Deck 16: Providing Competent Staff

Question 1

You are the charge nurse on the 3 P.M.to 11 P.M.shift.The nurses on this shift range from novice to competent.What response would be expected in the beginner stage of clinical competence development when the nurse is assigned a patient on beta-blockers and scheduled for a stress test?

A)Knows to hold a beta-blocker on a patient scheduled for a stress test because this happened earlier in the week on another patient
B)Must be told to hold the beta-blocker for a patient scheduled for a stress test
C)Understands the rationale for holding the beta-blocker prior to a stress test
D)Holds all medications when the patient is NPO

Answer 1

Knows to hold a beta-blocker on a patient scheduled for a stress test because this happened earlier in the week on another patient

Question 2

What retention strategies should the nurse manager use when working with a new orientee?

A)Provide a safe practice environment
B)Encourage more time shadowing preceptor
C)Encourage early independence
D)Provide multiple preceptors for diverse learning

Answer 2

Provide a safe practice environment

Question 3

Orientation of new employees is a two-stage process.The first stage includes orientation to the hospital and its policies and expectations.What would the new nurse expect to accomplish at the time of the unit orientation?

A)Computer training
B)Transcription of orders
C)ECG interpretation
D)BLS training

Answer 3

ECG interpretation

Question 4

Orientation of new employees is a two-stage process.The first stage includes orientation to the hospital and its policies and expectations.What would the new nurse expect to accomplish at the time of the hospital orientation?

A)ECG interpretation
B)Critical care course
C)Medication test
D)BLS training

Question 5

The second phase of the performance appraisal interview is the participation.It is important for the nurse manager to do which of the following first during this phase?

A)Provide feedback on employee's accomplishments and successes
B)Discuss areas of concern
C)Establish goals
D)Identify areas for improvement

Question 6

The nurse's progression from novice to expert is usually encouraged by the organizations for which they work.Which of the following is an example of a method used to encourage nurses to progress in their level of experience?

A)Rotating nurses to all shifts
B)Rotating nurses into the ICU
C)Quarterly Nursing Excellence awards
D)Tuition reimbursement for advanced degrees

Question 7

The third phase of the performance appraisal process is using the evaluation results.The nurse and nurse manager can set goals for improvement.Which of the following evaluation tools should be designed during the third stage of the performance appraisal process?

A)Provide coaching
B)Reassign to a less stressful unit
C)Determine nurse's values
D)Establish goals with outcome measures

Question 8

Accrediting agencies require that staff demonstrate competency in their jobs.Annual competency of mandatory skills is evaluated.Which of the following skills should be demonstrated annually in the health care field as required by accrediting agencies?

A)Management of violent patients
B)Fire safety
C)Transport of patients
D)Transcription of orders

Question 9

Performance appraisals provide the employee with which of the following?

A)Performance standards
B)Goals
C)Salary increases
D)Continuing education

Question 10

You are the charge nurse on a busy medical-surgical unit.You are also the preceptor to a novice nurse.What response would be expected from a nurse in the novice stage of clinical competence development when assigned to perform a morning assessment on a patient?

A)Nurse uses Doppler to obtain pulses on a patient with no palpable peripheral pulses
B)Reporting to the charge nurse that they cannot feel a patient's peripheral pulses and the blood pressure is only palpable
C)Nurse calls for help when she finds the patient with barely palpable blood pressure and hard to arouse
D)Reporting to the charge nurse that she decided to let the patient sleep until the breakfast trays arrive because the patient was sleeping so soundly

Question 11

In addition to evaluative feedback,the nurse manager is also involved in orientation in which areas?

A)Encourages precepting with several nurses
B)Provides for optimal learning experiences
C)Orients to delegation of UAPs
D)Orients to nurse manager role

Question 12

In what ways can hospitals meet The Joint Commission goals of adequate competent staffing? Select all that apply.

A)Using contract nurses
B)Training and educating staff
C)Promoting "best nurses"
D)Salary inequities

Question 13

Accrediting agencies require that staff demonstrate competency in their jobs.Annual competency of mandatory skills is evaluated.Which of the following skills should be demonstrated annually in the ICU setting as mandated by accrediting agencies?

A)ACLS
B)Fire safety
C)HIPAA
D)Infection prevention

Question 14

What is the nurse manager's primary role in a new nurse's orientation program?

A)Provides feedback
B)Acts as a role model
C)Orients to unit
D)Encourages shift changes

Question 15

In the first phase of the performance appraisal process,the nurse prepares for the interview with the nurse manager.Which of the following should the nurse do to prepare for the performance appraisal interview?

A)Make a list of patients who have remarked on your abilities as a nurse.
B)Identify accomplishments of last year's goals.
C)Bring documentation of charting.
D)Provide anecdotal notes of other staff evaluations of you.

Question 16

A new graduate requires a lengthy time commitment to orientation from the nurse manager.The socialization of the new nurse may take as long as 2 years.Which of the following would be expected as a time frame for developing confidence?

A)6 to 12 months
B)4 to 6 months
C)12 to 18 months
D)18 to 24 months

Question 17

In the first phase of the performance appraisal process,the nurse manager prepares for the interview with the nurse.What should the nurse manager plan in preparation for the performance appraisal?

A)Anecdotal notes from other staff
B)Complaints from patients and families
C)Documentation of examples of performance
D)Documentation of medication errors

Question 18

You are the nursing supervisor on the 11 P.M.to 7 A.M.shift.When making rounds,the charge nurse on the unit reports that one of the patients is dyspneic.What action would be expected from a nurse in the expertise stage of clinical competence when assessing shortness of breath in a patient?

A)Recognizes the patient may have pulmonary edema and orders (or asks the physician for an order)an IVP diuretic
B)Places a patient complaining of shortness of breath in high-Fowler's position after hearing coarse crackles and rhonchi and obtaining a pulse oxygenation of 88%
C)Increases the oxygen concentration
D)Notifies the instructor of the patient's complaints

Question 19

You are the nurse educator on a medical unit.What action would be expected from a nurse in the proficient stage of clinical competence when assessing shortness of breath in a patient?

A)Increases the oxygen concentration on a patient complaining of shortness of breath
B)Places a patient complaining of shortness of breath in high Fowler's position after hearing coarse crackles and rhonchi and obtaining a pulse oxygenation of 88%
C)Checks the oxygen saturation
D)Calls the physician to notify her of the patient's change in condition

Question 20

You are the nurse manager who is preparing the annual reviews for the staff members.You are aware that the nurse in the competent stage of clinical performance development would be expected to do what when assigned a patient on beta-blockers scheduled for a stress test?

A)Must be told to hold the beta-blocker for a patient scheduled for a stress test
B)Holds all medications when the patient is NPO
C)Calls the physician for an order to hold the beta-blocker prior to a stress test if there is no order
D)Repeats behavior learned from a previous experience

Question 21

During unit orientation,a preceptor is used to provide learning and role modeling.Which of the following would one expect to observe in a seasoned nurse preceptor? Select all that apply.

A)Teach unfamiliar procedures
B)Teach their way of charting
C)Teach delegation skills
D)Act as a role model
E)Tailor orientation to new nurses' specific needs

Question 22

During unit orientation,a preceptor is used to provide learning and role modeling.What should the nurse expect from a preceptor during orientation? Select all that apply.

A)Orient to unit.
B)Teach organizational skills.
C)Teach medication actions.
D)Teach unfamiliar skills.
E)Teach prioritization skills.

Question 23

The clinical ladder used in some hospitals allows for recognition of both the clinical and academic growth of the individual nurse.On which of the following is this ladder based?

A)The concept that people will work harder when recognized
B)The concept that nurses respond to harder work
C)The concept of growth in nursing from novice to expert
D)The concept that nurses like to be intellectually stimulated

Question 24

Clinical ladders for nurses are best used in what circumstance?

A)Horizontal advancement for clinicians who wish to stay at the bedside
B)Vertical advancement for management responsibilities
C)Horizontal ladder for nurses with more than 10 years of employment
D)Vertical ladder for nurses with more than 10 years of employment

Question 25

The Joint Commission ( TJC )has set standards for employee ongoing education in which situations? Select all that apply.

A)Must occur after the end of orientation
B)Must occur whenever responsibilities change
C)To increase knowledge of work-related issues
D)All staff must participate whenever an event occurs
E)When and how to report adverse events

Question 26

Which of the following topics would the new nurse expect to review in the hospital's new employee orientation program? Select all that apply.

A)HIPAA
B)Safety standards
C)Infection control
D)ACLS
E)Order transcription

Question 27

Which of the following best explains the use of career development strategies in health care institutions?

A)Encourages nurses to move into management
B)Reduces attrition
C)Reduces dissatisfaction
D)Reduces sick time