Chapter 11: Building Nursing Management
Skills
MULTIPLE CHOICE
1. What would be a good assignment for an experienced nursing assistant?
a. Help teach patients newly diagnosed with diabetes to give themselves
injections.
b. Report on the quality and quantity of urine on a continuous bladder
irrigation.
c. Obtain a clean-catch urine specimen from a patient.
d. Chart a diet for a patient with an eating disorder.
ANS: C.
The nursing assistant can be assigned activities that involve standard, unchanging
procedures such as helping to obtain a clean-catch urine specimen from a patient.
Charting, teaching, and assessing are not assigned to the nursing assistant.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 248 OBJ: Identify criteria for supervising and delegating care
provided by others. TOP: Supervision MSC: NCLEX®: Safe and
effective care environment—management of care.
2. The nurse calls a physician to come to the unit to assess a patient. Which of the
following is the most effective telephone communication by the nurse?
a. “This is the 4100 unit troublemaker again. You probably ought to come to
the unit to see Mr. Samuels. His condition doesn’t seem right.”
, b. “This is Ann Allen on 4100. I don’t quite know what to think about Mr.
Samuels. I think his condition is deteriorating, and I’d like to have you see
him.”
c. “Sorry to bother you. This may not be important, but I’m not completely
comfortable with Mr. Samuel’s response to care. His blood pressure has
dropped, and his pulse is elevated.”
d. “This is Sheila Ryan on 4100 calling regarding your patient, Mr. Samuels.
His BP has dropped from 130/90 at 8 AM to 100/70 at 10 AM. His pulse
has risen from 80 to 100, and he seems restless. He received his 8 AM
Cardizem.”
ANS: D.
A detailed, objective response is effective when communicating not only in person
but also by telephone. Try organizing your conversation in the I-SBAR-R
communication format. The other responses are subjective in nature with no
descriptive assessment data to provide to the . physician.
PTS: 1 DIF: Cognitive Level: Application/Applying
TOP: Effective communication REF: Box 11.4 OBJ: Analyze effective
communication as it relates to patient safety. MSC: NCLEX®: Not applicable.
3. A nurse is working on a busy orthopedic floor and is on the phone with the floor
manager when a physician comes up and gives a verbal order for pain
medications on an assigned patient. The physician then turns to leave the unit.
Which action by the nurse would be the most appropriate?
a. Write down the order and administer the medication. .
b. Put the nurse manager on hold and ask the physician to write the order.
c. Ignore the physician and continue the conversation with the nurse
manager.
d. Write down the order and document it as a telephone order. .
ANS: B
, The most appropriate action would be for the nurse to put the nurse manager on hold
and ask the physician to write the order. The Joint Commission states that there is a
big difference between verbal and telephone orders. Verbal orders should never be
accepted unless there is an emergency or the physician is in a sterile environment
because there is too much opportunity for a transcribing error.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 235 OBJ: Identify current methods of transcribing physicians’
orders. TOP: Communication and patient safety MSC: NCLEX®:
Safe and effective care environment
4. The nurse is reviewing I-SBAR-R with a coworker at the end of the shift. Which
statement indicates that they are discussing the Situation component?
a. The nurse states the patient’s name using two identifiers.
b. The nurse states that the patient was hospitalized for a broken tibia and
that surgery is scheduled for later today.
c. The oncoming nurse acknowledges the info that has been received.
d. The nurse states an opinion on what is happening with the patient. .
ANS: B
In the Situation component of I-SBAR-R, the nurse states what is going on with the
patient. In this situation, the patient was hospitalized with a broken tibia, and surgery
is planned for later today. The Identification component involves stating the patient’s
name, the Assessment component involves the nurse discussing what the nurse thinks
is happening with the patient, and the Read-Back or Response component involves
that the oncoming nurse repeating what the nurse has heard from the nurse who is
reporting at the end of the shift.
PTS: 1 DIF: Cognitive Level: Comprehension/Understanding REF: p.
240 OBJ: Utilize a standardized hand-off communication tool (SBAR or I-
SBAR-R) for receiving and giving change-of-shift report. TOP:
Communication and patient safety MSC: NCLEX®: Safe and effective care
environment
Skills
MULTIPLE CHOICE
1. What would be a good assignment for an experienced nursing assistant?
a. Help teach patients newly diagnosed with diabetes to give themselves
injections.
b. Report on the quality and quantity of urine on a continuous bladder
irrigation.
c. Obtain a clean-catch urine specimen from a patient.
d. Chart a diet for a patient with an eating disorder.
ANS: C.
The nursing assistant can be assigned activities that involve standard, unchanging
procedures such as helping to obtain a clean-catch urine specimen from a patient.
Charting, teaching, and assessing are not assigned to the nursing assistant.
PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 248 OBJ: Identify criteria for supervising and delegating care
provided by others. TOP: Supervision MSC: NCLEX®: Safe and
effective care environment—management of care.
2. The nurse calls a physician to come to the unit to assess a patient. Which of the
following is the most effective telephone communication by the nurse?
a. “This is the 4100 unit troublemaker again. You probably ought to come to
the unit to see Mr. Samuels. His condition doesn’t seem right.”
, b. “This is Ann Allen on 4100. I don’t quite know what to think about Mr.
Samuels. I think his condition is deteriorating, and I’d like to have you see
him.”
c. “Sorry to bother you. This may not be important, but I’m not completely
comfortable with Mr. Samuel’s response to care. His blood pressure has
dropped, and his pulse is elevated.”
d. “This is Sheila Ryan on 4100 calling regarding your patient, Mr. Samuels.
His BP has dropped from 130/90 at 8 AM to 100/70 at 10 AM. His pulse
has risen from 80 to 100, and he seems restless. He received his 8 AM
Cardizem.”
ANS: D.
A detailed, objective response is effective when communicating not only in person
but also by telephone. Try organizing your conversation in the I-SBAR-R
communication format. The other responses are subjective in nature with no
descriptive assessment data to provide to the . physician.
PTS: 1 DIF: Cognitive Level: Application/Applying
TOP: Effective communication REF: Box 11.4 OBJ: Analyze effective
communication as it relates to patient safety. MSC: NCLEX®: Not applicable.
3. A nurse is working on a busy orthopedic floor and is on the phone with the floor
manager when a physician comes up and gives a verbal order for pain
medications on an assigned patient. The physician then turns to leave the unit.
Which action by the nurse would be the most appropriate?
a. Write down the order and administer the medication. .
b. Put the nurse manager on hold and ask the physician to write the order.
c. Ignore the physician and continue the conversation with the nurse
manager.
d. Write down the order and document it as a telephone order. .
ANS: B
, The most appropriate action would be for the nurse to put the nurse manager on hold
and ask the physician to write the order. The Joint Commission states that there is a
big difference between verbal and telephone orders. Verbal orders should never be
accepted unless there is an emergency or the physician is in a sterile environment
because there is too much opportunity for a transcribing error.
PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 235 OBJ: Identify current methods of transcribing physicians’
orders. TOP: Communication and patient safety MSC: NCLEX®:
Safe and effective care environment
4. The nurse is reviewing I-SBAR-R with a coworker at the end of the shift. Which
statement indicates that they are discussing the Situation component?
a. The nurse states the patient’s name using two identifiers.
b. The nurse states that the patient was hospitalized for a broken tibia and
that surgery is scheduled for later today.
c. The oncoming nurse acknowledges the info that has been received.
d. The nurse states an opinion on what is happening with the patient. .
ANS: B
In the Situation component of I-SBAR-R, the nurse states what is going on with the
patient. In this situation, the patient was hospitalized with a broken tibia, and surgery
is planned for later today. The Identification component involves stating the patient’s
name, the Assessment component involves the nurse discussing what the nurse thinks
is happening with the patient, and the Read-Back or Response component involves
that the oncoming nurse repeating what the nurse has heard from the nurse who is
reporting at the end of the shift.
PTS: 1 DIF: Cognitive Level: Comprehension/Understanding REF: p.
240 OBJ: Utilize a standardized hand-off communication tool (SBAR or I-
SBAR-R) for receiving and giving change-of-shift report. TOP:
Communication and patient safety MSC: NCLEX®: Safe and effective care
environment
