Evolve HESI Leadership & Management Questions & Answers Correct 100%

Which actions of the nurse exhibit transactional leadership? Select all that apply. 1 Motivating or inspiring the employees 2 Meeting the targets within the deadline 3 Working according to organizational rules 4 Correcting the errors in a reactive manner 5 Increasing the employee commitment of an organization - Answer 2, 3, 4 The characteristics of transactional leadership include valuing the orders and structures of an organization. The nurse who exhibits transactional leadership will meet the targets within the deadline given by the organization. The nurse will also follow the rules of an organization and will correct the errors of an employee in a reactive manner. Motivating or inspiring the employees and increasing employee commitment are the characteristics of transformational leadership. The unit nurse manager comes to work obviously intoxicated. Which action is the staff nurse ethically obligated to take? 1 Call the security guard. 2 Tell the nurse manager to go home. 3 Have the supervisor validate the observation. 4 Offer the nurse manager a large cup of coffee - Answer 3 Have the supervisor validate the observation. The staff nurse should call the hospital supervisor to confirm and handle the problem. The security guard has no authority in this situation. Although sending the nurse manager home removes the nurse manager from the clinical setting, this action misses an opportunity for documenting the situation and the nurse manager is in no condition to drive safely. Drinking coffee does not make a person less intoxicated. Which aspects are considered when determining the willingness of a nursing assistant before delegating a task? Select all that apply. 1 Ability 2 Attitude 3 Personality 4 Confidence 5 Commitment - Answer 2, 4, 5 An individual's willingness is related to attitude, confidence, and commitment. Ability is related to knowledge and skills in a specific situation. Personality characteristics can influence the effectiveness of the delegator. Which performance appraisal method is used by nurse managers to measure the performance of the nurse both qualitatively and quantitatively? 1 Narrative method 2 Critical incidents method 3 Graphic rating scale form 4 Behaviorally anchored rating scales - Answer 4 The behaviorally anchored rating scale is a performance appraisal method that provides an overview of nursing standards by determining performance both qualitatively and quantitatively. The narrative method requires a manager to write a statement about the nurse's performance. The critical incidents type is a performance appraisal method in which a manager keeps a written record of positive and negative performance. The graphic rating scale form is a performance appraisal checklist on which a manager rates the nurse's performance on a continuum such as excellent, good, average, and poor. The healthcare team is caring for clients in an emergency department. How soon should the clients triaged as an emergency severity index-3 (ESI-3) be seen by the physician according to the five level triage system? 1 Immediately 2 Within 1 hour 3 Could be delayed 4 Within 10 minutes - Answer 2 Within 1 hour The clients triaged as an ESI-3 should be seen by the physician within an hour. The clients with life-threatening problems are triaged as ESI-1, and they should be provided with immediate care. The care of the clients in ESI-4 and ESI-5 can be delayed for some time because the condition of the clients in this level is stable. Clients with major injuries are triaged as an ESI-2 and require treatment within 10 minutes. Which question does the registered nurse recognize as related to the right of circumstance when delegating? 1 "Is the delegation appropriate to the situation?" 2 "Is the task within the delegatee's scope of practice?" 3 "Is the prospective delegate a willing and able employee?" 4 "Is the delegator able to monitor and evaluate the client appropriately?" - Answer 1 "Is the delegation appropriate to the situation?" The question, "Is the delegation appropriate to the situation?" is related to right circumstance. The question, "Is the task within the delegatee's scope of practice?" is related to right task. The question, "Is the prospective delegate a willing and able employee?" is related to right person. The question, "Is the delegator able to monitor and evaluate the client appropriately?" is related to right supervision. Which factors does the registered nurse consider in the decision to delegate process? Select all that apply. 1 Evaluation 2 Nursing judgment 3 Predictability of outcomes 4 Pervasive functions of assessment 5 Complexity of the task to be performed - Answer 3, 5 Two factors responsible for the decision to delegate process are predictability of outcomes and complexity of the task to be performed. Evaluation, nursing judgment, and pervasive functions are not factors in the decision to delegate process. Under a leader, a team of followers has failed to achieve success in conducting research. What does an effective leader do in this situation? 1 Criticizes the team members for failure 2 Provides excuses for the negative outcome 3 Refuses to take the responsibility for failure 4 Accepts failure and gains experience from it - Answer 4 Accepts failure and gains experience from it An effective leader should accept the failure and gain experience from it to avoid repetition of the same errors. The effective leader should counsel and motivate the team members for future success and should not criticize them. Making excuses for the negative outcome is not the correct action of the effective leader. The effective leader should take responsibility for the failure and the growth he or she will gain from it. The nursing manager wants to implement transformational leadership qualities. Which actions best describe this style of leadership? Select all that apply. 1 Providing intellectual stimulation 2 Intervening only when problems exist 3 Performing experiments with system redesign 4 Using motivator factors to inspire work performance 5 Monitoring performance and taking action to correct - Answer 1, 3, 4 Transformational leaders provide intellectual stimulation and encourage follower creativity. They experiment with systems redesign, empower staff, create enthusiasm for practice, and promote scholarship of practice in client care. They use motivator factors liberally to inspire work performance. Intervening only when problems exist is a behavior related to transactional leadership. Monitoring performance and taking corrective action is a transactional leadership quality. Which component of delegation is defined as the ability to perform duties in a specific role? 1 Authority 2 Supervision 3 Responsibility 4 Accountability - Answer 1 Authority is the ability to perform duties in a specific role. Supervision is the provision of guidance and oversight of a delegated task. Responsibility refers to reliability, dependability, and obligation to accomplish work. Accountability involves determining whether the actions are appropriate and providing a detailed explanation of what has occurred. The healthcare team is caring for a client with neutropenia. Which task is delegated to unlicensed assistive personnel? 1 Administering antibiotics 2 Assisting with personal hygiene 3 Monitoring for signs and symptoms of infection 4 Teaching the client and caregivers about how to avoid infection - Answer 2 Unlicensed assistive personnel assisting with the client's personal hygiene. The licensed practical nurse administers antibiotics. Monitoring for signs and symptoms is performed by the licensed practical nurse. The registered nurse teaches the client and caregivers how to avoid infection. A client's serum potassium level has increased to 5.8 mEq/L (5.8 mmol/L). What action should the nurse implement first? 1 Call the laboratory to repeat the test. 2 Take vital signs and notify the healthcare provider. 3 Inform the cardiac arrest team to place them on alert. 4 Take an electrocardiogram and have lidocaine available. - Answer 2 Vital signs monitor cardiorespiratory status; hyperkalemia causes cardiac dysrhythmias. The healthcare provider should be notified because medical intervention may be necessary. A repeat laboratory test will take time and probably reaffirm the original results; the client needs immediate attention. The cardiac arrest team is always on alert and will respond when called for a cardiac arrest. Taking an electrocardiogram and having lidocaine available are insufficient interventions. The nurse has accepted a position as a navigator. What should the nurse expect to learn during training for this role? Select all that apply. 1 Approaches to reduce the cost of health care 2 Learning ways to work through the health systems 3 Strategies to teach clients about disease, including prevention and treatment 4 Assessing barriers that clients have encountered while attempting to receive care 5 Helping clients cope with delays in receiving treatment until barriers are overcome - Answer 2, 3, 4, 5 Navigators are responsible for overcoming health system barriers, providing health education about diseases from prevention to treatment, addressing barriers to care, and providing psychosocial support. These are the areas the nurse should expect to focus on when being trained in the role. Learning approaches to reduce the cost of health care would be appropriate for a case manager to learn. What aspect of total client care needs to be taken into consideration if used on a 24-bed care area? 1 Cost of nurses 2 Training needs 3 Documentation 4 Time commitment - Answer 1 Cost of nurses Since total client care is provided by a registered nurse (RN) it can be very expensive and not realistic to use a highly skilled and extremely knowledgeable professional nurse to provide all the care required in a unit of 24 clients. There are no particular issues with training, documentation, or time commitment with total client care. For which situations would total client care be an appropriate delivery system? Select all that apply. 1 Client scheduled for lithotripsy for renal calculi 2 Client with an endotracheal tube for pulmonary sepsis 3 Client recovering from cardiovascular bypass graft surgery 4 Client recovering from the placement of a cerebrospinal fluid shunt 5 Client transferring to a rehabilitation unit after total hip replacement surgery - Answer 2, 3, 4 Total client care is used in critical care settings where one nurse provides total care to one or two critically ill clients. The client with an endotracheal tube for pulmonary sepsis and the client recovering from cardiovascular bypass graft surgery are considered acutely ill and will be receiving care in a critical care area. The client recovering from cranial surgery to place a cerebrospinal fluid shunt would be appropriate for total client care. Total client care would not be an ideal care approach for the client scheduled for lithotripsy or the client being transferred to a rehabilitation unit. Which intervention should the charge nurse perform to manage a task when the unlicensed nursing personal (UNP) is lacking competence? 1 Provide constructive feedback and assign another task. 2 Provide open vocal feedback and withdraw the UNP from task. 3 Provide additional support and temporarily lower expectations. 4 Provide accountability to the organization and undergo training again. - Answer 3 Provide additional support and temporarily lower expectations. The charge nurse should manage a task by temporarily lowering expectations and providing additional support to an unlicensed nursing personal (UNP) who is lacking competence. This strategy allows the UNP to build on strengths, minimize weaknesses, and gain confidence. Providing constructive feedback and assigning another task may not improve the strategy of the UNP and may affect the productivity of the new task. Withdrawing the UNP from the task and providing open vocal feedback may weaken the working relationship and the UNP may lose confidence or become frustrated. The charge nurse should be aware of accountability to the organization in case of a failure of the delegation, but assigning the UNP for further training may lead to high risk for legal liability. Which statement would most likely be made by a client who is receiving care through the functional method? 1 "My nurse's name is Amy." 2 "Susan will be caring for me until 7 pm." 3 "I have to wait until the medication nurse is available for a pain pill." 4 "Barbara coordinated all of my care but I might receive the care from other nurses." - Answer 3 "I have to wait until the medication nurse is available for a pain pill." In the functional method, staff are assigned tasks according to scope of practice. In this approach a medication nurse will be identified. Knowing the nurse's name would more likely be a characteristic of team or primary nursing. Knowing which nurse will provide care for a specific period of time would indicate the case approach to care. Knowing which nurse coordinated the care that might be provided by others would more likely indicate primary nursing or case management. Which constructive aspects of conflict does the nurse leader identify? Select all that apply. 1 Polarizes groups 2 Releases pent-up emotions 3 Promotes ineffective communication 4 Helps individuals grow personally 5 Builds cohesiveness among people - Answer 2, 4, 5 Conflict serves as a release for pent-up emotion, anxiety, and stress. It helps individuals to grow personally and apply what they learn to future situations. It helps to build cohesiveness among people sharing the conflict, celebrating in its settlement and learning more about each other. It polarizes groups so they increase internal cohesiveness and reduce intergroup cooperation; this is a destructive aspect of conflict. Authentic communication is an aspect of conflict but not improbable communication. When does delegation become more challenging? Select all that apply. 1 When the client is stable 2 When the client is pregnant 3 When the geographic area is small 4 When the resources are abundant 5 When school children are receiving care - Answer 2 When the client is pregnant, 5 When school children are receiving care The delegation process becomes more challenging when vulnerable populations such as pregnant women and school children are receiving care. Delegation can be safely and successfully carried out in the stable client. Delegation can be accomplished successfully when the geographical area is small and resources are abundant. A client reports severe pain 2 days after surgery. After assessing the characteristics of the pain, which initial action should the nurse take next? 1 Encourage rest. 2 Obtain vital signs. 3 Administer the prescribed analgesic. 4 Document the client's pain response. - Answer 2 Obtain vital signs. Immediately before administration of an analgesic, an assessment of vital signs is necessary to determine whether any contraindications to the medication exist (e.g., hypotension, respirations ≤12 breaths/min). Pain prevents both psychological and physiologic rest. Before administration of an analgesic, the nurse must check the healthcare provider's prescription, the time of the last administration, and the client's vital signs. A complete assessment, including vital signs, should be done before documenting the client's pain response. A nurse leader, along with the team, is caring for a client who is scheduled for colonoscopy. Which delegated task requires the leader's supervision? 1 Assisting the client with an enema 2 Assisting the client with bathing 3 Assisting the client with feeding 4 Assisting the client with ambulating - Answer 1 Assisting the client with an enema A client who is scheduled for colonoscopy requires having the gastrointestinal tract emptied, mainly the colon. Before undergoing this procedure the client is assisted with an enema and other laxatives to expel all bowel contents present in the gastrointestinal tract. A nurse leader should supervise this procedure, as an inadequately emptied colon may cause complications. Assisting the client with bathing, feeding, and ambulating are easy tasks and may not require supervision. Which comment by a team leader exemplifies team nursing the way it was intended? 1 "(Unlicensed assistive personnel), I need you to measure all vital signs." 2 "(Registered Nurse 1), check all of the intravenous (IV) sites and give the IV medications." 3 "(Licensed Practical Nurse), you pass all of the oral medications to the clients today." 4 "(Registered Nurse 2), Mr. Jones has a foot wound, two IV meds, and needs morning insulin." - Answer 2 "(Registered Nurse 1), check all of the intravenous (IV) sites and give the IV medications." The team leader must have excellent communication skills, delegation, and effective decision-making abilities to provide a working "team" environment for members. When the team leader is not prepared for this role, the team method becomes a miniature version of the functional method. The assignment given to RN 1 takes the nurse's experience and skills into consideration and exemplifies team nursing. The statements made to the UAP, LPN, and RN 2 exemplify functional nursing. The registered nurse finds that two nursing students are arguing with each other. Which action by the registered nurse best represents a leadership quality? 1 Complaining to management and asking the students to go outside 2 Letting them continue arguing until they resolve the matter themselves 3 Assessing the condition and strategizing to resolve the matter by reducing the difference 4 Asking the reason for their argument and reprimanding them for having the argument in the hospital - Answer 3 Visioning is required by an efficient leader to engage others to assess the current reality. This skill includes determining and specifying a desired end-point state and then strategizing to reduce the differences. Letting them continue arguing and waiting until they resolve the matter may allow the argument to escalate. Complaining to management would pass off responsibility for a resolution and would not indicate leadership. Reprimanding the nurses may stop the argument, but would not be a constructive approach. Which point should the nurse exclude when developing strategies to project a powerful image? 1 Using authoritative language 2 Maintaining good body posture 3 Making good eye contact with clients 4 Ensuring that clothing and hair are appropriate to the situation - Answer 1 Using authoritative language The nurse should treat people with courtesy and respect. The use of authoritative language does not help in developing a powerful image. The nurse should also maintain good body posture because it conveys self-confidence. Good eye contact helps in developing trust. Appropriate dress and hair help convey a powerful image. Which statement of the nurse leader reflects the actions suggested by the Joint Commission for disruptive behavior by a direct care nurse? 1 "This is the last warning for you." 2 "You are terminated, effective now." 3 "This will affect your assessment markings." 4 "You should not behave this way because you are very talented." - Answer 2 "You are terminated, effective now." According to the actions suggested by the Joint Commission, there is "zero" tolerance for an intimidating and/or disruptive behavior. The action to be taken for this type of behavior should be suspension, termination, loss of clinical privileges, and reporting to professional licensure bodies. The actions suggested by the Joint Commission do not include giving last a warning. The nurse who has behaved disruptively is not eligible for any assessment. By saying, "You should not behave this way because as you are very talented," the actions suggested by Joint Commission are not being carried out. According to the three-tiered triage system, which client requires urgent treatment? Select all that apply. 1 A client with renal colic 2 A client with strains and sprains 3 A client with respiratory distress 4 A client with severe abdominal pain 5 A client with multiple displaced fractures - Answer 1, 4, 5 According to the three-tiered triage system, renal colic, severe abdominal pain, and multiple displaced fractures require urgent treatment. Strains and sprains require nonurgent treatment and respiratory distress requires emergent treatment. The nurse finds the respiratory rate is 8 breaths per minute in a client who is on intravenous morphine sulfate. What should the nurse do immediately in this situation? 1 Measure other vital signs. 2 Stop administering the medication. 3 Elevate the head of the client's bed. 4 Report to the primary healthcare provider - Answer 2 Stop administering the medication. Morphine sulfate is an opioid analgesic and can depress the central nervous system, which results in respiratory depression. A respiratory rate of 8 breaths per minute indicates respiratory depression, and the nurse should stop the medication immediately. The nurse can measure the other vital signs after discontinuing the medication administration. Elevating the head of the client's bed ensures proper breathing. Therefore the nurse should elevate the client's bed after discontinuing the medication. The nurse should report to the primary healthcare provider for an appropriate antidote after stopping the medication administration. A client is admitted to the emergency department following a motor vehicle accident. The client's wounds are extensive. Which healthcare team member is best suited to care for this client in the emergency ward? 1 Charge nurse 2 Registered nurse 3 Licensed practical nurse 4 Unlicensed nursing personnel - Answer 2 Registered nurse A registered nurse should be the healthcare team member to care for the client in the emergency department. The charge nurse's role includes making client assignments, scheduling breaks for staff members, and serving as a staff resource person. The licensed practical nurse is involved in fast-track emergency care. Unlicensed nursing personnel perform all hygienic tasks and are not required in the emergency care unit. A registered nurse (RN) delegates the task of foot care for a client to an unlicensed nursing personnel (UNP). The UNP is skillful and willing to perform the given task, but was recently hired and is unfamiliar with the client's condition. What should the RN do in this situation? 1 Provide guidance to the UNP. 2 Observe and motivate the UNP. 3 Establish mutual expectations and conditions. 4 Explain what to do and how to perform the task. - Answer 3 Establish mutual expectations and conditions. If the delegatee is new to the workplace, but has the ability and willingness to perform a task, the RN should establish mutual expectations and conditions of performance to establish a good relationship. If the delegatee has limited knowledge and ability to perform a task, the delegator is expected to guide the UNP. The RN is expected to observe and monitor the task performed by the delegate to ensure the delegatee has the ability and willingness to establish a relationship and accomplish the work. The RN can also explain the task and how to execute it if the situation involves a new task and relationship is ongoing. Which characteristics of a licensed practical nurse should be considered before delegation of tasks? Select all that apply. 1 Critical thinking 2 Effective client care 3 Diagnostic reasoning 4 Synthesizing information 5 Accountability of assigned task - Answer 1, 3, 4 Critical thinking, diagnostic reasoning, and the ability to synthesize information from various sources are three factors that are characteristics of the licensed practical nurse that should be considered before delegating tasks. Planning effective client care is the role of a registered nurse. Accountability for an assigned task is the basic responsibility of a nurse. The registered nurse is caring for a client admitted to the hospital with chronic obstructive pulmonary disease. Which assessment by the registered nurse before delegating would help to determine the principle of "right person"? 1 "Is the environment conducive for completing the task safely?" 2 "Does the licensed practical nurse (LPN) know about polices of the institution?" 3 "Can the nursing assistive personnel (NAP) evaluate the client's' condition appropriately?" 4 "Does the nursing assistive personnel (NAP) have the knowledge and expertise to perform the task?" - Answer 4 "Does the nursing assistive personnel (NAP) have the knowledge and expertise to perform the task?"