Deck 21: Managing Patient Care

Question 1

A nurse uses the five rights of delegation when providing care. Which "rights" did the nurse use? (Select all that apply.)

A) Right task
B) Right person
C) Right direction
D) Right supervision
E) Right circumstances
F) Right cost-effectiveness

Answer 1

Right task
Right person
Right direction
Right supervision
Right circumstances

Question 2

Which staff member does the nurse assign to provide morning care for an older-adult patient who requires assistance with activities of daily living?

A) Licensed practical nurse
B) Cardiac monitor technician
C) Nursing assistive personnel (NAP)
D) Another registered nurse on the floor

Answer 2

Nursing assistive personnel (NAP)

Question 3

A nurse is assigned to care for the following patients who all need vital signs taken right now. Which patient is most appropriate for the nurse to delegate vital sign measurement to the nursing assistive personnel (NAP)?

A) Patient scheduled for a procedure in the nuclear medicine department
B) Patient transferring from the intensive care unit (ICU)
C) Patient returning from a cardiac catheterization
D) Patient returning from hip replacement surgery

Answer 3

Patient scheduled for a procedure in the nuclear medicine department

Question 4

A new nurse expresses frustration at not being to complete all interventions for a group of patients in a timely manner. The nurse leaves the rounds report sheets at the nurse's station when caring for patients and reports having to go back and forth between rooms for equipment and supplies. Which type of skill does the nurse need?

A) Interpersonal communication
B) Clinical decision making
C) Organizational
D) Evaluation

Question 5

Which assessment of a patient who is 1 day postsurgery to repair a hip fracture requires immediate nursing intervention?

A) Patient ate 40% of clear liquid breakfast.
B) Patient's oral temperature is 98.9° F.
C) Patient states, "I did not realize I would be so tired after this surgery."
D) Patient reports severe pain 30 minutes after receiving pain medication.

Question 6

A nurse is overseeing the care of patients with severe diabetes and patients with heart failure to improve cost-effectiveness and quality of care. Which nursing care delivery model is the nurse using?

A) Team nursing
B) Total patient care
C) Primary nursing
D) Case management

Question 7

A nurse manager sent one of the staff nurses on the unit to a conference about new, evidence-based wound care techniques. The nurse manager asks the staff nurse to prepare a poster to present at the next unit meeting, which will be mandatory for all nursing staff on the unit. Which type of opportunity is the nurse manager providing for the staff?

A) Staff education
B) Interprofessional collaboration
C) Providing a professional shared governance council
D) Establishing a nursing practice committee

Question 8

A staff member verbalizes satisfaction in working on a particular nursing unit because of the freedom of choice and responsibility for the choices. This nurse highly values which element of shared decision making?

A) Authority
B) Autonomy
C) Responsibility
D) Accountability

Question 9

A registered nurse (RN) is the group leader of practical nurses and nursing assistive personnel. Which nursing care model is the RN using?

A) Case management
B) Total patient care
C) Primary nursing
D) Team nursing

Question 10

A nurse is working in a facility that has fewer directors with managers and staff able to make shared decisions. In which type of organizational structure is the nurse employed?

A) Delegation
B) Research-based
C) Decentralization
D) Philosophy of care

Question 11

A staff nurse delegates a task to a nursing assistive personnel (NAP), knowing that the NAP has never performed the task before. As a result, the patient is injured, and the nurse defensively states that the NAP should have known how to perform such a simple task. Which element of the decision-making process is the nurse lacking?

A) Authority
B) Autonomy
C) Responsibility
D) Accountability

Question 12

A patient with an indwelling urinary catheter has been given a bed bath by a new nursing assistive personnel. The nurse evaluating the cleanliness of the patient notices crusting at the urinary meatus. Which action should the nurse take next?

A) Ask the nursing assistive personnel to observe while the nurse performs catheter care.
B) Leave the room and ask the nursing assistive personnel to go back and perform proper catheter care.
C) Tell the nursing assistive personnel that catheter care is sloppy.
D) Remove the catheter.

Question 13

A nurse is prioritizing care for four patients. Which patient should the nurse see first?

A) A patient needing teaching about medications
B) A patient with a healed abdominal incision
C) A patient with a slight temperature
D) A patient with difficulty breathing

Question 14

A nursing assistive personnel (NAP) reports seeing a reddened area on the patient's hip while bathing the patient. Which action should the nurse take?

A) Request a wound nurse consult.
B) Go to the patient's room to assess the patient's skin.
C) Document the finding per the NAP's report.
D) Ask the NAP to apply a dressing over the reddened area.

Question 15

A nurse is making a home visit and discovers that a patient's wound infection has gotten worse. The nurse cleans and redresses the wound. What should the nurse do next?

A) Notify the health care provider of the findings before leaving the home.
B) Ask the home health facility nurse manager to contact the health care provider.
C) Document the findings and confirm with the patient the date of the next home visit.
D) Tell the patient that the health care provider will be notified before the next home visit.

Question 16

A nurse manager discovers that the readmission rate of hospitalized patients is very high on the hospital unit. The nurse manager desires improved coordination of care and accountability for cost-effective quality care. Which nursing care delivery model is best suited for these needs?

A) Team nursing
B) Total patient care
C) Primary nursing
D) Case management

Question 17

A nurse manager conducts rounds on the unit and discovers that expired stock medicine is still in the cabinet despite the e-mail that was sent stating that it had to be discarded. The staff nurse dress code is not being adhered to as requested in the same e-mail. Several staff nurses deny having received the e-mail. Which action should the nurse manager take?

A) Close the staff lounge.
B) Enforce a stricter dress code.
C) Include the findings on each staff member's annual evaluation.
D) Place a hard copy of announcements and unit policies in each staff member's mailbox.

Question 18

A nurse is working in an intensive care unit (critical care). Which type of nursing care delivery model will this nurse most likely use?

A) Team nursing
B) Total patient care
C) Primary nursing
D) Case-management

Question 19

A nurse has a transactional leader as a manager. Which finding will the nurse anticipate from working with this leader?

A) Increased turnover rate
B) Increased patient mortality rate
C) Increased rate of medication errors
D) Increased level of patient satisfaction

Question 20

Which approach will be most appropriate for a nurse to take when faced with the challenge of performing many tasks in one shift?

A) Do as much as possible by oneself before seeking assistance from others.
B) Evaluate the effectiveness of all tasks when all tasks are completed.
C) Complete one task before starting another task.
D) Delegate tasks the nurse does not like doing.

Question 21

A nurse is prioritizing care. Match the level of priority to the patients.

High priority

A)Patient that needs to be turned to prevent pneumonia
B)Patient with acute asthma attack
C)Patient who will be discharged in 2 days who needs teaching

Question 22

A nurse is prioritizing care. Match the level of priority to the patients.

Low priority

A)Patient that needs to be turned to prevent pneumonia
B)Patient with acute asthma attack
C)Patient who will be discharged in 2 days who needs teaching

Question 23

A nurse is prioritizing care. Match the level of priority to the patients.

Intermediate priority

A)Patient that needs to be turned to prevent pneumonia
B)Patient with acute asthma attack
C)Patient who will be discharged in 2 days who needs teaching