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Resume DueReview for Midterm
Intro to Management
Leadership PVN 151Day 4 September 30,
2014
Your Resume is Due today
Your grade will be posted after I get the results from Graduate Services
Resume
Leadership Midterm Review
What should you include?
What should you leave out?
How do you get it noticed?
Resume
What you need to
know for the test -
ResumeWhat format and presentation
should you use?
What part does a cover letter play?
Do you need to include one?
Good Resume
Bad Resume
A student is really anxious to get everything they have ever done on their resume but they have way to much “stuff” to fit on one page.The student needs to remember (select all that apply)
a. Margins should be at least 0.5 inches on all 4 sides
b. Paper should be brightly colored to get their attention
c. ‘legal sized paper may be used when you have a lot to share
d. Standardized cover letters are the professional way to make a first impression
e. Include in the cover letter that after researching other positions this is the one the student prefers
Sample Question - Resume
What can’t an employer ask? Do you have kids?
What religious holidays do you celebrate?
What can an employer ask?
The Interview
Tell me about your work experience
The Interview
When should you start scheduling
them?
How to be more successful at them
How to prepare
What to take
When to arrive
The Interview
Sample Interview question
The graduate nurse arrives for her first interview and is feeling great about it until the interviewer asks which illegal question?
a. “Have you been convicted of a crime other than a minor traffic violation?”
b. “We are very interested in hiring you but you do understand the position is contingent on the results of the pre-employment physical and background check?”
c. “What do you consider to be your major weaknesses for this particular position?”
d. “Because you are applying for a position in the operating room, you must be able to be on call. How many children do you have responsibility for at home?”
Vocabulary
ADVANCED DIRECTIVE
What is it?Legal standing –
what legal standing does it have?Can it be ignored?What is your nursing obligation?
Sample question – Advanced Directive
A patient asks, “What is an advance directive?” The nurse explains that examples of advance directives are: (Select all that apply.)
a. preserving cord blood for possible future needs of a child.
b. providing instructions that life-sustaining medical procedures should be withheld in the event of a terminal situation.
c. giving someone the legal right to act on one’s behalf when one becomes incapacitated.
d. completing hospital admission paperwork before being admitted to the hospital.
What does Advocate mean?
What are the nursing implications?
Advocate
Burnout
• What is it?
• What causes it?
• How is it recognized?
• How is it treated?
DelegationWho can do it?
Who cannot do it?
Who can be delegated to?
Delegation5 Rights of Delegation Right Task Right
Circumstances Right Person Right Direction Right Supervision
and Evaluation
http://www.youtube.com/watch?v=Bp07WpHtV7E
Delegation - How is it done?1. Determine a task that
can be done by non licensed individual
2. Write out clear and concise instructions and have them reviewed by another person for clarity and thoroughness
3. Find a person with the ability and capability to learn the task and do it successfully
4. The person chosen to be delegated to has to be willing to take on the responsibility5. Teach the skill/task6. Have the delegate explain in their own words your instructions and7. then do a return demonstration of the skill8. Schedule times for monitoring task being performed and evaluations.
What must the nurse do once delegation occurs?
MonitorAnd evaluate
A nurse is concerned about the risk of delegating tasks to licensed practical nurses and unlicensed assistive personnel. What is the best way for the nurse to determine competency of the delegatee?
a. Actually observe the delegatee perform the assigned task.
b. Ask the delegatee how many times he/she has performed the task.
c. Ask the patient if the care provided was satisfactory.
d. Ask other nurses if they feel the delegatee is competent.
A Correct: The best way for the nurse to determine the competency of LPNs or UAPs is to observe them perform the task and check on them regularly throughout the shift. Incorrect:b. Asking the delegatee may inform the nurse of how many times the task has been performed but will not provide evidence of competency.c. Patients may be able to rate their satisfaction with care but cannot judge the competency of the LPN or UAP.d. The opinion of other nurses can be used to validate the nurse’s findings, but only firsthand observation can provide evidence of competency.
External Force (s)What is it ( are they)?
How do they relate to nursing?
HIPAA
LEADERSHIP
What is it?
Midterm Exam
A nurse is on break and checking emails. One email contains a picture of a celebrity who is a patient in the hospital, and on the same floor, where the nurse works. Included with the photo is a message, “check out my Facebook,” which contains additional photographs of the patient. The nurse immediately deletes the picture to prevent having to report the “friend” to supervisors. Based on the action of the nurse who received the message, which statement is correct?
a.The nurse is not at risk for having his/her license suspended since removing the photos made them temporary and invisible to all others.b.Because the nurse did not send the message and immediately deleted the photo, there is no risk for discipline.c.Failing to report receiving the message places the nurse at risk for discipline.d.Because the patient is on the same floor as the one on which the nurse works, the information can be ethically and legally shared.
_ C _ 1.Correct: Failing to report the image
can result in discipline.
Incorrect:
a. Removing a posting or a picture from a website does not make it
unavailable because it is retrievable.
b. Nurses who have received patient pictures and not
immediately reported the problem have been subject to the same
discipline as nurses who sent the pictures.
d. Information posted on social media can be viewed by others who are not providing health care—even
the public.
_a_ 2. Correct: Nursing scrubs have become a popular alternative to the traditional white uniform; clean wrinkle free matching scrubs presented a professional image. Small stud earrings reduce risk of injury to nurse when caring for confused or combative patients. Incorrect: b. Mismatched scrubs may be interpreted as someone who doesn’t take an interest in the profession or lacks time management.c. White uniforms have been replaced by scrubs in most healthcare facilities. The apron was used by student nurses from the past who also were restricted from wearing jewelry. Having the hair pulled back continues today to adhere to infection control policies that prevent hair from entering sterile fields or falling in patients personal space. Many feel the white uniform is associated with a time when nurses had less voice in patient care and were “handmaidens” to physicians.d. Caps were discontinued due to infection control. Most healthcare agencies prohibit nurses from visible piercing other than one small stud earring per ear.
a. Nurse in matched scrubs with lab coat, hair back, small stud earrings
b. Nurse in mismatched scrubs, no lab coat, large hoop earrings
c. Nurse in white uniform with apron with no jewelry/hair back
d. Nurse with nose ring and eyebrow piercing with starched white uniform and cap
Which nurse best portrays nursing as a “knowledge worker”?
_D_ 3. Correct: It is illegal for the recruiter or interviewer to ask number of children or dependents prior to making a job offer. Incorrect: a. Employers can ask questions about criminal convictions but not arrests.b. Job offers are contingent on the applicant passing required tests and background check.c. Interviewers often seek to determine individual candidates self-evaluation of skills needed for the position.
A new graduate arrives for the first interview feeling
prepared and excited about beginning a nursing career
but quickly becomes concerned when the
recruiter asks which illegal question?
a.
“Have you been convicted of a crime other than a minor traffic violation?”
b.
“We are very interested in hiring you but you do understand the position is contingent on the results of the pre-employment physical and background check?”
c. “What do you consider to be your major weaknesses for this particular position?”
d.
“Because you are applying for a position in the operating room, you must be able to be on call. How many children do you have responsibility for at home?”
_ A _ 4. Correct: A professional or appropriate message that lets the person know they have reached the correct number and that you will return the call as soon as available. Incorrect: b. Some music is offensive to callers, especially if it has a message that is contradictory to their beliefs or has lewd messages—a message like this may end the interview before it begins.c. This message implies the applicant is more important person than the caller and does not request caller to leave a message.d. This message asks the interviewer to leave information that is discussed during the interview.
Which message would be appropriate to leave on
answering systems?a.
“You have reached Jane Doe at 910-999-1212. Please leave your name and number and I look forward to returning your call as soon as possible.”
b.
Music that has messages that might be offensive to some callers downloaded as the response when applicant is unavailable.
c.
“Hi, I’m not here. Sorry you missed me. Call again.”
d.
“I am interviewing for positions, hope to be home soon. If you are calling about an interview, please leave your name, number and possible positions available.”
B, C, E 5. Correct: b. Core solutions to the nursing shortage include providing incentives for minorities and men to enter nursing.c. Core solutions to the nursing shortage include obtaining grant funding to increase the number of faculty members and scholarship availability for students entering baccalaureate nursing programs.e. Core solutions to the nursing shortage include developing ad campaigns that target younger students.Incorrect:a. Determining why few African-American women enter graduate school would not result in a greater number of nurses entering and staying in practice.d. Job satisfaction among nurses is currently high.
Which actions would result in a greater number of nurses entering and staying in
practice, given today’s state of nursing? (Select all that apply.)
a.
Determine why few African-American women enter graduate school.
b.
Provide incentives for minorities and men to enter nursing.
c.
Obtain grant funding to increase the number of faculty members and scholarship availability for students entering baccalaureate nursing programs.
d.
Survey nurses to determine why their job satisfaction is lower than that of other health care professions.
e.
Develop ad campaigns that target younger students.
_ A, C, D 6. Correct: a. The board of nursing ensures that nursing licenses are granted and renewed.c. The board of nursing assigns disciplinary action when provisions of the nurse practice act are violated.d. Members are appointed.Incorrect: b. The National Council of State Boards of Nursing constructs the licensure examination.e. Certification examinations are administered by the American Nurses Credentialing Center
A group of graduates were just notified that they had successfully passed the licensure examination. During the orientation process at the hospital, one asks, “I am looking at my license, but I don’t really
know the duties performed by the board of nursing.” The staff development nurse explains that
the board of nursing:(Select all that apply.)
a.
grants nursing licensure.
b.
constructs the licensure examination.
c.
assigns disciplinary action when the nurse acts in a manner that results in harm to a patient.
d.
members are appointed.
e.
conducts certification examinations for advanced practice nurses.
_B, C 7 Correct: Advance directives document an individual’s desires regarding end-of-life care. These wishes are generally stated through the execution of a formal document known as the living will. Right-to-die statutes vary from state to state; therefore, nurses must become familiar with their state-specific statute. Incorrect: a. Advance directives identify client wishes in terms of the right to die; they are not directives to help prevent illness or terminal illness.d. Completing hospital paperwork is part of the preadmission process. The client could bring his or her living will to the hospital on admission, but this document would have been prepared prior to the admission and is not part of the hospital documentation paperwork.
A patient asks, “What is an advance directive?” The nurse explains that
examples of advance directives are: (Select all that apply.)
a.
preserving cord blood for possible future needs of a child.
b.
providing instructions that life-sustaining medical procedures should be withheld in the event of a terminal situation.
c.
giving someone the legal right to act on one’s behalf when one becomes incapacitated.
d.
completing hospital admission paperwork before being admitted to the hospital.
C, D, E 8. Correct: c. Internal dialogue establishes a means for the graduate to recall achievements that will lead to success in the first nursing position.d. Jobs such as cashier at a convenience store or dog-sitting can demonstrate responsibility such as handing cash or arriving on time.e. Arriving too early may cause the recruiter to feel rushed and arriving too late may demonstrate lack of time management and professionalism. Incorrect: a. The primary goal for the first job is to find good match that fits the nurse’s abilities, lifestyle, and career aspirations.b. Interviews should be set up prior to graduation.
A new graduate nurse is preparing for an interview for her first position and
knows that: (Select all that apply.)
a.
the primary goal for the first job is to complete orientation and should be considered as an extension of nursing school.
b.
appointments for interviews should be scheduled immediately after graduation to avoid rushing into a position.
c. self-confidence can be improved with self-talk, which reminds the graduate that peers from her school are effective practitioners.
d.
work history of even nonmedical positions can demonstrate commitment and reliability so letters from these employers should be in portfolio.
e.
it is best to arrive 10 to 15 minutes before the scheduled interview dressed for success.
A, E 9. Correct: a. Ample margins—minimum of 0.5 inch (1 inch preferred)—should be used on all four sides to prevent appearing cluttered.e. A statement declaring this position is one’s first choice should be included. Incorrect: b. The paper should be white or ivory and on heavy bond paper, never bright colored.c. Legal size paper is not acceptable. Seek help from a professional to determine what to include and what can be placed in a portfolio. d. The applicant should write from their own perspective and writing style tailored to the position
A nurse preparing a resume for the first position is anxious to demonstrate all
achievements, which included completing a rigorous accelerated program and
maintaining a high GPA while also serving in many community projects and
leadership positions. The applicant finds it impossible to include all the accolades on
one page and researches tips for professional cover letters and resumes
and learns: (Select all that apply.)a.
margins should be at least 0.5 inch on all four sides, making conciseness important.
b.
paper should be bright colored to catch the attention of the recruiter.
c. legal size paper may be used when applicants have many accolades or extensive work history.
d.
standardized cover letters present a professional image as opposed to those that stress the applicant’s perspective too heavily.
e.
include in the cover letter that after researching other position, this is the applicant’s preference.
A_ 10. Correct: The best way for the nurse to determine the competency of LPNs or UAPs is to observe them perform the task and check on them regularly throughout the shift. Incorrect: b. Asking the delegatee may inform the nurse of how many times the task has been performed but will not provide evidence of competency.c. Patients may be able to rate their satisfaction with care but cannot judge the competency of the LPN or UAP.d. The opinion of other nurses can be used to validate the nurse’s findings, but only firsthand observation can provide evidence of competency.
A nurse is concerned about the risk of delegating tasks to licensed practical nurses and unlicensed assistive personnel. What is
the best way for the nurse to determine competency of the delegatee?
a.
Actually observe the delegatee perform the assigned task.
b.
Ask the delegatee how many times he/she has performed the task.
c.
Ask the patient if the care provided was satisfactory.
d.
Ask other nurses if they feel the delegatee is competent.
_C_ 11. Solution: c. "Forgetting to wash your hands between clients can lead to spread of infection." The employee needs to realize the unwanted behavior has consequences for the client. An employee may not realize the reason for the policy. A better understanding may prevent the behavior in the future. The employee must understand the consequences if the behavior does not change but this should not be communicated in a threatening manner.
A certified nurse's aide (CNA) has been reported to the nurse manager for refusing
to wash her hands between giving clients their morning care. Which of the following
statements by the nurse manager would be the most effective?
Choose one answer.
a.
"If I hear of any more instances of your not washing your hands, I will write you up.".
b.
"Why do you refuse to wash your hands?".
c.
"Forgetting to wash your hands between clients can lead to spread of infection.".
d.
"Do you need a class on hand washing?
_B_ 12. Answer = B “ B “ is best because not all individuals are poor performing.A is second best as at least you can talk about lower overall team performance (which may make those people most responsible lift their performance – without others knowing who is involved).C looks OK on the surface but not so good in allowing the team member to decide what to do next (after all you are the leader and should be inviting input rather than decisions).D is also not very helpful from a leadership perspective as it lets the situation drift.
A few individuals on your usually high performing team have been
underperforming in minor ways for a few weeks but you have said nothing so far.
What would you do now?
a.
Call the whole team together to discuss the need for better performance than the past few weeks.
b.
Talk to lower performing people on the team individually (one at a time).
c.
Ask one of the more trusted and longer experienced people on team what they think you should do..
d..
Do nothing at this stage as performance has yet to really suffer badly
_D_ 13. Let the staff ventilate her feelings and ask how she can be of help. Reaching out and helping the staff is the most effective strategy in dealing with burn out. Knowing that someone is ready to help makes the staff feel important; hence her self-worth is enhanced.
Kathleen knows that one of her staff is experiencing burnout. Which of the following is
the best thing for her to do?
A. Advise her staff to go on vacation.B. Ignore her observations; it will be resolved even without intervention
C. Remind her to show loyalty to the institution.
D. Let the staff ventilate her feelings and ask how she can be of help.
Her former manager demonstrated passion for serving her staff rather than being served. She takes time to listen, prefers to be a teacher first before being a leader, which is characteristic of
a. Transformational leaderb. Transactional leaderc. Servant leaderd. Charismatic leader
_c 14.
. Answer: (C) Servant leader Servant leaders
are open-minded, listen deeply, try
to fully understand
others and not being judgmental
One leadership theory states that “leaders are born and not made,” which refers to which of the following theories? a. Traitb. Charismaticc. Great Mand. Situational
_c_ 15. Answer: (C) Great
Man Leaders become leaders because
of their birth right. This is also
called Genetic theory or the
Aristotelian theory
She came across a theory which states that the leadership style is effective dependent on the situation. Which of the following styles best fits a situation when the followers are self-directed, experts and are matured individuals?a. Democraticb. Authoritarianc. Laissez faired. Bureaucratic
_c 16.
Answer: (C) Laissez faire
Laissez faire leadership is
preferred when the followers know what
to do and are experts in the field.
This leadership style is relationship-
oriented rather than task-centered.
She knows that there are external forces that influence changes in his unit. Which of the following is NOT an external force? a. Memo from the CEO to cut down on electrical consumptionb. Demands of the labor sector to increase wagesc. Low morale of staff in her unitd. Exacting regulatory and accreditation standards
_C_ 17.
Answer: (C) Low morale of staff in
her unit Low morale of staff is an internal factor
that affects only the unit. All the
rest of the options emanate from the
top executive or from outside the
institution.
True or False Transformational leadership is a leadership style where leaders create an inspiring vision of the future, motivate their followers to achieve it, manage implementation successfully, and develop the members of their teams to be even more effective in the future
_A_ 18. ( A) True
Transformational leadership is a leadership
style where leaders create an inspiring vision
of the future, motivate their followers to achieve
it, manage implementation
successfully, and develop the members of their
teams to be even more effective in the future
_A_ 19. True Good leaders lead by example . They do what they say, and say what they do. These types of leaders are trustworthy, and show integrity. They get involved in daily work where needed, and they stay in touch with what's happening throughout the organization. Great leaders don't just sit in their offices and give orders; they demonstrate the actions and values that they expect from the team.
True or False
Good leaders lead by example
_B 20 . False autocratic → focuses on teamwork and workgroup participation in decision-making, leader collaborates with others in making decisions.This is false.It should be autocratic → retains all authority, makes all decisions and establishes one-way communication with the work group.
True or False
autocratic → focuses on teamwork
and workgroup participation in
decision-making, leader
collaborates with others in making
decisions.
Review for Final
Everything is fair game from term 1 through Ethics
PVN 151 – Leadership and Management
5 “Rights” of Delegation• What are they? • What do they mean? • How do they work? • What are the nursing implications? • Who should you delegate to? • Are there ever any considerations
besides skill in delegating?
Advocate
What does this mean?
What are the nursing
implications?
How is it done?
American Nurses Association (ANA’s) Code of Ethics -
What is it?What does it mean to the nurse and the patient?First, the nurse is expected to practice kindness and respect, regardless of who is receiving his or her communication.
American Nurses Association (ANA’s) Code of Ethics -
What does it mean to the nurse and the patient?The therapeutic use of self is expected in this provision.In every human interaction, we communicateone of three statements:
In every human interaction, we communicateone of three statements:
1. Go away, my world would be better without you.2. You are an object, a task to be done, you meannothing to me.3. You are a person of worth, I care about you(Fowler, 2008, p. 6).
In every human interaction, we communicateone of three statements:
What do a nurse’s touch, look, and actions communicate?Do they convey respect for the person receivingcare?(On line handout “Practical Use of the Nursing Code of Ethics”)
AutonomyWhat does it mean?Autonomy is the right to self-determination.What are the Nursing implications?
Autonomy What are the Nursing implications?
“Patients have a moral and legal right to determine what will be done with their own person; to be given accurate, complete, and understandable informationin a manner that facilitates an informed judgment;
Autonomy What are the Nursing implications?
to be assisted with weighing the benefits, burdens, and available options in their treatment, including the choice of no treatment; to accept, refuse, or terminate treatment without deceit, undue influence duress, coercion, or penalty;
Autonomy What are the Nursing implications?
and to be given necessary support throughout the decision making and treatment process” (ANA, 2001, p. 8).
This support may involve calling a physician to come and re-explain the procedure, or assuring the surrogate who signed the consent has the best interest of the patient in mind.
This is a nursing obligation
Beneficence
Act for the patient’s benefit Relieve pain and suffering Keep society safe
Case Manager - What does a case manager do?
Case management nurses are registered nurses who coordinate all aspects of the care of individual patients. They ensure proper utilization of services and resources as well. Case managers provide assistance within, between, and outside of facilities. Nurses working in case management facilitate outstanding patient care using fiscally responsible strategies. They are experts at obtaining resources.
Charge Nurse
Charge nurses supervise and support a nursing staff while also treating a limited number of patients. Charge nurses are responsible for maintaining a high level of patient care, evaluating other nurses and acting as an educational resource for nurses.They are both leaders and managers
Charismatic Leader
What are the characteristics of a Charismatic Leader?
Collaboration
What does it mean?How is it used in nursing?When preparing care plans who is the most important person for the nurse to collaborate with?
Critical Thinking
What is it? Critical thinking is the disciplined, intellectual process of applying skillful reasoning as a guide to belief or action.
Critical Thinking
How is it done?
Critical Thinking
Critical ThinkingWhat are the nursing implications?In nursing, critical thinking for clinical decision-making is the ability to think in a systematic and logical manner with openness to question and reflect on the reasoning process used to ensure safe nursing practice and quality care. A manager needs to be able to think critically and solve complex problems.
In which of the following examples is the nurse not applying critical thinking skills in practice?
a. The nurse considers personnel experience in performing intravenous (IV) line insertion and ways to improve performance.
b. The nurse uses a fall risk inventory scale to determine a patient's fall risk.
c. The nurse observes a change in a patient's behavior and considers which problem is likely developing.
. d. The nurse explains the procedure for giving a tube feeding to a second nurse who has floated to the unit to assist with care.
Sample Question
DelegateWhat does it mean?
What are the nursing implications?
Ethical What does it mean and what are the nursing implications?
What is Ethics? Systematic way to form value judgments on
human actions Is organized and reflective Is NOT intuitive or based on “gut feeling”
Principles of right conduct within a social system
Critical concept: We make judgments all the time What results from these judgments?
Healthcare Ethics Bioethics
Clinical ethics In clinical care settings Ethics of the encounter between clinician and
patient Research ethics Organizational ethics
If you want more see her presentation on line
JargonWhat is it ?Why was it included here?
MalpracticeWhat does it mean?JCAHO defines malpractice as "improper or unethical conduct or unreasonable lack of skill by a holder of a professional or official position; often applied to physicians, dentists, lawyers, and public officers to denote negligent or unskillful performance of duties when professional skills are obligatory.
Malpractice
What does it mean?
What are the nursing implications?
(next slide)
MalpracticeWhat are the nursing implications?
Nursing malpractice occurs when a nurse fails to competently perform his or her medical duties and that failure harms the patient. There are a variety of ways that a nurse can harm a patient -- from administering the wrong drug to failing to notify a doctor when something is really wrong. In nursing malpractice cases, often a key issue is who is liable for the nurse's misdeeds -- the doctor or the hospital. Whoever is liable will be responsible for compensating the patient for the nurse's misdeeds.
Sample Question A nurse is caring for a client with a fractured
arm who has just received a plaster caster. Identify the situation that would put the nurse at the highest risk for malpractice a suit.
a. Failure to keep the care plan updated
b. Notifying the physician that the client is having pain in his armc. Failure to note that the client’s fingers are cold with a bluish colord. Charting that the client did not respond to the pain medication
Manager
What is a manager?What are their duties? What do they do?How do they do their job?What skills do they need to have?What management styles are there and how do they differ?What is the difference between a leader and a manager?
Management Vs Leadership Manager's job is to plan, organize and coordinate;
leader's job is to inspire and motivate
Manager administers; leader innovates
Manager is a copy; leader is an original
Manager maintains; leader develops
Manager focuses on systems and structure; leader focuses on people
Manager relies on control; leader inspires trust (Warren Bennis, 1989)
Manager
Does a manager ever lead?
The Answer is Yes But they each have their own duties and goals to accomplish and ways to accomplish them.
Sample Question
a. Transformational
b. Transactional
c. Laissez-faire
d. Authoritative
A nurse manager wants his nursing unit to be a place where all nurses want to work, where patient satisfaction is high, and care Is innovative and interdisciplinary. Staff are encouraged to chair taskforces to improve quality of care and he counsels staff in areas of measuring patient outcomes. Other managers want to mimic this manager’s approach to improve their own units. This nurse is which type of leader?
Negligence
What is it?a nurse is required to exercise the same ordinary or reasonable care as all other health practitioners to ensure that no unnecessary harm comes to the patient. Failure to meet this standard subjects nurses to medical malpractice liability.
Negligence
How is it different from malpractice?
It is a specific kind/act of malpractice.
NegligenceHow is it different from malpractice?Documentation describing negligent behavior often uses terms such as failure to, lack of, incomplete, ineffective, and improper. The categories of negligence are: failure to follow standards of care, failure to use equipment in a responsible manner, failure to communicate, failure to document, failure to assess and monitor, and failure to act as a patient advocate
Nonmalfeasance
What is it?
Those who missed the guest speaker should review her slides
Nonmaleficence Do no harm
Stopping a medication shown to be harmful Refusing to provide a treatment that has not
been shown to be effective Increased opioid prescriptions = increased
opioids on the street
An decision is required To act or not Doing nothing may cause harm
Nurse Delivery Systems
What are they?
A nursing care delivery system defines how work is organized, how nursing staff are deployed, and who does what in providing nursing care.
Nurse Delivery Systems
What are they?Primary nursing. Team nursing. Functional nursing.Total Patient Care.
Nurse Practice Act
What is it?We talked about this on Day 2 and it was on Quiz 1 – question4How does it affect your nursing practice?
Nursing Code of Ethics
What is it?
Where do you find it?
http://www.nursingworld.org/codeofethics
http://arcweb.sos.state.or.us/pages/rules/oars_800/oar_851/851_045.html
Nursing Process
What is it?
How does it work?
Do you remember? Lets look at the slide you first saw it on
Nursing process = problem-solving process
Nursing Process Problem Solving Process
Assessment ExamineAnalysis and Dx
Consider
Plan Find a solution
Implement Plan
Implement Solution
Evaluate Evaluate
PolicyWhat is it?
“course of action to be followed by a government, business, or institution to obtain a desired effect” (Nies and
McEwen, 2011, p. 200).
Policy
What are the nursing implications?Policy, politics, and legislation are influences that determine the nursing care to individuals, families and communities.
Sample Question
a. is showing empathy and as long as she lets the patient know the money is not from her, she is not violating any social media guidelines.
b. is at risk for HIPAA violations.
c. has properly followed policy and protected the patient by not using her name.
d. is demonstrating the logical fallacy of slippery slope.
The nurse caring for a patient states, “Your blood pressure is dangerously high. Are you taking antihypertensive medicine?” The patient states, “I can’t afford my medicine. I have no insurance.” The nurse states “I feel really sorry for that patient. I wish it wasn’t against policy to give her money.” The nurse wants to help and places a note on Facebook that any donations would be appreciated to help a waitress who works at the cafeteria next door to the hospital buy her medications. The nurse posts that “She was so sick last evening when she came to the ED. I can’t believe they don’t provide insurance. I can’t give her money but you all can help.” This nurse:
Prioritization
What is it?
Prioritization
How is it done?
PrioritizationWhat are the nursing implications?
Sample Question
a. Turn in time sheet due in 3 days.
b. Review dress code policy to give feedback before appointment in the morning.
c. Perform blood glucose test on a patient admitted with Kussmaul respirations and change in level of consciousness.
d. Complete patient teaching prior to discharge in 2 hours.
e. Review procedure for inserting a PIC line to assist with procedure later this morning.
A nurse hopes to improve time management skills using the ABC prioritization approach. Which tasks would be prioritized as “B”? (Select all that apply.)
Critical thinking –
ABC prioritization system – what is it?A = Most important and time sensitiveB = Important and has to be dealt with today but not criticalC = This can wait for another day
Sample Question
a. Turn in time sheet due in 3 days.
b. Review dress code policy to give feedback before appointment in the morning.
c. Perform blood glucose test on a patient admitted with Kussmaul respirations and change in level of consciousness.
d. Complete patient teaching prior to discharge in 2 hours.
e. Review procedure for inserting a PIC line to assist with procedure later this morning.
A nurse hopes to improve time management skills using the ABC prioritization approach. Which tasks would be prioritized as “B”? (Select all that apply.)
Procedure What is it?
Nursing implications
Can you give me an example?
Servant Leader What is a servant leader?the servant-leader shares power, puts the needs of others first and helps people develop and perform as highly as possible.
Servant leaders are open-minded, listen deeply, try to fully understand others and are not judgmental
Standards of Care
What are they?
Standards of care define actions that are permitted or prohibited in most nursing interventions. These standards are accepted as legal guidelines for appropriateness of performance.
What are the nursing implications?
Team Leader
This is direct from your vocabulary list“This nurse leads the team-usually of 4 to 6 members-”
Team Leader - Team NursingIf you have a team leader you must have team nursing
What is team nursing?Use your definition of team Leader to define team nursing – this is critical thinking – if you understand one you can make an inference about the other
Sample Question
Team nursing a. Is done by a nurse and a CNAb. Provides care to a group of
patients by a group of nurses and CNAs
c. Is when 1 nurse has 8 patients to care for
d. Defined in the Nurse Practice Act
Transactional Leader
What is a transactional leader?
How does a transactional leader differ from a transformational leader?
Transactional vs transformational
Focuses on management tasks
Is a caretaker Uses trade-offs to
meet goals Does not identify
shared values Examines causes Uses contingency
reward
Identifies common values
Is committed Inspires others with
vision Has long-term vision Looks at effects Empowers others
What are the 5 Rights of Delegation?
5 Rights of DelegationRight TaskRight CircumstancesRight PersonRight DirectionRight Supervision and Evaluation
Who should a nurse delegate to?
The person with: the right attitudeThe right aptitudeThe right capacity the person they want to develop.
What is a Hospital Ethics Committee and what do they do? An Ethics Committee in hospitals is an advisory group appointed by the Hospital Medical Executive Board. The multidisciplinary ethics committee represents the hospital and the community it serves.
What is the Nursing Code of Ethics and where do you find it?
The Code of Ethics tells nurses how they should behave ethically, What our responsibilities are to our patients and the profession
You can read it at http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics.pdf
What are the components of critical thinking and how do you use them to achieve critical thinking?
ReasoningEvaluatingProblem SolvingDecision MakingAnalyze
What skills does it take to be a manager?
A manager must:PlanOrganizeStaff
What skills does it take to be a manager?
A Manager is a Decision Maker and Problem Solver she needs to be able to:
Think Critically and solve complex problems
Be a Good NurseHave Effective Communication Skills
Sample Question
a. waiting for oncoming shift to start walking rounds.
b. failure to delegate tasks to the Licensed Practical Nurse and Unlicensed Assistive Personnel and instead, completing task herself.
c. talking with a patient’s family member who is also a personal friend.
d. spending time thinking about the vacation to the beach.
e. using the Internet to read about a new drug that will be administered; then taking time to look for news about the profession, new legislation about the Patient Protection and Affordable Care Act, and new uniforms for the season.
A nurse is hoping for a promotion and seeks the help of a coach to improve time management skills. The first task assigned by the coach is for the nurse to list all external distractors that prevent organization and completion of tasks. The nurse would include: (include all that apply)
What is the Nursing process- give the components,
AssessmentAnalysis and diagnosisplanningimplementationevaluation
Nursing Process - what they mean and how to use them
ASSESSMENTANALYSIS AND DIAGNOSIS
PLANNINGImplementingEVALUATION
How does the nursing process compare to the steps of problem solving? Nursing process = problem-solving
processNursing Process Problem Solving Process
Assessment ExamineAnalysis and Dx
Consider
Plan Find a solution
Implement Plan
Implement Solution
Evaluate Evaluate
Problem solving how its done
ASSESSMENT
Gather information about the situation
Identify the problem; separate the symptoms
Identify people and groups involvedIdentify cultural and environmental factors
Encourage input from involved parties
ASSESSMENT
Identify people and groups involved
Identify cultural and environmental factors
Encourage input from involved parties
ANALYSIS AND DIAGNOSIS
Analyze results of information gathered
Identify, clarify, and prioritize the actual problem (s)
Determine if intervention is appropriate
PLANNING
Identify as many solutions as possible
Elicit participation from people or groups affected
PLANNING
Review options and consider safety, efficiency, costs, quality, and legal issues
Consider positive and negative outcomes
Remain open-minded and flexible when considering options
IMPLEMENTING
Communicate plans to everyone affected
Be sure plans, goals, and objectives are clearly identified
IMPLEMENTING
Maintain open, two-way communication with staff
Support and encourage compliance among all staff
EVALUATION
Identify evaluation criteria in the planning
Identify who is responsible for evaluation, what will be measured, and when it will take place
EVALUATION
Maintain open communication with all involved
Was the decision successful?
What might have made it better?
What are the 5 “Rights ” of delegation?
Right TaskRight CircumstanceRight PersonRight DirectionRight Supervision and Evaluation
Explain the role of the practical nurse in delegation guided by the nurse practice act. The LPN must assess the task to be delegated - is it a task that someone else can do, the patient for stability of condition, the ability of the staff to do the task, Staff attitude about being delegated to , your ability to give the directions clearly both verbally and in written form, and whether they can provide adequate super vision and evaluation
What does it take to have effective communication?
Effective Communication Skills
Effective Communication – How Do You Do It?
Learn to Listen Be Aware of Other Peoples Emotions
EmpathizeEncourage
Effective Communication – How Do You Do It?Use Humor
.
Treat People Equally
Attempt to Resolve Conflict
Maintain a Positive Attitude and Smile
FINAL
1. THE PURPOSE OF LICENSING LAWS FOR LPN/LVNS IS TO
a.limit the number of LPN/LVNs.
b.prevent malpractice.
c.protect the public from unqualified people.
d.increase revenue for the state board of nursing.
1. ANS: CThe purpose of licensing laws for LPN/LVNs is to protect the public from unqualified practitioners
2. A NURSE COULD BE CITED FOR MALPRACTICE IN THE EVENT OF
a.
refusing to give 60 mg of morphine as ordered.
b.
giving Compazine to a patient allergic to phenothiazines.
c.
dragging an injured motorist off the highway and causing further injury.
d.
informing a visitor about a patient’s condition.
: BStandards of care dictate that a nurse must be aware of all the properties of drugs administered. Compazine is a phenothiazine. Giving out confidential information is a HIPAA violation; refusing to give an excessively large narcotic dose is not considered malpractice because you might have a really good reason. Good Samaritan laws protect anyone giving aid to an injured motorist.
3. WHEN CONFRONTED WITH AN ETHICAL DECISION, THE NURSE MUST OBSERVE THE FIRST FUNDAMENTAL
PRINCIPLE OF
a.
autonomy.
b.
beneficence.
c.
respect for people.
d.
nonmalfeasance.
CThe first fundamental principle is respect for persons.
4.THE NEW LPN/LVN IS VERY CONCERNED REGARDING WHAT SHOULD OR SHOULD NOT BE DONE FOR PATIENTS. SELECT THE ANSWER THAT WILL PROVIDE THIS INFORMATION FOR HER.
a.
state nurse practice act
b.
standards of care
c.
scope of nursing practice
d.
professional organizations
BStandards of care define what should or should not be done for patients.
5. THE NURSE WHO DILIGENTLY WORKS FOR THE PROTECTION OF PATIENTS’
INTERESTS IS FUNCTIONING IN THE ROLE OF
a.
caregiver.
b.
health care administrator.
c.
advocate.
d.
health care evaluator.
CA nurse accepts the role of advocate when, in addition to general care, the nurse protects the patient’s interests.
6.THE NURSE, WHEN SEEKING ADVICE WHILE . ATTEMPTING TO MAKE AN ETHICAL DECISION . INVOLVING THE PATIENT’S RIGHT TO REFUSE MEDICATION, WOULD MOST APPROPRIATELY CONSULT
a.
a minister or priest.
b.
the hospital ethics committee.
c.
her supervisor.
d.
a more experienced nurse.
BThe nurse should seek the advice of the hospital ethics committee.
7. HER FORMER MANAGER DEMONSTRATED PASSION FOR SERVING HER STAFF RATHER THAN BEING SERVED. SHE TAKES
TIME TO LISTEN, PREFERS TO BE A TEACHER FIRST BEFORE BEING A LEADER, WHICH IS CHARACTERISTIC OF
a. Transformational leader
b. Transactional leader
c. Servant leader
d. Charismatic leader
c Servant leader Servant leaders are open-minded, listen deeply, try to fully understand others and not being judgmental
8. WHICH OF THE FOLLOWING IS THE BEST GUARANTEE THAT THE PATIENT’S PRIORITY NEEDS ARE MET?
a. Checking with the relative of the patient
b. Preparing a nursing care plan in collaboration with the patient
c. Consulting with the physician
d. Coordinating with other members of the team
b Preparing a nursing care plan in collaboration with the patient The best source of information about the priority needs of the patient is the patient himself. Hence using a nursing care plan based on his expressed priority needs would ensure meeting his needs effectively.
9. WHEN HARRY USES TEAM NURSING AS A CARE DELIVERY SYSTEM, HE AND HIS TEAM NEED TO ASSESS THE PRIORITY OF CARE FOR A GROUP OF PATIENTS, WHICH OF THE FOLLOWING SHOULD BE A PRIORITY?
a. Each patient as listed on the worksheet
b. Patients who needs least care
c. Medications and treatments required for all patients
d. Patients who need the most care
d Patients who need the most care In setting priorities for a group of patients, those who need the most care should be number-one priority to ensure that their critical needs are met adequately. The needs of other patients who need less care can be attended to later or even delegated to assistive personnel according to rules on delegation.
10. MS. CASTRO LEARNS THAT SOME LEADERS ARE TRANSACTIONAL LEADERS. WHICH OF THE FOLLOWING DOES NOT CHARACTERIZE A TRANSACTIONAL LEADER?
a. Focuses on management tasks
b. Is a caretaker
c. Uses trade-offs to meet goals
d. Inspires others with vision
d Inspires others with vision Inspires others with a vision is characteristic of a transformational leader. He is focused more on the day-to-day operations of the department/unit.
11. STEPHANIE DELEGATES EFFECTIVELY IF SHE HAS AUTHORITY TO ACT, WHICH IS BEST DEFINED AS:
a. having responsibility to direct others v
b. being accountable to the organization
c. having legitimate right to act
d. telling others what to do
c Having legitimate right to act Authority is a legitimate or official right to give command. This is an officially sanctioned responsibility
12. STEPHANIE CONSIDERS SHIFTING TO TRANSFORMATIONAL LEADERSHIP. WHICH OF THE FOLLOWING STATEMENTS BEST DESCRIBES THIS TYPE OF LEADERSHIP?
a. Uses visioning as the essence of leadership.b. Serves the followers rather than being served.c. Maintains full trust and confidence in the subordinatesd. Possesses innate charisma that makes others feel good in his presence.
a Uses visioning as the essence of leadership. Transformational leadership relies heavily on visioning as the core of leadership.
3. A NURSE IS CARING FOR A CLIENT WITH A FRACTURED ARM WHO HAS JUST RECEIVED A PLASTER CASTER. IDENTIFY THE SITUATION THAT WOULD PUT THE NURSE AT THE HIGHEST RISK FOR MALPRACTICE A SUIT. FAILURE TO KEEP THE CARE PLAN UPDATED
a. Failure to keep the care plan updated
b. Notifying the physician that the client is having pain in his arm
c. Failure to note that the client’s fingers are cold with a bluish color
d. Charting that the client did not respond to the pain medication
C Failure to note changes that indicate a circulatory problem, could be used against the nurse if complications arose from treatment - this is an unintentional torts – or Malpractice
14. YOU ARE PARTICIPATING IN A CLINICAL CARE COORDINATION CONFERENCE FOR A PATIENT WITH TERMINAL CANCER. YOU TALK WITH YOUR COLLEAGUES ABOUT USING THE NURSING CODE OF ETHICS FOR PROFESSIONAL REGISTERED NURSES TO GUIDE CARE DECISIONS. A NON-NURSING COLLEAGUE ASKS ABOUT THIS CODE. WHICH OF THE FOLLOWING STATEMENTS BEST DESCRIBES THIS CODE?
a. Improves self-health care
b. Protects the patient's confidentiality
c. Ensures identical care to all patients
d. Defines the principles of right and wrong to provide patient care.
AThe code of ethics for nurses is composed and published by ANA (American Nursing Association) Defines the principles of right and wrong to provide patient care.
15. A NURSE IS CARING FOR A PATIENT WITH END-STAGE LUNG DISEASE. THE PATIENT WANTS TO GO HOME ON
OXYGEN AND BE COMFORTABLE. THE FAMILY WANTS THE PATIENT TO HAVE A NEW SURGICAL PROCEDURE. THE NURSE EXPLAINS THE RISK AND BENEFITS OF THE SURGERY TO THE FAMILY AND
DISCUSSES THE PATIENT'S WISHES WITH THE FAMILY. THE NURSE IS ACTING AS THE PATIENT'S:
a. Educator
b. Advocate
c. Caregiver
d. Case manager
b Advocate trying to convince the family to honor the patient’s wishes
16. TRUE OR FALSE
Ethical principles for professional nursing practice in a clinical setting are guided by the principles of conduct that are written as the: American Nurses Association's (ANA's) Code of Ethics
True Ethical principles for professional nursing practice in a clinical setting are guided by the principles of conduct that are written as the: American Nurses Association's (ANA's) Code of Ethics
17. IN WHICH OF THE FOLLOWING EXAMPLES IS THE NURSE NOT APPLYING CRITICAL THINKING SKILLS IN PRACTICE?
a. The nurse considers personnel experience in performing intravenous (IV) line insertion and ways to improve performance. .
b. The nurse uses a fall risk inventory scale to determine a patient's fall risk. .
c. The nurse observes a change in a patient's behavior and considers which problem is likely developing. .
d. The nurse explains the procedure for giving a tube feeding to a second nurse who has floated to the unit to assist with care.
d The nurse explains the procedure for giving a tube feeding to a second nurse who has floated to the unit to assist with care
18. KATHERINE IS A YOUNG UNIT MANAGER OF THE PEDIATRIC WARD. MOST OF HER STAFF NURSES ARE SENIOR TO HER, VERY ARTICULATE, CONFIDENT AND SOMETIMES AGGRESSIVE. KATHERINE FEELS UNCOMFORTABLE BELIEVING THAT SHE IS THE SCAPEGOAT OF EVERYTHING THAT GOES WRONG IN HER DEPARTMENT. WHICH OF THE FOLLOWING IS THE BEST ACTION THAT SHE MUST TAKE?
a. Identify the source of the conflict and understand the points of friction
b. Disregard what she feels and continue to work independently
c. Seek help from the Director of Nursing
d. Quit her job and look for another employment.
AIdentify the source of the conflict and understand the points of friction . This involves a problem solving approach, which addresses the root cause of the problem.
19. THE DOCUMENT THAT DEFINES AND LIMITS THE SCOPE OF NURSING PRACTICE IN THAT STATE IS
a.
standards of care.
b.
regulation of practice.
c.
American Nurses Association code.
d.
nurse practice act.
DIt is the nurse’s responsibility to know the nurse practice act in his or her state.
20. THE NEW LPN/LVN IS VERY CONCERNED REGARDING WHAT SHOULD OR SHOULD NOT BE DONE FOR PATIENTS. SELECT THE ANSWER THAT WILL PROVIDE THIS INFORMATION FOR HER.
a.
state nurse practice act
b.
standards of care
c.
scope of nursing practice
d.
professional organizations
BStandards of care define what should or should not be done for patients.
21. ONE DIFFERENCE BETWEEN A LEADER AND A MANAGER IS THAT A:
a. leader has legitimate authority.
b. manager motivates and inspires others.
c. manager focuses on coordinating resources.
d. leader focuses on accomplishing goals of the organization.
C
Correct: The terms leadership and management are often used interchangeably, and it is difficult to discuss one without discussing the other. However, these roles have specific traits unique to themselves. The manager is the coordinator of resources (time, people, and supplies) needed to achieve outcomes.
Incorrect: a. Authority is the legitimate right to
direct others that is given to a person by the organization through assignment to an authorized position such as a nurse manager.
b. It is the nurse leader who has the ability to guide or influence, as well as to motivate and inspire, others on the team.d. Managers are assigned responsibility for accomplishing the goals of an organization.
22. A PATIENT IS ADMITTED WITH HYPOTENSION, SHORTNESS OF BREATH, FLUSHING, AND HIVES. ALL LEVELS OF STAFF HAVE BEEN TRAINED TO ASSESS VITAL SIGNS. GIVEN BUDGET RESTRICTIONS AND PROPER DELEGATION RULES, TO WHICH CARE PROVIDER WOULD THE RN DELEGATE THE TASK OF OBTAINING THE INITIAL BLOOD PRESSURE READING?
a. RN
b. LPN/LVN
c. Unlicensed assistive personnel (UAP)
d. Use the blood pressure obtained in the ambulance, because it was assessed via electronic monitoring.
A - Correct: The patient’s condition is not stable; therefore, the skills of an RN are required.Incorrect:b. The assessment expertise of an RN is needed because of the unstable nature of the patient’s condition.c. Obtaining a baseline set of vital signs for an unstable patient would be considered high-risk delegation for a UAP.d. The patient’s condition is very dynamic; assessments will have to be completed by the RN on admission and then as indicated by the stability of the patient.
23. A MANAGER
a. Leads by example
b. Gives bed baths
c. Transforms their
employees
d. Handles the day-to-day
operations to achieve a
desired outcome
DA manager Handles the day-to-day operations to achieve a desired outcome
Incorrect:a. Is incorrect because leaders
lead – managers mangeb. Is incorrect because while a
manager under unusual circumstances might give a bed bath it is not in her regular scope of duties
c. Is incorrect because that is a function of a transformational leader not a manager
24. A MANAGER NEEDS TO HAVE WHAT SKILLS (SELECT ALL THAT APPLY)
a. Critical Thinking
b. Effective Communication Skills
c. Strong Nursing skills
d. Be able to intubate a patient
A, B, C
A manager needs to be able to think critically and solve complex problems. Critical thinking is the disciplined, intellectual process of applying skillful reasoning as a guide to belief or action. In nursing, critical thinking for clinical decision-making is the ability to think in a systematic and logical manner with openness to question and reflect on the reasoning process used to ensure safe nursing practice and quality care. They need to be able to communicate effectively as they will be directing others in what needs to be done and when it needs to be done as well as dealing with patients, family, other departments, and administration. The manager also needs to be a good nurse – compassionate, caring, and have strong skills – this will enable them to help their staff when necessary, act as a mentor, preceptor and coach. Also it enables them to understand the needs of their staff when making assignments.
25. WHAT IS THE NURSING PROCESS?
a. Assessment, evaluate, plan, implement
b. Assess, diagnose, implement , plan
c. Assessment, Analysis and diagnosis, plan, implement plan, evaluate
d. Look at the patient, talk to the family, make a care plan
C Assessment, Analysis and Diagnosis, Plan, Implement plan, Evaluate
26. A NURSE MANAGER WANTS HIS NURSING UNIT TO BE A PLACE WHERE ALL NURSES WANT TO WORK, WHERE PATIENT SATISFACTION IS HIGH, AND CARE IS INNOVATIVE AND INTERDISCIPLINARY. STAFF ARE ENCOURAGED TO CHAIR TASKFORCES TO IMPROVE QUALITY OF CARE AND HE COUNSELS STAFF IN AREAS OF MEASURING PATIENT OUTCOMES. OTHER MANAGERS WANT TO MIMIC THIS MANAGER’S APPROACH TO IMPROVE THEIR OWN UNITS. THIS NURSE IS WHICH TYPE OF LEADER?
a.
Transformational
b.
Transactional
c.
Laissez-faire
d.
Authoritative
ACorrect: Transformational leaders mentor followers through a vision and are admired and emulated. Incorrect: b. Transactional leaders are concerned with day-to-day activities rather than visionary leadership. c. Laissez-faire leadership lack vision, provide little guidance and feedback. d. Authoritative leadership accepts little or no input from staff, makes decisions alone.
27. WHAT ARE THE 5 “RIGHTS” OF DELEGATION?
a. Right patient, right medication, right dose, right time, right route
b. Right person, right patient, right task, right attitude, right place
c. Right task, right circumstance, right person, right directions, right supervision and evaluation
d. Right place, right time, right circumstance, right person, right doctor
• C• 5 Rights of
Delegation• Right Task
Right CircumstancesRight PersonRight DirectionRight Supervision and Evaluation
28. A NURSE TELLS A PATIENT, “THIS PM YOU ARE GOING FOR AN ABDOMINAL A&P, AN H&H, AS WELL AS AN IV PYELOGRAM. PLEASE SIGN THESE CONSENT FORMS.” THE USE OF MEDICAL JARGON CAN CAUSE:
a. understanding.
b. speed in communication.
c. misinterpretation.
d. clarity in the message.
CJargon is terminology unique to people in a special type of work and is not understood by everyone. Although jargon does speed communication and is clear to those who know it, it may be misinterpreted and not understood by all people.
29. THE DOCUMENT IN WHICH THE ROLE AND RESPONSIBILITIES OF THE LPN/LVN ARE IDENTIFIED IS THE:
a. NLN Accreditation Standards.
b. Nurse Practice Act.
c. NAPNE Code.
d. American Nurses’ Association Code.
BThe LPN/LVN functions under the Nurse Practice Act.
30. TEAM NURSING
a. Is done by a nurse and a CNA
b. Provides care to a group of patients by a group of nurses and CNAs
c. Is when 1 nurse has 8 patients to care for
d. Defined in the Nurse Practice Act
BProvides care to a group of patients by a group of nurses and CNAs
31. LEADERSHIP IS DEFINED AS
a. The coordination of people, time, and supplies to achieve desired outcomes,
b. Seeing that resources are used appropriately – with conservation in mind
c. Maintaining control of the day-to-day operations
d. The art of getting others to want to do something you are convinced should be done
D
The art of getting others to want to do something you are convinced should be done
32. WHICH OF THE FOLLOWING STATEMENTS IS NOT TRUE ABOUT PERFORMANCE APPRAISAL?
A. Informing the staff about the specific impressions of their work help improve their performance. .
B. A verbal appraisal is an acceptable substitute for a written report
.
C. Patients are the best source of information regarding personnel appraisal.
.
D. The outcome of performance appraisal rests primarily with the staff.
C Patients are the best source of information regarding personnel appraisal. The patient can be a source of information about the performance of the staff but it is never the best source. Directly observing the staff is the best source of information for personnel appraisal.
33. ETHICAL MEANS
A. The way one should act/ behaveB. Doing what is required by lawC. Doing what the patient’s family asks even if it isn’t what the patient wantsD. Defines the principles of right and wrong to provide patient care
AEthical means “The way one should act/ behave” Nurses are charged with using ethical concepts in their delivery of patient care. Ethical concepts include providing care which is good, correct, and rational.
34. AN EXPLOSION JUST OCCURRED AT THE LOCAL FACTORY, AND HUNDREDS OF EMPLOYEES HAVE SUSTAINED VARYING DEGREES OF INJURY. WHICH TYPE OF NURSING LEADERSHIP IS MOST EFFECTIVE IN THIS SITUATION?
a.
Autocratic
b.
Democratic
c.
Laissez-faire
d.
Referent
AAutocratic – there isn’t time to discuss and reach consensus things have to be done immediately
35. ETHICAL IS
a.
Always doing what your charge nurse asks without question
b.
Doing what the family wants because it will keep the patient alive
c.
Doing what is required by law
d.
“The way one should act/ behave”
DEthical is ““The way one should act/ behave””
36. WHICH TASK IS MOST LIKELY TO BE CONSIDERED IN A STATE’S PRACTICE ACT AS APPROPRIATE TO DELEGATE TO A LPN/LVN IF THE PATIENT’S CONDITION IS STABLE AND COMPETENCE IN THE TASK HAS BEEN ESTABLISHED?
a.
Administer an enema for an elective surgery patient.
b.
Administer an antiarrhythmic medication IV while interpreting the patient’s rhythm on the cardiac monitor.
c.
Develop a plan of care for a stable patient admitted for observation after a head injury.
d.
Teach a patient how to instill eye drops for glaucoma.
ACorrect: The RN who is delegating must consider the following: (1) the delegatee’s current workload and the complexity of the task, (2) whether the staff member is familiar with the patient population and with the task to be performed, and (3) whether the RN is able to provide the appropriate level of supervision. The delegation decision-making tree would also support delegation of this task.Incorrect:b. Administration of an antiarrhythmic drug requires the skill of an RN to evaluate outcomes, especially when it is administered IV because of its fast rate of distribution.
c. Only an RN can develop the patient’s plan of care, although others may assist in updating information.d. The task of teaching is limited to RNs
37. THE NURSE CARING FOR A PATIENT STATES, “YOUR BLOOD PRESSURE IS DANGEROUSLY HIGH. ARE YOU TAKING ANTIHYPERTENSIVE MEDICINE?” THE PATIENT STATES, “I CAN’T AFFORD MY MEDICINE. I HAVE NO INSURANCE.” THE NURSE STATES “I FEEL REALLY SORRY FOR THAT PATIENT. I WISH IT WASN’T AGAINST POLICY TO GIVE HER MONEY.” THE NURSE WANTS TO HELP AND PLACES A NOTE ON FACEBOOK THAT ANY DONATIONS WOULD BE APPRECIATED TO HELP A WAITRESS WHO WORKS AT THE CAFETERIA NEXT DOOR TO THE HOSPITAL BUY HER MEDICATIONS. THE NURSE POSTS THAT “SHE WAS SO SICK LAST EVENING WHEN SHE CAME TO THE ED. I CAN’T BELIEVE THEY DON’T PROVIDE INSURANCE. I CAN’T GIVE HER MONEY BUT YOU ALL CAN HELP.” THIS NURSE:
a.
is showing empathy and as long as she lets the patient know the money is not from her, she is not violating any social media guidelines.
b.
is at risk for HIPAA violations.
c.
has properly followed policy and protected the patient by not using her name.
d.
is demonstrating the logical fallacy of slippery slope.
BCorrect: The National Council State Board of Nursing’s policy on social media prohibits posting of patient information on social media sites. This patient could be identified by knowing where she works and the fact that she was seen in the ED the day before.Incorrect:a. The nurse is showing empathy but she violated patient confidentiality when she put the patient’s occupation, place of work, and fact she was seen in ED the night before on Facebook.c. It is against Negligence to place any patient information on social media.d. Slippery slope is the belief that one event will inevitably follow another without any real support for that belief
38. WHEN CHOOSING TO DELEGATE, THE NURSE SHOULD DELEGATE THE TASK TO THE MOST QUALIFIED PERSON OR TO THE PERSON HE OR SHE WISHES TO:
a.develop.
b.promote.
c.punish.
d.reward.
ACorrect: Delegating is giving other people tasks to be accomplished. The benefits of delegation involve (1) assisting in developing the initiative, skills, knowledge, and competence of others; (2) maintaining the level of responsibility and decision-making of others; (3) freeing time for more important tasks; (4) extending results that can be accomplished from what one person can do alone to what he or she can manage through others; and (5) ensuring that completing the task is cost effective.Incorrect:b. Delegating an activity to a person for promotion is not appropriate; the act of delegating requires multiple considerations, and promotion is not one of them.c. Delegating to punish a person is not appropriate; that person may sabotage the goal to be accomplished.d. Delegating is a process that is used to attain a goal, not to reward a person for a job well done
39. A NEW GRADUATE NURSE IS PREPARING FOR AN INTERVIEW FOR HER FIRST POSITION AND KNOWS THAT: (SELECT ALL THAT APPLY.)
a.
the primary goal for the first job is to complete orientation and should be considered as an extension of nursing school.
b.
appointments for interviews should be scheduled immediately after graduation to avoid rushing into a position.
c.
self-confidence can be improved with self-talk, which reminds the graduate that peers from her school are effective practitioners.
d.
work history of even nonmedical positions can demonstrate commitment and reliability so letters from these employers should be in portfolio.
e.
it is best to arrive 10 to 15 minutes before the scheduled interview dressed for success.
C, D, ECorrect:c. Internal dialogue establishes a means for the graduate to recall achievements that will lead to success in the first nursing position.d. Jobs such as cashier at a convenience store or dog-sitting can demonstrate responsibility such as handing cash or arriving on time.e. Arriving too early may cause the recruiter to feel rushed and arriving too late may demonstrate lack of time management and professionalism.Incorrect:a. The primary goal for the first job is to find good match that fits the nurse’s abilities, lifestyle, and career aspirations.b. Interviews should be set up prior to graduation
40. A NURSE PREPARING A RESUME FOR THE FIRST POSITION IS ANXIOUS TO DEMONSTRATE ALL ACHIEVEMENTS, WHICH INCLUDED COMPLETING A RIGOROUS ACCELERATED PROGRAM AND MAINTAINING A HIGH GPA WHILE ALSO SERVING IN MANY COMMUNITY PROJECTS AND LEADERSHIP POSITIONS. THE APPLICANT FINDS IT IMPOSSIBLE TO INCLUDE ALL THE ACCOLADES ON ONE PAGE AND RESEARCHES TIPS FOR PROFESSIONAL COVER LETTERS AND RESUMES AND LEARNS:
a.
margins should be at least 0.5 inch on all four sides, making conciseness important.
b.
paper should be bright colored to catch the attention of the recruiter.
c.
legal size paper may be used when applicants have many accolades or extensive work history.
d.
standardized cover letters present a professional image as opposed to those that stress the applicant’s perspective too heavily.
e.
include in the cover letter that after researching other position, this is the applicant’s preference.
A, E Correct:a. Ample margins—minimum of 0.5 inch (1 inch preferred)—should be used on all four sides to prevent appearing cluttered.e. A statement declaring this position is one’s first choice should be included.Incorrect:b. The paper should be white or ivory and on heavy bond paper, never bright colored.c. Legal size paper is not acceptable. Seek help from a professional to determine what to include and what can be placed in a portfolio.d. The applicant should write from their own perspective and writing style tailored to the position.
41. A NURSE IS HOPING FOR A PROMOTION AND SEEKS THE HELP OF A COACH TO IMPROVE TIME MANAGEMENT SKILLS. THE FIRST TASK ASSIGNED BY THE COACH IS FOR THE NURSE TO LIST ALL EXTERNAL DISTRACTORS THAT PREVENT ORGANIZATION AND COMPLETION OF TASKS. THE NURSE WOULD INCLUDE:
a.
waiting for oncoming shift to start walking rounds.
b.
failure to delegate tasks to the Licensed Practical Nurse and Unlicensed Assistive Personnel and instead, completing task herself.
c.
talking with a patient’s family member who is also a personal friend.
d.
spending time thinking about the vacation to the beach.
e.
using the Internet to read about a new drug that will be administered; then taking time to look for news about the profession, new legislation about the Patient Protection and Affordable Care Act, and new uniforms for the season.
A, CCorrect:a. Waiting, such as for meetings or oncoming shift, is an external distraction.c. Socializing with visitors is an external distraction.Incorrect:b. ineffective delegation is an internal distraction.d. Daydreaming about an upcoming vacation is an internal distraction.e. Surfing the Internet after using it wisely to ensure patient safety is an internal distractor.
42. A NURSE HOPES TO IMPROVE TIME MANAGEMENT SKILLS USING THE ABC PRIORITIZATION APPROACH. WHICH TASKS WOULD BE PRIORITIZED AS “B”? (SELECT ALL THAT APPLY.)
a.
Turn in time sheet due in 3 days.
b.
Review dress code policy to give feedback before appointment in the morning.
c.
Perform blood glucose test on a patient admitted with Kussmaul respirations and change in level of consciousness.
d.
Complete patient teaching prior to discharge in 2 hours.
e.
Review procedure for inserting a PIC line to assist with procedure later this morning.
B, D, ECorrect:b. Task that fall within Priority B include the medium-value items, such as tasks that are not urgent but most likely will not “fall” off the list. Since the dress code must be reviewed and feedback constructed for a morning appointment, this would be level B, it is not urgent nor will it likely fall off the list.d. Completing patient teaching for a patient to be discharged in 2 hours must be completed but does not take priority over “A” tasks.e. Reviewing a procedure to be performed later in the day is Level “B”.Incorrect:a. Turning in a time sheet due in 3 days is level C.c. Performing a blood sugar test on an unstable patient is level A.
RESOURCES THAT NEED TO BE MANAGED INCLUDE: (SELECT ALL THAT APPLY.)
a.Peopleb.Timec.Suppliesd.Patientse.Vendors
A, B, CResources include the:
personnel, time, and supplies needed to accomplish the goals of the organization.
Incorrect: D, EPatients are not resources they are customers
A vendor is not a resource
44. WHAT SKILLS/ ABILITIES MUST A GOOD MANAGER HAVE?: (SELECT ALL THAT APPLY.)
a. Authority from the organization
b. Strong nursing skillsc. Strong problem
solving skillsd. Effective
Communication skillse. Where does she fit
into the organization
B, C, D, EA good manager must have: Strong nursing skills Strong problem solving skills Effective Communication skills, and Know where she fits into the organizationIncorrect: AAuthority is given it is not a skill
45. A STUDENT IS REALLY ANXIOUS TO GET EVERYTHING THEY HAVE EVER DONE ON THEIR RESUME BUT THEY HAVE WAY TO MUCH “STUFF” TO FIT ON ONE PAGE. THE STUDENT NEEDS TO REMEMBER (SELECT ALL THAT APPLY)
a. Margins should be at least 0.5 inches on all 4 sides
b. Paper should be brightly colored to get their attention
c. ‘legal sized paper may be used when you have a lot to share
d. Standardized cover letters are the professional way to make a first impression
e. Include in the cover letter that after researching other positions this is the one the student prefers
A and E
The answer is A and E
You need to have ample margins – 1” is preferred and a statement that this is your preferred position should be included in your cover letter
It can’t be “B” because the paper should never be colored but if you want to make a real impression use heavy bond paper,
and “C” is incorrect because you NEVER use legal sized paper If you have too much put some of it into your portfolio and only include what relates specifically to this job application – match your resume to what was posted in the advertisement
“D” is wrong because that is a form letter and you want this to be original and specific to the person that will be interviewing you
46. A PATIENT ASKS, “WHAT IS AN ADVANCE DIRECTIVE?” THE NURSE EXPLAINS THAT EXAMPLES OF ADVANCE DIRECTIVES ARE: (SELECT ALL THAT APPLY.)
a. preserving cord blood for possible future needs of a child.
b. providing instructions that life-sustaining medical procedures should be withheld in the event of a terminal situation.
c. giving someone the legal right to act on one’s behalf when one becomes incapacitated.
d. completing hospital admission paperwork before being admitted to the hospital
B, C
Advance directives document an individual’s desires regarding end-of-life care. These wishes are generally stated through the execution of a formal document known as the living will. Right-to-die statutes vary from state to state; therefore, nurses must become familiar with their state-specific statute. Incorrect: a. Advance directives identify client wishes in terms of the right to die; they are not directives to help prevent illness or terminal illness.d. Completing hospital paperwork is part of the preadmission process. The client could bring his or her living will to the hospital on admission, but this document would have been prepared prior to the admission and is not part of the hospital documentation paperwork
47. A NURSE IS CONCERNED ABOUT THE RISK OF DELEGATING TASKS TO LICENSED PRACTICAL NURSES AND UNLICENSED ASSISTIVE PERSONNEL. WHAT IS THE BEST WAY FOR THE NURSE TO DETERMINE COMPETENCY OF THE DELEGATEE?
a.
Actually observe the delegatee perform the assigned task.
b.
Ask the delegatee how many times he/she has performed the task.
c.
Ask the patient if the care provided was satisfactory.
d.
Ask other nurses if they feel the delegatee is competent.
A Correct: The best way for the nurse to determine the competency of LPNs or UAPs is to observe them perform the task and check on them regularly throughout the shift. Incorrect:b. Asking the delegatee may inform the nurse of how many times the task has been performed but will not provide evidence of competency.c. Patients may be able to rate their satisfaction with care but cannot judge the competency of the LPN or UAP.d. The opinion of other nurses can be used to validate the nurse’s findings, but only firsthand observation can provide evidence of competency.
48. BURNOUT IS (SELECT ALL THAT APPLY.):
a. Emotional exhaustion,
b. A sickness healed through medication
c. Physical exhaustion,
d. Spiritual exhaustion
e. All of the above
Correct: A, C, DBurnout is when the nurse has given all that she has physically, emotionally, and spiritually and she has totally bankrupted her self. She is no longer able to continue on.
Incorrect:
It is not “B” because it is not an illness that can be cured by medication which eliminated “E”
49. TEAM NURSING, AND PRIMARY CARE NURSING ARE NURSING DELIVERY SYSTEMS
a. Trueb. False
A - TrueTeam Nursing, and Primary Care Nursing are Nursing Delivery Systems - True
50. A LEADER (SELECT ALL THAT APPLY.):
a. Often doesn’t have delegated authority
b. Emphasizes interpersonal relationships
c. Directs willing follower(s)
d. Determines a task that can be done by a non licensed individual
e. All of the above
A, B, CA leader often doesn’t have delegated authority they lead by the shear power of their personality, they frequently emphasize interpersonal relationships, and they direct willing followersIncorrect:D-Determining a task to asign an unskilled worker is not part of leading that is managing therefore E is wrong as well
