TEST BANK for Nursing Leadership, Management, and Professional Practice for the LPN/LVN 7th Edition

Nursing Leadership, Management, and Professional Practice for the LPN/LVN 7th Edition Dahlkemper Test Bank Chapter 1. Historical Perspectives and Current Trends Chapter 1: Historical Perspective and Current Trends Multiple Choice Identify the choice that best completes the statement or answers the question.

1.

The nursing student predominantly uses knowledge about the history of nursing for what purpose?

1.

To understand the professional choices open to the student 2.

To prevent making medication errors in practice 3.

To determine what geographical area is the best place to practice 4.

To reduce the cost of delivering quality healthcare

2.

The nurse is working in an underdeveloped country and observes the natives lighting ritual fires and pounding on primitive drums around the sick person to promote recovery. The nurse interprets this behavior as indicating the natives believe illness results from what?

1.

Pathogens and genetics 2.

Evil spirits 3.

Tides and planets 4.

Plants and animals

3.

The person credited with making a written record of healthcare practices and removing the mythical aspect of healthcare is who?

1.

Hammurabi 2.

Florence Nightingale 3.

Hippocrates 4.

Apollo

4. poor?

1.

2.

Who served as the first public health nurses, caring for the sick and the The Presbyterian Church Salerno

3.

4.

Jewish scholars Convent deaconesses

5.

What is a crucial issue the nurse working in the late industrialization era would need to address in order to promote health?

1.

Reducing spread of infection 2.

Reducing sedentary lifestyle 3.

Teaching proper use of medications 4.

Teaching use of car seats

6.

What types of skills would a nursing student learn while attending Kaiserworth Deaconess Institution in 1836?

1.

Administering immunizations 2.

Assisting in surgery 3.

Washing and changing bed linens 4.

Developing a plan of care

7.

The nurse demonstrates Florence Nightingale’s theory of nursing with what intervention?

1.

Respecting the patient’s culture and incorporating cultural needs in the plan of care 2.

Promoting good health and treating those who are ill in a holistic manner 3.

Understanding how to motivate people to practice a healthy lifestyle and reduce risks 4.

Teaching other nurses how to deliver the highest quality of nursing care.

8.

What action performed by the nurse directly resulted from the contribution made by Linda Richards?

1.

Using an antiseptic before administering an injection 2.

Exploring the psychosocial needs of the patient 3.

Documenting patient care in the medical record 4.

Listening to a patient describe his or her condition

9.

After graduating from nursing school, the graduate takes a licensure examination as the result of what nurse’s contribution?

1.

Florence Nightingale 2.

Mary Adelaid Nutting 3.

Lavinia L. Dock 4.

Isabel Hampton Robb

10.

In addition to caring for the sick, what other skills would the first LPN students learn when attending the Ballard School in New York in 1893?

1.

Political advocacy 2.

Homemaking 3.

Communication 4.

Carpentry

11.

The nurse responds to an alarm on a pulse oximeter and sees the patient’s oxygen saturation is reading 38%. The nurse observes the patient, noting a respiratory rate of 12 breaths per minute, pink mucous membranes, and easy regular respirations.

The nurse concludes the pulse oximeter is not reading accurately. Whose theory of nursing is this nurse demonstrating?

1.

Annie Goodrich 2.

Lillian D. Wald 3.

Florence Nightingale 4.

Linda Richards

12.

What statement describes Florence Nightingale’s beliefs about nursing?

Practicing nurses should be licensed.

Promotion of good health and treating the ill are nursing priorities.

Nurses could simultaneously have a career and a marriage.

Organisms cause infection.

13.

What was Mary Eliza Mahoney’s contribution to nursing?

She organized the first visiting nurse association.

She founded the American Journal of Nursing.

1.

2.

3.

4.

1.

2.

3.

4.

She founded the National League of Nursing.

She worked for the acceptance of African Americans into the nursing profession.

14.

What professional organization was the first to focus on licensed practical nurses (LPNs)?

1.

National Association for Practical Nurse Education and Services (NAPNES) 2.

National Federation of Licensed Practical Nurses (NFLPN) 3.

National League for Nursing (NLN) 4.

American Nurses Association (ANA)

15.

What statement accurately describes the NFLPN? It represents both registered nurses (RNs) and LPNs. It represents LPNs/LVNs only.

It is open to anyone interested in nursing.

It is open to anyone in the healthcare field.

16.

What organizations represent only LPNs/LVNs? ANA and NLN NFLPN and NLN NAPNES and NFLPN NAPNES and ANA

1.

2.

3.

4.

1.

2.

3.

4.

17.

The nurse working in mental health nursing honors what historical nurse for working to improve care of the mentally ill?

1.

Clara Barton 2.

Florence Nightingale 3.

Dorothea Dix 4.

Lillian D. Wald

18.

1.

2.

What is the difference between the LPN and LVN nursing title?

LPNs have a longer educational program than LVNs. LVNs and LPNs have the same duties and skills, just different titles.

3.

LVNs are able to perform venipuncture and LPNs cannot.

LPNs are working toward an RN license while LVNs are not.

4.

19.

What mythical god was believed to promote healthcare in ancient times?

Apollo Zeus Isis Ares

20.

What factor has had the greatest impact on the current nursing shortage?

Later age of women having children Fewer women being born Overall unemployment rate More employment options for women

1.

2.

3.

4.

1.

2.

3.

4.

21.

What health condition is classified as a World Health Organization priority and a focus of health promotion for nurses?

1.

HIV 2.

MRSA 3.

Natural disasters 4.

Terrorism

22.

What trend in healthcare has only existed for the past decade and has changed nursing education to prepare student nurses for practice after graduation?

1.

Technology 2.

Cultural diversity 3.

HIV 4.

Nursing shortage

Multiple Response Identify one or more choices that best complete the statement or answer the question.

23. apply.)

1.

2.

What factors are contributing to the nursing shortage? (Select all that Increased demand for nurses Shortage of nursing faculty

3.

4.

5.

Lack of nursing organizations Nurses leaving the profession due to poor working conditions Not enough interest in nursing

24.

The newly licensed LPN joins a professional organization for what benefits? (Select all that apply.)

1.

Opportunities to maintain current nursing knowledge 2.

Most facilities mandate membership before hiring a nurse.

3.

Organizations offer a way for the LPN’s voice to be heard regarding concerns.

4.

They advocate for the LPN in professional matters.

5.

It is a requirement for licensure in most states.

25.

In order to deliver the safest possible care, the nurse needs to understand what? (Select all that apply.)

1.

How to perform the procedure correctly 2.

Why the procedure is being performed 3.

How the procedure will affect the patient 4.

The cost of performing the procedure 5.

The equipment needed to perform the procedure Chapter 1: Historical Perspective and Current Trends Answer Section MULTIPLE CHOICE 1.

ANS: 1 Understanding nursing history helps the nurse to better recognize the many choices available when choosing their own future path.

PTS: 1 REF: Chapter: 1 OBJ: Objective: 1 KEY: Content Area: History | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 2.

ANS: 2 A belief that disease was caused by evil spirits would result in lighting fires or candles and making loud noise to try to ward off the spirits.

PTS: 1 REF: Chapter: 1 OBJ: Objective: 2 KEY: Content Area: History | Integrated Processes: Nursing Process | Client Need: Psychosocial Integrity | Cognitive Level: Analyzing 3.

ANS: 3 Hippocrates wrote the first medical textbook, outlining current healthcare practices and removed the mythical belief that Apollo was responsible for health. Hammurabi wrote a code of laws to protect the patient and define legal limitations of caregivers, Florence Nightingale introduced modern nursing during the Crimean War, and Apollo was a mythical God who was believed to control health and wellness.

PTS: 1 REF: Chapter: 1 OBJ: Objective: 2 KEY: Content Area: History | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 4.

ANS: 4 Deaconesses from local convents acted as the first public health nurses, providing care for the sick and the poor based on the Christian belief in the importance of caring for one another.

PTS: 1 REF: Chapter: 1 OBJ: Objective: 2 KEY: Content Area: History | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 5.

ANS: 1 Many deaths resulted from communicable diseases and lack of cleanliness in hospitals, so the nurse’s priority concern with health promotion would be reducing the spread of infection.

PTS: 1 REF: Chapter: 1 OBJ: Objective: 2 KEY: Content Area: History | Integrated Processes: Teaching/Learning | Client Need: Health Promotion and Maintenance | Cognitive Level: Analyzing 6.

ANS: 3 Washing and changing bed linens, mopping floors, and housekeeping tasks were included as part of the nurse’s education. Immunizations did not exist at that time in history, and surgery was uncommon and very primitive with frequent poor outcomes. Thus assistants were rarely required and not part of nursing school. Plan of care considerations were not used until after the mid 1900s.

PTS: 1 REF: Chapter: 1 OBJ: Objective: 2 KEY: Content Area: History | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 7.

ANS: 2

Nightingale believed the nurse’s primary responsibilities included promoting health and treating the ill.

PTS: 1 REF: Chapter: 1 OBJ: Objective: 3 KEY: Content Area: History | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Applying 8.

ANS: 3 Linda Richards developed a system for recording details about patients and patient care.

This system evolved into today’s documentation system.

PTS: 1 REF: Chapter: 1 OBJ: Objective: 3 KEY: Content Area: History | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 9.

ANS: 4 Isabel Hampton Robb fought for licensing examinations and registration to protect patients from incompetent nurses, in order to raise the standard of the profession.

PTS: 1 REF: Chapter: 1 OBJ: Objective: 3 KEY: Content Area: History | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 10.

ANS: 2 LPN students learned homemaking skills, because much of the patient care they provided was within the patient’s home.

PTS: 1 REF: Chapter: 1 OBJ: Objective: 4 KEY: Content Area: History | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 11.

ANS: 3 Florence Nightingale promoted treating the patient based on the patient’s individual needs rather than treating the disease or, in this case, the machinery.

PTS: 1 REF: Chapter: 1 OBJ: Objective: 3 KEY: Content Area: History | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing 12.

ANS: 2 One of Florence Nightingale’s strongest beliefs was that promoting good health and treating the ill were nursing priorities. Throughout her career, Nightingale implemented changes in the nursing practice to enhance the health of all who were ill.

PTS: 1

REF: Chapter: 1

OBJ: Objective: 3

KEY: Content Area: History | Integrated Processes: Nursing Process | Client Need: Health Promotion and Maintenance | Cognitive Level: Understanding 13.

ANS: 4 Mary Eliza Mahoney was the first African American nurse in the United States. She spent her life working for the acceptance of African Americans into the nursing profession, and was also the organizer and the first president of the National Association for Colored Graduate Nurses.

PTS: 1 REF: Chapter: 1 OBJ: Objective: 3 KEY: Content Area: History | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 14.

ANS: 1 NAPNES was the first professional organization to focus on LPNs. NAPNES is very active today, with continuing education opportunities and publications for LPNs. While NFLPN focuses on LPNs, they were not the first to do so. NLN and ANA focus on both RNs and LPNs. PTS: 1 REF: Chapter: 1 OBJ: Objective: 5 KEY: Content Area: Nursing Organizations | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Remembering 15.

ANS: 2 The NFLPN is considered the official membership organization for the licensed practical nurse/licensed vocational nurse (LPN/LVN); therefore, only the LPN/LVN may join this organization.

PTS: 1 REF: Chapter: 1 OBJ: Objective: 5 KEY: Content Area: Nursing Organizations | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Remembering 16.

ANS: 3 The two vocational LPN organizations are the National Federation for Licensed Practical Nurses (NFLPN) and the National Association for Practical Nurse Education and Service (NAPNES). Both the ANA and the NLN focus on both RNs and LPNs. PTS: 1 REF: Chapter: 1 OBJ: Objective: 5 KEY: Content Area: Nursing Organizations | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Remembering 17.

ANS: 3 Dorothea Dix championed the development of psychiatric hospitals, and her work also brought about improvement for prisoners in jails.

PTS: 1 REF: Chapter: 1 OBJ: Objective: 3 KEY: Content Area: History | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 18.

ANS: 2 Both LPNs and licensed vocational nurses (LVNs) are legally recognized and practice in diverse healthcare settings today. LVN education predominantly takes place in California and Texas, whereas LPN education is common in other geographic areas of the country.

PTS: 1 REF: Chapter: 1 OBJ: Objective: 4 KEY: Content Area: Role of LPN | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 19.

ANS: 1 The primitive healthcare that was available was provided by males, except for the midwives, and was promoted by a belief in Apollo, the mythical Greek healer.

PTS: 1 REF: Chapter: 1 OBJ: Objective: 2 KEY: Content Area: History | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Remembering 20.

ANS: 4 One reality of the nursing shortage is that the 21st century woman has more employment options than women had previously.

PTS: 1 REF: Chapter: 1 OBJ: Objective: 6 KEY: Content Area: Trends | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing 21.

ANS: 1 The prevention and treatment of HIV is a World Health Organization priority. While MRSA is a focus of health promotion for nurses, it is the CDC that is focusing on reducing occurrence. The World Health Organization has not set natural disasters as a priority because they cannot be controlled, and it is not focused on reducing terrorism; nurses respond to terrorist events when they occur, but it is not a source of health promotion.

PTS: 1 REF: Chapter: 1 OBJ: Objective: 6 KEY: Content Area: Trends | Integrated Processes: Caring | Client Need: Health Promotion and Maintenance | Cognitive Level: Remembering 22.

ANS: 1 The use of technology in healthcare has increased dramatically over the last decade, and has become a major consideration in nursing education.

PTS: 1 REF: Chapter: 1 OBJ: Objective: 6 KEY: Content Area: Trends | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing MULTIPLE RESPONSE 23.

ANS: 1, 2, 4 Aging Baby Boomers, people living longer, and the increasing complexity of healthcare have all increased the demand for nurses. Insufficient nursing faculty results in turning potential nursing students away from nursing programs because there aren’t enough educated faculty to teach them. Mandatory overtime, working holidays and weekends, long hours without breaks, and other working conditions can cause nurses to leave the profession. There is no lack of nursing organizations and this does not contribute to the nursing shortage, and there is no lack of interest in nursing but not everyone is designed to be a nurse.

PTS: 1 REF: Chapter: 1 OBJ: Objective: 6 KEY: Content Area: Trends | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 24.

ANS: 1, 3, 4 Professional organizations provide lifelong learning opportunities for the LPN in the form of journals, seminars, and annual meetings. They also provide the LPN a voice for concerns and opinions, and they serve as an advocate for LPNs at the state and national level. Membership in a nursing organization is not usually a requirement for employment, but it can serve as a favorable indicator that the nurse is maintaining current knowledge.

While ongoing education is required by some boards of nursing for licensure, there is no requirement the nurse belong to an organization.

PTS: 1 REF: Chapter: 1 OBJ: Objective: 6 KEY: Content Area: Trends | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 25.

ANS: 1, 2, 3, 5 Understanding how to perform the procedure correctly is important if the nurse is to maintain safety. The nurse should never perform any procedure without understanding why it is being performed and what outcome is desired. The nurse is responsible for teaching the patient what to expect before the procedure is begun, so the nurse must understand how the procedure will impact the patient. The nurse will gather the equipment required to perform the procedure, therefore needs to know what will and what might be needed. The nurse is not responsible for knowing the cost of the procedure.

PTS: 1

REF: Chapter: 1

OBJ: Objective: 6

KEY: Content Area: QSEN | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying Chapter 2. Caring as a Personal and Professional Behavior Chapter 2: Caring as a Personal and Professional Behavior Multiple Choice Identify the choice that best completes the statement or answers the question.

1.

The patient tells the nurse that he has no interest in quitting smoking, even though he knows it is bad for his health. The nurse demonstrates caring with what response?

1.

“If you would rather die young than quit smoking, that is your choice to make.”

2.

“Let’s look at ways you could reduce the harm from smoking as much as possible.”

3.

“I am going to enroll you in a smoking cessation program and maybe you’ll change your mind.”

4.

“Continuing to smoke is your choice but that leaves me no way to help you stay healthy.”

2.

The hospital nurse caring for a terminally ill patient who wishes she could see her dog one more time demonstrates holistic care with what action?

1.

Explaining the infection risk associated with animals 2.

Arranging for the patient to be discharged to see the dog 3.

Explaining the hospital rules against animals 4.

Arranging a reunion with the dog in front of the hospital

3.

The nurse demonstrates transpersonal caring for patients when maintaining what attitude?

1.

Nonjudgmental 2.

Detached 3.

Loving 4.

Friendly

4.

The nurse is teaching the newly diagnosed diabetic patient how to provide self-care, and demonstrates a caring paradigm with what statement?

“I want you to check your blood sugar level at 8 a.m., 12 noon, 4 p.m., and 9 p.m.”

“Check your blood sugar 4 times a day— before each meal and at bedtime.”

“Blood sugar levels are most accurate if taken before meals. Let’s figure out the best times for you.”

“Ask your doctor to tell you when to check blood sugar levels each day.”

1.

2.

3.

4.

5.

1.

2.

3.

4.

The medical model of nursing is demonstrated when the nurse does what?

Takes time to learn more about the patient Sits with a dying patient and holds her hand Administers medications Uses touch as an indication of concern and caring

6.

The nursing model of care is demonstrated with what nursing intervention?

1.

Administering medications 2.

Changing a sterile dressing skillfully 3.

Inserting an indwelling catheter using aseptic technique 4.

Consoling a fearful mother whose child is in surgery

7.

What action would be interpreted as the nurse demonstrating a coparticipative manner?

1.

The nurse tells the patient exactly what to do.

2.

The nurse works as part of a team with coworkers.

3.

The nurse asks the patient to choose activities.

4.

The nurse works together with the patient to choose activities.

8. what action?

1.

The student nurse demonstrates transpersonal caring in the classroom with Correcting a comment made by another student in front of the class

Earning A’s in every class test and assignment Leading most discussions and offering opinions on each question asked Encouraging shy class members to share their thoughts and ideas

2.

3.

4.

9.

What is the term used by Florence Nightingale that is similar to Watson’s transpersonal caring?

1.

Patient-centered care 2.

Holistic nursing care 3.

Spiritual care 4.

Transcultural care

10.

1.

2.

3.

4.

The nurse demonstrates the concept of caritas with what intervention?

Holding the patient’s hand while undergoing a painful procedure Requesting an order for a low pressure bed to prevent decubitus ulcers Using sterile technique when changing IV tubing Ordering a low-sodium diet for the patient with heart failure

11.

The nurse observes another nurse performing a procedure incorrectly.

How would the nurse apply Dr. Watson’s theory to this situation?

1.

Avoid asking the errant nurse to perform this procedure again.

2.

Talk with the nurse privately and review the procedure together.

3.

Tell the nursing supervisor that the nurse needs a review class.

4.

Speak with other nurses on the floor and devise a plan to help this nurse.

12.

A nursing assistant asks the nurse, “I keep hearing talk of transpersonal nursing care. What does that mean?” What is the best response to explain the concept?

1.

Transpersonal nursing care is care that treats everyone the same.

2.

Transpersonal nursing care is care that is based on self-respect.

3.

4.

Transpersonal nursing care is based on the belief that people can’t live in a vacuum.

Transpersonal nursing care is care based on the belief that everyone is unique and deserves respect.

13.

The nurse is caring for a patient who just received a terminal diagnosis and is tearful and frightened. What is the best action to demonstrate caring?

1.

Call the nurse’s spiritual leader to talk to the patient.

2.

Call the family and ask them to come sit with the patient.

3.

Cry with the patient while sympathizing with her situation.

4.

Sit with the patient and listen to his or her fears.

14. patient?

1.

2.

3.

4.

How does the nurse best demonstrate the spiritual aspect of caring for the Explain the nurse’s spiritual beliefs to the patient.

Ask the patient to explain all the intricacies of his or her beliefs.

Ask what the patient requires to meet spiritual needs.

Talk with the family to learn the patient’s spiritual needs.

15.

The nurse overhears a physician yelling at a newly hired graduate nurse in the hall. What is the nurse’s best caring response?

1.

Yell at the physician for yelling at a new graduate, and report the incident to the supervisor.

2.

Wait until the situation ends and comfort the graduate privately.

3.

Suggest that the physician take a quieter and more private approach to the problem.

4.

Ignore the situation to avoid embarrassing the graduate further.

16.

The student nurse enters the cafeteria and joins others who are making fun of the nursing instructor for being so particular in the skills lab. What is the most caring response the student can make?

1.

Tell the other students that they are being mean and then leave the table.

2.

Shame the students for being so uncaring and cruel.

3.

Ask the other students why they think the instructor is so picky.

4.

Laugh and tell a story of a personal reprimand received from the instructor.

17.

1.

2.

3.

4.

The student nurse demonstrates care for classmates with what behavior?

Preparing for class discussion by reading the assigned chapter Calling the instructor to explain the reason for arriving late Ducking behind a book to hide eye rolling Arriving for class on time and prepared for class

18.

The new graduate nurse is sharing a journal article about caring with peers when a more experienced nurse says, “You’d be a lot better off studying pathophysiology instead of wasting time on caring.” How does the graduate interpret the experienced nurse’s comment?

1.

The experienced nurse is just mean and doesn’t like new graduates.

2.

The experienced nurse is most likely overworked and cranky.

3.

The experienced nurse was educated in the medical model.

4.

The experienced nurse is uncaring and dislikes new graduates.

19.

1.

2.

3.

4.

What is the reason for things the nurse does, whether at work or off duty?

Personal motivation Facility policies Fear of reprisals Parental expectations

20.

The nurse is caring for a patient transferred from the local prison who was arrested and convicted of child sexual abuse. The nurse feels disgust for the patient’s behavior but can avoid being judgmental by understanding what?

1.

Motivation 2.

State laws 3.

The patient’s social history 4.

Code of ethics

21.

1.

2.

3.

4.

How does the nurse describe motivation?

As a stagnant, unchanging force As a fluid, dynamic process that changes over time As a process that requires great force to change As a process that differs every day

22.

The nurse accepts a new job and will move from a long-term care facility to a job in an acute care facility. The nurse will need to do what?

1.

Adapt motivational approaches 2.

Work more hours per week 3.

Obtain further formal education 4.

Reduce the time spent caring for patients

Multiple Response Identify one or more choices that best complete the statement or answer the question.

23.

What actions performed by the nurse reflect a nursing model of patient care? (Select all that apply.)

1.

Administer medications as ordered.

2.

Call the patient by title and last name, such as Mr. or Mrs. 3.

Arrange for a translator for the patient who doesn’t speak English.

4.

Offer an opinion of the patient’s choice of plan of care.

5.

Spend time with the patient who received bad news.

24.

What features are components of Jean Watson’s caring theory of nursing?

(Select all that apply.)

1.

2.

3.

4.

5.

Caritas Transpersonal caring High-touch Intentionality Hierarchy of needs

25.

The nurse uses what terms to describe Dr. Watson’s concept of caritas?

(Select all that apply.)

1.

Transpersonal caring 2.

High-touch care 3.

Curative care 4.

Medical model 5.

Nursing model Chapter 2: Caring as a Personal and Professional Behavior Answer Section MULTIPLE CHOICE 1.

ANS: 2 Caring means responding to others as unique individuals, sensing their emotions, and accepting them as they are, unconditionally. This response accepts the patient’s choice without condemning or frightening him.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 6 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Health Promotion and Maintenance | Cognitive Level: Analyzing 2.

ANS: 4 Finding a way for the patient to see the dog, even if she can only look out a window, shows caring by understanding this patient’s needs.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 6 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying 3.

ANS: 1 The definition of transpersonal caring includes accepting individuals for who they are, so a nonjudgmental attitude is essential.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 3 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding

4.

ANS: 3 This statement includes the patient in planning care, demonstrating caring for the patient’s needs and preferences.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 3 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing 5.

ANS: 3 Curative nursing care is high-tech, or nursing care that is based on the medical model of care, which often is based on the use of technology.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 2 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 6.

ANS: 4 Consoling a family member is a high-touch demonstration of the nursing model of care.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 2 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 7.

ANS: 4 A coparticipative manner is demonstrated when the nurse works with the patient and family to achieve the best outcome.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 3 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 8.

ANS: 4 Encouraging the shy student shows appreciation for that student’s value and what he or she can add to class discussions, and it demonstrates transpersonal caring.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 4 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying 9.

ANS: 2 Nightingale talked about holistic care, providing care for the physical, spiritual, and psychological needs of patients, and seeing them not as a diagnosis but as unique individuals.

PTS: 1

REF: Chapter: 2

OBJ: Objective: 1

KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Remembering 10.

ANS: 1 Caritas measures, such as holding the patient’s hands during a painful procedure, are high-touch.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 6 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Health Promotion and Maintenance | Cognitive Level: Applying 11.

ANS: 2 Talking to the nurse privately will prevent embarrassment, and reviewing the procedure together will offer the opportunity to improve patient care for both nurses.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 5 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 12.

ANS: 4 Transpersonal nursing care is care that recognizes the value and unique qualities of each individual and treats everyone with respect.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 3 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 13.

ANS: 4 Sitting with the patient and allowing him or her to talk about fears and concerns demonstrates caring and provides the nurse with needed information about how to best support the patient.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 6 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying 14.

ANS: 3 Asking the patient what the nurse can do to support spiritual beliefs shows caring.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 6 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying 15.

ANS: 3 Quietly talking to the physician to deescalate the situation immediately is the most caring

way to handle it.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 5 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 16.

ANS: 3 Guiding the conversation toward thinking about why the instructor is so particular and how patient care improves as a result is a productive response to the situation.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 4 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying 17.

ANS: 4 Arriving to class prepared and on time shows caring for other students, because the student will be able to participate fully and will not disrupt the class.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 4 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying 18.

ANS: 3 Nurses with many years of experience were most likely educated in the medical model, in which less emphasis was placed on the nursing model.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 2 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying 19.

ANS: 1 All actions are based on personal motivation, whether performed at work or off duty, because the nurse, and every individual, chooses how to respond to a given situation.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 7 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying 20.

ANS: 1 Understanding the patient’s motivation may help the nurse be less judgmental.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 7 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying

21.

ANS: 2 Motivation is a dynamic process that changes over time because of experiences and the influence of others.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 7 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Understanding 22.

ANS: 1 The nurse will need to adapt motivational approaches to suit the new job, the change in acuity, and the many changes that will come with working in a new facility.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 7 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying MULTIPLE RESPONSE 23.

ANS: Showing respect by the manner in which the nurse addresses the patient, arranging for a translator to show caring about and consideration of the patient’s unique individuality, and spending time with the anxious or upset patient all demonstrate the nursing model of care.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 2 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing 24.

ANS: 1, 2, 3, 4 Caritas measures are high-touch or nursing models of patient care and are part of Jean Watson’s caring theory of nursing. Transpersonal caring and high-touch are important terms discussed by Dr. Watson; the latter also includes terminology such as caritas and the nursing model of care. Intentionality is a term used by Dr. Watson to indicate the need for nurses to enter every interaction with the intention of giving good care in a personalized, patient-focused manner.

PTS: 1 REF: Chapter: 2 OBJ: Objective: 3 KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 25.

ANS: 1, 2, 5 Caritas measures are described as transpersonal caring and high-touch care. The nursing model of care can be called caritas or caring measures.

PTS: 1

REF: Chapter: 2

OBJ: Objective: 3

KEY: Content Area: Caring | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding Chapter 3. Understanding the Changing Roles in Nursing Chapter 3: Understanding the Changing Roles in Nursing Multiple Choice Identify the choice that best completes the statement or answers the question.

1. what?

1.

One’s mathematical knowledge and ability to solve math problems The ability to see 20 feet away without wearing glasses An individual’s perception or frame of reference about the world A nurse’s ability to solve patient-care problems

2.

3.

4.

2.

1.

2.

3.

4.

The nurse is teaching a group about paradigm thinking and defines it as

Most nursing paradigms are based on what?

The nurse’s ability to perform procedures with skill Dr. Jean Watson’s transpersonal caring theory Maslow’s theory of hierarchy of needs Learning by studying nursing theories and clinical experiences

3.

The increasing use of licensed practical nurses (LPNs) in management positions, especially in long-term care facilities, is an example of what?

1.

Assertive management 2.

A shifting paradigm 3.

Critical thinking 4.

Smarter LPN graduates

4.

Why is critical thinking necessary for the nurse to identify and understand paradigms that exist in nursing practice?

1.

Critical thinking allows the nurse to make superficial decisions.

2.

Critical thinking allows the nurse to thoroughly examine situations and issues.

3.

Critical thinking provides the nurse with quick answers.

Critical thinking allows the nurse to accept information without needing to check its validity.

4.

5.

The nurse values respect for the individual, more than anything else, as defining high-quality patient care. What does this describe about the nurse?

1.

Critical thinking 2.

Caritas 3.

Paradigm 4.

Hierarchy of needs

6. The nurse reads a peer-reviewed nursing journal article that recommends changing the procedure for caring for a patient with an indwelling urinary catheter. The nurse displays critical thinking with what action?

1.

Changing how the nurse provides care for a patient with an indwelling catheter according to the article 2.

Taking the journal article to the nurse manager and suggesting the procedure be rewritten 3.

Searching for other peer-reviewed articles that support this author’s recommendation 4.

Ignoring the article and following the procedure as written at the facility where the nurse works

7.

1.

2.

3.

4.

The nurse applies Maslow’s hierarchy of needs to what aspect of care?

Judging the patient’s behavior Improving the skillfulness of care Understanding the patient’s behavior Improving communication skills

8.

The nurse is caring for a patient who has just received a cancer diagnosis.

The patient is crying. The nurse recognizes this patient is operating on what level of Maslow’s hierarchy of needs?

1.

Self-esteem 2.

Love and belonging 3.

Safety

4.

Self-actualization

9.

1.

2.

3.

4.

The caring LPN manager avoids what approach when dealing with staff?

Delegating Understanding Judging Evaluating

10.

The student nurse experiences a paradigm shift as a result of increasing knowledge and finds the result of the shift is what?

1.

Life changing 2.

Temporary 3.

Short-lived 4.

Overwhelming

11.

The nurse is caring for an adolescent who will be hospitalized for several weeks while in traction. The patient frequently has a room full of friends and they can be heard laughing. The nurse recognizes this patient is meeting which of Maslow’s hierarchy of needs?

1.

Self-esteem 2.

Love and belonging 3.

Safety 4.

Self-actualization

12.

The nurse is providing pre-operative teaching to the anxious patient, who doesn’t seem to be learning. What need must the nurse help this patient meet before continuing to teach?

1.

Self-esteem 2.

Love and belonging 3.

Safety 4.

Self-actualization

13.

The nurse manager learns that one of the staff nurses on the unit has a substance addiction and is arriving at work under the influence of the substance. Using Watson’s theory, how should the nurse manager deal with this staff member?

1.

Send the nurse home with instructions not to return until clear of the substance.

2.

3.

4.

Call the police and have the nurse arrested for working while impaired.

Confront the nurse privately, order drug testing, and suggest a substance-abuse program.

Notify the board of nursing and fire the nurse immediately.

14.

The nurse receives a shift report from the nurse going off shift and asks about a patient’s state of mind and emotional needs, which demonstrates what aspect of Dr. Watson’s theory?

1.

Intentionality 2.

Curiosity 3.

Caritas 4.

Holism

15.

While working in a long-term care facility, the nurse notices that older residents take pleasure in telling stories about their earlier lives and reliving special events. The nurse recognizes this helps residents meet what level of Maslow’s Hierarchy of needs?

1.

Self-esteem 2.

Love and belonging 3.

Safety 4.

Self-actualization

16.

The nurse makes the decision to return to school to obtain a bachelor of science degree in nursing. What theme of critical thinking is the nurse displaying?

1.

Critical thinking is a productive and positive activity.

2.

Critical thinking is a process, not an outcome.

3.

Manifestations of critical thinking vary, depending on the context in which they occur.

4.

Critical thinking is triggered by both positive and negative events.

17.

The nursing assistant asks the nurse to explain the meaning of advocacy.

The nurse explains the fundamental principle of patient advocacy is what?

1.

Independence 2.

Caring

3.

4.

Competence Protection

18.

The nurse listens as the physician asks the patient to participate in a research study and realizes the physician is not adequately explaining the risks of the study. As they leave the patient’s room, the nurse encourages the physician to go back and explain the risks more thoroughly. What role is this nurse playing in patient care?

1.

Teacher 2.

Caregiver 3.

Advocate 4.

Communicator

19.

The nurse is caring for a patient with HIV who is known to have infected others due to unsafe sexual practices. What is the nurse’s priority action to advocate for this client and others with whom he may have a relationship?

1.

Teach the patient of the increased risk to his own health from sexually transmitted diseases.

2.

Inform the patient that he can be sued or arrested for endangering the health of others.

3.

Explore the patient’s knowledge of safer sexual practices and help him find methods that work for him.

4.

Report his behavior to the public health department for follow-up as needed.

20.

The charge nurse is preparing assignments when one of the staff nurses requests not to be assigned a specific patient, using a derogatory name to refer to the patient’s ethnicity. What is the charge nurse’s best response?

1.

Encourage the nurse to embrace diversity and reject prejudice.

2.

Report the nurse to human resources for demonstrating prejudicial behavior.

3.

Assign the patient to a different nurse and make a note not to ever assign this patient to this nurse.

4.

Schedule a staff meeting to talk to the entire staff about avoiding prejudice.

21.

The nurse is caring for a diabetic patient whose religious beliefs require

fasting from sun up to sun down on holy days. How can the nurse best advocate for this patient?

1.

Teach the patient the importance of eating throughout the day to avoid hypoglycemia.

2.

Choose the nursing diagnosis of noncompliance if the patient becomes hypoglycemic due to fasting.

3.

Invite the spiritual leader of his faith to talk with him about exceptions to the need to fast.

4.

Meet the patient’s caloric needs before sunrise and after sunset and monitor blood sugar closely.

22.

The nurse arrives to work impaired and under the influence of alcohol.

What patient right has this nurse infringed on?

1.

Research-related rights 2.

Right to refuse treatment or medication 3.

Right to be fully informed about procedures 4.

The right to safe care

Multiple Response Identify one or more choices that best complete the statement or answer the question.

23.

Which patient rights is the nurse likely to be called to advocate for?

(Select all that apply.)

1.

Research-related rights 2.

Right to refuse treatment or medication 3.

Right to be fully informed about procedures 4.

The right to safe care 5.

The right to the treating physician of choice

24. that apply.)

1.

2.

3.

4.

The nurse identifies critical thinking through which themes? (Select all Critical thinking is a productive and positive activity.

Critical thinking is a process, not an outcome.

Manifestations of critical thinking vary depending on the context in which they occur.

Critical thinking is triggered by both positive and negative events.

5.

Critical thinking requires supreme intellect to be effective.

25.

The successful nurse manager applies Anderson’s rules for successfully working with people, which include what two statements? (Select all that apply.)

1.

It is better to understand people than to judge them.

2.

There is a reason for every behavior.

3.

Follow the Golden Rule when working with people.

4.

The nurse manager must have control of all situations.

5.

Set expectations high and people will rise to meet them.

Chapter 3: Understanding the Changing Roles in Nursing Answer Section MULTIPLE CHOICE 1.

ANS: 3 Paradigm refers to a model, theory, assumption, or a frame of reference. Generally, it means the way a person “sees” the world; this does not refer to a person’s visual sight, but a person’s mental perception.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 1 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 2.

ANS: 4 Most nursing paradigms, or ways of seeing nursing practice, are based on learning through theories or clinical experiences. Culture is another paradigm that impacts nursing.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 1 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 3.

ANS: 2 The use of LPNs in more management positions is a paradigm shift. A shifting paradigm is a break with older ways of thinking. This shift changes the world of those who experience it, and it is the source of attitudes and behaviors.

PTS: 1

REF: Chapter: 3

OBJ: Objective: 2

KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 4.

ANS: 2 The LPN must have the tools to identify paradigm strategies. One tool is critical thinking, which allows the nurse to identify existing paradigms and to devise strategies needed to shift paradigms. Critical thinking also allows the nurse to be open to alternative ways of thinking and to be wary of “quick-fix” solutions.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 3 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 5.

ANS: 3 Respect is the nurse’s perspective of how care should be delivered, so this describes the nurse’s paradigm.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 2 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 6.

ANS: 3 The critically thinking nurse seeks further support for the author’s conclusions to determine if further research is available.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 3 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 7.

ANS: 3 Maslow’s hierarchy of needs allows the nurse to understand the patient’s behavior by recognizing the level of need from which the patient is operating.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 5 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Health Promotion and Maintenance | Cognitive Level: Understanding 8.

ANS: 3 Cancer diagnoses often result in fear of death, even when the patient is told the disease is curable, so this patient is operating at the level of safety as he or she copes with the fear of death.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 5 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying

9.

ANS: 3 Judging others is a negative approach and should be avoided at all times.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 6 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 10.

ANS: 1 Whether the shift is positive or negative, life altering, or as simple as when to make your bed, a paradigm shift changes the world of the person experiencing it.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 1 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 11.

ANS: 2 The adolescent is seeking a sense of belonging from peers, which is of particular importance during this age group.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 5 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Analyzing 12.

ANS: 3 The patient’s safety feels threatened by the impending surgery, and the nurse needs to listen to this patient’s concerns and provide support to lower anxiety before continuing with preoperative teaching.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 1 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Analyzing 13.

ANS: 3 Talking with the nurse privately, confirming drug use, and helping the nurse to recover all show true caring.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 6 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 14.

ANS: 1 Intentionality is the concept that the nurse enters every patient encounter with the intention of acting with care. Learning more about the patient’s emotional needs demonstrates intentionality in planning care.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 6 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Health Promotion and Maintenance | Cognitive Level: Analyzing 15.

ANS: 4 Individuals look back over their lives and achieve self-actualization by recognizing their accomplishments and finding that they lived a full life.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 1 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 16.

ANS: 2 This theme is demonstrated by the belief that continuous learning contributes to the ongoing process of critical thinking.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 4 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing 17.

ANS: 4 To advocate for is to protect. When the nurse advocates for the patient, the nurse protects the patient from infringement on his or her rights as a patient and as a human being.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 7 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 18.

ANS: 3 The nurse is protecting the patient’s rights by asking the physician to be more forthcoming, so the nurse is acting in the role of advocate.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 7 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Health Promotion and Maintenance | Cognitive Level: Analyzing 19.

ANS: 3 Exploring what the patient knows is the first priority, because the nurse cannot understand the patient’s behavior without understanding why the patient acts as he does.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 8 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Health Promotion and Maintenance | Cognitive Level: Applying

20.

ANS: 1 While the nurse’s request may need to be granted to protect the patient from poor care, the nurse should be encouraged to embrace diversity and reject prejudice.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 8 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 21.

ANS: 4 Respecting a patient’s religious needs demonstrates caring. Work with the patient and the physician to develop a diet that allows the patient to fast while adjusting when and what the patient eats and medications are taken.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 8 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Health Promotion and Maintenance | Cognitive Level: Applying 22.

ANS: 4 The impaired nurse cannot deliver safe patient care and is infringing on the patient’s right to safe care.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 8 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing MULTIPLE RESPONSE 23.

ANS: 1, 2, 3, 4 No one can perform research, even of an innocent nature such as an interview, without the research process being scrutinized by a committee (the IRB) and the patient being fully informed of the research being done. The nurse is often the one who learns that the patient consented to participation due to fear of retribution if he or she declines, and the nurse must advocate for that patient. Whatever the ailment or disease, every patient has the right to refuse treatments, including medications, surgery, or other things as simple as a bath or the measurement of blood pressure. While it is the physician’s responsibility to explain the procedure, it is the nurse’s responsibility when asked to obtain the patient’s signature to ensure that the patient fully understands what the physician told the patient.

Every patient has the right to safe care. Although the patient’s right to safe care seems a simple concept, it can become complicated by things such as an impaired nurse or short staffing.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 8 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding

24.

ANS: 1, 2, 3, 4 Critical thinkers are actively engaged in life, value creativity, and are innovative people.

In addition, they are self-confident about themselves personally and their ability to contribute to a group process. No one is ever “done” if he or she is a critical thinker.

Critical thinking suggests a continual assessment of the “certainties” of life. Critical thinking can be demonstrated quietly through writing or talking. It also can be more dramatic when it is a political change, a march for a particular cause, or a strike. A common theme to many discussions of critical thinking is an activity resulting from a traumatic experience that prompts re-examining the situation that caused the trauma. Just as true is the occurrence of a joyful, pleasing, or fulfilling event—a hallmark life experience that alters one’s view of how the world has previously functioned.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 4 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 25.

ANS: 1, 2 Nurse managers should avoid judging, criticizing, or rejecting behavior but instead should seek to understand people according to Anderson’s rules for successfully working with people. It is the nurse manager’s responsibility to identify the reason for people’s behavior and work with it rather than judge it according to Anderson’s rules for successfully working with people.

PTS: 1 REF: Chapter: 3 OBJ: Objective: 5 KEY: Content Area: Nursing Role | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Understanding Chapter 4. Health-care Environment Chapter 4: Healthcare Environment Multiple Choice Identify the choice that best completes the statement or answers the question.

1.

Which statement about the U.S. healthcare system made by the nurse is untrue and inaccurate?

1.

There is no central agency to govern healthcare systems.

2.

Access to healthcare is available to all persons regardless of ability to pay.

3.

Legal risk must be considered when providing healthcare.

4.

High-tech equipment is available but payment for its use is troublesome to the system.

2.

Why is it important for nurses to have some understanding of healthcare issues in the United States?

1.

The nurse has the responsibility of doing the paperwork related to the patient’s insurance.

2.

Reimbursement often influences the services that can be offered to the public.

3.

The LPN will determine the quality of care to deliver based on the patient’s insurance.

4.

The practical nurse cannot graduate until proficiency on this topic is displayed.

3.

The nurse is attending a class on insurance and learns about Medicaid, which is financed by what part of the government?

1.

State 2.

Federal 3.

County 4.

State and federal

4.

What is a major source of stress on the current U.S. healthcare system?

Rising cost of providing healthcare to all citizens Lack of adequate education for healthcare professionals Inadequate number of hospital beds across the country Increasing cost of malpractice insurance

5.

What role is not appropriate for the LPN to participate in?

Administering medications Dressing changes Designing a research study Reporting patient changes

1.

2.

3.

4.

1.

2.

3.

4.

6.

The patient asks the nurse how most people can afford medical insurance.

The nurse explains many people get medical insurance from what source?

1.

The primary care physician 2.

The local clinic 3.

Social security office 4.

The employer

7.

The patient tells the nurse that his insurance company requires him to pick a primary provider and asks what that means. The nurse explains that a primary provider means choosing what?

1.

A doctor 2.

A staff nurse 3.

One insurance provider 4.

A hospital

8.

1.

2.

3.

4.

The LPN requires what skills to successfully manage care?

The ability to organize and prioritize tasks The ability to work weekends and off shifts The ability to develop a comprehensive care plan Close relationship with the supervising RN

9.

The nurse is caring for a patient who will be discharged from acute care to home. How can the nurse best advocate for this client?

1.

Arranging for Meals on Wheels to provide inhome meals 2.

Administering pain medication prior to discharge 3.

Teaching a client how to take medications at home 4.

Taking the client by wheelchair to the car

10.

What patient would be appropriately transferred to an assisted living facility by the nurse?

1.

The patient requiring ongoing skilled-nursing observation 2.

The patient recovered enough to return to work and daily life 3.

The child burned in a fire who lost both parents to the tragedy 4.

The patient who needs minimal assistance in performing activities of daily living but cannot live alone

11.

The U.S. healthcare system is based on what fiscal approach?

1.

2.

3.

4.

Healthcare is a basic right provided to all equally.

Ability to pay determines access to care.

Only the rich are entitled to healthcare.

Health insurance is required to obtain care.

12.

The nurse assists a patient to receive hospice care for a terminal illness, which is classified as what level of healthcare service?

1.

Primary 2.

Secondary 3.

Tertiary 4.

Primary and tertiary

13.

The nurse works in a clinic and provides classes to reduce the spread of sexually transmitted infection and unwanted pregnancy. What level of healthcare services are these classes?

1.

Primary 2.

Secondary 3.

Tertiary 4.

Primary and secondary

14.

The nurse works in the local hospital emergency room, treating patients with serious illnesses as well as those requiring teaching to prevent injury. What level of healthcare services is the nurse providing?

1.

Primary 2.

Secondary 3.

Tertiary 4.

Primary and secondary

15.

The nurse explains that the primary purpose of the Patient Protection and Affordable Care Act is what?

1.

To protect providers from lawsuits when providing first aid at an accident 2.

To mandate states provide Medicaid to all who cannot afford healthcare 3.

To require illegal immigrants to pay in advance for any healthcare needed 4.

To reduce the number of Americans without health insurance

16.

Under the Patient Protection and Affordable Care Act what will happen to individuals who do not purchase health insurance?

1.

They cannot receive medical care.

2.

They can be arrested and jailed.

3.

They are fined for noncompliance.

4.

They are charged more for healthcare.

17.

The nurse is preparing staff assignments as the charge nurse for the shift.

What role is the nurse performing?

1.

Clinician 2.

Collaborator 3.

Advocate 4.

Manager

18.

The nurse contacts a reporter at a local television station to correct some misinformation included in the news last evening. What role is the nursing filling?

1.

Clinician 2.

Collaborator 3.

Advocate 4.

Manager

19.

The nurse sits with a patient who is tearful after receiving a diagnosis of new onset multiple sclerosis. The patient is fearful of further physical degeneration, and the nurse listens and helps the patient express her fears. What role is the nurse performing?

1.

Consultant 2.

Advocate 3.

Researcher 4.

Counselor

20.

The LPN informs the RN that the patient is short of breath with labored breathing and is not responding to interventions. What role is the nurse performing 1.

Consultant 2.

Advocate 3.

Educator 4.

Counselor

21.

The nurse plans a patient-care meeting that includes all of the physicians, physical therapists, and respiratory therapists involved in a patient’s care as well as the patient’s primary nurses. What role is the nurse performing?

1.

Consultant 2.

Advocate 3.

Clinician 4.

Collaborator

22.

The patient no longer requires acute care but is unable to receive the complex care required in the patient’s home. The nurse may arrange for this patient to be transferred to what type of facility?

1.

Hospice 2.

Home healthcare 3.

Assisted-living center 4.

Extended-care facility

Multiple Response Identify one or more choices that best complete the statement or answer the question.

23.

The nurse is involved in an active discussion with people in the community about healthcare systems in the United States. The nurse explains characteristics that cause problems in the current system, including what? (Select all that apply.)

1.

There is no central agency to govern healthcare systems.

2.

Access to healthcare is governed by ability to pay.

3.

Insurance payers must approve most procedures and services.

4.

Prejudice prevents some groups from receiving adequate care.

5.

People have no faith in the quality of patient care at local hospitals.

24.

Which patient would the nurse expect to have Medicare as their health insurance? (Select all that apply.)

1.

The 83-year-old patient diagnosed with heart failure 2.

The 35-year-old patient who is a quadriplegic

3.

4.

5.

The 53 year old with end-stage renal disease receiving dialysis The 19 year old diagnosed with attention deficit disorder The 6 year old admitted to the hospital diagnosed with appendicitis

25.

The nurse evaluates different healthcare systems and determines that those delivering safe and high-quality care require what? (Select all that apply.)

1.

Health professionals such as nurses, physicians, occupational and physical therapists 2.

Medical vendors such as supplies of linens, foods, medications, and supplies 3.

Ancillary service professionals such as food, maintenance, and business office services 4.

An adequate intake of cash to pay competitive salaries to employees 5.

National certification as a magnet hospital in the community Chapter 4: Healthcare Environment Answer Section MULTIPLE CHOICE 1.

ANS: 2 While access to healthcare for all is the ideal, the U.S. healthcare system has struggled to meet this ideal. There is hope that this will improve with changes in healthcare system laws.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 1 KEY: Content Area: Healthcare Environment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 2.

ANS: 2 LPNs need to be aware that healthcare agencies’ policies determine what services you can provide that will be reimbursed by payers. Reimbursement often influences the services the agency can offer to the public.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 1 KEY: Content Area: Healthcare Environment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing

3.

ANS: 4 Both the state and federal governments fund Medicaid.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 1 KEY: Content Area: Healthcare Environment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 4.

ANS: 1 The rising cost of healthcare results in increasing government spending. When the government spends more money on healthcare there is less money to spend on other things.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 1 KEY: Content Area: Healthcare Environment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 5.

ANS: 3 While LPNs may be asked to collect data to contribute to research they would not design a research study. This requires a registered nurse with a graduate degree.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 2 KEY: Content Area: Healthcare Environment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 6.

ANS: 4 Employers pay for some healthcare services through employee insurance benefits. The federal government pays for some healthcare for persons over 65 years of age though Medicare plans. State governments pay for healthcare for low-income populations through Medicaid plans.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 1 KEY: Content Area: Healthcare Environment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 7.

ANS: 1 A primary provider is one person who manages care and may be a doctor, nurse practitioner, or physician’s assistant.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 1 KEY: Content Area: Healthcare Environment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 8.

ANS: 1 The nurse’s ability to organize and prioritize care is essential to care management because multiple issues may be occurring at once and the nurse must always meet the highest

priority needs first.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 2 KEY: Content Area: Healthcare Environment | Integrated Processes: Nursing Process: Planning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 9.

ANS: 1 The tasks of an advocate are to be an ally, supporter, and a source of information for the patient, and the patient’s significant others.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 2 KEY: Content Area: Healthcare Environment | Integrated Processes: Nursing Process: Intervention | Client Need: Health Promotion and Maintenance | Cognitive Level: Applying 10.

ANS: 4 The patient requiring ongoing skilled-nursing observation would be most appropriately transferred to an extended care facility, specifically one that provides skilled care. The patient recovered enough to return to work and daily life would be discharged to home.

The child burned in a fire after losing both parents to the tragedy would require acute care initially. The patient who needs minimal assistance in performing activities of daily living but cannot live alone would be appropriate for an assisted-living center, where minimal assistance and no constant supervision are provided.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 3 KEY: Content Area: Healthcare Environment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing 11.

ANS: 2 In the U.S., the ability to pay often determines who has access to care. Those with limited access are often referred to as medically indigent.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 1 KEY: Content Area: Healthcare Environment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 12.

ANS: 3 Hospice care is a tertiary service providing comfort care to those with an irreversible condition.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 3 KEY: Content Area: Healthcare Environment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing 13.

ANS: 1

Primary healthcare services emphasize health promotion and prevention of illness, which is the primary focus of the nurse’s classes.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 1 KEY: Content Area: Healthcare Environment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing 14.

ANS: 4 The nurse provides primary care in promoting health to the patient with minor illness and preventing disease through the teaching provided. However, the nurse also provides secondary care to those with acute illness.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 1 KEY: Content Area: Healthcare Environment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing 15.

ANS: 4 The primary goal of the Patient Protection and Affordable Care Act is to reduce the number of Americans without health insurance and thus improve the number of people who have full access to healthcare.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 1 KEY: Content Area: Healthcare Environment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 16.

ANS: 3 The Patient Protection and Affordable Care Act contains a contingency for individuals to be fined if they fail to buy health insurance.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 1 KEY: Content Area: Healthcare Environment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 17.

ANS: 4 The nurse is acting as a manager managing others as a charge nurse using management skills.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 2 KEY: Content Area: Healthcare Environment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing 18.

ANS: 3 An advocate protects the patient’s rights and serves as an ally, supporter, and source of information. By correcting misinformation, the nurse advocates for the community by making sure people have essential and correct information.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 2 KEY: Content Area: Healthcare Environment | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing 19.

ANS: 4 In the counseling role the LPN helps the patient explore feelings and attitudes about wellness and illness.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 2 KEY: Content Area: Healthcare Environment | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Analyzing 20.

ANS: 1 The LPN works in the role of the consultant by communicating patient assessments to the RN and by working to understand health issues as demonstrated in this scenario.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 2 KEY: Content Area: Healthcare Environment | Integrated Processes: Nursing Process: Assessment | Client Need: Physiological Integrity | Cognitive Level: Analyzing 21.

ANS: 4 A collaborator works with other members of the healthcare team. While this may be a form of advocacy, the focus here is on working with other members of the team.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 2 KEY: Content Area: Healthcare Environment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing 22.

ANS: 4 Extended-care facilities, particularly skilled-nursing homes, can provide continuous nursing care for patients who require more care than those who are discharged to home.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 3 KEY: Content Area: Healthcare Environment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying MULTIPLE RESPONSE 23.

ANS: 1, 2, 3 While regulations come from the government, it does not control or govern the entire system. Only those who can afford to pay have family doctors who they see regularly.

Medically indigent often rely on emergency rooms for care. Insurance providers dictate what they will pay for and often require preapproval for procedures and services.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 1 KEY: Content Area: Healthcare Environment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 24.

ANS: 1, 2, 3 People over age 65, people who are permanently disabled, and people with end-stage renal disease qualify for Medicare.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 1 KEY: Content Area: Healthcare Environment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 25.

ANS: 1, 2, 3 In order to deliver safe and high-quality care, there must be educated professionals to administer the care. There must be a continuous supply of equipment and resources such as linens, food, medications, and supplies. support or ancillary services are also essential to the delivery of high-quality safe care.

PTS: 1 REF: Chapter: 4 OBJ: Objective: 1 KEY: Content Area: Healthcare Environment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding Chapter 5. Nursing and Informatics Chapter 5: Nursing and Informatics Multiple Choice Identify the choice that best completes the statement or answers the question.

1.

The nurse delivers safer healthcare using electronic medical records because of what feature?

1.

Accessibility of medical record by multiple people 2.

Improved accuracy in reading documentation 3.

Tighter control of data privacy 4.

Lowers cost of care delivery

2.

The nurse demonstrates compliance with the Health Insurance Portability and Accountability Act (HIPAA) with what action?

1.

Logging off the computer before walking away 2.

Entering data as soon as it is collected 3.

Verifying all medication dosages are within normal range

4.

Remembering to charge for all equipment used

3.

The nurse protects against self-injury when working with the computer by performing what action?

1.

Maintaining the security of the password 2.

Using the computer only for work related tasks 3.

Becoming familiar with facility policy regarding computer use 4.

Maintaining good body mechanics when sitting at the computer

4. computer?

1.

2.

3.

4.

How can the nurse reduce the spread of infection related to the use of the By cleaning the mouse and keyboard regularly By turning the monitor so it cannot be seen by visitors By using good body mechanics when sitting at the computer By becoming familiar with facility policies regarding data entry

5.

The nurse is sitting down to prepare a presentation on risk reduction in the long-term care facility. What is the first thing the nurse should do?

1.

Develop an outline of information to be included 2.

Find research articles containing the necessary information 3.

State the objectives 4.

Plan the ending of the presentation

6.

1.

2.

3.

4.

When creating the introduction to a presentation, what is the nurse’s goal?

Staying within the designated time frame Grabbing the audience’s attention Not overwhelming the audience with content Providing references

7.

The nurse talks to the nurse manager to suggest making changes to the way a procedure is performed, and the manager asks if this change is evidence-based.

What does the manager mean by evidence-based?

1.

Research findings or other reliable evidence show that the change is appropriate.

2.

Another facility is doing it in the manner proposed by the nurse.

3.

The nurse performed the procedure the suggested way while in nursing school.

4.

Several nurses discussed the new way to perform the procedure and agree it would be better.

8.

1.

2.

3.

4.

9. data?

1.

2.

3.

4.

The nurse assesses the patient’s health literacy through what action?

Teaching the patient about health issues and assessing learning Watching the patient read a brochure containing health information Obtaining agreement from the patient to read health information they are given Quizzing the patient about their health knowledge

What is the nurse manager likely to use in order to manage numerical Statistical analysis Word processors Spreadsheets Graphed tablets

10. The nurse manager is working on compiling a budget for the next fiscal year. What software will work best for this purpose?

1.

Word processor 2.

Internet explorer 3.

Presentation software 4.

Spreadsheet software

11.

The nurse is working in the hospital when a tornado causes a power outage. How will the nurse manage documentation of care until the computer system

returns?

1.

2.

3.

4.

Hold off on documenting and wait until the power returns to document care.

Write notes as reminders to be transcribed into the computer when the power returns.

Record what needs to be documented so the oncoming shift can document when power returns.

Document care in a paper patient record according to facility policy.

12.

When writing a work-related email, what is the best guideline for the nurse to follow related to length?

1.

Write emails the same as writing narrative patient-care records.

2.

Get to the point and write only what is necessary.

3.

Write a long, detailed letter that restates important points for emphasis.

4.

Use multiple colors and fonts to make the letter stand out.

13.

The nurse manager writes a business letter to a manager at another facility.

What email style is appropriate for this letter?

1.

Using several different font colors to make the email friendlier 2.

Using all capital letters to make the email more readable 3.

Inserting a funny cartoon at the end to create rapport with the reader 4.

Running spell-check and reviewing the tone of the letter to avoid misunderstanding

14.

The nurse manager is given a fax machine to receive physician orders and fax patient information to physicians’ offices. Where is the best place for the nurse manager to place the new machine?

1.

In the hallway away from patient rooms 2.

Behind the nurse’s desk on the unit 3.

In the manager’s office 4.

In the supply room

15.

Why does the nurse manager prefer email when communicating with multiple recipients?

1.

The letter can be copied and pasted multiple times to send to each recipient.

2.

The letter can be sent to multiple recipients at one time with no extra effort.

3.

Emails are more private than letters sent through the mail system.

4.

The email can be secretly sent to friends.

16.

The nursing unit is informed early in the shift that the computers will be unavailable for four hours during the middle of the shift. What will the nurse manager tell the staff to do regarding documentation of patient care during this time period?

1.

Make good notes and document care during the next working shift.

2.

Anticipate care to be administered during downtime and document before the computers go down.

3.

Make notes and document all care as soon as the computers come back up.

4.

Use the downtime documentation described in facility policy.

17.

The nurse wants to attend a teleconference, but the price is too high. What might the nurse explore to help reduce the cost?

1.

Multiple nurses may be able to attend for one fee.

2.

Costs may go down closer to the date of the conference.

3.

They may give the nurse a discount out of sympathy.

4.

Borrow money from others to pay for the conference.

18.

The nurse is preparing a presentation using Microsoft PowerPoint software. Where does the nurse write notes to remember what to say when each slide is shown?

1.

In the white space under the slide portion 2.

In the column at the left of the slide 3.

In the actual slide section

4.

In a separate Word document

19.

What task would the nurse be most likely to perform using spreadsheet software rather than word-processing software?

1.

Writing a paper on an assigned topic for school 2.

Creating a presentation for an audience 3.

Developing a budget for the nursing unit 4.

Writing an email to a nurse manager on another unit

20.

The nurse interprets what statement from the patient as a possible indication of healthcare illiteracy?

1.

“I’ll read this brochure and let you know if I have questions.”

2.

“Can you give me another brochure for my wife?”

3.

“I’ll read this later. I don’t have my glasses.”

4.

“I read this brochure and have some questions about what I read.”

21.

What is the nurse’s primary and most essential purpose in reading nursing research on a regular basis?

1.

To maintain an evidence-based nursing practice 2.

To obtain continuing education credits 3.

To teach peers about new findings 4.

To obtain a promotion at work

22.

The nurse accepts a new job as a manager, spending much more time doing desk work instead of patient care. After a week in the new job, the nurse experiences pain in the right wrist and an ache around the shoulders and back. What is the most likely cause of these discomforts?

1.

A stressful work environment 2.

Lack of management skills 3.

Poor body mechanics when using the computer 4.

Lack of cooperation from staff

Multiple Response Identify one or more choices that best complete the statement or answer the question.

23.

What advantages does the nurse identify in providing patient care using an electronic medical record? (Select all that apply.)

1.

Accessibility of medical record by multiple people 2.

Faster reporting of diagnostic study results 3.

Easier readability of documentation 4.

Improved privacy of information 5.

Error reduction

24.

How do computers and nursing informatics improve patient care? (Select all that apply.)

1.

Learning more about best practices 2.

Acting as a monitor to protect patient safety 3.

Providing easy access to new knowledge 4.

Delivering hands-on care 5.

Using critical thinking to plan care

25.

The nurse specializing in nursing informatics uses the computer for what tasks? (Select all that apply.)

1.

Documenting patient care 2.

Learning about medication side effects 3.

Finding evidence-based research related to patient care 4.

Scheduling staff work shifts 5.

Programming new software Chapter 5: Nursing and Informatics Answer Section MULTIPLE CHOICE 1.

ANS: 2 Mistakes can result when handwriting needs to be interpreted because it may be interpreted incorrectly. Neat, easy-to-read documentation improves the safety of care delivery.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 2 KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level:

Applying 2.

ANS: 1 HIPAA regulates the confidentiality of patient information. Logging off the computer before walking away protects patient privacy by preventing others from looking at information.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 4 KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 3.

ANS: 4 Maintaining good body mechanics when sitting at the computer prevents repetitive movement injuries, improves concentration, and prevents poor posture.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 3 KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 4.

ANS: 1 It is important to clean the mouse and keyboard regularly because many people will be touching this equipment. Keeping the equipment clean will prevent infection for the nurse and the patients.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 3 KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 5.

ANS: 1 The presentation cannot be developed until its main points are determined and set down as a guideline.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 5 KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 6.

ANS: 2 The purpose of the introduction is to grab the audience’s attention and explain what the presentation will involve.

PTS: 1

REF: Chapter: 5

OBJ: Objective: 5

KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 7.

ANS: 1 For a change to be evidence-based means either that it has been researched and found to be more effective or that reliable evidence is available to support the change.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 3 KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 8.

ANS: 1 Health literacy is determined by assessing not only the patient’s ability to read but also to understand and make decisions based on what they have learned.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 5 KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 9.

ANS: 3 Spreadsheets are tables with columns and rows that allow for entry and management of numbers, including complex calculations when needed.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 5 KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 10.

ANS: 4 A spreadsheet is a table with columns and rows that manages numerical data and allows for simple to complex computations.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 5 KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 11.

ANS: 4 Care will be documented on a facility form specifically designed for downtime documentation. Knowing and following facility procedures is most important.

PTS: 1

REF: Chapter: 5

OBJ: Objective: 3

KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 12.

ANS: 2 Writing emails should involve getting to the point and avoiding long rambling letters.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 3 KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 13.

ANS: 4 Spell-check should be run on all business communication, and the letter should be reviewed for tone, grammar, and understanding.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 5 KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 14.

ANS: 2 The nurse’s desk on the unit is a good spot because it will allow the nurses to protect the privacy of information arriving via fax and will also be in a place where someone will notice when a new fax arrives.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 4 KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 15.

ANS: 2 Emails can be addressed to many different people, and one email can be seen by as many recipients as the author desires.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 5 KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 16.

ANS: 4 Every facility has a policy for documentation during downtime. It should be followed to maintain patient safety.

PTS: 1

REF: Chapter: 5

OBJ: Objective: 3

KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 17.

ANS: 1 Many teleconferences anticipate multiple nurses will participate and will give out CEUs to a limited number of people. This reduces the cost because multiple nurses can split the charge.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 5 KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 18.

ANS: 1 There is a speaker’s note section under the actual slide for notes to remind the speaker of what to say. This section is unseen by the audience.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 5 KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 19.

ANS: 3 A spreadsheet was designed for managing numbers such as a nursing-unit budget.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 5 KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 20.

ANS: 3 Saying it cannot be read until one gets his or her glasses could be an indication that the patient does not know how to read. Further assessment is needed to determine if this is true.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 2 KEY: Content Area: Nursing Informatics | Integrated Processes: Nursing Process: Assessment | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing 21.

ANS: 1 The most important reason for reading nursing research is to provide optimal nursing care in the form of evidence-based nursing practice.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 2 KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 22.

ANS: 3 Poor body mechanics when sitting at the computer can result in muscle aches, carpal tunnel syndrome, and headaches.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 3 KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying MULTIPLE RESPONSE 23.

ANS: 1, 2, 3, 5 Electronic medical records allow multiple team members to access the patient’s records at the same time, eliminating the need to wait for the paper chart to be available. Diagnostic study results are available as soon as they are entered into the computer, eliminating the need to wait for printouts to be delivered to the patient’s unit. Struggling to read sloppy handwriting is eliminated by use of electronic medical records. Prompts, warning messages, and the free access to information has helped to reduce errors and improve the safety of healthcare delivery. One of the disadvantages of electronic medical records is the availability of information to those with no need to know. Staff must be taught to read only the records of those for whom they are providing care.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 2 KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 24.

ANS: 1, 2, 3 Computers improve access to information regarding best practices and promote networking of nurses to maintain best practices. They are also excellent at monitoring, whether monitoring patient vital signs or monitoring nursing documentation, to improve patient safety. There is so much information available quickly on the Internet that providing access to new information is perhaps one of the computer’s greatest strengths.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 1 KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 25.

ANS: 1, 2, 3, 4

A common use of nursing informatics includes documenting nursing assessments and patient care. Consulting databases for information about medications is a convenient use of nursing informatics that improves safety. Maintaining currency in the provision of patient care requires keeping up with the most common evidence-based research.

Computers are also useful for creating staff work schedules, representing a good use of nursing informatics. Computer programming is not a part of nursing informatics.

PTS: 1 REF: Chapter: 5 OBJ: Objective: 1 KEY: Content Area: Nursing Informatics | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying Chapter 6. Fulfill Your Role as a Student Chapter 6: Fulfill Your Role as a Student Multiple Choice Identify the choice that best completes the statement or answers the question.

1.

1.

2.

3.

4.

How does the student nurse best prepare for the clinical experience?

Practice and review procedure for performing skills Review class notes for the past week Walk through the clinical facility Show up for clinical 1 hour early

2.

The student nurse is working in the clinical facility and learns a family member has been admitted to the same facility. What statement is true about the student’s access to the family member’s medical record?

1.

The student may access the family member’s medical record as a nurse in the facility.

2.

The student nurse should not access the family member’s record until obtaining instructor’s approval.

3.

The student may access the family member’s medical record because of the family relationship.

4.

The student nurse should not view the record unless they are providing care for the family member.

3.

The student nurse is able to perform at his or her physical and emotional best by taking what action?

1.

2.

3.

4.

Get adequate exercise.

Eat plenty of carbohydrates the day before.

Drink caffeinated beverages before clinical.

Study late into the night to be prepared.

4.

The nurse demonstrates therapeutic use of self when performing what nursing intervention?

1.

Sitting with a dying patient 2.

Attending class 3.

Studying for a test 4.

Learning the nursing code of ethics

5. classroom?

1.

2.

3.

4.

6.

1.

2.

3.

4.

The student nurse gains what type of knowledge in the pathophysiology Aesthetic Empirical Ethical Personal

What is the primary way the student nurse gains personal knowing?

Arriving at every class on time Never missing a clinical experience Taking religious classes Self-evaluation and conscious examination

7.

The student nurse has a question about the requirements of an upcoming assignment. What should the student nurse do first?

1.

Send an email to the instructor.

2.

Review the syllabus.

3.

Ask a peer for help.

4.

Call a nurse on the clinical unit.

8. The student nurse is listening to a lecture and becomes confused. Looking around the room the student sees everyone else is nodding in understanding. What should the student do first?

1.

Ask for clarification.

2.

Wait and read the material tonight after class.

3.

Ask peers during the next break to explain the material.

Wait until after class to talk to the instructor privately.

4.

9.

1.

2.

3.

4.

The student nurse demonstrates percolated thinking by doing what?

Reading the assigned material as soon as it is assigned Practicing skills in the skills lab an hour before testing Following a healthy diet and exercising regularly Studying the night before the test

10.

A classmate asks the student nurse how to make a flashcard. What is the student nurse’s most accurate response?

1.

Write all the information about a topic on the front of the card.

2.

Write a list of key terms on the front of the card.

3.

Write a question about a key topic on the front and the answer on the back.

4.

Use different colored cards for each topic discussed in class.

11.

1.

2.

3.

4.

How would the student nurse use a study checklist to prepare for an exam?

Write a brief description of everything to be studied for an exam.

Organize class notes into a bullet list to be studied for an exam.

As the student nurse studies, he or she makes a list of everything learned.

Make a list of everything that needs to be known for the next test.

12.

Of what type are a majority of questions on the National Council Licensure Examination for Practical Nurses (NCLEX-PN)?

1.

True or false 2.

Essay questions 3.

Matching

4.

Multiple choice

13.

The student nurse is taking a multiple-choice test and does not know the answer to a question. What should the student nurse do first?

1.

Guess B, because that is the most common answer to multiple choice questions.

2.

Find answers the student knows are incorrect and rule them out.

3.

Look at the answer to the previous three questions and choose an answer that was not used.

4.

Find answers that are almost correct and choose one of those.

14.

The student nurse is taking a true-or-false quiz and does not know the answer to a question. The test question contains the word “always,” which indicates a high likelihood of what?

1.

True 2.

False 3.

A poorly written question 4.

Answer is opposite of previous question

15.

The student nurse is waiting for the instructor to hand out the test and is thinking, “I am going to fail this test. I know I’m not as prepared as everyone else.”

What is the term for the student’s thoughts?

1.

Encouraging words 2.

Preparation for a bad grade 3.

Negative self-talk 4.

Test preparedness

16. test-taking?

1.

2.

3.

4.

17.

The student nurse uses what psychological strategy to promote successful Stopping negative self-talk Eating a low carbohydrate meal the morning of a test Getting enough sleep the night before a test Doing aerobic exercise prior to the test

When the student nurse writes a paper, each sentence must contain what?

1.

2.

3.

4.

A subject and a predicate An adjective and a preposition A colloquial phrase and a noun A noun and a conjunction

18.

Why is it important for the nurse to be an effective writer?

The nurse can document care effectively.

The nurse cannot adequately teach patients without writing skills.

The nurse cannot speak well without writing well.

Writing skills equate with intellect.

19.

The student nurse will not be accused of plagiarism if what action is

1.

2.

3.

4.

taken?

1.

2.

3.

4.

Copying another author’s words verbatim Paraphrasing the author’s words in the paper Finding a book that others will not recognize Using original research and citing it properly

20.

1.

2.

3.

4.

When writing a paper, which statement indicates gender neutrality?

The nurse takes excellent care of her patients.

The patient and his wife were ready for discharge.

The patient still lived at home with his mother.

Men and women both make excellent nurses.

21.

The student nurse writes a paper, deletes the errors and unnecessary words, and revises sentences to make the paper read better. What is the next step in the process?

1.

Proof 2.

Polish 3.

Submit 4.

Delete

22.

The nursing student displays an understanding of the rules of grammar regarding paragraphs by doing what?

1.

Writing short one-sentence paragraphs that are concise and to the point.

Limiting your paper to no more than two to three paragraphs.

Limiting colloquialisms to no more than three per paragraph.

Changing paragraphs when the main idea changes.

2.

3.

4.

Multiple Response Identify one or more choices that best complete the statement or answer the question.

23.

The student nurse has severe test anxiety. What strategies might the student use to reduce the stress associated with tests? (Select all that apply.)

1.

A 10-minute vacation 2.

Stopping negative self-talk 3.

Remembering others succeed despite challenges 4.

Studying hard the night before the test 5.

Showering before going to class

24. that apply.)

1.

2.

3.

4.

5.

The ways a nurse knows information includes what methods? (Select all Empirical knowing Aesthetic knowing Statistical knowing Personal knowing Financial knowing

25.

The student nurse begins with an outline when writing a paper for what reason? (Select all that apply.)

1.

Required for all papers 2.

Helps to save time when writing the paper 3.

Organizes information to be included 4.

Prevents overwriting and repetition 5.

Improves grammar in written paper Chapter 6: Fulfill Your Role as a Student Answer Section MULTIPLE CHOICE

1.

ANS: 1 Being prepared for clinical means understanding what types of interventions you may be called upon to perform. Practicing skills, reviewing procedures, and understanding facility rules are ways you can prepare for the clinical experience.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 3 KEY: Content Area: Role of Student | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 2.

ANS: 4 The student does not have the authority to look at the family member’s chart unless they are providing care for this patient, which would be highly unethical if they are related.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 3 KEY: Content Area: Role of Student | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 3.

ANS: 1 Exercise is an excellent means of controlling stress so the student nurse can function at optimum levels both physically and emotionally.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 2 KEY: Content Area: Role of Student | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 4.

ANS: 1 Use of self means the nurse acts in an appropriate manner and demonstrates caring when providing patient care, such as taking time to sit with a dying patient.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 1 KEY: Content Area: Role of Student | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 5.

ANS: 2 The student nurse gains empirical knowledge through the observation and experience gained in the study of pathophysiology.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 1 KEY: Content Area: Role of Student | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 6.

ANS: 4 Personal knowing comes from understanding your own ethics, values, and personal motivation. We all carry biases, but understanding where your bias lies will help you to

overcome this bias in patient care.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 1 KEY: Content Area: Role of Student | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 7.

ANS: 2 Many instructors provide step-by-step details on expectations for students in a syllabus.

Before asking the instructor for help, review the syllabus to see if answers can be found there.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 2 KEY: Content Area: Role of Student | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 8.

ANS: 1 Nodding in understanding does not mean there really is understanding. The student should ask the question because the whole class can benefit from the instructor’s response, and it may spark a class discussion.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 2 KEY: Content Area: Role of Student | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 9.

ANS: 1 Reading early in the week, or as soon as the material is assigned, allows you time to think about it or let it “percolate,” giving the ideas time to develop in your mind.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 4 KEY: Content Area: Role of Student | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 10.

ANS: 3 Flashcards are most effective if you write a question concerning a key topic, word, or concept on the front of the card and the answer on the back.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 5 KEY: Content Area: Role of Student | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 11.

ANS: 1 Checklists contain the briefest possible description of each item to be studied. The item is checked off when the student learns the information.

PTS: 1

REF: Chapter: 6

OBJ: Objective: 5

KEY: Content Area: Role of Student | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 12.

ANS: 4 The NCLEX-PN uses multiple choice questions predominantly, although there are also some hot-spot, fill-in-the-blank, multiple response, and rating/ordering questions as well.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 6 KEY: Content Area: Role of Student | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 13.

ANS: 2 By ruling out the answers the student knows are incorrect, the student increases the odds of guessing the right answer from the remaining responses.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 6 KEY: Content Area: Role of Student | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 14.

ANS: 2 There are not many situations in nursing where something “always” applies, so unconditional words like “always,” “never,” or “everyone” are usually false.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 6 KEY: Content Area: Role of Student | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 15.

ANS: 3 The name for the student’s thoughts are negative self-talk, and it is very self-defeating.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 7 KEY: Content Area: Role of Student | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Remembering 16.

ANS: 1 Psychological aspects include stopping negative self-talk and taking breaks to rest the mind. Eating well, getting enough sleep, and getting enough exercise before the test are all physiological factors.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 7 KEY: Content Area: Role of Student | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 17.

ANS: 1 A complete sentence must have both a subject or noun and a predicate, or verb.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 9 KEY: Content Area: Role of Student | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 18.

ANS: 1 Eight-five to 90 percent of the nurse’s time at work is spent communicating, both verbally and in writing. Documenting patient care requires strong writing skills.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 8 KEY: Content Area: Role of Student | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 19.

ANS: 4 Using original research rather than quoted sources and citing the source in the paper will prevent charges of plagiarism.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 11 KEY: Content Area: Role of Student | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 20.

ANS: 4 “Men and women both make excellent nurses” is a gender-neutral statement.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 12 KEY: Content Area: Role of Student | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 21.

ANS: 1 Proofreading follows the revising step.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 10 KEY: Content Area: Role of Student | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 22.

ANS: 4 Each paragraph should represent one main idea. When the idea or topic changes, begin a new paragraph.

PTS: 1

REF: Chapter: 6

OBJ: Objective: 9

KEY: Content Area: Role of Student | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying MULTIPLE RESPONSE 23.

ANS: 1, 2, 3 A 10-minute vacation allows you to daydream and to reduce stress, clearing the mind, before returning to study. Negative self-talk is highly self-defeating, and eliminating it will resolve test anxiety. Everyone, no matter how famous or brilliant, has moments of failure, and they do not indicate your ability to succeed.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 7 KEY: Content Area: Role of Student | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 24.

ANS: 1, 2, 4 Empirical knowing is having the skills or technical knowledge known as the science of nursing. Aesthetic knowing refers to the art of nursing. Personal knowing involves knowing yourself.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 1 KEY: Content Area: Role of Student | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 25.

ANS: 2, 3, 4 Outlines reduce the time it takes to write the paper. Thoughts will be organized and in the proper order, reducing time spent thinking about what to cover next. Outlines help to put material in the correct order so the paper flows properly and does not hop around from subject to subject. Outlines give each topic a place in the paper so you don’t repeat a topic, preventing rambling or overwriting.

PTS: 1 REF: Chapter: 6 OBJ: Objective: 10 KEY: Content Area: Role of Student | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying Chapter 7. The Importance of Critical Thinking Chapter 7: The Importance of Critical Thinking Multiple Choice Identify the choice that best completes the statement or answers the question.

1.

The nurse considers a problem and arrives at one possible solution. What should the nurse do next?

1.

2.

3.

4.

Apply the solution to the problem.

Continue looking for other solutions.

Evaluate the effectiveness of the solution.

Ask others for their opinion of the solution.

2.

What skill will the nurse need to be an effectively thorough thinker?

Quick thinking Sharpened intuition Proactive thinking Creative thinking

3.

The nurse displays the essence of critical thinking by doing what?

Having all the answers Accepting what is read as true Asking questions Sharpening intuition

1.

2.

3.

4.

1.

2.

3.

4.

4.

The instructor asks the student nurse a question, and the student responds by saying, “I studied, but I don’t know the answer to that question.” The student is displaying what?

1.

Thorough thinking 2.

Creative thinking 3.

Reactive thinking 4.

Critical thinking

5.

The nurse listens as a patient relates having multiple abortions. While the nurse does not personally believe abortion should be legal, the nurse respects the patient’s beliefs and opinion. What is this nurse demonstrating?

1.

Tolerance 2.

Shyness 3.

Bigotry 4.

Serendipity

6.

1.

2.

Critical thinking is of most value to the nurse who is doing what?

Performing a procedure by following the steps in the procedure manual Making decisions about how to handle a patient-based situation

3.

Documenting patient care delivered over the past hour Holding the hand of a dying patient who is alone

4.

7.

1.

2.

3.

4.

What situation demonstrates that the nurse is thinking critically?

Questioning a physician regarding the rationale for an order Performing CPR on a pulseless patient who is not breathing Teaching coworkers how to use a new piece of equipment Attending class on time every day

8.

The nurse is dealing with a problem at work and has been focused on finding solutions. After a good night’s sleep the nurse wakes with a solution. How did sleeping help the nurse solve the problem?

1.

It was focus time.

2.

It was letting-go time.

3.

It was time for creative thinking.

4.

It provided serendipity.

9.

The nurse is one of five nurses selected to brainstorm solutions to a problem on the unit. The group sits quietly to relax for two minutes, then sets a time.

What will the group do next?

1.

Have someone write down all ideas produced by the group.

2.

Review all of the ideas generated by the group.

3.

Eliminate ideas that are not usable.

4.

Begin to prioritize workable solutions.

10.

The nurse is trying to solve a problem and begins by brainstorming, being as creative as possible. Next the nurse looks at all of the ideas to determine if there are any workable solutions in the written list. The nurse decides to take a break from problem solving and returns after a pleasant afternoon with friends to think about the problem more. Which of these actions demonstrates letting go?

1.

Brainstorming 2.

Reviewing written list for workable solution 3.

Spending the afternoon with friends

4.

Returning to the problem

11.

The graduate nurse takes a new job and meets many nurses who are very knowledgeable and experienced. After one week at the new job, the graduate nurse realizes how much he or she learned. What does this demonstrate?

1.

Serendipity 2.

Creativity 3.

Critical thinking 4.

Thorough thinking

12.

When a patient complains of sudden onset left-sided chest pain, the nurse asks questions to better understand the pain and collects data such as vital signs, ECG, and breath sounds to determine the possible cause of the pain. Once data is analyzed the nurse develops a plan and begins to intervene. What has this nurse demonstrated?

1.

Serendipity 2.

Creative thinking 3.

Critical thinking 4.

Thorough thinking

13. thinker?

1.

2.

3.

4.

What action would lead a nurse to believe a coworker is not a good critical Consistently follows the charge nurse’s directions without question Asks many questions when confronted with a new situation Freely admits to not knowing the answer to questions Verifies the meaning of communication to improve understanding

14.

The nurse with strong critical thinking skills accepts information without question from what source?

1.

Textbook 2.

Physician 3.

Nursing instructor 4.

No one

15.

What is the primary reason the nurse needs to be a skilled critical thinker?

1.

2.

3.

4.

To earn promotions at work To pass the nurse licensure exam To graduate at the top of the class To provide excellent patient care

Multiple Response Identify one or more choices that best complete the statement or answer the question.

16.

For what purpose does the nurse use brainstorming? (Select all that apply.)

To find solutions To create plans To minimize time spent problem solving To discover new ideas To make new friends

17.

The nurse uses what approach as a good critical thinker? (Select all that

1.

2.

3.

4.

5.

apply.)

1.

2.

3.

Following every doctor’s order as written Learning all facts needed to pass a test Applying thorough thinking to complex situations Using creativity in thinking Obediently doing everything asked to do

4.

5.

18.

The nurse develops serendipity by doing what? (Select all that apply.)

1.

Reading textbooks 2.

Being attentive to the world 3.

Following all directions 4.

Spending time with classmates 5.

Learning more about faculty members Chapter 7: The Importance of Critical Thinking Answer Section MULTIPLE CHOICE 1.

ANS: 2 The nurse should continue thinking of other potential solutions and should come up with at least three options. This allows the nurse to weigh different options and act on the best possible solution.

PTS: 1 REF: Chapter: 7 OBJ: Objective: 3 KEY: Content Area: Critical Thinking | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 2.

ANS: 4 Creative thinking is essential to thorough thinking.

PTS: 1 REF: Chapter: 7 OBJ: Objective: 3 KEY: Content Area: Critical Thinking | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 3.

ANS: 3 The essence of critical thinking is asking questions to gain more knowledge. A true critical thinker asks questions others did not think to ask.

PTS: 1 REF: Chapter: 7 OBJ: Objective: 1 KEY: Content Area: Critical Thinking | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 4.

ANS: 4 One component of critical thinking is honesty and admitting when the answer is unknown instead of trying to make something up.

PTS: 1 REF: Chapter: 7 OBJ: Objective: 3 KEY: Content Area: Critical Thinking | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 5.

ANS: 1 Tolerance is respecting other people’s opinions and beliefs without criticism.

PTS: 1 REF: Chapter: 7 OBJ: Objective: 3 KEY: Content Area: Critical Thinking | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 6.

ANS: 2 Critical thinking is most valuable when making decisions because it guides the nurse to ask questions, use creative thinking, and consider the situation carefully.

PTS: 1 REF: Chapter: 7 OBJ: Objective: 2 KEY: Content Area: Critical Thinking | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 7.

ANS: 1 Critical thinking involves questioning and decision making. A nurse who doesn’t understand the reason for an order questions the physician and demonstrates critical

thinking.

PTS: 1 REF: Chapter: 7 OBJ: Objective: 2 KEY: Content Area: Critical Thinking | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 8.

ANS: 2 The nurse’s night of sleep served as letting-go time, allowing the mind to focus again after some rest, which led to the solution.

PTS: 1 REF: Chapter: 7 OBJ: Objective: 3 KEY: Content Area: Critical Thinking | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 9.

ANS: 1 The first thing the group will do is generate ideas. One member of the group will write everything down, no matter how crazy or farfetched.

PTS: 1 REF: Chapter: 7 OBJ: Objective: 3 KEY: Content Area: Critical Thinking | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 10.

ANS: 3 Letting go means taking a break from thinking about the problem. This is best demonstrated by the nurse spending time not thinking about the problem and having a pleasant afternoon with friends.

PTS: 1 REF: Chapter: 7 OBJ: Objective: 3 KEY: Content Area: Critical Thinking | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 11.

ANS: 1 The nurse has found value in interacting with new peers, which indicates serendipity.

PTS: 1 REF: Chapter: 7 OBJ: Objective: 1 KEY: Content Area: Critical Thinking | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 12.

ANS: 3 This nurse displayed critical thinking in not just responding to the patient’s pain but in assessing and collecting data, analyzing the data, and developing a plan for how to respond. By the time the nurse begins to intervene, there is a strong enough base of data to indicate what is required for this patient.

PTS: 1

REF: Chapter: 7

OBJ: Objective: 2

KEY: Content Area: Critical Thinking | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 13.

ANS: 1 A critical thinker does not blindly follow another but finds the best route.

PTS: 1 REF: Chapter: 7 OBJ: Objective: 3 KEY: Content Area: Critical Thinking | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 14.

ANS: 4 No single source should be blindly accepted as correct without question or finding other sources of support.

PTS: 1 REF: Chapter: 7 OBJ: Objective: 3 KEY: Content Area: Critical Thinking | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 15.

ANS: 4 The reason nurses need to be strong critical thinkers is to provide optimal patient care and make sound decisions when planning care.

PTS: 1 REF: Chapter: 7 OBJ: Objective: 2 KEY: Content Area: Critical Thinking | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying MULTIPLE RESPONSE 16.

ANS: 1, 2, 4 Some purposes of brainstorming are to find creative and effective solutions and to create plans to avoid future problems. Brainstorming is also useful for finding new ideas.

PTS: 1 REF: Chapter: 7 OBJ: Objective: 2 KEY: Content Area: Critical Thinking | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 17.

ANS: 3, 4 Thorough thinking is one part of critical thinking and requires asking questions and gaining information about a situation before making a decision. Creativity is essential to good critical thinking because it considers new possibilities.

PTS: 1 REF: Chapter: 7 OBJ: Objective: 1 KEY: Content Area: Critical Thinking | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying

18.

ANS: 2, 4, 5 Serendipity is finding things of value in unexpected places and requires the nurse to be aware of things occurring in the world. Spending time with classmates allows the nurse to learn more about them and perhaps find something serendipitous. Learning more about faculty members opens the nurse’s eyes to possible value and finding something serendipitous.

PTS: 1 REF: Chapter: 7 OBJ: Objective: 3 KEY: Content Area: Critical Thinking | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying Chapter 8. Entry Into Practice Chapter 8: Entry into Practice Multiple Choice Identify the choice that best completes the statement or answers the question.

1.

The student nurse is applying knowledge learned in class to the care of a patient. What type of knowledge is the student nurse using?

1.

Knowing that 2.

Knowing how 3.

Knowing why 4.

Knowing when

2.

After the student graduates and begins to practice the healing art in the real world of nursing, he or she develops what type of knowledge?

1.

Knowing that 2.

Knowing how 3.

Knowing why 4.

Knowing when

3. knowledge?

1.

2.

3.

4.

The actual practice of nursing requires extensive use of what type of Knowing that Knowing how Knowing why Knowing when

4. The physician asks the nurse to perform a procedure. The nurse is unsure whether nurses are allowed to perform this procedure. What is the nurse’s best source of information to determine whether the procedure can legally be performed by the nurse?

1.

2.

3.

4.

Ask another nurse with more experience Nurse Practice Act Call the nursing instructor Call any school of nursing

5.

The nurse was originally licensed in one state and is accepting a job in a different state. What statement regarding the nurse’s practice in the new state is accurate?

1.

Every state’s Nurse Practice Act is the same so the nurse’s practice will not change.

2.

The nurse will need to take the NCLEX-PN again in the new state.

3.

The nurse is responsible for understanding the Nurse Practice Act in the new state.

4.

The nurse will need to take a quiz regarding differences in the Nurse Practice Act in the new state.

6.

The nurse working in the long-term care facility reviews a physician order that the nurse feels is unsafe. The physician is contacted and upholds the order. What should the nurse do?

1.

Carry out the order and document the order was questioned with the physician.

2.

Refuse to carry out the order and document the rationale for why it was not done.

3.

Consult the RN supervisor and explain the situation and the physician’s response.

4.

Explain the dilemma to the patient and ask the patient to give permission for the order to be done.

7.

What level of Maslow’s hierarchy of needs is most threatened when the new graduate nurse begins working?

1.

Physiological needs 2.

Safety needs 3.

Love and belonging needs 4.

Self-actualization needs

8.

The LPN is offered a job working alone in an office treating patients. The only coworkers the nurse will have are secretarial and billing clerks. What will the nurse need to ask about this job to determine if it is in compliance with the Nurse Practice Act?

1.

Is there an RN or physician who will supervise the LPN? Is there adequate financial compensation for the work expected?

Will the LPN be supervising the secretaries and billing clerks?

How long will the LPN need to work before receiving a raise?

2.

3.

4.

9.

A new graduate accepts a job that provides a strong support system, giving the nurse a sense of what?

1.

Financial security 2.

Safety 3.

Love and sense of belonging 4.

Health and well being

10.

The new graduate would like to work on an obstetrics unit in the local hospital. After applying for several jobs, the long-term care facility offers the graduate a position caring for older residents. What is the nurse’s best action?

1.

Thank the facility for the job offer but explain that caring for older adults is not the job desired.

2.

Take the job caring for older adults temporarily until a better job in the desired field is offered.

3.

Refuse the job by explaining that another job has been offered to avoid hurting feelings.

4.

Accept the job and work there for one or two years to gain experience before applying for a different job.

11.

Why is it important for the new graduate LPN to seek a job with strong support systems?

1.

Support systems will make the job easier.

2.

Social needs will be met more effectively.

3.

Support systems will help ensure job safety.

4.

Self-esteem needs will be met more effectively.

12.

How long should the nurse’s career plan extend?

1.

2.

3.

4.

One year Two years Five years Ten years

13. A nurse who has experience and knowledge and is willing to help a new graduate is called what?

1.

An instructor 2.

A mentor 3.

An in-service educator 4.

A teaching assistant

14. The new graduate nurse is asked to start an IV on a patient but isn’t sure whether post-graduate certification is required to perform this skill. What is the nurse’s best response?

1.

Check the state’s Nurse Practice Act. 2.

Refuse to perform the skills.

3.

Call the school where the nurse graduated.

4.

Take the opportunity to practice this skill.

15.

How can the new graduate LPN best meet the ongoing educational requirements of the nursing profession?

1.

Sit in on the classes taken during nursing school as a refresher course.

2.

Share ideas with coworkers during quiet times at work.

3.

Ask your nursing supervisor to teach you about new things.

4.

Join a professional organization to attend seminars.

16.

1.

2.

3.

4.

What nursing organization limits membership exclusively to LPNs? National Federation of Licensed Practical Nurses (NFLPN) American Nurses Association (ANA) National League for Nursing (NLN) National Association for Practical Nurse Education and Services (NAPNES)

17.

1.

2.

3.

4.

Why is networking important for the novice nurse?

Networking helps the nurse get the desired job just by knowing the right person.

Networking educates the nurse on what institutions should be avoided.

Networking is an effective way to informally share goals, concerns, or desires.

Networking helps the nurse to get the best salary and benefit package.

18.

How can the LPN expand practice areas without advancing their career by becoming a registered nurse?

1.

Attain certification in a specific area.

2.

Work in a nursing specialty area.

3.

Work in the same facility for five or more years.

4.

Learn by watching how other nurses perform at work.

19.

The nurse sets a goal in a career plan to be working as a charge nurse in one year. When the year has passed and the nurse is not working as a charge nurse, what priority action should the nurse take?

1.

Complain to the nursing supervisor because the nurse’s talents are not being fully utilized.

2.

Quit this job and find another job in a facility where nurses are promoted faster.

3.

Determine which of the nurse’s coworkers is most likely saying bad things about the nurse.

4.

Determine the reasons why the nurse hasn’t been promoted and create an action plan.

20.

The new graduate nurse is looking for a mentor and is considering several coworkers. Which experienced nurse would make the best mentor for the new graduate?

1.

The nurse who has a great sense of humor and always invites the new grad to go out after work.

2.

The nurse who says graduate nurses are poorly prepared and attended the same school as the graduate.

3.

4.

The nurse who is always delegating to the graduate tasks like making beds and feeding patients.

The nurse who is very skillful and often calls the graduate over to teach something new.

21.

The charge nurse tells the graduate nurse to talk to a dying patient’s family, who are very upset. The graduate says, “What should I say? I’ve never dealt with a situation like this before.” The charge nurse assures the graduate everything will be fine. What type of mentor is this charge nurse?

1.

Avoider 2.

Dumper 3.

Destroyer 4.

Blocker

22.

The new graduate accepts a position at a facility and is assigned a preceptor to act as a mentor during the orientation process. After two weeks on orientation the graduate overhears the preceptor telling a coworker, “This new graduate I’m working with is never going to make it as a nurse. She doesn’t know what she is doing.” What type of mentor is this preceptor?

1.

Avoider 2.

Dumper 3.

Destroyer 4.

Blocker

Multiple Response Identify one or more choices that best complete the statement or answer the question.

23. that apply.)

1.

2.

3.

4.

5.

What types of nursing mentors are considered toxic mentors? (Select all Dumpers Unfriendly Avoiders Passive–aggressive Blockers

24.

The nurse asks the three major questions when searching for a job. What information received from the hiring manager would the nurse consider as answers to these questions? (Select all that apply.)

1.

2.

3.

4.

5.

Explanation of the type of patients the facility admits Description of the orientation process for new graduates Skills the nurse will need to function in the new job Hourly wage and compensation package for employees Number and type of staff working on the unit with the nurse

25.

What events might threaten the nurse’s need for sense of safety and security when starting the first job after graduation? (Select all that apply.)

1.

Passing medications for a team independently 2.

Choosing benefits from the options provided by the facility 3.

Eating lunch with new coworkers for the first time 4.

Performing a complex procedure without assistance 5.

Challenging a physician’s order that is unsafe Chapter 8: Entry into Practice Answer Section MULTIPLE CHOICE 1.

ANS: 1 This type of knowledge is called “knowing that,” which is the type of knowledge learned in the classroom. This knowledge is the theory of nursing.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 1 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 2.

ANS: 2 The nurse develops “knowing how” knowledge when caring for a patient or a category of patients over time. This information evolves without explanation while performing the day-to-day responsibilities of the profession.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 1 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying

3.

ANS: 1 The practice of nursing requires extensive “knowing that” knowledge, which is why the program to become a nurse requires many months of classes in order to build the foundation of nursing knowledge.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 1 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 4.

ANS: 2 The Nurse Practice Act is the best resource to determine what practices are allowable for LPNs in that state.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 2 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 5.

ANS: 3 The nurse holds responsibility for reading and understanding the Nurse Practice Act in any state where the nurse accepts a job.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 2 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 6.

ANS: 3 The nurse should inform the supervisor of the problem and follow the supervisor’s direction. The supervisor may explain why the order is acceptable or may call the physician to have the order changed.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 2 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 7.

ANS: 2 The nurse’s safety needs are likely to feel challenged as the new nurse begins to practice without an instructor acting as supervisor. A strong support system in the new job will help the nurse maintain safe practice.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 3 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 8.

ANS: 1 The LPN must work under the supervision of a registered nurse or physician, so it is

important for the nurse to ensure there will be adequate supervision to meet requirements of the Nurse Practice Act. PTS: 1 REF: Chapter: 8 OBJ: Objective: 4 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 9.

ANS: 2 A strong support system will give the LPN a sense of safety because there will be resources for the nurse to rely on when new situations are encountered.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 4 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 10.

ANS: 4 Taking the job offered will allow the nurse to build experience and improve skills, making it easier to get another job in a few years.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 4 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 11.

ANS: 3 Support systems will help you feel safe on the job. If you do not have these support systems, your second level on the hierarchy of needs is not being met, and you cannot advance up the pyramid.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 3 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 12.

ANS: 3 The five-year career plan is recommended so that you understand where you want to go with your nursing career. You are also your best evaluator. The plan may require outside help and should be made with flexibility.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 5 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 13.

ANS: 2 A mentor is a more experienced nurse who provides guidance and support to a novice nurse in a continuing and caring relationship. The guidance and support can be provided through counseling, role modeling, and teaching.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 6 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 14.

ANS: 1 Your state’s Nurse Practice Act provides all guidelines, rules, and regulations for LPNs practicing in that state.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 2 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 15.

ANS: 4 Nursing constantly changes and in five years, 50 percent of what you learned in school could be obsolete. When you join a professional organization, you receive their journal, which will keep you up to date. There will also be periodic seminars you can attend.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 7 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 16.

ANS: 1 The NFLPN is the exclusive membership organization for LPNs and provides many educational opportunities.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 7 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 17.

ANS: 3 Having an association with experienced nurses, such as faculty members or LPNs employed in various positions and who are members of professional organizations, is an effective way of networking. A network of others will assist the novice nurse through their experience, information, and opportunities.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 8 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 18.

ANS: 1 An LPN can expand his or her practice by becoming certified in a specific area. This certification can lead to a job change or advancement in the same facility. Professional healthcare organizations grant national certification in such areas as hospice care, gerontology, and stoma therapy. Certification also can come from an agency, such as

certification in IV therapy.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 5 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 19.

ANS: 4 The nurse needs to figure out why a promotion has not been offered, and then create an action plan to improve the situation.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 6 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 20.

ANS: 4 Mentors should demonstrate a high level of skill and take interest in the graduate’s learning needs. So this individual would be a good choice.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 6 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 21.

ANS: 2 Dumpers throw people into new roles or positions and let them fail, which is exactly what this charge nurse is doing in this situation.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 6 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing 22.

ANS: 3 Destroyers tear down the individual by tearing down the nurse’s self-confidence. This preceptor is acting as a destroyer, perhaps because she is threatened by the new nurse’s knowledge.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 6 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing MULTIPLE RESPONSE 23.

ANS: 1, 3, 5 Toxic mentors are people who are destructive or “toxic” to the novice nurse. “Dumpers” throw people into a new role or position and let them fail. “Avoiders” are nonresponsive people who are unavailable or inaccessible. “Blockers” may refuse to help, withhold

information needed to succeed, or stifle the development of the individual by hovering too closely.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 6 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 24.

ANS: 1, 2, 3, 5 One of the questions asked by the nurse is what the day-to-day job is really like. An understanding of the patient types admitted would give the nurse a better idea of day-today job needs. Understanding the support system and resources for the new nurse includes a need to understand the orientation process. Skills the nurse will need to know is one of the three questions the nurse will seek to answer. Knowing what types of staff (CNA, RN, LPN, etc) the nurse will work with tells the nurse the support system available.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 4 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 25.

ANS: 1, 4, 5 Passing medications for the first time without a nursing instructor to supervise, performing a complex procedure alone for the first time, and challenging a physician’s order for the first time can all be frightening and may make the nurse worry about job security.

PTS: 1 REF: Chapter: 8 OBJ: Objective: 3 KEY: Content Area: Entry into Practice | Integrated Processes: Teaching/Learning | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying Chapter 9. Employment Process Chapter 9: Employment Process Multiple Choice Identify the choice that best completes the statement or answers the question.

1.

You have graduated and passed your National Council Licensure Examination (NCLEX). You are now a licensed practical nurse (LPN) and are searching for a job. Your employer will have certain expectations of you as a potential employee.

One of those important expectations is that you: 1. are highly skilled in all aspects of patient care.

2. show loyalty to the institution and its leaders.

3. can perform highly skilled procedures, such as administration of IV and morphine.

4. graduated with straight As.

2.

How might a prospective employee get an unbiased view of expectations of a future employer?

1.

Take an informal tour of the facility.

2.

Read the employer’s advertisement for jobs.

3.

Ask someone who is currently employed there.

4.

Read newspaper articles about the facility.

3.

A nurse should only make one application for employment at a time to prevent multiple job offers and unrealistic expectations of prospective employers.

1.

Absolutely, the nurse should focus on the application for the most desired job.

2.

Yes, working on multiple applications can be confusing.

3.

No, the nurse should send out several job applications to provide more opportunity for securing a position.

4.

Possibly, but only if the nurse has already been promised that job.

4.

After you have sent out your letter of application and a resume, it is recommended that you follow up with a(n): 1. thank-you note.

2. phone call.

3. e-mail.

4.

1 and 2

5.

The letter of application should be written as a(n): e-mail. informal letter. business letter. form letter.

6.

Just as important as the content of the resume is the: appearance. color of the paper. color of the ink.

1.

2.

3.

4.

1.

2.

3.

4.

number of pages.

7.

A letter of application should:

1.

2.

3.

4.

contain only one paragraph of introduction. be written in bullet format. be no longer than one page. include a personal photograph.

8.

1.

2.

A resume should include: all jobs ever held. jobs that are relevant to the job for which you are applying. hobbies. religious affiliation.

3.

4.

9.

There are many things you can do to prepare for your job interview.

Which of the following is critical to success of the interview?

1.

Arriving 45 minutes early 2.

Wearing a nursing uniform to the interview 3.

Chewing gum to freshen breath 4.

Your clothing and general appearance

10.

It is suggested that you practice which skills prior to your interview?

Nursing skills Writing skills Entrance skills Math skills

11.

It is illegal for an interviewer to ask you which of the following?

Questions about your age and birthplace Questions about your present employment Questions about your physical health Questions about your education

1.

2.

3.

4.

1.

2.

3.

4.

12.

How much notice should you give your employer when terminating your employment?

1.

1 week

2.

3.

4.

2 weeks 3 weeks 10 working days

13.

Which of the following people should be the first one informed when you are terminating your employment?

1.

Your best friend 2.

Your nurse manager 3.

The CEO of your institution 4.

Another employee on your unit

14.

The employer’s first impression of a potential employee comes from: your appearance. your professional communication. your resume. your physical appearance.

15.

Which of the following is not considered an entrance skill?

A smile Gait and body position A firm handshake Manner of dress

1.

2.

3.

4.

1.

2.

3.

4.

16. interview?

1.

2.

3.

4.

What is the purpose of “ice breaking” time in the first few minutes of an To motivate the prospective employer To determine your likes and dislikes To allow for a comfort level to be established To allow time for personal questions

17.

After a nurse has gathered information about potential jobs, what should be done with that information?

1.

The nurse should keep an organized list of potential employers.

2.

The nurse should keep various notes about potential employers in a notebook.

3.

The nurse should keep all information in one envelope.

4.

It is not necessary for the nurse to keep any information.

18.

1.

2.

3.

4.

The best dress for an interview is: your uniform. scrubs. a dark suit. jeans.

19. The interviewer explains to the LPN applying for the position that the facility will expect the LPN to work on committees as part of the job responsibilities.

This expectation is: 1. reasonable.

2. beyond the scope of the LPN’s practice.

3. optional for the LPN. 4. totally unrealistic and excessive.

20.

1.

2.

3.

4.

How will the nurse address the letter of application?

Dear Sir or Madam Dear Human Resources Director Dear Sue Dear Ms. Anskey

21.

The nursing student is preparing a resume to find a job after graduation.

Previous work experience includes working as a nursing assistant while in school, a job working in a fast-food restaurant for two years in high school, and a position as a clerk in a department store between high school graduation and starting nursing school. What job(s) should the nursing student include on the resume?

1.

All jobs 2.

None of these jobs – leave employment section empty 3.

The nursing assistant job and the department store job 4.

Only the nursing assistant job

22.

The nurse is interviewing for a job and first interviews with human resources, then is called back to interview with the nurse manager, and finally is asked to interview with the staff. What type of interview is the nurse undergoing?

1.

2.

3.

4.

Leveled interview Single interview Double interview Ice breaker interview

Multiple Response Identify one or more choices that best complete the statement or answer the question.

23.

1.

2.

3.

4.

5.

What should the nurse take to the job interview? (Select all that apply.)

LPN license Cardiopulmonary certification Immunization record Transcripts from nursing school Instructor’s evaluation of clinical performance

24.

The nurse is writing a letter of application to a potential employer. What specific items must the nurse include in the letter? (Select all that apply.)

1.

Copy of diploma from school of nursing 2.

Promise to work all holidays for the first year 3.

Statement of why the nurse is interested in the position 4.

Explanation of the nurse’s qualifications for the job 5.

Statement of availability to discuss the job

25.

What would be considered reasonable expectations of an employer hiring a new graduate nurse? (Select all that apply.)

1.

Knowledge required to provide expert care 2.

Honesty and integrity 3.

A strong sense of responsibility 4.

Ability to work unsupervised 5.

Appropriately educated for the position Chapter 9: Employment Process Answer Section MULTIPLE CHOICE 1.

ANS: 2 An important expectation of employers is that potential employees will be loyal to the

institution and its leaders. This concept should be put into effect at every place of employment.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 1 KEY: Content Area: Employment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 2.

ANS: 1 An informal tour through a hospital or nursing home can give you additional information about the expectations of your potential employer, as well as additional information for you regarding the desirability of the job.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 2 KEY: Content Area: Employment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 3.

ANS: 3 It is appropriate to make several job applications at the same time. This provides more opportunity to secure a position.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 2 KEY: Content Area: Employment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 4.

ANS: 2 You should follow up with a phone call to make sure your application and your resume have been received. Also note this on your master list.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 3 KEY: Content Area: Employment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 5.

ANS: 3 Write a letter of application as a business letter. Type the letter without errors on good white paper, and get help if necessary.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 2 KEY: Content Area: Employment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 6.

ANS: 1 The appearance of the resume is just as important as the content because it is a vital first impression to your prospective employer.

PTS: 1

REF: Chapter: 9

OBJ: Objective: 3

KEY: Content Area: Employment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 7.

ANS: 3 A letter of application should be only three or four paragraphs in length. It should not be longer than one page; the concept of being concise is an important one in this communication.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 2 KEY: Content Area: Employment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 8.

ANS: 2 A resume is a summary of who you are as a professional person and often determines if you receive further consideration for a position in which you have an interest.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 3 KEY: Content Area: Employment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 9.

ANS: 4 Your clothing and general appearance are crucial to a successful interview. How you look tells the employer that you are proud of yourself and your profession. Your clothing should be professional (a suit for women and a tie for men). Regarding general appearance, hair should be neat, jewelry should be kept to a minimum, and makeup should be conservative. Arriving on time is important, but you should not arrive too early.

Chewing gum and wearing a nursing uniform are not appropriate for a job interview.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 4 KEY: Content Area: Employment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 10.

ANS: 3 You should practice your entrance skills prior to an interview. Entrance skills include your gait when entering a room, a smile, and a firm handshake.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 4 KEY: Content Area: Employment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 11.

ANS: 1 Questions about your age, religion, and birthplace are considered discrimination, which is illegal.

PTS: 1

REF: Chapter: 9

OBJ: Objective: 4

KEY: Content Area: Employment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 12.

ANS: 2 Unless there is an emergency, you should give your employer 2 weeks notice, which is the minimum required by professional courtesy.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 5 KEY: Content Area: Employment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 13.

ANS: 2 Your termination of employment should be in a letter to your immediate nurse manager or employer.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 5 KEY: Content Area: Employment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 14.

ANS: 3 Your resume makes the first impression on your prospective employer. It is generally the first contact between the employer and the potential employee.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 3 KEY: Content Area: Employment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 15.

ANS: 4 Your manner of dress is not considered to be an entrance skill. Entrance skills are your gait, facial expression, and handshake.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 4 KEY: Content Area: Employment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 16.

ANS: 3 Ice breaking allows time for a comfort level to be established. This is a time for casual conversation and helps with an effective interview because both people are relaxed.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 4 KEY: Content Area: Employment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 17.

ANS: 1 The nurse should keep an organized list of each employer with any other information that

the nurse gathers. This list should be easily accessible and will allow the nurse to have all information in one place.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 2 KEY: Content Area: Employment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 18.

ANS: 3 The best dress for an interview is a dark suit. It is acceptable to wear a uniform to an interview if one is coming from the work area and the interviewer know this. But a dark business suit is more professional.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 4 KEY: Content Area: Employment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 19.

ANS: 1 Working on committees is part of the expectation of many employers who often expect more than just patient care from their nurses. It is a professional obligation to contribute to the facility so patient care is optimized.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 1 KEY: Content Area: Employment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 20.

ANS: 4 The letter should address the human resource director by name and should use the formal Mr. or Ms. Do not use the abbreviation Mrs. because you have no way of knowing the marital status of the woman.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 2 KEY: Content Area: Employment | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 21.

ANS: 4 The nursing assistant job is related to the job being applied for and should be listed.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 3 KEY: Content Area: Employment | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 22.

ANS: 1 Leveled interviews are those that require successive interviews with different levels of

personnel.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 5 KEY: Content Area: Employment | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying MULTIPLE RESPONSE 23.

ANS: 1, 2, 3 The nurse should take a copy of the LPN license as well as the original. CPR certification and any other certifications should be taken to the job interview, as well as immunization record, including the TB skin test if less than a year old.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 4 KEY: Content Area: Employment | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 24.

ANS: 3, 4, 5 The first paragraph of the application letter explains why the nurse is seeking this open position. The second paragraph explains the nurse’s qualifications and why the nurse should be hired. The final paragraph informs the reviewer of when the nurse is available to schedule an interview.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 2 KEY: Content Area: Employment | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 25.

ANS: 2, 3, 5 All nurses should be honest with a strong sense of integrity, so this would be a reasonable expectation of an employer. Nurses should also have a strong sense of responsibility, so this would be a reasonable expectation of an employer. The new graduate nurse should be appropriately educated for the position under consideration.

PTS: 1 REF: Chapter: 9 OBJ: Objective: 1 KEY: Content Area: Employment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying Chapter 10. Leadership and Management as a Professional Concept Chapter 10: Leadership and Management as a Professional Concept Multiple Choice Identify the choice that best completes the statement or answers the question.

1.

1.

2.

3.

4.

Which comes first?

Management Leadership Organization Participation

2.

There are different types of leaders. Which of the following is an (are) example(s) of a type of leader?

1.

Formal 2.

Natural born 3.

Educated 4.

Informal 5.

1 and 4

3.

In healthcare, a name commonly given to a formal leader is: executive. chief officer. administrator. manager.

4.

An example of an informal leader in nursing is: a nurse manager. a team leader. a director of nursing. a competent staff nurse.

5.

Which of the following is not a leader’s job?

Interview and hire new employees Establish goals for the organization Execute goals The ability to anticipate changes in healthcare

6.

Which of the following is a function of a nurse manager?

Determine employees’ schedules Develop individual goals Give direct care to patients on a daily basis Teach student nurses in the clinical area

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

7.

An autocratic leader is likely to: seek the employee’s input. be committed to what is best for the group. allow workers to go ahead without direction. make decisions independently.

1.

2.

3.

4.

8.

1.

2.

3.

4.

Another term for a participative leader is: democratic. multicratic. autocratic. laissez-faire.

9.

What will happen if you get involved in a power struggle with an autocratic leader?

1.

You will win and your ideas will get praise from your leader.

2.

Your individual needs will be met.

3.

You and the organization will lose.

4.

You will be seen as an individual.

10.

Which of the following often results with a laissez-faire leader?

Job satisfaction Chaos in the system A free exchange of ideas Every person is seen as an individual.

11.

The manager is responsible for:

1.

2.

3.

4.

1.

2.

3.

4.

establishing goals for the facility. getting work done through others. establishing goals for the facility and acting as an agent of change. acting as an agent of change and getting work done through others.

12.

Dr. Jean Watson’s work in the science of human caring has established credibility for nurses:

1.

2.

3.

4.

who believe in the medical paradigm. who believe in the nursing paradigm. who see the physician’s role as a power role. who accept the paradigm of male dominance and superiority.

13.

Licensed practical nurses (LPNs) have commonly held management positions in which of the following places?

1.

Hospitals 2.

The military 3.

Long-term care 4.

Clinics

14.

Which historical change had the most impact on increasing the manager’s role for LPNs? 1.

The Industrial Revolution 2.

Medicare reform 3.

Clinton administration healthcare reform 4.

Institution of state-funded Medicaid

15.

Which type of leadership style do most people prefer initially?

Autocratic Democratic Laissez-Faire Participative

16.

Which type of leadership style do most people try to avoid?

Autocratic Democratic Laissez-Faire Participative

1.

2.

3.

4.

1.

2.

3.

4.

17. actions?

1.

2.

3.

4.

What is the primary origin of personal scripts that guide the nurse’s Lifetime learning Past health problems A mentor’s perception Recent experiences

18. leader?

1.

What differentiates a formal nursing leader from an informal nursing A formal leader has been hired into a position of power.

A formal leader is the more effective leader.

A formal leader is respected due to wisdom rather than position.

A staff nurse is a formal leader.

2.

3.

4.

19.

The new graduate nurse often asks the experienced nurse for advice on how to handle a situation. The charge nurse often consults with this nurse. During a crisis on the unit the evening supervisor asks the experienced nurse for suggestions to manage the crisis. Who is the informal leader?

1.

The new graduate 2.

The experienced nurse 3.

The charge nurse 4.

The evening supervisor

20.

The new graduate nurse often asks the experienced nurse for advice on how to handle a situation. The charge nurse often consults with this nurse. During a crisis on the unit the evening supervisor asks the experienced nurse for suggestions to manage the crisis. Who is the formal leader?

1.

The new graduate 2.

The experienced nurse 3.

The charge nurse 4.

The evening supervisor

21.

What leadership style would be most effective for the nurse to assume during a resuscitation of a patient?

1.

Autocratic 2.

Democratic 3.

Laissez faire 4.

Participative

Multiple Response Identify one or more choices that best complete the statement or answer the question.

22.

Staff nurses consider their manager as effective when the manager has

what skills? (Select all that apply.)

1.

2.

3.

4.

5.

Interpersonal relationship skills Understanding of the organization and how it works Ability to establish goals and objectives Maintains focus on upper management Skilled at avoiding change and maintaining a steady state

23.

The nurse accepts a job working on a unit for a manager who is known to use a laissez-faire leadership style. What expectations will the nurse have about the functioning of this unit? (Select all that apply.)

1.

The nurse will have a great deal of autonomy 2.

The unit often runs out of synchrony with the rest of the facility 3.

Nurses remain in the safety level of Marlow’s hierarchy 4.

Staff nurses usually love their nurse manager’s efficiency 5.

The manager provides daily guidance and information

24.

What types of leadership positions can the experienced LPN potentially obtain? (Select all that apply.)

1.

Director of nursing for long-term care facilities 2.

Charge nurse of long-term care units 3.

Unit manager in the teaching hospital 4.

Shift supervisor in long-term care 5.

Staff educator at the long-term care facility

25.

Which of the following persons are viewed as leaders and managers in nursing? (Select all that apply.)

1.

Florence Nightingale 2.

Steven Covey 3.

Lillian D. Wald 4.

Mary Brewster 5.

Warren Bennis Chapter 10: Leadership and Management as a Professional Concept Answer Section

MULTIPLE CHOICE 1.

ANS: 2 Leadership comes first, then management. Leaders establish visions and goals for an organization. Managers then organize, motivate, and manage personnel.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 1 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 2.

ANS: 5 There are both formal and informal leaders. The formal leader is the boss, whereas the informal leader has no official title or office. The informal leader works within the assignment and is the one everyone goes to for assistance.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 2 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 3.

ANS: 3 In healthcare, one of the names commonly given to a leader is that of administrator. Other names given to healthcare leaders are president or CEO. PTS: 1 REF: Chapter: 10 OBJ: Objective: 1 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 4.

ANS: 4 An informal leader is the nurse who works with patients and other nurses on a daily basis, shows leadership skills, and is competent, caring, and helpful to others.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 2 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 5.

ANS: 1 Hiring new employees is not the job of a leader but that of a manager.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 3 KEY: Content Area: Leadership and Management | Integrated Processes: Communication

and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 6.

ANS: 1 One of the functions of a nurse manager is to determine the schedule of employees. All of the other functions belong to the leader.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 1 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 7.

ANS: 4 Autocratic leaders make decisions independently. This type of leader is task oriented and does not seek input from the group. Many workers avoid this type of leader because working with this person is uncomfortable.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 5 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 8.

ANS: 2 Another term for a participative leader is a multicratic leader, which is a compromise between autocratic and democratic leadership styles. A multicratic leader works well within groups.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 5 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 9.

ANS: 3 No one wins a power struggle. Both the involved persons and the organization lose.

Power struggles are disabling to an organization.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 5 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 10.

ANS: 2 When a laissez-faire leader is in charge, there is chaos in the system. This individual refuses to assume leadership responsibilities; therefore, there is no supervision, direction, or coordination of the employees.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 5 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 11.

ANS: 4 The manager acts as an agent of change and gets work done through others. The manager organizes details so the leader’s vision and goals can be achieved.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 3 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 12.

ANS: 2 Dr. Watson’s work in human caring pioneered the effort to establish credibility for nurses who adopt the nursing paradigm, as opposed to the medical paradigm. This theory of caring returns holistic nursing and personal caring to nurses. These concepts do not fit into the medical paradigm.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 4 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 13.

ANS: 3 LPNs have long been managers and leaders in long-term care facilities. LPNs have more opportunities today to assume roles of a leader and a manager in healthcare facilities.

These roles have been outlined by nursing leaders and are supported by both clients and other nurses.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 4 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 14.

ANS: 3 One of the most significant changes of the Clinton administration healthcare reform was the laying off of large numbers of RNs and hiring LPNs as their replacement. LPNs found they were required to assume more management responsibility in terms of working as the manager of other LPNs and multiskilled paraprofessional workers.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 4 KEY: Content Area: Leadership and Management | Integrated Processes: Communication

and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 15.

ANS: 2 Most people are initially drawn to the democratic leader. They like the individualized attention this type of leader gives to subordinates and enjoy being part of a team.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 5 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 16.

ANS: 3 Response: Many people avoid working with a laissez-faire leader because of the high level of dissatisfaction caused by the lack of guidance, caring, and instructions.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 5 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 17.

ANS: 1 Personal scripts come from a lifetime of learning and experiences.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 1 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 18.

ANS: 1 A formal leader has been given a position of power and has facility support for the role.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 2 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 19.

ANS: 2 The experienced nurse does not have a position of authority but is the one others turn to for advice when things go wrong.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 3 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying

20.

ANS: 4 The evening supervisor holds a management position of power and is the formal leader.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 3 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 21.

ANS: 1 During a code blue, or resuscitation, there is no time to discuss what to do because time is of the essence so an autocratic leader who simply tells people what to do would be most effective.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 5 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing MULTIPLE RESPONSE 22.

ANS: 1, 2, 3 Being able to work with others and motivate others to get the job done is a skill of a good manager. A good manager needs to understand the organization and how it works, knowing whom to contact to get things done. The manager must be able to set reasonable goals and objectives to meet those goals.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 3 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 23.

ANS: 1, 2, 3 Nurses working for a laissez-faire leader will receive little guidance and work with a great deal of autonomy. Working for a laissez-faire leader results in lack of synchrony with the rest of the organization. This leader generally does not provide mechanisms for the workers to move beyond the safety level of Maslow’s hierarchy of needs.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 5 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 24.

ANS: 1, 2, 5 Some unskilled long-term care facilities may promote LPNs to director of nursing. LPNs

often act as charge nurse in long-term care facilities. LPNs may be asked to lead the staff education department in long-term care facilities, providing orientation to new employees as well as staff development opportunities.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 4 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 25.

ANS: 1, 3, 4 Florence Nightingale is viewed as a leader because she had a vision for nurses in her century. She did perform management duties in the beginning of her career, but she also hired managers to get work done. Lillian D. Wald and Mary Brewster established the visiting nurse service in the United States. This action required leadership skills. Lillian D. Wald also demonstrated management skills when she went to tenements to clean and give care. She recruited and did most of the work herself.

PTS: 1 REF: Chapter: 10 OBJ: Objective: 4 KEY: Content Area: Leadership and Management | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing Chapter 11. Communication Skills in Leadership and Management Chapter 11: Communication Skills in Leadership and Management Multiple Choice Identify the choice that best completes the statement or answers the question.

1.

Therapeutic communication is used when: you ask another student to explain the action of carbamazepine (Tegretol) to you. you spend time talking to patients about their feelings and listening to their concerns. you listen carefully while the doctor explains to you what is to be done for your patient. you and your patient talk about the results of Sunday’s football game.

2.

When effective communication occurs, which of the following is true?

The message is understood by the sender and the receiver.

The message is fully understood by the receiver.

1.

2.

3.

4.

1.

2.

3.

The message is fully understood by the sender.

Communication is effective by telling someone what to do.

4.

3.

You are a charge nurse in a long-term care facility and you have to talk to Betty, a certified nursing assistant, about the care of one of her residents. You and Betty sit in your office, and as you begin to talk with her, she becomes very angry and storms out of the office. What has taken place?

1.

Successful communication 2.

Social communication 3.

Honest communication 4.

Failed communication

4.

In which of the following situations could failed communication occur?

Your instructor tells you to perform a procedure but does not let you ask questions.

A family member yells at you because you forgot to go to the dry cleaners.

The patient begins to cry when you are caring for them.

All of the above.

5.

Which of the following situations best describes feedback?

The answers the patient gives to your questions.

The patient explains what another nurse taught him.

The doctor gives you an order and leaves the unit.

You recognize the patient does not speak English well, but you explain and hope for the best.

1.

2.

3.

4.

1.

2.

3.

4.

6.

Which of the following best describes the most honest form of communication?

1.

Your body language as you explain the dressing change you are doing 2.

The instructions you give the patient on his or her discharge from the hospital

3.

Listening to your instructor as he or she explains directions for the test Talking with your friends at lunch about your final exam results

4.

7.

1.

2.

3.

4.

As a manager, it is important for you to develop skills in: social communication with your staff. understanding nonverbal messages from those you manage. understanding nonverbal messages from both those you manage and your leaders. therapeutic communication with patients.

8.

Which of the following types of communication often is not a natural behavior for nurses?

1.

Assertive communication 2.

Aggressive communication 3.

Caring communication 4.

Subjective communication

9.

1.

2.

3.

4.

In the profession of nursing, it is necessary to develop: leadership skills. management skills. assertiveness. aggressive techniques.

10.

The use of “I” messages by the nurse means that the nurse has developed the ability to: 1. be assertive.

2. manage others.

3. give excellent directions.

4. be a leader.

11.

1.

2.

3.

4.

An important part of assertiveness is the nurse’s ability to say: yes.

I don’t understand.

Can you help me? no.

12.

1.

2.

3.

4.

Resolving problems in the long term Positive feelings Keeping the peace Failure to move up Maslow’s hierarchy

13.

Passive-aggressive behavior is demonstrated by the nurse who: gossips about other people. constantly complains during shift report. complains to everyone except the right person. all of the above.

14.

Which of the following is critical to communication?

Using professional terms when talking to a patient Listening carefully to your staff member as he or she shares a problem Hearing what another nurse tells you as you continue to prepare a medication Having the ability to calm an angry family member

15.

Other forms of communication by the licensed practical nurse include: charting on the nurse’s notes. reading the patient’s chart. taking notes during a staff meeting. all of the above.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

Passive communication results in:

16.

Friendly conversation is an important skill for the student. Friendly conversation is best described as: 1. conversing politely in the clinical area.

2. talking to families about a patient’s prognosis.

3. talking cheerfully to friends about your nursing classes and social events.

4. group discussions on nursing topics.

17.

When negative or hostile conversation occurs, which of the following actions is most appropriate?

1.

Respond immediately to what is said.

2.

Always stop and listen rather than responding.

3.

React forcefully and negatively to what has been said.

4.

Be reactive rather than proactive.

18. setting is: 1.

2.

3.

4.

19.

1.

2.

3.

4.

One of the strongest communication skills a student can have in any speaking. hearing. listening. writing.

Communication occurs when: the sender understands the meaning of the communication. the receiver understands the meaning of the communication. the sender uses both verbal and nonverbal ways of communicating. both the sender and the receiver have understood the meaning of the communication.

20.

It is necessary for the practical nursing student to be in communication with patients and families in the clinical area.

1. friendly and eager 2. cheerful and loud so the patient can hear 3. quiet and gentle 4. firm and strong

Multiple Response Identify one or more choices that best complete the statement or answer the question.

21.

The nurse brings the patient’s lunch tray into the room and sets it on the over-bed table, positioning it so that it is comfortable for the patient to eat. The patient sweeps the tray off the table, screaming “Get this slop out of here! I’m not hungry.” What

response by the nurse reflects therapeutic communication? (Select all that apply) 1.

“You seem angry. Would you like to talk about what’s bothering you?”

2.

“That behavior in unacceptable. You could simply ask me to remove the tray.”

3.

“Why did you do that? Now I have to clean up that mess.”

4.

“How would you feel in my place if someone did that to you?”

5.

“You need to eat to maintain your strength.

I’ll get another tray.”

22.

The physician stands in the hallway speaking to the nurses in a loud voice saying, “I don’t know why you nurses don’t follow the orders I’ve written. Can’t you read?” Which response by the nurse demonstrates assertiveness? (Select all that apply) 1.

“You’re such a jerk. Lower your voice!”

2.

“We are all professionals here and there is no need to shout.”

3.

“I know you’re angry but your behavior is inappropriate.”

4.

“If you would like to discuss the problem professionally we’ll be glad to listen.”

5.

“If you treat your wife like this I know why you’re getting a divorce.”

23.

What commonly happens when failed communication occurs?

Nothing. Most people are able to forget about it.

A “mind tape” results, which is played over and over to justify what was done.

The reason for the failed communication is determined quickly and dismissed.

It can take a lot of energy and time to resolve.

People hold grudges against each other for not understanding what was said.

24.

An example of a communication block is: preconceived opinions. physical disabilities. good emotional health.

1.

2.

3.

4.

5.

1.

2.

3.

4.

5.

bad hygiene. missed phone calls.

25.

You are a good listener when:

1. others frequently come to you for advice.

2. you cut off a speaker to tell your own story.

3. you nod along to everything that is said.

4. you always give your opinion.

5. you listen both with your ears and visually.

Chapter 11: Communication Skills in Leadership and Management Answer Section MULTIPLE CHOICE 1.

ANS: 2 Therapeutic communication is the professional communication used by nurses that occurs when you talk to your patients and listen carefully. This type of communication also occurs with families, staff members, and physicians.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 1 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 2.

ANS: 1 Effective communication occurs when both the sender and the receiver understand the message.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 1 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 3.

ANS: 4 Failed communication has occurred, which means that the planned or anticipated communication did not take place. This type of communication often involves nonproductive and uncaring behaviors, such as anger, frustration, and “storming away.”

PTS: 1 REF: Chapter: 11 OBJ: Objective: 4 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying

4.

ANS: 4 All of these situations are examples of possible failed communication. These situations involve people who trigger your least-effective communication experiences.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 4 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 5.

ANS: 2 Feedback is an important part of communication and helps to prevent or correct failed communication. Feedback requires acknowledgment of what has been said.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 1 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 6.

ANS: 1 Body language, which is nonverbal communication, is the most honest form of communication.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 1 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 7.

ANS: 3 Management requires the skills for understanding nonverbal messages of both those you manage and your leaders because of the possibility of mixed messages. You must be attentive to these mixed messages, as opposed to believing that everything that is said is accurate.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 3 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 8.

ANS: 1 Assertive communication is not usually a natural behavior for nurses for two reasons.

One reason is that the 100-year history of nursing has placed nurses in the role of being the “handmaidens” of physicians at times. The other reason is that most nurses are female and have not been socialized to be assertive.

PTS: 1

REF: Chapter: 11 OBJ: Objective: 5

KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 9.

ANS: 3 Focused or assertive communication can improve nurses both professionally and personally. As a nurse and a manager, the caring way to communicate is assertively because this way does not violate anyone’s rights.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 5 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 10.

ANS: 1 The use of “I” messages is one of the rules of being assertive. These messages allow the nurse to take responsibility for personal feelings and share them with the appropriate person.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 5 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 11.

ANS: 4 Assertive communication is based on the right to say no. Every person has the right to say no.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 6 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 12.

ANS: 4 Passive communication is not based in caring theory and does not allow those involved to move up Maslow’s hierarchy. This type of communication is stifling and limited in promoting individual worth. Passive communication also causes negative feelings that are often ignored until they become overwhelming and the passive person becomes aggressive.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 5 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding

13.

ANS: 4 All of these are examples of passive–aggressive behavior, which is common among nurses. People who exhibit this behavior are not focused on solving problems and helping others to understand, learn, or change.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 5 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 14.

ANS: 2 Listening is a critical part of communication because communication is a two-way loop.

Listening can solve more problems than screaming, talking, or leaving.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 1 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 15.

ANS: 4 All of these answers are examples of other forms of communication. The nurse manager must be assertive in written communication, and it is also important for all nurses to be able to write well.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 6 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 16.

ANS: 3 Friendly conversation is a significant aspect of what makes school fun. It is the ability to talk to others about both school-related and other issues.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 2 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 17.

ANS: 2 Stopping and listening is important because it allows the person to step back and think about what is being said. Reacting immediately is either going to be “fight or flight” and neither is helpful. Stopping and listening in this situation also indicates respect for the other person.

PTS: 1

REF: Chapter: 11 OBJ: Objective: 3

KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 18.

ANS: 3 Listening to others is the most important skill, and students must learn to listen carefully.

Listening carefully to others (the doctor, the patient, and other staff members) allows the student to get needed information, avoid misunderstanding, and contribute greatly to successful communication.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 2 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 19.

ANS: 4 Communication involves both the sender and the receiver; both understand the meaning of communication.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 1 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 20.

ANS: 3 In the clinical area, the student should be both quiet and gentle in communication because patients are sick, their families are distressed, and staff often is stressed.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 3 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding MULTIPLE RESPONSE 21.

ANS: 1, 2 First the nurse should acknowledge the patient’s emotion and attempt to learn more.

Assertive communication can be therapeutic, and it would be appropriate to tell the patient the behavior is unacceptable.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 3 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying

22.

ANS: 2, 3, 4 “We are all professionals here and there is no need to shout,” “I know you’re angry but your behavior is inappropriate,” and “If you would like to discuss the problem professionally we’ll be glad to listen” are all statements that are assertive without being aggressive or passive.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 5 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 23.

ANS: 2, 3 When failed communication occurs, it is often played over and over in one’s mind to figure out what happened. This is referred to as a mind tape. This constant mental replay takes much energy and time from one’s daily life.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 4 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 24.

ANS: 1, 2 A communication block prevents effective communication. Preconceived opinions and physical disabilities are two examples of a communication block. A physical disability can be a block when you are not aware of the disability or do not know how to successfully communicate about the disability. When a preconceived opinion is present and is wrong, a communication block exists.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 4 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 25.

ANS: 1, 5 Others come for advice to a person because of his or her listening skills. They seek that person out also because of the interest the person is displaying to them and making eye contact.

PTS: 1 REF: Chapter: 11 OBJ: Objective: 2 KEY: Content Area: Communication | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding Chapter 12. Understanding the Benefits of Change Chapter 12: Understanding the Benefits of Change

Multiple Choice Identify the choice that best completes the statement or answers the question.

1.

Which of the following is not an example of culture?

A family places shoes outside their door the night before Christmas for St. Nikolas.

A Jewish family keeps a kosher home.

Native Americans are at greater risk for diabetes mellitus.

A Mexican girl celebrates her womanhood with a special event in her honor.

2.

Nursing culture in the 21st century promotes which concept?

Caring White uniforms Nursing caps Subservience to doctors

3.

The growing number of elderly in our population is primarily due to: global warming. more people are graduating from college. improved healthcare.

Social Security and Medicare.

4.

Cultural competence means the nurse will have a general understanding of four or more common cultures. be able to speak more than one language. develop care plans that incorporate a patient’s cultural traits. be accepting of cultural differences of patients and coworkers.

5.

The majority of North Americans belong to which cultural group?

Asian Native American/Indian European African

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

6. sensitivity?

1.

2.

3.

4.

7.

1.

2.

3.

4.

Which of the following comments by the nurse demonstrates cultural “I ordered you a kosher meal since you are Jewish.”

“I saw in your chart you are Jewish. Do you prefer a kosher meal?”

“What do Jewish people eat?”

“I am Jewish too, so I know you want to keep kosher.”

Which action by a nurse is necessary to provide culturally competent care?

Acceptance of the beliefs and characteristics of a patient Participation in rituals and prayers of a patient Knowledge of customs of a patient Allowing all practices requested by a patient

8.

A nurse manager will not allow a Muslim nurse to wear a head covering while on duty. This is an example of: 1. cultural blindness.

2. ethnocentrism.

3. cultural shock.

4. cultural competence.

9.

Which of the following examples best describes the concept of ethnocentrism?

1.

Requesting people to remove their shoes prior to entering a Buddhist temple 2.

Providing a head covering for men and women entering a Jewish synagogue.

3.

Recognizing only religions that believe in Jesus as the Savior.

4.

Bowing the head instead of kneeling in a Catholic church.

10. imposition?

Which of the following examples best demonstrates the concept of cultural

1.

2.

3.

4.

Offering spicy foods to the sick Baptizing comatose patients without family approval Asking a patient what they think caused their cancer Helping a son plan funeral arrangements for his father

11.

The nurse caring for an African American patient knows this patient is at higher risk for hypertension and teaches the patient how to eat healthy to reduce this risk.

This is an example of the nurse’s awareness of this patient’s what?

1.

Culture 2.

Ethnicity 3.

Race 4.

Dietary habits

12.

The student nurse wishes to be culturally competent. What should the student do first?

1.

Discover the most predominant cultures in the community.

2.

Determine what cultural group is likely to be most represented in the clinical facility.

3.

Learn more about the student’s own personal cultural background.

4.

Read more about different cultural beliefs in the school library.

13.

The nurse admits a new patient and wants to deliver culturally competent care. How can the nurse best learn about the patient’s culture?

1.

Read about it on the Internet.

2.

Talk with more experienced staff nurses.

3.

Ask the patient’s family.

4.

Ask the patient.

14.

The nurse is standing in the hallway talking to one of the residents in the long-term care facility. Every time the nurse moves closer to the patient he takes a step backward. What aspect of this patient’s culture does the nurse need to consider?

1.

Communication needs 2.

Socialization needs

3.

4.

Personal space needs Health beliefs

15.

The nurse truly wants to learn more about the patient’s culture in order to improve the quality of care delivered. What component of cultural competence is this nurse displaying?

1.

Cultural awareness 2.

Cultural desire 3.

Cultural knowledge 4.

Cultural skill

16.

The patient explains her belief in use of hot and cold treatments for specific diseases and uses this information when ordering the patient’s meal tray. What component of cultural competence is this nurse displaying?

1.

Cultural awareness 2.

Cultural desire 3.

Cultural knowledge 4.

Cultural encounter

17.

The patient uses terminology in describing cultural beliefs the nurse has never heard before, so the nurse goes to the Internet to better understand what the patient is talking about. What component of cultural competence is this nurse displaying?

1.

Cultural awareness 2.

Cultural desire 3.

Cultural knowledge 4.

Cultural skill

Multiple Response Identify one or more choices that best complete the statement or answer the question.

18.

When assessing the patient’s culture the nurse explores what factors?

(Select all that apply.)

1.

Values 2.

Customs 3.

Communication 4.

Behavior 5.

Disease history

19.

The nurse demonstrates cultural competence when including what components of cultural understanding? (Select all that apply.)

1.

Integration 2.

Intellect 3.

Communication 4.

Sensitivity 5.

Acceptance

20.

The nurse is attempting to deliver culturally competent care to a patient from an unusual culture the nurse has never encountered before. The patient is becoming irritated. What actions might be causing barriers to cultural competence?

1.

Planning care according to the nurse’s textbook 2.

Showing distaste when the patient explains her diet 3.

Applying what was learned on the Internet into the plan of care 4.

Asking the patient about their beliefs and customs 5.

Helping the patient choose food for tomorrow’s meal Chapter 12: Understanding the Benefits of Change Answer Section MULTIPLE CHOICE 1.

ANS: 3 Culture is a chosen lifestyle, but risk for disease is not chosen. Culture refers to the unique characteristics of human beings wherein they share similar symbols, language, rituals, rules, and other learned behaviors. The concept of culture also includes the group values, customs, communication styles, and the group’s behavior and social practices.

PTS: 1 REF: Chapter: 12 OBJ: Objective: 1 KEY: Content Area: Culture | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Understanding 2.

ANS: 1 Important within the nursing culture is the expectation of caring people who are clean and efficient.

PTS: 1 REF: Chapter: 12 OBJ: Objective: 2 KEY: Content Area: Culture | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Understanding

3.

ANS: 3 The growing number of people who are aging is attributed to immunizations, improved nutrition, and the advancement in pharmaceutical science that allows people to live with multiple chronic diseases.

PTS: 1 REF: Chapter: 12 OBJ: Objective: 1 KEY: Content Area: Culture | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Knowing 4.

ANS: 4 A simple definition of cultural competence is awareness and acceptance of cultural differences.

PTS: 1 REF: Chapter: 12 OBJ: Objective: 3 KEY: Content Area: Culture | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Understanding 5.

ANS: 3 The descendants of the European immigrants constitute approximately 83 percent of the people in this country.

PTS: 1 REF: Chapter: 12 OBJ: Objective: 2 KEY: Content Area: Culture | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Knowing 6.

ANS: 2 One of the critical aspects of being culturally sensitive is to recognize that one member of an ethnic group is not always the same as the next, so it is important to ask what customs they follow instead of making assumptions.

PTS: 1 REF: Chapter: 12 OBJ: Objective: 4 KEY: Content Area: Culture | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying 7.

ANS: 1 Acceptance of the beliefs and characteristics of another person is essential for culturally competent care to be given.

PTS: 1 REF: Chapter: 12 OBJ: Objective: 3 KEY: Content Area: Culture | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying 8.

ANS: 1 Cultural blindness occurs when a person refuses to recognize the cultural needs of

another person.

PTS: 1 REF: Chapter: 12 OBJ: Objective: 5 KEY: Content Area: Culture | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying 9.

ANS: 3 Ethnocentrism is a concept that indicates one person’s culture is “the best” or only correct belief.

PTS: 1 REF: Chapter: 12 OBJ: Objective: 5 KEY: Content Area: Culture | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Understanding 10.

ANS: 2 The concept of cultural imposition is similar to ethnocentrism. It occurs when one person imposes the rules of their culture on another person.

PTS: 1 REF: Chapter: 12 OBJ: Objective: 5 KEY: Content Area: Culture | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying 11.

ANS: 3 Genetic predisposition to disease is associated with the patient’s race.

PTS: 1 REF: Chapter: 12 OBJ: Objective: 1 KEY: Content Area: Culture | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying 12.

ANS: 3 In order to understand others, the nurse must first understand his or her own personal cultural background, including beliefs and values.

PTS: 1 REF: Chapter: 12 OBJ: Objective: 4 KEY: Content Area: Culture | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying 13.

ANS: 4 Only the patient can provide insight into how they practice their culture.

PTS: 1 REF: Chapter: 12 OBJ: Objective: 6 KEY: Content Area: Culture | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying 14.

ANS: 3

This patient is indicating the need for personal space by moving away from the nurse when the nurse invades his personal space.

PTS: 1 REF: Chapter: 12 OBJ: Objective: 6 KEY: Content Area: Culture | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying 15.

ANS: 2 This nurse demonstrates a desire to understand the patient’s culture.

PTS: 1 REF: Chapter: 12 OBJ: Objective: 4 KEY: Content Area: Culture | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying 16.

ANS: 4 Cultural encounter is demonstrated by incorporating the patient’s culture into the plan of care, such as when the nurse uses the information learned to order meals that will meet the patients’ needs.

PTS: 1 REF: Chapter: 12 OBJ: Objective: 4 KEY: Content Area: Culture | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying 17.

ANS: 3 Knowledge is obtained by this nurse in order to better understand the patient’s cultural beliefs.

PTS: 1 REF: Chapter: 12 OBJ: Objective: 4 KEY: Content Area: Culture | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying MULTIPLE RESPONSE 18.

ANS: 1, 2, 3, 4 Values, customs, communication patterns, and behavior are components of the patient’s culture.

PTS: 1 REF: Chapter: 12 OBJ: Objective: 6 KEY: Content Area: Culture | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying 19.

ANS: 1, 3, 4, 5 Integration of your nursing knowledge with the cultural needs of the patient results in the patient being better informed and, it is hoped, more cooperative with the healthcare regimen. Communication, based on cultural understanding, provides a strong bridge to

identifying the overall needs of a patient. Sensitivity to another’s cultural needs provides a mechanism for health-related needs to be met more successfully. Acceptance of the beliefs and characteristics of another person is essential for culturally competent care to be given.

PTS: 1 REF: Chapter: 12 OBJ: Objective: 5 KEY: Content Area: Culture | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Understanding 20.

ANS: 1, 2, 3 Standardized plans of care do not incorporate the patient’s individual cultural needs, which can create a barrier to cultural competence. Showing distaste when the patient describes favorite foods can result in a barrier to culturally competent care. While learning about the patient’s culture is a positive step, the patient may not share every belief and custom, so it is important to individualize care to avoid barriers.

PTS: 1 REF: Chapter: 12 OBJ: Objective: 5 KEY: Content Area: Culture | Integrated Processes: Caring | Client Need: Psychosocial Integrity | Cognitive Level: Applying Chapter 13. Setting Meaningful Priorities Chapter 13: Setting Meaningful Priorities Multiple Choice Identify the choice that best completes the statement or answers the question.

1.

Which of the following is one reason why nurses often resist change?

A lack of assertiveness The history of nursing Many nurses are passive–aggressive.

Change often does not work.

2.

Which of the following is a characteristic of effective people?

Opportunity-oriented Problem-oriented Management-oriented People-oriented

3.

Another term for accidental change is: unintentional change. unplanned change. short-term change.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

change by drift.

4.

1.

2.

3.

4.

Planned change usually comes from which of the following people?

An individual supervisor An administrator An administrative group The director of nursing

5.

Kurt Lewin’s theory of change involves three phases. He called these three phases unfreezing, moving, and .

1. refreezing 2. completed 3. restraining 4. driving

6.

1.

2.

3.

4.

Forces that tell you not to take part in certain behaviors are: subjective forces. restraining forces. objective forces. good forces.

7.

Licensed practical nurses (LPNs) need to be able to identify both driving and restraining forces because they: 1. allow the LPN to be a better nurse.

2. allow the LPN to be a better manager.

3. are key factors in making planned changes.

4. allow the LPN to be more qualified for a job.

8.

1.

2.

3.

4.

Making a planned change in your job depends on your ability to: be selective in your choices. be the first to apply for a position. effectively use your network. make meaningful decisions.

9.

Your long-term care facility is making a change to the team method of caregiving. Administration holds planning meetings for all shifts and keeps all involved employees informed in writing, as well. Which of the following explains the actions of

the administrator?

1.

2.

3.

4.

10.

1.

2.

3.

4.

Planned change Unfreezing Refreezing Moving

What has happened in the process of refreezing?

The change has occurred and has been formalized.

The change has met resistance and has been suspended.

The change has been discussed but has not been implemented.

All driving and restraining forces have been identified.

11.

Which of the following is a common mistake that can be made during the change process?

1.

Failure to provide adequate meeting time 2.

Failure to provide psychological safety for the staff 3.

Failure to identify a mentor 4.

Failure to network

12.

1.

2.

3.

4.

Caring theory practice requires: kindness on the part of the nurse manager frequent staff meetings patience by the nurse an awareness of the implications of change on both you and others

13.

The nurse working in a long-term care facility has joined a committee with the goal of implementing electronic medical records within the next six months. The committee is planning how best to prepare staff for the change. What type of change is occurring?

1.

Planned change 2.

Change by drift 3.

Accidental change 4.

Occidental change

14.

The nurses make walking rounds with the physician on the long-term care unit. At the completion of rounds several nurses gather in the break room and agree that they need to be more effective and efficient the next time rounds are performed. What is the first step these nurses need to take?

1.

Review the process and define the problem.

2.

Suggest ways to improve walking rounds.

3.

Develop a plan to change the way walking rounds are performed.

4.

Select an informal leader to organize the group.

15.

The nurse has worked as a staff nurse in the acute care facility for three years and is considering quitting and taking a job at a large clinic in town. The nurse draws up a list of pros and cons related to the job change. What part of Lewin’s change theory is the nurse demonstrating?

1.

Unfreezing 2.

Moving 3.

Refreezing 4.

Identifying driving and restraining forces

16.

The staff nurses formed a committee to improve holiday scheduling. After several meetings they have designed a new schedule and are preparing to put it into action today. What phase of Lewin’s change theory is this committee performing?

1.

Unfreezing 2.

Moving 3.

Refreezing 4.

Identifying driving and restraining forces

17.

The nurses have performed a comprehensive literature review and used their findings to change the facility’s policy for performing tracheostomy care to make it more evidence-based. The new procedure is put in place, and they are receiving a good deal of positive feedback about the new approach. What phase of the change process are these nurses involved in?

1.

Unfreezing 2.

Moving 3.

Refreezing 4.

Identifying driving and restraining forces

18.

The new graduate LPN accepts a position as a staff nurse in a hospice home-care unit. Upon attending the first staff meeting the nurse learns there has been a problem with keeping nurses safe when visiting certain areas of town, and the nurses are requesting improvement. What role can this new graduate expect to take in the change process?

1.

Participate in the change process.

2.

Identify needed changes.

3.

Recommend changes to improve processes.

4.

Evaluate the effectiveness of change.

19.

The nurse works on a unit that did not have time to fully implement the change process before changing from written time cards to a time clock. What might the nurse experience as a result of this improper preparation of staff nurses?

1.

Reduction in overtime and fewer payroll mistakes 2.

Effective use of the time clock and reduced staff morale 3.

Vandalism to the time clocks and poor morale 4.

Effective use of time clocks and complaints at staff meetings

20.

The nurse reads a research article concluding that patients newly diagnosed with diabetes should receive a referral to a nutritionist to avoid complications.

What is the nurse’s priority action related to evidence-based practice after reading this article?

1.

The nurse should share the article with the nurse manager and suggest changing the procedure to give referrals to all newly diagnosed diabetic patients.

2.

Form a committee to talk with the physicians suggesting the need for a referral to a nutritionist for all diabetic patients on the unit.

3.

Talk to the dietician and suggest he or she talk to diabetic patients who are admitted to the unit from now on.

4.

Conduct a literature search to see if more articles can be found recommending the involvement of a nutritionist in care of the diabetic patient.

21.

1.

2.

3.

4.

What is the LPN’s role related to evidence-based practice?

Analyze the research to determine its credibility for changing practice.

Recommend changes to practice based on the credibility of research.

Be aware of research that could influence how care is delivered.

Ask peers to provide evidence-based research.

Multiple Response Identify one or more choices that best complete the statement or answer the question.

22.

The LPN has worked on this unit at an acute care hospital for the past four years. It is announced that the hospital wants to change the process for admitting new patients. What roles can this nurse serve in the change process? (Select all that apply.)

1.

Participate in the change process.

2.

Identify needed changes.

3.

Recommend changes to improve processes.

4.

Participate in evaluating the effectiveness of change.

5.

Act as the informal leader of the group researching the needed change.

23. The nurse is serving on a committee to implement new cardiorespiratory monitors in the unit. What actions can the committee recommend to avoid the common mistakes that can occur during the change process? (Select all that apply.)

1.

Identify the pros and cons of the new system as compared to the old system.

2.

Allow adequate time for the staff to learn how to work the monitors before installing them.

3.

Provide a resource person knowledgeable about the new monitors when they are put in use.

4.

Keeping the old procedure in place for use of the monitors to prevent confusion 5.

Install the new monitors the day after informing the unit about the change.

24.

The nurse is caring for a patient whose left leg was amputated below the knee following a skiing accident. The nurse recognizes the patient is experiencing a transition to his new body image when observing what characteristics? (Select all that

apply.)

1.

2.

3.

4.

5.

Irritability Anxiety Asking how he will do the things he used to do Depression Wanting to spend all his time in physical therapy

25.

The LPN manager must support the staff as they make the second phase of change, which is moving. In order for this stage to be effective, the manager should: 1. spend time teaching the staff.

2. implement the change prior to unfreezing.

3. criticize mistakes that are made.

4. pay attention to any signs of hyperenergy.

Chapter 13: Setting Meaningful Priorities Answer Section MULTIPLE CHOICE 1.

ANS: 2 Nurses often resist change because of the history of nursing. They have either not been taught how to deal with change or have not had role models for the process of change.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 1 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 2.

ANS: 1 Effective people are opportunity-oriented, not problem-oriented.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 1 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 3.

ANS: 4 Another term for accidental change is change by drift, which occurs as a result of an imbalance in the system.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 1 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing

4.

ANS: 3 Planned change usually comes from an administrative group or committee.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 1 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 5.

ANS: 1 The three phases of change, according to Kurt Lewin, are unfreezing, moving, and refreezing, which are based on the two concepts of driving and restraining forces.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 3 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 6.

ANS: 2 Restraining forces are the realities that tell you not to take part in certain behaviors. This force is one of two concepts that are the basis for Kurt Lewin’s theory of change.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 2 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 7.

ANS: 3 Identification of both driving and restraining forces is necessary for change because it tells LPNs the reason behind certain behavior. Identification of these forces is also a key factor in making a planned change.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 2 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 8.

ANS: 4 Planned change is the most effective and desirable form of change, and it requires meaningful decisions.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 2 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 9.

ANS: 2 Unfreezing allows all involved to understand what is happening and what is being considered. If employees do not understand the change, there will be resistance.

Unfreezing gives everyone assurance that the change is being made for a good purpose.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 3 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 10.

ANS: 1 Refreezing is the final phase of the change process and refers to the fact that the actual change has taken place and has become part of the work routine.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 3 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 11.

ANS: 2 A common mistake that can be made during the change process is failure to provide psychological support for those who are going through the change. People should be allowed to talk out their feelings and should be appreciated for their efforts. Change can be unsettling and it takes time. Supporting staff through change helps ensure that the change will be successful.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 3 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 12.

ANS: 4 Caring theory practice requires awareness of the implications of change on both you and others. When you or others are threatened by change, you cannot move to a higher level on Maslow’s hierarchy, and you may regress to lower levels. You are then unable to contribute to nursing and your job.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 3 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 13.

ANS: 1 This is a planned change with thought going into how to make the transition as easy as possible on the staff.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 1 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 14.

ANS: 4 The first step is selecting an informal leader who will organize the group.

PTS: 1

REF: Chapter: 13 OBJ: Objective: 2

KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 15.

ANS: 4 Identifying driving and restraining forces is another way of saying identifying the pros and cons of the considered change.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 3 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 16.

ANS: 2 Moving is the actual act of making the change, which is what this committee is planning to do today.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 3 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 17.

ANS: 3 Refreezing is settling into the changed situation and developing stability, which is demonstrated in this scenario because the change has been put in place.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 3 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 18.

ANS: 1 The graduate nurse who is new to this department will participate in changes decided by more experienced nurses in the department.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 4 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 19.

ANS: 3 People can regress to violent reactions, such as damaging the time clock, and be very unhappy with the new process if change is not implemented properly.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 5 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 20.

ANS: 4 More evidence is needed before practice should be changed, so it would be wise to find

other articles that supported this change.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 6 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 21.

ANS: 3 The LPN should keep up to date by reading current nursing literature and be aware of trends in nursing that could influence the delivery of care.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 6 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying MULTIPLE RESPONSE 22.

ANS: 1, 3, 4 The nurse can participate in implementing the changes once they are decided. The nurse could act on the committee that will recommend how the processes should be changed.

Once the change is put in place, the nurse could contribute data to help in the evaluation process.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 4 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 23.

ANS: 1, 2, 3 Identifying the driving and restraining forces early in the change process will prevent common mistakes. Allowing adequate time for unfreezing is important to avoid common mistakes when implementing change. Providing for psychological safety in terms of a resource person during the change process will avoid a common mistake.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 5 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 24.

ANS: 1, 2, 3, 4 Irritability, anxiety, and depression are all common responses to transition, as well as a feeling of disconnectedness or incongruity between past and current life.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 6 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 25.

ANS: 1, 4

To implement the moving part of change, the manager needs to show a strong sense of support to the staff, and he or she needs to reinforce the process. Hyperenergy is an unbalanced feeling that indicates people are ready to move ahead. The manager generally needs to spend more time with staff to teach and reinforce the process in which they are engaged.

PTS: 1 REF: Chapter: 13 OBJ: Objective: 3 KEY: Content Area: Change | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying Chapter 14. Handling Conflict in the Nursing Profession Chapter 14: Handling Conflict in the Nursing Profession Multiple Choice Identify the choice that best completes the statement or answers the question.

1.

A nursing student’s friends ask her to go on a weekend camping trip. The student has a major exam on Monday. In helping set personal priorities, what should be considered?

1.

The student’s diminishing finances, which must last throughout the semester.

2.

The student’s parents’ pride in her academic success.

3.

The student’s personal stress level as finals grades are approaching.

4.

The student’s friends, who have supported her in the past.

2. statement?

1.

2.

3.

4.

3.

1.

2.

3.

4.

Which of the following statements is true about your personal mission It remains unchanged throughout your life.

It defines your relationship with society.

It describes your purpose in life.

It requires knowledge of triage and disaster planning.

When setting nursing priorities, which factors must be considered?

Compassion and patient needs Patient and family requests Physician’s orders and patient status Knowledge base and nursing theories

4.

The nurse has given report to the oncoming nurse. She must clock out in 10 minutes to avoid overtime, which has been looked upon as poor time management and discouraged by nursing administration. The oncoming nurse has been called away. A client who has experienced ineffective pain management during the shift is due for more medication and requests it. What is the nurse’s decision-making regarding personal priorities based on?

1.

Alternative plans to meet all of the objectives 2.

A strong knowledge base 3.

Input from others 4.

A personal value system

5.

You have received oncoming report. Using concepts of Maslow and Watson for priority setting, which client would you assess first?

1.

A diabetic patient with a newly diagnosed foot ulcer 2.

A patient who is 3-days postoperative following abdominal surgery with no bowel sounds 3.

An asthmatic pediatric patient with expiratory wheezing 4.

A cardiac client who had chest pain relieved after the third nitroglycerin 1 hour ago.

6. setting?

1.

2.

3.

4.

How does priority setting in your personal setting differ from a clinical Priority setting in a personal setting requires teamwork.

Priority setting in a personal setting requires advanced planning.

Priority setting in a clinical setting requires teamwork.

Priority setting in a clinical setting requires advanced planning.

7.

Your hospital has moved from paper and pen documentation to computerized documentation. Although you have attended the required training session, you still feel it takes longer and is not as descriptive. What is your best response?

1.

Continue charting using paper and pen.

2.

Ask another nurse to chart for you in exchange for you passing her medications.

3.

4.

Resign and look for another job at a hospital with a paper documentation system.

Ask your supervisor for additional training on computerized documentation.

8.

The nurse is caring for a client admitted for complications following an abortion. The nurse values adoption over abortion. How will the nurse best serve this patient?

1.

Discussing her feeling about adoption with the client 2.

Asking the charge nurse for an alternate assignment 3.

Clustering care so she will not have to go into the room often 4.

Ask the local chapter of Planned Parenthood to meet with the client.

9.

A single mother is staying with her 8-month-old daughter, admitted for dehydration secondary to gastroenteritis. After the third hospital day, the exhausted mother states she would like to go home to shower and get clean clothes, but she does not want to leave her daughter. The nurse should: 1. inquire if another family member is available to stay in her absence.

2. offer to stay with her child while the mother is gone.

3. advise the mother to wait until the child falls asleep before she leaves.

4. suggest that someone bring the mother clothes and tell her she can shower at the hospital.

10. difficult?

1.

2.

3.

4.

Which of the following makes decision making during an emergency more The institution’s policies and procedures may not address the specific issue.

The situation may fit Watson’s but not Maslow’s theory.

The consequences to each decision are not known.

The decision may conflict with the nurse’s personal values.

11.

What is the common result when the nurse has not identified her own personal values?

1.

Decisions are made in a timelier manner.

2.

Patient’s input can be utilized in the decisionmaking process.

3.

The care team can be consulted for desirable outcomes.

4.

Delayed decision making results in confusion.

12.

Learning to set meaningful priorities will help the nurse to do what?

Make decisions quickly Make correct decisions Incorporate patients in the decision-making process Become a better member of the healthcare team

13.

The nurse’s personal values help the nurse determine what?

Priorities Culture Ability to work on a team What grade will be earned in class

1.

2.

3.

4.

1.

2.

3.

4.

14.

The nurse begins work by setting priorities of care. What intervention will be the nurse’s highest priority?

1.

Insert a straight catheter to relieve the patient’s urinary retention.

2.

Perform a bed bath to make the febrile patient more comfortable.

3.

Administer a diuretic to the patient with pulmonary edema.

4.

Ambulate the postoperative patient to prevent complications.

15.

Applying Maslow’s hierarchy of needs, what patient requires the nurse’s priority attention?

1.

The patient who is anxious about upcoming surgery

2.

3.

The patient who is lonely and bored The patient who is frightened by a new diagnosis of cancer The patient who is hungry after being NPO for several days

4.

16.

The nurse is caring for a patient who has just signed an informed consent to be included in a research study for an experimental medication. The patient tells the nurse that she really doesn’t want to be part of this study, but her doctor was so excited about the possibilities and talked so ideologically about how her participation could help all of mankind that she felt she couldn’t decline to participate. What is the nurse’s priority action?

1.

Reassure the patient that she did the right thing.

2.

Inform the physician the patient signed the consent under duress.

3.

Document the patient’s statement in the medical record.

4.

Maintain the patient’s confidentiality by not telling anyone what she said.

17.

1.

2.

3.

4.

How does Watson’s theory direct the nurse’s prioritizing of patient care?

The patient who requests the nurse’s attention the most should get it.

The patient who is the sickest should be cared for first.

The patient with the best health insurance should be cared for first.

The patient who can be discharged soonest should receive care first.

18.

The LPN is asked by a physician to administer a medication that can only be administered by an RN or a physician according to facility policy. The LPN explains why she cannot give the medication, but the physician keeps insisting the LPN should give the medication while the physician supervises. What is the best resource for the LPN to use to base decision-making?

1.

The physician’s order 2.

The facility procedure manual 3.

The encouragement of peers 4.

A nursing instructor

19.

The LPN is considering going back to school to become an RN. What type of decision making is required in this situation?

1.

Decisions for a common problem 2.

Decisions based on rules 3.

Emergency decision 4.

Decision allowing time to process

20.

The nurse is working on a busy unit that is short-staffed. Which of the following patient assessments is the highest priority?

1.

A patient with chest pain radiating to the left arm and diaphoresis 2.

A confused patient crying out for her husband who died several years ago 3.

A patient with an elevated temperature requiring an antipyretic 4.

A postoperative patient in severe pain 5.

A patient who is to be discharged tomorrow and needing self-care teaching Chapter 14: Handling Conflict in the Nursing Profession Answer Section MULTIPLE CHOICE 1.

ANS: 3 The only consideration that incorporates the student’s own personal values is the one related to personal stress level.

PTS: 1 REF: Chapter: 14 OBJ: Objective: 1 KEY: Content Area: Priorities | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 2.

ANS: 3 A personal mission statement is your own purpose in life, frequently influenced by family values. It changes as you progress through life.

PTS: 1 REF: Chapter: 14 OBJ: Objective: 2 KEY: Content Area: Priorities | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 3.

ANS: 1 Maslow’s (needs) and Watson’s (caring) theories are perfect examples of a framework for setting meaningful priorities in nursing.

PTS: 1 REF: Chapter: 14 OBJ: Objective: 3 KEY: Content Area: Priorities | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 4.

ANS: 4 The first step in setting personal priorities is to develop a personal value system that will guide the nurse in determining what is most important.

PTS: 1 REF: Chapter: 14 OBJ: Objective: 3 KEY: Content Area: Priorities | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 5.

ANS: 3 Applying the theorist concepts and the ABCs, the patient with altered airway or breathing gets first priority, followed by the patient with circulatory problems.

PTS: 1 REF: Chapter: 14 OBJ: Objective: 3 KEY: Content Area: Priorities | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 6.

ANS: 3 When setting your personal priorities, you often can do that by yourself; but when setting priorities in the clinical arena, teamwork is required.

PTS: 1 REF: Chapter: 14 OBJ: Objective: 4 KEY: Content Area: Priorities | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 7.

ANS: 4 The nurse must learn to work on the changing priorities of the organization and progress toward emerging practice opportunities. The nurse should keep her personal value system of quality and time-efficient patient care representative of the new things she learns.

PTS: 1 REF: Chapter: 14 OBJ: Objective: 5 KEY: Content Area: Priorities | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 8.

ANS: 2 Abortion is against the nurse's personal values, so the nurse should ask the charge nurse to change her assignment. The nurse was better able to serve the client because she was familiar with her own personal values.

PTS: 1 REF: Chapter: 14 OBJ: Objective: 5 KEY: Content Area: Priorities | Integrated Processes: Caring | Client Need: Safe,

Effective Care Environment | Cognitive Level: Applying 9.

ANS: 1 The first step is to define the problem. The problem is that the mother is exhausted and by allowing her to refresh with a trip home to shower and get clean clothes, she will be better able to care for her daughter. The nurse has other patients to care for so cannot offer to stay with the child. If the mother leaves while the child is asleep, the child will be afraid to fall asleep in the future for fear her mother will leave again.

PTS: 1 REF: Chapter: 14 OBJ: Objective: 4 KEY: Content Area: Priorities | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 10.

ANS: 3 In an emergency, the nurse may not know the consequences to each decision, therefore the decision-making processes are more difficult.

PTS: 1 REF: Chapter: 14 OBJ: Objective: 5 KEY: Content Area: Priorities | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 11.

ANS: 4 When the nurse has not established her own personal value system, the decision-making process is more difficult.

PTS: 1 REF: Chapter: 14 OBJ: Objective: 1 KEY: Content Area: Priorities | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 12.

ANS: 1 When the nurse learns about setting priorities, she will be able to make decisions quickly.

PTS: 1 REF: Chapter: 14 OBJ: Objective: 5 KEY: Content Area: Priorities | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 13.

ANS: 1 The nurse’s personal values help determine what is of most importance, or in other words, the nurse’s priorities in life.

PTS: 1 REF: Chapter: 14 OBJ: Objective: 2 KEY: Content Area: Priorities | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 14.

ANS: 3

Pulmonary edema can cause hypoxia, so resolving breathing issues is the highest priority.

PTS: 1 REF: Chapter: 14 OBJ: Objective: 3 KEY: Content Area: Priorities | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 15.

ANS: 4 This patient’s physiological needs would be of higher priority, according to Maslow, than patients with higher level needs.

PTS: 1 REF: Chapter: 14 OBJ: Objective: 3 KEY: Content Area: Priorities | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing 16.

ANS: 2 It is the nurse’s responsibility to inform the physician that the patient signed the consent because she felt she had to, which is a form of duress. This puts the nurse in the role of advocating for the patient.

PTS: 1 REF: Chapter: 14 OBJ: Objective: 4 KEY: Content Area: Priorities | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 17.

ANS: 2 Watson’s theory of caring says the sickest patient should receive care first.

PTS: 1 REF: Chapter: 14 OBJ: Objective: 3 KEY: Content Area: Priorities | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 18.

ANS: 2 The facility procedure manual will tell the nurse exactly what is allowed and would be a good resource for decision making.

PTS: 1 REF: Chapter: 14 OBJ: Objective: 4 KEY: Content Area: Priorities | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 19.

ANS: 4 This is a decision that can be made over time, which allows time to consider many factors and to process them.

PTS: 1 REF: Chapter: 14 OBJ: Objective: 5 KEY: Content Area: Priorities | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying

20.

ANS: 1 The patient with chest pain is the highest priority because altered circulation takes priority over everything except airway and breathing problems.

PTS: 1 REF: Chapter: 14 OBJ: Objective: 4 KEY: Content Area: Priorities | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Analyzing Chapter 14. Handling Conflict in the Nursing Profession Chapter 14: Welcome to Conflict Multiple Choice Identify the choice that best completes the statement or answers the question.

1.

Poorly managed conflict:

1.

2.

is inevitable. is a result of putting nurses in management roles. results in lowered productivity. is caused by autocratic managers.

3.

4.

2.

Well-managed conflict:

1.

2.

3.

4.

can stimulate competition. identifies legitimate differences. serves as a strong motivator for employees.

All of the above are correct.

3.

1.

2.

3.

4.

Conflict is best handled by: managing it. avoidance behavior. aggressive management. passive management.

4. Category-two conflict, or mental struggle resulting from incompatible or opposing needs, drives, wishes, or internal or external demands, is best demonstrated by which scenario?

1.

Students compete for front-row seating in the classroom.

A student disagrees with an instructor’s point of view.

A student is unhappy with her clinical assignment due to attitudes of staff.

Two nurses bicker over who gets which patient assignments.

2.

3.

4.

5.

Category-three conflict is best demonstrated by which scenario?

Students compete to register early for favorite classes.

Two nurse’s aides argue about whose turn it is to take care of a belligerent patient.

A husband and wife argue about the time the wife spends on her nursing studies.

Faculty compete for merit raises.

6.

In order for you to understand conflict, you must be able to: quickly judge the behavior of those involved. identify the conflict and its category. manage the conflict yourself. realize that conflict is inevitable.

1.

2.

3.

4.

1.

2.

3.

4.

7.

(LPNs) is: 1.

2.

3.

4.

A strong and frequent cause of conflict for licensed practical nurses scarce resources. family problems. unclear roles. competition among staff nurses.

8.

As an LPN charge nurse, one of the best actions you can take when there is a problem of scarce resources is to: 1. be proactive and manage potential conflict.

2. wait until a decision has to be made.

3. keep everyone at a distance.

4. do nothing and wait until your supervisor gives you directions.

9.

The most effective way for you, the charge nurse, to manage perceived

conflict is to: 1.

wait until the argument takes place, because you are only relying on your feelings. have individual conversations with those you think sense these feelings. bring everyone together in the same meeting to express feelings. be aggressive in getting answers to your questions.

2.

3.

4.

10.

1.

2.

3.

4.

The greatest cause of conflict is: uncaring and aggressive nurses. managers who distance themselves. an unresolved conflict. a manager who uses win–lose strategies.

11.

Which of the following conflict management strategies is considered the most desirable?

1.

Win–win 2.

Win–yield 3.

Win–lose 4.

Yield–lose

12. You work on a skilled unit in a long-term care facility. Over the past several months, there has been conflict over the schedule. Your manager should use which of the following methods to resolve this conflict successfully?

1.

Staff meetings so that everyone can state their complaints about the schedule 2.

Ask the director of nursing to step in and settle the problem once and for all.

3.

Use the process of negotiation.

4.

Inform the staff that the schedule will be followed without further changes or discussion.

13.

Which of the following techniques should be used when a staff member has lost his or her temper?

1.

Do what comes naturally and respond with anger.

2.

3.

4.

Listen in a respectful, polite way.

Ask the staff member why he or she is angry.

Refuse to listen to this person because he or she is simply too upset at this point.

14.

What is your responsibility in a threatening situation with a staff member on your unit?

1.

Protect yourself; do not worry about others at this time.

2.

Attempt to remove the person from the unit.

3.

Immediately call the police.

4.

Protect yourself, other employees, and patients and their families.

15.

What is the term for listening respectfully and not responding with anger to another who is angry?

1.

Negotiation 2.

Good management 3.

White out 4.

Brown out

16.

When negotiating because of a conflict you should: quickly respond with an answer. take what is said personally; after all, this conflict does affect you. respond with criticism. identify the need that the person is expressing.

17.

In which of the following situations is conflict always present?

Lose–lose Yield–lose Win–yield Win–lose

1.

2.

3.

4.

1.

2.

3.

4.

18. to conflict?

1.

2.

Which of the following theories will help you develop a positive approach Caring theory Transactional analysis theory

Maslow’s theory Lewin’s theory

3.

4.

19.

1.

2.

3.

4.

In the ideal work situation what description of conflict is best?

There is no conflict and everyone gets along.

Some conflict is beneficial to the organization.

Frequent conflict arises and almost everyone conflicts daily.

A constant state of conflict with many angry people

20.

A coworker makes nasty comments to the nurse and the nurse notices the coworker shooting dirty looks at the nurse. The nurse approaches the coworker and says, “You seem angry with me. Can we talk about what’s bothering you?” The coworker responds, “I’m not angry with you. Everything is fine.” What behavior is this coworker demonstrating?

1.

Conflict management 2.

Conflict control 3.

Passive-aggressive 4.

Aggressive

Multiple Response Identify one or more choices that best complete the statement or answer the question.

21.

What are causative factors for how conflict occurs in the nurse’s work environment? (Select all that apply.)

1.

Competitve actions of incompatibles 2.

Mental struggle between opposing internal or external demands 3.

Hostile encounter or collision 4.

Intrinsic human behavior 5.

Mental illness

22.

What are the never-changing rules of conflict the nurse must know about a conflict situation? (Select all that apply.)

1.

Conflict is inevitable.

2.

Results of conflict can be constructive.

3.

Conflict is often best managed by ignoring it.

4.

5.

Violence is sometimes essential to conflict.

Conflict is an indication of a lack of education.

23.

The nurse is negotiating as the first step toward conflict resolution after finding two coworkers arguing in the medication room. What rules must the nurse know to negotiate successfully between these two coworkers? (Select all that apply.)

1.

Don’t take what is said personally.

2.

Don’t get defensive.

3.

Identify the need being expressed.

4.

Determine which person is willing to concede their need.

5.

Be prepared to choose a winner.

24.

Category one, or the conflict from competitive or opposing actions, is shown by: (Select all that apply.)

1. two friends who have a disagreement.

2. racial prejudice.

3. students who compete for an “A” in a course.

4. an ongoing feud between two neighbors.

5. an argument between siblings.

25.

When an LPN distances coworkers, what is the result? (Select all that apply.)

1.

It brings the staff too close together.

2.

It causes others on the staff to feel left out.

3.

It increases personal conflicts among staff.

4.

It causes the rest of the staff to “white out.”

5.

It creates a warm, caring workplace.

Chapter 14: Answer Section

MULTIPLE CHOICE 1.

ANS: 3 Poorly managed conflict can create distance and distrust among employees and lead to lowered productivity or less attention to the quality indicators of patient care.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 1 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing

2.

ANS: 4 Well-managed conflict can stimulate competition, identify legitimate differences and problems in an organization, and serve as a strong motivator for employees.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 1 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 3.

ANS: 1 Currently, sociologists say that conflict should not be encouraged or discouraged, but when it occurs, it must be managed.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 4 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 4.

ANS: 1 When individuals or groups of people participate in a mental struggle resulting from incompatible or opposing needs, drives, wishes, or external or internal demands, they have a category-two conflict. This is a conflict that often focuses on the distribution of scarce resources.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 2 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 5.

ANS: 2 The third category of conflict is a hostile encounter or a collision.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 2 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 6.

ANS: 4 Conflict is a reality that is present in all aspects of life, and also in all organizations because of their complexity and the multiple interactions of those who work in these organizations. Conflict is inevitable.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 1 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 7.

ANS: 3 Unclear roles for LPNs are a potential source of conflict. The way that LPNs are assigned

in healthcare often leads to unclear roles. To alleviate or prevent any conflict when a change in assignment is taking place, the LPN should clarify with management the extent of the role and the length of time this change will remain in effect.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 2 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 8.

ANS: 1 A problem of scarce resources calls for you to be proactive and manage potential conflicts before they escalate into unmanageable situations.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 3 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 9.

ANS: 2 Perceived or felt conflict is the feeling you have when you think someone is upset with you. When there is a perceived conflict, for any reason, people feel that something is going to happen. They are nervous and edgy, so it is important for you to talk to people individually in a pleasant and caring manner about their perception of the situation. After you have obtained enough information, you can return to the group and share the information with them.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 4 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 10.

ANS: 3 Unresolved conflict is the greatest cause of conflict, which occurs when an individual is aggressive and devalues another person. Angry feelings remain unresolved because the devalued person does not know how to manage the conflict.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 2 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 11.

ANS: 1 A win–win strategy is the most effective conflict management strategy because it brings out the best in people. This strategy is based on caring theory, and it values others and their ideas.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 4 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing

12.

ANS: 3 Your nurse manager should use negotiation to resolve this conflict because it has come up repeatedly and negotiation is necessary for a win–win result. Telling the staff what to do will only temporarily solve the conflict, while the problem with the schedule will continue to exist.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 4 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 13.

ANS: 2 A good technique for dealing with this situation is to stop and listen without returning the anger. Returning the anger only makes the situation worse.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 4 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 14.

ANS: 4 In a threatening situation, you should white out and give the person what he or she wants.

Let the person go and then call security. Your responsibility is to protect yourself, other staff, and patients and their families.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 3 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 15.

ANS: 3 White out means that you do not respond to a person who is angry, but you stop and listen to the angry person in a respectful and polite way.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 5 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 16.

ANS: 4 A rule of successful negotiation is that you identify the need the employee is expressing.

You cannot solve a problem when you do not know the need that is not being met. You need to use Maslow’s hierarchy of needs.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 6 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding

17.

ANS: 1 Conflict is active and always present in a lose–lose situation. There are never winners when this management style is used. Anger and frustration are constantly present, and most people will not remain in this work environment.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 4 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 18.

ANS: 2 Transactional analysis is a theory of human behavior. This theory provides a framework for thinking about life in a positive way and shows you how to develop a positive approach to conflict and its management.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 3 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 19.

ANS: 2 Some conflict is desirable because conflict is necessary to bring awareness of needs and act as an impetus to make changes.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 1 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 20.

ANS: 3 The coworker is demonstrating passive-aggressive behavior, which includes angry body language and nasty comments while denying there is a problem.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 4 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying MULTIPLE RESPONSE 21.

ANS: 1, 2, 3 The conflict that results from competitive or opposing actions of incompatible people or ideologies is common in most people’s lives. Some people, groups, and whole societies are simply incompatible. When individuals or groups of people participate in a mental struggle resulting from incompatible or opposing needs, drives, wishes, or external or internal demands, they have a category-two conflict. This is a conflict that often focuses on the distribution of scarce resources. The third category of conflict is a hostile encounter or a collision.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 2 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 22.

ANS: 1 Conflict is inevitable is rule one, and it can be found everywhere. The results of conflict can be constructive if there is a complete analysis of the conflict before its escalation to unmanageable proportions.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 2 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 23.

ANS: 1, 2, 3 The information you have asked for may be negative about the organization, you as a manager, or your best friend who also works on the unit. Don’t take it personally. Just listen, and try to identify the core of the problem. Often when people are criticized in an angry manner, it is natural to become defensive and protect their ego, job, friend, or whatever is being criticized. Don’t do what comes naturally. Don’t get defensive. Identify the need being expressed because it will help to identify the problem at the heart of the argument.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 6 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 24.

ANS: 2, 4 Category one conflict results from competitive or opposing actions of incompatible people, groups, or whole societies. Family feuds, wars, and all racial prejudice are examples of this type of conflict.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 2 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 25.

ANS: 2, 3 The result of the LPN distancing others is that they feel discriminated against or left out, while some may feel that they are not good enough for this person. Distancing also increases the potential for conflict and a lack of camaraderie among the staff.

PTS: 1 REF: Chapter: 15 OBJ: Objective: 3 KEY: Content Area: Conflict | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding Chapter 15. Dealing with Chaos

Chapter 15: Dealing with Chaos Multiple Choice Identify the choice that best completes the statement or answers the question.

1.

Which of the following is a characteristic of the Newtonian Age? Industrialization Chaos Organization Unpredictability

2.

Newtonian nurses are considered to be good at: following orders and taking direction. creative problem-solving. focusing on patient outcome. taking time to sit with families and provide emotional support.

3.

With quantum mechanics, humans recognize: orderliness. mechanization. structure. the dynamics of life and its living qualities.

4.

New Science nursing is:

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

procedure oriented. focused on person outcomes. focused on rules and regulations. time-oriented.

5.

1.

2.

3.

4.

The New Science Age stresses: predictability. empowerment for everyone. order. paperwork.

6.

Much of the chaos that is present in healthcare comes from:

1.

the mix of Newtonian and New Science nurses and doctors. the demands of health maintenance organizations. the lack of healthcare coverage for many Americans. the opposition of some physicians to the insurance companies.

2.

3.

4.

7.

You are working as a staff nurse on a 20-bed medical-surgical unit in the hospital. One of the registered nurses (RNs) called in sick, no unit secretary has arrived, doctors have been in early, and a stack of charts needs attention. In addition, there are some very ill patients who require immediate attention. The staff currently consists of one RN, you (the licensed practical nurse [LPN]), and two certified nursing assistants (CNAs). A unit secretary has been promised but has not come yet. Which of the following terms best describes the situation?

1.

Newtonian 2.

Empowerment 3.

Chaos 4.

Quantum mechanics

8.

1.

2.

3.

4.

When chaos exists in your work situation, what will happen?

Total disruption of patient care People will self-organize Failure of the staff to cooperate with each other The nurse manager will delegate certain functions

9.

A New Science nurse manager provides which of the following environments for employees?

1.

Controlled 2.

Relaxed 3.

Empowering 4.

Pleasant

10.

Licensed nurses have the authority to delegate duties. Which of the following gives nurses that authority?

1.

The state health department

2.

3.

4.

The Nurse Practice Act The American Hospital Association The American Nurses Association

11.

Before LPNs can delegate a function to the CNA, they must: assess the patient carefully. evaluate the patient carefully. plan the care for the patient. write out instructions for the CNA.

12.

A rule of delegation is:

1.

2.

3.

4.

1.

2.

choose only the best person for the job. determine if the person is qualified to perform the task. follow the procedure in your policy manual. delegate only to other nurses.

3.

4.

13.

You get certain benefits when you delegate functions to the CNA. One is: you will have more time to relax. you create an empowering environment for the CNA by teaching what you know. you will finally be able to take breaks and lunch. you will be able to write a better evaluation of the CNA.

14.

A basic principle of making chaos work is being able to: perform procedures quickly. tell your supervisor that you need help. delegate properly. assess your patients carefully.

15.

Which of the following theories is the best approach for nursing today?

Newtonian theory Caring theory Maslow’s theory The New Science theory

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

16.

Which of the following examples is the current measure of nursing excellence in practice?

1.

Statistics demonstrating positive patient outcomes 2.

Staffing ratio of one nurse to five patients 3.

Hospital cleanliness 4.

Nurses wearing white uniforms and caps

17.

What is the primary term for defining the view of the universe according to quantum physics?

1.

Compartmentalized 2.

Subatomic 3.

Chaotic 4.

Orderly

18.

The nurse needs to delegate care of a patient to the certified nursing assistant (CNA). Care of which patient would be most appropriate to delegate?

1.

Mrs. Smith, who is being discharged today 2.

Mr. Jones, who was admitted last night after experiencing a right-sided stroke 3.

Mrs. Franklin, who is bedridden and requires total am care 4.

Mr. Morrison, who is going to surgery today to have his fractured hip repaired

Multiple Response Identify one or more choices that best complete the statement or answer the question.

19.

The nurse has delegated ambulating a patient to a certified nursing assistant. What statement is true regarding the nurse’s legal obligation to the patient?

(Select all that apply.)

1.

The nurse is responsible for performing the task.

2.

The nurse is accountable for the safety of the patient.

3.

The nurse is accountable for making sure the task is performed safely.

4.

If the patient falls the nurse is accountable and responsible for any patient injury.

5.

If the patient falls the CNA is not responsible or accountable.

20.

What characteristics would the Newtonian nurse use when providing patient care? (Select all that apply.)

1.

Orderly 2.

Compartmentalized 3.

Predictable 4.

Unquestioning 5.

Chaotic Chapter 15: Dealing with Chaos Answer Section MULTIPLE CHOICE 1.

ANS: 3 A strong sense of organization is a characteristic of the Newtonian Age. Because of Newtonian physics, the world was orderly, predictable, and compartmentalized. The Age of Industrialization demonstrated Newtonian physics.

PTS: 1 REF: Chapter: 16 OBJ: Objective: 1 KEY: Content Area: Chaos | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 2.

ANS: 1 Newtonian nursing is orderly and predictable. These nurses follow orders without question and obey the rules.

PTS: 1 REF: Chapter: 16 OBJ: Objective: 1 KEY: Content Area: Chaos | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 3.

ANS: 4 Quantum mechanics helps humans recognize the dynamics of life and its living qualities.

PTS: 1 REF: Chapter: 16 OBJ: Objective: 2 KEY: Content Area: Chaos | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 4.

ANS: 2 New Science nursing focuses on person outcome whether that person is the patient, the patient’s family, or the staff. These people are all more important than performing the task.

PTS: 1 REF: Chapter: 16 OBJ: Objective: 2 KEY: Content Area: Chaos | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 5.

ANS: 2 The New Science Age stresses empowerment for all, allowing nurses to focus on people and providing the opportunity to move up Maslow’s hierarchy.

PTS: 1 REF: Chapter: 16 OBJ: Objective: 2 KEY: Content Area: Chaos | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 6.

ANS: 1 The mix of Newtonian and New Science by doctors and nurses creates chaos, because one functions under order and rule and the other focuses on people and relationships.

PTS: 1 REF: Chapter: 16 OBJ: Objective: 4 KEY: Content Area: Chaos | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 7.

ANS: 3 Chaos is a movement away from order and occurs frequently in nursing. Every factor in this situation has contributed to the chaos.

PTS: 1 REF: Chapter: 16 OBJ: Objective: 4 KEY: Content Area: Chaos | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 8.

ANS: 2 When chaos exists, people will self-organize. This is known as the strange attraction theory.

PTS: 1 REF: Chapter: 16 OBJ: Objective: 4 KEY: Content Area: Chaos | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 9.

ANS: 3 A New Science nurse manager creates an empowering environment for his or her staff.

This theory states that one should focus on people and relationships because they are more important than task outcome.

PTS: 1 REF: Chapter: 16 OBJ: Objective: 3 KEY: Content Area: Chaos | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding

10.

ANS: 2 The Nurse Practice Act in each state gives both LPNs and RNs the authority to delegate.

PTS: 1 REF: Chapter: 16 OBJ: Objective: 5 KEY: Content Area: Chaos | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 11.

ANS: 1 Before actually delegating a task, the LPN must carefully assess the patient. Delegation means that, for one time only, you are transferring to another person a specific function for a specific patient.

PTS: 1 REF: Chapter: 16 OBJ: Objective: 5 KEY: Content Area: Chaos | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 12.

ANS: 2 You must be sure that the person is qualified and can safely perform the task. You are totally responsible for any task you delegate.

PTS: 1 REF: Chapter: 16 OBJ: Objective: 5 KEY: Content Area: Chaos | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 13.

ANS: 2 Your delegation creates an empowering environment because it shows that you value your relationship with the CNA. When you see a problem, you take the time to teach and share your knowledge. You also encourage the CNA to learn, grow, and work with others.

PTS: 1 REF: Chapter: 16 OBJ: Objective: 6 KEY: Content Area: Chaos | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 14.

ANS: 3 Delegating properly by following all of the rules of delegation is a basic principle of making chaos work. By delegating, you create an empowering environment, and you believe in staff collaboration.

PTS: 1 REF: Chapter: 16 OBJ: Objective: 4 KEY: Content Area: Chaos | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 15.

ANS: 4 The New Science, or quantum mechanics, approach works best in today’s healthcare

settings because it allows nursing leaders to focus on patient outcomes. The emphasis in nursing today is on this approach.

PTS: 1 REF: Chapter: 16 OBJ: Objective: 2 KEY: Content Area: Chaos | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 16.

ANS: 1 Cost effectiveness and patient outcomes are the current measures of nursing excellence.

PTS: 1 REF: Chapter: 16 OBJ: Objective: 3 KEY: Content Area: Chaos | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 17.

ANS: 3 Quantum physics sees the world as chaotic and ever-changing.

PTS: 1 REF: Chapter: 16 OBJ: Objective: 2 KEY: Content Area: Chaos | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 18.

ANS: 3 This patient would be a good patient to be cared for by the CNA because she requires basic care.

PTS: 1 REF: Chapter: 16 OBJ: Objective: 5 KEY: Content Area: Delegation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying MULTIPLE RESPONSE 19.

ANS: 2, 3 The nurse remains accountable for the safety of the patient and should not delegate to anyone who is unable to perform the task properly. The nurse should supervise performance of the task to make sure it is done safely.

PTS: 1 REF: Chapter: 16 OBJ: Objective: 1 KEY: Content Area: Chaos | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 20.

ANS: 1, 2, 3, 4 Newtonian nursing is orderly, compartmentalized, and predictable. Nurses followed physicians’ orders without questioning them.

PTS: 1

REF: Chapter: 16 OBJ: Objective: 1

KEY: Content Area: Chaos | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying Chapter 16. Ethics and Law in Nursing Management Chapter 16: Ethics and Law in Nursing Management Multiple Choice Identify the choice that best completes the statement or answers the question.

1.

The theory of utilitarianism states that an ethical decision is based on the greatest good for the greatest number of people. This theory often leaves out which of the following groups?

1.

Elderly people 2.

Those who are in a minority 3.

Patients who, for the most part, can independently care for themselves 4.

Certain ethnic groups

2.

You are a nurse manager on the 11 p.m. to 7 a.m. shift. You periodically make rounds, observing and checking on your staff and residents. You do this on a regular basis throughout your shift because: 1. your facility requires you to do so.

2. the policy manual states this as a regulation.

3. you are responsible for the behavior of those you manage.

4. state law requires this action.

3.

Your orientation as a nurse manager in a long-term care facility was done quickly. You are unsure of some of the regulations relating to your new position. As a responsible nurse manager, what should you do to remedy this situation?

1.

Review your agency regulations and know the Nurse Practice Act. 2.

When a situation comes up, ask the staff what the normal procedure is.

3.

Call the state board of nursing.

4.

Call the state department of health.

4.

You are a student practical nurse assigned to a medical-surgical unit. The night before going to the clinical area, you are very tired and fail to look up your patient’s diagnosis as assigned. Which of the following is appropriate?

1.

Ask your friend to quickly give you the information during shift report.

Look up the information while your patient is eating breakfast.

Use break time to get the information you need.

Tell your instructor what happened as soon as you arrive in the clinical area.

2.

3.

4.

5.

You are an LPN employed in your first job. A resident complains to you about the care and incompetence of a nurse on the previous shift. Which of the following actions is most appropriate?

1.

Discuss the situation with another staff member.

2.

Argue with the resident.

3.

Agree with the resident.

4.

Report the incident to your head nurse or supervisor.

6.

Ethical dilemmas are situations that result in a fundamental values.

1. conflict 2. blending 3. change 4. discussion

of two or more

7.

Your classmate, who is also a good friend, tells you this morning that she didn’t have time to study for the anatomy and physiology test because her daughter was sick all night. She sits next to you in class and asks you to position your answer sheet so that she can copy your answers. You reply that you are very sorry, but that you do not feel it would be appropriate behavior to do so. You suggest that your friend talk to the instructor to see if she can take the test at a later time. Your actions exhibit: 1. ethical behavior.

2. unethical behavior.

3. abuse of power.

4. deontology.

8.

1.

Another term for ethical behavior is: mandatory.

2.

3.

4.

lawful. appropriate. ideal.

9.

David, a student practical nurse, is bathing Mr. Smith. He puts on gloves to brush Mr. Smith’s dentures and keeps the same gloves on throughout the bath. His reasoning is that he will be able to get the bath finished more quickly and allow Mr. Smith to rest. This is an example of: 1. ethical behavior.

2. unethical behavior.

3. abuse of power.

4. deontology.

10.

You make an error while caring for a patient. Which of the following is the appropriate person to whom to report the mistake?

1.

Your classmate 2.

Wait until you go off duty and then report the error to your instructor.

3.

Report the error to your instructor immediately.

4.

Leave your clinical area immediately and go see the director of the nursing program.

11.

1.

2.

3.

4.

12. following?

1.

2.

3.

4.

Personal values are: customs of society. personal beliefs about truth, behavior, and thoughts. society’s behavioral code. legal standards of an action.

When a nurse uses ethical reasoning, the nurse does which of the Clearly identifies the issue based on the perspective of the persons involved Follows gut reaction and trusts instincts Ignores personal values Puts a plan into action but does not need to evaluate the plan

13.

The LPN is assigned to 30 residents in a LTC facility. She is administering medications and is supposed to administer a heart medication. The apical pulse must be taken before the medication is given. The nurse feels she just doesn’t have time to stop and take the pulse. When she charts, she looks at the record of previous pulse counts and arrives at an average. She charts this pulse with the medication. This is an example of: 1. ethical behavior.

2. unethical behavior.

3. abuse of power.

4. deontology.

14.

The night shift nurse is late in coming into work to relieve the evening shift nurse. The evening shift nurse does not leave until a replacement nurse can be found. This is an example of the theory of: 1. unethical behavior.

2. utilitarianism.

3. negligence.

4. deontology.

15.

Using animals for research studies for human drugs is an example of which theory?

1.

Utilitarianism 2.

Deontology 3.

Permission to treat 4.

Informed consent

16.

1.

2.

3.

4.

The Nurse Practice Act is an example of which type of law?

Common Statutory Institutional policies and procedures Criminal

17.

The rule that states a nurse must delegate care to another nurse while on a lunch break is an example of: 1. regulatory law.

2. statutory law.

3. institutional policies and procedures.

4. criminal law.

18.

A nurse works in delivery and is attending two women in labor. The patient in bed A asks how dilated the patient in bed B is. The nurse tells her, “She is farther along than you. She is 7 cm dilated and 100 percent effaced.” This is an example of: 1. standard of care.

2. informed consent.

3. permission to treat.

4. breaking confidentiality.

19. is: 1.

One way to assure that you, as the nurse, have permission to treat a patient ask the patient to sign an informed consent document each time you administer medications. explain to patients the procedure you are going to do and what to expect. check admitting documents for permission to treat before entering a patient’s room. have patient cosign physician orders and medication sheets.

2.

3.

4.

20.

Prior to surgery, the nurse should assure that which of the following tasks has been completed?

1.

Informed consent has been signed by the patient.

2.

ID band is attached to the patient.

3.

The patient understands the type of surgery that is being performed.

4.

All of the above are correct.

21.

A nurse writes in the nursing notes that a physician is “unreasonable and refuses to prescribe morphine for a patient in pain.” This is an example of: 1. informed consent.

2. libel.

3. slander.

4. negligence.

22.

The purpose of advanced directives is:

1.

2.

3.

4.

to give guidance to the person who has durable power of attorney. to give caregivers authority to allow a patient to die with dignity. to allow an individual to instruct caregivers prior to surgery what their wishes are about end-of-life decisions.

All of the above are correct.

23.

Which of the following individuals cannot be sued for malpractice in the event of a case of negligence?

1.

Physician 2.

Pharmacist 3.

Licensed practical nurse 4.

Certified nursing assistant

24.

An LPN on the unit has a name tag that has her name and RN listed after it. She doesn’t change it because she is an RN student. This is an example of: 1. fraud.

2. negligence.

3. battery.

4. against medical advice.

25.

A nurse asks you to hold a patient down against his wishes while she attempts to start an IV. If you do this, you can be prosecuted for: 1. assault.

2. battery.

3. performing a procedure against medical advice.

4. libel.

26.

What best demonstrates the student nurse performing in an ethical manner in the clinical setting?

1.

Performing procedures as taught 2.

Talking with patients 3.

Using the personal cell phone as infrequently as possible 4.

Visiting with family members

27.

1.

2.

3.

4.

How do novice student nurses make ethical decisions?

Based on their intuition Based on the class’s consensus Based on facts and instructor guidance Based on what they think is right

28.

A nurse gives a diabetic inpatient an injection of regular insulin as ordered. The patient is not checked for 4 hours. The patient is found dead due to insulin shock. What does this demonstrate?

1.

Negligence 2.

Libel 3.

Slander 4.

Acting outside the scope of practice

29.

A resident in a long-term care facility is status poststroke and has difficulty swallowing. She is left to eat her meal on her own and has a choking incident in which she aspirates a portion of her meal. What does this constitute?

1.

Negligence 2.

Libel 3.

Slander 4.

Acting outside the scope of practice

30.

A patient is experiencing delirium tremens as a result of alcohol withdrawal. The nurse applies soft wrist and ankle restraints without an order demonstrating what?

1.

Slander 2.

Libel 3.

False imprisonment 4.

Malpractice Chapter 16: Ethics and Law in Nursing Management Answer Section MULTIPLE CHOICE 1.

ANS: 2 Use of the utilitarian approach often neglects those who are in a minority and may have special or serious needs.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 2 KEY: Content Area: Ethics & Law | Integrated Processes: Caring| Client Need: Safe,

Effective Care Environment | Cognitive Level: Knowing 2.

ANS: 3 A nurse manager has additional legal responsibilities. As a manager, you are responsible not only for your own behavior, but also for the behavior of those whom you supervise.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 3 KEY: Content Area: Ethics & Law | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 3.

ANS: 1 When you obtain a management position, you must be responsible for informing yourself about laws and agency regulations that apply to your position. It is also a good idea to informally increase your knowledge through nursing journals and newspapers.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 4 KEY: Content Area: Ethics & Law | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 4.

ANS: 4 It is not ethical behavior for you to get the information you need from others or make do with limited information. Go to the instructor immediately so that the instructor can assist you in getting the correct information you need to provide safe patient care.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 1 KEY: Content Area: Ethics & Law | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 5.

ANS: 4 Reporting the error to your supervisor is the appropriate action. The supervisor is then responsible for speaking to the resident and finding out what happened. Also, every person in the healthcare system has the absolute right to be protected from being discussed by inappropriate persons.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 1 KEY: Content Area: Ethics & Law | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 6.

ANS: 1 Ethical dilemmas are situations that result in a conflict of two or more fundamental values. These dilemmas are complex and do not have apparent solutions.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 1 KEY: Content Area: Ethics & Law | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level:

Knowing 7.

ANS: 1 This is an example of ethical behavior. Even though your classmate may not be happy with your response, it is the correct action. It is very likely that when the instructor learns of the problem, the instructor would delay the test for this student. If you had allowed her to see your paper, you share in the act of cheating with your classmate. Cheating is never ethical behavior. Also, students must adjust their lives so they have time for study.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 1 KEY: Content Area: Ethics & Law | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 8.

ANS: 4 Ethical behavior is the quest for ideal behavior.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 1 KEY: Content Area: Ethics & Law | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 9.

ANS: 2 This is an example of unethical behavior. David's reasoning is faulty. Through his actions, he is putting his patient at risk for an infection. This should be his first priority in caring for Mr. Smith. His second priority should be to get the bath done well with good technique in a timely manner, so his patient will be comfortable and able to rest.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 1 KEY: Content Area: Ethics & Law | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 10.

ANS: 3 Reporting to your instructor immediately is responsible and accountable behavior.

Nursing requires ideal behavior both as a student practical nurse and as a licensed practical nurse.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 7 KEY: Content Area: Ethics & Law | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 11.

ANS: 2 Personal values are personal beliefs about truth, thoughts, and behaviors of another person. These values are the underlying principle of ethical behavior.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 3 KEY: Content Area: Ethics & Law | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 12.

ANS: 1 Using this type of thinking, the nurse does follow personal values and recognizes personal values of all involved. The nurse does not trust “gut reaction” but follows the steps for ethical reasoning.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 1 KEY: Content Area: Ethics & Law | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 13.

ANS: 2 This is an example of unethical behavior. The LPN is required to administer medication with accuracy. She is also lacking in honesty when she charted a blood pressure she did not take. Finally, she is putting the patient at risk. Perhaps the patient’s blood pressure reading is such that the medication should be withheld and the doctor notified.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 2 KEY: Content Area: Ethics & Law | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 14.

ANS: 4 Duty is what the theory of deontology represents. It is the nurse’s duty to remain at work until a competent replacement arrives. Leaving before the night nurse arrives is patient abandonment and can result in license suspension.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 2 KEY: Content Area: Ethics & Law | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 15.

ANS: 1 Utilitarianism is the doctrine that what is useful is good and the determining consideration of right conduct should be the usefulness of its consequences. In other words, determining what is “right” is based on the greatest benefit for the greatest number of people.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 2 KEY: Content Area: Ethics & Law | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding

16.

ANS: 2 Statutory law has two component parts: enacted law and regulatory law. Enacted laws are the written and passed by a law-making body, such as the state and national legislatures.

Enacted laws also can be made by city councils and county organizations. Regulatory laws are made by regulatory agencies to regulate or govern according to established rules.

For example, regulatory laws for nursing are the rules and regulations of the State Board of Nursing.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 5 KEY: Content Area: Ethics & Law | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 17.

ANS: 3 Institutional policies and procedures provide guidance to the nurse as to how a situation should be managed and the proper course of action to be taken. Frequently the court will consider institutional policies as common law.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 5 KEY: Content Area: Ethics & Law | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 18.

ANS: 4 In addition to what a patient may share with you, you have access to the person’s hospital records. The law requires you to treat all such information with strict confidentiality.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 7 KEY: Content Area: Ethics & Law | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 19.

ANS: 2 Patients admitted to hospitals, nursing homes, and home health services, sign a document that gives personnel permission to treat them. However, every time the nurse provides nursing care to a person, permission must be obtained. The courts have ruled that people are expected to have some understanding of basic care, which means the nurse should briefly explain what he or she is about to do without going into an exhaustive explanation.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 7 KEY: Content Area: Ethics & Law | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding

20.

ANS: 4 The law states that the persons receiving healthcare must give permission to treat based on informed consent. The principle of informed consent states that the person receiving the treatment fully understands the possible outcomes, alternatives to treatment, and all possible consequences.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 5 KEY: Content Area: Ethics & Law | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 21.

ANS: 2 Defamation of character is the act of sharing information that is malicious and false.

When the defamation is written it is called libel. Libelous defamation is most frequently seen on a chart when inappropriate comments are made about a patient or the patient’s family.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 7 KEY: Content Area: Ethics & Law | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 22.

ANS: 4 The purpose of advance directives is to give the person an opportunity to make decisions regarding healthcare before an illness or a need for treatment that would prohibit making such critical decisions. The major decision made is in regard to resuscitation. Some people have assigned a durable power of attorney to someone they trust to make healthcare decisions in their stead. Often, people designate on their advance directive a person assigned to sign consent forms and make other decisions about the welfare and treatment of the patient.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 7 KEY: Content Area: Ethics & Law | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 23.

ANS: 4 Malpractice is a term used for negligence. It specifically refers to negligence by a professional person with a license. CNAs do not have a license.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 7 KEY: Content Area: Ethics & Law | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 24.

ANS: 1

Fraud is a deliberate deception for the purpose of personal gain and is usually prosecuted as a crime.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 7 KEY: Content Area: Ethics & Law | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 25.

ANS: 2 Battery is the unlawful touching of another without consent, justification, or excuse. In legal medicine, battery occurs if a medical or surgical procedure is performed without patient consent.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 7 KEY: Content Area: Ethics & Law | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 26.

ANS: 1 Ethical behavior includes the fact that the student is accountable for his or her actions.

The student’s duty is to give the best care possible and in performing procedures as taught. The student is demonstrating responsible and ethical behavior. Talking with the patient or family may not be ethical, depending on the information shared during the conversation. A personal cell phone should not be used at all in the clinical facility.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 1 KEY: Content Area: Ethics & Law | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 27.

ANS: 3 Nursing students are still learning and do not have the knowledge to make difficult ethical decisions independently, so they should seek guidance from their instructors or another experienced nurse. Intuition is the feeling that you should or should not do something and yet there is no reason for having the feeling. It is not an acceptable way for a novice nurse to make an ethical decision.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 2 KEY: Content Area: Ethics & Law | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 28.

ANS: 1 Negligence occurs when a person fails to perform according to the standards of care or as a reasonably prudent person would perform in the same situation.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 7 KEY: Content Area: Ethics & Law | Integrated Processes: Caring | Client Need: Safe,

Effective Care Environment | Cognitive Level: Understanding 29.

ANS: 1 Negligence occurs when a person fails to perform according to the standards of care or as a reasonably prudent person would perform in the same situation.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 7 KEY: Content Area: Ethics & Law | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 30.

ANS: 3 Preventing movement or making a person stay in a place without obtaining consent is false imprisonment. This can be done through physical or nonphysical means. To restrain a person is a very serious decision. It requires a physician’s order and permission of the patient or the patient’s family members. It is something that should be used in the most dire situations and then only if everything else has been tried.

PTS: 1 REF: Chapter: 17 OBJ: Objective: 7 KEY: Content Area: Ethics & Law | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding Chapter 17 Understanding Use of Power Chapter 17: Understanding Use of Power Multiple Choice Identify the choice that best completes the statement or answers the question.

1. bedside?

1.

2.

3.

4.

Licensed practical nurses (LPNs) should use what kind of power at the Professional power Personal power Reward power Expert power

2.

There is a chain of command in every facility where nurses are employed.

Which of the following terms refers to that chain?

1.

Administrative levels 2.

Managerial chain 3.

Chain of power 4.

Administrative chain

3.

The strongest power base for nursing is:

1.

2.

3.

4.

reward power. information power. personal power. expert power.

4.

Susie has just become an LPN and is at her first job on a geriatric transitional unit as a staff nurse. Mary, an expert geriatric nurse, has been asked to mentor Susie. What functions will Mary perform to best help Susie as she begins this job?

1.

Direct and evaluate Susie’s care.

2.

Support and teach Susie.

3.

Observe Susie for mistakes.

4.

Wait to help until Susie asks for it.

5.

With some nurse managers, reward power can be: supportive. legitimate. manipulative. a failure.

6.

Manipulative use of reward power turns into: coercion. anger. frustration. powerlessness.

1.

2.

3.

4.

1.

2.

3.

4.

7.

As an LPN, how should you view information coming from your manager on changes in your nursing unit, as compared with information from your best friend, who is also a staff nurse?

1.

Trust your friend; she really knows the truth about the changes.

2.

Compare your friend’s information to the information from other staff.

3.

Trust your nurse manager and believe and value his or her information.

4.

Trust your nurse manager only to a point, and question other nurses about information.

8.

Legitimate power refers to:

1.

2.

3.

4.

power that comes with caring for patients. power that comes with knowledge. power that comes with increased education. power that comes with job responsibilities.

9.

When you apply theory learned in your medical-surgical nursing class in a caring manner to your patient, what kind of power do you use?

1.

Expert power 2.

Positive power 3.

Referent power 4.

Information power

10.

If you have self-confidence and are empowered, you are able to: give better patient care. pass all of your courses with high grades. control situations in your life. keep things predictable.

11.

One of the things that you can do if you experience powerlessness is: talk to your mentor. attempt to reverse these feelings yourself. get more rest. exercise regularly.

12.

Referent power is demonstrated by: someone with authority in an organization. sharing information with employees. personally knowing a well-known leader in nursing and sharing their ideas. a self-confident nurse.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

13.

When you are involved with a nurse manager who uses negative power, what type of communication is considered the most appropriate, and why?

1.

Social—so that you can be friends with the manager 2.

Aggressive—so that you can force the manager to change

3.

Assertive—so that you can stand up for your rights without violating the rights of others Professional—so that you can encourage this manager to change his or her methods by observing your positive behavior

4.

14. patient?

1.

2.

3.

Which of the following is a correct statement about the empowerment of a The nurse tells the patient what to do.

The nurse treats all patients the same.

The patient must actively participate in his or her own care.

The doctor tells the patient what to do without input from the patient.

4.

15.

1.

2.

3.

4.

your instructor. within yourself. your classmates. the director of your nursing program.

16.

Increasing my self-esteem as a nurse contributes to my feelings of: being “in charge.” being a skilled nurse. empowerment. being a “good” nurse.

17.

Which of the following is necessary for self-empowerment?

Reliability Responsibility Efficiency Self-esteem

1.

2.

3.

4.

1.

2.

3.

4.

Empowerment comes from:

18.

When you create empowering conditions for others, you empowerment.

1. decrease 2. facilitate 3. manage

their

4.

change

19.

1.

2.

3.

4.

What statement about empowerment is accurate?

Others can create conditions that make it easier for us to empower ourselves.

Empowerment can only come from others.

Empowerment can only come from within oneself.

Empowerment leads to self-confidence.

20.

How can nurses help to empower patients to make better decisions about their own care?

1.

Working as a partner with the patient 2.

Telling the patient they need to take more responsibility for self-care 3.

Asking the patient why they make so many poor decisions 4.

Working with the health care team to provide quality care

21.

When the nurse creates conditions in which the patient feels empowered, it has what effect on the nurse?

1.

The nurse loses importance to the patient.

2.

The patient leans more on the physician.

3.

The nurse is seen as more competent by the physician.

4.

The nurse feels empowered.

Multiple Response Identify one or more choices that best complete the statement or answer the question.

22.

What actions can the newly graduated LPN take to improve their sense of empowerment? (Select all that apply.)

1.

Take a job that will require a high level of expertise.

2.

Join a nursing organization.

3.

Continue to read and study new topics encountered at work.

4.

Seek a mentor with expertise who works well with the LPN.

5.

Handle all situations that arise at work independently.

23.

Negative use of power helps: (Select all that apply.) personal gain. professional gain. meet the needs of the group. group harmony. promote the ideas of an individual without regard for the group.

24.

You add to your patient’s empowerment when you: (Select all that apply.) do everything for the patient without input from the patient. believe in your patients. act as a patient advocate. perform all procedures without error. act aloof.

1.

2.

3.

4.

5.

1.

2.

3.

4.

5.

25. that apply.)

1.

2.

3.

4.

5.

One way for you, as an LPN, to be empowered would be to: (Select all run for political office in your community. volunteer to work extra shifts. join your professional organization. find ways to become involved in LPN issues. always know what to do and never ask questions.

Chapter 17: Understanding Use of Power Answer Section MULTIPLE CHOICE 1.

ANS: 2 Personal power allows nurses to practice the art of nursing. This power enables the nurse to give the kind of care that makes a difference in a patient’s life and to truly develop a relationship with that person.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 2 KEY: Content Area: Use of Power | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding

2.

ANS: 3 Chain of command can also be called “chain of power.” This chain of command, or power, is demonstrated through a nurse manager’s power to connect with other departments; thus, that manager has the ability to influence others to work toward the overall goals of the unit or team.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 2 KEY: Content Area: Use of Power | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 3.

ANS: 4 Expert power relates to becoming an expert as a LPN, although not everyone can be an expert in every part of nursing. Expertise can be developed in specific areas of nursing and can be just as powerful.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 2 KEY: Content Area: Use of Power | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 4.

ANS: 2 Nursing mentors should be nurses who are experts and who support and teach novice nurses. These mentors give willingly to help novice nurses become experts.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 4 KEY: Content Area: Use of Power | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 5.

ANS: 3 Reward power is giving rewards to others. This concept of giving rewards can change a person’s behavior, and some managers use this power to manipulate others. A manipulative manager identifies and rewards favorite employees. These managers are recognizable because of obvious unfair conditions in the work environment.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 1 KEY: Content Area: Use of Power | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 6.

ANS: 1 Coercion occurs when a manager uses reward power to treat employees negatively.

PTS: 1

REF: Chapter: 18 OBJ: Objective: 1

KEY: Content Area: Use of Power | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 7.

ANS: 3 The information that comes from someone in a management position should be valued and recognized as coming from a source of power. The nurse manager knows important information from participation on different committees and through meetings with departmental heads and administrators.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 3 KEY: Content Area: Use of Power | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 8.

ANS: 4 People earn legitimate power, which comes with a job and its responsibilities.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 2 KEY: Content Area: Use of Power | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 9.

ANS: 2 When caring and professional application of theory is used in patient care, it means that the patient will be cared for on a higher level.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 3 KEY: Content Area: Use of Power | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 10.

ANS: 3 Self-empowerment means that a person has truly developed from within the self. Selfconfidence is a feature of this self-development. The person who has self-confidence is able to control life’s situations.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 4 KEY: Content Area: Use of Power | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 11.

ANS: 1 If you experience powerlessness, you need immediate help and are usually unable to help yourself. Talking to your mentor is one way of getting help; another is seeking professional counseling.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 5 KEY: Content Area: Use of Power | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 12.

ANS: 3 Referent power comes from feelings of admiration and respect for another person. When nurses want advice on a professional topic and they go to someone they admire and respect, they have referent power toward that person, but they do not recognize it.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 2 KEY: Content Area: Use of Power | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 13.

ANS: 3 Assertive communication is the most appropriate for this situation. This communication is focused on group needs, is a healthy way to communicate, and demonstrates value for others.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 1 KEY: Content Area: Use of Power | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 14.

ANS: 3 Empowerment enables patients to take control over at least part of their lives. The nurse has to be careful not to exert power over those who are more disadvantaged than the nurse.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 5 KEY: Content Area: Use of Power | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 15.

ANS: 2 Empowerment is tapping into power from within one’s self and is different from gaining power from another person.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 4 KEY: Content Area: Use of Power | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 16.

ANS: 3

Raising one’s self-esteem is important to the empowerment of self.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 3 KEY: Content Area: Use of Power | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 17.

ANS: 4 Enhancing the self-esteem of others is important to their empowerment.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 4 KEY: Content Area: Use of Power | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 18.

ANS: 2 You, as the nurse, give patients the knowledge and skills they need. You create empowering conditions for your patients, so you are facilitating their empowerment.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 4 KEY: Content Area: Use of Power | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 19.

ANS: 1 Contributions such as feedback from others, experiences of love and trust, and general feeling of acceptance assist in building self-confidence and the inner core of confidence that a person needs to feel self-empowered.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 4 KEY: Content Area: Use of Power | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 20.

ANS: 1 When your patients participate in their care, they feel more control over their situation and, thus, empowered.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 5 KEY: Content Area: Use of Power | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 21.

ANS: 4 Most people, regardless of how empowered they are in some areas, will still need to depend on the nurse to help empower them in other areas.

PTS: 1

REF: Chapter: 18 OBJ: Objective: 5

KEY: Content Area: Use of Power | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding MULTIPLE RESPONSE 22.

ANS: 2, 3, 4 Joining a nursing organization will help to empower the new graduate by providing learning and growth opportunities. Learning increases the feeling of empowerment.

Having a mentor who is experienced and works well with the LPN will empower the new graduate.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 4 KEY: Content Area: Use of Power | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 23.

ANS: 1, 5 Power is used for negative purposes when it is used without regard for the larger group or for personal gain. There is no caring in the use of this power.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 1 KEY: Content Area: Use of Power | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 24.

ANS: 2, 3 The nurse helps others feel worthwhile by believing in them and treating them with dignity and respect. Advocacy is using your power with patients to help them reach their health goals.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 4 KEY: Content Area: Use of Power | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 25.

ANS: 3, 4 You gain knowledge and information about your profession when you join professional organizations and get involved in LPN issues.

PTS: 1 REF: Chapter: 18 OBJ: Objective: 3 KEY: Content Area: Use of Power | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding Chapter 18. Motivating Employees Chapter 18: Motivating Employees

Multiple Choice Identify the choice that best completes the statement or answers the question.

1.

1.

2.

3.

4.

Which of the following types of needs are most people more tolerant of?

Psychological Physiological Safety and security Self-actualization

2.

Why is Maslow’s hierarchy of needs so important to licensed practical nurses (LPNs)?

1.

It enables them to label the behavior of a patient.

2.

It enables them to judge the patient’s behavior.

3.

It enables them to understand that each behavior is motivated by a need.

4.

It enables them to make assumptions about their patient.

3.

As a nurse manager, you cannot motivate others without: power. technical skills. charisma. understanding.

4.

“Nurses who eat their young” is an example of what type of behavior?

Codependency Horizontal hostility Theory X Theory Y

5.

When you accept a bad situation as okay, you are demonstrating: belief in a lesser value. belief in superiority of decisions. belief in codependency. belief in horizontal hostility.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

6.

An especially dangerous belief for LPNs is to: believe they can make do when staffing is inadequate. believe they constantly need the support and presence of another staff member to function. believe that all decisions made at the top are superior to decisions made by subordinates. believe it is okay to label others on the staff.

7.

McGregor’s Theory X and Theory Y focus on: a nurse manager’s ability to manage. a nurse manager’s attitudes about people. a nurse manager’s ability to supervise. a nurse manager’s ability to accept responsibility.

8.

Theory Y managers believe that:

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

people lack motivation. people cannot accept responsibility. people accept responsibility. people like to be directed.

9.

Which type of communication is a characteristic of Theory Y people?

Assertive Aggressive Social Passive–aggressive

10.

Herzberg’s motivational theory has two factors. They are: Theory X and Theory Y. care and support. self-discipline and creativity. job hygiene and job motivation.

11.

Which of the following is an example of a job hygiene factor?

A clean facility Cleanliness of the staff

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

Job security Advancement in the workplace

12.

In order for you, as an LPN nurse manager, to create a motivational environment, you must be: 1. strong and aggressive.

2. a caring professional.

3. an effective organizer.

4. an able enforcer of rules and regulations.

13.

Which area of the hierarchy would be involved when you are in danger of failing a class?

1.

Safety 2.

Self-actualization 3.

Belonging 4.

Esteem

14.

When you focus on the needs in Maslow’s theory of human motivation and relate the hierarchy to your patients, you will understand: 1. how to perform procedures correctly.

2. how to follow your instructor’s directions.

3. the motivation for your patient’s behavior.

4. how to follow the doctor’s orders.

15.

You can meet your patient’s belonging needs by: performing all care efficiently. being a good listener and providing emotional support. maintaining confidentiality. giving a back massage.

16.

To achieve self-actualization, which of the following must take place?

All of the prior needs of the hierarchy must have been met.

Only one of the prior needs must have been met.

Only the need for self-esteem must have been met.

1.

2.

3.

4.

1.

2.

3.

4.

It is of no particular importance whether or not any of the previous needs have been met.

17.

Herzberg’s theory of motivation is focused on: motivating all people at their jobs. motivating people in their personal lives. motivating males in their jobs. motivating factory workers on the job.

18.

Maslow’s theory of human motivation is important because: it identifies motivation in the workplace. it helps explain what motivates behavior in individuals based on need. it identifies the needs of patients when they are ill. it identifies problems faced by all humans.

19.

As one travels up Maslow’s hierarchy, the behaviors are: less of a challenge to meet. of equal challenge. more of a challenge to meet. impossible to meet.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

20. been met?

1.

2.

3.

4.

The need for belonging cannot be met unless which of the following has The need for esteem and self-actualization The need for safety The need for self-esteem The need for safety and physiological needs

21.

The nurse overhears the nursing supervisor tell a certified nursing assistant (CNA) that she is hopeless and will never function competently. The nurse knows that labeling this CNA will have what impact on motivation?

1.

It will challenge the CNA to do better.

2.

It will anger the CNA and motivate her to get even.

3.

It will demotivate the CNA and cause her to stop trying to improve.

It will not have any impact on the CNA’s motivation.

4.

Multiple Response Identify one or more choices that best complete the statement or answer the question.

22.

What historical factors contributed to oppressed nursing behavior? (Select all that apply.)

1.

Physicians were leaders and decision makers.

2.

Nurses served as handmaidens to the physicians.

3.

Nurses were educated to do what they were told without question.

4.

Nurses had to manage jobs, families, and homes.

5.

Nurses were expected to maintain an attractive appearance.

23.

The nurse recognizes the nurse manager demonstrates Theory X behavior when the manager exhibits what behavior? (Select all that apply.)

1.

Control used to increase productivity 2.

Force used to make nurses work harder 3.

Frequent direction provided to tell nurses what to do 4.

Expects staff nurses to accept responsibility 5.

Believes nurses like their work

24.

The nurse manager identifies a staff nurse as dissatisfied according to Herzberg’s theory when what behavior is observed? (Select all that apply.)

1.

The employee calls in sick frequently.

2.

The employee filed multiple grievances in a few months.

3.

The nurse does not contribute in a meaningful way.

4.

The nurse does not make a difference in the work environment.

5.

The nurse submits a letter of resignation.

25.

1.

Which of the following is a characteristic of a Theory X manager?

The manager respects others.

2.

3.

4.

The manager believes in punishment.

The manager believes that people like to work.

The manager believes that people lack ambition.

Chapter 18: Motivating Employees Answer Section MULTIPLE CHOICE 1.

ANS: 2 Most people are more tolerant of basic, physiological survival needs (food, water, and oxygen) because they are easy to recognize.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 2 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 2.

ANS: 3 Every behavior has a cause, and every behavior is motivated by a need. Maslow’s hierarchy identifies the needs that lead to behaviors and places them on levels.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 2 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 3.

ANS: 4 You will not be able to motivate those who work with you without an understanding of each employee’s motivation. The employees may do their work but not at the optimal level.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 5 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 4.

ANS: 4 Horizontal hostility occurs when nurses do not support each other. Nurses who eat their young is an example of oppressed group behavior. “I had to do it the hard way and so do they” is a statement often made by older nurses about younger nurses and refers to nurses who eat their young.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 2 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding

5.

ANS: 1 When a nurse “makes do” when there is not enough staffing, the nurse is accepting a bad situation as okay. This indicates that the nurse feels she is of lesser value than other people are and needs to suffer more to receive any acknowledgment.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 2 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 6.

ANS: 4 This is a myth of oppression and is a dangerous belief for the LPN because it means that his or her decisions and thinking are not worthwhile. The LPN’s thoughts and decisions are as powerful and meaningful as anyone else’s are.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 2 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 7.

ANS: 2 Theory X and Theory Y take opposing points of view and focus on a manager’s attitudes about people.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 3 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 8.

ANS: 3 Theory Y managers recognize the complexity of others; therefore, this manager acknowledges creativity and identifies ways to motivate creativity.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 3 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 9.

ANS: 1 Theory Y people use assertive communication, which encourages dialogue, the sharing of ideas, and the elimination of value judgments.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 3 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 10.

ANS: 4 Herzberg says that there are two types of factors that play into motivation. Both job hygiene and job motivation are necessary for an employee to be motivated in a job and to

remain in that job.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 4 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 11.

ANS: 3 Hygiene factors, such as insurance, working conditions, vacation time, and job security, are the attractors and maintainers of a job.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 4 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 12.

ANS: 2 The LPN manager can create a motivational environment by being a caring professional.

A caring manager provides employees with an environment of growth and opportunity.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 5 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 13.

ANS: 1 When one is in danger of failing, the student does not feel safe. The student feels the threat of failing and experiences a need to survive that threat.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 5 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 14.

ANS: 3 Maslow’s hierarchy identifies human needs, and need motivates behavior.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 5 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 15.

ANS: 2 You provide emotional support and listen to the patient while that patient is in your care.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 5 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 16.

ANS: 1

All prior or lower needs must be met before the highest level of need can be met.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 5 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 17.

ANS: 1 Herzberg’s theory is focused on motivating people at their jobs.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 4 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 18.

ANS: 2 When you focus on the needs in Maslow’s hierarchy, you understand not only your motivation but also that of others.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 5 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 19.

ANS: 3 The needs are listed in hierarchical form, meaning from the lowest to the highest need.

The shape of the figure indicates that the higher one goes, there are fewer people who have achieved that level.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 5 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing 20.

ANS: 4 The first need, safety, must be met before the second, physiological needs; and so continues the progress through each need, step by step. Only when one need is met can the person focus on the next level of need.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 5 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 21.

ANS: 3 Labeling and stereotyping is likely to strip the CNA of all motivation and she will stop trying to improve.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 1 KEY: Content Area: Motivation | Integrated Processes: Communication and

Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying MULTIPLE RESPONSE 22.

ANS: 1, 2, 3 In the early days of nursing, physicians were seen as leaders, and they made all decisions.

Nurse’s jobs were considered the helper to the physician and led to oppressed nursing behavior. When nurses went to school they were taught to follow all physicians’ orders without question, leading to the oppression of nurses’ own thoughts.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 2 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 23.

ANS: 1, 2, 3 Theory X managers believe control is needed to make employees productive, and force is needed to make employees work harder. They provide a great deal of direction because they believe employees will do nothing if left without direction.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 3 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 24.

ANS: 1, 2, 5 The dissatisfied nurse calls in sick frequently because he or she does not like being at work, often files grievances, and is far more likely to quit the job.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 4 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 25.

ANS: 2, 4 A Theory X manager believes that people are lazy, dislike responsibility, prefer to be directed, resist change, and want to be kept safe. This manager also believes in punishment because he or she thinks this is the only way workers will perform.

PTS: 1 REF: Chapter: 19 OBJ: Objective: 3 KEY: Content Area: Motivation | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Knowing Chapter 19. Team Building Chapter 19: Team Building Multiple Choice

Identify the choice that best completes the statement or answers the question.

1.

1.

2.

3.

4.

What is one of the functions of a healthcare team?

Reward nurses for a job well done.

Protect nurses in employment disputes.

Allow both team and individual growth for the improvement of overall healthcare.

Outline employment requirements for nurses in specialty areas.

2.

When the licensed practical nurse (LPN) manager is involved in building and maintaining a team, the LPN usually works with: 1. the registered nurse (RN).

2. the physician.

3. the administrator.

4. other LPNs.

3.

1.

2.

3.

4.

4.

1.

2.

3.

4.

One characteristic of a high performance team is both an elevating and a goal. specific clear unified single

A team member is considered competent and successful when: the team member is either a RN or a LPN. the team member is an expert in all areas of patient care. the team member is pleasant and easy to work with. the team member is expert in a skill desired by the team.

5.

Unified commitment is a characteristic of a high-functioning team. This type of commitment requires all of the following characteristics except: 1. modesty.

2. caring.

3. mentoring.

4. individual professional goals.

6.

When team members or a nursing unit work together and make decisions as a group, this team demonstrates what type of environment?

1.

Autocratic 2.

Collaborative 3.

Professional 4.

Relaxed

7.

1.

2.

3.

4.

If a nursing team is successful, it is receiving support from: physicians. other units in the facility. the owners. administration.

8.

There are four stages of team development. Stage one, which is called forming, allows: 1. the formation of goals.

2. team members time to get to know each other.

3. the establishment of work schedules.

4. the definition of roles for each team member.

9. avoid?

1.

2.

3.

4.

Storming Norming Performing Forming

10.

In which stage is the team most productive?

Storming Norming Performing Forming

11.

The stage in which groups share ideas and form goals is called: storming. norming.

1.

2.

3.

4.

1.

2.

Which of the following stages will some members of the team attempt to

3.

4.

performing. forming.

12.

Regression can occur in the four stages of team development. Which of the following is a possible reason for this?

1.

The team is required to work beyond scheduled hours.

2.

Change in members due to job changes.

3.

The administrator makes too many visits to the unit.

4.

The goals of the team remain the same.

13.

1.

2.

3.

4.

Functional behavior of a group is: specific. normal. desirable. undesirable.

14.

Dysfunctional behaviors indicate dysfunction in the group. What can an effective LPN manager do when dysfunction occurs?

1.

Give the team his or her time and support.

2.

Do the work himself or herself so that it gets done.

3.

Go to the administrator and report on specific people who are showing these behaviors.

4.

Require that the team ignore these behaviors and continue to move ahead.

15.

1.

2.

3.

4.

Teamwork is critical in the healthcare system today because: health maintenance organizations and insurance companies require teamwork. teams can address the diversity in care, as well as plan and process additional needs. teamwork is required by the Nurse Practice Act. teams are required by most healthcare regulatory agencies.

16.

The nurse is working on a team whose leader is more focused on earning recognition than on the goals of the team. What important characteristic is missing and causing this team to perform poorly?

1.

External support 2.

Standards of excellence 3.

Principled leadership 4.

Competent team members

17.

The new graduate LPN is taking a job in a local clinic. How can the nurse discover group norms in the new job?

1.

Observing the behavior of the group 2.

Ask the human resources department 3.

Perform an Internet search for clinic group norms 4.

Read the policy and procedure manual

18.

The nurse manager has one or two staff nurses who frequently inform the manager of things that were done incorrectly on the unit even when it is a minor infraction. What does this indicate?

1.

The nurse manager is trusted by these two staff nurses.

2.

The nurse manager is not observing unit care closely enough.

3.

There is distrust in the group due to lack of confidentiality.

4.

The two nurses are disliked by the rest of the group.

19.

The LPN is working as a team member and notices signs of a dysfunctional team. What should the LPN do?

1.

Share what was seen in an open and caring manner.

2.

Act as the manager to correct the problem.

3.

Report the problem to the next most senior member of the team.

4.

Ignore it and it will probably resolve on its own.

20.

A student nurse who normally attends classes during the day attends an evening class. On returning to the day class, the student tells classmates how different the

evening class is; the evening students just shout out answers in discussions and are far more casual. What is this student describing?

1.

Functional behavior 2.

Group norms 3.

Dysfunctional behavior 4.

A group in transition

21.

The nurse belongs to a group in the performing stage. What will the nurse anticipate if two members of the team leave the group and new members join?

1.

The team will dissolve.

2.

The team will become dysfunctional.

3.

The team will regress to a previous stage.

4.

There will be no significant change.

Multiple Response Identify one or more choices that best complete the statement or answer the question.

22.

The nurse is a member of a newly formed team that is meeting to develop their team’s goals. What features should the goal have? (Select all that apply.)

1.

Importance and meaning 2.

Elevating and inspiring 3.

Clear and easy to understand 4.

Assigned to specific individuals 5.

Monetary value and costs

23.

The nurse manager observes the nurses working on the unit and determines the team is working successfully when what behaviors are noted? (Select all that apply.)

1.

Newly hired nurses are welcomed into the group.

2.

All nurses chip in to help when a nurse has a busy assignment.

3.

The group meetings always run over because they have so much to say to one another.

4.

The nurses often throw parties to celebrate each other’s special occasions.

5.

Nurses often show up at staff meetings even when an agenda is not announced.

24.

What are some of the characteristics the nurse looks for in a highperformance team? (Select all that apply.)

1.

Holding a clear and elevating goal 2.

Cost-driven structure 3.

Adequate quantity of team members 4.

Ability to collaborate 5.

External support and recognition

25.

The characteristic of having a results-driven structure is the responsibility of: (Select all that apply.)

1. the staff nurses.

2. the staff physicians.

3. the manager.

4. the administrator.

5. the maintenance crew.

Chapter 19: Team Building Answer Section MULTIPLE CHOICE 1.

ANS: 3 In healthcare, teams provide support and strength for the changes occurring. Teams unite people in a common cause and purpose and allow team and individual growth for the improvement of overall healthcare.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 1 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 2.

ANS: 1 The management role of building and maintaining a team is usually accomplished along with the RN. The role of LPNs on most teams might not be as a manager but as a team member.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 1 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 3.

ANS: 2 The goal should be one that the team can be proud of, and it must also be clear to all team members. When people work together and they have no clear and elevating goal, they are not really working as a team.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 2 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 4.

ANS: 4 People are successful on a team if they know how a team works, if they can work as a part of that team, and if they are experts in a skill that is desired by the team.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 2 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 5.

ANS: 4 An unspoken aspect of unified commitment is the commitment each member needs to have for others on the team: caring, mentoring, nurturing, and role modeling. If there is a unified commitment among the team members, all can focus on the team goal and assist others to achieve it as well. Unified commitment calls for modesty in seeking the rewards of the team’s work and a never-ending focus for the completion of the work being done.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 2 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 6.

ANS: 2 Collaboration is the ability to work together. A collaborative environment is a comfortable environment for people and supports both learning and teaching.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 1 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 7.

ANS: 4 Successful nursing teams have the support of administration. The team knows it has support and can call on that support when necessary.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 2 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 8.

ANS: 2 Stage one allows team members time to develop trust in each other and recognize and value each member’s expertise.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 3 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective

Care Environment | Cognitive Level: Understanding 9.

ANS: 1 Some members will try to avoid stage one, or storming, because it involves conflict and various viewpoints. This stage is emotionally uncomfortable for people because of the conflict.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 4 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 10.

ANS: 3 Stage four, performing, is the time when a team is most productive and the members are able to accomplish goals successfully.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 3 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 11.

ANS: 1 It is a time when people share their ideas, recognize that the group members have different ideas, and then work out any problems that the variety of ideas present to the team.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 3 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 12.

ANS: 2 Regression often occurs when a new member replaces the original member of the team.

The team must learn to work together with the new member. Usually the stages of team development do not take as long as they did before.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 3 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 13.

ANS: 3 Functional behaviors of a group, such as willingness to help a group member in crisis, are desirable behaviors.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 5 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding

14.

ANS: 1 A successful manager must have the ability to recognize dysfunctional behaviors and acknowledge that the team needs time and support to change.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 5 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 15.

ANS: 2 One nurse or caregiver cannot meet the many complex needs of today’s healthcare recipients. Teams have the ability to provide for the diversity in care, as well as plan and process additional needs.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 1 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 16.

ANS: 3 A principled leader is focused on the members of the team and their needs rather than on self-recognition. The absence of this characteristic can have a negative impact on team function.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 2 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 17.

ANS: 1 Group norming can only be discovered by observing how members behave.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 4 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 18.

ANS: 3 If these nurses are breaking confidentiality of team members to report to the nurse manager all the time, there is a problem with trust within the group.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 5 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 19.

ANS: 1 The LPN should share the dysfunctional behavior observed with the other team members in a caring and open way and participate in resolution strategies.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 5 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 20.

ANS: 2 The student is describing group norms, which vary between groups and are decided on by group expectations.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 3 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 21.

ANS: 3 Regression often occurs when an established member leaves the group and new members join.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 3 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying MULTIPLE RESPONSE 22.

ANS: 1, 2, 3 The goal should be important and have meaning if team members are to feel there is a real need for their work. The team goal should be elevating and inspiring to motivate team members to work hard and contribute to the team. Team goals should be stated clearly so everyone understands what they are working to achieve.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 2 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 23.

ANS: 1, 2, 4 Welcoming new members is a behavior that indicates a functional group. Willingness to assist one another is an indication of a highly functioning team. Celebrating special occasions together bonds the group and indicates a high level of team function.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 2 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 24.

ANS: 1, 5 The goal has to be clear to the potential team members, and it should be elevating and something the participants can take pride in doing. Functional teams don’t require a certain number of team members but rather have competent members. The team needs to

be able to share and collaborate to be successful.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 2 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 25.

ANS: 3, 4 A results-driven structure is the responsibility of the manager and sometimes the administrator. Results-driven structures require planning, performing, evaluating, and changing.

PTS: 1 REF: Chapter: 20 OBJ: Objective: 2 KEY: Content Area: Teams | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding Chapter 20. Delegating, Coaching, and Evaluating Performance Chapter 20: Making Assignments, Coaching, and Analyzing Performance Multiple Choice Identify the choice that best completes the statement or answers the question.

1.

Which of the following is an important role of the nurse manager?

Give daily bedside care.

Administer medications at least 2 to 3 times weekly.

Coordinate the unit’s activities.

Independently set goals.

2.

Effective delegation involves which of the following?

Clear identification of the delegated task Accurate documentation The ability to reward positive behavior of a staff member The assignment of a specific number of inservice education hours

1.

2.

3.

4.

1.

2.

3.

4.

3.

You are the nurse manager and know that you must assess a client’s needs before you can delegate a task regarding that patient to a certified nursing assistant.

Assessing the client’s needs involves: 1. determining whether patient goals have been met.

2. gathering information about the client.

3.

4.

giving care to the client. planning care and formulating the written nursing care plan.

4.

In order to gain the cooperation of staff members, you ask for their input on patient care and share information regarding patient care. These actions are examples of: 1. empowerment.

2. delegation.

3. accountability.

4. teaching.

5.

As the nurse manager, when you hold staff members responsible for their actions and require them to document on flow sheets such tasks as intake, output, and personal care, which of the following terms applies?

1.

Responsibility 2.

Empowerment 3.

Accountability 4.

Delegation

6.

Susie, an LPN, is employed in her first job. She has been there for 8 months, and yesterday she was informed that she had been chosen as employee of the month. The facility’s recognition of Susie’s work is an example of: 1. empowerment.

2. formal positive feedback.

3. informal positive feedback.

4. rewards.

7.

When a staff member makes a mistake, the nurse manager should: ignore the mistake and give the person another chance. punish the person. call all staff members together to discuss the mistake. accept the mistake and help the person learn from the mistake.

8.

The most common reason for employee error is:

1.

2.

3.

4.

1.

2.

3.

4.

lack of adequate supervision. lack of adequate staffing. lack of knowledge. lack of adequate counseling.

9.

The primary reason for employee counseling is: to inform employees that they need to do something differently or that they have done something well. to punish employees for errors. to discipline employees. to reward employees.

10.

Counseling sessions should be private and brief. They should also be: confrontational. nonconfrontational. empowering. frequent.

1.

2.

3.

4.

1.

2.

3.

4.

11.

A positive approach to discipline requires a certain focus from the manager. That focus is: 1. punitive.

2. giving criticism in a very sweet manner.

3. helping the employee to improve performance and behavior.

4. a written warning to the employee.

12.

The emphasis in performance analysis is on: the present. the future. the past. the employee’s personality.

13.

Performance review is based on:

1.

2.

3.

4.

1.

2.

3.

4.

past reviews of the employee. how the manager views the job. a review of job standards. the job description.

14. refers to: 1.

2.

3.

4.

rating an employee by comparison with other employees. the ratings being all higher or lower than the expected average. allowing past performance ratings to influence current ratings. rating all areas at average or midpoint.

15.

The major components of a performance analysis are: personality characteristics. goals or objectives. behavioral characteristics. performance standards.

16.

A performance plan for improvement should include: a time frame for achieving each goal. behavioral characteristics. personality characteristics. a job description.

17.

Patient assignments are best made by delegating tasks based on: patient acuity. patient age. staff ages. medical diagnoses.

1.

2.

3.

4.

1.

2.

3.

4.

1.

2.

3.

4.

When a manager uses the contrast effect in performance analysis, this

18.

When is it appropriate to give an employee a written warning as part of a disciplinary action?

1.

After previous counseling and employee is aware of the rule being broken 2.

A first occurrence of breaking a rule occurs.

3.

A severe violation of a rule occurs.

4.

Employee is suspected of breaking a rule.

19.

The nurse manager incorporates verbal reports and walking rounds for what purpose?

1.

To provide staff members with adequate exercise 2.

To introduce different staff members to promote teamwork 3.

To improve communication and provide opportunities for feedback 4.

To allow staff nurses to take time off from patient care

20.

At a staff meeting the nurse manager tells the group of nurses, “I know census was high last month, but you all did an amazing job of taking care of your patients while keeping the quality of care high. I am very proud of you.” What is this manager doing?

1.

Providing verbal report 2.

Coaching 3.

Mentoring 4.

Goal setting

21.

The nurse manager has given a verbal warning to a nurse who calls in sick frequently, usually on scheduled Fridays or Mondays for a long weekend. When the behavior continues the manager provides a written warning. What is the next step if the employee’s behavior doesn’t improve?

1.

Verbal warning 2.

Written warning 3.

Suspension 4.

Termination

22.

The nurse manager gives a staff nurse a performance evaluation with several recommended areas for improvement. What should the staff nurse do to indicate that he or she appreciates the feedback and wants to improve?

1.

Say, “Thank you.”

2.

Ask questions about how to improve.

3.

Apologize for poor performance.

4.

Say, “I’ll do my best to get better.”

Multiple Response Identify one or more choices that best complete the statement or answer the question.

23. The nurse is going to delegate bathing a patient to another member of the team. What information should the nurse communicate when delegating? (Select all that apply.)

1.

What is to be done 2.

When to seek help 3.

Any expected abnormal findings 4.

How long they have to do the job 5.

When the job is to be complete

24.

What does the nurse need to put in place in order for the environment to be considered empowering? (Select all that apply.)

1.

Incorporate the staff’s input into unit decisions 2.

Share information with staff regarding patients assigned to them 3.

Use staffing models based on empowerment 4.

Let staff make all unit decisions 5.

Hold monthly staff meetings

25.

The nurse manager is preparing to hold a counseling session with a certified nursing assistant who has been consistently coming to work late. What strategies should the nurse manager use? (Select all that apply.)

1.

Conduct counseling in private 2.

Keep session brief 3.

Avoid wording that will seem confrontational 4.

Emphasize the negative behavior repeatedly 5.

Sympathize with the employee Chapter 20: Delegating, Coaching, and Analyzing Performance Answer Section MULTIPLE CHOICE 1.

ANS: 3 The nurse manager needs to coordinate the creative ideas of the staff. The manager cannot unilaterally set goals but must add the input of all involved so goals can be achieved.

PTS: 1 REF: Chapter 20 OBJ: Objective: 1 KEY: Content Area: Delegation | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding

2.

ANS: 1 The delegated task must be clearly identified before work can be assigned.

PTS: 1 REF: Chapter 20 OBJ: Objective: 1 KEY: Content Area: Delegation | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 3.

ANS: 2 You are gathering information about the client both subjectively and objectively, which will give you the information you need to make assignments.

PTS: 1 REF: Chapter 20 OBJ: Objective: 1 KEY: Content Area: Delegation | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 4.

ANS: 1 You demonstrate empowerment by showing respect for the staff and valuing their input.

PTS: 1 REF: Chapter 20 OBJ: Objective: 2 KEY: Content Area: Empowerment | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 5.

ANS: 3 Accountability requires that the staff understands your expectations and that they are responsible for their assignments and goals.

PTS: 1 REF: Chapter 20 OBJ: Objective: 3 KEY: Content Area: Coaching | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 6.

ANS: 2 Formal recognition programs are important for employee morale and are a way of recognizing valued employees and their contributions.

PTS: 1 REF: Chapter 20 OBJ: Objective: 3 KEY: Content Area: Analyzing Performance | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 7.

ANS: 4 Mistakes are learning opportunities that should be dealt with positively, not negatively.

Managers should help staff members learn from their mistakes.

PTS: 1 REF: Chapter 20 OBJ: Objective: 3 KEY: Content Area: Coaching | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 8.

ANS: 3 Most mistakes occur because the employee lacks knowledge about the policies and procedures of the facility. Teaching and providing the correct information will prevent the recurrence of errors.

PTS: 1 REF: Chapter 20 OBJ: Objective: 3 KEY: Content Area: Counseling | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 9.

ANS: 1 Counseling sessions are for discussions of either negative or positive behaviors.

PTS: 1 REF: Chapter 20 OBJ: Objective: 3 KEY: Content Area: Counseling | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 10.

ANS: 2 Counseling should be done in a nonconfrontational manner in a positive atmosphere.

PTS: 1 REF: Chapter 20 OBJ: Objective: 3 KEY: Content Area: Counseling | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 11.

ANS: 3 A positive approach to discipline is a problem-solving approach. A punitive focus emphasizes punishment for mistakes, whereas a positive approach means that the employee is being helped to improve performance.

PTS: 1 REF: Chapter 20 OBJ: Objective: 4 KEY: Content Area: Coaching | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 12.

ANS: 2 In performance analysis, the manager and the employee establish realistic targets for

performance improvement together. This involves a focus on the future as opposed to a focus on the mistakes of the past.

PTS: 1 REF: Chapter 20 OBJ: Objective: 5 KEY: Content Area: Analyzing Performance | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 13.

ANS: 4 The performance review should be based on the employee’s job description. The review is designed to help the employee do a better job, so the manager should be aware of the job requirements.

PTS: 1 REF: Chapter 20 OBJ: Objective: 5 KEY: Content Area: Analyzing Performance | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 14.

ANS: 1 The contrast effect is when the manager rates the employee by comparing that employee with other employees. When managers use the contrast effect, they are not using the established performance standards of the facility.

PTS: 1 REF: Chapter 20 OBJ: Objective: 5 KEY: Content Area: Analyzing Performance | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 15.

ANS: 2 Goals or objectives are the tasks that both the manager and the employee agree should be completed during the evaluation time. Emphasis on goals focuses attention on individual achievements and motivates the employee. Goals are based on the employee’s strengths and weaknesses.

PTS: 1 REF: Chapter 20 OBJ: Objective: 5 KEY: Content Area: Analyzing Performance | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 16.

ANS: 1 A reasonable time frame should be established, which the employee should know.

PTS: 1 REF: Chapter 20 OBJ: Objective: 6 KEY: Content Area: Analyzing Performance | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level:

Understanding 17.

ANS: 1 Acuity systems are used in making assignments by allocating patients by category to each staff member.

PTS: 1 REF: Chapter 20 OBJ: Objective: 1 KEY: Content Area: Delegation | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 18.

ANS: 3 A repeated occurrence or a severe violation of a rule warrants a written warning.

PTS: 1 REF: Chapter 20 OBJ: Objective: 4 KEY: Content Area: Analyzing Performance | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Understanding 19.

ANS: 3 Improving communication and offering staff nurses the opportunity to provide input and feedback is the goal of verbal reports and walking rounds.

PTS: 1 REF: Chapter 20 OBJ: Objective: 2 KEY: Content Area: Empowerment | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 20.

ANS: 2 Coaching, demonstrated by the commendation provided by this nurse manager, pumps up the team’s enthusiasm.

PTS: 1 REF: Chapter 20 OBJ: Objective: 3 KEY: Content Area: Coaching | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 21.

ANS: 3 The next step in the process is to suspend the employee for a short period of time to consider whether continued employment is desired and whether the employee is able to change behavior.

PTS: 1 REF: Chapter 20 OBJ: Objective: 4 KEY: Content Area: Performance Evaluation | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level:

Applying 22.

ANS: 2 Asking questions about how to improve indicates the nurse really wants to perform better and is asking for information about how to go about making steps in the right direction.

PTS: 1 REF: Chapter 20 OBJ: Objective: 5 KEY: Content Area: Performance Evaluation | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying MULTIPLE RESPONSE 23.

ANS: 1, 2, 3, 5 The nurse needs to carefully explain exactly what is to be done and then test for understanding. The nurse tells the person accepting delegation when and from whom to seek help if problems are encountered. The nurse explains any known abnormalities the person accepting the duty might encounter, such as where the patient has a wound, extremity weaknesses, or other known issues. The nurse explains when a job needs to be completed.

PTS: 1 REF: Chapter 20 OBJ: Objective: 1 KEY: Content Area: Delegation | Integrated Processes: Communication and Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 24.

ANS: 1, 2, 3 Taking staff suggestions makes staff members feel valued and important, which is empowering. As the person assigned to provide care, knowing all information regarding the patient will help staff feel more competent, and that leads to empowerment. Using staffing models that are based on empowerment allows the nurse to facilitate empowering policies and procedures.

PTS: 1 REF: Chapter 20 OBJ: Objective: 2 KEY: Content Area: Empowerment | Integrated Processes: Caring | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying 25.

ANS: 1, 2, 3 The general rule of thumb is to reward in public and reprimand in private, so this counseling session should be held privately. Counseling should be brief and to the point.

Counseling sessions should be nonconfrontational and should state the facts as objectively as possible.

PTS: 1 REF: Chapter 20 OBJ: Objective: 3 KEY: Content Area: Performance Evaluation | Integrated Processes: Communication and

Documentation | Client Need: Safe, Effective Care Environment | Cognitive Level: Applying