EXAM 2 LEADERSHIP RN400 UPDATED QUESTIONS AND
CORRECT ANSWERS
Question:
1. A charge nurse teaches a class about delegation prin-ciples to a group of staff nurses. Which of the
follow-ing information should the nurse include in the teach-ing?
"An assistive personnel member can delegate tasks to another AP." "An RN should delegate a task
they do not have the skill to perform." "A delegator can delegate simple tasks to a client's family
member." "A delegator should dele-gate tasks that have pre-dictable outcomes."
Answer:
"A delegator should delegate tasks that have predictable out-comes."
Question:
2. A charge nurse is assign-ing client care for the on-coming shift. Which of the following tasks
should the nurse assign to an RN?
Changing an appliance for a client who has an estab-lished ostomy Providing postmortem care for a
client Calling a client to evaluate their condition 24 hr. follow-ing discharge Administering an oral
med-ication to a client who has type 2 diabetes mellitus
Answer:
Calling a client to evaluate their condition 24 hr. following dis-charge
Question:
3. A charge nurse is delegat-ing client care for the on-coming shift. Which tasks should the nurse
delegate to assistive personnel (AP)?
Obtaining a wound culture from a client who has a stage 2 pressure injury Collecting vital signs from
a client who is on contact pre-cautions Teaching a client who is pre-operative about how to per-form
leg exercises Assisting a client in choos-ing 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 fol-lowing actions
should the nurse plan to take first?
Assign a task to the nurse.
Determine client care re-quirements.
Clarify instructions with the nurse.
Evaluate client outcomes.
Answer:
Determine client care requirements.
Question:
5. A charge nurse is assigning client care for the oncom-ing nursing shift. Which tasks should the
nurse as-sign to a licensed practical nurse (LPN)?
Initiating a blood transfu-sion 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 feed-ing
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 pro-viding 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 mem-ber 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 pa-tients Providing total patient
care to the most acutely ill pa-tients 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 mem-bers. 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 follow-ing 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 em-ployee new to the orga-nization. When
coaching this employee, the manag-er should:
Encourage the nurse to share their plans with the other nurses in the organi-zation.
Conduct the coaching in a group of no more than six to eight nurses.
Make sure not to intimidate the employee during ques-tioning.
Help the nurse establish goals and make the attain-ment of the goals a condi-tion of employment.
Answer:
Make sure not to intimidate the employee during questioning. To make coaching a productive
activity, it is crucial that the man-ager 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 fiscal-ly 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 ca-pacity 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 as-sociated with staffing and scheduling?
Uses patient classification tools to minimize under-staffing Periodically examines the unit standard of
productiv-ity to determine if changes are needed.
Role models the use of ev-idence in making appropri-ate 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 re-cession When the economy is on an upswing When nursing salaries
de-cline When client acuity increas-es
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 de-scribes the manager's main role in socializing a new nurse?
Ensuring that there are suf-ficient numbers of good role models Providing the employee with
organizational rules and regulations Providing the new employ-ee with a good preceptor Sharing
organizational val-ues, 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 effec-tiveness of a staff work-shop on establishing IV
ac-cess. What is the manager's best method for determin-ing this?
Giving participants an ex-amination or test after the course Having class participants evaluate the
instructor and the class Having a documented de-crease 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 oc-curred, showing that the
education was adequate. Observation of the staff will fulfill
, Question:
14. A hospital unit has an ex-ceptionally high census for several weeks, and manda-tory overtime is
routinely required. What is the priori-ty consequence of this prac-tice?
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
an-ticipate the consequences of this staffing alternative. Increased reliance on unli-censed 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
conti-nuity 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.
Question:
16. A nurse-manager team has finished interviewing qual-ified candidates for a po-sition and has
begun the selection process. During this process, the managers should:
Schedule times for induc-tion and orientation.
Carefully verifying the cho-sen applicant's references and credentials.
Review the results of the ap-plicants' physical examina-tions.
Reflect on the overall effi-ciency of the hiring process.
Answer:
Carefully verifying the chosen applicant's references and creden-tials. Positions should never be
offered until information on the applica-tion has been verified and references have been checked.
Physical examinations should be performed after a position has been pro-vided to a particular
applicant. It would generally be impractical to schedule induction and orientation until an applicant
has been offered the position. Evaluation is usually focused on the end of the hiring process.
Question:
17. An experienced nurse is ap-plying for a clinical nurse leader (CNL) position. In ad-dition to the
nurse's clini-cal experience, what char-acteristic best qualifies the nurse for this position?
The nurse currently sits on the hospital's ethics board.
Specialty certification in a specific area of practice.
The nurse has a master of Science degree in nursing.
The nurse has consistently adhered to the standards of practice.
Answer:
The nurse has a master of Science degree in nursing. The CNL, as an advanced generalist with a
master's degree in nursing, is expected to provide clinical leadership at the point of care. CNLs have
advanced knowledge and education in general practice instead of specialization in one primary
discipline, like clinical nurse specialists. Adherence to standards of practice is a minimum
requirement for nursing practice, not a specific qualifier for a CNL role. Similarly, sitting on an ethics
board is a valuable aspect of experience but not a particular qualifier for a CNL role.
CORRECT ANSWERS
Question:
1. A charge nurse teaches a class about delegation prin-ciples to a group of staff nurses. Which of the
follow-ing information should the nurse include in the teach-ing?
"An assistive personnel member can delegate tasks to another AP." "An RN should delegate a task
they do not have the skill to perform." "A delegator can delegate simple tasks to a client's family
member." "A delegator should dele-gate tasks that have pre-dictable outcomes."
Answer:
"A delegator should delegate tasks that have predictable out-comes."
Question:
2. A charge nurse is assign-ing client care for the on-coming shift. Which of the following tasks
should the nurse assign to an RN?
Changing an appliance for a client who has an estab-lished ostomy Providing postmortem care for a
client Calling a client to evaluate their condition 24 hr. follow-ing discharge Administering an oral
med-ication to a client who has type 2 diabetes mellitus
Answer:
Calling a client to evaluate their condition 24 hr. following dis-charge
Question:
3. A charge nurse is delegat-ing client care for the on-coming shift. Which tasks should the nurse
delegate to assistive personnel (AP)?
Obtaining a wound culture from a client who has a stage 2 pressure injury Collecting vital signs from
a client who is on contact pre-cautions Teaching a client who is pre-operative about how to per-form
leg exercises Assisting a client in choos-ing 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 fol-lowing actions
should the nurse plan to take first?
Assign a task to the nurse.
Determine client care re-quirements.
Clarify instructions with the nurse.
Evaluate client outcomes.
Answer:
Determine client care requirements.
Question:
5. A charge nurse is assigning client care for the oncom-ing nursing shift. Which tasks should the
nurse as-sign to a licensed practical nurse (LPN)?
Initiating a blood transfu-sion 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 feed-ing
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 pro-viding 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 mem-ber 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 pa-tients Providing total patient
care to the most acutely ill pa-tients 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 mem-bers. 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 follow-ing 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 em-ployee new to the orga-nization. When
coaching this employee, the manag-er should:
Encourage the nurse to share their plans with the other nurses in the organi-zation.
Conduct the coaching in a group of no more than six to eight nurses.
Make sure not to intimidate the employee during ques-tioning.
Help the nurse establish goals and make the attain-ment of the goals a condi-tion of employment.
Answer:
Make sure not to intimidate the employee during questioning. To make coaching a productive
activity, it is crucial that the man-ager 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 fiscal-ly 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 ca-pacity 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 as-sociated with staffing and scheduling?
Uses patient classification tools to minimize under-staffing Periodically examines the unit standard of
productiv-ity to determine if changes are needed.
Role models the use of ev-idence in making appropri-ate 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 re-cession When the economy is on an upswing When nursing salaries
de-cline When client acuity increas-es
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 de-scribes the manager's main role in socializing a new nurse?
Ensuring that there are suf-ficient numbers of good role models Providing the employee with
organizational rules and regulations Providing the new employ-ee with a good preceptor Sharing
organizational val-ues, 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 effec-tiveness of a staff work-shop on establishing IV
ac-cess. What is the manager's best method for determin-ing this?
Giving participants an ex-amination or test after the course Having class participants evaluate the
instructor and the class Having a documented de-crease 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 oc-curred, showing that the
education was adequate. Observation of the staff will fulfill
, Question:
14. A hospital unit has an ex-ceptionally high census for several weeks, and manda-tory overtime is
routinely required. What is the priori-ty consequence of this prac-tice?
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
an-ticipate the consequences of this staffing alternative. Increased reliance on unli-censed 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
conti-nuity 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.
Question:
16. A nurse-manager team has finished interviewing qual-ified candidates for a po-sition and has
begun the selection process. During this process, the managers should:
Schedule times for induc-tion and orientation.
Carefully verifying the cho-sen applicant's references and credentials.
Review the results of the ap-plicants' physical examina-tions.
Reflect on the overall effi-ciency of the hiring process.
Answer:
Carefully verifying the chosen applicant's references and creden-tials. Positions should never be
offered until information on the applica-tion has been verified and references have been checked.
Physical examinations should be performed after a position has been pro-vided to a particular
applicant. It would generally be impractical to schedule induction and orientation until an applicant
has been offered the position. Evaluation is usually focused on the end of the hiring process.
Question:
17. An experienced nurse is ap-plying for a clinical nurse leader (CNL) position. In ad-dition to the
nurse's clini-cal experience, what char-acteristic best qualifies the nurse for this position?
The nurse currently sits on the hospital's ethics board.
Specialty certification in a specific area of practice.
The nurse has a master of Science degree in nursing.
The nurse has consistently adhered to the standards of practice.
Answer:
The nurse has a master of Science degree in nursing. The CNL, as an advanced generalist with a
master's degree in nursing, is expected to provide clinical leadership at the point of care. CNLs have
advanced knowledge and education in general practice instead of specialization in one primary
discipline, like clinical nurse specialists. Adherence to standards of practice is a minimum
requirement for nursing practice, not a specific qualifier for a CNL role. Similarly, sitting on an ethics
board is a valuable aspect of experience but not a particular qualifier for a CNL role.
