Question 1

Which statement by the nurse manager shows understanding of what initiated the development of the team Strategies and Tools to Enhance Performance and Patient Safety (STEPPS)?

Accepted Answer

A)  "The increased need for health care coverage"
B)  "The need for more qualified nurses"
C)  "A need for improved communication and teamwork"
D)  "The increased cost of health care" C

Question 2

A nurse has received report on assigned patients and is prioritizing their care.Which of the following patients should the nurse assess first?

Accepted Answer

A)  A female patient who is complaining of a headache
B)  A patient who has just returned from surgery and has saturated his dressing
C)  A patient with a femur fracture who is requesting pain medications
D)  A male patient who needs to use the bathroom B

Question 3

A nurse has noticed that a coworker consistently has a negative attitude,criticizes others,and even shows aggression toward other members of the health care team.Which action(s)by the nurse would help to limit time with this individual?

Accepted Answer

A)  Try to help the coworker deal with personal problems during work.
B)  Steer clear of the coworker.
C)  Use assertive communication.
D)  Learn to say "no."
E)  Set clear boundaries with the coworker. B,C,D,E

Question 4

The nurse manager is in charge of a busy nursing unit.Today the nurse manager is planning to evaluate the work of nurses on the unit.Which of the following actions would help complete this task in an effective manner?

Accepted Answer

A)  Provide feedback as necessary to staff.
B)  Verify the tasks are being performed according to standards of practice.
C)  Allow nurses to complete all tasks,even if performed incorrectly.
D)  Provide directions with clear expectations of how the task is to be performed.
E)  Evaluate the performance of the task by the staff.

Question 5

What are critical points to communicate during a shift report or hand-off communication?

Accepted Answer

A)  Patient name,current physical status,activities that have contributed to current status,problems that have occurred during the shift,nursing care to address problems,and a readback or response
B)  Patient name,room number and date of birth,changes in current orders,provider's visits,laboratory tests that have been completed,and physical activity of the patient
C)  Patient name,health care provider,diagnosis,review of all current orders,family visits and involvement in care,review of history leading to hospitalization,and current status of the patient
D)  Physician orders for past 24 hours,patient name and date of birth,medical and social history prior to hospitalization,and review of health problems since hospitalization

Question 6

The nurse receives report on an assigned group of patients.Which patient would the nurse assess first?

Accepted Answer

A)  A patient 2 days postoperative who is complaining of pain
B)  An older adult patient reported to have increasing lethargy and confusion
C)  A newly admitted patient with a serum blood urea nitrogen (BUN) of 32 mg/dL
D)  A hypertensive patient complaining of severe mid-sternum pain

Question 7

The nurse is reviewing I-SBAR-R with a coworker at the end of the shift.Which statement indicates that they are discussing the Situation component?

Accepted Answer

A)  The nurse states the patient's name using two identifiers.
B)  The nurse states that the patient was hospitalized for a broken tibia and that surgery is scheduled for later today.
C)  The oncoming nurse acknowledges the info that has been received.
D)  The nurse states an opinion on what is happening with the patient.

Question 8

A nurse is assigned to care for five patients.The nurse is concerned about the ability to care for this many patients.The nurse needs to

Accepted Answer

A)  delegate one of the patients to someone else.
B)  prioritize the needs of the patients and determine the sickest patient.
C)  report this situation to the charge nurse.
D)  do the easiest patients first to allow more time for sicker patients.

Question 9

The charge nurse is assigning patient care activities to the nursing care team.In supervising the team,what is the most effective activity to determine that the nursing care has been completed satisfactorily?

Accepted Answer

A)  Have hourly checks with personnel to determine how effectively nursing care is being completed.
B)  Review with personnel at the end of the shift regarding the status of patients and how care was delivered.
C)  Discuss with each person the status of their assigned patients and what type of nursing care each will require.
D)  Schedule routine patient care rounds to evaluate the patients and the nursing care that has been completed.

Question 10

A nurse is working with a nurse aide to care for a group of patients.Which of the following activities would be inappropriate to delegate to the nurse aide?

Accepted Answer

A)  Providing discharge instructions to a patient
B)  Refilling water containers
C)  Obtaining a lift to help a patient out of a chair
D)  Feeding a patient who is unable to feed himself

Question 11

What would be a good assignment for an experienced nursing assistant?

Accepted Answer

A)  Help teach patients newly diagnosed with diabetes to give themselves injections.
B)  Report on the quality and quantity of urine on a continuous bladder irrigation.
C)  Obtain a clean-catch urine specimen from a patient.
D)  Chart a diet for a patient with an eating disorder.

Question 12

Which action(s)can the nurse take during report to ensure patient safety?

Accepted Answer

A)  Give report at the bedside.
B)  Give report as soon as the new nurse arrives.
C)  Use I-SBAR-R during shift change report.
D)  Focus on giving report,not on answering telephones.
E)  Be prepared for report.

Question 13

The charge nurse is determining which activities to delegate to the nursing assistant.Which of the following would not be appropriate for the charge nurse to delegate to the nursing assistant?

Accepted Answer

A)  Changing soiled linen
B)  Taking a blood pressure on someone receiving blood
C)  Removing a urinary catheter
D)  Assessing a patient's lung sounds

Question 14

The nurse is receiving a phone order from a health care provider.How will the nurse make sure that the provider's order is received without error?

Accepted Answer

A)  Advise the health care provider that the order must be written on the chart within the next 24 hours.
B)  Ask the nurse in charge to come to the phone to take the order.
C)  Write the order without using any unclear or unapproved abbreviations.
D)  Repeat the order,write the order verbatim,and read it back to the provider.

Question 15

A new nurse understands that organization is key to providing safe,effective care.Which of the following actions would help to achieve this?

Accepted Answer

A)  Memorize assignments and patient reports.
B)  Create a work organization sheet.
C)  Keep info about each patient on separate sheets of paper.
D)  Write down all pertinent patient info.
E)  Minimize distractions during report.

Question 16

A nurse is working on a busy orthopedic floor and is on the phone with the floor manager when a physician comes up and gives a verbal order for pain medications on an assigned patient.The physician then turns to leave the unit.Which action by the nurse would be the most appropriate?

Accepted Answer

A)  Write down the order and administer the medication.
B)  Put the nurse manager on hold and ask the physician to write the order.
C)  Ignore the physician and continue the conversation with the nurse manager.
D)  Write down the order and document it as a telephone order.

Question 17

A nurse is discharging a patient who primarily speaks German.Which action(s)should the nurse take to communicate effectively with the patient?

Accepted Answer

A)  Contact interpreter services to interpret discharge instructions to the patient.
B)  Provide discharge instructions for the patient that are written in German.
C)  Ask the patient to repeat the discharge instructions back to the interpreter as he understands them.
D)  Forego the interpreter because you are just showing him how to change a dressing.
E)  Give the patient discharge instructions that are written in English.

Question 18

The nurse manager is updating unit staff on findings by The Joint Commission.Which of the following statements shows an understanding of untoward events in the hospital setting? The primary cause of untoward events is

Accepted Answer

A)  "unclear,ineffective communication."
B)  "unclear chain of communication for reporting."
C)  "ineffective reporting of the untoward event."
D)  "lack of consistent supervision of nursing staff."

Question 19

A nurse has received an abnormal result on a critical test for an assigned patient.The nurse has been trying to reach the resident for 20 minutes but has been unsuccessful.What should be done to ensure the best care for the patient?

Accepted Answer

A)  Page the resident once and document this in the chart;he/she will make rounds soon.
B)  Page the attending physician.
C)  Continue to provide care for the patient,and document all actions in the medical record.
D)  Wait until the resident makes rounds to review the test results.
E)  Begin treating the patient for the test result because the nurse knows what the resident will likely order.

Question 20

During clinical experience,the student nurse is assigned a patient scheduled to undergo numerous treatments.The student decides it is not possible to complete all the needed treatments in the time scheduled for this clinical day.The student nurse consults with the clinical instructor to

Accepted Answer

A)  delegate.
B)  prioritize.
C)  procrastinate.
D)  do the easiest treatment first.

Exam 11: Building Nursing Management Skills

Which statement by the nurse manager shows understanding of what initiated the development of the team Strategies and Tools to Enhance Performance and Patient Safety (STEPPS) ?