EXAM 2 - LEADERSHIP RN400 UPDATED
QUESTIONS AND CORRECT ANSWERS
Question:
1. A charge nurse teaches a class about delegation principles to a group of staff nurses. Which of the
following information should the nurse include in the teaching?
A. "An assistive personnel member can delegate tasks to another AP."
B. "An RN should delegate a task they do not have the skill to perform."
C. "A delegator can delegate simple tasks to a client's family member."
D. "A delegator should delegate tasks that have predictable outcomes."
Answer:
"A delegator should delegate tasks that have predictable outcomes."
Question:
2. A charge nurse is assigning client care for the oncoming shift. Which of the following tasks should the
nurse assign to an RN?
A. Changing an appliance for a client who has an established ostomy Providing postmortem care for a client
B. Calling a client to evaluate their condition 24 hr. following discharge
C. Administering an oral medication to a client who has type 2 diabetes mellitus
Answer:
Calling a client to evaluate their condition 24 hr. following discharge
Question:
3. A charge nurse is delegating client care for the oncoming shift. Which tasks should the nurse delegate to
assistive personnel (AP)?
A. Obtaining a wound culture from a client who has a stage 2 pressure injury
B. Collecting vital signs from a client who is on contact precautions
C. Teaching a client who is preoperative about how to perform leg exercises
D. Assisting a client in choosing a meal containing low-sodium foods
Answer:
Collecting vital signs from a client who is on contact precautions
Question:
4. A charge nurse is planning to delegate client care to a nurse. Which of the following actions should the
nurse plan to take first?
A. Assign a task to the nurse.
B. Determine client care requirements.
C. Clarify instructions with the nurse.
D. Evaluate client outcomes.
Answer:
Determine client care requirements.
,Question:
5. A charge nurse is assigning client care for the oncoming nursing shift. Which tasks should the nurse
assign to a licensed practical nurse (LPN)?
Initiating a blood transfusion for a client who has anemia
Creating a plan of care for a client who had a stroke
Providing dietary teaching to a client who has celiac disease Administering a tube feeding for a client who
has an established gastrostomy tube
Answer:
Administering a tube feeding for a client who has an established gastrostomy tube
Question:
6. A registered nurse is providing care in a setting that uses modular nursing. What task should the nurse
perform during a shift?
Collaborating with another registered nurse to plan the care of all the mini-team's assigned patients
Confirming that each member of the mini-team is completing their assigned tasks
Providing every aspect of care to one-half to one-third of the mini-team's assigned patients Providing total
patient care to the most acutely ill patients that the mini-team is assigned
Answer:
Confirming that each member of the mini-team is completing their assigned tasks
The modular team leader should check the work of team members. Care is divided among the mini-team
members, so the RN does not provide every aspect of care to some patients, even those who are acutely ill.
Modular nursing does not usually involve collaboration between two RNs; it is more common for each
team to have only one RN.
Question:
7. Determine the nursing care hours per client day (NCH/PPD) if the following staffing existed for 24
hours (unit census = 10): 12 midnight to 12 noon, one registered nurse, one licensed vocational nurse 12
noon to 12 midnight, one registered nurse, one licensed vocational nurse, 1 unit clerk (8 hours only)
5.0 NCH/PPD
5.6 NCH/PPD
4.8 NCH/PPD
6.2 NCH/PPD
Answer:
5.6 NCH/PPD
Fifty-six nursing hours were worked in 24 hours (unit clerks are counted in NCH/PPD), and the census was
10 clients. Dividing the total number of nursing care hours by the census (56 divided by
10) yields an NCH/PPD calculation of 5.6 NCH/PPD.
Question:
8. A manager is conducting career coaching for an employee new to the organization. When coaching this
employee, the manager should: Encourage the nurse to share their plans with the other nurses in the
organization.
Conduct the coaching in a group of no more than six to eight nurses.
Make sure not to intimidate the employee during questioning.
Help the nurse establish goals and make the attainment of the goals a condition of employment.
,Answer:
Make sure not to intimidate the employee during questioning.
To make coaching a productive activity, it is crucial that the manager not intimidate the nurse. Coaching is
usually performed one-on-one, not in a group setting. In most cases, the nurse is not obliged or expected to
describe these private and personal communications to the other nurses. Coaching should not usually
become a precursor to binding expectations for performance.
Question:
9. What is the most fiscally responsible method for determining staffing needs for a hospital unit?
An agreed-upon staffing formula based on client acuity
The number of patients present for an upcoming shift
Maximum patient load capacity of the unit
Total beds in the unit
Answer:
An agreed-upon staffing formula based on client acuity
A staffing formula is the best way to determine staffing needs, provided it is based on an accurate patient
classification system (PCS). A robust formula considers the other variables listed, none of which can be
used in isolation to determine staffing needs accurately.
Question:
10. What is a leadership role associated with staffing and scheduling?
Uses patient classification tools to minimize understaffing
Periodically examines the unit standard of productivity to determine if changes are needed.
Role models the use of evidence in making appropriate staffing and scheduling decisions.
Evaluates scheduling and staffing procedures and policies regularly
Answer:
Role models the use of evidence in making appropriate staffing and scheduling decisions.
Role modeling is classified as a leadership responsibility. The other options are recognized management
responsibilities associated with staffing and scheduling.
Question:
11. When do nursing shortages historically occur?
When the economy is in recession
When the economy is on an upswing
When nursing salaries decline
When client acuity increases
Answer:
When the economy is on an upswing
Historically, nursing shortages occur when the economy is on the upswing and decline when the economy
recedes. Historically, salaries were not a causative factor in existing nursing shortages. Client acuity is not
identified as a factor directly contributing to nursing shortages.
Question:
12. Which statement best describes the manager's main role in socializing a new nurse?
Ensuring that there are sufficient numbers of good role models
Providing the employee with organizational rules and regulations
Providing the new employee with a good preceptor
Sharing organizational values, expected attitudes, and behaviors
, Answer:
Sharing organizational values, expected attitudes, and behaviors
New group members must be socialized into the group, and the manager should lead and model these
socialization efforts.
Question:
13. The nurse-manager needs to determine the effectiveness of a staff workshop on establishing IV access.
What is the manager's best method for determining this?
Giving participants an examination or test after the course
Having class participants evaluate the instructor and the class
Having a documented decrease in the unit's IV site infections
Observing staff perform and document the practice
Answer:
Observing staff perform and document the practice
Instructor evaluation supports effective teaching, but not learning new skills. Testing someone at the end of
educational training does not confirm that the learning changed behavior, which is the primary goal of staff
development. There needs to be some method of follow-up to observe whether a behavior change
occurred, showing that the education was adequate. Observation of the staff will fulfill
Question:
14. A hospital unit has an exceptionally high census for several weeks, and mandatory overtime is
routinely required. What is the priority consequence of this practice?
Temporary cost savings
Ethics violations
Increased continuity of care Decreased client safety
Answer:
Decreased client safety
Frequent use of overtime creates a safety risk because exhausted nurses are much more likely to commit
errors. This practice is costly but does not significantly affect the continuity of care. Ethics violations can
occur in any staffing situation and are not necessarily more common when overtime is used.
Question:
15. A busy medical unit has been increasing the use of agency nurses. The nurse-manager should
anticipate the consequences of this staffing alternative.
Increased reliance on unlicensed assistive personnel by nurses
Short-term cost savings
Decreased continuity of nursing care
A need for 8-hour rather than 12-hour shifts
Answer:
Decreased continuity of nursing care
The use of agency nurses can increase costs and decrease continuity of care. There is no apparent need to
change the length of shifts, or for Nurses to become more reliant on UAPs with agency nurses.
QUESTIONS AND CORRECT ANSWERS
Question:
1. A charge nurse teaches a class about delegation principles to a group of staff nurses. Which of the
following information should the nurse include in the teaching?
A. "An assistive personnel member can delegate tasks to another AP."
B. "An RN should delegate a task they do not have the skill to perform."
C. "A delegator can delegate simple tasks to a client's family member."
D. "A delegator should delegate tasks that have predictable outcomes."
Answer:
"A delegator should delegate tasks that have predictable outcomes."
Question:
2. A charge nurse is assigning client care for the oncoming shift. Which of the following tasks should the
nurse assign to an RN?
A. Changing an appliance for a client who has an established ostomy Providing postmortem care for a client
B. Calling a client to evaluate their condition 24 hr. following discharge
C. Administering an oral medication to a client who has type 2 diabetes mellitus
Answer:
Calling a client to evaluate their condition 24 hr. following discharge
Question:
3. A charge nurse is delegating client care for the oncoming shift. Which tasks should the nurse delegate to
assistive personnel (AP)?
A. Obtaining a wound culture from a client who has a stage 2 pressure injury
B. Collecting vital signs from a client who is on contact precautions
C. Teaching a client who is preoperative about how to perform leg exercises
D. Assisting a client in choosing a meal containing low-sodium foods
Answer:
Collecting vital signs from a client who is on contact precautions
Question:
4. A charge nurse is planning to delegate client care to a nurse. Which of the following actions should the
nurse plan to take first?
A. Assign a task to the nurse.
B. Determine client care requirements.
C. Clarify instructions with the nurse.
D. Evaluate client outcomes.
Answer:
Determine client care requirements.
,Question:
5. A charge nurse is assigning client care for the oncoming nursing shift. Which tasks should the nurse
assign to a licensed practical nurse (LPN)?
Initiating a blood transfusion for a client who has anemia
Creating a plan of care for a client who had a stroke
Providing dietary teaching to a client who has celiac disease Administering a tube feeding for a client who
has an established gastrostomy tube
Answer:
Administering a tube feeding for a client who has an established gastrostomy tube
Question:
6. A registered nurse is providing care in a setting that uses modular nursing. What task should the nurse
perform during a shift?
Collaborating with another registered nurse to plan the care of all the mini-team's assigned patients
Confirming that each member of the mini-team is completing their assigned tasks
Providing every aspect of care to one-half to one-third of the mini-team's assigned patients Providing total
patient care to the most acutely ill patients that the mini-team is assigned
Answer:
Confirming that each member of the mini-team is completing their assigned tasks
The modular team leader should check the work of team members. Care is divided among the mini-team
members, so the RN does not provide every aspect of care to some patients, even those who are acutely ill.
Modular nursing does not usually involve collaboration between two RNs; it is more common for each
team to have only one RN.
Question:
7. Determine the nursing care hours per client day (NCH/PPD) if the following staffing existed for 24
hours (unit census = 10): 12 midnight to 12 noon, one registered nurse, one licensed vocational nurse 12
noon to 12 midnight, one registered nurse, one licensed vocational nurse, 1 unit clerk (8 hours only)
5.0 NCH/PPD
5.6 NCH/PPD
4.8 NCH/PPD
6.2 NCH/PPD
Answer:
5.6 NCH/PPD
Fifty-six nursing hours were worked in 24 hours (unit clerks are counted in NCH/PPD), and the census was
10 clients. Dividing the total number of nursing care hours by the census (56 divided by
10) yields an NCH/PPD calculation of 5.6 NCH/PPD.
Question:
8. A manager is conducting career coaching for an employee new to the organization. When coaching this
employee, the manager should: Encourage the nurse to share their plans with the other nurses in the
organization.
Conduct the coaching in a group of no more than six to eight nurses.
Make sure not to intimidate the employee during questioning.
Help the nurse establish goals and make the attainment of the goals a condition of employment.
,Answer:
Make sure not to intimidate the employee during questioning.
To make coaching a productive activity, it is crucial that the manager not intimidate the nurse. Coaching is
usually performed one-on-one, not in a group setting. In most cases, the nurse is not obliged or expected to
describe these private and personal communications to the other nurses. Coaching should not usually
become a precursor to binding expectations for performance.
Question:
9. What is the most fiscally responsible method for determining staffing needs for a hospital unit?
An agreed-upon staffing formula based on client acuity
The number of patients present for an upcoming shift
Maximum patient load capacity of the unit
Total beds in the unit
Answer:
An agreed-upon staffing formula based on client acuity
A staffing formula is the best way to determine staffing needs, provided it is based on an accurate patient
classification system (PCS). A robust formula considers the other variables listed, none of which can be
used in isolation to determine staffing needs accurately.
Question:
10. What is a leadership role associated with staffing and scheduling?
Uses patient classification tools to minimize understaffing
Periodically examines the unit standard of productivity to determine if changes are needed.
Role models the use of evidence in making appropriate staffing and scheduling decisions.
Evaluates scheduling and staffing procedures and policies regularly
Answer:
Role models the use of evidence in making appropriate staffing and scheduling decisions.
Role modeling is classified as a leadership responsibility. The other options are recognized management
responsibilities associated with staffing and scheduling.
Question:
11. When do nursing shortages historically occur?
When the economy is in recession
When the economy is on an upswing
When nursing salaries decline
When client acuity increases
Answer:
When the economy is on an upswing
Historically, nursing shortages occur when the economy is on the upswing and decline when the economy
recedes. Historically, salaries were not a causative factor in existing nursing shortages. Client acuity is not
identified as a factor directly contributing to nursing shortages.
Question:
12. Which statement best describes the manager's main role in socializing a new nurse?
Ensuring that there are sufficient numbers of good role models
Providing the employee with organizational rules and regulations
Providing the new employee with a good preceptor
Sharing organizational values, expected attitudes, and behaviors
, Answer:
Sharing organizational values, expected attitudes, and behaviors
New group members must be socialized into the group, and the manager should lead and model these
socialization efforts.
Question:
13. The nurse-manager needs to determine the effectiveness of a staff workshop on establishing IV access.
What is the manager's best method for determining this?
Giving participants an examination or test after the course
Having class participants evaluate the instructor and the class
Having a documented decrease in the unit's IV site infections
Observing staff perform and document the practice
Answer:
Observing staff perform and document the practice
Instructor evaluation supports effective teaching, but not learning new skills. Testing someone at the end of
educational training does not confirm that the learning changed behavior, which is the primary goal of staff
development. There needs to be some method of follow-up to observe whether a behavior change
occurred, showing that the education was adequate. Observation of the staff will fulfill
Question:
14. A hospital unit has an exceptionally high census for several weeks, and mandatory overtime is
routinely required. What is the priority consequence of this practice?
Temporary cost savings
Ethics violations
Increased continuity of care Decreased client safety
Answer:
Decreased client safety
Frequent use of overtime creates a safety risk because exhausted nurses are much more likely to commit
errors. This practice is costly but does not significantly affect the continuity of care. Ethics violations can
occur in any staffing situation and are not necessarily more common when overtime is used.
Question:
15. A busy medical unit has been increasing the use of agency nurses. The nurse-manager should
anticipate the consequences of this staffing alternative.
Increased reliance on unlicensed assistive personnel by nurses
Short-term cost savings
Decreased continuity of nursing care
A need for 8-hour rather than 12-hour shifts
Answer:
Decreased continuity of nursing care
The use of agency nurses can increase costs and decrease continuity of care. There is no apparent need to
change the length of shifts, or for Nurses to become more reliant on UAPs with agency nurses.
