Deck 10: Delegation, Leadership, and Management

Question 1

The behavior least likely seen in an autocratic leader would be a person who:

A) provides close supervision of work by staff members.
B) often consults staff when making decisions.
C) quickly points out mistakes made by staff members.
D) frequently gives out new directives.

Answer 1

often consults staff when making decisions.

Question 2

The nurse in a long-term care facility is aware that the accuracy and comprehensiveness of the Minimum Data Set (MDS) facilitate the:

A) patient receiving the appropriate treatments.
B) effectiveness of the planning for quality improvement.
C) reimbursement to the facility from Medicare and Medicaid payments.
D) enhancement of the database for procedures related to risk management.

Answer 2

reimbursement to the facility from Medicare and Medicaid payments.

Question 3

Nursing documentation that would best assist with reimbursement to a facility would be:

A) patient was up in chair for 2 hours after breakfast.
B) patient was ambulated in the hall three times this shift.
C) patient was assisted to a recliner chair to use the oxygen concentrator.
D) patient received bath in shower room.

Answer 3

patient was assisted to a recliner chair to use the oxygen concentrator.

Question 4

The nurse recognizes that one of the responsibilities of a charge nurse as opposed to the team leader is that the charge nurse is responsible for:

A) evaluating members of the health care team.
B) evaluating unlicensed assistive personnel.
C) making rounds and assessing all patients on the unit.
D) collaborating with primary care providers and other health team members.

Question 5

When the team leader becomes concerned about the frequent tardiness of the unlicensed assistive personnel (UAP), the most appropriate documentation would be:

A) has been late to work six times in this pay period (January 2, 4, 6, 8, 10, and 14). States she overslept. Counseled on January 9. Unit management made aware.
B) frequently late to work. States she overslept. Co-workers state she is working elsewhere at night. Will follow up.
C) tardiness is causing inability to finish assignments without assistance from others.
D) oversleeping and active social life have caused tardiness six times in this pay period.

Question 6

The nurse is aware that assignment of an unlicensed assistive personnel (UAP) differs from delegation in that in delegation:

A) the nurse has transferred the authority to perform the task.
B) the UAPs are covered by their own certification.
C) the UAPs are performing activities within the scope of their job description.
D) the licensed person must accompany the UAP to supervise the activity.

Question 7

Prior to addressing a situation, the nurse is aware that an effective leader must:

A) define the problem.
B) identify persons to address the problem.
C) know the legal implications of the problem.
D) look to alternatives to address the problem.

Question 8

The nurse is aware that when a task is delegated to an unlicensed assistive personnel (UAP), the nurse is:

A) no longer responsible to that patient.
B) responsible to communicate outcome to appropriate senior staff.
C) responsible for overall patient care.
D) liable for all adverse outcomes.

Question 9

The best description of an autocratic leader is a leader who:

A) is permissive.
B) has confidence in the staff.
C) tightly controls team members.
D) accepts all responsibility for the team.

Question 10

The most effective communication from a nurse leader to a team member that is most likely to have a positive outcome would be:

A) "Jane, be sure to get those vital signs recorded on time today."
B) "Jane, I need those vital signs before breakfast."
C) "Jane, please give me a list of those vital signs before breakfast."
D) "Jane, breakfast trays are being served. You need to get those vital signs."

Question 11

A nurse can best minimize the liability of a lawsuit against the facility by:

A) strictly adhering to the policies and procedures of the facility.
B) demonstrating concern and attending to patient complaints.
C) advising the supervisor of significant events or problems with patient relations.
D) giving a copy of the policy and procedures to each patient.

Question 12

A team leader with effective communication skills would:

A) make precise authoritarian assignments to team members.
B) give specific information in a tactful, friendly manner.
C) maintain eye contact when giving directions.
D) limit time for feedback and complaints.

Question 13

The nurse is aware that the best way to evaluate an unlicensed assistive personnel's (UAP's) ability to perform a skill or task is to:

A) obtain verbal confirmation from another nurse that the nursing assistant is proficient.
B) review documentation that the nursing assistant is competent in skills.
C) observe the nursing assistant performing the skill or task.
D) demonstrate the skill to the nursing assistant before his demonstration.

Question 14

The nurse is initially guided in the process of delegation to an unlicensed assistive personnel (UAP) by the:

A) state's nurse practice act.
B) competencies of the UAP.
C) policies of the facility.
D) needs of the patient.

Question 15

A nurse has received a new medication order for a patient on the CPOE. Which of the following is the most appropriate response by the nurse?

A) Acknowledge the order that includes the patient's name, room number, and generic name of the medication.
B) Acknowledge the order that has been entered by the primary care provider and has been verified by the pharmacist.
C) Send a text message to the nurse responsible for giving the medication to communicate the new order.
D) Check to make sure the patient's regular medication orders have been renewed every 48 to 72 hours.

Question 16

The nurse's most appropriate selection of a task to be delegated to an unlicensed assistive personnel (UAP) would be:

A) assessing circulation in the toes of a patient in a cast.
B) changing a patient's wound dressing.
C) taking the blood pressure of a patient who has just returned from surgery.
D) toileting a patient on a bladder training regimen.

Question 17

An inappropriate delegation to an unlicensed assistive personnel (UAP) would be:

A) applying a condom catheter.
B) assessing a patient's pain.
C) giving a sitz bath.
D) giving an enema.

Question 18

Leadership is best defined as a process that:

A) motivates people to accomplish set goals.
B) provides a framework for health care delivery systems.
C) guides staff to use resources to meet patient needs.
D) uses advanced management training.

Question 19

A laissez faire leader would be most likely to:

A) consult staff members.
B) tightly control team members.
C) allow team members to function independently.
D) set goals that are task oriented.

Question 20

The nurse recognizes that the use of the democratic approach in leadership will:

A) cause team members to feel that their feelings are secondary to the accomplishment of the goal.
B) cause mistakes to be discovered and pointed out.
C) take more time to accomplish goals.
D) use the leader's skills and knowledge.

Question 21

Which responsibilities are common to an LPN/LVN team leader in both health care facilities and medical clinics? (Select all that apply.)

A) Organizes staff meetings.
B) Assists in writing policies and procedures.
C) Assists in resolving staff conflicts.
D) Prepares the schedule for patient activities.
E) Evaluates unlicensed assistive personnel (UAPs).

Question 22

Staff nurses have many responsibilities to their patients throughout their shift. However, the ______ is responsible for the total nursing care of patients during a shift and is also responsible for giving handoff reports to the oncoming shift and evaluating members of the health care team.

Question 23

A nurse is caring for a patient who is being discharged. However, the patient's blood pressure is elevated. The primary care provider enters orders for discharge. Which is the best response of the nurse acting as an advocate for the patient?

A) The nurse states to the patient, "Your primary care provider has discharged you. When you get home call his office for an appointment to have your blood pressure rechecked."
B) The nurse states to the primary care provider, "I refuse to discharge the patient because his blood pressure is too high."
C) The nurse states to her co-worker, "The patient's blood pressure is too high to be discharged. I think I will tell the patient that it is too high, and that it puts him at risk for another stroke?"
D) The nurse states to the primary care provider, "The patient's diastolic blood pressure is up to 112 mm Hg this morning, should he still be discharged?"

Question 24

A team leader of a busy oncology unit has had three unexpected discharges today and two new admissions. He needs to communicate the changes to his staff and reorganize the plan to facilitate an effective workflow for the rest of the shift. Which team communication strategy would work best in this scenario?

A) Briefing
B) Call-Out
C) Huddle
D) Debrief

Question 25

Two nurses have worked together for a few months. One nurse will assist others when her work is complete and the other will not assist unless asked by the charge nurse. This has created conflict in the past between the two. Which of the following is an effective strategy to resolve these issues peacefully?

A) The team leader will discuss the specific issue in a staff meeting, asking for feedback on how they would resolve the issue.
B) The team leader will schedule a guest speaker to discuss teamwork at the next staff meeting.
C) The team leader will discuss the issue with the nurse that is willing to assist others and formulate a plan of improvement for the other nurse.
D) The team leader will discuss the issue with each nurse individually, listening to their perspective, and then focus on the goal to be achieved; effective patient care and a harmonious work environment.

Question 26

The team leader who is reviewing the list of the assigned patients would give priority to the patient who:

A) has a scheduled medication due.
B) requires dressing changes three times a day.
C) is experiencing acute chest pain.
D) is confused and disoriented.

Question 27

The best communication given by the nurse to the unlicensed assistive personnel (UAP) would be:

A) "Let me know if my patient's temperature is high."
B) "Please measure each urine output and report it to me."
C) "Tell me if the patient seems more uncomfortable."
D) "Notify me when the dressing needs to be changed."

Question 28

The nurse is aware that orders for a patient going to surgery are:

A) pertinent only for the immediate preoperative period.
B) canceled when the primary care provider writes, "resume previous orders."
C) can be continued when the patient returns to the unit.
D) canceled by the nurse in the operating room when the surgery is complete.

Question 29

The nurse receiving a telephone order from a primary care provider who is following the Joint Commission International Center for Patient Safety should:

A) enter the order into the CPOE system, enter the order to the medical record, and ask the primary care provider if he/she will confirm the order.
B) write the order down from the primary care provider, repeat the order to the primary care provider, and then enter the order to the medical record.
C) enter the order into the CPOE system and then read back the order to the primary care provider.
D) write the telephone order verbatim as the primary care provider gives it and then read it back to the charge nurse.

Question 30

Which statements are true regarding delegation of duties to unlicensed assistive personnel (UAPs) by a licensed nurse? (Select all that apply.)

A) The LPN/LVN in charge must be familiar with the competency of staff.
B) The LPN/LVN must be familiar with the job descriptions of UAPs.
C) An LPN/LVN may delegate any skill or task to a UAP once the nursing assistant has demonstrated proficiency.
D) A nurse must be familiar with the nurse practice act.
E) The certification of the UAP makes nursing assistants liable for their actions.

Question 31

Characteristics of effective communication would include: (Select all that apply.)

A) using eye contact.
B) using concise statements when giving information.
C) addressing conflicts before delegation of duties.
D) obtaining feedback about directions given.
E) assigning responsibility for creation of any conflict.

Question 32

A nurse is aware that the medication orders on the MAR should be verified with the medical record orders every _____.

A) shift
B) 12 hours
C) 24 hours
D) 48 hours

Question 33

The considerations for an LPN/LVN to be eligible for an advanced leadership role as a charge nurse include a minimum of staff nursing experience of:

A) 12 months.
B) 18 months.
C) 24 months.
D) 36 months.

Question 34

The LPN/LVN who is transcribing orders is unclear about the intent of an order. The LPN/LVN should:

A) consult the charge nurse.
B) call the primary care provider.
C) acknowledge the order as written.
D) mark the order in red as UNACKNOWLEDGED.

Question 35

A nurse is caring for an infant who is seen in the ER with wheezing. The mother states that they are traveling to her parent's home, out of town that afternoon. Which is the best response of the nurse acting as a patient advocate using the CUS technique?

A) "I am concerned about you leaving on a road trip with your baby. Wheezing is a sign that your baby is having difficulty breathing and may be at risk for respiratory complications."
B) "I'm sure that once the primary care provider examines your baby and gives him medication he will be fine to travel."
C) "Once the primary care provider sees your baby he will admit him to the hospital for further evaluation and treatment."
D) "I am concerned about you traveling today, but as the parents, you know best."

Question 36

Important characteristics of delegation to an unlicensed assistive personnel (UAP) include: (Select all that apply.)

A) use of effective communication.
B) provision of constructive criticism immediately.
C) direction for the desired result and time for completion.
D) provision of tactful feedback.
E) informing the patient that the delegated task will be performed by a UAP.