Eastern Florida NUR4827 Full Course Latest 2019 January NUR 4827 Leadership and management in Healthcare

Week 1
Discussion

List four words that come to mind when you
think of a leader. List four words that
come to mind when you think of a follower.
Analyze the difference between the two lists. Do you think of leaders in different ways
than you think of followers? Discuss
what is different and why?

NUR 4827 Leadership and management in Healthcare

Week 2
Discussion

DQ1 Are leaders born or made? If you think
they are born, can anything be done to help someone who wants to lead but was
not born a leader? If you think they are made, how are they made? What
strategies can you use to improve your leadership skills?

DQ2 Nurses manage day to day challenges at
the workplace. Consider the following
scenario about violence in the workplace:

A young, husky male is brought to the
Emergency Department because of his escalating angry behavior. As he is being
interviewed, a 6-inch knife is found in his possession. When he is asked to
surrender the knife, he refuses and becomes quite agitated. How can this
situation best be handled? Provide a rationale for your selected strategies.

Call the code-green team for a show of
force.

Push the panic button to summon the
security guards.

Try to talk the patient into giving up the weapon.

Other responses

NUR 4827
Leadership and management in Healthcare

Week 3
Discussion

What can happen when the employer is held
liable based solely on the actions of the staff member’s negligence and the
employer pays monetary damages because of the employee’s negligent
actions? Does the institution have the
right to counter-sue the nurse for damages paid to an injured patient?

NUR 4827
Leadership and management in Healthcare

Week 6
Discussion

DQ1
Team building

Working in a team is an important strategy
for accomplishing work. Understanding
what is required of a strong teammate becomes clear as you are assigned team
projects.

For this discussion question, Identify the
17 characteristics that make a good team.
Select four of those characteristics and discuss why each of these is
important.

DQ2 Managing Quality and Risk

How does the Magnet Recognition Program®
relate to quality management?

NUR 4827
Leadership and management in Healthcare

Week 7
Discussion

DQ1 Managing Personal/Personnel Problems

Take a few moments to recall the past 2 to
3 weeks in the clinical setting or work location. How many times were they
praised for a job well done? Was the praise or reward warranted? What are their
strengths and weaknesses in praising others?

DQ2 Workplace Incivility

How can incivility impact patient care?
Discuss how communication problems are at the heart of nearly 70% of events
impacting patient care (TJC, 2008).

NUR 4827
Leadership and management in Healthcare

Week 9
Discussion

DQ1 This discussion can be found in your
book, chapter 7 called Exercise 7-1.

Using the local phone directory, determine
the types and numbers of primary care, secondary care, and tertiary care
services available in our community.
Table 7-2 provides an example of a format for collecting the data.

Review the list of your classmates, is
there anything you can add to their list?
Do you think this information is useful and why?

DQ2 A nurse on a medical/surgical unit has
made the same medication error 2 days in a row. As the nursing manager,
describe how you would decide whether this is a systems problem or a problem
related to the individual nurse. In either case, explain how you (the manager)
should correct the problem?

NUR 4827
Leadership and management in Healthcare

Week 10
Discussion

DQ1 Many nursing experts believe that
evaluation is the most crucial part of employee development. Debate the pros
and cons of this statement, and decide whether the statement is true. If it is
not true, then what constitutes the most important part of employee
development?

DQ2 Differentiate failure mode effects
analysis (FMEA) from root cause analysis (RCA)?

NUR4827
Leadership and management in Healthcare

Week 12
Discussion

This question refers to Chapter 14 Exercise
14-3. It pertains to your place of work
so it only needs the reference of the book and/or any other source you
utilize. If you would like to provide an
example, please ensure that all names have been removed for privacy.

Questions to determine the potential
employer’s scheduling practices might include the following. Relate these
questions to your place of business.

How many hours are included in each shift?
Is there any flexibility in this?

Have minimum and maximum numbers of days
been determined that an individual should work before he takes a day off?

What input does staff have in determining
schedule practices?

What is the process for requesting specific
time off?

What other questions might you ask about
scheduling?

NUR4827
Leadership and management in Healthcare

Week 14
Discussion

DQ1 Bachelors prepared nurses are leaders
in their fields. Making the transition and transformation into a management
role is worth the effort.

Leading lives of integrity and commitment,
nurse managers set examples, bringing out the best in direct care nurses and
thereby multiplying their influence on quality patient care.

How can you set yourself up for success
when transitioning between roles? or enhance your role as leader?

DQ2 Job stress can be defined as the
physical and emotional responses that arise when the job requirements do not
match the abilities, resources or needs of the worker.

External sources of stress include
work-related stressors, and may be related to change, social pressures,
position (role stress), and gender roles.

Internal sources of stress include personal
triggers, unrealistic self-beliefs, and lifestyle choices. An individual’s
ability to deal with stress may be moderated by psychological hardiness.

Initially, increased stress produces
increased performance. However, when stress continues to increase or remains
intense, performance decreases.

What is General Adaptation Syndrome? What are the stages of stress response in this
theory?

NUR 4827
Leadership and management in Healthcare

Group
Project Case Study

Case Study #1 for Team A and B

Mr. and Mrs. O. are from Sudan and are
temporarily living in the United States while Mr. O. is a university graduate
student. They have a daughter age 6 and a son age 10. Mrs. O. brings her
daughter to the clinic requesting a modified female genital mutilation (FGM), a
form of female circumcision. They plan to return to Sudan within 2 years. Dr.
M., the pediatrician, is outraged and discusses this with K., his RN, and the
clinic social worker, G. He emphatically stated that her request was unethical
and a primitive practice. He tells the social worker (MSW) to call the
Children’s Protective Service (CPS), because the parents are endangering their
daughter’s health. They are in need of counseling, and to an extreme action of
placing the daughter in a foster home temporarily until the situation is
resolved.

The RN has cared for Mrs. O. during her
clinic appointments. In the presence of the MSW, she tries to explain to Dr. M.
that the parents are very concerned about their daughter’s “future.” The RN and
the MSW are opposed to bringing in the CPS. They believe that the parents are
good, responsible parents and are trying to do the best for their daughter.
They think that Dr. M. doesn’t understand the cultural issues. They explain
that FGM is commonly done in Sudan and the parents will need to have this
surgery done or else their daughter will not be “marriageable” and will be
forced to live as a prostitute or even a beggar on the streets. The parents
desperately would like the surgical procedure to be done as a minimum, minor
incision, rather than the major, more mutilating excision. If they return to
Sudan without the daughter having surgery, the daughter will be subjected to a
more invasive excision (infibulation). According to the mother, it most likely would
be done by a nonmedical person under unsanitary conditions using a butcher
knife. The dangers of these procedures are severe pain, hemorrhage, infection,
damage to adjacent tissue, and poor healing. The long-term effects include
recurrent urinary tract infections, infertility, serious complications with
pregnancy, and development of excess scar tissue requiring additional
procedures.

What are some of the cross-cultural ethical
issues occurring with this case?

What should each healthcare professional
(RN, MSW, pediatrician) do individually and/or collectively in managing this
case?

What are the parents’ rights acting on
behalf of their minor child in this situation?

What are the pediatrician’s rights in this
situation?

Case Study #2 for Team C and D

Millicent, RN, MSN is a white, 40-ish
certified therapist in “Healing Touch.” She has been offering this therapy to
her hospitalized culturally diverse post-surgical patients with good responses
from them. She is aware that that there is some research suggesting that the
therapy lessens the need for pain medication, reduces anxiety, and induces
better sleep. Dr. Jones becomes angry when he learns about her doing “touch
therapy” on his patients, which he calls “the work of the devil.” He strongly
tells Millicent that she cannot do anything to his or his partner’s patients
without a physician’s order.

What facts should be known about the RN’s
scope of practice?

What are the ethical issues in this case
between the RN and the physician?

What should be considered by the RN in
relationship to “research ethics”? Patient’s fully informed consent? Cultural
beliefs about an alternative therapy?

Case Study #3 for Team E and F

Benito F. is a 66-year-old Latino/Hispanic
male retired after 45 years as a lineman with the telephone company in a rural
community. His wife died from cancer within the past year. He had been a
significant caregiver in addition to neighbors. They were married for 42 years
and have two grown sons who live out of state. Lately, he has spent a lot of time
alone, no longer going hunting with a friend and becoming less involved in
activities at the Catholic Church. A concerned neighbor, who was unable to
reach Benito by telephone, went to his home to check on him. Subsequently, he
drove him to a large public hospital in a city 50 miles from his home. Benito
was admitted to the Emergency Room. The nurse’s assessment revealed that he was
in a “stuperous state with a strong smell of alcohol on his breath.” His
rambling speech included comments about his wife’s death and that life wasn’t
worth living anymore.

What are common family beliefs/values of
the Hispanic culture and how has Benito’s family structure changed based on
these beliefs?

What factors about Benito’s lifestyle might
have led to his health condition?

What might be potential medical and mental
consequences of Benito’s current lifestyle?

What appropriate patient teaching should be
given to Benito in writing on his discharge, and why?

Why should “health literacy” be considered
in teaching Benito about his care?

Case Study #4 for Team G and H

Mr. H. is a 59-year-old Arab business
executive who lives in Saudi Arabia. His physicians have sent him to a large
medical center hospital in the United States for evaluation of a potential
heart-lung transplant. He speaks fluent English as do his wife and son, who
accompanied him to the United States. On arrival at the hospital unit, Mr. H.
stated that he was very tired from the long plane flight and was anxious about
his condition. Because of his “status,” his attending physician transferred him
to the Medical Intensive Care Unit. While undergoing extensive testing in
preparation for a heart-lung transplant, Mr. H. has a lethal pulmonary embolus
on Day 2 of hospitalization (physician diagnosis). Mr. H.’s wife and son were
devastated.

What cultural information should the
healthcare team know about Mr. H.’s beliefs/values about organ allographic
transplant? Food practices? Spirituality/religious practice?

What is the general decision-making process
in Arab family relationships?

What death care/rituals should be addressed
with the family and by whom from the healthcare team? Consider care of the body
at time of death, consent for autopsy, grief intervention, return of body to
Saudi Arabia.

NUR 4827
Leadership and management in Healthcare

Week 16
Assignment Career Marketing Strategies

Even the steady-state or experienced nurse
who is not seeking a new position needs to have a curriculum vitae (CV) or
resume that can document continued development of expertise. Interviewing,
which is a two-way process, also contributes to successful position choices and
career development.

To begin data collection, especially if you
have not kept records before, begin with where you are and think back. The
important aspect of this phase is to begin the process and to save it
electronically so that you can shape information for specific reasons.

A curriculum vitae (CV) is the
documentation of one’s professional life.

Resumes are customized documents that
relate to the qualifications of a specific organizational position and help
create an image of you serving in that position.

During your career, you will need to
communicate effectively through letters. The commonly used letters are a cover
letter, a thank-you letter, and a resignation letter.

Develop your own curriculum vitae, resume,
and cover letters. Sample resumes are included on the Evolve Website. Submit
them as they would to actual employers, typed correctly and formatted
appropriately.

NUR 4827
Leadership and management in Healthcare

Midterm
Exam

Question 1

At a second negotiation session, the unit
manager and staff nurse are unable to reach a resolution. What is the best next action?

Arrange another meeting in a week’s time so as to allow a cooling-off
period

Insist that participants continue to talk until a resolution has been
reached

Turn the dispute over tot he direcxtor of nursing

Back the unit manager’s actions and end the dispute

Question 2

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 nurse manager’s decision based
on?

Experience

Unit protocol

An
established clinical pathway.

Confirmatory scientific evidence.

Question 3

A family is keeping vigil at a critically
ill patient’s bedside. Other, distant family members, not yet able to come,
call the unit continuously, asking for updates and wanting to express concern.
You speak with the distant family members and suggest that you are going to
refer them to the hospital social worker, whose role is to work with people in
such situations. What role are you assuming through this action?

Leader

Manager

Laissez-faire

Follower

Question 4

As the head of a nursing program, you
consistently invite the ideas of your team about innovations in teaching,
community partnerships, and curriculum design and invite participation in
decisions. Many of these ideas have been implemented successfully, and your
staff members are keen to try on other ideas. You are employing _____
leadership.

Contingency-based

Transformational

Trait-based

Situational

Question 5

You recently acquired a position as a unit
manager. During your time on the unit, you have formed a strong social network
among your staff, have promoted the development of relationships between your
staff and workers in other areas of the organization, and have formed
relationships that generate ideas from patient organizations and the local
nursing education program. According to complexity theory, you are engaging
which principle?

Empowerment

Development of networks

Bottom-up interactions

Systematic thinking

Question 6

As a nurse manager on the West Surgery
Unit, you are interested in increasing patient safety and reducing morbidity
and mortality on your unit. Which of the following recommendations would be
consistent with the IOM The Future of Nursing report?

Careful screening of nursing staff for substance use and abuse

Increase in the percentage of
baccalaureate-prepared nurses to 80%

Salary and benefits that reflect nursing accountabilities

Increased RN staffing on the unit

Question 7

In preparation for re-designation as a
Magnet Hospital, how would you prepare?

Commit staff resources over a 6-month period to updating procedure
manuals.

Prepare a manual that outlines orientation procedures and ensure that
all safety issues are addressed.

Educate staff through meetings and training sessions regarding appropriate
answers to questions.

Ensure that there are empirical data to support review of patient
outcomes, actions taken, and results of actions.

Question 8

The SBAR approach to patient safety
encourages which of the following?

Continuing education.

Patient feedback.

Consistency in assessment and practices.

Multidisciplinary approaches.

Question 9

As the manager on an acute care medical
unit, you note that the incidence of medication errors has increased since the
implementation of staffing changes. As part of your strategy to reduce errors,
it is important to do which of the following?

Re-visit reporting standards for medication errors in your organization.

Provide staff with additional education related to safe practice in
medication administration.

Involve RN staff in determining reasons for errors and practice
solutions to increase the safety of medication administration.

Ensure that medication errors are consistently reported.

Question 10

A nurse executive is hired to restore a
unit’s productivity, which has decreased as the result of low staff morale. The
nurse executive utilizes which of the following leadership principles?

If
staff members increase productivity, then they are given opportunity to engage
in learning events such as workshops and conferences. If the staff members are
not satisfied, they will insist on a different leader, who will get them what
they want.

Workplace satisfaction depends on staffing ratios, adequate pay, and
tuition reimbursement, and these are things the leader can control.

Leaders at the national level who are seeking relief for nurses in the
workplace are seen as the solution to the nursing shortage.

The
leader declares the intent and goals to enhance productivity and assumes that
the unit also wishes to increase productivity, which allows nurses to feel in
control of the environment.

Question 11

After being interviewed for the unit
manager position, the staff nurse reflects on the interview process. The staff
nurse is aware that leadership begins:

Through a relationship with a mentor.

With the chief nursing officer of the organization.

Within.

With the job description.

Question 12

The nurse manager in the Emergency
Department needs to implement new staffing patterns. As a transformational
leader, the nurse manager shoulddo which of the following?

Explain in detail how well the new idea will work.

Reason with staff members that the new idea will save money and allow
more free time.

Imply that raises will be smaller than anticipated if the new idea is
not accepted.

Reinforce how this change will respond to the ideas and solutions
generated by staff members.

Question 13

Recruiting among the emerging workforce
(18- to 35-year-olds) is a challenge for healthcare agencies. Marketing
brochures should address the leadership and vision of the healthcare agency.
Which of the following workplace environments will attract applicants in the
emerging workforce?

An
environment highlighted by lots of meetings, so staff members can have lots of
input

A
nurturing and receptive environment

A
totally online environment, so staff members will not have to interface with
uncaring colleagues

A
highly professional environment

Question 14

The Sunny Long-Term Care Facility has experienced
numerous difficulties with staff relationships, despite its success in
maintaining financial viability and judicious use of resources. Staff members
complain that the primary concerns of the facility include applying policy,
saving money, and ensuring that lawsuits are avoided. There is little trust in,
and involvement of, staff members. This facility may be:

Well managed and well led.

Overly led and overly managed.

Poorly managed and well led.

Overly managed and not well led.

Question 15

The adage “leaders are born and not made”
reflects which of the following ideas around leadership?

Leadership is a natural skill that cannot be refined or developed.

Succession planning and formal education related to leadership are
ineffective.

Mentorship is important in developing innate
skills of leaders.

Management can be taught; leadership depends on abilities.

Question 16

A nurse manager in a hospital is deeply
concerned that senior administration makes decisions about budgetary directions
that affect staffing and other resources without sharing the rationale for
changes or demonstrating concern as to how these changes may affect patients or
staff. She says she does not feel respected and is emotionally tired as a
result. This situation represents:

Negative organizational culture.

Quantum leadership.

Realities of current health care.

Bureaucratic organization.

Question 17

As a nurse manager, you embrace the
usefulness of resources such as Smart Bed. This behavior is important to do
which of the following?

Succession planning.

A
manager’s role.

Budget development.

Encouragement of staff utilization of technology.

Question 18

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:

Supersede the need for staff members to file incident reports.

Compensate for previous injuries.

Eliminate these risks before anyone else is harmed.

Discipline staff members who have been involved in previous incident
reports.

Question 19

The risk manager informs the nurse manager
of an orthopedic unit that her unit has had an increase in incident reports
about patients falling during the 11-7 shift. What is the best way for the
nurse manager to resolve the problem?

Identify the problem.

Obtain support from the 7-3 shift.

Use
institutional research.

Use
creativity.

Question 20

A clinic nurse has observed another nurse
deviating from agency policy in performing wound care. What is the best
approach for the clinic nurse to take?

Assess the risk to the client and the agency before proceeding.

Stay out of it.

Fill out a notification form (incident report).

Inform the nursing supervisor.

Question 21

John Smith, one of three managers at BSG
Labs, drafted a policy that would allow his department to do more testing in
his lab. This policy included the times for regular collection as well as a new
process for emergency laboratory testing. The policy and procedures were never
followed. What is the reason for this?

The
policy was too lengthy and inundated readers with too much detail.

The
policy made decisions for other departments in the company.

Testing should not be done in the lab.

The
staff did not believe that the new policy would be effective.

Question 22

Jane, an experienced head nurse, is given
the task of completing the summer vacation schedule for the pediatric unit. She
is fully aware of the hospital’s restrictions on time off and the number of
staff on vacation at any given time, as well as its issues regarding seniority.
She weighs the options of allowing staff choice, such as it takes more time but
gives employees options. However, if choice is allowed, this could cause
arguments. Which of the following is the best alternative?

Post a tentative schedule, and request feedback.

Ask
for requests for vacation time in advance, and post the times.

Post the completed vacation schedule.

Post a blank schedule, and ask staff members to fill in their times by a
given date.

Question 23

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. What is the
best response to this patient?

“Do
you think acupuncture relieves your pain satisfactorily?”

“Have you tried nonprescription pain medication or been given a
prescription drug for your headaches?”

“How long have you been using acupuncture treatment?”

“What have you told your heart specialist about your migraines and
treatment?”

Question 24

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?

Behavior

Genetic predisposition

Shared vision

love for people

Question 25

During managers’ meetings, Lindsay is
surprised by the forthrightness of male managers. She finds that, during
discussions, she would be more likely to say which of the following?

“I
wonder if we should consider changing our policy on performance appraisals?
What do you think?”

“Forget about change in this policy. It is fine as it is.”

“Sean, your approach to appraisal is completely off track and does not
reflect available evidence.”

“The system that has been developed needs to be implemented. We have
already spent enough time in discussion.”

Question 26

The nurse manager used a mediator to help
resolve conflicts on the unit. During the mediation process, the nurse manager
saw signs of potential team-building. One key concept of an effective team is
which of the following?

Conflict

Commitment

Task clarity

A
designated leader

Question 27

A mediator suggested that the nurse manager
and staff members decide on a method to resolve conflicts. It is important to
have agreements about how team members will work together because:

If
there are no agreements, each member will make up rules about how to handle
disagreements and relationships.

A
way to eliminate nonproductive team members must be available.

People are naturally difficult and will not work well together without
such agreements.

People will naturally ask for agreements about how to be together.

Question 28

The staff development educator developed
strategies to help nurse managers actively listen. Guidelines for active
listening include which of the following?

Speed up your internal processes so that you can process more data.

Realize that the first words of the sender are the most important.

Cultivate a desire to learn about the other person.

Be
prepared to make an effective judgment of the communication sender.

Question 29

You are charged with developing a new
nursing curriculum and are committed to developing a curriculum that reflects
the needs of the profession and of the workplace. To address deficits that may
already be present in nursing curricula related to the workplace, you include
more content and skills development related to which of the following?

Generational differences in communication.

Therapeutic communication with patients.

Increased emphasis on sender-receiver dyads.

Effective communication in the workplace.

Question 30

Hospital ABCD is a Magnet™ hospital. This
designation has been applied to Hospital ABCD because it:

Is
establishing career ladders for nurses.

Has
implemented a graduate nurse orientation program.

Facilitates active staff participation in decision making related to
quality nursing care.

Espouses commitment to excellence in patient care.

Question 31

As a nurse manager, you know that the
satisfaction of patients is critical in making QI decisions. You propose to
circulate a questionnaire to discharged patients, asking about their
experiences on your unit. Why does your supervisor cautions you to also
consider other sources of data for decisions?

The
return rate on patient questionnaires is frequently low.

Patients are reliable sources about their own experiences but are
limited in their ability to gauge clinical competence of staff.

Hospital experiences are frequently obscured by pain, analgesics, and
other factors affecting awareness.

Patients are rarely reliable sources about their own hospital
experiences.

Question 32

Through the QI process, the need to
transform and change the admissions process across administrative and patient
care units is identified. In this particular situation, what method of data
organization will be most effective?

Flowchart

Line graphs

Histogram

Narrative

Question 33

The outcome statement “Patients will
experience a ten percent reduction in urinary tract infections as a result of
enhanced staff training related to catheterization and prompted voiding” is:

Physician-sensitive and nonmeasurable.

Patient care–centered and nonmeasurable.

Precise, measurable, and physician-sensitive.

Measurable and nursing-sensitive.

Question 34

Your institution has identified a recent
rise in postsurgical infection rates. As part of your QI analysis, you are
interested in determining how your infection rates compare with those of
institutions of similar size and patient demographics. What is this known as?

Quality
assurance

Benchmarking

Statistical analysis

Sentinel data

Question 35

At Hospital Ajax, there has been a 20%
increase in instruments and sponges being left in patients during surgery and
surgeries on the wrong limbs. What are these are known as?

Medically sensitive events.

Never events.

Sentinel events.

Nurse-sensitive events.

Question 36

The chief nursing officer at a local
hospital seeking Magnet™ status creates staff development classes about
incorporating evidence-based practice in nursing. What best describes
evidence-based practice?

Conducting a randomized control trial to determine effectiveness of
handwashing techniques

Developing standards for practice

Using research-based information to develop practice guidelines

Applying best research evidence to care of patients

Question 37

Before implementation of the new policy and
procedure on central line catheter care, the nurse manager uses an appraisal
system to evaluate the evidence. What is important in using an appraisal system
to evaluate the evidence gathered in preparation for development of a new
protocol?

Using only pre-processed evidence

Eliminating qualitative research studies

Limiting the search to randomized clinical trials

Matching the appraisal tool to the type of evidence

Question 38

Tara, the unit manager, is telling her
colleague about her recent project, which involves seeking the most effective
approaches to incontinence care, with the intention of adopting
evidence-supported approaches on her dementia care unit. Her colleague suggests
that translation of research into practice is which of the following?

Characterized by lack of knowledge about how to use evidence to guide
practice.

A
priority of all healthcare practitioners to improve patient care.

Less important than knowledge-generating research, which is required to
advance the nursing profession.

So
difficult that it is useless to begin the query in the first place.

Question 39

The clinical guidelines for management of incontinence
developed by the Registered Nurses Association of Ontario (RNAO):

Are
intended to increase awareness of issues in incontinence management.

Reflect practice that is fiscally directed and sound.

Articulate practice recommendations developed from synthesis and review
of evidence.

Reflect a compilation of information from a variety and range of sources
related to incontinence.

Question 40

Once evidence related to the use of
prompted voiding in patients with cognitive impairment has been appraised and
integrated with practice, it is important to:

Search large databases such as CINAHL to amass further evidence.

Solicit input regarding integration with practice.

Clarify the clinical practice question.

Consider whether patients’ families see this as necessary for the
well-being of family members.

Question 41

A nurse manager must be familiar with the
agency’s policies regarding termination. Termination procedures include which
of the following?

Having a friend present during the termination meeting

Having adequate written documentation to support the action

Following specific procedures from other organizations

Having an attorney present at the termination meeting

Question 42

All of the following are grounds for immediate
dismissal except:

Restraining a patient in bed for 7 hours, unsupervised, as punishment
for hitting a staff member.

Grabbing the unit manager and threatening further physical harm after a
poor performance appraisal.

Selling narcotics obtained from the unit supply of narcotics.

Failing to pursue further medical help for a patient; patient dies.

Question 43

When progressive discipline is used, the
steps are followed progressively only for repeated infractions of the same
rule. On some occasions, rules that are broken are so serious that the employee
is:

Asked to attend a union grievance meeting.

Transferred to another unit.

Suspended indefinitely.

Terminated after the first infraction.

Question 44

Jenny tells you that she is always able to
tell when others are about to become violent because they yell. Your response
to Jenny is based on your understanding of which of the following?

Violence is signaled by a variety of behaviors.

Her perception is accurate.

Yelling is more likely associated with aggression.

She
is mostly accurate in her thinking.

Question 45

Becky, RN, works as a staff nurse in mental
health; Sharon works as a data entry clerk in Admissions; Sarah is an emergency
room physician; and Donna is a housekeeper in geriatrics. Which of these four
is most at risk for violence and aggression?

Becky

Sarah

Donna

Sharon

Question 46

Sarah wonders about the direction that you
have given regarding management of incontinent, confused patients. She brings
you evidence that she has found regarding incontinence interventions and asks
you if she and you could talk about the guidance that you have given after you
have had an opportunity to read the articles she has given you. This is an
example of (select all that apply):

Assertiveness

Management

Followership

Insubordination

Question 47

With regard to nursing practice, nurse
managers are held responsible for (select all that apply):

Ensuring that physicians are properly licensed to provide care on patient
care units.

Referring all errors in nursing judgment to state discipline boards.

Practicing within legal guidelines established under state law and nurse
practice acts.

Ensuring that nursing staff under their supervision are currently
licensed to practice.

Question 48

Examples of sentinel events include which
of the following: (select all that
apply)

Administration of morphine overdose.

Forceps left in an abdominal cavity.

Patient fall, with injury.

Death of patient related to postpartum hemorrhage

Short staffing.

Question 49

A nurse manager introduces prompted voiding
into nursing practice on a unit, which is supported by clinical guidelines
based on evidence-based practice. The nurses on the unit resist implementation,
indicating that the bathroom facilities are too far away for efficient
implementation of the guidelines, and that resources are too few to accomplish
the initial voiding observations. For the nurse manager in this situation, it is
important to have further discussion with the staff regarding (select all that
apply):

Feasibility of the program with respect to unit design.

Compatibility of this intervention with the values of staff on the unit.

Usefulness of prompted voiding with the particular population of
patients on the unit.

Advantages of prompted voiding over incontinence products and
catheterizations.

Question 50

Clinical incompetence is one of the more
serious problems facing a nurse manager. Joyce, the nurse manager, is not aware
of the problems of Sarah, a novice nurse. After she investigates, it is obvious
that Sarah’s peers are covering for her. Which of the following might Joyce
include in her meeting with the nurses? (Select all that apply.)

“It
is a nurse’s professional responsibility to maintain quality control.”

“Patient care is the number one concern. Meeting standards is mandatory
and necessary.”

“It
is not considered being disloyal when one nurse reports another for poor care.”

“All instances of clinical incompetence are to be reported.”