Leadership and Management Question
Leadership and Management Question
Leadership and Management Question
raisaMaeshow.....
2. The nurse manager has implemented a change in the method
of the nursing delivery system from functional to team nursing. A
nursing assistant is resistant to the change and is not taking an
active part in facilitating the process of change. Which of the
following is the best approach in dealing with the
nursing assistant?
a) ignore the resistance
b) exert coercion with the nursing assistant
c) provide a positive reward system for the nursing assistant
d) confront the nursing assistant to encourage verbalization of
feelings regarding the change
3. A nurse is giving a report to a nursing assistant who will be
caring for a client who has hand restraints. The nurse instructs
the nursing assistant to assess the skin integrity of the restrained
hands every:
a) 2 hours
b) 3 hours
c) 4 hours
d) 30 minutes
4. Fibrinolysin and desoxyribonuclease (Elase) is prescribed to
treat a skin ulcer, and the nurse is observing a nursing student
perform the treatment. The nurse intervenes if the nursing
student is observed doing which of the following?
a) applies a thin layer of medication
b) cleans the wound with a sterile solution
c) places petrolatum gauze over the fibrinolysin and
desoxyribonuclease
d) applies a thick layer of medication and covers with a dry
sterile dressings
5. A nursing student is caring for a client with a brain attack
(stroke) who is experiencing unilateral neglect. The nurse would
intervene if the student plans to use which of the following
strategies to help the client adapt to this deficit?
a) tells the client to scan the environment
b) approaches the client from the unaffected side
c) places the bedside articles on the affected side
d) moves the commode and cahir to the affected side
6. A nursing instructor asks the nursing student to describe the
definition of a critical path. Which of the following statements, if
made by the student, indicates a need for further understanding
regarding critical paths?
a) they are developed through the collaborative efforts of all
members of the health care team
b) they provide an effective way of monitoring care and for
reducing or controlling the length of hospital stay for the client
c) they are developed based on appropriate standards of care
d) they are nursing care plans and use the steps of the nursing
process
7. A community health nurse is working with a disaster relief
12. A nurse is caring for a client who has just had a plaster leg
cast applied. The nurse would plan to prevent the development
of compartment syndrome is instructing the licensed practical
nurseassigned to care for the client to:
d) an electric bed
a) a foot board
b) extra pillows
c) a bed trapeze
5) B
6) D
- Use the process of elimination and
knowledge regarding the definition and
purpose of critical paths to direct you to
option D. Note the strategic words in the
question, a need for further understanding.
These words indicate a negative event query
and ask you to select an option that is
incorrect.
If you had difficulty with this
question, review critical paths.
7) C
- Tertiary prevention involves the reduction of
the amount and degree of disability, injury,
and damage following a crisis. Primary
prevention means keeping the crisis from
occurring, and secondary prevention focuses
on reducing the intensity and duration of a
crisis during the crisis itself. There is no known
aggregate care prevention level.
3) D
8) A
4) D
- The wound should be cleansed with a sterile
solution and gently patted dry. A thin layer of
fibrinolysin and desoxyribonuclease (Elase) is
applied and covered with petrolatum gauze. If
a dry powder preparation is used, for best
effects, the solution should be prepared just
before use.
9) B
- In the preicteric phase, the client has
nonspecific complaints of fatigue, anorexia,
nausea, cough, and joint pain. Options A, C,
and D are clinical manifestations that occur in
the icteric phase. In the posticteric phase,
jaundice decreases, the color of urine and
stool return to normal, and the clients
appetite improves.
10) A
14) A
11) D
- It is important to encourage the client to
cough and deep breathe when a chest tube
drainage system is in place. This will assist in
facilitating appropriate lung re-expansion.
Water is added to the suction chamber as it
evaporates to maintain the full suction level
prescribed. Connections between the chest
tube and the drainage system are taped to
prevent accidental disconnection. The client is
positioned in semi-Fowlers to facilitate ease
in breathing.
12) A
- Compartment syndrome is prevented by
controlling edema. This is achieved most
optimally with the use of elevation and
application of ice. Options B, C, and D are
incorrect.
13) D
15) A
- In the use of a CPM machine, the leg should
be kept in a neutral position and not rotated
either internally or externally. The knee should
be positioned at the hinge joint of the
machine. The nurse should monitor for
pressure areas at the knee and the groin and
should follow the physicians orders and
institutional protocol regarding extension and
flexion and speed of the CPM machine.
16) C
- The purpose of the water bottle is to
humidify the oxygen that is bypassing the
nose during mouth breathing. The humidified
oxygen may help keep mucous membranes
moist but will not substantially alter fluid
balance (options A and B). A client who is
breathing through the mouth is not at risk for
nosebleeds.
17) C
- Postural drainage uses specific client
positions that vary depending on the affected
lobe(s). The positions usually involve having
the head lower than the affected lung
segment(s) to facilitate drainage of secretions.
37) A
- The autocratic style of leadership is task
oriented and directive. The leader uses his or
her power and position in an authoritarian
manner to set and implement organizational
goals. Decisions are made without input from
the staff. Democratic styles best empower
staff toward excellence because this style of
leadership allows nurses to provide input
regarding the decision-making process and an
opportunity to grow professionally. The
situational leadership style utilizes a style
depending on the situation and events. The
laissez-faire style allows staff to work without
assistance, direction, or supervision.
38) D
- A nurse must be able to function at a level
that does not affect the ability to provide safe,
quality care. The highest priority is to
determine how the illness affects the nurse's
43) C
44) D
- A client with acute glomerulonephritis
commonly experiences fluid volume excess
and fatigue. Interventions include fluid
restriction as well as monitoring weight and
intake and output. The client may be placed
on bed rest or at least encouraged to rest,
because a direct correlation exists between
proteinuria, hematuria, edema, and increased
activity levels. The diet is high in calories but
low in protein. It is unnecessary to monitor the
temperature as frequently as every 2 hours.
45) D
- A potential complication of hemodialysis is
the acquisition of dialysis-associated hepatitis
B. This is a concern for clients (who may carry
the virus), client families (at risk from contact
with the client and with environmental
surfaces), and staff (who may acquire the
virus from contact with the client's blood).
This risk is minimized by the use of standard
precautions, appropriate handwashing and
sterilization procedures, and the prohibition of
eating, drinking, or other hand-to-mouth
activity in the hemodialysis unit. The first
nurse should ask the second nurse to stop
eating and drinking in the client area.
46) D
- Basic rules for handling evidence include
limiting the number of people with access to
the evidence, initiating a chain of custody log
to track handling and movement of evidence,
and carefully removing of clothing to avoid
destroying evidence.
cutting clothes along
areas where there are
Potential evidence is
family to take home.
47) B
- Proper handwashing procedure involves
wetting the hands and wrists and keeping the
hands lower than the forearms so that water
flows toward the fingertips. The nurse uses 3
to 5 mL of soap and scrubs for 10 to 15
seconds, using rubbing and circular motions.
The hands are rinsed and then dried, moving
from the fingers to the forearms. The paper
towel is then discarded, and a second one is
used to turn off the faucet to avoid hand
contamination.
48) C
- Nurses are advised not to document the
filing of an incident report in the nurses' notes
for legal reasons. Incident reports inform the
facility's administration of the incident so that
risk management personnel can consider
changes
that
might
prevent
similar
occurrences in the future. Incident reports also
alert the facility's insurance company to a
potential claim and the need for further
investigation. Options A, B, and D are
accurate interventions.
49) D
- Nurses are encouraged not to accept verbal
orders from the physician because of the risks
of error. The only exception to this may be in
an emergency situation, and then the nurse
must follow agency policy and procedure.
Although the client will be informed of the
change in the treatment plan, this is not the
appropriate action at this time. The physician
needs to write the new order. It is
inappropriate to ask another individual other
than the physician to write the order.
50) C
- Nurse Practice Acts require reporting the
suspicion of impaired nurses. The Board of
Nursing has jurisdiction over the practice of
52) A
- Secondary prevention focuses on the early
diagnosis and prompt treatment of disease.
Tertiary prevention is represented by
rehabilitation services. Options B, C, and D
identify screening procedures. Option A
identifies a rehabilitative service.
53) B
- When the nurse asks a "why" question of the
client, the nurse is requesting an explanation
for feelings and behaviors when the client
may not know the reason. Requesting an
explanation is a nontherapeutic
communication technique. In option A, the
nurse is encouraging the verbalization of
emotions or feelings, which is a therapeutic
communication technique. In option C, the
nurse is using the therapeutic communication
technique of exploring, which involves asking
the client to describe something in more detail
or to discuss it more fully. In option D, the
nurse is using the therapeutic communication
technique of giving information. Identifying
the common fear of death among clients with
end-stage heart failure may encourage the
client to voice concerns.
54) D
- When communicating with a hearingimpaired client, the nurse should speak in a
normal tone to the client and should not
58) D
- The skin is cleansed with soap and water
(not Betadine), denatured with alcohol, and
allowed to air-dry before electrodes are
applied. The other three options are correct.
59) A