Deck 10: Delegation, Leadership, and Management

Question 1

Prior to addressing a situation, the nurse is aware that an effective leader must _____ the problem.

A) define
B) identify persons to address
C) know the legal implications of
D) look to alternatives to address

Answer 1

define

Question 2

The best description of an autocratic leader is a leader who:

A) is permissive.
B) has confidence in the staff.
C) tightly controls team members.
D) accepts all responsibility for the team.

Answer 2

tightly controls team members.

Question 3

The nurse is aware that the best way to evaluate an unlicensed assistive personnel's (UAP's) ability to perform a skill or task is to:

A) obtain verbal confirmation from another nurse that the nursing assistant is proficient.
B) review documentation that the nursing assistant is competent in skills.
C) observe the nursing assistant performing the skill or task.
D) demonstrate the skill to the nursing assistant before his demonstration.

Answer 3

observe the nursing assistant performing the skill or task.

Question 4

The nurse is aware that when a task is delegated to an unlicensed assistive personnel (UAP), the nurse is:

A) no longer responsible to that patient.
B) responsible to communicate outcome to appropriate senior staff.
C) responsible for overall patient care.
D) liable for all adverse outcomes.

Question 5

The nurse is initially guided in the process of delegation to an unlicensed assistive personnel (UAP) by the:

A) state's nurse practice act.
B) competencies of the UAP.
C) policies of the facility.
D) needs of the patient.

Question 6

The nurse in a long-term care facility is aware that the accuracy and comprehensiveness of the Minimum Data Set (MDS) facilitate the:

A) patient receiving the appropriate treatments.
B) effectiveness of the planning for quality improvement.
C) reimbursement to the facility from Medicare and Medicaid payments.
D) enhancement of the database for procedures related to risk management.

Question 7

A laissez-faire leader would be most likely to:

A) consult staff members.
B) tightly control team members.
C) allow team members to function independently.
D) set goals that are task oriented.

Question 8

A team leader with effective communication skills would:

A) make precise authoritarian assignments to team members.
B) give specific information in a tactful, friendly manner.
C) maintain eye contact when giving directions.
D) limit time for feedback and complaints.

Question 9

Nursing documentation that would best assist with reimbursement to a facility would be:

A) Patient was up in chair for 2 hours after breakfast.
B) Patient was ambulated in the hall three times this shift.
C) Patient was assisted to a recliner chair to use the oxygen concentrator.
D) Patient received bath in shower room.

Question 10

When transcribing a physician's orders, the nurse must:

A) transcribe only the generic name of the drug.
B) give a copy of the order to the nurse responsible for that patient's care.
C) review unclear orders with the charge nurse.
D) transfer orders to the Medication Administration Record (MAR).

Question 11

A nurse can best minimize the liability of a lawsuit against the facility by:

A) strictly adhering to the policies and procedures of the facility.
B) demonstrating concern and attending to patient complaints.
C) advising the supervisor of significant events or problems with patient relations.
D) giving a copy of the policy and procedures to each patient.

Question 12

Leadership is best defined as a process that:

A) motivates people to accomplish set goals.
B) provides a framework for health care delivery systems.
C) guides staff to use resources to meet patient needs.
D) uses advanced management training.

Question 13

The most effective communication from a nurse leader to a team member that is most likely to have a positive outcome would be:

A) "Jane, be sure to get those vital signs recorded on time today."
B) "Jane, I need those vital signs before breakfast."
C) "Jane, please give me a list of those vital signs before breakfast."
D) "Jane, breakfast trays are being served. You need to get those vital signs."

Question 14

The behavior least likely seen in an autocratic leader would be a person who:

A) provides close supervision of work by staff members.
B) often consults staff when making decisions.
C) quickly points out mistakes made by staff members.
D) frequently gives out new directives.

Question 15

The nurse's most appropriate selection of a task to be delegated to an unlicensed assistive personnel (UAP) would be:

A) assessing circulation in the toes of a patient in a cast.
B) changing a patient's wound dressing.
C) taking the blood pressure of a patient who has just returned from surgery.
D) toileting a patient on a bladder-training regimen.

Question 16

An inappropriate delegation to an unlicensed assistive personnel (UAP) would be:

A) applying a condom catheter.
B) assessing a patient's pain.
C) giving a sitz bath.
D) giving an enema.

Question 17

The example of a physician's order that was received by telephone that has all the essential documentation is:

A) Increase Coumadin to 3 mg daily: order from A. Doctor received by A. Nurse 11/11/11 @ 0930.
B) 11/11/11 @ 0930 TO. From A. Doctor: Increase Coumadin (Warfarin) to 3 mg daily. A. Nurse, LVN.
C) TO: from A. Doctor: Increase Coumadin to 3 mg every day. A. Nurse.
D) 11/11/11 received TO to increase Coumadin (Warfarin) to 3 mg daily A. Nurse.

Question 18

The nurse recognizes that the use of the democratic approach in leadership will:

A) cause team members to feel that their feelings are secondary to the accomplishment of the goal.
B) cause mistakes to be discovered and pointed out.
C) take more time to accomplish goals.
D) use the leader's skills and knowledge.

Question 19

The nurse recognizes that one of the responsibilities of a charge nurse as opposed to the team leader is that the charge nurse is responsible for:

A) evaluating members of the health care team.
B) evaluating unlicensed assistive personnel.
C) making rounds and assessing all patients on the unit.
D) collaborating with physicians and other health team members.

Question 20

The nurse is aware that assignment of an unlicensed assistive personnel (UAP) differs from delegation in that in delegation, the:

A) nurse has transferred the authority to perform the task.
B) UAPs are covered by their own certification.
C) UAPs are performing activities within the scope of their job description.
D) licensed person must accompany the UAP to supervise the activity.

Question 21

Staff nurses have many responsibilities to their patients throughout their shift. However, the _________ is responsible for the total nursing care of patients during a shift and is also responsible for giving reports to the oncoming shift and evaluating members of the health care team.

Question 22

The nurse is aware that orders for a patient going to surgery are:

A) pertinent only for the immediate preoperative period.
B) canceled when the physician writes, "resume previous orders."
C) can be continued when the patient returns to the unit.
D) canceled by the nurse in the operating room when the surgery is complete.

Question 23

The LPN/LVN who is transcribing orders is unclear about the intent of an order. The LPN/LVN should:

A) consult the charge nurse.
B) call the physician.
C) transcribe the order as written.
D) mark the order in red as UNTRANSCRIBED.

Question 24

The nurse receiving a telephone order from a physician who is following the Joint Commission International Center for Patient Safety should:

A) receive the order from the physician, transcribe the order to the chart, and ask the physician if he will confirm the order.
B) receive the order from the physician, repeat the order to the physician, and then transcribe the order to the chart.
C) receive the order from the physician, transcribe the order to the chart, and then read back the order to the physician.
D) write the telephone order verbatim as the physician gives it and then read it back to the charge nurse.

Question 25

The considerations for an LPN/LVN to be eligible for an advanced leadership role as a charge nurse include a minimum of staff nursing experience of _____ months.

A) 12
B) 18
C) 24
D) 36

Question 26

The team leader who is reviewing the list of the assigned patients would give priority to the patient who:

A) has a scheduled medication due.
B) requires dressing changes three times a day.
C) is experiencing acute chest pain.
D) is confused and disoriented.

Question 27

Characteristics of effective communication would include: (Select all that apply.)

A) using eye contact.
B) using concise statements when giving information.
C) addressing conflicts before delegation of duties.
D) obtaining feedback about directions given.
E) assigning responsibility for creation of any conflict.

Question 28

A nurse is aware that the medication orders on the MAR/Kardex should be verified with the chart orders every:

A) shift.
B) 12 hours.
C) 24 hours.
D) 48 hours.

Question 29

The best communication given by the nurse to the unlicensed assistive personnel (UAP) would be:

A) "Let me know if my patient's temperature is high."
B) "Please measure each urine output and report it to me."
C) "Tell me if the patient seems more uncomfortable."
D) "Notify me when the dressing needs to be changed."

Question 30

Which statements are true regarding delegation of duties to unlicensed assistive personnel (UAPs) by a licensed nurse? (Select all that apply.)

A) The LPN/LVN in charge must be familiar with the competency of staff.
B) The LPN/LVN must be familiar with the job descriptions of UAPs.
C) An LPN/LVN may delegate any skill or task to a UAP once the nursing assistant has demonstrated proficiency.
D) A nurse must be familiar with the nurse practice act.
E) The certification of the UAP makes nursing assistants liable for their actions.

Question 31

When the team leader becomes concerned about the frequent tardiness of the unlicensed assistive personnel (UAP), the most appropriate documentation would be:

A) Has been late to work 6 times in this pay period (January 2, 4, 6, 8, 10, and 14). States she overslept. Counseled on January 9. Unit management made aware.
B) Frequently late to work. States she overslept. Co-workers state she is working elsewhere at night. Will follow up.
C) Tardiness is causing inability to finish assignments without assistance from others.
D) Oversleeping and active social life have caused tardiness six times in this pay period.

Question 32

Place the steps of transcription of physician's orders in proper sequence. (Separate letters with a comma and space as follows: A, B, C, D, E.)

A) Transmit orders to pharmacy, dietary, or ancillary services.
B) Add medication changes to MAR.
C) Process the "stat" orders first.
D) Read through all of the order.
E) Sign off order with a red line across page.

Question 33

Important characteristics of delegation to an unlicensed assistive personnel (UAP) include: (Select all that apply.)

A) use of effective communication.
B) provision of constructive criticism immediately.
C) direction for the desired result and time for completion.
D) provision of tactful feedback.
E) informing the patient that the delegated task will be performed by a UAP.

Question 34

Which responsibilities are common to an LPN/LVN team leader in both health care facilities and medical clinics? (Select all that apply.)

A) Organizes staff meetings
B) Assists in writing policies and procedures
C) Assists in resolving staff conflicts
D) Prepares the schedule for patient activities
E) Evaluates unlicensed assistive personnel (UAPs)