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?

Accepted Answer

The advanced beginner repeats behavior learned from an earlier similar situation but may not understand the rationale.The other options are appropriate for a nurse at a different level of experience.

Question 2

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

Accepted Answer

The nurse manager is responsible for providing a safe learning and practice environment to encourage retention.The other strategies would not make for a good learning environment during orientation and could adversely affect retention.

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?

Accepted Answer

ECG interpretation is a unit-specific orientation.The other options are incorrect because they are hospital orientation.

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?

Accepted Answer

At the time of hospital orientation, the new nurse would expect to accomplish BLS (basic life support) training, which teaches the skills needed to respond to cardiac arrests, respiratory emergencies, and other life-threatening situations. ECG interpretation, critical care courses, and medication tests are typically part of later stages of orientation or continuing education programs.

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?

Accepted Answer

Providing positive feedback at the beginning of the interview sets a positive tone.The other factors are discussed after the initial feedback is accomplished.

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?

Accepted Answer

Recognition of nurses through awards gives an incentive to continually improve performance.The other examples may improve the nurse's performance or cause burnout.

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?

Accepted Answer

During the third stage of the performance appraisal process, the evaluation results are used to establish goals for improvement. Therefore, the evaluation tool that should be designed during this stage is one that helps establish these goals with outcome measures. Providing coaching and reassigning to a less stressful unit are actions that may follow the evaluation, but they are not evaluation tools themselves. Determining a nurse's values is also not an evaluation tool, but rather a separate activity related to understanding an individual's personal values and beliefs.

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?

Accepted Answer

Annual mandatory skill evaluations include fire safety.The other skills are not included in annual mandatory skill evaluations.

Question 9

Performance appraisals provide the employee with which of the following?

Accepted Answer

Performance appraisals today are tools for setting goals.The other options are not part of the purpose of performance appraisals today.

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?

Accepted Answer

A novice nurse would go into the patient's room prepared to get vital signs in the morning and decide not to further assess a patient who is "sleeping soundly." The other options would be the response of a nurse as she becomes more experienced.

Question 11

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

Accepted Answer

Nurse managers are responsible for providing the best learning environment for new staff.The other options are not the nurse manager's role.

Question 12

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

Accepted Answer

The answer of In what ways can hospitals meet The...

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?

Accepted Answer

ACLS demonstration is necessary for anyone working in an ICU.The other skills are evaluated in all mandatory skills evaluations and are not specific to the ICU setting.

Question 14

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

Accepted Answer

Nurse managers provide feedback evaluations at certain intervals.The other options are not the role of the nurse manager.

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?

Accepted Answer

Bringing a list of accomplishments from last year's appraisal may support a good appraisal this year.The other options are not beneficial to the process.

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?

Accepted Answer

The process of clinical decision making is lengthy and confidence in clinical judgment should not be expected before 6 to 12 months.4 to 6 months is the time frame for learning practice norms.12 to 18 months is the time frame for consolidation of relationships.18 to 24 months is the time frame for seeking challenges.

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?

Accepted Answer

The nurse manager should plan to document specific examples of the nurse's performance in preparation for the performance appraisal. This will allow for a more thorough and objective evaluation of the nurse's work. Anecdotal notes from other staff and complaints from patients and families may be useful in identifying areas for improvement or further discussion during the appraisal, but should not be the primary focus of preparation. Documentation of medication errors may be relevant if it pertains to the nurse's performance, but should not be the sole focus of preparation.

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?

Accepted Answer

The expert nurse typically is the advanced nurse practitioner who has the ability to make clinical judgments and direct care.The other options are appropriate for a nurse at a different level of nursing.

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?

Accepted Answer

The proficient nurse will assess and reposition a patient first before taking the next step of calling the physician.The other options are appropriate for a nurse at a different level of nursing.

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?

Accepted Answer

A nurse in the competent stage of clinical performance development would know to assess the patient's medication orders before administering any medication. If a patient is scheduled for a stress test and is on beta-blockers, the nurse would call the physician for an order to hold the medication prior to the test. This is because beta-blockers can affect the results of the test by lowering heart rate, which would not provide an accurate assessment of the patient's heart function under stress. Holding the medication before the test allows for accurate results. Therefore, option C is the best choice. Options A, B and D do not reflect the expected behavior of a nurse in the competent stage of clinical performance development.

Quiz 16: Providing Competent Staff