D) Implements punishment rather than rewards
A
Motivates employees to work to their highest potential
5. Which of the following qualities would be detrimental to effective nursing management?
A) Leadership
B) Clinical expertise
C) Business sense
D) Minimum communication
D
Minimum communication
6. Michelle believes that her employees operate from the Theory Y philosophy. Based on this, how would she assist them in developing a scheduling plan for the unit?
A) Send a completed schedule for 2 months out over e-mail.
B) Ask for a committee of volunteers to develop the schedule.
C) Meet with each employee to get his or her input about the best scheduling plan.
D) Delegate scheduling to her assistant nurse manager.
C
Meet with each employee to get his or her input about the best scheduling plan.
7. Nancy has been working as an RN in long-term care for 4 months. She has been offered the evening supervisor position at a local nursing home. The salary is attractive. What should be her main consideration prior to accepting this position?
A) Her clinical expertise, business sense, and leadership skills.
B) Staffing ratios and number of RNs on the evening shift.
C) Vacation, sick time, and tuition reimbursement.
D) Mission and philosophy of the facility.
A
Her clinical expertise, business sense, and leadership skills.
8. Which of the following actions would be typical for a manager who adheres to the scientific management approach?
A) Reads research studies on management
B) Stays in touch with his or her feelings
C) Carefully works out the time each nursing task should take
D) Allows staff to develop and enforce their own holiday schedule
C
Carefully works out the time each nursing task should take
9. Servant leadership is best described as:
A) An “employees first” attitude
B) Emphasis on serving the patient
C) A laissiz-faire approach
D) Multi-tasking as much as possible
A
An “employees first” attitude
10. Which of the following is an example of the decisional activities of a manager?
A) Providing leadership
B) Encouraging continuing education
C) Coaching employees
D) Completing staff evaluations
D
Completing staff evaluations
11. What is the “essence” of management?
A) Providing close supervision
B) Getting work done through others
C) Constant monitoring of unit expenses
D) Staff development
B
Getting work done through others
12. A new graduate has been offered a nurse manager position. What is the graduate’s best response?
A) “Thank you, but I’m not ready to be a manager.”
B) “When can I start?”
C) “What is the starting salary?”
D) “Tell me what the benefits of the positions are.”
A
“Thank you, but I’m not ready to be a manager.”
1. Mr. Reynolds is admitted through the emergency department after being involved in a motor vehicle accident. His airbag failed to deploy, and he was hit in the abdomen with the steering wheel. He has an IV of 0.9% NS @ 100 mL/hr, BP 92/58, and complains of weakness, fatigue, and abdominal pain. On assessment, the nurse discovers that Mr. Reynolds is nauseated and just vomited 560 mL. The nurse is quite busy and decides to delegate client care activities to the nursing assistant. Of the following activities, which should the nurse keep?
A) Taking and recording vital signs every 15 minutes
B) Recording accurate intake and output
C) Obtaining a baseline weight to guide therapy
D) Increasing the IV rate to 250 mL/hr if the blood pressure drops to 85/50
D
Increasing the IV rate to 250 mL/hr if the blood pressure drops to 85/50
2. Mrs. Dillon, a client recovering from CHF, is being discharged this afternoon. She needs teaching reinforced. The most appropriate caregiver to complete this activity is:
A) An LPN/LVN
B) A UAP
C) A unit secretary
D) A second-year nursing student working as a nurse tech on the unit
A
An LPN/LVN
3. Of the following clients, which one could be assigned to a UAP?
A) A client with a recent head injury
B) A fresh postoperative laparoscopy client for the removal of an ovarian cyst
C) A client with stable angina
D) A client with a sepsis
C
A client with stable angina
4. The RN who is the team leader gives assignments to all the team members. The decision is based on:
A) The number of staff willing to work
B) The age and desires of the team members
C) The RN needing to take orders and write client outcomes
D) The condition and needs of each client
D
The condition and needs of each client
5. Eddie, an RN, is charge nurse and is setting up the day’s assignments. Lindsey, a newly licensed RN, has been floated to the unit. When making an assignment for Lindsey, Eddie must consider:
A) Lindsey’s age
B) Lindsey’s knowledge of the institution’s standards of practice
C) Lindsey’s nursing degree
D) Lindsey’s knowledge base and level of skill
D
Lindsey’s knowledge base and level of skill
6. When making assignments, two legal responsibilities the RN must take into consideration are:
A) Knowing the job requirements and evaluating the outcomes.
B) Assessing how much supervisory time is necessary and assessing the competence of each staff member
C) Writing job descriptions and communicating them to all staff members
D) Making sure the supervisor’s and the employee’s strengths are matched and giving adequate supervision
B
Assessing how much supervisory time is necessary and assessing the competence of each staff member
7. Luci, an RN, arrives at work. The nurse manager tells her that the ICU needs more help and as Luci is the most experienced RN on this unit, she is being reassigned to work in the ICU for the day. Luci tells the nurse manager that although she is the most experienced, she has never worked in the ICU. She shares her concerns with the nurse manager regarding the lack of familiarity with the technical equipment and protocols of the ICU. The nurse manager states that she understands Luci’s concern and reluctance, however, Luci is to go to the ICU. The most appropriate action Luci should take is to:
A) Refuse to go to the ICU.
B) Go to the ICU and tell the charge nurse that she is ill and needs to go home.
C) Go to the ICU and inform the charge nurse of the tasks she is able to perform and those tasks with which she feels she needs assistance.
D) Call the nurse manager’s supervisor and report her for unsafe delegation.
C
Go to the ICU and inform the charge nurse of the tasks she is able to perform and those tasks with which she feels she needs assistance.
8. The RN has delegated the care of a fresh postoperative client to the LPN on the team. The LPN notifies the RN that the client’s vital signs are elevated and that the client is complaining of pain and dyspnea. Which of the following is the most appropriate action to be taken by the RN?
A) No further action is necessary as the LPN is experienced.
B) Request that the LPN offer the client a narcotic analgesic that had been ordered for the postoperative period.
C) Place a call to the attending surgeon and report that the client is having pain.
D) Assess the client and analyze the preoperative and perioperative data before calling the surgeon.
D
Assess the client and analyze the preoperative and perioperative data before calling the surgeon.
9. Delegation is defined as:
A) Reassigning the responsibility of performing a job from one person to another
B) Explaining how you want a job done
C) Telling other people what to do
D) Developing ways to classify people into job categories to learn what they are capable of doing
A
Reassigning the responsibility of performing a job from one person to another
10. Lorena has worked in Labor and Delivery for 15 years with a total RN staff. She is now the associate nurse manager of a busy postpartum unit and has RNs and UAPs. She realizes that she needs to make assignments to members of the health-care team based on each individual’s:
A) Length of service
B) Scope of practice
C) Ability to perform the task
D) Job title
C
Ability to perform the task
11. Kimberly has been a nurse for 10 years, and she is precepting Loren, a new RN. Loren is having difficulty prioritizing client care. Kimberly explains to her that prioritizing client care is based on:
A) The nursing process
B) Virchow’s triad
C) Client requests
D) Maslow’s hierarchy
D
Maslow’s hierarchy
12. As a charge nurse, which of the following clients would be the most appropriate to assign to a nurse pulled to a neurological unit from a general surgical unit?
A) A client with a stable cervical fracture who is in halo traction
B) A client with Guillain-Barré syndrome who is having respiratory difficulties
C) A client with chronic amyotrophic lateral sclerosis
D) A newly admitted client diagnosed with myasthenia gravis
A
A client with a stable cervical fracture who is in halo traction
13. A nurse is caring for a client who has dementia and urinary incontinence. Which nursing action could be appropriately delegated to a UAP?
A) Teaching the client to use the call bell when needing the bed pan.
B) Offering the bed pan to the client every 2 hours.
C) Obtaining a sterile urine sample for culture and sensitivity.
D) Assessing the client for skin breakdown.
B
Offering the bed pan to the client every 2 hours.
14. Which of the following clients should be assigned to the UAP?
A) A client who has just returned from the post-anesthesia recovery room.
B) A client whose call light is not working.
C) A client with Alzheimer’s type dementia.
D) A client who is receiving heat treatment.
B
A client whose call light is not working.
1. The first item to include on your résumé is:
A) The objective
B) Your education
C) Your work history
D) Personal references
A
The objective
2. A SWOT analysis includes all of the following EXCEPT:
A) Strengths
B) Weaknesses
C) Objectives
D) Threats
C
Objectives
3. Being a career survivalist means:
A) Developing multiple options
B) Always searching for more income
C) Knowing your current position very well
D) Being independent of everyone
A
Developing multiple options
4. Skills that are needed for employment do NOT include:
A) Oral and written communication skills
B) Proficiency in nursing competencies
C) Ability to be irresponsible
D) Self-discipline
C
Ability to be irresponsible
5. It is important to learn about the organization for which you wish to work. You can start by looking at its:
A) Mission statement
B) Policy and procedures
C) Advertisement size
D) Salary ranges
A
Mission statement
6. The information not needed in your résumé is:
A) Qualifications
B) Educational experiences
C) Personal references
D) Work history
C
Personal references
7. The best résumé is:
A) Crammed with everything about you
B) Printed on brightly colored stationery
C) Lean and to the point
D) In a paragraph format
C
Lean and to the point
8. In the interview process, you should:
A) Be vague about experiences
B) Not exaggerate your knowledge and skills
C) Talk in abstract terminology
D) Defend your ability to do this job
B
Not exaggerate your knowledge and skills
9. In citing your skills on your résumé do NOT include:
A) Management and leadership positions
B) Problem-solving ability
C) Volunteer experience
D) Personal issues about previous work experiences
D
Personal issues about previous work experiences
10. Recommendations for career success from experienced nurses include all of the following EXCEPT:
A) Find a mentor.
B) Recognize that health-care is a business.
C) Communicate effectively.
D) Don’t take risks in the workplace.
D
Don’t take risks in the workplace.
11. In searching for a new position you should do everything EXCEPT:
A) Review the philosophy of the organization.
B) Speak with nurses in the organization.
C) Request the organizational chart.
D) Call the nursing office regarding salaries.
D
Call the nursing office regarding salaries.
12. The following information should be included on your résumé:
A) Accurate spelling and grammar
B) Family information
C) Clear objective
D) Education and experience
B
Family information
13. Your resume should NOT include skills related to:
A) Leadership
B) Teamwork
C) Volunteer activities
D) Childcare arrangements
D
Childcare arrangements
According to “trait theories,” the most common traits of a good leader are:
A) Information giving and decision-making
B) Public speaking and nonrisk behaviors
C) Intelligence and initiative
D) Verbal and written communication skills
C) Intelligence and initiative
Of the following qualities, which would least likely be attributed to an effective nursing leader?
A) Energy and integrity
B) Pessimism and stress
C) Courage and initiative
D) Optimism and perseverance
B) Pessimism and stress
Sally has been working only 3 months after graduating from her nursing program. She confides in a friend that she wants to develop herself as a “good follower.” Her friend says, “Anyone can follow—just walk behind someone and do nothing.” How might Sally respond?
A) “I don’t mean now, but when I become a nurse manager.”
B) “Effective followers need to be active participants in the workings of this unit.”
C) “Effective followers need to do everything the administrators want.”
D) “Effective followers need to always question the status quo and strive to make changes.”
B) “Effective followers need to be active participants in the workings of this unit.”
Which skills will not be useful in becoming a better follower?
A) Supporting the ideas of your colleagues
B) Becoming an effective listener
C) Demonstrating energy and enthusiasm in the workplace
D) Contradicting others if their ideas are not useful to the team
D) Contradicting others if their ideas are not useful to the team
11. The major hallmark of situational leadership is:
A) Understanding the readiness of the follower
B) Major focus on interpersonal relationships
C) Effective listening skills
D) Motivating others
A) Understanding the readiness of the follower
Michelle believes that her employees operate from the Theory Y philosophy. Based on this, how would she assist them in developing a scheduling plan for the unit?
A) Send a completed schedule for 2 months out over e-mail.
B) Ask for a committee of volunteers to develop the schedule.
C) Meet with each employee to get his or her input about the best scheduling plan.
D) Delegate scheduling to her assistant nurse manager.
C) Meet with each employee to get his or her input about the best scheduling plan.
Which of the following actions would be typical for a manager who adheres to the scientific management approach?
A) Reads research studies on management
B) Stays in touch with his or her feelings
C) Carefully works out the time each nursing task should take
D) Allows staff to develop and enforce their own holiday schedule
C) Carefully works out the time each nursing task should take
2. Jeremy graduated from an associate degree nursing program 2 years ago. He is brought before the State Board of Nursing for offering to give physicals for summer camp for $25. Because Jeremy has violated the Nurse Practice Act in his state, he is charged with committing a:
A) Misdemeanor
B) Felony
C) Civil law
D) Common law
B) Felony
Which of the following would not be considered one of the elements for a negligence claim?
A) Duty
B) Breach of duty
C) Spontaneous duty
D) Harm
C) Spontaneous duty
Three nursing students are in the elevator and overhear Evan, one of the staff nurses, discussing his neighbor who was hospitalized last night for liver failure. Evan told his colleague that a mutual friend told him that the neighbor was “known for liking his brandy.” A family member was in the elevator and also overheard the conversation. Evan may be charged with:
A) Slander
B) Libel
C) Fraud
D) Breach of confidentiality
A) Slander
Mr. Phillipe has suffered a stroke. His daughter brings DNR and power of attorney documents to the hospital. The purpose of the DNR is to:
A) Document the terminal nature of the client’s condition
B) Allow an alternative to the universal standing order to provide cardiopulmonary resuscitation to all clients
C) Provide an opportunity for the client, family, and caregivers to discuss the nature of the client’s condition and the best possible course of action if the client has a cardiac arrest
D) Provide legal protection for nurses who believe a client should not be resuscitated
B) Allow an alternative to the universal standing order to provide cardiopulmonary resuscitation to all clients
Glenn is an RN on a busy medical-surgical unit. He comes to work today for his usual shift after working a double shift yesterday. At the end of this day, two RNs call in, and the nurse manager tells Glenn he needs to stay and cover the next shift. Glenn may refuse to accept an assignment if:
A) He is being asked to care for too many difficult clients
B) He believes his assignment is unsafe
C) He is being asked to work overtime
D) He believes there are not enough nurses to work with him
C) He is being asked to work overtime
The health-care provider orders an injection for a pediatric client. The client’s legal guardian refuses to allow the nurse to administer the medication, however, the nurse proceeds to administer the injection. Legally, the nurse has committed:
A) An assault
B) A battery
C) An invasion of privacy
D) False imprisonment
B) A battery
After administering an incorrect dosage of a medication the nurse realizes that too little medication was given to the client. The nurse then administers a second dose in order to give the correct dosage. Legally, the nurse must:
A) Not tell anyone about the error
B) Document that the correct medication was administered
C) Document the error in the nursing notes
D) Both A and B
C) Document the error in the nursing notes
A family insists that their father, Alvin Shure, 68 years old, not be told he is dying of lung cancer. While hanging his IV medication, Mr. Shure asks the nurse, “I never had a medication in a bag like that. What is it for?” The nurse knows that the medication is an antineoplastic agent. The best response by the nurse is:
A) “This is a new drug your physician ordered.”
B) “This medication is often used in the treatment of cancer.”
C) “This medication has more than one use, and I am not sure why you are receiving it.”
D) Request that the family tell him why he is getting the medication.
B) “This medication is often used in the treatment of cancer.”
A nurse working in the critical care unit is described as being an excellent friend and critical thinker. This would be considered an example of:
A) Virtue ethics
B) Moral ethics
C) Nursing ethics
D) Power ethics
A) Virtue ethics
Sources of coercive power come from which of the following?
A) Responsibility
B) Recognition
C) Expertise
D) Punishment
D) Punishment
Empowerment is psychological and includes a feeling of:
A) Control
B) Loss
C) Effectiveness
D) Quantity
C) Effectiveness
Maggie is a new UAP. She has been working the 7:00 p.m. to 7:00 a.m. shift on a busy telemetry unit for 3 months. She is perpetually late to work. The other UAPs on the unit are complaining about the situation. Of the following responses, which demonstrates the best example of assertive communication?
A) “You are always late; what are you going to do about this situation?”
B) “Being late is unacceptable; you need to change this behavior.”
C) “I noticed that you often arrive late; I think we need to discuss how this affects your performance.”
D) “Lateness creates a situation that leads to a negative day; I think it is time to work out a plan to eliminate this problem.”
D) “Lateness creates a situation that leads to a negative day; I think it is time to work out a plan to eliminate this problem.”
Which of the following is usually not part of a job evaluation?
A) The job description
B) Being compared with others
C) The results of the employee’s efforts
D) What the evaluator has seen
B) Being compared with others
When giving feedback it is important to include:
A) Suggestions for change
B) Only negative feedback
C) Positive feedback followed by negative feedback
D) A general opening statement comparing this person with others
A) Suggestions for change
Resistance to change has three major sources:
A) Technical concerns, psychosocial needs, threats to a person’s position
B) Staffing concerns, physical needs, threats to hierarchy needs
C) Prior concerns, social needs, threats to self-actualization
D) Technology concerns, personal needs, threats to hospitalized clients
A) Technical concerns, psychosocial needs, threats to a person’s position
One way to lower the resistance to change would include:
A) Centralization of information
B) Confirmation of currently held beliefs
C) Provision of psychological safety
D) Ensuring the involvement of few people to reduce confusion
C) Provision of psychological safety
A problem-solving process used in the nurse-client relationship is known as:
A) Case management
B) Nursing process
C) Evaluation techniques
D) Remediation theory
B) Nursing process
Problem resolution, as opposed to negotiation, is appropriate in which of the following situations?
A) Complex, widespread disagreement
B) Highly charged situation
C) Political issue
D) Interpersonal misunderstanding
D) Interpersonal misunderstanding
When making assignments, two legal responsibilities the RN must take into consideration are:
A) Knowing the job requirements and evaluating the outcomes.
B) Assessing how much supervisory time is necessary and assessing the competence of each staff member
C) Writing job descriptions and communicating them to all staff members
D) Making sure the supervisor’s and the employee’s strengths are matched and giving adequate supervision
B) Assessing how much supervisory time is necessary and assessing the competence of each staff member
Which of the following non-profit agency or organization completed the report that now serves as the foundation and strategy for health system reform?
A) The Joint Commission
B) The U.S. Senate
C) The American Medical Association
D) The Institute of Medicine
D) The Institute of Medicine
In many states there is a legal requirement to report:
A) Adverse events
B) Skill-based errors
C) Safety gaps
D) Near misses
A) Adverse events
State and federal governments have attempted to restrain the cost of health care through all of the following EXCEPT:
A) Mandated nurse staffing ratios
B) Regulation and competition
C) Employer incentives
D) Bedside nursing responsibilities
D) Bedside nursing responsibilities
To promote safe, quality health care, the American Nurses Association (ANA):
A) Mandates safe RN staffing levels to health-care agencies
B) Regulates RN competency to practice at the bedside
C) Maintains oversight of the National Database of Nursing Quality Indicators
D) Funds research promoting consumer protection from RN mistakes and errors
C) Maintains oversight of the National Database of Nursing Quality Indicators
The IOM identified five Core Competencies for health professionals. As the RN you identify and plan to develop all of the following identified competencies EXCEPT:
A) Implement quality and safety initiatives
B) Employ evidence-based practice
C) Work in interdisciplinary teams
D) Utilize informatics
A) Implement quality and safety initiatives
Historical, social, political, and economic trends and issues:
A) Have contributed to the complexity of today’s health-care system
B) Have had a limited impact on today’s health-care delivery system
C) Can be positively correlated with outcomes of care at the bedside
D) Have been mitigated by the strong influence of professional organizations like the ANA and the AMA
A) Have contributed to the complexity of today’s health-care system
Which of the following is NOT accurate regarding the organization and agency efforts to support quality and safety in the health-care system?
A) The U.S. Department of Health and Human Services is the primary agency responsible for protecting health in America.
B) The American Nurses Association manages a database of unit-specific nurse-sensitive data known as NDNQI.
C) Nonprofit organizations such as the Robert Wood Johnson Foundation and Leapfrog Group all have the singular focus to improve health-care outcomes for the underserved.
D) The purpose of the Joint Commission is to provide voluntary accreditation of hospitals and health-care organizations.
C) Nonprofit organizations such as the Robert Wood Johnson Foundation and Leapfrog Group all have the singular focus to improve health-care outcomes for the underserved.
The RN identifies a treatment error when:
A) An RN fails to communicate to the health-care provider a change in condition.
B) An RN incorrectly administers an IV drug dose.
C) A health-care provider fails to order an indicated serum lab exam.
D) A nursing assistant uses an automatic sphygmomanometer that fails to deflate.
B) An RN incorrectly administers an IV drug dose.
The Rhythm Model uses the anachronism PQRST. The letters stand for:
A) Prioritize, Question, Re-check, Self-reliance, Treat
B) Plan, Quantify, Re-evaluate, Self-assurance, Treat
C) Prioritize, Quantify, Re-check, Self assurance, Treat
D) Plan, Question, Re-evaluate, Self-reliance, Treat
A) Prioritize, Question, Re-check, Self-reliance, Treat
Germaine, an RN for 6 months, has just finished orientation and is placed on the 7:00 p.m. to 7:00 a.m. shift. She is responsible for eight clients. She never leaves before 9:00 a.m. of the morning following her shift. She comes to the associate nurse manager on nights and says, “I don’t think I am cut out for this. I just can’t seem to get organized!” A method designed to assist Germaine organize her client care is referred to as a(n):
A) Assignment sheet
B) Care plan.
C) Flow sheet
D) Worksheet
D) Worksheet
Threats to the employee do NOT include:
A) Potentially lethal chemicals
B) Exposure to infectious materials
C) Recapping safety devices in each room
D) Radioactive materials in open containers
C) Recapping safety devices in each room
Circumstances surrounding health-care work that contribute to workers’ susceptibility to homicide and assault include:
A) Working in low-crime areas
B) Having good hospital security
C) Experienced staff to deal with problems
D) Working in large groups
C) Experienced staff to deal with problems
Workplace issues currently under discussion by the American Nurses Association do NOT include:
A) Mandatory overtime
B) Rotating shifts
C) Staff development opportunities
D) Staffing ratios
C) Staff development opportunities
The agency responsible for protecting the worksite against terrorism is:
A) ANA
B) OSHA.
C) CDC
D) NIOSH
B) OSHA.
What is the least effective way for a new graduate to manage pressures from the first position?
A) Develop more effective communication skills.
B) Set new professional goals.
C) Do not focus on self in order to have more time to work.
D) Work with a mentor.
C) Do not focus on self in order to have more time to work.
Which statement is least likely to be related to stress?
A) Stress can be cumulative.
B) The impact of stress is the same no matter how you respond to it.
C) Perceptions of stress vary with individuals.
D) Stress is always self-limiting.
B) The impact of stress is the same no matter how you respond to it.
Ways to deal with reality shock include all of the following EXCEPT:
A) Finding a mentor
B) Leaving the profession
C) Exhausting yourself
D) Communicating effectively
C) Exhausting yourself
Stress, according to Hans Selye, is best described in the general adaptation syndrome (GAS) and includes three stages. Which one is NOT included in the three stages?
A) Alarm
B) Acceptance
C) Resistance
D) Exhaustion
B) Acceptance
A SWOT analysis includes all of the following EXCEPT:
A) Strengths
B) Weaknesses
C) Objectives
D) Threats
C) Objectives
Who is considered the “Florence Nightingale of the 20th century”?
A) Margaret Sanger
B) Virginia Henderson
C) Clara Barton
D) Mary Mahoney
B) Virginia Henderson
Where did Florence Nightingale receive her basic nursing training?
A) St. Thomas Hospital, England
B) Kaiserworth, Germany
C) St. Elizabeth’s Hospital and Training School in Scotland
D) She never received a “formal” nursing training
B) Kaiserworth, Germany
Lillian Wald is best known for her work in:
A) Women’s health reform
B) Children’s immunization reform
C) Creating an independent nursing professional
D) Developing a nurse practitioner curriculum
C) Creating an independent nursing professional
The reason Lillian Wald created the term “public health nursing” was because it:
A) Described individualized nursing care in the home
B) Addressed the social and economic influences on health and illness
C) Described the specialization in which nurses were involved
D) Addressed the need for home-based preventive care
B) Addressed the social and economic influences on health and illness
One of Margaret Sanger’s primary contributions was:
A) Recordkeeping
B) Education reform
C) Sanitation reform
D) Labor reform
D) Labor reform
Nightingale believed that:
A) Schools of nursing should be independent of hospital control.
B) Schools of nursing should be linked to medical schools.
C) Nursing courses should be taught by physicians.
D) Schools of nursing should be established within hospitals.
A) Schools of nursing should be independent of hospital control.
Who was the earliest collegiate nursing leader?
A) Florence Nightingale
B) Mary Mahoney
C) Virginia Henderson
D) Adelaide Nutting
D) Adelaide Nutting
Mary Mahoney is best known for:
A) Being one of the original members of the Nurses Associated Alumnae of the United States and Canada (later known as the American Nurses Association)
B) Her work as a child advocate
C) Founding the nursing school at Massachusetts General Hospital
D) Her work in promoting birth control for women
A) Being one of the original members of the Nurses Associated Alumnae of the United States and Canada (later known as the American Nurses Association)
Mildred Montag’s greatest contribution to nursing was:
A) To shift nursing education from the hospital, institutions to the institutions of higher learning
B) To develop the Student Nurses Association
C) To form the Navy Nurse Corps
D) To bring nurses to the war theatre
A) To shift nursing education from the hospital, institutions to the institutions of higher learning
Nursing theories allow nurses to:
A) Practice nursing using the medical model
B) Examine human experiences and behavior responses closely
C) Become nurse practitioners
D) Bill Medicare and Medicaid for their services
B) Examine human experiences and behavior responses closely
The significant contributions by nurses as designated by the TriCouncil did NOT include:
A) Nurses as resource people
B) Nurses as health-care coordinators
C) Nurses as expert practitioners
D) Nurses as physician extenders
D) Nurses as physician extenders
The nursing profession does NOT regulate itself through:
A) The Code for Nurses
B) The American Nurses Association
C) The Standards of Clinical Nursing Practice
D) The Nurse Practice Act
D) The Nurse Practice Act
In which year did the American Nurses Association recommend that the minimum preparation for beginning professional nursing practice should be a baccalaureate degree?
A) 1955
B) 1965
C) 1985
D) 1995
B) 1965
The international nursing honor society is called:
A) The National League for Nursing
B) The American Nursing Society
C) The Nursing Education Coalition
D) Sigma Theta Tau
D) Sigma Theta Tau
The American Nurses Association does not provide its members with the following benefits:
A) Health insurance
B) Scholarships to beginning students
C) Continuing education courses
D) Lobbyists for nurses in governmental issues
B) Scholarships to beginning students
Who first proposed the establishment of associate degree programs?
A) Margaret Sanger
B) Lillian Wald
C) Mary Mahoney
D) Mildred Montag
D) Mildred Montag
Studying the history of nursing is important because it helps us:
A) Appreciate our professional heritage
B) Understand how nursing developed as a profession
C) Avoid making the same mistakes over and over again
D) All of the above
D) All of the above
Who defined nursing as putting the client “in the best possible condition” to get well?
A) Martha Rogers
B) Florence Nightingale
C) Lillian Wald
D) Margaret Sanger
B) Florence Nightingale
Who was the first African American RN in the United States?
A) Virginia Henderson
B) Margaret Sanger
C) Harriet Beecher Stowe
D) Mary Eliza Mahoney
D) Mary Eliza Mahoney
Which of the following organizations is most concerned with nursing education?
A) National Institute of Nursing Research
B) American Nurses Association
C) National League for Nursing
D) The Red Cross
C) National League for Nursing
Which of the following best describes the present U.S. health-care system?
A) Sick and broken
B) The best in the world by all measures
C) Providing universal health insurance coverage
D) Efficient, effective, and caring
A) Sick and broken

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