Leadership and Management Exam 2 Test Bank

Leadership Exam #2 1. The nurse has attended a refresher course on successful delegation. Which statement indicates successful learning has taken place? A. “I just don’t understand why people think delegation is difÏcult all you must do is tell other people what to do.” B. “Now I know that effective delegation means telling my nursing staff when they need to have their regular work done. C. “I knew that effective delegation made my job easier, but I never thought about how it could benefit the hospital.” D. “The clients on our unit come and go so frequently that delegation is of little benefit.” 2. A healthcare organization has provided intensive education to staff regarding benefits and correct methods of delegation. Which of the following would be reasons for the organization to sponsor these sessions? SATA A. Delegation transfer accountability to the delegatee. B. Patient satisfaction scores increase when care is efÏcient and effective. C. Good delegation helps reduced overtime. D. Good delegation increases productivity. E. Delegation is required by joint commission. 3. When researching interventions that affect the quality and cost of care. Which action would be best for the nurse to take? A. Implement a quality improvement project. B. Increase the amount of orientation time. C. Reduce the use of supplies. D. Encourage overtime schedule. 4. The nurse manage observes a social media post by a staff nurse that discusses the care of a client. Which action should the nurse manager take? A. Notify the board of nursing. B. Inform client about the post. C. Report the post to a supervisor. D. Request the post to be deleted. 5. The nurse manager is preparing a budget using the incremental method for an existing cardiac care unit. Which action the nurse mange take? A. Verify that the revenue would generate from the care of one client. B. Calculate the expense of taking care of one client. C. Determine the expected increase in salaries from the previous year. D. Predict the average client volume for the unit. 6. A nurse asks an unlicensed assistant to help with discharging clients since so many are going home at one time. The nurse asks, “Can you help get these clients ready to go home by helping them pack?” Which option best describes the statement regarding effective delegation? A. The delegation is ineffective because the nurse has no authority to ask the UAP to help with clients. B. Delegation could have been more effective had the nurse gone with the assisstant to ensure the assistant did the packing. 7. 8. 9. 10. 11. 12. 13. C. The delegation is ineffective since the nurse has no responsibility to pack the client’s belongings. D. Delegation would have been more effective had the nurse been more specific about which client and when it should be completed. The healthcare provider orders dopamine at 8mcg/kg/min for a client who weighs 264 lbs. Dopamine is supplied as 800mg in 250mL D5W. the nurse will set the infusion rate at mL/hour? - 18mL Which situation indicates the nurse needs additional training on effective delegation? A. A rehabilitation nurse ask a physical therapy assistant to assist a client with ambulation around the facility. B. The charge nurse tells the UAP to help prepare rooms for the new clients. C. A home health nurse calls the ofÏce and asks another nurse to make the visit on her next client. D. The ofÏce nurse calls in orders for admission on a client following a surgical complication. Which factor influences a persons interpretation of information? SATA A. Environment B. Precipitating events C. Context D. Past experiences E. Preconceptions Which task is appropriate for the RN to delegate to the UAP, provided the delegate has had experienced and training? A. Change the disposable tracheostomy cannula for a new postoperative tracheostomy patient if secretions are thick. B. Evaluate the ability of a patient to swallow ice after a gastroscopy. C. Obtain a sterile urine sample from a patient with a foley catheter that is connected to a closed drainage system. D. Assist a patient who is postoperative hip replacement to ambulate with a walker for the first time. The nurse is preparing to administer total parenteral nutrition (TPN) 2100 ml to infuse over 24 hours. The total volume of the TPN mixture is 1865 mL. The nurse should set the IV pump to deliver mL/hr. Round to the nearest whole number. - 88mL For the nurse to effectively and legally delegate, which document must be consulted and followed to reduce the likelihood of liability? A. The regulations state nurse practice acts B. The rules of the governing specialty organization C. The American nurses association bylaws D. The National council of state board of nursing A nurse is concerned about the risks of delegating tasks to LPN and UAP. What is the best way for the nurse to determine competency of an inexperienced delegate? A. Question the patient to confirm that the care provided was satisfactory. B. Ask other nurses if they feel the delegate is competent, 14. 15. 16. 17. 18. 19. C. Ask the delegate how many times he/she has performed the task. D. Personally observe the delegate perform the assigned task. A nurse manager is delegating a new, complex task to the unit secretary. Which of the following strategies would be effective if used by the nurse manager? A. Introduce generalities of the task with the promise of providing additional details such as a timeline. B. Make eye contact with the secretary when explaining the task. C. Discuss the importance of the task to the organization. D. Talk to the secretary in person rather than by telephone or in e-mail. A nurse manager has made a goal to be more available to staff. Which action(s) by the nurse manager would send a conflicting message to staff members? SATA A. Keep the ofÏce door shut during open ofÏce hours. B. Follow up on emails within 24 hrs. C. Delegate staff evaluations to charge nurses. D. Limit availability beyond 8a-5p Mon-Fri. E. Greet staff members at the beginning of the shift. A newly licensed nurse is concerned about the legal aspects of delegation. What is the most important question for the nurse to consider prior to delegating a task ? A. Does this task involve nursing judgment? B. Do other nurses in the facility delegate similar tasks? C. How busy is the delegate? D. How long has the assistant worked at the facility? The nurse manager is discussing a situation that has occurred between staff nurse and UAP. The staff nurse states, “When I work with the UAP, they always ignore the client care tasks I have delegated." Which statement by the nurse manager promotes open communication? A. “Why didn’t you discuss your concerns with the UAP first?” B. “You may be delegating too many tasks to the UAP?” C. “What I hear you saying is that your clients are not getÝng the care you expect?” D. “Does the UAP performs tasks delegated by other nurses?” A nurse manager has calculated that providing 75 hours of direct nursing care per day requires that 120 hours must be worked by nursing staff. The manager is involved in what activity? SATA A. Applying productivity metric B. Incremental budgeting processes C. Monitoring the labor budget D. Addressing budget assumptions E. Developing the capital budget The nurse prepares the medication ordered for the client. The nurse ask the nurse assistant to give the medication when the client receives breakfast and to report on the task as its completion. The nurse assistant agrees. Which components of the steps of delegation was violated by this request? A. Determining the task B. Reaching agreement C. Deciding on the delegate D. Defining the task 20. The nurse manager is reviewing the communication technique preference for different generations. Which strategy would be appropriate for staff who are considered baby boomers? A. Printed memo B. Formal meeting C. Email D. Group discussion 21. The client needs to receive an insulin drip of 9.5 units per hour. The insulin drip is supplied as 200 units in 150mL 0.9% NS. The nurse will set the infusion rate at mL/hour? Round to the nearest whole number. - 7mL 22. An organization uses the top-down method for budget development. Which role should the nurse manager expect to take in the budgeting process? A. Implementation of the budget B. Participation in planning meetings C. Identification of operational expenditures D. Creation of targeted goals 23. An LPN/LVN has transferred to a nursing unit and arrives for the first day. The RN checks with the LPN often throughout the shift to provide support and determined if assistance is needed. The RN is providing which level of? A. Continual supervision is being provided until the RN determines competency. B. There is no supervision, because at times the LPN is not with the RN. C. Initial supervision is being provided because this is the LPN first day on the unit. D. Periodic inspection is being used because the LPN/LVN is licensed, the RN is relieved of the need to evaluate care. 24. A nurse moves from California to Arkansas and due to having 20 years of experienced as a registered nurse is immediately placed in charge of the telemetry unit. The stafÏng consist of LPN’s and two UAP’s. The RN is unsure of the scope of practice of the LPN and reviews the nurse practice act for Arkansas. Which lacks clarity on some tasks. What should the RN do to best acquire the necessary information? A. Contact The State Board of Nursing to determine legal scope of practice of the LPN B. Refer to California’s nurse practice act because the scope of LPN/LVN is consistent across the united states. C. Query the state nursing association to determine their stances on the role of the LPN’s D. Ask the LPN’s on the unit to list what tasks they routinely performed 25. The job description of the staff nurse states the nurse is responsible for attending hospital committee meeting as assigned. The nurse manager asking the staff member to attend a risk management meeting is an example of which concept? A. Ineffective delegation B. Transfer of authority C. Work assignment D. Over delegation 26. Which describes the time frame the nurse manager should begin developing the budget for the next fiscal year? A. Every month of the current fiscal year 27. 28. 29. 30. 31. 32. B. Within a month of the new fiscal year C. At least three months before the new fiscal year D. A year in advance of the new fiscal year The nurse manager is completing a chart audit on the documentation completed by a new nurse. Which documented statement would require the nurse manager to intervene? A. The client reports feeling unsteady when ambulating with 1 person assist. B. The client ambulated daily down the hall safely with a stand-by-assist. C. The client ambulated down the hall requiring a 1 person assist. D. The client had an unsteady gait when ambulating, requiring a 1 person assist to avoid falling. The manager is handling conflict between a female staff nurse and a male unlicensed assistive personnel. The UAP was delegated hygiene care for a client and did not complete a task. Which statement by the UAP demonstrates a red herring logical fallacy? A. “ I am not the only one who can do the task” B. “You just don’t care how hard I actually work” C. This is because you do not like male UAP’s” D. She thinks she knows everything because she is the nurse” The nurse manager is developing the budget for a brand-new outpatient clinic. Which resource allocation will be a priority before the clinic generates revenue? A. Staff development B. Décor C. Advertising D. Housekeeping Which initial action will the action should the new nurse manager take when learning to develop a budget? A. Gain an understanding of the cost of care for the unit B. Review the organizational budgeting guidelines C. Review budgetary needs for the unit D. Meet with the chief financial ofÏcer When considering the feasibility of an all-RN staff, a nursing a nursing administrator determines what fact concerning the RN’s role? SATA A. They are usually more reactive than proactive to patient care errors. B. They are effective overseers on patient’s overall health condition C. They have a positive effect on patient outcomes when managing patient care. D. Their training makes them effective care delegates. E. They are generally costlier and less efÏcient than LPNs Which action by the nurse manager participating in the budget process demonstrates monitoring? A. Reviewing the revenue for services to be provided B. Adjusting the staff assignment based on the client census. C. Calculating the expected annual staff salaries. D. Surveying staff determine which equipment needs to be replaced. 33. The nurse manager is confronted by a staff nurse who had their vacation request denied. The staff nurse states, “ I think this was a mistake, my vacation should have been approved.” Which statement would be the most appropriate response by the nurse manager? A. If you can find someone to cover your shift, then I will approve it. B. You seem upset, but I will not be able to approve your vacation. C. I am sure it was not a mistake, but we can talk about it. D. I understand that this must be frustrating for you. 34. A staff nurse asks the nurse manager. “ What assignment are you delegating to me today? I would like to begin to organize my day before the shift report begins.” What is the error inherent in this statement? A. The nurse manager is not delegating but rather making daily assignments. B. There is no way for the nurse to know how to organize until the assignment is clear. C. Assignment occurs after a shift report. D. The nurse manager would not make assignments. 35. As a member of the budgeting committee, the nurse manager reviews the salaries for the file clerks in the accounting department. These salaries should be included in which budget item? A. The indirect cost B. The fixed cost C. The direct cost D. The variable cost 36. A nurse is preparing to administer an IV bolus of 1 liter 0.9% normal saline to infuse over 3 hours. The nurse will set the infusion pump at mL/hr? - 333ml/hr 37. The nursing supervisor states, “ I really don’t have the time to delegate this task to a nurse. I can do it faster!” What is the most likely basis for this statement? A. The nursing supervisor feels that he or she can do the job faster. B. The nursing supervisor is concerned that staff is ill-prepared to assume additional responsibilities. C. The nursing supervisor’s job description needs to be redefined. D. The nursing supervisor does not have time to delegate. 38. The nurse manager is preparing discuss with a staff member who has repeatedly called in. How their actions have affected the unit Which statement by the nurse manager would be best to make ? A. When you call in for your shift, it creates more work for the staff. B. Your actions have consequences for everyone. C. You keep putÝng in a tough position when you call in for your shift. D. I am challenged to maintain the quality of care when you call in for your shift. 39. The nurse manager overhears a discussion between the charge nurse and staff nurse, discussing the delegation of responsibilities. Which response by the staff nurse demonstrates aggressive communication? A. I will do the task since it might be the challenge for you. B. If you think I need to do this, I will. C. I guess I will make time to do the task. D. Who gives you the authority to tell me what to do ? 40. Which of these represent an obstacle to delegation? SATA A. Unclear chains of command B. Most of the nursing staff deliver highly skilled care. C. Each employee knows and executes job responsibilities. D. The entire organization has a team-centered culture E. There is a budget shortfall for the current fiscal year. 41. A nurse educator is asked by the chairperson of the department to submit a list of equipment that could be used to meet the department’s goals. The list includes projectors, computers, ofÏce supplies, and computer-assisted programs. How would the educator categorized the materials? A. As part of the operating budget. B. As an expense. C. As part of the capital budget. D. As part of the revenue