Exam Review

A floor manager discovers widespread dissatisfaction and a high turnover rate amongst LPN and certified nursing assistants (CNA). Which of the following strategies might motivate the staff and lead to enhanced job satisfaction?
A)
Allow LPNs and CNAs to perform tasks beyond their scope of practice.
B)
Establish a rewards program to recognize achievements of the staff.
C)
Hire additional staff so individual workloads are lessened.
D)
Improve the working conditions of the unit by investing in ergonomic chairs.
A nurse is planning care for a client who has anorexia nervosa. The nurse should make which of the following client goals the priority?
A)
Encouraging the patient to attend group therapy.
B)
Monitoring for thoughts of self-harm.
C)
Preventing fluid and electrolyte imbalance.
D)
Fostering feelings of self-respect.
As a nurse manager, you have to be effective in managing a culturally diverse staff. Which of the following nurse manager attributes would assist you in addressing the cultural needs of your staff? (Select all that apply.)
(SATA)
A)
Assuming the thoughts and behaviors of individuals based on their race or ethnicity.
B)
Encouraging the potential in all staff.
C)
Being conscious of the dynamics when culture interacts.
D)
Conducting a cultural self-assessment.
E)
Fostering unity by imposing American values upon all staff members.
Which of the following is an effective approach in the appraisal of research studies?
A)
Evaluate the quality of the research against the standards for that type of research.
B)
Select only studies with a sample size of at least 100 people.
C)
Discard systematic reviews and meta-analyses since they are the weakest form of evidence.
D)
Accept only studies that use a randomized controlled trial design.

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Exam Review

A strategic goal for nursing in the facility developed by the chief nursing officer is to implement an evidence-based practice program. What is an appropriate strategy that can be used by a nurse manager who is beginning to implement an evidence-based practice program on the unit?
A)
Identifying patients with extended lengths of stay.
B)
Reviewing specialty organization guidelines.
C)
Conducting a review of adverse events and incident reports.
D)
Soliciting input from staff members.
Which of the following is most accurate regarding evidence-based practice?
A)
Evidence-based practice should focus solely on the advancement of the nursing profession, while prohibiting involvement of other healthcare disciplines.
B)
Evidence-based practice replaces continuous quality improvement.
C)
Evidence-based practice integrates the best research evidence with clinical expertise and the patient's unique values and circumstances in making care decisions.
D)
Evidence-based practice began with medicine and assists in determining which medical models can be applied in nursing practice.
Mary is a newly-hired, new graduate nurse. Mary adapts her practice to imitate her co-workers on the unit. She is demonstrating:
A)
cultural awareness.
B)
cultural sensitivity.
C)
acculturation.
D)
cultural marginality.
To help staff nurses prepare for evidence-based practice, which strategy is NOT appropriate for the nurse manager to recommend?
A)
Establishing a journal club.
B)
Encouraging staff to join a professional association.
C)
Instituting mandatory writing assignments discussing a chosen best-practice article.
D)
Creating an incentive program for staff to pursue a specialty certification.

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Exam Review

After several months of heavy patient loads in the Emergency Department and inability to secure sufficient and experienced staff, the department is especially taxed by a train accident that brings in many seriously injured individuals. You observe that Rama ignores the requests of several of the injured, even when time is available to care for them and is rude to two older adult patients. You are concerned that Rama is evidencing which state?
A)
depersonalization
B)
role ambiguity
C)
depression
D)
hardiness
The Rehabilitation Unit at Pleasant Valley Hospital has a high number of falls. What interventions might assist to reduce the number of falls on the unit?
A)
Restrain patients at risk for falls.
B)
Recognize that errors are solely the result of the actions of individual people.
C)
Provide an in-service that informs nurses of the current, best practices of fall prevention.
D)
Punish the staff who are caring for the patients who fall.
With regard to nursing practice, nurse managers are held responsible for: (Select all that apply.)
A)
Referring all errors in nursing judgment to state disciplinary boards.
B)
Verifying that attending physicians are properly licensed to provide care on patient care units.
C)
Practicing within legal guidelines established under state law and nurse practice acts.
D)
Creating an environment of severe consequences for nursing errors to ensure quality practice.
E)
Ensuring that nursing staff under their supervision are currently licensed to practice.
A family is keeping vigil at a critically ill patient's bedside. The nurse speaks with the family members and asks if they would benefit from a chaplain visit or resources to aid with grief and coping. What role is the nurse assuming through this action?
A)
Follower
B)
Manager
C)
Laissez-faire
D)
Leader

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Exam Review

A charge nurse notes that a staff nurse delegates an unfair share of tasks to the assistive personnel (AP) and the nurses on next shift report the staff nurse frequently leaves tasks uncompleted. Which of the following statements should the charge nurse make to resolve this conflict?
A)
"I need to speak with you about unit expectations regarding delegating and completing tasks."
B)
"You have been very inconsiderate of others by not completing your share of the work."
C)
"If you don't do your share of the work, I will have to inform the nurse manager."
D)
"Several staff members have commented that you don't do your fair share of the work."
Volunteers in a study are assigned randomly to groups. Some of the volunteers receive an herbal supplement that is reputed to control nausea, and some of the volunteers are assigned to a control group where a placebo is administered. This is an example of a(n):
A)
longitudinal study.
B)
appraisal tool.
C)
meta-analysis.
D)
RCT.
Feedback from staff suggests that the new scale is too difficult for patients who have limited language skills and who are already under duress to understand. The difficulty in implementing the new scale refers to testing:
A)
practice failure.
B)
efficacy.
C)
effectiveness.
D)
comparative error.
During an annual performance evaluation, a manager provides truthful feedback about the nurse's performance. What ethical principle does this represent?
A)
autonomy
B)
nonmaleficence
C)
justice
D)
fidelity

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Exam Review

When planning delegation of tasks to assistive personnel (AP), a nurse considers the five rights of delegation. Which of the following does NOT correspond with the five rights of delegation?
A)
The task being delegated matches the AP's skill level.
B)
The task being delegated to the AP is relatively non-invasive.
C)
The task being delegated to the AP is within their scope of practice.
D)
The task being delegated requires close supervision.
A charge nurse is planning to conduct a performance appraisal of a staff member on her unit. Which of the following actions should the nurse take?
A)
Evaluate how well employees were able to perform duties outside of their job description.
B)
Conduct the performance appraisal in a public setting to ease tension.
C)
Provide the staff member the opportunity to disagree with the evaluation.
D)
Initiate a random time to conduct the performance appraisal to ensure authentic responses by the staff member.
The chief nursing officer at a local hospital seeking Magnet® status creates staff development classes concerning translation of research into practice (TRIP). What best describes TRIP?
A)
Searching the literature for a systematic review.
B)
Applying strategies that aid in adoption of research in practice.
C)
Providing the results of research studies to practitioners.
D)
Conducting an integrative review of the literature.
During a review of back injuries, a unit manager discovers a large number of injuries are occurring in spite of mechanical lifts being used. Furthermore, it is determined that some lifts are outdated. In establishing a quality improvement plan, the unit manager should:
A)
Review the correct procedure with staff members who use the mechanical lifts incorrectly.
B)
Remind employees who sustain back injuries that they are solely responsible for their actions.
C)
Compile Wikipedia articles to develop a revised procedure to operate mechanical lifts.
D)
File a grievance about inadequate funding and an unsafe work environment.

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Exam Review

A nurse manager of a 20-bed medical unit finds that 80% of the patients are older adults. She is asked to assess and adapt the unit to better meet the unique needs of the older adult patient. Using complexity principles, what would be the best approach to take for implementation of this change?
A)
Involve affected staff in the decision-making process.
B)
Focus the assessment on the unit and do not consider the hospital as a whole.
C)
Create a mandatory policy to force workers to participate in problem-solving solutions.
D)
Select a management approach that does not change.
A charge nurse allows a nurse an additional twenty minutes for his lunch break to take care of a personal matter. The charge nurse agrees to watch his patients for the additional twenty minutes, only if he agrees to help with the end-of-shift drug count. The charge nurse is demonstrating which of the following types of conflict management?
A)
Avoiding
B)
Compromising
C)
Cooperating
D)
Competing
A manager notes that the incidence of medication errors has increased since the implementation of staffing changes. What strategy should the manager consider to reduce errors?
A)
Deter mistakes by emphasizing the consequences of committing a medication error.
B)
Include the bedside nurses in the decision-making process involving their practice.
C)
Encourage nurses who commit medication errors to file incident reports, placing them in the patient's chart.
D)
Relinquish responsibility by asking a separate department to oversee quality improvement.
A nurse is serving on a continuous quality improvement (CQI) committee that has been assigned to develop a program to reduce the number of medication administration errors following a sentinel event at the facility. Which of the following strategies should the committee plan to initiate first?
A)
Review the events leading up to each medication administration error.
B)
Require staff nurses to demonstrate competency by passing a medication administration examination.
C)
Develop a quality improvement program for nurses involved in medication administration errors.
D)
Provide an inservice on medication administration to all the nurses.

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