Miami Regional University Florida NURSING 5950: Review for Mid-Term (Leadership).

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Review for Mid-Term (Leadership). 1- 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? 2- A unit manager of a 25-bed medical/surgical area receives a phone call from a nurse who has called in sick five times in the past month. He tells the manager that he very much wants to come to work when scheduled but must often care for his wife, who is undergoing treatment for breast cancer. According to Maslow’s need hierarchy theory, what would be the best approach to satisfying the needs of this nurse, other staff, and patients? 3- A grievance brought by a staff nurse against the unit manager requires mediation. At the first mediation session, the staff nurse repeatedly calls the unit manager’s actions unfair, and the unit manager continues to reiterate the reasons for the actions. What would be the best course of action at this time? 4- At a second negotiation session, the unit manager and staff nurse are unable to reach a resolution. What is the appropriate next step? 5- The manager of a surgical area has a vision for the future that requires the addition of RN assistants or unlicensed persons to feed, bathe, and ambulate patients. The RNs on the staff have always practiced in a primary nursing-delivery system and are very resistant to this idea. What would be the best initial strategy for implementation of this change? 6- As the RN charge nurse on the night shift in a small long-term care facility, you’ve found that there is little turnover among your LPN and nursing assistant (NA) staff members, but they are not very motivated to go beyond their job descriptions in their work. Which of the following strategies might motivate the staff and lead to greater job satisfaction? 7- The nurse manager wants to increase motivation by providing motivating factors for the nurse on the unit. What action would be appropriate to motivate the staff? 8- A charge nurse on a busy 40-bed medical/surgical unit is approached by a family member who begins to complain loudly about the quality of care his mother is receiving. His behavior is so disruptive that it is overheard by staff, physicians, and other visitors. The family member leaves the unit abruptly, and the nurse is left feeling frustrated. Which behavior by the charge nurse best illustrates refined leadership skills in an emotionally intelligent practitioner? 9- The chief nursing officer has asked the staff development coordinator to facilitate the development of a clinical competency program for the facility. While making rounds on the units, the staff development coordinator overhears RN staff complaining that they feel it is insulting to be required to participate in a competency program. What behavior by the staff development coordinator is most appropriate in this situation? I. 10- The nurse manager has been asked to implement an evidence-based approach to teach ostomy patients self-management skills postoperatively. The program is to be implemented across the entire facility. What illustrates effective leadership in this situation? J. 11- You overhear a new graduate RN telling a nurse colleague that leadership and management belong to the unit manager, not to her. As a nursing colleague, what do you know to be true in regard to the statement? 12- The charge nurse walks into Mr. Smith’s room and finds him yelling at the LPN. He is obviously very upset. The charge nurse determines that he has not slept for three nights because of unrelieved pain levels. The LPN is very upset and calls Mr. Smith an “ugly, old man.” The charge nurse acknowledges the LPN’s feelings and concerns and then suggests that Mr. Smith’s behavior was aggressive but was related to lack of sleep and to pain. The charge nurse asks, “Can you, together with Mr. Smith, determine triggers for the pain and effective approaches to controlling his pain?” This situation is an example of what? 13- After assessing an older adult patient in long-term care who has been slowly deteriorating for weeks, the nurse manager calls the family and asks them to come in, as the patient is dying. What is the most likely basis for the nurse manager’s request? 14- Chart audits have revealed significant omissions of data that could have legal and financial guideline ramifications. The unit manager meets with the staff to discuss audit findings and to find approaches that will address the gaps in charting and achieve desired goals. What is the manager demonstrating? 15- A family is keeping vigil at a critically ill patient’s bedside. Distant family members call the unit continuously asking for updates and expressing concern. The nurse speaks with the distant family members and states she is referring them to the hospital social worker, whose role is to work with family in this situation. What role is the nurse assuming through this action? 16- o unit manager. During the time on the unit, the nurse formed a strong social network among staff, has promoted the development of relationships between staff and workers in other areas of the organization, and has formed relationships that generate ideas from patient organizations and the local nursing education program. According to complexity theory, what principle is being engaged? 17- The manager in the coronary care unit believes an important ethical consideration in performance evaluations is to include the employee’s good qualities and give positive direction for professional growth. What ethical principle does this represent? 18- A staff nurse in the area that you manage has excelled in the delivery of patient education. You are considering implementing a new job description that would broaden her opportunity to teach patients and orient new staff members to the value of patient education. What ethical principle is being reinforced? 19- A patient refuses a simple procedure that you believe is in the patient’s best interest. What two ethical principles are in conflict in this situation? 20- An individual in a wheelchair is applying for the position of receptionist in an outpatient clinic. What does the nurse manager understand based on The Americans with Disabilities Act of 1990 requirements for employers? 21- A staff nurse, who was fired for reporting patient abuse to the appropriate state agency, files a whistleblower lawsuit against the former employer. What reason would the court provide to uphold a valid whistleblower suit claiming retaliation by the nurse? 22- In keeping with standards of The Joint Commission (TJC), the nurse manager organizes an orientation for new staff members. As part of the orientation, the nurse manager reviews the employee handbook. What is the basis that binds employers to statements in the employee handbook? 23- To reduce the incidence of falls in a skilled nursing unit, the nurse manager contacts the risk manager. Risk management is a process that attempts to identify potential hazards and: 24- One means of ensuring that the nurses floated to other patient care areas in healthcare organizations are qualified to work in the areas they are floated is: 25- A colleague asks you to give her your password access so that she can view her partner’s healthcare record without using her login. This request violates the patient’s right to: 26- On your nursing unit, you employ LPNs, RNs, and advanced practice nurses. You will need to be familiar with at least: 27- A nurse on your inpatient psychiatric unit is found to have made sexually explicit remarks toward a patient with a previous history of sexual abuse. The patient sues, claiming malpractice. What conditions do not apply in this situation and do not support malpractice? 28- As a charge nurse, you counsel your RN staff member that they have has their duty of care by notifying a child’s physician regarding concerns about deterioration in the child’s status at 0330 hours. The physician does not come in to assess the child and does not provide additional orders. The child dies at 0630 hours. As the charge nurse, you could be held liable for what? 29- The parents of a toddler who dies after being brought to the ER launch a lawsuit, claiming that the failure of nurses to pursue concerns related to their son’s deteriorating condition contributed to his death. How is senior nurse executive is named in the suit? 30- During a staff shortage, you hire an RN from a temporary agency. The RN administers a wrong IV medication that results in cardiac arrest and a difficult recovery for the patient. Liability in this situation: 31- You volunteer at a free community clinic. A 13-year-old girl presents with chlamydia. The team leader at the clinic advises that: 32- According to Leininger, “cultural imposition” is a major concern in nursing because nurses have a tendency to impose their values, beliefs, and practices on patients of other cultures. The discussion topic most likely to be without cultural imposition would be: 33- Cultural diversity is the term used to describe a vast range of cultural differences. Events have symbolic meanings for the nurse manager and the staff. The event that would be most likely to provide symbolic meaning to a nurse manager and staff is a: 34- One of the staff nurses on your unit makes the comment, “All this time I thought Mary was black. She says she is Jamaican.” The best response would be to say: 35- As a nurse manager, you notice that Maria, a Hispanic nurse aide, is visibly upset. When you ask her if something is wrong, she becomes tearful and says, “Why is it that when John and I work together in giving patients care, he jokes about my being “a little fat Mexican”? The nurse manager’s best response is, “Do you think he: 36- The nurse manager of a unit is asked by a family member of a dying Native American patient if it is possible to have the patient’s eight-member family recite the rosary by the bedside. The manager responds affirmatively. The nurse manager is most likely exhibiting behavior related to: 37- A 66-year-old native Chinese patient, hospitalized for a myocardial infarction, asks the nurse manager about seeing his “acupuncture doctor” for treatment of his migraine headache. The best response to this patient would be: 38- Maintaining a culturally diverse staff and working with a culturally diverse patient population is an important function of a nurse manager who works in the hospital of a large medical center. On your palliative care unit, you have recently received complaints from families about ineffective pain management for their family members and you determine this occurs primarily when certain nurses are working. What approach might you take to resolve the concerns of the families, patients, and potentially, the staff? 39- Because an increasing number of Hispanic patients are being admitted, a nurse manager designs a staff-development program to help her staff understand the Hispanic culture. A nurse should understand that culture is determined by which of the following? 40- The nurse manager for a unit’s culturally diverse staff creates a staff-development program so the professional nursing staff members can enhance their understanding of cultures on the basis of published literature. The literature reveals that the following characteristic is inherent in a culture. It: 41- In designing programs through your institution to address the health needs of Hispanics in your community, you most likely would develop programs related to: 42- Within the deaf culture, there is considerable disagreement about the use of SEE (Signed Exact English) and ASL (American Sign Language). This is indicative of: 43- When interviewing a candidate for a nursing position who has an Aboriginal background, you recognize that the candidate’s lack of eye contact reflects the candidate’s: 44- When interviewing a candidate for a nursing position who has an Aboriginal background, you recognize that the candidate’s lack of eye contact reflects the candidate’s cultural sensitivity. You are exhibiting: 45- Mary joins 5W nursing unit. Mary is a new graduate who is anxious to fit in. She soon learns that some of her “book learning” is being criticized by her colleagues, so she adapts her practice to what others on the unit are doing. She is demonstrating: 46- At Health Center XYZ, staff members on the rehabilitation unit have a head nurse who is intolerant of error and publicly chides anyone who makes a mistake. Over time, the rules on the unit dictate that mistakes are hidden and that areas of concern related to the functioning of the unit are discussed in tub rooms and are never openly discussed during periodic meetings. New staff members are quickly made to realize that silence is expected. The situation described is an example of: 47- As a nurse manager, you observe a staff nurse who over the past few weeks has become withdrawn and has had several absences due to minor ailments. Your best action would be to: 48- The nurse manager of a unit has lost many staff members, and the unit is now staffed with a large number of agency and traveling nurses. She knows that the agency and traveling nurses are all contracted to stay on the unit for the next 3 months. One way to improve morale and decrease stress in the unit would be to: 49- As a nurse manager, the one activity you should not overlook is: 50- A nurse manager has decided that she must institute some personal time-management steps to survive work and home life. Her first step should be to: 51- A hospice nurse has been feeling very stressed at work because of both the physical strain and the emotional drain of working with clients with AIDS. She tries to walk 1 to 2 miles three times a week and to talk regularly with her husband about her work-related feelings. One reasonable stress-management strategy would be to: 52- The nurse manager is implementing a shared governance model to help with communication and decision making. Although staff members like the concept, change is difficult. Staff nurses feel: 53- The chief nursing officer listens to nurse managers verbalize their feelings of internal stress. One common source of internal stress seems to be: 54- The staff development educator presents a series of programs on stress management to the nurse managers. Research has indicated that an individual’s ability to deal with stress is moderated by psychological hardiness. Psychological hardiness is a composite of: 55- The chief nursing officer understands that a nurse manager can exhibit stress that is related to trying to keep up with the number of electronic messages that arrive, as well as trying to remain accessible to staff. What is a strategy that would assist the manager to manage the information overload effectively? 56- In helping nurse managers to manage their time, the chief nursing officer suggests that they: 57- Which of the following statements would best define stress? Stress is: 58- In a job interview for a nursing position, Marley can be assured that which of the following will occur? 59- Which one of the following statements has been proven to be true? 60- An example of role stress occurs when: 61- A staff nurse approaches the unit manager and indicates to her that because of her father’s death in the previous month, she is now finding it very difficult to do her work effectively. This would be considered a(n) stress. 62- A group of staff nurses is dissatisfied with the new ideas presented by the newly hired nurse manager. The staff wants to keep their old procedures, and they resist the changes. Conflict arises from: 63- Two staff nurses are arguing about whose turn it is to work on the upcoming holiday. In trying to resolve this conflict, the nurse manager understands that interpersonal conflict arises when: 64- The nurse manager is aware that conflict is occurring on her unit; however, she is focused on preparing for a state health department visit, so she ignores the problem. What factor can increase stress and escalate conflict? 65- The nurse manager decides to use a mediator to help resolve the staff’s conflict. A basic strategy for truly addressing this conflict is to: 66- Sarah, a staff nurse on your unit, witnesses another nurse striking a patient. Sarah wants to remain friends with her colleague and worries that confrontation with her colleague or reporting her colleague will destroy their relationship. Sarah is experiencing which type of conflict? 67- The chief nursing officer plans a series of staff development workshops for the nurse managers to help them deal with conflicts. The first workshop introduces the four stages of conflict, which are: 68- After using a mediator to resolve a conflict between the nurse manager and two staff nurses, the chief nursing officer decides to: 69- A nursing instructor is teaching a class on conflict and conflict resolution. She relates to the class that conflict in an organization is important, and that an optimal level of conflict will generate: 70- Jane has transferred from the ICU to the CCU. She is very set in the way she makes assignments and encourages her new peers to adopt this method without sharing the rationale for why it is better. This is a good example of a process and procedure that creates which type of conflict? 71- Two nurses on a psychiatric unit come from different backgrounds and have graduated from different universities. They are given a set of new orders from the unit manager. Each nurse displays different emotions in response to the orders. Nurse A indicates that the new orders include too many changes; Nurse B disagrees and verbally indicates why. This step in the b- 72- Mrs. Hill, aged 68, was hospitalized after a stroke. The speech therapist recommended that oral feeding be stopped because of her dysplasia. During visiting hours, Mr. Hill fed his wife some noodles. The nurse noticed this and stopped Mr. Hill from feeding his wife, telling him it was the doctor’s decision. An hour later, the nurse returned and found Mr. Hill feeding his wife again. The nurse tried to stop him again. Mr. Hill refused and claimed that the clinical staff was trying to starve his wife; he also threatened to get violent with the nurse. The nurse decided to walk away and documented the event in Mrs. Hill’s chart. According to Thomas’ four stages of conflict, in which stage could the nurse have been more effective? 73- Mrs. Hill, aged 68, was hospitalized after a stroke. The speech therapist recommended that oral feeding be stopped because of her dysplasia. During visiting hours, Mr. Hill fed his wife some noodles. The nurse noticed this and stopped Mr. Hill from feeding his wife, telling him it was the doctor’s decision. An hour later, the nurse returned and found Mr. Hill feeding his wife again. The nurse tried to stop him again. Mr. Hill refused and claimed that the clinical staff was trying to starve his wife; he also threatened to get violent with the nurse. The nurse decided to walk away and documented the event in Mrs. Hill’s chart. The outcome as depicted by Thomas’ conflict stages can be considered to be: 74- Jill is the head nurse on a unit in a large hospital. Two of the staff nurses are constantly arguing and blaming each other, and a resolution has not occurred in months. To solve the existing conflict, which is the most creative conflict resolution? 75- A nurse educator is giving a workshop on conflict. During the sessions, he makes various statements regarding conflict. All of the statements are true except: 76- Sarah is a nurse manager in a surgical unit. She is concerned about a conflict between Lucy (a staff nurse) and one of the maintenance personnel. Sarah explains to Lucy that unsatisfactory resolution of the conflict is typically destructive and will result in: 77- The number of adverse events such as falls and pressure ulcers on the unit is increasing. An ideal staffing plan to address this issue would include which of the following? Increasing the: 78- A small rural hospital has been designated as a critical access hospital. It has 40 beds and an average occupancy of 34 beds. To prepare the staffing, the chief nursing officer computes the occupancy as being: 79- To prepare staffing schedules, a nurse manager needs to calculate paid nonproductive time. When calculating paid nonproductive time, the nurse manager considers: 80- An important aspect of managing the costs on a unit is to plan accurately for staffing needs. Nurse managers use staffing plans to: 81- A nurse manager must consider a number of external variables when preparing the personnel budget and projecting the unit’s staffing needs. An external variable to be considered is: 82- A nurse manager must also consider a number of internal variables that will affect staffing patterns. An internal variable to be considered is: 83- A nurse manager uses many sources of data when planning the unit’s workload for the year. Which of the following data must be considered in [Show More]

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