1
Q
What are characteristics of the authoritarian leadership style?
6
A
- Directive behaviors
- Dictate tasks and techniques
- Tell what to do and how to do it
- Can create hostility and dependency among followers
- Very efficient in crisis
- Effective for employees with little or no formal education
2
Q
What are characteristics of the democratic leadership style?
4
A
- Group discussion and decision
- Leader shares responsibility with the followers involving them in the decision making process
- Challenge to get people to agree and focus on problem
- Good design if cooperation and collaboration
3
Q
What are characteristics of the Laissez-Faire leadership style?
6
A
- Freedom for group and individuals
- Leader seems apathetic
- Non-interference
- Clear decision may never be formulated
- Let events take their own course
- Good for independent care providers and professionals working together
4
Q
What are benefits of good time management?
5
A
- Greater productivity
- Quality care
- Decrease stress
- Complete one client care before beginning another
- Schedule for breaks and meals
5
Q
What are effects of poor time management?
3
A
- Stress
- Omission of important tasks
- Creates dissatisfaction
6
Q
What are two types of unsafe assignments?
A
- Assign the nurse to care for an excessive number of clients or a mix including too many clients with high acuity
- Assign the nurse to care for clients in specialty areas where the nurse lacks the knowledge, skills, and ability to provide safe and competent care
7
Q
What actions should the nurse take after receiving an unsafe assignment?
3
A
- Bring the unsafe assignment to the attention of the scheduling/charge nurse and negotiate a new assignment
- If no resolution is arived at, take the concern up the chain of command
- If a satisfactory resolution is still not arrived at, the nurse should file a written protest to the assignment (an assignment despite objection ADO or document of practice situation DOPS) with the appropriate administrator
8
Q
What can failing to follow the proper channels when failing to accept an unsafe assignment be considered?
A
Client abondonment
9
Q
What clients require a private room?
2
A
- Clients who have an infections disease requiring airborne precautions
- Clients who require a protective environment
10
Q
What requirements must be met for patients with droplet/contact precautions to share a room?
3
A
- The clients have the same active infection with the same microorganisms
- The clients can remain at least 3 feet away from each other
- The clients have no other existing infection
11
Q
Other than patients with infections, what clients are private rooms also preferred for?
5
A
- Clients who are agitated
- Clients who have dementia and a history of wandering
- Clients who require a quiet environment (like those at risk of IICP)
- Clients who are at risk of sensory overload (pain, acute illness, invasive tubes, or reduced cognitive function)
- Clients who require privacy
12
Q
What are other considerations for room assignments?
2
A
- Clients who are disoriented or confused should be assigned a room away from noise and away from exits
- Children who are transitioning from a critical care unit to a lower level of care should be assigned a room near the nurses station and with a roomate of similar age
13
Q
What is delegating?
A
Transferring the authority to perform duties that are in the LPN/LVN or APs job description
14
Q
Who can RNs delegate to?
3
A
- Other RNs
- PNs
- APs
15
Q
Who can LPNs delegate to?
2
A
- Other PNs
- APs
16
Q
Can UAPs make a judgement or interpret the data they obtain when caring for residents?
A
No, they do not have the nursing education to make judgements or interpret data
17
Q
What are characteristics of orientation to the institution?
4
A
- The nurse is introduced to the philosophy, mission, and goals of the institution and department.
- Policies and procedures that are based on institutional standards are reviewed.
- Use of and access to the institution’s computer system is a significant focus.
- Safety and security protocols are emphasized in relation to the nurse’s role.
18
Q
What are characteristics of orientation to the unit?
5
A
- Classroom orientation is usually followed by orientation to the unit by an experienced nurse.
- Preceptors assist in orienting nurses to a unit and supervising their performance and acquisition of skills.
- Preceptors are usually assigned to nurses for a limited amount of time.
- Mentors can also serve as a nurse’s preceptor, but their relationship usually lasts longer and focuses more on assumption of the professional role and relationships, as well as socialization to practice.
- Coaches establish a collaborative relationship to help a nurse establish specific individual goals. The relationship is often task-related and typically time limited.
19
Q
What are characteristics of orientation programs for newly licensed nurses?
3
A
- A successful orientation and mentoring program can increase retention of new nursing staff.
- Transition to practice programs are used to transition the newly licensed nurse to a nursing role in practice.
- Nurse preceptors/mentors are frequently used to assist newly licensed nurses with the orientation process on the clinical unit.
20
Q
Why are benchmarks used for quality improvement? What are the benefits?
2 benefits
A
- Goals are set where outcome should be met
- Best approach as it covers practice, process, and performance
- Continuous process by which an organization can measure and compare its own processes with those of other organizations
21
Q
What do audits provide?
A
Quantitative data
22
Q
What are the timings when audits may be performed
3
A
- Retrospective (after)
- Concurrent (while there)
- Prospective (future)
23
Q
What is a root cause analysis? What does it help prevent?
A
A process used to identify the root causes of problems or events; helps develop a way to prevent them from recurring.
24
Q
What are conflict resolution strategies?
3
A
- Open communication
- Use “I” statements and focus on the problem instead of personal differences
- Only one person speaking at a time
25
What are the three communication styles?
- Nonassertive/passive
- Aggressive
- Assertive
26
What is a grievance?
A wrong perceived or a feeling of unfair treatment (real or imagined)
27
What are steps for the grievance process?
| 3
- Proper chain of command
- Formal hearing if not resolved on a lower level
- Professional mediation
28
What are examples of grievances in healthcare?
| 3
- Problems getting an appointment
- Having to wait a long time for an appointment
- Disrespectful or rude behavior by healthcare staff
29
What are key situations in which a nurse must protect client rights?
| 5
- Informed consent
- Refusal of treatment
- Advance directives
- Confidentiality
- Information security
30
What does each client have the right(s) to?
| 5
- Be informed of all aspects of care
- Take an active role in the decision making process
- Accept, refuse, or request modification to the plan of care
- Receive care that is delivered by competent individuals
- Be treated with respect
31
What must patients be informed of upon admission?
Their right to accept or refuse care
32
What does the client have to be informed of when they refuse a treatment?
The risk involved with refusing the treatment
33
What should the client be informed of prior to leaving AMA?
| 4
- Possible complications that could occur without treatment
- Possibility of permanent physical or mental impairment or disability
- Possibiity of other complications that could lead to death
- The client is asked to sign an AMA form
34
What should the nurse do when a client refuses to sign an AMA form?
Document the refusal
35
What is the nursing role for advance directives?
| 5
- Providing written information regarding advance directives
- Documenting the client’s advance directives status
- Ensuring that advance directives are current and reflective of the client’s current decisions
- Recognizing that the client’s choice takes priority when there is a conflict between the client and family, or between the client and the provider
- Informing all members of the health care team of the client’s advance directives
36
What is the nurse's role regarding referrals?
| 5
- Begin discharge planning upon the client’s admission.
- Evaluate client/family competencies in relation to home care prior to discharge.
- Involve the client and family in care planning.
- Collaborate with other health care professionals to ensure all health care needs are met and necessary referrals are made.
- Complete referral forms to ensure proper reimbursement for prescribed services
37
What are hand-off tools used for?
Maintaining continuity of care during transfers/shift change
38
What should the nurse assess or ensure is completed at discharge?
| 4
- Patient's learning needs and how well they were met
- Teaching is completed
- Referrals are made
- Coordinated care plan to be implemented after discharge
39
What does accountability mean?
The nurse is answerable to themselves and others for their actions and impact on others
40
40
What are the areas of core accountabilities according to the ANA?
| 7
- Safety, quality, and risk management
- Health advocacy
- Clinical care delivery
- Healthy work environment
- Accountability for resource management
- Legal and regulatory compliance
- Networking, partnering, and collaborating
41
What is the most common unintentional tort?
Negligence
42
What is negligence?
Misconduct or practice below standards of care
43
What are examples of descriptors for negligent behaviors?
| 5
- Failure to
- Lack of
- Incomplete
- Ineffective
- Improper
44
What is an example of quasi-intentional torts?
- Defamation (Libel/Slander)
45
What is libel?
Defamation with words or photos
46
What is slander?
Dafamation with spoken word
47
What is malpractice?
A type of negligence that occurred while the person was performing as a professional (physician, nurses, etc.)
48
What are the four elements of malpractice? What are they each defined as?
| 4
- Duty: nurse had a legal obligation toward the patient
- Breach of duty: nurse's conduct violated duty to the patient based on compliance with reasonable standards of care compared with an average
- Causation: determination of whether the nurses action or inaction caused the patients injury and whether the patient's injury was forseeable
- Damages: patient suffered injury or harm
49
What are standards of care? Where are they found?
- Legal guidelines for care
- Found in the nurse practice act of each state
50
What should the nurse do when they suspect a coworker is impaired?
Report it immediately to the charge nurse/immediate supervisor
51
What are examples of behaviors consistent with a substance use disorder?
| 10
- Smell of alcohol on breath or frequent use of strong mouthwash or mints
- Impaired coordination, sleepiness, shakiness, and/or slurred speech
- Bloodshot eyes, Mood swings and memory loss
- Neglect of personal appearance
- Excessive use of sick leave, tardiness, or absences after a weekend off, holiday, or payday
- Frequent requests to leave the unit for short periods of time or to leave the shift early
- Frequently “forgetting” to have another nurse witness wasting of a controlled substance
- Frequent involvement in incidences where a client assigned to the nurse reports not receiving pain medication or adequate pain relief
- Documenting administration of pain medication to a client who did not receive it or documenting a higher dosage than has been given by other nurses
- Preferring to work the night shift where supervision is less or on units where controlled substances are more frequently given
52
What are two situations in which the nurse has to madatorily report something?
| 2
- Abuse
- Communicable diseases
53
True or false: nurses are not responsible for answering questions regarding the donation process of organs?
False, nurses are responsible for answering questions
54
What are two typical institution policies/good practices regarding transcribing medical orders?
| 2
- Usually must sign within 24 hours
- Repeat back to clarify orders
55
What are the Seven C's of Caring? What doe they each mean?
| 7
- Creative thinking: critically thinking and using the imagination to gain insights in how to provide care
- Competent: knowledge, skill, and attitude a nurse exhibits in their role
- Compassionate: being with another in their suffering with understanding and empathy
- Commitment: assuring the deliverance of excellent care
- Confident: in self and ability to understand another person's life
- Conscientious: adhering to standards of practice as an accountable and responsible nurse
- Comportment: communicating a caring presence through professional behaviors and appearance
56
What are ways a nurse can be culturally competent?
| 3
- Self-evaluating one's bias
- Addressing inequities in healthcare
- Developing partnerships that work with communities in a mutually beneficial way
57
What are things that might keep older nurses working longer?
| 6
- Flexible scheduling
- Preceptor positions
- Positive relations between nurses of all ages
- Better ergonomics
- Improved environmental design of the workplace to decrease time walking
- Strategic placement of aids such as mechanical lifts/storage
58
What areas must be attractive to recruit new nurses?
| 3
- Nursing salaries
- Work environment
- Safe staffing with no floating or mandatory overtime
59
What does each letter in the PICOT Framework stand for?
| 5
- P: patient/population
- I: Intervention
- C: Comparison
- O: Outcome
- T: Time
60
What are best practices and evidence based practice used to do?
Improve the quality of care
61
What is a service occurrence?
Slight delay or unsatisfactory service
62
What is a near miss?
Negative outcome almost occurred
63
What is a serious incident?
Minor injury, loss of equipment or property, or significant service interrupted
64
What is a sentinel event?
An unexpected death or major injury (attempted suicide, transfusion reaction, etc.)
65
What is failure to rescue?
Most severe event. Patient develops complication that leads to death
66
What does the institudte of medicine aim to do?
Help to understand mistakes through root cause analysis, moving away from punitive action
67
What are occupational safety and health guidelines as set by OSHA?
| 6
- Provide each employee a work environment that is free from recognized hazards that can cause or are likely to cause death or serious physical harm.
- Make protective gear accessible to employees
- Provide measurement devices such as dosimeters and keep records that document an employee’s level of exposure over time to hazardous materials (e.g., radiation from x-rays).
- Provide education and recertification opportunities to each employee regarding rules and regulations for handling hazardous materials.
- Provide a manual containing safety data sheets (SDSs)
- Designate an institutional hazardous materials (HAZMAT) response team that responds to hazardous events.
68
What are examples of safe use of equipment?
| 5
- Maintain competency in equipment use and regularly check that it functions properly throughout each shift.
- Use and unplug electrical equipment safely to reduce risks of electrical shock.
- Ensure life-support equipment is connected to backup-powered outlets for reliability during outages.
- Prevent overdose risks by confirming that all pumps have free-flow protection.
- Regularly inspect equipment for damage; report and remove faulty items from use to prevent accidents.
69
What are general measures to prevent falls?
| 10
- Ensure that clients understand how to use all assistive devices and can locate necessary items.
- Place near the nurses’ station.
- Ensure that bedside tables, overbed tables, and frequently used items (telephone, water, tissues, call light) are within the client’s reach.
- Maintain beds in low position.
- Keep bed rails up for clients who are sedated, unconscious, or otherwise compromised, and partly up for other clients.
- Provide clients with nonskid footwear.
- Keep the floor free from clutter with a clear path to the bathroom.
- Ensure adequate lighting.
- Lock wheels on beds, wheelchairs, and carts to prevent the devices from rolling during transfers or stops.
- Use chair or bed sensors.
70
What are aspects of seizure precautions?
| 5
- Assign the client a room close to the nurses' station and insert a peripheral IV.
- Ensure that rescue equipment, including oxygen, an oral airway, and suction equipment, is at the bedside.
- A saline lock can be placed for intravenous access if the client is at high risk for experiencing a generalized seizure.
- Avoid possible seizure triggers when out of bed.
- If a seizure occurs, provide monitoring and treatment as indicated.
71
What are risks associated with restraints?
| 2
- Deaths by asphyxiation and strangulation, especially with vest restraints
- Complications related to immobility
72
What is the goal of mass casualty triage?
Doing the greatest good for the greatest number of people
73
What should be done for patients exposed to hazardous material?
| 3
- Carefully remove contaminated clothing
- Wash with copious amounts of water and antibacterial soap
- Put contaminated items in a large plastic bag and seal
74
What should be done for patients who have been exposed to nuclear incidents?
| 2
- Decontamination
- Treat burns
75
What should the nurse do when caring for a patient exposed to radiation?
| 3
- Monitor their duration with, distance from, and shielding from the client
- Wear a radiation badge
- Decontamination with soap and water
76
What are the steps of RACE?
- Rescue
- Alarm
- Contain fire
- Extenguish
77
What are options the nurse may take during an active shooter situation?
| 3
- Running (if there is a clear path, first option)
- Hiding (if no safe path out)
- Fighting (only as a last resort)
NUR 212
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