Deck 37: Collaboration

Question 1

A nurse is working as the designated leader of a group of healthcare providers in a community clinic setting.The team members are working to decrease the number of adolescent pregnancies in the community.They have defined the problem and are now focusing on objectives and considering various viewpoints presented by the group.The nurse is tasked with helping the team to stay focused in order to address the defined problem.Which of the competencies of collaboration does this describe?

A) Decision making
B) Mutual respect
C) Trust
D) Communication

Answer 1

Decision making

Question 2

A staff nurse learns before reporting to work that a close family member has been diagnosed with terminal cancer.The nurse is receiving the shift report and finds the family member has been assigned as a client.The nurse reporting off duty states that the client is very demanding and complains a lot.Which action by the staff nurse who is assigned care for the oncoming shift is appropriate?

A) Discuss the situation with the charge nurse.
B) Resolve to refrain from reacting negatively to the client.
C) Tell the client to change the behavior.
D) Ask the healthcare provider to help control the client.

Answer 2

Discuss the situation with the charge nurse.

Question 3

A nurse manager who is employed by a community hospital is asked to implement critical pathways on the medical-surgical unit.When educating the staff nurses about critical pathways,which primary reason for their use with the nurse manager include in the teaching session?

A) "Critical pathways are used to evaluate care provided to clients with certain medical conditions."
B) "Critical pathways direct care provided to clients with certain medical conditions."
C) "Critical pathways track care provided to clients with certain medical conditions."
D) "Critical pathways direct, track, and evaluate care provided to clients with certain medical conditions."

Answer 3

"Critical pathways direct, track, and evaluate care provided to clients with certain medical conditions."

Question 4

The nurse is preparing a client for discharge who will be requiring physical therapy (PT)to rehabilitate after a total knee replacement.After reading the healthcare provider's order for PT,which would be the nurse's initial action?

A) Set up appointments according to the order with the hospital PT department.
B) Call home health and schedule a therapist to visit the home for therapy.
C) Discuss the various types of settings for therapy and have the client choose the venue.
D) Teach the family the exercises needed for the client.

Question 5

A community hospital wants to implement a labor delivery recovery postpartum unit to replace the labor and delivery and mother/baby units.The nurses who work on the mother/baby unit are concerned they will not be able to care for a laboring mother and may lose their jobs.The nurse manager for both units supports the plan for an integrated unit,reports that jobs would not be lost and involves the team members in the planning process,which includes cross-training all nursing staff.Based on the information presented,what causes of conflict may occur in spite of the nurse manager's effort for a smooth transition? Select all that apply.

A) Mistrust
B) Miscommunication
C) Ambiguous role expectations
D) Resistance to change
E) Ineffective leadership

Question 6

A nurse manager overhears two staff nurses talking about a third nurse,who has the day off.The nurses are making unflattering comments regarding the nurse in front of several other nurses who work on the unit.The nurse manager discretely asks to speak to the nurses' in private and states,"This behavior isn't OK,especially in a hospital like ours with a 'zero-tolerance policy.' If you have an issue with this nurse please deal with that nurse directly.If you'd like me to help you with this,please let me know,and the four of us can meet." The nurse manager's behavior modeled strategies for which type of work-place conflict?

A) Stress
B) Sexual harassment
C) Horizontal violence
D) Intrapersonal conflict

Question 7

A group of nurses are in a staff meeting on a medical-surgical unit headed by the new unit nurse manager.The manager announces that nurses should not criticize and make fun of other nurses or there will be repercussions.Several nurses at the meeting suggest that the nurse manager talk to the individual nurses who are exhibiting this behavior.When assessing the staff's group dynamics,which action by the nurse manager is appropriate?

A) Insist that this is an appropriate new policy.
B) Recognize that the group has already defined behavioral norms.
C) Discipline the staff nurses who spoke out.
D) Request a transfer to another unit.

Question 8

The nurse educator is teaching a management and leadership class to a group of nursing students.The educator presents information regarding case management and case manager.Which statement,if made by a student,indicates the need for additional education on this subject matter?

A) "Case managers can only be licensed professional nurses who have extensive patient care experience."
B) "The collection of baseline data for conditions or diagnoses that will be managed is an essential component of case management."
C) "Case managers usually do not provide direct client care; instead, they coordinate and monitor others providing direct client care."
D) "A case manager's typical caseload is 10-15 clients, mostly representing high-volume, high-cost, and high-risk diagnoses for the hospital."

Question 9

The nurse caring for an adult client in the intensive care unit (ICU)is given a verbal prescription by a first-year medical resident.The nurse determines that the best course of action is to check with the attending healthcare provider before implementing the prescription.Which is the rationale for why the nurse is experiencing conflict regarding this situation?

A) The resident seems unsure of the prescription.
B) The nurse only takes prescription from attending healthcare providers.
C) The nurse does not like first-year residents.
D) The nurse may not trust the resident to make the best care decisions.

Question 10

Which statement is a primary and historical barrier to effective nurse-physician collaboration that has persisted over time?

A) The view among the general population that that nurses' contributions to clients' care is less important to their health and well-being compared to the contribution of physicians
B) The nurses' and physicians' perceptions of inequity in their roles, with nurses assuming a subservient role and physicians assuming leadership and superior role in healthcare settings
C) A general lack of education provided in schools for health professionals about the benefits on healthcare quality linked to nurse-physician collaboration
D) A lack of published evidence about the effectiveness of collaborative efforts among and between nurses and physicians
E) The lack support at the federal level for efforts to improve health care among the general population through increased nurse-physician-client collaboration.

Question 11

The hospital's nurse case manager has been extensively involved with a shooting victim and members of the client's family in coordinating care of providers from many disciplines as the client progressed from the emergency department (ED)to the intensive care unit (ICU)and then onto the medical-surgical unit.After 3 weeks of hospitalization,the case manager is helping to prepare the client for discharge to a rehabilitation center where treatment will continue.Which outcomes have been documented in the literature as benefits of such collaboration? Select all that apply.

A) Improved client outcomes
B) Reduction in duplication of healthcare services
C) Increased overall cost of health care services
D) Decreased client morbidity and mortality
E) Higher level of job satisfaction

Question 12

A client who is recovering from coronary bypass surgery is placed on a critical pathway for extended care.Which client statement indicates appropriate understanding of the plan of care?

A) "I cannot alter the critical pathway plan."
B) "The chosen critical pathway can be altered to meet my needs."
C) "My insurance plan can deny payment if I do not meet goals."
D) "I must be able to meet goals that are set for me."

Question 13

A nurse is discussing the plan of care with a client who is preparing for discharge.The client has a strong objection to portions of the plan of care.The nurse recognizes that there is a conflict.Which response by the nurse indicates an understanding of the client's position and a willingness to collaborate regarding the discharge plan?

A) "You are not being cooperative in your plan of care."
B) "This plan of care was ordered by the physician."
C) "Let's talk about what your objections are and possible solutions or alternatives."
D) "I will ask your family to convince you that this plan of care is best."

Question 14

A client with type 1 diabetes mellitus has developed an open sore on the shin and is having trouble meeting daily goals for exercising.The client is scheduled for discharge in a couple of day.When planning for this client's continued care,who will the nurse notify regarding the client's needs after discharge?

A) The pharmacy
B) The case manager
C) The occupational therapist
D) The physical therapist

Question 15

The nurse is discussing follow-up care with a client who is being discharged.The client and family cross their arms and state angrily that the team's suggestions are not acceptable.Which response by the nurse is appropriate?

A) "We will leave you alone to discuss your options."
B) "We only want what's best for you."
C) "Let's discuss other options that might work well for you and your family."
D) "Perhaps you did not understand the recommendations."

Question 16

The nurse is caring for a client with rheumatoid arthritis who expresses the desire to remain active as long as possible.In order for the client to meet this goal,what should the nurse prepare to do?

A) Teach the client nutrition and joint exercises.
B) Ask the client the reason for the decision.
C) Tell the client there is no hope.
D) Refer the client to the appropriate professionals.

Question 17

The nurse managers in a community hospital have been charged with reviewing job descriptions of unlicensed assistive personnel (UAPs)and have questions about the delegation of certain client care activities to UAPs by nurses.To which group,organization,or individual would committee members direct their questions to obtain definitive answers about the parameters of nurse delegation to UAPs?

A) The hospital's Chief Nursing Officer
B) The hospital's Chief Executive Officer
C) The state board of nursing
D) The American Nurses Association

Question 18

The nurses in the emergency department (ED)and the staff nurses on the neurological unit are experiencing conflict.The ED nurses are not pleased with the amount of time is takes for the neurological unit's admitting nurse to receive face-to-face hand-off communication for clients who are being admitted to that unit.Which type of conflict is being experienced by these nurses?

A) Intrapersonal conflict
B) Interpersonal conflict
C) Intergroup conflict
D) Interorganizational conflict

Question 19

A home health nurse is planning care for an adult client being discharged from the hospital after experiencing complications of diabetes mellitus.The client requires an extensive dressing change twice a day,help with activities of daily living,and comprehensive education.The nurse is coordinating home visits from aides and therapists.Which role is the nurse assuming by coordinating this client's care?

A) Health educator
B) Case manager
C) Collaborator
D) Health promoter

Question 20

The case manager interviews an older adult client hospitalized after hip replacement surgery.The client requires in-patient rehabilitation prior to being discharged home.The case manager works with the hospital nursing staff,the rehabilitation center,the client's family members,and other care providers to assist with a smooth transition.Which is the primary goal of the care management model described here?

A) To provide greater peace of mind for the client and his or her family members
B) To help manage concerns that are related to the client's medical care and treatment regimen only
C) To track a client's progress to ensure that appropriate care is provided until the time of discharge
D) To provide a continuum of clinical services in order to help contain costs and improve client outcomes

Question 21

The Chief Nursing Officer and Chief Medical Officer in an urban teaching hospital are leading a series of meetings with nurses,physicians,hospital lawyers,and risk managers to review and update hospital privileging procedures and requirements for advanced practice RNs and physicians new to the hospital.This is an example of which type of collaborative team?

A) Intradisciplinary
B) Interdisciplinary
C) Multidisciplinary
D) Complementary

Question 22

Nurse leaders in a local hospital created a neurotrauma (NT)unit healthcare team focused on improving outcomes for their stroke clients.This team includes acute care nurses,physicians,other care partners (e.g.,physical therapists,social workers,case managers,dieticians),and representatives from the NT outpatient clinic.This team is led by a physician who makes treatment decisions based on the treatment plans developed by individual team members who each communicate with the clients,asking the same or similar questions to obtain data needed for their treatment plan.Which type of communication and action is represented in the scenario described?

A) Parallel communication
B) Parallel functioning
C) Information exchange
D) Coordination and consultation
E) Co-management and referral

Question 23

The client's case manager,diabetes educator,and nutritionist meet to discuss the client's needs in preparation for discharge to home.The client's primary healthcare provider arrives and states,"I will be making all decisions regarding the client's discharge care." With the primary healthcare provider's decision to lead the team,the dynamic has shifted between which two types of teams?

A) Intradisciplinary to interdisciplinary team
B) Multidisciplinary to intradisciplinary team
C) Interdisciplinary to multidisciplinary team
D) Interprofessional to interdisciplinary team

Question 24

The home health care nurse is planning care for the older adult client.Which interdisciplinary program would best support the needs of an older adult client within the community? Select all that apply.

A) Assertive Community Treatment (ACT)
B) YMCA
C) Programs of All-Inclusive Care for the Elderly (PACE)
D) Outpatient clinic
E) Meals on Wheels

Question 25

The charge nurse working in the emergency department (ED)is preparing to receive a client with traumatic amputation of the lower left arm secondary to shark attack.The nurse assembles appropriate members of the healthcare team to be present when the client arrives with the goal of allowing the client to regain as much upper extremity function as possible.Which is the rationale for why the charge nurse assembled the entire healthcare team upon arrival to the ED?

A) Healthcare teams utilize collaborative delivery of high-quality, interdisciplinary health services in a shared leadership role, where accountability is both individual and mutual in nature.
B) Healthcare teams are made up of members of the same profession who work under one leader to achieve one goal.
C) Healthcare teams exist only to make decisions for clients.
D) Healthcare teams are assembled only to manage the care of extremely ill clients.

Question 26

In arranging community services for a client who is diagnosed schizophrenia,the nurse case manager discusses options with the Assertive Community Treatment (ACT)team.Which team disciplines should the nurse expect will be part of the client's ACT interdisciplinary team?

A) Psychiatrists, nurses, social workers, employment specialists, substance abuse specialists
B) Speech pathology, occupational therapy
C) Teachers, school administrators
D) Handi-Cab drivers

Question 27

The nurse educator is teaching a group of nursing students about the benefits of participating in an interdisciplinary team when planning and implementing client care.When quoting research on this subject,which statement by the educator is appropriate?

A) "Team members feel a greater sense of commitment and contribution to the organization."
B) "Team members report feeling more respected and valued within and across professional disciplines."
C) "Pooling resources and ideas results in greater efficiency in providing care to clients."
D) "Organizations can report greater compliance with the 2010 Patient Protection and Affordable Care Act."

Question 28

The case manager assembles a team of healthcare professionals,including the client's primary healthcare provider,physical therapist,and social worker,for the purpose of collaborative discharge planning and decision making.Which type of team did the case manager assemble? Select all that apply.

A) Intradisciplinary team
B) Interdisciplinary team
C) Primary nursing care team
D) Management team

Question 29

A school-age client is admitted to the pediatric intensive care unit (PICU),unconscious and with multiple traumatic injuries,after a skateboard accident that included a closed head injury.Many health professionals are involved in the client's and the scene is chaotic.The parents are extremely anxious and want to know what's happening.The case manager asks for an interdisciplinary team meeting to speak with the client's parents.Which is the rationale for this meeting?

A) To allow for each specialty to practice independently
B) To share and evaluate information for care planning and implementation, and prevent priority conflicts, redundancy, and omissions in care.
C) To all the primary healthcare provider to make all the decision regarding the client's care
D) To prevent the parents from trying to change the plan of care