Leadership and Management 2021/2022 questions and answers

A nurse-manager in the office of a group of surgeons has received complaints from discharged clients about inadequate instructions for performing home care. Knowing the importance of good, timely client education, the nurse-manager should take which steps? Work with the surgeons' staff and the nursing staff in the hospital and outpatient surgical center to evaluate current client education practices and make revisions as needed. Every nurse who provides client care should provide client education. Nurses must work together to establish the best methods of educating clients. The most appropriate response is to contact the facility's nurse-manager, not the nursing staff. Evaluating client education in only the surgeon's office doesn't consider the entire client education process and all of the staff providing it. Client education is an important nursing responsibility and every complaint deserves attention. A client with stage II Alzheimer's disease is admitted to the short stay unit after cardiac catheterization that involved a femoral puncture. The client is reminded to keep his leg straight. A knee immobilizer is applied, but the client repeatedly attempts to remove it. The nurse is responsible for three other clients who underwent cardiac catheterization. What's the best step the nurse can take? Ask the staffing coordinator to assign a nursing assistant to sit with the client. The nurse should ask the staffing coordinator to assign a nursing assistant to sit with the client. This action promotes client safety while avoiding restraint use. Applying wrist restraints doesn't prevent injury to the lower leg. Also, restraints should be applied only after other less restrictive measures have been attempted. A client with stage II Alzheimer's disease has memory impairment that impedes his ability to remember repeated instruction. Sedation isn't indicated for this client. 00:20 01:46 A nurse on the mental health unit tells the nurse manager, "Kids with conduct disorders might as well be jailed because they all end up as adults with antisocial personality disorder anyway." What is the best reply by the nurse manager? "You sound really frustrated. Let us talk about the meaning of their behavior." The nurse manager needs to focus on the frustration that the nurse is expressing. Additionally, the nurse manager needs to correct any misinformation or misinterpretation that the staff nurse has. Saying that the nurse sounds burned out and asking about a vacation does not focus on the nurse's frustration or address the inaccuracy of the nurse's statement. There is no evidence to suggest that children with conduct disorder have more than the average adult's risk of depression or anxiety. Therefore, this response is inaccurate and inappropriate. Anecdotal information from personal experience does not supply the nurse with accurate, reliable information. The charge nurse is making client care assignments for the evening shift. One of the licensed practical nurses (LPNs) is a new graduate in orientation. Which client would be an appropriate care assignment for this LPN? a 72-year-old client with diverticulitis The client with diverticulitis will need care that the LPN should be able to provide safely. The client with angina is unstable and requires a registered nurse for continuous assessment. The client receiving chemotherapy treatment requires a registered nurse who is certified in chemotherapy administration. A child with Kawasaki's disease must be watched closely for cardiac complications, and it would be best to assign the child to an experienced pediatric nurse, not a new graduate. The nurse instructs the unlicensed assistive personnel (UAP) on how to care for a client with chest tubes that are connected to water-seal drainage. The nurse should instruct the UAP to: mark the time and amount of drainage on the collection container. It is appropriate for a UAP to mark the time of measurement and fluid level on the collection container. Milking of chest tubes is not routinely recommended but, if performed, would be the responsibility of the nurse. The collection container should not be raised to bed height because this can cause fluid to flow back toward the client. Chest tubes should not be secured to the bed linens because they could be pulled on and potentially disconnected when the client moves and turns in bed. A nurse is caring for a client with a fresh postoperative wound following a femoral-popliteal revascularization procedure. The nurse fails to routinely assess the pedal pulses on the affected leg, and missed the warning sign that the blood vessel was becoming occluded. The nurse manager is made aware of the complication and the nurse's failure to assess the client properly. What action should be taken by the nurse manager? Address the nurse's omissions as negligent behavior. Negligence refers to careless acts on the part of an individual who is not exercising reasonable or prudent judgment. It also refers to the failure to do something that a reasonable person (another nurse) would do. A home health agency is seeing an increase in the number of clients with GI disorders. How can the staff education coordinator ensure that the staff is knowledgeable about advances in GI care? Select all that apply. Incorporate bi-annual competencies Allow time off for educational programs and conferences Make instructional videos and educational materials accessible The nurse observes an unlicensed assistive personnel (UAP) sharing extensive stories of her own mother's death with a dying client's husband. Which statement demonstrates appropriate feedback for the nurse to offer to the UAP? "It is probably best to avoid talking about your personal experience very much; keep communication client-centered." Therapeutic communication is always purposeful, goal-directed, and client-centered. If self-disclosure is used by the nurse or the UAP, it should be very focused and limited to just enough to support further communication with the client. It is not always helpful (or educational) and often inappropriate to share personal stories with clients. A client with pulmonary fibrosis is prescribed home oxygen therapy. Which health team member is responsible for evaluating the client's knowledge of home oxygen use? Home health nurse The home health nurse is responsible for evaluating the client's knowledge of home oxygen use. The social worker is responsible only for coordinating the services. The hospital staff nurse and physician do not observe the client in the home, so they can't adequately evaluate the client's knowledge of home oxygen use. A float nurse is assigned to a surgical unit. The nurse is receiving 2 clients from the post anesthesia care unit (PACU) at the same time. When delegating tasks to other PACU personnel who are not known to the nurse, which question would be most important to ask? Are you comfortable in performing the tasks being assigned? Since the float nurse is not familiar with staff, it is important to ask the worker if he/she is comfortable and had instruction in the task assigned. Principles of delegation state that the right task in the right situation by the right personnel is essential to client care. Asking the highest educational level, how long they worked on the floor, and who provided their training is not as important as if they are comfortable with performing the task. The staff of an outpatient clinic has formed a task force to develop new procedures for swift, safe evacuation of the unit. The new procedures haven't been reviewed, approved, or shared with all personnel. When a nurse-manager receives word of a bomb threat, the task force members push for evacuating the unit using the new procedures. Which action should the nurse-manager take? Determine that the procedures currently in place must be followed and direct staff to follow them without question. In an emergency such as a bomb scare, the nurse-manager must determine, without hesitation, the best action for the safety and welfare of clients and staff. Allowing staff members to do whatever they think best will cause confusion and inefficient client evacuation because no one will know how to function effectively as a team during the crisis. A staff meeting would waste valuable time. The selection of a nursing care delivery system (NCDS) is critical to the success of client care in a nursing area. Which factor is essential to the evaluation of an NCDS? The selection of a nursing care delivery system (NCDS) is critical to the success of client care in a nursing area. Which factor is essential to the evaluation of an NCDS? Determining who has responsibility for making decisions regarding client care is an essential element of all client care delivery systems. Dress code, salary, and scheduling planned staff absences are important to any organizations, but they are not actually determined by the NCDS.