Question 1

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

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 2

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 a teamwork system focused on improving communication and teamwork"
D)   "The increased cost of health care" C

Question 3

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 A

Question 4

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 midsternum pain

Question 5

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? (Select all that apply.)

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 6

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 leaves 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 7

A nurse is working on a medical-surgical unit and receives phone call from a physician who would like to give orders for a new patient.What should the nurse do to make the telephone order safer for the patient? (Select all that apply.)

Accepted Answer

A)   Refuse to accept the telephone order and request that the physician come to the unit to write the order.
B)   Accept the order and perform a "read back."
C)   Write down the telephone order as it is being given.
D)   Accept the telephone order,but write it down later.
E)   Ask another nurse to accept the telephone order.

Question 8

Which action(s)can the nurse take during report to ensure patient safety? (Select all that apply.)

Accepted Answer

A)   Give report at the bedside.
B)   Give report while the nurse is finishing up charting on another patient,so that the new nurse doesn't have to wait.
C)   Use I-SBAR-R during shift change report.
D)   Focus on giving report,not on answering telephones.
E)   Be prepared for report.

Question 9

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.

Question 10

The instructor has suggested that the student nurse could improve organizational skills and manage time better by scheduling selected nursing activities in the daily assignment.Which activity should be scheduled?

Accepted Answer

A)   Suctioning the tracheostomy tube of a patient
B)   Administering medications
C)   Assessing patient knowledge of colostomy care
D)   Assisting a patient with personal hygiene

Question 11

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

Accepted Answer

A)   Memorize her assignment 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 12

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 13

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 14

The nurse wants to anticipate patient needs in order to increase patient satisfaction and decrease the use of call bells in the assigned section.What actions can be taken to achieve this?

Accepted Answer

A)   Tell patients to turn on their call bells if they need something.
B)   Perform hourly rounding on each patient.
C)   Check on the patient every 2 to 3 hours.
D)   Check on the patient only when medication needs to be administered.

Question 15

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? (Select all that apply.)

Accepted Answer

A)   Page the resident once and document this in the chart; he 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 with him.
E)   Begin treating the patient for the test result because the nurse knows what the resident will likely order.

Question 16

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 17

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 18

A nurse has been assigned the following patients.Which patient is a priority to assess first?

Accepted Answer

A)   A patient with abdominal pain
B)   A patient who has been NPO all morning and wants to eat
C)   A patient with pneumonia and O2 saturation of 88%
D)   A patient complaining of ear pain

Question 19

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

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 20

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 that is requesting pain medications
D)   A male patient who needs to use the bathroom

Exam 11: Building Nursing Management Skills

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

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) ?