Leadership and Management in Nursing Practice Test | Quiz

• (A) a task approach methods is used to provide care to clients
• (B) a single registered nurse (RN) is responsible for providing nursing care to a group of clients
• (C) managed care concepts and tools are used in providing client care
• (D) nursing personnel are led by a RN in providing care to a group of clients

Check Answer Solution (A):-In functional nursing, a task approach method is used to provide care to clients. Option B exemplifies primary nursing. Option C exemplifies a component of case management. Option D exemplifies team nursing.

• (A) client w/ lrg shard of glass piercing chest wall, RR 32
• (B) client w/ forearm disfigured w/ protruding bone, finger cap refill 2 seconds
• (C) child w/ 3-in. oozing laceration on leg
• (D) woman who is 2 months pregnant, partial-thickness burn on forearm

Check Answer Solution (A):-the integrity of the chest wall has been compromised and is becoming a “breathing” problem. The others can wait up to two hours

• (A) planning vacation time for staff
• (B) directing staff activities if a client has a cardiac arrest
• (C) evaluating a new medication administration process
• (D) identifying the strengths and weaknesses of a client education video

Check Answer Solution (B):-directing staff activities if a client has a cardiac arrest

• (A) situational
• (B) laissez-faire
• (C) participative
• (D) authoritarian

Check Answer Solution (C):-Participative leadership demonstrates an “in-between” style, neither authoritarian nor democratic style. In participative leadership, the manager presents an analysis of problems and proposals for actions to team members, inviting critique and comments. The participative leader then analyzes the comments and makes the final decision. A laissez-faire leader abdicates leadership and responsibilities, allowing staff to work without assistance, direction, or supervision. The autocratic style of leadership is task oriented and directive. The situational leadership style utilizes a style depending on the situation and events.

• (A) ignore the resistance
• (B) tell the LPN that the registered nurse will do all of the documentation
• (C) confront the LPN, and encourage verbalization of feelings regarding the change
• (D) tell the LPN that she must comply with the change

Check Answer Solution (C):-Confrontation is an important strategy to meet resistance head-on. Face-to-face meetings to confront the subject at hand will allow verbalization of feelings, identification of problems and subjects, and development of strategies to solve the problem. Option A will not address the problem. Option B might provide a temporary solution to the resistance but will not specifically address the concern. Option D might produce additional resistance.

• (A) ignore the resistance
• (B) exert coercion with the nursing assistant
• (C) provide a positive reward system for the nursing assistant
• (D) confront the nursing assistant to encourage verbalization of feelings regarding the change

Check Answer Solution (D):-Confrontation is an important strategy to meet resistance head on. Face-to-face meetings to confront the issue at hand will allow verbalization of feelings, identification of problems and issues, and development of strategies to solve the problem. Option A will not address the problem. Option B may produce additional resistance. Option C may provide a temporary solution to the resistance but will not address the concern

• (A) a survey of the unit’s nurses indicates perceived improvement in results
• (B) a total decrease in the number of central line IV line infections on the unit has been identified
• (C) retrospective chart audits for infection rate show improvement in clients with central line IV lines
• (D) comparison of total number of IV ABX used b/w the two time periods has shown a decreased in ABX use

Check Answer Solution (C):-retrospective chart audits for infection rate show improvement in clients with central line IV lines

• (A) plan strategies to implement the change
• (B) set goals and priorities regarding the change process
• (C) identify the inefficiency that needs improvement or correction
• (D) identify potential solutions and strategies for the change process

Check Answer Solution (C):-When beginning the change process, the nurse should identify and define the problem that needs improvement or correction. This important first step can prevent many future problems, because, if the problem is not correctly identified, a plan for change may be aimed at the wrong problem. This is followed by goal setting, prioritizing, and identifying potential solutions and strategies to implement the change

• (A) introduce the change gradually
• (B) confront the individuals involved in the change process
• (C) use coercion to implement the change
• (D) manipulate the participants in the change process

Check Answer Solution (A):-The primary technique that can used to handle resistance to change during the change process is to introduce the change gradually. Confrontation is an important strategy used to meet resistance when it occurs. Coercion is another strategy that can be used to decrease resistance to change but is not always a successful technique for managing resistance. Manipulation usually involves a covert action, such as leaving out pieces of vital information that the participants might receive negatively. It is not the best method of implementing a change.

• (A) accept the nurse-manager’s evaluation by signing in agreement
• (B) contribute a self-evaluation and suggested areas for future growth
• (C) have peers vouch for his or her performance
• (D) giver her perception of how the manager is performing

Check Answer Solution (B):-contribute a self-evaluation and suggested areas for future growth

• (A) Scores on client satisfaction surveys
• (B) surveys on staff’s perception of the effectiveness
• (C) comparing fall rates after the rounds are initiated
• (D) documentation that the rounds are completed as scheduled

Check Answer Solution (C):-comparing fall rates after the rounds are initiated

• (A) reassign the LPN to the care of clients not receiving opioids
• (B) b) notify the physician that the client needs an increase in opioid dosage
• (C) review the client’s medication administration record immediately and discuss the observations with the nursing supervisor
• (D) confront the LPN with the information about the client having pain control problems and ask if the LPN is using the opioids personally

Check Answer Solution (C):-In this situation, the nurse has noted an unusual occurrence, but before deciding what action to take next, the nurse needs more data than just suspicion. This can be obtained by reviewing the client’s record. State and federal labor and opioid regulations, as well as institutional policies and procedures, must be followed. It is therefore most appropriate that the nurse discuss the situation with the nursing supervisor before taking further action. The client does not need an increase in opioids. To reassign the LPN to clients not receiving opioids ignores the issue. A confrontation is not the most advisable action because it could result in an argumentative situation.

• (A) track the number of supplies used by the clients on the unit
• (B) document the time spent on direct client care
• (C) administer a client and family satisfaction survey
• (D) assess clients and report acuity daily

Check Answer Solution (C):-administer a client and family satisfaction survey

• (A) maintain expertise in practice
• (B) report unsafe staffing levels to supervisor
• (C) Both
• (D) None

Check Answer Solution (C):-Both

• (A) position the client in semi-fowler’s position
• (B) add water to the suction chamber as it evaporates
• (C) tape the connection sites between the chest tube and the drainage system
• (D) instruct the client to avoid coughing and deep breathing

Check Answer Solution (D):-It is important to encourage the client to cough and deep breathe when a chest tube drainage system is in place. This will assist in facilitating appropriate lung re-expansion. Water is added to the suction chamber as it evaporates to maintain the full suction level prescribed. Connections between the chest tube and the drainage system are taped to prevent accidental disconnection. The client is positioned in semi-Fowler’s to facilitate ease in breathing.

• (A) pass the dinner trays
• (B) empty the Foley cath
• (C) admin morning daily meds
• (D) suction client who is one day postop after tracheostomy

Check Answer Solution (C):-admin morning daily meds

• (A) team nursing
• (B) primary nursing
• (C) functional nursing
• (D) case management

Check Answer Solution (C):-Functional nursing-best uses the skills of all staff in a timely manner during this crisis. This delivery system requires the lest staff and delegates tasks to those who can best perform them.

• (A) the nosepiece is readjusted if air is detected escaping around the nose
• (B) another particulate respirator is obtained if air is escaping around the nose
• (C) the new nursing graduate states that a fit check is not needed
• (D) the new nursing graduate states that a fit check is necessary only when putting on the respirator for the first time

Check Answer Solution (A):-Personal protective equipment, called particulate respirators, is required for all health care workers entering a tuberculosis isolation room. When fitted and used properly, these respirators filter droplet nuclei. It is important that no air escapes around the nose while wearing the respirator. The strap needs to be adjusted if air is escaping. It is important to exhale forcefully while placing both hands over the apparatus. It is necessary to perform a fit check each time the nurse uses the mask.

• (A) removing the client from the mechanical ventilator for a short period
• (B) connecting the T-piece to the client’s artificial airway
• (C) providing supplemental oxygen through the T-piece at an Flo2 that is 10% higher than the ventilator setting
• (D) gradually decreasing the respiratory rate on the ventilator until the client takes over all of the work of breathing

Check Answer Solution (D):-The T-piece or Briggs device requires that the client is removed from the mechanical ventilation for a short time, usually beginning with a 5-minute period. The ventilator is disconnected and the T-piece is connected to the client’s artificial airway. Supplemental oxygen is provided through the device, often at a FIo2 that is 10% higher than the ventilator setting. Option 4 describes the process of weaning via synchronized intermittent mandatory ventilation

• (A) has the ventilator routinely assessed by the respiratory therapist
• (B) realizes that the ventilator readings provide information without human error
• (C) teaches family members how to reset controls during their visits if necessary
• (D) establishes a rest pattern before morning care

Check Answer Solution (A):-Ventilators need to be assessed routinely by the respiratory therapist. Ventilators are machines, and machines can fail. Therefore, option B is not a reasonable option. Family members should not reset ventilator controls. Although option D is considered good nursing practice for the comfort of the client, it is not the priority option