HESI Exit Exam - Leadership & Management Questions and Answers Graded A

HESI Exit Exam - Leadership & Management Questions and Answers Graded A By what authority may RNs delegate nursing care to others? State Nurse Practice Act A UAP may perform care that falls within which component of the nursing process? Implementation Which type of communication is necessary to implement a democratic leadership style? Assertive communication skills What are the five rights of delegation? A. Right task B. Right circumstance C. Right person D. Right direction or communication E. Right supervision Which of the following tasks can be delegated to a UAP? A) Inserting a Foley catheter B) Measuring and recording the client's output through a Foley C) Teaching a client how to care for a catheter after discharge D) Assessing the symptoms of a urinary tract infection A) Is a sterile invasive procedure and should not be delegated to a UAP *B) Falls within the implementation phase of the nursing process and does not require nursing judgment. Evaluation of the I&O must be done by the nurse C) Client teaching requires the abilities of a nurse and should not be delegated. The USP may be instructed to report anything unusual that is observed and any symptoms reported by the client, but this does not replace assessment by the nurse D) Assessment must be performed by the nurse and should not be delegated. The UAP may be instructed to report anything unusual that is observed or any symptoms reported by the client, but this does not replace assessment by the nurse. What are the essential steps of effective supervision? Direction, evaluation, and follow-up Which of the following is an example of assertive communication? A) "You need to improve the way you spend your time so that all of your care gets performed." B) "I've noticed that many of your clients did not get their care today." A) This is an aggressive communication, which causes anger, hostility, and defensive attitude. B) Assertive communication begins with "I" rather than "You" and clearly states the problem. What are common signs of substance (nurse substance abuse)? Common signs of substance (nurse substance abuse) are clients complaining that pain medication foes not relieve pain when administered by a certain nurse, frequent inaccuracies of controlled medication counts for a specific nurse, and client reports not taking pain medication but several doses are signed out for that client. Describe common characteristics of incivility/bullying among nurses. Common characteristics of incivility/bullying are refusing to work with others, yelling or cursing at peers, making degrading comments, and verbal abuse. Workplace violence contributes to high staff turnover rate and decline in client care. HESI Hint #1 Motivation comes from within an individual. A nurse leader can provide an environment that will promote motivation through positive feedback, respect, and seeking input. Look for responses that demonstrate these behaviors. HESI Hint #2 NCLEX-RN questions often include examples of nursing intervention that do or do not demonstrate the skills and characteristics of the nurse manager - act as a liaison between clients and others - engage in conflict resolution as needed with staff - plan overall strategies to address client problems - review management outcomes - identify roles/responsibilities of health care team members - supervise care provided by others - serve as resource person to other staff HESI Hint #3 Assertive communication starts with "I need" rather than with "You must" HESI Hint #4 Delegating to the right person requires that the nurse be aware of the qualifications of the delegatee: appropriate education, training, skills, experience, and demonstrated and documented competence HESI Hint #5 Remember the nursing process: Assessments, analysis, diagnosis, planning, and evaluation (any activity requiring nursing judgment) may not be delegated to a UAP. Delegated activities fall within the implementation phase of the nursing process HESI Hint #6 UAP generally do not perform invasive or sterile procedures HESI Hint #7 RNs should give clear instructions--be specific, communicating the objectives of the delegated task and the expected results. Remember that even though a task may be delegated under law and facility policy, you, the nurse, are responsible for its outcome HESI Hint #8 The RN is accountable for adhering to the 3 basic aspects of supervision (direction/guidance, evaluation/monitoring, follow-up) when delegating to other health care personnel, such as LPNs, graduate nurses unexperienced nurses, student nurses, and UAP HESI Hint #9 Priorities often center on which client the nurse should assess first. Ask yourself the following questions: Which client is the most critically ill and unstable? Which client is most likely to experience a significant change in condition? Which client requires assessment by an RN? HESI Hint #10 The nurse manager must analyze all the desired outcomes involved when assigning rooms for clients or assigning client care responsibilities. For example, a client with an infection should not be assigned to share a room with a surgical or immunocompromised client. A nurse's client care management should be based on the nurse's abilities, the individual client's needs, and the needs of the entire group of assigned clients. Safety and infection control are high priorities HESI Hint #11 Change causes anxiety. An effective nurse change agent uses problem-solving skills to recognize factors such as anxiety that contribute to resistance to change and uses decision making and interpersonal skills to overcome that resistance. Intervention that demonstrate these skills include seeking input, showing respect, valuing opinions, and building trust. HESI Hint #12 The Interprofessional Education Collaborative Expert Panel (PEC) recommended development of four core competencies for interprofessional collaborative practice. Those competency domains among health care professionals include: 1) values/ethics for interprofessional practice; 2) roles/responsibilities; 3) interprofessional communication; and 4) teams and teamwork