Chapter 14: Leading, Delegating, and Collaborating
Claywell: LPN to RN Transitions
MULTIPLE CHOICE
1. Which of these tasks is appropriate for the RN to delegate to a licensed practical nurse/license
vocational nurse (LPN/LVN)?
a. Documenting patient teaching about a routine surgical procedure
b. Teaching a patient how to self-administer insulin
c. Administering an oral medication to a patient
d. Completing the initial assessment and plan of care
ANS: C
The education and scope of practice of the LPN/LVN include administration of oral
medication. Patient teaching and the initial assessment and development of the plan of care
are nursing actions that require RN-level education and scope of practice.
DIF: Cognitive Level: Application OBJ: Compare leadership styles.
TOP: Leadership Styles
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
2. All of these nursing actions are included in the plan of care for a patient who is malnourished.
Which action is appropriate for the RN to delegate to a nursing assistant?
a. Assist the patient in choosing high-nutrition items from the menu.
b. Monitor the patient for skin breakdown over the bony prominences.
c. Assess the patient’s strength while ambulating the patient in the room.
d. Offer the patient the ordereN
d nutritional supplement between meals.
ANS: D
Feeding the patient and assisting with oral intake are included in nursing assistant education
and scope of practice. Assessing the patient’s strength and assisting the patient in choosing
high-nutrition foods require LPN/LVN- or RN-level education and scope of practice.
DIF: Cognitive Level: Application OBJ: Compare leadership styles.
TOP: Leadership Styles
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
3. A nurse manager must confront an employee about excessive absenteeism. During the
confrontation with this employee, which introductory statement is most appropriate?
a. “Is there something occurring in your life that is interfering with your attendance at
work?”
b. “What is your understanding of our absenteeism policy and being placed on
probation?”
c. “You are always calling in sick and leaving the staff in a real mess.”
d. “Let’s pull the policy manual out and read the absenteeism policy together.”
ANS: A
, Similar to a focused patient assessment when a complaint pain is given, a manager must also
assess and gather more information about an employee’s excessive absenteeism. With this in
mind, the statement asking about the employee’s life occurrences interfering with work is an
appropriate way to start this conversation. Asking the employee about the absenteeism policy
and offering to read the policy together give no opportunity to engage in a healthy discussion.
Attacking the employee by saying “You are always calling in sick and leaving the staff in a
real mess” is not a respectful and professional way to begin this conversation.
DIF: Cognitive Level: Application OBJ: Compare leadership styles.
TOP: Leadership Styles
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
4. A nurse is assigned to care for a patient who has been admitted with an opiate overdose and
tells the nursing supervisor, “This is a waste of my time. The patient will be back on the
needle right after being discharged.” The most appropriate response by the nursing supervisor
is
a. “Your lack of professionalism will make it difficult for you to provide adequate
care.”
b. “You know we are obligated to provide appropriate care no matter how we feel.”
c. “It is important to recognize these feelings and then figure out how to deal with
them.”
d. “Since you feel so strongly, perhaps you should be assigned to care for a different
patient.”
ANS: C
To provide nonjudgmental care for substance-abusing patients, the nurse must examine his or
her own values and feelings. This statement validates the nurse’s feelings but recognizes the
need to care for the patient in aNnonjudgmental way. The response about the lack of
professionalism is critical of the nurse and is unlikely to lead to a change in the nurse’s
attitude. The response about the obligation to care for this patient is accurate but does not
encourage the nurse to examine his or her own values. The response about feeling strongly
about the patient would solve the immediate problem but would not encourage
self-examination.
DIF: Cognitive Level: Application OBJ: Describe the leadership role in nursing.
TOP: Leadership and Collaboration in Care
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
5. A charge nurse and staff nurse are in disagreement over the team assignment for the shift that
is about to begin. What is the charge nurse’s best first step to resolving the conflict
collaboratively?
a. Determine the shared goal.
b. Open a respectful dialogue to bring forth each point of view.
c. Design a plan to meet the shared goal.
d. Determine the roles of those involved in the plan.
ANS: B
Claywell: LPN to RN Transitions
MULTIPLE CHOICE
1. Which of these tasks is appropriate for the RN to delegate to a licensed practical nurse/license
vocational nurse (LPN/LVN)?
a. Documenting patient teaching about a routine surgical procedure
b. Teaching a patient how to self-administer insulin
c. Administering an oral medication to a patient
d. Completing the initial assessment and plan of care
ANS: C
The education and scope of practice of the LPN/LVN include administration of oral
medication. Patient teaching and the initial assessment and development of the plan of care
are nursing actions that require RN-level education and scope of practice.
DIF: Cognitive Level: Application OBJ: Compare leadership styles.
TOP: Leadership Styles
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
2. All of these nursing actions are included in the plan of care for a patient who is malnourished.
Which action is appropriate for the RN to delegate to a nursing assistant?
a. Assist the patient in choosing high-nutrition items from the menu.
b. Monitor the patient for skin breakdown over the bony prominences.
c. Assess the patient’s strength while ambulating the patient in the room.
d. Offer the patient the ordereN
d nutritional supplement between meals.
ANS: D
Feeding the patient and assisting with oral intake are included in nursing assistant education
and scope of practice. Assessing the patient’s strength and assisting the patient in choosing
high-nutrition foods require LPN/LVN- or RN-level education and scope of practice.
DIF: Cognitive Level: Application OBJ: Compare leadership styles.
TOP: Leadership Styles
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
3. A nurse manager must confront an employee about excessive absenteeism. During the
confrontation with this employee, which introductory statement is most appropriate?
a. “Is there something occurring in your life that is interfering with your attendance at
work?”
b. “What is your understanding of our absenteeism policy and being placed on
probation?”
c. “You are always calling in sick and leaving the staff in a real mess.”
d. “Let’s pull the policy manual out and read the absenteeism policy together.”
ANS: A
, Similar to a focused patient assessment when a complaint pain is given, a manager must also
assess and gather more information about an employee’s excessive absenteeism. With this in
mind, the statement asking about the employee’s life occurrences interfering with work is an
appropriate way to start this conversation. Asking the employee about the absenteeism policy
and offering to read the policy together give no opportunity to engage in a healthy discussion.
Attacking the employee by saying “You are always calling in sick and leaving the staff in a
real mess” is not a respectful and professional way to begin this conversation.
DIF: Cognitive Level: Application OBJ: Compare leadership styles.
TOP: Leadership Styles
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
4. A nurse is assigned to care for a patient who has been admitted with an opiate overdose and
tells the nursing supervisor, “This is a waste of my time. The patient will be back on the
needle right after being discharged.” The most appropriate response by the nursing supervisor
is
a. “Your lack of professionalism will make it difficult for you to provide adequate
care.”
b. “You know we are obligated to provide appropriate care no matter how we feel.”
c. “It is important to recognize these feelings and then figure out how to deal with
them.”
d. “Since you feel so strongly, perhaps you should be assigned to care for a different
patient.”
ANS: C
To provide nonjudgmental care for substance-abusing patients, the nurse must examine his or
her own values and feelings. This statement validates the nurse’s feelings but recognizes the
need to care for the patient in aNnonjudgmental way. The response about the lack of
professionalism is critical of the nurse and is unlikely to lead to a change in the nurse’s
attitude. The response about the obligation to care for this patient is accurate but does not
encourage the nurse to examine his or her own values. The response about feeling strongly
about the patient would solve the immediate problem but would not encourage
self-examination.
DIF: Cognitive Level: Application OBJ: Describe the leadership role in nursing.
TOP: Leadership and Collaboration in Care
MSC: NCLEX: Safe and Effective Care Environment: Management of Care
5. A charge nurse and staff nurse are in disagreement over the team assignment for the shift that
is about to begin. What is the charge nurse’s best first step to resolving the conflict
collaboratively?
a. Determine the shared goal.
b. Open a respectful dialogue to bring forth each point of view.
c. Design a plan to meet the shared goal.
d. Determine the roles of those involved in the plan.
ANS: B
