NCLEX Leadership and Management Test Bank

NCLEX Leadership and Management Test Bank Autocratic Leadership Centralized decision-making style with the leader making decisions and using power to command and control others Bureaucratic Organization Hierarchy with clear superior-subordinate communication and relationships, based on positional authority, in which orders from the top are transmitted down through the organization via a clear chain of command Consideration Activities that focus on the employee and emphasize relating and getting along with people Contingency Theory Style that acknowledges that other factors in the environment influence outcomes as much as leadership style and that leader effectiveness is contingent upon or depends upon something other than the leader's behavior Democratic Leadership Style in which participation is encouraged and authority is delegated to others Emotional Intelligence Component of leadership and refers to the capacity for recognizing your own feelings and those of others, for motivating yourself, and for managing emotions well in yourself and in your relationships. Employee-Centered Leadership Style with a focus on the human needs of subordinates Formal Leadership When a person is in a position of authority or in a sanctioned role within an organization that connotes influence Hawthorne effect Term coined to reflect the findings of a research study that demonstrated that change in employee behavior occurs as a result of being observed informal leader Individual who demonstrates leadership outside the scope of a formal leadership role or as a member of a group rather than as the head or leader of the group initiating structure style that involves an emphasis on the work to be done a focus on the task and production job-centered leaders Style that focuses on schedules, cost, and efficiency with less attention to developing work groups and high-performance groups knowledge workers health care professionals who are well educated and technologically savvy and see themselves as owning their intellectual capital laissez-faire leadership Passive and permissive style in which the leader defers decision making leader-member relations Feelings and attitudes of followers regarding acceptance, trust, and credibility of the leader leadership Process of influence whereby the leader influences other toward goal achievement maintenance or hygiene factors Elements such as salary, job security, working conditions, status, quality of supervision, and relationships with others that prevent job dissatisfaction management Process of coordinating actions and allocating resources to achieve organizational goals management process Function of planning, organizing, coordinating, and controlling motivation Whatever influences our choices and creates direction, intensity, and persistence in our behavior motivation factors Elements such as achievement, recognition, responsibility, advancement, and the opportunity for development that contribute to job satisfaction position power Degree of formal authority and influence associated with the leaders substitutes for leadership Variable that may influence or have an effect on followers to the same extent as the leader's behavior task structure Involves the degree that work is defined, with specific procedures, explicit directions and goals taxonomy System that orders principles into a grouping or classification Theory X View that in bureaucratic organizations, employees prefer security, direction, and minimal responsibility; coercion, threats, or punishment are necessary because people do not like the work to be done Theory Y View that in the context of the right conditions, people enjoy their work, they can show self-control and discipline, are able to contribute creatively and are motivated by ties to the group, the organization, and the work itself; belief that people are intrinsically motivated by their work Theory Z View of collective decision making and a focus on long term employment that involves less direct supervision transactional leader traditional manager concerned with day-to-day operations transformational leader Leader who is committed to a vision that empowers others Hawthorne effect phenomena of how being observed or studied results in a change in behavior NEGLIGENT ACTS *Medication errors that result in injury to the client *IV administration errors: incorrect flow rates; failure to monitor a flow rate that results in injury *Falls that occur as a result of failure to provide safety *Failure to check equipment for proper functioning *Burns sustains as a result of failure to monitor bath temperature or equipment *Failure to monitor client's condition *Failure to report changes in client's condition to HCP *Failure to provide complete end of shift report NEGLIGENCE *Conduct that falls below the standard of care *Can include acts of commission and omission *A nurse who does not meet standards of care can be held liable MALPRACTICE *Negligence on the part of a nurse *Determined if the nurse owed a duty to the client & did not carry out the duty and the client was injured PROOF OF LIABILITY *DUTY: At the time of injury, a duty existed between the plaintiff & the defendant *BREACH OF DUTY: The defendant breached duty of care *PROXIMATE CAUSE: The breach of duty was the legal cause of injury to the client *DAMAGE/INJURY: The plaintiff experienced injury or damages or both & can be compensated by law LEGAL RISK AREAS **Assault When a person puts another person in fear of a harmful or offensive contact *The victim fears & believes that harm will result because of the threat LEGAL RISK AREAS **Battery Intentional touching of another without consent LEGAL RISK AREAS **Invasion of Privacy Violating confidentiality *Intruding on private client/family matters *Sharing client information with unauthorized persons LEGAL RISK AREAS **False Imprisonment *When a client is not allowed to leave a health care facility when there is no legal justification to detain *When restraining devices are used without an appropriate clinical need (includes meds) LEGAL RISK AREAS **Defamation False communication that causes damage to someone's reputation *In writing: libel *Verbal: slander LEGAL RISK AREAS **Fraud Deliberate deception to produce unlawful gains INCIDENT REPORTS *Used as a means of identifying risk situations & improving care *Follow specific documentation guidelines *Fill out report completely, accurately & factually *Report form should not be copied or placed in client's record *Make no reference to the incident report form in the client's record *The report is not a substitute for a complete entry in the client's record regarding the incident (record the incident and actions taken but not the report itself) *If a client injury or error in care occurred, assess the client frequently INCIDENTS THAT NEED TO BE REPORTED *Accidental omission of prescribed therapies *Circumstances that lead to injury or a risk for client injury *Client falls *Needle stick injuries *Medication administration errors *Procedure related/equipment related accidents *A visitor injury that occurred in the facility *A visitor who exhibits symptoms of a communicable disease TELEPHONE PRESCRIPTIONS *Date & time the entry *Repeat the prescription to the HCP & record *Sign the prescription: begin with "t.o. (telephone order), write the HCP's name & sign *If another nurse witnessed the prescription, that nurses' name follows *The HCP needs to countersign the prescription within a time frame according to agency policy COMPONENTS OF A MEDICATION PRESCRIPTION *Date & time written *Medication name *Medication dosage *Route of administration *Frequency of administration *HCP's signature REPORTING RESPONSIBILITIES *Certain communicable diseases *Child/elder abuse *Domestic violence *Dog/other animal bite *Gunshot *Stab wounds *Assaults *Homicides *Suicides **Impaired nurse (report to administration) PATIENT'S BILL OF RIGHTS *Right to considerate & respectful care *Right to be informed about diagnosis, possible treatments, likely outcome, and discussion with HCP *Right to know the names & roles of persons involved in care *Right to consent or refuse a treatment *Right to have an advance directive *Right to privacy *Right to expect that medical records are confidential *Right to review medical record & to have it explained *Right to expect that the hospital will provide necessary health services *Right to know if the hospital has relationships with outside parties that may influence care *Right to consent or refuse to take part in research *Right to be told of realistic care alternatives when hospital care is no longer appropriate *Right to know about hospital rules that affect treatment and charges & payment options MENTALLY OR EMOTIONALLY INCOMPETENT CLIENTS **Unable to sign informed consent *Declared incompetent *Unconscious *Under the influence of chemical agents (alcohol or drugs..even legal ones) *Chronic dementia or other mental deficiency that impairs thought processes and ability to make decisions VIOLATIONS OF PRIVACY *Taking photographs of the client *Release of medical information to unauthorized person *Use of client's name/picture for health care facility's advantage *Intrusion into client's affairs *Publication of information or embarrassing facts about client *Public disclosure of private information *Leaving the curtains/room door open while providing care *Allowing individuals to observe care without consent *Interviewing a client in a room with only a curtain between clients or where conversation can be overheard *Accessing medical records when unauthorized to do so COMPUTERIZED MEDICAL RECORDS **Protecting client's information *Employees should have access only to records in the nursing unit or work area *Use of special computer access codes to limit what employees have access to *Use of password/identification code is needed to enter and sign off computer system *Password/identification code should never be shared with another person *Passwords should be changed periodically to prevent unauthorized computer access Remove all tubes and equipment (unless organ donation is to take place), clean the body, and position appropriately. A client who had a "Do Not Resuscitate" order passed away. After verifying there is no pulse or respirations, the nurse should next: False True or False - The nurse practice acts are an example of civil law. Collecting all available information about the situation The nurse is working with parents of a seriously ill newborn. Surgery has been proposed for the infant, but the chances of success are unclear. In helping the parents resolve this ethical conflict, the nurse knows that the first step is The sequencing of stages of grief may occur in order, they may be skipped, or they may reoccur When helping a person through grief work, the nurse knows Relationships The philosophy sometimes called the code of ethics of care suggests that ethical dilemmas can best be solved by attention to Civil The client's right to refuse treatment is an example of _________ laws. True True or False - The dominant value in American society of individual autonomy and self-determination may be in direct conflict with diverse groups. Current health standards should determine the acceptability of cultural practices. When providing care to clients with varied cultural backgrounds, it is imperative for the nurse to recognize that: Bio-cultural needs Which factor is least significant during assessment when gathering information about cultural practices? Assess the client's point of view and prepare to articulate this point of view. Nurses agree to be advocates for their patients. Practice of advocacy calls for the nurse to: The choices involved do not appear to be clearly right or wrong. A health care issue often becomes an ethical dilemma because American Nurses Association's (ANA's) Code of Ethics Ethical principles for professional nursing practice in a clinical setting are guided by the principles of conduct that are written as the: American Nursing Association The code of ethics for nurses is composed and published by 4. Defines the principles of right and wrong to provide patient care. You are participating in a clinical care coordination conference for a patient with terminal cancer. You talk with your colleagues about using the nursing code of ethics for professional registered nurses to guide care decisions. A nonnursing colleague asks about this code. Which of the following statements best describes this code? 1. Improves self-health care 2. Protects the patient's confidentiality 3. Ensures identical care to all patients 4. Defines the principles of right and wrong to provide patient care. 3. Assessment An 18-year-old woman is in the emergency department with fever and cough. The nurse obtains her vital signs, auscultates her lung sounds, listens to her heart sounds, determines her level of comfort, and collects blood and sputum samples for analysis. Which standard of practice is performed? 1. Diagnosis 2. Evaluation 3. Assessment 4. Implementation 4. Implementation A patient in the emergency department has developed wheezing and shortness of breath. The nurse gives the ordered medicated nebulizer treatment now and in 4 hours. Which standard of practice performed? 1. Planning 2. Evaluation 3. Assessment 4. Implementation 2. Advocate A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with the family. The nurse is acting as the patient's: 1. Educator 2. Advocate 3. Caregiver 4. Case manager 3. A problem-solving approach that integrates best current evidence with clinical practice Evidence-based practice is defined as: 1. Nursing care based on tradition 2. Scholarly inquiry of nursing and biomedical research literature 3. A problem-solving approach that integrates best current evidence with clinical practice 4. Quality nursing provided in an efficient and economically sound manager 4. Provides a minimal standard of knowledge for a registered nurse in practice The examination for registered nurse licensure is exactly the same in every state in the United States. The examination: 1. Guarantees safe nursing care for all patients 2. Ensures standard nursing care for all patients 3. Ensures that honest and ethical care is provided 4. Provides a minimal standard of knowledge for a registered nurse in practice 1. Caregiver 2. Autonomy and accountability 3. Patient advocate 4. Health promotion Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples? (Select all that apply.) 1. Caregiver 2. Autonomy and accountability 3. Patient advocate 4. Health promotion 5. Lobbyist 1. Function independently Advanced practice registered nurses generally: 1. Function independently 2. Function as unit directors 3. Work in acute care settings 4. Work in the university setting. 1. Moving from an acute illness to a health promotion, illness prevention model Health care reform will bring changes in the emphasis of care. Which of following models is expecting from health care reform? 1. Moving from an acute illness to a health promotion, illness prevention model 2. Moving from illness prevention to a health promotion model 3. Moving from an acute illness to a disease management model 4, Moving from a chronic care to an illness prevention model 2. Nurse practitioner 3. Certified clinical nurse specialist Which of the following nursing roles may have prescriptive authority in their practice? (Select all that apply.) 1. Critical care nurse 2. Nurse practitioner 3. Certified clinical nurse specialist 4. Charge nurse 4. Informatics A critical care nurse is using a computerized decision support system to correctly position her ventilated patients to reduce pneumonia cause by accumulated respiratory secretions. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? 1. Patient-centered care 2. Safety 3. Teamwork and collaboration 4. Informatics 2. Safety A nurse is caring for an older-adult couple in a community-based assisted living facility. During the family assessment he notes that the couple has many expired medications and multiple medications for their respective chronic illnesses. They note that they go to two different health care providers. The nurse begins to work with the couple to determine what they know about their medications and helps them decide on one care provider rather than two. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? 1. Patient-centered care 2. Safety 3. Teamwork 4. Informatics 4. nurse researcher The nurses on an acute care medical floor notice an increase in pressure ulcer formation in their patients. A nurse consultant decides to compare two types of treatment. The first the procedure currently used to assess for pressure ulcer risk. The second uses a new assessment instrument to identify at-risk patients. Given this information, the nurse consultant exemplifies which career? 1. clinical nurse specialist 2. nurse administer 3. nurse educator 4. nurse researcher 3. In-service education Nurses at a community hospital are in an education program to learn how to use a new pressure-relieving device for patients at risk for pressure ulcers. This is which type of education? 1. Continuing education 2. Graduate education 3. In-service education 4. Professional Registered Nurse Education 4. Problem solving. While assessing a patient, the nurse observes that the patient's intravenous (IV) line is not infusing at the ordered rate. The nurse assesses the patient for pain at the IV site, checks the flow regulator on the tubing, looks to see if the patient is lying on the tubing, checks the point of connection between the tubing and the IV catheter, and then checks the condition of the site where the intravenous catheter enters the patient's skin. After the nurse readjusts the flow rate, the infusion begins at the correct rate. This is an example of: 1. Inference. 2. Diagnostic reasoning. 3. Competency. 4. Problem solving. 1. Diagnostic reasoning. The nurse sits down to talk with a patient who lost her sister 2 weeks ago. The patient reports she is unable to sleep, feels very fatigued during the day, and is having trouble at work. The nurse asks her to clarify the type of trouble. The patient explains she can't concentrate or even solve simple problems. The nurse records the results of the assessment, describing the patient as having ineffective coping. This is an example of: 1. Diagnostic reasoning. 2. Competency. 3. Inference. 4. Problem solving. 3. Conducting reflective practice. A patient on a surgical unit develops sudden shortness of breath and a drop in blood pressure. The staff respond, but the patient dies 30 minutes later. The manager on the nursing unit calls the staff involved in the emergency response together. The staff discusses what occurred over the 30-minute time frame, the actions taken, and whether other steps should have been implemented. The nurses in this situation are: 1. Problem solving. 2. Showing humility. 3. Conducting reflective practice. 4. Exercising responsibility. 3. Analyticity 4. Self-Confidence A nurse has worked on an oncology unit for 3 years. One patient has become visibly weaker and states. "I feel funny." The nurse knows how patients often have behavior changes before developing sepsis when they have cancer. The nurse asks the patient questions to assess thinking skills and notices the patient shivering. The nurse goes to the phone, calls the physician, and begins the conversation by saying, "I believe that your patient is developing sepsis. I want to report symptoms I'm seeing." What examples of critical thinking concepts does the nurse show? (Select all that apply.) 1. Experience 2. Ethical 3. Analyticity 4. Self-Confidence 5. Risk taking 2. Think about past experience with patients who develop postoperative complications. 3. Decide which activities can be combined for patient B and C. A nurse who is working on a surgical unit is caring for four different patients. Patient A will be discharged home and is in need of instruction about wound care. Patients B and C have returned from the operating room within an hour of each other, and both require vital signs and monitoring of their intravenous (IV) lines. Patient D is resting following a visit by physical therapy. Which of the following activities by the nurse represent(s) use of clinical decision making for groups of patients? (Select all that apply.) 1. Consider how to involve patient A in deciding whether to involve the family caregiver in wound care instruction. 2. Think about past experience with patients who develop postoperative complications. 3. Decide which activities can be combined for patient B and C. 4. Carefully gather any assessment information and identify patient problems. 3. Consistent The surgical unit has initiated the use of a pain-rating scale to assess patients' pain severity during their postoperative recovery. The registered nurse (RN) looks at the pain flow sheet to see the pain scores recorded for a patient over the last 24 hours. Use of the pain scale is an example of which intellectual standard? 1. Deep 2. Relevant 3. Consistent 4. Significant 1. "I understand your reluctance, but the exercises are necessary for you to regain function in your shoulder. Let's go a bit more slowly and try to relax." During a home health visit the nurse prepares to instruct a patient in how to perform range-of-motion (ROM) exercises for an injured shoulder. The nurse verifies that the patient took an analgesic 30 minutes before arrival at the patient's home. After discussing the purpose for the exercises and demonstrating each one, the nurse has the patient perform them. After two attempts with only the second of three exercises, the patient stops and says, "This hurts too much. I don't see why I have to do this so many times." The nurse applies the critical thinking attitude of integrity in which of the following actions? 1. "I understand your reluctance, but the exercises are necessary for you to regain function in your shoulder. Let's go a bit more slowly and try to relax." 2. "I see that you're uncomfortable. I'll call your doctor to decide the next step." 3. "Show me exactly where your pain is and rate it for me on a scale of 0 to 10." 4. "Is anything else bothering you? Other than the pain, is there any other reason you might not want to do the exercises?" 2. Description of the efforts to restore the child's blood pressure, what was used, ad questions about the child's response 3. The meaning the experience had for the nurse with respect to her understanding of dealing with a patient's death 4. A description of what the nurse said to the mother, the mother's response, and how the nurse might approach the situation differently in the future The nurse cared for a 14-year old with renal failure who dies near the end of the work shift. The health care team tried for 45 minutes to resuscitate the child with no success. The family was devastated by the loss, and, when the nurse tried to talk with them, the mother said, "You can't make me feel better; you don't know what it's like to lose a child." Which of the following examples of journal entries might best help the nurse reflect and think about this critical experience? (Select all that apply.) 1. Data entry of time of day, who was present, and condition of the child 2. Description of the efforts to restore the child's blood pressure, what was used, ad questions about the child's response 3. The meaning the experience had for the nurse with respect to her understanding of dealing with a patient's death 4. A description of what the nurse said to the mother, the mother's response, and how the nurse might approach the situation differently in the future 3. Basic critical thinking A nurse has been working on a surgical unit for 3 weeks. A patient requires a Foley catheter to be inserted, so the nurse reads the procedural manual for the institution to review how to insert it. The level of critical thinking that the nurse is using is: 1. Commitment 2. Scientific method 3. Basic critical thinking 4. Complex critical thinking 2. Evaluation A patient had hip surgery 16 hours ago. During the previous shift the patient had 40 mL of drainage in the surgical drainage collection device for an 8 hour period. The nurse refers to the written plan of care, noting that the health care provider is to be notified when drainage in the device exceeds 100 mL for the day. On entering the room, the nurse looks at the device and carefully notes the amount of drainage currently in it. This is an example of: 1. Planning 2. Evaluation 3. Intervention 4. Diagnosis 3, 5, 2, 4, 1 A 67-year old patient will be discharged from the hospital in the morning. The health care provider has ordered three new medications for her. Place the following steps of the nursing process in the correct order: 1. The nurse returns to the patient's room and asks her to describe the medications she will be taking at home. 2. The nurse talks with the patient and family about who will be available if the patient has difficulty taking medicines and considers consulting with the health care provider about a home health visit. 3. The nurse asks the patient if she is in pain, feels tired, and is willing to spend the next few minutes learning about her medications. 4. The nurse brings the containers of medicines and information leaflets to the bedside and discusses each medication with her. 5. The nurse considers what she learns from the patient and identifies the patient's nursing diagnosis. 3. knowledge application The nurse asks a patient how she feels about her impending surgery for breast cancer. Before the discussion the nurse reviewed the description of loss and grief and therapeutic communication principles in his textbook. The critical thinking component involved in the nurse's review of the literature is: 1. experience 2. problem solving 3. knowledge application 4. clinical decision making 1. A nurse explain to the NAP the approach to use in getting the patient up and why the patient has activity limitations. 3. The nurse sees the NAP preparing to help a patient out of bed, goes to assist, and thanks the NAP for her efforts to get the patient up early. 4. The nurse is in Patient B's room to check an intravenous (IV) line and collects the urine specimen while in the room. A nurse is working with a nursing assistive personnel (NAP) on a bust oncology unit. The nurse has instructed the NAP on the tasks that need to be performed, including getting patient A out of bed, collecting a urine sample from patient B, and checking vital signs on patient C, who is scheduled to go home. Which of the following represent(s) successful delegation? (Select all that apply.) 1. A nurse explain to the NAP the approach to use in getting the patient up and why the patient has activity limitations. 2. A nurse is asked by a patient to help her to the bathroom; the nurse leaves the room and directs the NAP to assist the patient instead. 3. The nurse sees the NAP preparing to help a patient out of bed, goes to assist, and thanks the NAP for her efforts to get the patient up early. 4. The nurse is in Patient B's room to check an intravenous (IV) line and collects the urine specimen while in the room. 5. The nurse offers to support the NAP when needed but allows her to complete patient care tasks without constant oversight. 4. Anticipated when to make choices without others' assistance. Which of the following is unique to the commitment level of critical thinking? 1. Weighs benefits and risks when making a decision. 2. Analyzes and examine choices more independently. 3. Concrete thinking. 4. Anticipated when to make choices without others' assistance. 4. The nurse explains the procedure for giving a tube feeding to a second nurse who has floated to the unit to assist with care. In which of the following examples is the nurse not applying critical thinking skills in practice? 1. The nurse considers personnel experience in performing intravenous (IV) line insertion and ways to improve performance. 2. The nurse uses a fall risk inventory scale to determine a patient's fall risk. 3. The nurse observes a change in a patient's behavior and considers which problem is likely developing. 4. The nurse explains the procedure for giving a tube feeding to a second nurse who has floated to the unit to assist with care. 4. Feedback The nurse summarizes the conversation with the patient to determine if the patient has understood him or her. This is what element of the communication process? 1. Referent 2. Channel 3. Environment 4. Feedback 2. Coach her to give herself positive messages about her ability to do this Mrs. Jones states that she gets anxious when she thinks about giving herself insulin. How do you use your understanding of intrapersonal communication to help with this? 1. Provide her the opportunity to practice drawing up insulin 2. Coach her to give herself positive messages about her ability to do this 3. Bring her written material that clearly describes the steps of insulin administration 4. Use therapeutic communication to help her express her feeling about giving herself an injection 3. The patient is short of breath. The nurse has a patient who is short of breath and calls the health care provider using SBAR (situation-background-assessment-recommendation) to help with the communication. What does the nurse first address? 1. The respiratory rate is 28. 2. The patient has a history of lung cancer. 3. The patient is short of breath. 4. He or she requests an order for a breathing treatment. 4. Talk with him about his favorite hobbies You are caring for Mr. Smith, who is facing amputation of his leg. During the orientation phase of the relationship, what would you do? 1. Summarize what you have talked about in the previous sessions 2. Review his medical record and talk to other nurses about how he is reacting 3. Explore his feelings about losing his leg 4. Talk with him about his favorite hobbies 2. Clarifying The nurse states, "When you tell me that you're having a hard time living up to expectations, are you talking about your family's expectations?" The nurse is using which therapeutic communication technique? 1. Providing information 2. Clarifying 3. Focusing 4. Paraphrasing 2. "Why do you always put so much salt on your food?" Which of the following statements would be most likely to block communication? 1. "You look kind of tired today." 2. "Why do you always put so much salt on your food?" 3. "It sounds like this has been a hard time for you." 4. "If you use your oxygen when you walk, you may be able to walk farther." 3. Move to her bedside, get her attention, and repeat the question while facing her You are caring for an 80-year old woman, and you ask her a question while you are across the room washing your hands. She does not answer. What is your next action? 1. Leave the room quietly since she evidently does not want to be bothered right now 2. Repeat the question in a loud voice, speaking very slowly 3. Move to her bedside, get her attention, and repeat the question while facing her 4. Bring her a communication board so she can express her needs 2. "When you brush me off like that, it takes me even longer to do my job." You ask another nurse how to collect a laboratory specimen. The nurse raises her eyebrows and asks, "Why don't you figure it out?" what would be the best response? 1. Say nothing and walk away. Find a different nurse to help you. 2. "When you brush me off like that, it takes me even longer to do my job." 3. "Why do you always put me down like that?" 4. "I guess I just enjoy having you make fun of me." 3. 18 inches to 4 feet from the patient. When the nurse takes the patient's history, he or she sits: 1. Next to the patient. 2. 4 to 12 feet from the patient. 3. 18 inches to 4 feet from the patient. 4. 12 inches to 3 feet from the patient. 3. Shifting quickly from subject to subject. When working with an older adult, the nurse remembers to avoid: 1. Touching the patient. 2. Allowing the patient to reminisce. 3. Shifting quickly from subject to subject. 4. Asking the patient how he or she feels. 4. The professional nurse works with colleagues and the patient's family to provide combined expertise in planning care. The statement that best explains the role of collaboration with others for the patient's plan of care is which of the following? 1. The professional nurse consults the health care provider for direction in establishing goals for patients. 2. The professional nurse depends on the latest literature to complete an excellent plan of care for patients. 3. The professional nurse works independently to plan and deliver care and does not depend on other staff for assistance. 4. The professional nurse works with colleagues and the patient's family to provide combined expertise in planning care. 1. Answer the call light promptly. 4. Answer questions honesty. 5. Demonstrate competence when doing treatments. Identify behaviors that foster the development of trust. (Select all that apply.) 1. Answer the call light promptly. 2. Call the patient by first name unless requested otherwise. 3. Do all the care as quickly as possible and leave the room as the patient can rest. 4. Answer questions honesty. 5. Demonstrate competence when doing treatments. 3. Obtains an interpreter to facilitate communication of medication information A patient with limited English proficiency is going to be discharged on new medication. How does the nurse complete the discharge teaching? 1. Uses a dictionary to give directions for medication administration 2. Explains the directions to the patient's 14-year old daughter 3. Obtains an interpreter to facilitate communication of medication information 4. Uses a picture board and visual aids to communicate medication administration information 2. Pulling the curtain to provide privacy 3. Offering to discuss information about her condition 5. Sitting quietly by her bed and hold her hand Your patient has just been told that she has cancer, and she is crying. Which actions facilitate therapeutic communication? (Select all that apply.) 1. Turning on the television to her favorite show 2. Pulling the curtain to provide privacy 3. Offering to discuss information about her condition 4. Asking her why she is crying 5. Sitting quietly by her bed and hold her hand 3. Deflect your eyes downward to show respect Mr. Sakda emigrated from Thailand. When taking care of him, you note that he looks relaxed and smiles but seldom looks at you directly. How do you respond? 1. Use therapeutic communication to assess for increased anxiety 2. Sit down and position yourself closer so you are at eye level 3. Deflect your eyes downward to show respect 4. Continue to maintain eye contact 4. Psychomotor domain A patient needs to learn to use a walker. Which domain is required for learning this skill? 1. Affective domain 2. Cognitive domain 3. Attentional domain 4. Psychomotor domain 2. When the patient's pain medications are working 3. Just before lunch, when the patient is most awake and alert The nurse is planning to teach a patient about the importance of exercise. When is the best time for teaching to occur? (Select all that apply.) 1. When there are visitors in the room 2. When the patient's pain medications are working 3. Just before lunch, when the patient is most awake and alert 4. When the patient is talking about current stressors in his or her life 3. Provide only the information that the patient needs to go home A patient newly diagnosed with cervical cancer is going home. The patient is avoiding discussion of her illness and postoperative orders. What is the nurse's best plan in teaching this patient? 1. Teach the patient's spouse 2. Focus on knowledge the patient will need in a few weeks 3. Provide only the information that the patient needs to go home 4. Convince the patient that learning about her health is necessary 3. Develop topics for discussion that require problem solving The school nurse is about to teach a freshman-level high school health class about nutrition. What is the best instructional approach to ensure that the students meet the learning outcomes? 1. Provide information using a lecture 2. Use simple words to promote understanding 3. Develop topics for discussion that require problem solving 4. Complete an extensive literature search focusing on eating disorders 3. The patient will perform breast self-examination correctly on herself before the end of the teaching session. A nurse is going to teach a patient how to perform breast self-examination. Which behavioral objective does the nurse set to best measure the patient's ability to perform the examination? 1. The patient will verbalize the steps involved in breast self-examination within 1 week. 2. The nurse will explain the importance of performing breast self-examination once a month. 3. The patient will perform breast self-examination correctly on herself before the end of the teaching session. 4. The nurse will demonstrate breast self-examination on a breast model provided by American Cancer Society. 1. Telling approach A patient with chest pain is having an emergency cardiac catheterization. Which teaching approach does the nurse use in this situation?