Chapter 11: Building Nursing
Management Skills
MULTIPLE CHOICE
1. What would be a good assignment for an experienced nursing
assistant?
a. Help teach patients newl y diagnosed with diabetes to give
themselves injections.
b. Report on the qualit y and quantit y 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 probabl y
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 condi tion 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
completel y comfortable with Mr. Samuel’s response to care.
His blood pressure has dropped, and his pulse is elevated.”
d. “This is Sheila R yan 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 eff ective when communicating not
onl y 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/Appl ying
TOP: Effective communication REF: Box 11.4 OBJ: Anal yze
effective communication as it relates to patient safet y. MSC:
NCLEX®: Not applicable.
3. A nurse is working on a busy orthopedic floor and is on the phon e
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 administ er 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 appro priate 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 th ere
is an emergency or the physician is in a sterile environment because
there is too much opportunit y for a transcribing error.
PTS: 1 DIF: Cognitive Level: Application/Appl ying
REF: p. 235 OBJ: Identify current methods of transcribing
physicians’ ord ers. TOP: Communication and patient
safet y MSC: NC LEX®: 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 o pinion 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 repeat ing 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 safet y MSC: NC LEX®: Safe and
effective care environment
5. A nurse has received report on assigned patients and is prioritizing
their care. Which of the following patients should the nurse assess
first?
a. A female patient who is complaining of a headache
b. A patient who has just returned from surgery and has
saturated his dressing .
c. A patient with a femur fracture who is requesting pain
medications
d. A male patient who needs to use the bathroom
ANS: B.
Management Skills
MULTIPLE CHOICE
1. What would be a good assignment for an experienced nursing
assistant?
a. Help teach patients newl y diagnosed with diabetes to give
themselves injections.
b. Report on the qualit y and quantit y 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 probabl y
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 condi tion 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
completel y comfortable with Mr. Samuel’s response to care.
His blood pressure has dropped, and his pulse is elevated.”
d. “This is Sheila R yan 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 eff ective when communicating not
onl y 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/Appl ying
TOP: Effective communication REF: Box 11.4 OBJ: Anal yze
effective communication as it relates to patient safet y. MSC:
NCLEX®: Not applicable.
3. A nurse is working on a busy orthopedic floor and is on the phon e
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 administ er 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 appro priate 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 th ere
is an emergency or the physician is in a sterile environment because
there is too much opportunit y for a transcribing error.
PTS: 1 DIF: Cognitive Level: Application/Appl ying
REF: p. 235 OBJ: Identify current methods of transcribing
physicians’ ord ers. TOP: Communication and patient
safet y MSC: NC LEX®: 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 o pinion 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 repeat ing 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 safet y MSC: NC LEX®: Safe and
effective care environment
5. A nurse has received report on assigned patients and is prioritizing
their care. Which of the following patients should the nurse assess
first?
a. A female patient who is complaining of a headache
b. A patient who has just returned from surgery and has
saturated his dressing .
c. A patient with a femur fracture who is requesting pain
medications
d. A male patient who needs to use the bathroom
ANS: B.
