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    Exam Review

    1. Which of the following actions made by the nurse manager best exemplifies Lewin's Refreezing Stage?
      A)
      Gathering anonymous data to gauge the opinions of the staff concerning an upcoming proposed change.
      B)
      Conducting a systematic evaluation of forces that will facilitate or block change.
      C)
      Hosting educational seminars to convince the staff a need for change.
      D)
      Creating an incentive program rewarding staff who adhere to the recent policy changes.
    2. The following statements describe the keys to an effective team EXCEPT:
      A)
      Team members express their ideas and feelings openly.
      B)
      Each team member strives to accomplish a shared objective.
      C)
      Successful teams understand the necessity of avoiding conflict.
      D)
      Effective team leadership is shared and shifts according to expertise.
    3. The maintenance department wishes to have the nursing lounge renovated, so the lounge will be more "user-friendly." The department asks the nursing staff to make a wish list of everything that they would like to see in the new lounge. This process is an example of which part of the decision-making process?
      A)
      Assessment/Data collection
      B)
      Generating hypotheses
      C)
      Planning
      D)
      Data interpretation
    4. An RN on a behavioral health unit is assessing a client. The RN plans to delegate part of the nursing process to a licensed practical nurse (LPN). Which of the following statements by the RN indicates appropriate delegation to the LPN?
      A)
      "Please use these client assessment findings to draw a conclusion so that a plan can be developed."
      B)
      "Please verify with the client which of the following medications they are taking."
      C)
      "Please document the admission assessment in the chart."
      D)
      "Please perform the initial assessment of the client."
    Page 1 of 8

    Exam Review

    1. Read the scenario below and highlight the statement (by clicking the sentence) that does NOT demonstrate shared governance. Select all that apply. The board of directors of a hospital engages in a strategic planning process for the implementation of a facility-wide change that especially affects the nursing department. The directors insist on hosting regular "closed-door" board meetings, in which affected staff members and stakeholders are prohibited to attend. Information from these meetings are kept confidential, inaccessible to anyone outside the meetings. The directors have scheduled periodic town hall meetings, inviting all stakeholders and employees within the organization to share their thoughts concerning the impending change. After months of planning, the board of directors considers the feedback gathered and makes an unexpected decision to which leaders of the nursing department were largely unaware.
      (Highlight — findings requiring follow-up are marked)

      Read the scenario below and highlight the statement (by clicking the sentence) that does NOT demonstrate shared governance. Select all that apply.

      The board of directors of a hospital engages in a strategic planning process for the implementation of a facility-wide change that especially affects the nursing department. The directors insist on hosting regular "closed-door" board meetings, in which affected staff members and stakeholders are prohibited to attend. Information from these meetings are kept confidential, inaccessible to anyone outside the meetings. The directors have scheduled periodic town hall meetings, inviting all stakeholders and employees within the organization to share their thoughts concerning the impending change. After months of planning, the board of directors considers the feedback gathered and makes an unexpected decision to which leaders of the nursing department were largely unaware.

    2. You are supervising a new graduate LPN who is ordered to perform tracheostomy care. The LPN states that she has performed this procedure only a handful of times, and completes the task slowly. Which of the following actions made by you is most appropriate?
      A)
      Perform the task yourself, and have the LPN watch.
      B)
      Reassure the LPN that they are likely being overly self-critical and encourage them to perform the task alone.
      C)
      Observe the LPN, then provide positive feedback after the task is completed.
      D)
      Protect patient safety by prohibiting the LPN from performing tracheostomy care until the LPN feels confident.
    3. As a nurse manager, you notice that one of your new nurses has provided exceptional care for a patient with complex needs. What would be the MOST effective way of acknowledging the nurse's performance?
      A)
      Saving the nurse from embarrassment by complimenting the nurse in private.
      B)
      Waiting for the nurse to come out of the patient's room, then telling them specifically what you appreciated about the care that was provided.
      C)
      Sending an e-mail to the nurse thanking them for their excellent performance.
      D)
      Praising the nurse's behavior during the nurse's next performance review.
    4. A nurse is caring for a client who is unconscious and has a living will. The client's family asks if they can make changes to lifesaving measures now that the client is unconscious. Which of the following statements should the nurse make?
      A)
      "The Patient Self-Determination Act (PSDA) will explain your rights to change lifesaving measures."
      B)
      "The durable power of attorney for health care can cancel the client's living will."
      C)
      "The living will can be changed by you at any time."
      D)
      "The living will states the client's wishes regarding lifesaving measures."
    Page 2 of 8

    Exam Review

    1. A nurse is caring for a client whose informed consent form has been signed in preparation for a procedure. The client states, "I have decided not to have the procedure." Which of the following actions should the nurse take?
      A)
      Explain the risks and benefits of refusing the surgery.
      B)
      Discuss alternatives to the procedure.
      C)
      Remind the client the consent form has already been signed.
      D)
      Inform the provider that the client is withdrawing consent.
    2. Resistance is most likely when change:
      A)
      involves nonprofessional workers.
      B)
      requires interdisciplinary collaboration.
      C)
      involves many layers in an organization.
      D)
      threatens personal security.
    3. A nurse is caring for a client who is unconscious and has a living will. The client's family asks if they can make changes to lifesaving measures now that the client is unconscious. Which of the following statements should the nurse make?
      A)
      "The Patient Self-Determination Act (PSDA) will explain your rights to change lifesaving measures."
      B)
      "The durable power of attorney for health care can cancel the client's living will."
      C)
      "The living will can be changed by you at any time."
      D)
      "The living will states the client's wishes regarding lifesaving measures."
    4. At the beginning of the shift, the RN charge nurse instructs an RN to care for a particular set of patients. Upon receiving and acknowledging their assignment, the RN assumes:
      A)
      sole responsibility and accountability for the patient's wellbeing.
      B)
      responsibility for their tasks, but accountability lies with the charge nurse.
      C)
      accountability for their tasks, but overall responsibility lies with the charge nurse.
      D)
      neither responsibility nor accountability for the patient's wellbeing.
    Page 3 of 8

    Exam Review

    1. Which of the following are notable benefits and characteristics of debriefing? Select all that apply.
      A)
      Debriefing success is affected by the skills of the debriefer.
      B)
      Debriefing encourages an analysis of the implication of our actions.
      C)
      Debriefing can result in a cognitive reframing of a situation.
      D)
      Debriefing is a self-guided exploration that works best without a debriefer.
      E)
      Debriefing involves intentionally disregarding the meaning of our actions in order to focus on the action itself.
    2. A nurse is giving a presentation about client confidentiality to a group of newly licensed nurses. Which of the following actions is an example of a violation of confidentiality?
      A)
      Reporting laboratory findings to a member of the client's family.
      B)
      Notifying the provider of physical examination findings.
      C)
      Discussing a client's surgical procedure with the nurse manager.
      D)
      Identifying the client by name when making a referral for home health services.
    3. At the beginning of the shift, the RN charge nurse instructs an RN to care for a particular set of patients. Upon receiving and acknowledging their assignment, the RN assumes:
      A)
      sole responsibility and accountability for the patient's wellbeing.
      B)
      responsibility for their tasks, but accountability lies with the charge nurse.
      C)
      accountability for their tasks, but overall responsibility lies with the charge nurse.
      D)
      neither responsibility nor accountability for the patient's wellbeing.
    4. A night shift nurse is assigning a specific component of care to an unlicensed nursing personnel (UNP) employee. The night nurse shift nurse understands that though the unlicensed personnel is for the task, the nurse would remain for the patient's wellbeing.
      A)
      accountable, responsible
      B)
      accountable, free from responsibility
      C)
      responsible, free from accountability
      D)
      responsible, accountable
    Page 4 of 8

    Exam Review

    1. An RN is delegating a task to an unlicensed assistive personnel. Which of the following scenarios best demonstrates appropriate delegation?
      A)
      "Mr. G's lunch tray should arrive in 30 minutes. Before you deliver his meal tray, please reinforce the information that the diabetes educator went over with him earlier this morning. If necessary, re-teach him to regulate his intake of carbohydrates. Report to me when you are finished."
      B)
      "Mr. G in Room 258 finished taking a shower and needs help getting back to bed. Help him as soon as possible. Please ensure he wears non-slip socks before ambulating. Once you have assisted him back to bed, notify me so I can assess him."
      C)
      "Mr. G just called and is complaining of dizziness. Please see him as soon as possible and feel his pulse. If you suspect he is hypoglycemic, give him orange juice then check his blood sugar. When you are done, report to me your findings."
      D)
      "Mr. G requests assistance to the bathroom. Please help him as soon as possible. I understand you are new and are uncomfortable with this task, but the best way to learn is to try on your own. When you are done, let me know how it went."
    2. A nurse is instructing a newly licensed nurse about the scope and standards of nursing practice. Which of the following characteristics best describes standards of practice?
      A)
      Focuses only on the ethical expectations of the nursing profession.
      B)
      Lists a set of skills and responsibilities that every nurse is expected to provide regardless of their role.
      C)
      Establishes a protocol for care to provide for a specific health problem.
      D)
      Outlines the necessary criteria for nursing schools to receive accreditation.
    3. At the beginning of the shift, the RN charge nurse instructs an RN to care for a particular set of patients. Upon receiving and acknowledging their assignment the RN assumes:
      A)
      sole responsibility and accountability for the patient's wellbeing.
      B)
      responsibility for their tasks, but accountability lies with the charge nurse.
      C)
      accountability for their tasks, but overall responsibility lies with the charge nurse.
      D)
      neither responsibility nor accountability for the patient's wellbeing.
    4. A charge nurse is providing an in-service to a group of staff members on incivility. Which of the following situations should the nurse include as an example of lateral violence?
      A)
      A charge nurse speaks to an assistive personnel (AP) with a demeaning tone.
      B)
      A charge nurse is rude to their nurse manager when speaking.
      C)
      A nursing supervisor refuses to help a charge nurse with staffing.
      D)
      A nurse rolls their eyes at another nurse after providing report.
    Page 5 of 8

    Exam Review

    1. Two nurses approach their manager about a conflict regarding the patient assignment. The nurses are talking loudly and at the same time. Which of the following actions made by the manager demonstrates effective negotiation skills?
      A)
      The manager instructs the nurses to resolve the issue amongst themselves.
      B)
      The manager warns the nurses that if the problem is not resolved, disciplinary measures are warranted.
      C)
      The manager dismisses both nurses, insisting that they stop complaining.
      D)
      The manager asks each nurse, one at a time, to present their opening position.
    2. A charge nurse is observing the actions of an assistive personnel (AP). Which of the following actions by the AP is appropriate?
      A)
      Logging off the computer after entering a client's intake and output totals.
      B)
      Posting the client's medical diagnosis on a message board in the client's room.
      C)
      Discarding her nursing activity worksheet in a waste basket at the nurse's station at the end of the shift.
      D)
      Providing her password to a new nurse in orientation so that the new nurse can enter her client's vital signs.
    3. By following a shared leadership model, the nurse manager believes that staff members will learn to function synergistically. Some teams function synergistically because members:
      A)
      do not speak unless they are absolutely sure they are correct in their views.
      B)
      listen to the person who believes he or she is an expert.
      C)
      actively listen to each other.
      D)
      do not volunteer unwanted information.
    4. In the cardiac intensive care unit, a group of nurses is disgruntled by a recent policy change enacted by the new unit manager. The new manager insists that this decision is "right," and for critics to adopt the policy immediately. Though many nurses agree with the change, many others feel the decision was made without their consent, fostering mistrust of the manager and each other. Which of the following statements demonstrates the most probable result of this situation?
      A)
      Upon noticing the positive outcomes of the decision, the disagreeing nurses will see the error of their ways, resulting in intergroup cohesiveness.
      B)
      Patient care may suffer because attention and energy is being diverted.
      C)
      The conflict will allow nurses to more clearly identify their shared values.
      D)
      Overall unit outcomes will be enhanced since the policy change is the right decision.
    Page 6 of 8