NCLEX Leadership and Management Test Bank

NCLEX Leadership and Management Test Bank Autocratic Leadership Centralized decision-making style with the leader making decisions and using power to command and control others Bureaucratic Organization Hierarchy with clear superior-subordinate communication and relationships, based on positional authority, in which orders from the top are transmitted down through the organization via a clear chain of command Consideration Activities that focus on the employee and emphasize relating and getting along with people Contingency Theory Style that acknowledges that other factors in the environment influence outcomes as much as leadership style and that leader effectiveness is contingent upon or depends upon something other than the leader's behavior Democratic Leadership Style in which participation is encouraged and authority is delegated to others Emotional Intelligence Component of leadership and refers to the capacity for recognizing your own feelings and those of others, for motivating yourself, and for managing emotions well in yourself and in your relationships. Employee-Centered Leadership Style with a focus on the human needs of subordinates Formal Leadership When a person is in a position of authority or in a sanctioned role within an organization that connotes influence Hawthorne effect Term coined to reflect the findings of a research study that demonstrated that change in employee behavior occurs as a result of being observed informal leader Individual who demonstrates leadership outside the scope of a formal leadership role or as a member of a group rather than as the head or leader of the group initiating structure style that involves an emphasis on the work to be done a focus on the task and production job-centered leaders Style that focuses on schedules, cost, and efficiency with less attention to developing work groups and high-performance groups knowledge workers health care professionals who are well educated and technologically savvy and see themselves as owning their intellectual capital laissez-faire leadership Passive and permissive style in which the leader defers decision making leader-member relations Feelings and attitudes of followers regarding acceptance, trust, and credibility of the leader leadership Process of influence whereby the leader influences other toward goal achievement maintenance or hygiene factors Elements such as salary, job security, working conditions, status, quality of supervision, and relationships with others that prevent job dissatisfaction management Process of coordinating actions and allocating resources to achieve organizational goals management process Function of planning, organizing, coordinating, and controlling motivation Whatever influences our choices and creates direction, intensity, and persistence in our behavior motivation factors Elements such as achievement, recognition, responsibility, advancement, and the opportunity for development that contribute to job satisfaction position power Degree of formal authority and influence associated with the leaders substitutes for leadership Variable that may influence or have an effect on followers to the same extent as the leader's behavior task structure Involves the degree that work is defined, with specific procedures, explicit directions and goals taxonomy System that orders principles into a grouping or classification Theory X View that in bureaucratic organizations, employees prefer security, direction, and minimal responsibility; coercion, threats, or punishment are necessary because people do not like the work to be done Theory Y View that in the context of the right conditions, people enjoy their work, they can show self-control and discipline, are able to contribute creatively and are motivated by ties to the group, the organization, and the work itself; belief that people are intrinsically motivated by their work Theory Z View of collective decision making and a focus on long term employment that involves less direct supervision transactional leader traditional manager concerned with day-to-day operations transformational leader Leader who is committed to a vision that empowers others Hawthorne effect phenomena of how being observed or studied results in a change in behavior NEGLIGENT ACTS *Medication errors that result in injury to the client *IV administration errors: incorrect flow rates; failure to monitor a flow rate that results in injury *Falls that occur as a result of failure to provide safety *Failure to check equipment for proper functioning *Burns sustains as a result of failure to monitor bath temperature or equipment *Failure to monitor client's condition *Failure to report changes in client's condition to HCP *Failure to provide complete end of shift report NEGLIGENCE *Conduct that falls below the standard of care *Can include acts of commission and omission *A nurse who does not meet standards of care can be held liable MALPRACTICE *Negligence on the part of a nurse *Determined if the nurse owed a duty to the client & did not carry out the duty and the client was injured PROOF OF LIABILITY *DUTY: At the time of injury, a duty existed between the plaintiff & the defendant *BREACH OF DUTY: The defendant breached duty of care *PROXIMATE CAUSE: The breach of duty was the legal cause of injury to the client *DAMAGE/INJURY: The plaintiff experienced injury or damages or both & can be compensated by law LEGAL RISK AREAS **Assault When a person puts another person in fear of a harmful or offensive contact *The victim fears & believes that harm will result because of the threat LEGAL RISK AREAS **Battery Intentional touching of another without consent LEGAL RISK AREAS **Invasion of Privacy Violating confidentiality *Intruding on private client/family matters *Sharing client information with unauthorized persons LEGAL RISK AREAS **False Imprisonment *When a client is not allowed to leave a health care facility when there is no legal justification to detain *When restraining devices are used without an appropriate clinical need (includes meds) LEGAL RISK AREAS **Defamation False communication that causes damage to someone's reputation *In writing: libel *Verbal: slander LEGAL RISK AREAS **Fraud Deliberate deception to produce unlawful gains INCIDENT REPORTS *Used as a means of identifying risk situations & improving care *Follow specific documentation guidelines *Fill out report completely, accurately & factually *Report form should not be copied or placed in client's record *Make no reference to the incident report form in the client's record *The report is not a substitute for a complete entry in the client's record regarding the incident (record the incident and actions taken but not the report itself) *If a client injury or error in care occurred, assess the client frequently INCIDENTS THAT NEED TO BE REPORTED *Accidental omission of prescribed therapies *Circumstances that lead to injury or a risk for client injury *Client falls *Needle stick injuries *Medication administration errors *Procedure related/equipment related accidents *A visitor injury that occurred in the facility *A visitor who exhibits symptoms of a communicable disease TELEPHONE PRESCRIPTIONS *Date & time the entry *Repeat the prescription to the HCP & record *Sign the prescription: begin with "t.o. (telephone order), write the HCP's name & sign *If another nurse witnessed the prescription, that nurses' name follows *The HCP needs to countersign the prescription within a time frame according to agency policy COMPONENTS OF A MEDICATION PRESCRIPTION *Date & time written *Medication name *Medication dosage *Route of administration *Frequency of administration *HCP's signature REPORTING RESPONSIBILITIES *Certain communicable diseases *Child/elder abuse *Domestic violence *Dog/other animal bite *Gunshot *Stab wounds *Assaults *Homicides *Suicides **Impaired nurse (report to administration) PATIENT'S BILL OF RIGHTS *Right to considerate & respectful care *Right to be informed about diagnosis, possible treatments, likely outcome, and discussion with HCP *Right to know the names & roles of persons involved in care *Right to consent or refuse a treatment *Right to have an advance directive *Right to privacy *Right to expect that medical records are confidential *Right to review medical record & to have it explained *Right to expect that the hospital will provide necessary health services *Right to know if the hospital has relationships with outside parties that may influence care *Right to consent or refuse to take part in research *Right to be told of realistic care alternatives when hospital care is no longer appropriate *Right to know about hospital rules that affect treatment and charges & payment options MENTALLY OR EMOTIONALLY INCOMPETENT CLIENTS **Unable to sign informed consent *Declared incompetent *Unconscious *Under the influence of chemical agents (alcohol or drugs..even legal ones) *Chronic dementia or other mental deficiency that impairs thought processes and ability to make decisions VIOLATIONS OF PRIVACY *Taking photographs of the client *Release of medical information to unauthorized person *Use of client's name/picture for health care facility's advantage *Intrusion into client's affairs *Publication of information or embarrassing facts about client *Public disclosure of private information *Leaving the curtains/room door open while providing care *Allowing individuals to observe care without consent *Interviewing a client in a room with only a curtain between clients or where conversation can be overheard *Accessing medical records when unauthorized to do so COMPUTERIZED MEDICAL RECORDS **Protecting client's information *Employees should have access only to records in the nursing unit or work area *Use of special computer access codes to limit what employees have access to *Use of password/identification code is needed to enter and sign off computer system *Password/identification code should never be shared with another person *Passwords should be changed periodically to prevent unauthorized computer access Remove all tubes and equipment (unless organ donation is to take place), clean the body, and position appropriately. A client who had a "Do Not Resuscitate" order passed away. After verifying there is no pulse or respirations, the nurse should next: False True or False - The nurse practice acts are an example of civil law. Collecting all available information about the situation The nurse is working with parents of a seriously ill newborn. Surgery has been proposed for the infant, but the chances of success are unclear. In helping the parents resolve this ethical conflict, the nurse knows that the first step is The sequencing of stages of grief may occur in order, they may be skipped, or they may reoccur When helping a person through grief work, the nurse knows Relationships The philosophy sometimes called the code of ethics of care suggests that ethical dilemmas can best be solved by attention to Civil The client's right to refuse treatment is an example of _________ laws. True True or False - The dominant value in American society of individual autonomy and self-determination may be in direct conflict with diverse groups. Current health standards should determine the acceptability of cultural practices. When providing care to clients with varied cultural backgrounds, it is imperative for the nurse to recognize that: Bio-cultural needs Which factor is least significant during assessment when gathering information about cultural practices? Assess the client's point of view and prepare to articulate this point of view. Nurses agree to be advocates for their patients. Practice of advocacy calls for the nurse to: The choices involved do not appear to be clearly right or wrong. A health care issue often becomes an ethical dilemma because American Nurses Association's (ANA's) Code of Ethics Ethical principles for professional nursing practice in a clinical setting are guided by the principles of conduct that are written as the: American Nursing Association The code of ethics for nurses is composed and published by 4. Defines the principles of right and wrong to provide patient care. You are participating in a clinical care coordination conference for a patient with terminal cancer. You talk with your colleagues about using the nursing code of ethics for professional registered nurses to guide care decisions. A nonnursing colleague asks about this code. Which of the following statements best describes this code? 1. Improves self-health care 2. Protects the patient's confidentiality 3. Ensures identical care to all patients 4. Defines the principles of right and wrong to provide patient care. 3. Assessment An 18-year-old woman is in the emergency department with fever and cough. The nurse obtains her vital signs, auscultates her lung sounds, listens to her heart sounds, determines her level of comfort, and collects blood and sputum samples for analysis. Which standard of practice is performed? 1. Diagnosis 2. Evaluation 3. Assessment 4. Implementation 4. Implementation A patient in the emergency department has developed wheezing and shortness of breath. The nurse gives the ordered medicated nebulizer treatment now and in 4 hours. Which standard of practice performed? 1. Planning 2. Evaluation 3. Assessment 4. Implementation 2. Advocate A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with the family. The nurse is acting as the patient's: 1. Educator 2. Advocate 3. Caregiver 4. Case manager 3. A problem-solving approach that integrates best current evidence with clinical practice Evidence-based practice is defined as: 1. Nursing care based on tradition 2. Scholarly inquiry of nursing and biomedical research literature 3. A problem-solving approach that integrates best current evidence with clinical practice 4. Quality nursing provided in an efficient and economically sound manager 4. Provides a minimal standard of knowledge for a registered nurse in practice The examination for registered nurse licensure is exactly the same in every state in the United States. The examination: 1. Guarantees safe nursing care for all patients 2. Ensures standard nursing care for all patients 3. Ensures that honest and ethical care is provided 4. Provides a minimal standard of knowledge for a registered nurse in practice 1. Caregiver 2. Autonomy and accountability 3. Patient advocate 4. Health promotion Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples? (Select all that apply.) 1. Caregiver 2. Autonomy and accountability 3. Patient advocate 4. Health promotion 5. Lobbyist 1. Function independently Advanced practice registered nurses generally: 1. Function independently 2. Function as unit directors 3. Work in acute care settings 4. Work in the university setting. 1. Moving from an acute illness to a health promotion, illness prevention model Health care reform will bring changes in the emphasis of care. Which of following models is expecting from health care reform? 1. Moving from an acute illness to a health promotion, illness prevention model 2. Moving from illness prevention to a health promotion model 3. Moving from an acute illness to a disease management model 4, Moving from a chronic care to an illness prevention model 2. Nurse practitioner 3. Certified clinical nurse specialist Which of the following nursing roles may have prescriptive authority in their practice? (Select all that apply.) 1. Critical care nurse 2. Nurse practitioner 3. Certified clinical nurse specialist 4. Charge nurse 4. Informatics A critical care nurse is using a computerized decision support system to correctly position her ventilated patients to reduce pneumonia cause by accumulated respiratory secretions. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? 1. Patient-centered care 2. Safety 3. Teamwork and collaboration 4. Informatics 2. Safety A nurse is caring for an older-adult couple in a community-based assisted living facility. During the family assessment he notes that the couple has many expired medications and multiple medications for their respective chronic illnesses. They note that they go to two different health care providers. The nurse begins to work with the couple to determine what they know about their medications and helps them decide on one care provider rather than two. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? 1. Patient-centered care 2. Safety 3. Teamwork 4. Informatics 4. nurse researcher The nurses on an acute care medical floor notice an increase in pressure ulcer formation in their patients. A nurse consultant decides to compare two types of treatment. The first the procedure currently used to assess for pressure ulcer risk. The second uses a new assessment instrument to identify at-risk patients. Given this information, the nurse consultant exemplifies which career? 1. clinical nurse specialist 2. nurse administer 3. nurse educator 4. nurse researcher 3. In-service education Nurses at a community hospital are in an education program to learn how to use a new pressure-relieving device for patients at risk for pressure ulcers. This is which type of education? 1. Continuing education 2. Graduate education 3. In-service education 4. Professional Registered Nurse Education 4. Problem solving. While assessing a patient, the nurse observes that the patient's intravenous (IV) line is not infusing at the ordered rate. The nurse assesses the patient for pain at the IV site, checks the flow regulator on the tubing, looks to see if the patient is lying on the tubing, checks the point of connection between the tubing and the IV catheter, and then checks the condition of the site where the intravenous catheter enters the patient's skin. After the nurse readjusts the flow rate, the infusion begins at the correct rate. This is an example of: 1. Inference.