Deck 11: Building Nursing Management Skills

Question 1

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?

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

Answer 1

Assessing a patient's lung sounds

Question 2

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

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."

Answer 2

"unclear,ineffective communication."

Question 3

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?

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.

Answer 3

Repeat the order,write the order verbatim,and read it back to the provider.

Question 4

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

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 5

A nurse is working on a medical-surgical unit and receives a phone call from a provider 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.)

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 6

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

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

Question 7

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

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

Question 8

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

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 9

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?

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 10

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?

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 11

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)?

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"

Question 12

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?

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 13

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?

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 14

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?

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 15

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

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 16

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.)

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 17

The nurse calls a physician to come to the unit to assess a patient.Which of the following is the most effective telephone communication by the nurse?

A)"This is the 4100 unit troublemaker again.You probably ought to come to the unit to see Mr.Samuels.His condition doesn't seem right."
B)"This is Ann Allen on 4100.I don't quite know what to think about Mr.Samuels.I think his condition is deteriorating,and I'd like to have you see him."
C)"Sorry to bother you.This may not be important,but I'm not completely comfortable with Mr.Samuel's response to care.His blood pressure has dropped,and his pulse is elevated."
D)"This is Sheila Ryan on 4100 calling regarding your patient,Mr.Samuels.His BP has dropped from 130/90 at 8 AM to 100/70 at 10 AM.His pulse has risen from 80 to 100,and he seems restless.He received his 8 AM Cardizem."

Question 18

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

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 19

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

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 20

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?

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 21

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.)

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 22

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.)

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 23

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? (Select all that apply.)

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.

Question 24

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.)

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 25

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

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.