Deck 17: Collaboration: Leading and Managing

Question 1

For an LPN/LVN to motivate staff members to meet the goals of the organization, it is helpful if the nurse

A) practices intimidation.
B) understands work motivators.
C) offers laissez-faire leadership.
D) emphasizes policies rather than people.

Answer 1

understands work motivators.

Question 2

The LPN/LVN spends time exploring the agency mission statement with the nursing assistants who work that shift. They create a list of ways they can contribute to achieving the agency goals. This process is called

A) stress management.
B) problem solving.
C) team building.
D) conflict resolution.

Answer 2

team building.

Question 3

The LPN/LVN charge nurse notices that a nursing assistant has not weighed her assigned residents. The best statement by the nurse is:

A) "You didn't weigh your assigned residents this morning. Let's get with the program."
B) "I need to have you weigh your assigned residents and report to me by 10 AM."
C) "Would you mind explaining why you didn't weigh your residents today?"
D) "You've been goofing off lately. Not weighing your assigned residents is a good example of this."

Answer 3

"I need to have you weigh your assigned residents and report to me by 10 AM."

Question 4

Which behavior should the LPN/LVN charge nurse identify as dysfunctional behavior that violates OBRA regulations by threatening resident quality of life, health, or safety?

A) The nursing assistant praises a resident who is having poststroke speech therapy for attempts to communicate verbally.
B) The nursing assistant asks to talk to the LPN/LVN charge nurse about changes the nursing assistant would like to make in a resident's plan of care.
C) The nursing assistant uses a sharp tone of voice and body posture, suggesting impatience when feeding a resident.
D) The nursing assistant offers to help coworkers after finishing his resident care assignment.

Question 5

The action the LPN/LVN charge nurse takes independently that would most likely require conflict resolution at the unit level is

A) organizing shift activities before morning report.
B) making sure the necessary equipment and supplies are available.
C) eliminating morning breaks and adding 10 minutes to the lunch hour.
D) creating a calm, supportive environment.

Question 6

A nursing assistant (NA) did an exceptionally good job by encouraging a resident to leave his room and go to an activity. Select the response by the LPN/LVN charge nurse that would best encourage the employee to continue this effort.

A) Write a note for the NA's file explaining that she did not leave the resident in his room.
B) Tell the NA she is a great nursing assistant and that the charge nurse wished all assistants were like her.
C) Report the NA's good efforts to the nursing home's administrator and board of directors.
D) Tell the NA that the charge nurse knows how hard she worked to get the resident out of his room and how pleased the nurse is that the NA is concerned with the resident's need for socialization.

Question 7

What LPN/LVN charge nurse behavior will best accomplish the goal of promoting team building?

A) Using "I" statements exclusively when talking about the unit's mission and goals
B) Never using rewards to change nursing assistant behaviors because this strategy is manipulative
C) Assuming each nursing assistant is fully informed about the unit's mission and goals
D) Encouraging politeness, cooperation, respect, and trust

Question 8

A nursing assistant states, "I have never learned how to transfer a resident with end-stage Parkinson's disease from the bed to the chair." The nursing assistant refuses to transfer the resident at this time. Select the appropriate approach for the LPN/LVN charge nurse to take.

A) Reprimand the nursing assistant for not performing the job.
B) Encourage the nursing assistant to carry through with the transfer.
C) Arrange to teach the nursing assistant how to transfer the resident.
D) Mention that nursing assistants can be charged with insubordination if they do not perform their jobs.

Question 9

The LPN/LVN day shift charge nurse in a nursing home usually reports to the

A) owner of the nursing home.
B) administrator of the nursing home.
C) RN manager of the unit.
D) board of directors of the nursing home.

Question 10

Which quality is rarely found in democratic leaders?

A) Assertiveness
B) Arrogance
C) Desire for new learning
D) Effective communication

Question 11

The LPN/LVN notices that the nursing assistants are taking longer breaks than agency policy permits and wishes to change this behavior as quickly as possible. The LPN/LVN's initial actions should be to

A) verbally confront the employees with their behavior.
B) write reprimands to be placed in each employee's file.
C) ask for in-service classes on time management.
D) determine the reason staff members are taking longer breaks.

Question 12

LPN/LVNs functioning in an expanded role are most often employed in

A) critical care units.
B) pediatric clinics.
C) home health care.
D) long-term care.

Question 13

Which understanding about leadership would help the LPN/LVN become a more skillful leader?

A) Leaders in nursing are appointed by management to accomplish organizational goals.
B) Leaders rarely take risks and virtually never make mistakes.
C) Leaders have little confidence in themselves until they develop a power base.
D) Leaders see change as challenging and providing opportunities for improving quality of care.

Question 14

Which of the following is an example of objective, rational thinking rather than subjective, irrational thinking about nursing assistants whom the LPN/LVN charge nurse supervises?

A) "I want nursing assistants to be on time for report."
B) "Neat appearance means good clinical skills."
C) "Nursing assistants who are late intend to take advantage of coworkers."
D) "Beware of nursing assistants who smile a lot. They're manipulative."

Question 15

The LPN/LVN reads this statement, "Stress is the body's reaction to the mind's analysis of a situation." The LPN/LVN concludes that the critical factor to teach nursing assistants to help them control their stress levels is to

A) manage how they think about a situation.
B) consider the stressful situation as subjectively as possible.
C) focus on developing good clinical skills.
D) apply time management principles.

Question 16

The LPN/LVN nursing home charge nurse encourages nursing assistants to make suggestions regarding improvement of nursing care and shows concern for the staff. This leadership style is called

A) laissez-faire.
B) democratic.
C) autocratic.
D) situational.

Question 17

The LPN/LVN charge nurse asks the nurse manager, "How can I motivate the nursing assistants on my shift?" The best answer would be:

A) "Motivation is an inner force. You can't motivate someone else, but understanding the things that are important to workers can be helpful."
B) "Encouragement is the only way. If you praise and encourage the workers, you will have them eating out of your hand and doing their best."
C) "Money is the only thing that motivates workers. Since you can't set a higher salary, you can't change their motivation."
D) "Communicate! Communicate! Communicate! Be clear and specific. Spell things out. Give the impression that you know what you're talking about at all times."

Question 18

The LPN/LVN nursing home charge nurse usually tells nursing assistants what to do and offers little opportunity for input or suggestions for how to improve care. This leadership style is called

A) autocratic.
B) democratic.
C) situational.
D) laissez-faire.

Question 19

To discover the expanded role of the practical nurse, the LPN/LVN should investigate

A) the state's Nurse Practice Act.
B) job descriptions for the practical nurse in local health care agencies.
C) information gained from practical nurses working in various clinical settings.
D) the opinions of physicians who service area nursing homes and extended care facilities.

Question 20

How can the LPN/LVN charge nurse meet needs for affiliation among staff on their shift?

A) Reorient all staff to policies and shift routine.
B) Encourage attendance at continuing education seminars.
C) Arrange a social gathering for the staff on the shift.
D) Offer training in violence prevention.

Question 21

A new LPN/LVN asks the LPN/LVN charge nurse what continuous quality improvement (CQI) is all about. The charge nurse should explain that the focus of CQI in a health care agency is

A) saving time.
B) better patient care outcomes.
C) making money for the health care agency.
D) reducing stress for employees.

Question 22

The most fundamental requirement for assuming the practice role of LPN/LVN charge nurse is

A) licensure in the state of practice.
B) experience with resident assignment.
C) the ability to coordinate patient care services.
D) a knowledge of the principles of delegation.

Question 23

The plan of care for a resident in the rehabilitation unit requires the resident to receive teaching about how to monitor blood glucose as part of discharge teaching. The RN is working with a resident whose condition is deteriorating. The LPN/LVN charge nurse has performed blood glucose monitoring many times but is new and has not received facility certification. The nursing assistant assigned to the patient is a diabetic and monitors blood glucose several times a day. Who should perform the teaching?

A) RN
B) LPN/LVN charge nurse
C) Nursing assistant
D) Physician

Question 24

In which situation would the LPN/LVN charge nurse be in violation of OBRA provisions?

A) Letting the unit secretary, who has completed 30 hours of instruction in a CNA program, bathe and ambulate a resident
B) Allowing a son to feed his father, who is a resident on the unit
C) Scheduling a nursing assistant to attend a 2-hour in-service training session
D) Notifying the RN supervisor that a nursing assistant needs additional training in administration of tap water enemas

Question 25

The LPN/LVN charge nurse has assigned tasks to the nursing assistant staff and the LPN/LVN orienting to the unit. On which statement about responsibility for outcomes should the LPN/LVN charge nurse base her or his actions?

A) The LPN/LVN charge nurse has no further responsibility, because the staff members have accepted the assignments and are responsible for completing all tasks.
B) The LPN/LVN charge nurse is responsible for checking the outcomes of care of the LPN/LVN orientee only because he is not an official member of the staff.
C) The LPN/LVN charge nurse is responsible for checking the outcomes of care of the nursing assistants only, because the nursing assistants are unlicensed, whereas the LPN/LVN orientee is a licensed employee.
D) The LPN/LVN charge nurse is legally responsible for checking the outcomes of all assignments made.

Question 26

A leadership style that focuses on both the task and the employee is the

A) autocratic style.
B) situational style.
C) democratic style.
D) laissez-faire style.

Question 27

A people-oriented leadership style that focuses on people's feelings but ignores the task at hand and allows people to act without any direction is the

A) autocratic style.
B) situational style.
C) democratic style.
D) laissez-faire style.

Question 28

Assuming all the following are staff members on the unit, to whom should the LPN/LVN charge nurse assign a newly admitted 65-year-old resident with left hemiplegia and a large sacral decubitus requiring a sterile dressing change?

A) LPN/LVN orientee with 1 week of experience
B) LPN/LVN with 2 years of experience
C) Nursing assistant with 3 years of experience
D) Nursing assistant who is a nursing student at a local college

Question 29

When the Nurse Practice Act of the state permits delegation as part of the LPN/LVN charge nurse duties, which task could be delegated to experienced, unlicensed assistive personnel who have been trained to perform the task?

A) Calling the physician when a resident's condition deteriorates
B) Providing a performance evaluation for another nursing assistant
C) Taking the vital signs of a resident whose condition is not critical
D) Handling a grievance brought by a nursing assistant

Question 30

The new nursing assistant arrived 1 hour late for duty on the second day of employment, giving the excuse of car trouble. The LPN/LVN charge nurse should

A) note the incident of tardiness in the charge nurse's personal file.
B) send a letter of reprimand to the nursing assistant.
C) give an oral reprimand to the nursing assistant.
D) arrange to terminate the nursing assistant before a pattern develops.

Question 31

The LPN/LVN charge nurse notices that a new nursing assistant has offensive body odor. The LPN/LVN charge nurse should

A) report this finding to the RN supervisor.
B) send the person to the locker room to shower and put on clean clothes.
C) terminate the nursing assistant.
D) meet with the person to inform her of the problem and reinforce agency expectations.

Question 32

The 3 to 11 shift LPN/LVN charge nurse on a 20-bed nursing home unit is asked by the only other staff member on duty, a nursing assistant, "Will it be all right if I go home tonight while you are giving report to the night shift? My husband needs the car so he can go to work." The best response by the charge nurse is:

A) "It's all right tonight, but don't make a habit of it."
B) "Sure, our residents will be sound asleep by 11 PM."
C) "Have you lost your mind? What would happen if the owner dropped in for a surprise visit?"
D) "That won't be possible. You must be here to answer lights while I give report to the night staff."

Question 33

The long-term care agency has recently announced that it will soon lay off six LPN/LVNs and hire eight nursing assistants. Today, the RN charge nurse presents the LPN/LVN charge nurse with a certificate recognizing her ability to manage effectively despite short staffing. The LPN/LVN responds somewhat politely but seems more angry than pleased. In terms of the Howlett hierarchy of needs, which of the following is the best explanation for the employee's reaction?

A) The LPN/LVN is probably responding to the poor working conditions.
B) When job security is threatened, recognition needs assume lesser importance.
C) Achievement and advancement needs are more fundamental than recognition needs.
D) The adequacy of benefits is more basic to job satisfaction than affiliation needs.

Question 34

During an emergency, the charge nurse tells the LPN/LVN, "I need you to place the patient on a non-rebreather mask now." The charge nurse has little regard for the LPN/LVN's input at this time. The charge nurse is displaying what leadership style?

A) Autocratic
B) Situational
C) Democratic
D) Laissez-faire

Question 35

The priority step the LPN/LVN charge nurse should take before delegating one of the charges to another LPN/LVN on staff is to

A) determine whether the other LPN/LVN is competent to perform the task to be delegated.
B) check the Nurse Practice Act of the state to learn whether an LPN/LVN charge nurse is allowed to delegate duties.
C) delegate both the task and the responsibility that goes with the task.
D) determine the directions that will be provided to the person to whom the task is delegated.

Question 36

When a resident's family complains that their mother is receiving inferior care in the extended care facility, which action should the LPN/LVN charge nurse initially take?

A) Gently explain that Continuous Quality Improvement (CQI) would not permit giving inferior care.
B) Mention that the staff is overworked and would be glad for the family's assistance.
C) Ask the family to be specific and give examples of "inferior care" the mother has received.
D) Tell the family that their reaction is based on guilt because of their need to place their mother in an extended care facility.

Question 37

The LPN/LVN charge nurse at the long-term care facility has assigned a newly licensed LPN/LVN to care for a resident needing a colostomy irrigation. The new LPN/LVN voices concern, because he has never performed a colostomy irrigation. What would be the best course of action for the LPN/LVN charge nurse?

A) State, "A colostomy irrigation is just like giving an enema. You'll be fine."
B) Tell the new LPN/LVN, "I'll do the irrigation while you care for your other assigned residents."
C) Delegate the procedure to a willing nursing assistant.
D) Arrange to supervise the new LPN/LVN as he performs the irrigation.

Question 38

A resident has not voided in 6 hours. Which instruction to a nursing assistant would likely ensure getting the information needed by the LPN/LVN charge nurse?

A) "Watch the resident's output closely today."
B) "I need to know if the resident is voiding sufficiently."
C) "The resident should void at least twice during the shift in quantities of 200 mL or more."
D) "Report to me immediately if the resident voids between now and 10 AM, and tell me the amount he voids. If he has not voided by 10 AM, please report this to me."

Question 39

When conducting an employee performance evaluation conference, the LPN/LVN charge nurse should understand that

A) giving measurable feedback such as "You're doing fine" promotes personal growth.
B) positive feedback should be given at the beginning of the interview to set the tone.
C) the employee should develop a plan for improvement without input from the charge nurse.
D) the employee should be encouraged to identify strengths and ask questions for clarification.

Question 40

Which information can be omitted when the LPN/LVN charge nurse gives the change-of-shift report?

A) Routine care for each resident
B) New problems for any resident
C) Prn medication administered
D) New medical orders

Question 41

To which goal should the LPN/LVN give priority?

A) Resident X, who has been experiencing a medication reaction, will have no rash and uncompromised respirations.
B) Resident Y, who is obese and has had a recent knee replacement, will ambulate using a walker with the assistance of a staff member.
C) Resident Z will receive blood glucose monitoring and insulin as ordered.
D) All residents will be weighed before breakfast.

Question 42

During a staff meeting, the charge nurse encourages feedback from staff nurses about improving patient safety. The charge nurse is displaying the _______________ leadership style.

Question 43

Which principles of delegation should the LPN/LVN charge nurse follow when delegating a duty to a nursing assistant? (Select all that apply.)

A) Choose a nursing assistant who is competent to perform the delegated duty.
B) Determine the nursing assistant's willingness to accept the delegated duty.
C) Transfer responsibility for the duty to the nursing assistant accepting the delegation.
D) Permit the nursing assistant to perform the duty without guidance or monitoring.
E) Plan to delegate duties the LPN/LVN charge nurse enjoys least.

Question 44

A purely task-centered leadership style that thrives on power and involves telling someone what to do, with little regard for the employee as a person, is the ____________________ style.

Question 45

Examples of tasks the LPN/LVN charge nurse of the extended care unit might assign to a nursing assistant (NA) include which of the following? (Select all that apply.)

A) Bathing a resident who is in stable condition
B) Administering a nasogastric tube feeding
C) Assisting a resident with Parkinson disease to ambulate
D) Transferring a resident from bed to chair with the assistance of another NA

Question 46

An LPN/LVN is working in a health care facility that allows delegation of nursing duties to nursing assistants by the LPN/LVN. Which of the following duties could be delegated to the nursing assistant?

A) Weighing a patient
B) Initial patient education
C) Assessing a patient's pain
D) Changing a sterile dressing