Question 1

You ask Evelyn,a new UNP,to check what is left in Mrs.N.'s inhaler when Evelyn makes visits to Mrs.N.and also to check whether Mrs.N.is receiving any positive effect from the medication.Evelyn reports for 3 weeks that Mrs.N.is using the inhaler and that there is enough medication left in the device.The day of her last visit to Mrs.N. ,Mrs.N.is admitted to the hospital in severe respiratory distress.When she is admitted,she tells the physician that she has not been using the inhaler for 4 weeks.Determination of Evelyn's educational preparation and certification is related to the concept of:

Accepted Answer

A)  Accountability.
B)  Authority.
C)  Role performance.
D)  Assignment. B

Question 2

An example of a care activity that would likely not be delegated by an RN to a UNP is (select all that apply):

Accepted Answer

A)  Teaching self-catheterization to a patient with paraplegia who has limited English.
B)  Basic care for a patient with a head injury who is rapidly deteriorating.
C)  One-to-one observation with a suicidal patient.
D)  Assessment of patients being admitted through the Emergency Department.
E)  Basic hygienic care for a patient who is post MI and stable. A,B,D

Question 3

Which of the following exemplifies accountability? Karen,the nurse manager on 5E:

Accepted Answer

A)  Consistently submits her budgets on time.
B)  Gets along well with her staff and with other managers.
C)  Outlines her rationale for reduction of RN coverage on nights to the Nursing Practice Committee after serious patient injury.
D)  Actively solicits ideas regarding scheduling from her staff. C

Question 4

The day shift nurse asks an LPN/LVN to complete a component of care for a client.The day shift nurse is engaging in what function?

Accepted Answer

A)  Delegating
B)  Assigning
C)  Sharing
D)  Authorizing

Question 5

Which of the following would be most in line with Hersey and Blanchard's concepts?

Accepted Answer

A)  The team of caregivers on day shift are familiar with their roles and with the patients. The nurse manager decides to work on the unit budget in her office.
B)  After a year of working on the unit, Shari, an LPN, is still hesitant about many policies and procedures. The charge nurse decides to challenge Shari with more difficult patients.
C)  The nursing supervisor asks one of her charge nurses to lead a technology integration project. The supervisor continuously demands involvement in decisions that the charge nurse is making in the project.
D)  Team members complain that Alysha, an RN, is unmotivated, and that she refuses assignments that are complex or difficult. The charge nurse suggests that Alysha is relatively new and that she needs time to adjust.

Question 6

Leslie,a UNP,transfers a patient while using improper technique.The patient is injured,and as a result,a suit is launched in which both Sarah (the delegator)and Leslie (the delegatee)are named.Sarah is named in the suit because she:

Accepted Answer

A)  Retains accountability for the care of the patient.
B)  Worked the same shift as Leslie.
C)  Has passive accountability for delegation.
D)  Retains accountability for the outcomes of care for the patient.

Question 7

During a fire drill,the nurse manager becomes very assertive and directive in her communications with staff.This type of situational leadership depends on:

Accepted Answer

A)  Supportive behavior by the leader and immature followers.
B)  The development level of the followers and the type of behavior of the leader.
C)  Well-developed followers combined with a strong leader who acts quickly.
D)  The leader's ability to evaluate personnel and communicate that evaluation.

Question 8

An RN colleague,who is a long-standing and collaborative member of your team,is performing a complex and novel dressing for the first time for the patient to whom she has been assigned.Which of the following would be the most appropriate communication with her?

Accepted Answer

A)  "How do you usually do this kind of dressing?"
B)  "The dressing needs to be done today and tomorrow with the supplies on this cart."
C)  "Here is what you need for the dressing, and I will show you what needs to be done."
D)  "I know you know what you are doing. Let me know if you have any problems."

Question 9

-Which of the following indicates safe delegation?

Accepted Answer

A)  The nurse supervisor for a large urban acute care department asks the unit manager to accept two new acutely ill patients, which the manager does. The unit is short two staff, and the replacement is inexperienced.
B)  A unit manager agrees to release a staff from her unit to Unit B. The staff member she agrees to release is experienced on Unit B and is agreeable to the change. The unit manager's unit is fully staffed and patients are stable.
C)  The nurse supervisor asks the head nurse for Unit A to make do without a replacement for an ill staff member because Unit A was originally overstaffed anyway. Patient acuity levels are very high on Unit A and two staff are orientating.
D)  The nurse supervisor asks the charge nurse on Unit B to cover Unit F, which is two floors up, because the charge nurse for Unit F is ill. The charge nurse for Unit B is an experienced manager but has no experience with the nursing care required on Unit F.

Question 10

County Hospital has position descriptions for all staff,including RN Team Leaders.Sarah,a team leader on the rehab unit,assesses the needs of the patients in her area,assesses the skills and backgrounds of each of the individuals on her team,and then assigns and delegates the appropriate care provider to each patient and task.Sarah's activity in the example described is termed:

Accepted Answer

A)  Passive delegation.
B)  Passive accountability.
C)  Active delegation.
D)  Active responsibility.

Question 11

Functions such as "delegates tasks to assistive personnel" that are outlined in a position description for an RN Team Leader would be considered:

Accepted Answer

A)  Active delegation.
B)  Passive delegation.
C)  Passive accountability.
D)  Active responsibility.

Question 12

The unit manager is working in a large metropolitan facility and is told that two UNPs are to be assigned to work with her.Delegation begins with:

Accepted Answer

A)  Acknowledging the arrival of the second UNP on the unit.
B)  Providing clear directions to both UNPs.
C)  Matching tasks with qualified persons.
D)  Receiving reports from the prior shift.

Question 13

In delegating to a UNP in a home health setting,which of the following represents the most appropriate delegation communication?

Accepted Answer

A)  "You will be taking care of Mrs. S., who needs assistance with her bath."
B)  "You will need to help Mrs. S. get into and out of her shower. Ensure that you check the condition of her feet, and let me know if you have any concerns when you check in."
C)  "I am not sure that you know how to do this, but I am giving you Mrs. S. She is quite obese and needs skin care."
D)  "Mrs. S. needs help to get into and out of her bathtub. Her bath will need to be completed by 10:00. When you are helping her to dry, please check between her toes and toenails, and phone me by 10:30 if you notice nail discoloration or redness."

Question 14

Ali,an RN on your unit,is consistently late to work and makes remarks such as "Do you really want me to do that?" when patients and care are assigned to her.You have spoken with her frequently about her:

Accepted Answer

A)  Ability.
B)  Skills.
C)  Attitude.
D)  Personal issues.

Question 15

The night nurse understands that certain factors need to be considered before delegating tasks to others.These factors include the:

Accepted Answer

A)  Complexity of the task and the age of the delegatee.
B)  Potential for benefit and the complexity of the task.
C)  Potential for benefit and the number of staff.
D)  Complexity of the task and the potential for harm.

Question 16

You are a member of a team assigned to care for 15 general medical/surgical clients.You have all worked well together in the past in this same type of care.If you are assigned to coordinate this team's work,your best strategy,based on the Hersey and Blanchard model,would be to:

Accepted Answer

A)  Have a list of tasks to be accomplished and tell each member of the team what he or she must do.
B)  Encourage people to discuss their frustrations in providing this care.
C)  Ignore them-they've done it before.
D)  Provide minimal direction and let them come to you with questions.

Question 17

You ask Evelyn,a new UNP,to check what is left in Mrs.N.'s inhaler when Evelyn makes visits to Mrs.N.and also to check whether Mrs.N.is receiving any positive effect from the medication.Evelyn reports for 3 weeks that Mrs.N.is using the inhaler and that there is enough medication left in the device.The day of her last visit to Mrs.N. ,Mrs.N.is admitted to the hospital in severe respiratory distress.When she is admitted,she tells the physician that she has not been using the inhaler for 4 weeks.Before assigning Evelyn to Mrs.N.'s care,the most appropriate action of the care coordinator would have been to:

Accepted Answer

A)  Determine Evelyn's educational background and preparation for this role.
B)  Ask Evelyn if she has worked with inhalers before and to describe what she knows about them.
C)  Advise that if Evelyn has any questions about what to do with the inhaler, she should come to the coordinator.
D)  Advise Evelyn that working the inhaler is not really complicated and that she should ask the patient how to check medication levels in the inhaler.

Question 18

You ask Evelyn,a new UNP,to check what is left in Mrs.N.'s inhaler when Evelyn makes visits to Mrs.N.and also to check whether Mrs.N.is receiving any positive effect from the medication.Evelyn reports for 3 weeks that Mrs.N.is using the inhaler and that there is enough medication left in the device.The day of her last visit to Mrs.N. ,Mrs.N.is admitted to the hospital in severe respiratory distress.When she is admitted,she tells the physician that she has not been using the inhaler for 4 weeks.This incident is an example of:

Accepted Answer

A)  Incompetence of the UNP.
B)  Failure to follow through.
C)  Skills but no motivation.
D)  Lack of accountability.

Question 19

The nurse on the 7-7 shift is assigning a component of care to an unlicensed nursing personnel (UNP)employee.The night nurse should remain:

Accepted Answer

A)  Accountable.
B)  Responsible.
C)  Authoritative and liable.
D)  Responsible and task-oriented.

Question 20

County Hospital has position descriptions for all staff,including RN Team Leaders.Sarah,a team leader on the rehab unit,assesses the needs of the patients in her area,assesses the skills and backgrounds of each of the individuals on her team,and then assigns and delegates the appropriate care provider to each patient and task.Sarah provides Colleen,her RN colleague with details regarding the patients to whom Colleen has been assigned on the day shift.This is an example of:

Accepted Answer

A)  Accountability.
B)  Responsibility.
C)  Assignment.
D)  Delegation.

Exam 26: Delegation An Art of Professional Nursing Practice

An example of a care activity that would likely not be delegated by an RN to a UNP is (select all that apply) :