Role & Scope REAL Final (solutions) Latest 2020.

Role & Scope REAL Final Question 1 1. A nurse manager notices that a nurse in the unit is not delivering care in accordance with a recent policy change. What is the most effective approach for the nurse manager to ta ...

Role & Scope REAL Final Question 1 1. A nurse manager notices that a nurse in the unit is not delivering care in accordance with a recent policy change. What is the most effective approach for the nurse manager to take? Encourage the nurse to openly verbalize the reasons for resistance to the change. Explain to the nurse the importance of implementing the new policy. Ignore the resistance and allow peer pressure to facilitate change in the nurse's behavior. Threaten disciplinary consequences if the nurse does not implement the new policy. 1 points Question 2 1. A nurse's brother had a lab test performed at the facility where the nurse is employed. The brother has asked the nurse to look up the result in the computer. In replying, the nurse realizes that disclosing the result is Permissible. Because this is an immediate family member, the action is allowable. Not permissible. The primary physician is the only one allowed to disclose laboratory results or findings to a client. Permissible. Because the sibling has paid for the service, the test results are actually the sibling's property. Not permissible. Despite the request, there is no nurse-client relationship between the sibling and the nurse. 1 points Question 3 1. A nurse is caring for a client who is in a coma, and the client’s brother reports that the family does not want any heroic measures performed. How should the nurse respond? "Have you discussed this with the client?" "I will verify the status of advance directives." "Does the client have a living partner?" "The provider will write a DNR order." 1 points Question 4 1. A nurse is caring for a client. The nurse demonstrates adherence to the ethical principle of fidelity in practice by doing which of the following? Confirming that a client going for surgery has signed a consent form. Refusing to disclose information about a client to the media. Keeping an appointment with the client. Allowing a new mother to hold her stillborn infant. 1 points Question 5 1. A nurse receives a client care assignment that he believes is unfair. Which of the following is an appropriate action for him to take? Contact the nursing supervisor and ask her to intervene on his behalf. Ask another nurse to review the equity of the assignment. Speak with the charge nurse about the assignment and his concerns. Accept the assignment and talk with the nurse manager at a later time. 1 points Question 6 1. A nursing unit has recently implemented new actions designed to reduce medication errors. Which of the following methods of evaluation is appropriate to measure the results of these new actions? The number of medication errors avoided after the actions were implemented The number of medication errors before and after the actions were implemented. Results of a staff questionnaire that quantifies staff satisfaction with the changes Results of a study about the time and money costs of implementing the changes 1 points Question 7 1. The nurse is working with a group of clients assisted by an assistive personnel (AP). The nurse should make which of the following determinations before delegating a task to the AP? The AP's ability to prioritize. The AP's rapport with the clients. Whether the nurse can more efficiently complete the task without assistance. The task is within the AP's scope of practice. 1 points Question 8 1. The new Unit Manager on the Medical Unit is not satisfied with the patient satisfaction rate of 60% for two consecutive months and staff morale is at its lowest. The decision to plan and initiate change has been decided. Prior to implementing any change, which of the following actions is a priority? Call for a staff meeting and get input from all members of the team. Seek help from his manager. Develop a strategic action on how to deal with these concerns. Ignore the issues since these will be resolved naturally. 1 points Question 9 1. A new nurse wants to provide client centered care. Which of the following is the best guarantee that the patient’s priority needs are met? Checking with the relative of the patient Preparing a nursing care plan in collaboration with the patient Consulting with the physician Coordinating with other members of the team 1 points Question 10 1. A charge nurse observes that a staff nurse is not able to meet client needs in a reasonable time frame, does not problem-solve situations, and does not prioritize nursing care. The charge nurse has the responsibility to: supervise the staff nurse more closely so that tasks are completed ask other staff members to help the staff nurse get the work done provide support and identify the underlying cause of the staff nurse's problem report the staff nurse to the supervisor so that something is done to resolve the problem 1 points Question 11 1. Nursing often has challenges in gaining independence as a profession. What deciding factors must the nursing profession embrace? Health and happiness of nurses Recognition that the doctors know best Loss of control and negative feedback Responsibility and accountability 1 points Question 12 1. Recommendations made by the Robert Wood Johnson Foundation in The Future of Nursing include: The Bachelor's Degree in Nursing (BSN) must be the minimum entry point for registered nurse. Nurses are not aware that policy making requires better data collection and information infrastructure . Nurses with associate's degrees should not be practicing bedside nursing. Nurses should practice to the full extent of the education and training. 1 points Question 13 1. As part of quality management, the nurse manager double checks to see that all patient teaching is documented in the Electronic Health Record. This is because: She is concerned that nurses are not doing their full share of the work Joint Commission requires documentation of patient teaching in the charts. Nurses do not plan teaching interventions based upon outcomes or goals Discharge teaching should begin when the discharge orders are made by the provider 1 points Question 14 1. Which of the following statements best describes transformational leadership? Shares vision and encourages staff to develop professional goals Serves the followers rather than being served Maintains full trust and confidence in the subordinates Possesses innate charisma that makes others feel good in his presence 1 points Question 15 1. The nurse manager notes that there is an increasing unrest of the staff due to fatigue. Which action is a priority? Evaluate the overall result of the unrest. Initiate a group activity for communication to begin. Develop a plan and implement it. Identify internal and external forces causing the fatigue. 1 points Question 16 1. What is the nurse’s role in Continuity of Care? (Select all that apply). Facilitate the continuity of care provided. Diagnose the patient's medical condition. Coordinate the discharge planning. Act as the liaison and a client advocate. Prescribe the recommended treatments before discharge. 1 points Question 17 1. A nurse manager permits her staff to request which holidays they would prefer to work. This style of leadership is best described as: Autocratic Laissez-faire Democratic Authoritarian 1 points Question 18 1. A nurse manager is called upon to settle a disagreement between two staff nurses. What needs to be done in order to find a solution to the dispute? Go up the chain of command File an incident report Identify the source of the conflict Survey the other nurses to see who is at fault 1 points Question 19 1. Which of the following tasks can safely be delegated to the LPN? Discharge planning Diabetes education Pain medication via IV push Tracheostomy care 1 points Question 20 1. Which of the following are elements of effective team building? Encouraging a workplace OR fostering a culture that values collaboration and cooperation Publicly announcing staff problems and issues that are of concern Discouraging new ideas that may make older nurses feel uncomfortable Smoothing over potential issues that disturb the patients on the unit 1 points Question 21 1. A charge nurse on a medical unit has been informed that one nurse is talking on the cell phone during her shift. What would be the first step in analyzing the situation? Have a nurses’ meeting reviewing proper use of cell phones. Speak with the nurse in question about the cell phone use. Require all cell phones to be on silent during the shift. Give the nurse a written warning about her use of the phone. 1 points Question 22 1. A school bus driving through a small town ran into a train. There are numerous injuries, many of which are serious. Which type of leadership style would be the most appropriate for the Chief Nursing Officer in this situation? Laissez-faire Authoritative (Autocratic) Directional Democratic 1 points Question 23 1. A nurse is planning an educational session for a newly diagnosed diabetic client. Which action should the nurse take first? Refer the client to the American Diabetic Association. Assess the client's abilities and readiness to learn. Ask a nursing assistant to give the client pamphlets on diabetes. Demonstrate the measurement of blood sugar to the client. 1 points Question 24 1. Which task is best suited for the new LPN who is assisting you today? Administer furosemide 100mg IV Give discharge instructions to the client and family members Insert a no. 16 Fr Foley catheter Draw blood for a potassium level 1 points Question 25 1. A nurse is caring for a client with a right breast lumpectomy and lymph node dissection. Which nursing action can be delegated to the UAP? Teaching the client why blood pressure will be taken on the left arm only Elevating the client's arm on pillows to promote lymphatic drainage Assessing the client’s right arm for lymphedema Reinforcing the dressing if it is saturated 1 points Question 26 1. Evidence-based practice has been established to advance nursing practice. The goals for this practice have been to: reduce health care costs and improve health care. facilitate the highest quality care and the best client outcomes. encourage increased research utilization in nursing practice. evaluate research findings and scientific evidence to a specific clinical question. 1 points Question 27 1. Which factors have been most clearly identified as major influences on the future of nursing practice? Aging of the American population and increases in chronic illnesses Increasing birth rates coupled with decreased average life expectancy Increased awareness of determinants of health and improved self-care Apathy around health behaviors and the relationship of lifestyle to improved health 1 points Question 28 1. Which of the following nursing actions supports interdisciplinary collaboration? (Select all that apply.) Open communication with all team members Designation of a nurse who will serve as the group leader Acknowledgement of the knowledge and skill each discipline offers Invitation to the client to participate in team meetings Disposition of the client’s valuables to the unit safe 1 points Question 29 1. A new nurse manager understands that in order to resolve conflicts in difficult crises, he must: Have decreased self-esteem and motivation Use established coping skills to resolve future crises View the experience as personally destructive Avoid all difficult situations in the future 1 points Question 30 1. A nurse manager has been called upon to mediate a dispute between two staff nurses. The manager recognizes that anger is: Typically negative and usually destructive. Can sometimes be positively used to produce needed change. Should be held in as long as possible as controlled rage. Needs to be expressed immediately. 1 points Question 31 1. A nurse manager encourages staff to work it out between themselves when conflicts occur between 2 nurses. What leadership style is this? Democratic? Autocratic Laissez-faire Controlling 1 points Question 32 1. The nurse manager requests a staff nurse to submit an incident/occurrence report. Select the statements which describe why this reporting is necessary. (Select all that apply). The facts about the occurrence are documented The facility needs to find out who is responsible for causing the incident Identify systems issues that contributed to the occurrence Engage in strategies to prevent future occurrences Assign blame for the problems caused 1 points Question 33 1. Which statement describes the impacts absenteeism can have on patients and health care workers? Replacement nurses are capable of working in any unit assigned. The unit saves money and patient care is still accomplished. Managers are prepared to staff units and expect some absenteeism. High rates of absenteeism may lower morale of fully engaged nurses. Short staffing can be linked to poorer patient outcomes 1 points Question 34 1. The electronic health record (EHR) has advantages and disadvantages to health-care workers. Select the statements which describe the advantages to EHR. (Select all that apply.) Multiple care providers can access the client's record Provide reminders about completing information Reduces redundancy of patient information? Steep learning cures are involved Improves interdepartmental collaboration 1 points Question 35 1. A nurse is caring for a dying patient. Which is an indication that the needs of the terminally ill nonverbal client is not well-managed? Hyperactive bowel sounds Crackles in the lungs Unwillingness to eat Constant restlessness and leg movement 1 points Question 36 1. The freedom to make decisions that affect self and to take action for self is called: Advocacy Authority Autonomy Autocracy 1 points Question 37 1. A nurse volunteers for the hospital quality improvement team and has been asked to evaluate nursing care on the unit. What would be most appropriate for the nurse to initially ask the staff to do? Track the number of supplies used by clients on the unit Document the time spent on direct client care Administer a client and family satisfaction survey Assess clients and report acuity daily 1 points Question 38 1. After receiving a shift report, the nurse (RN) has many tasks to complete during the next 12 hours. Which tasks would the nurse delegate to an unlicensed assistant person (UAP)? Flushing a nasogastric tube on a client who has had a colectomy Irrigating a clogged urinary catheter on an older adult client Measuring and recording hourly urine output for a client who had a nephrectomy Changing a dressing on a client with an infected foot ulcer 1 points Question 39 1. The primary nurse is assigned to four clients on the unit. Of the following, which one should the nurse assess first? 45 year old client scheduled for a chest x-ray 29 year old client needing a daily dressing change 72 year old postoperative client being discharged today 33 year old client on oxygen for recent shortness of breath 1 points Question 40 1. A nurse is working with a female client interested in complementary and alternative medical (CAM) treatments for a chronic health condition. The nurse should: Recommend the herbal remedies that the client should be using Provide education about the therapies she is most interested in using Discourage the client from using any form of alternative therapies Advise the client about “good” vs “bad” therapies 1 points Question 41 1. The novice nurse is experiencing a difficult transition from student to registered nurse, finding that the hospital environment is much different than the one previously envisioned. This is known as: Reality shock Role disparity / confusion Clinical incompetence Theory-Practice let down 1 points Question 42 1. A state of emotional exhaustion that results from the accumulative stress of an individual's life, including work, personal, and family responsibilities is known as: Case management Downtime Burnout syndrome Cognitive disfunction 1 points Question 43 1. Which of the following factors have contributed to the nursing shortage? (Select all that apply). Shortage of qualified nursing faculty An ever-increasing demand for health care Working conditions such as short staffing and long hours Equitable pay for equitable work The unprofessional image of nurses portrayed in the media 1 points Question 44 1. Research is showing the growing elderly population in the United States has major health care consequences. Some of them include: (Select all that apply). As more of the elderly seek health care, the nursing shortage will only become more pronounced. There is an increasing need for practitioners who specialize in elderly care.? Resources such as fresh fruits and vegetables are becoming scarce. Mental disorders and cognitive function problems are the leading cause of compromised self-care and self-management of the elderly at home. Nurses are not taught to deal with elderly patients. 1 points Question 45 1. The nurse practitioner has ordered 180 mg of Dilantin po q8h. Your patient weighs 98 lb. The label of the drug reads 250 mg per 5 mL. How many milliliters will you adminster to this patient per dose? 3.9 mL 6.2 mL 3.6 mL 5 mL 1 points Question 46 1. The type of leadership style that can be used many times is dependent on the situation at hand. Reflect on the 3 different types of leadership styles that you have learned. In 100-400 words, define each leadership style. Be complete and thorough using key words that help understand the thoughts and ideas of a particular type of leader. Each description must be in detail, but clear and concise. 47. a nurse is working in a skilled nursing facility and wants to change a policy regarding emptying foley cath bags. Which of the following demonstrates the nurse is using informatics for improving the police by using EBP? He looks up the procedure in a police book on the floor. He uses the EMR to assess the number of UTIs being treated within the last yr. He asks the provider for written information on infection rate 44. ED Nurse is checking orders prescribed by the provider. For safety purposes, which one most require clarification? Start nitro drip per protocol prn chest pain 42. a new graduate nurse is seeking employment at a magnet hospital and learns that the hospital promotes shared leadership. Which of the following describes this style of leadership? 41. which of the following guidelines should be considered in formulating objectives for nursing care? 39. identify the reasons a new graduate nurse to be reluctant to delegate tasks to members of the care team. 34. What is a recommended method of nurses to prepare for future professional practice? 33. The newly appointed manager of a large medical surgical unit feels uncomfortable believing that she is the scapegoat of everything that goes wrong in her department. Most the staff nurses are senior to her. They are very confident and sometimes aggressive. WOTF is the best action that she must take? 30. The charge nurse hears from a client that the floor nurses have not been responding to requests for pain meds. What should be the initial action for the charge nurse? 26. You are a preceptor for a novice nurse who is caring for a client with lung cancer. The new nurse gives the client oxycodone 10 mg orally for pain. Which finding would you direct the nurse to report immediately? 17. Mark is a hospice nurse has had problems working with another nurse Nicholas. Nicholas has been telling patients that he is better than the others, and the patients have not been accepting mark’s instruction when he was covering for Nicholas. Noelle is their supervisor. WOTF actions would she recommend to mark in dealing with the issue?