NRSNG NUR2868 Role and Scope Exam 3 2020 1. A nurse tells a coworker that he is probably going to call in “sick” tomorrow. The coworker urges him not to do so, because absenteeism creates problems for everyone on the unit. To which problems is the coworker referring? SATA Inadequate staffing adversely affects patient care both directly and indirectly -Working with inadequate staffing or working overtime to cover for absent workers creates physical and mental stress and strain -Chronic absenteeism lead to increased staff conflicts, to decreased morale, and eventually to increased absenteeism among the entire staff.
2. A nurse and a physician are having a polite but animated disagreement about what plan of care should be suggested to the client. The family also gets into the conversation, giving their opinions. Which type of conflict is this situation? INTERprofessional
3. The nurse is teaching a newly diagnosed client about celiac disease and diet. The client has a master’s degree in astronomy. What does the nurse recognize as a key factor in the client’s motivation? the clients higher the education highly indicates motivation to attend to his diet
4. A nurse calls the health care provider with an update on a client whose blood pressure has gone from 130/80 to 116/56 in one hour. The client’s pulse is 56. The nurse says “I am not sure what is happening but the client seems to be deteriorating.” What part of SBAR is the nurse using? -assessment
5. A nurse is having personal problems at home and takes one alprazolam tablet from a client’s medication bin. After seeing how it worked, the nurse continued to divert medications from clients. The nurse-manager fires the nurse for the theft of the drugs but
does not report it to the State Board of Nursing. What might be the consequences of this action? a manager might be in violation of the law and allow the nurse to practice in a different facility
6. Professional nurses are constantly required to communicate patient information to other members of the nursing team. The SBAR is a system developed to help nurses and other medical professionals to communicate. What does SBAR stand for? situation, background, assessment, recommendation
7. A new nurse manager is assembling a team to work on a project. Which of the following are traits of an effective team? SATA any group of people that can easily be an effective team teams should be focused on accomplishing a specific task effective and respectful communication is essential to team success
8. Identify the purpose of an electronic healthcare record (HER). SATA communication education research
9. A charge nurse is scolding an unlicensed assistive personnel (UAP) member for failing to complete a task. She calls the UAP lazy in front of other nurses and aides. What type of communication style is the charge nurse using? Aggressive vertical violence
10. A novice RN is feeling upset because she made a minor error. An experienced LPN teases her about it, which makes her feel worse. However, the novice RN says it does not matter and that she probably deserved teasing. Which style of communication is the RN using? submissive
11. An unlicensed assistive personnel (UAP) is assigned to help the Antepartum nurse on a busy shift. One of the clients on the unit is in the process of completing a 24-hour urine collection. What can the nurse assign to the UAP to do for this client? ensure that all the urine collected is kept on ice
12. A new nurse is having a disagreement with an older, more experienced nurse. The older nurse says, “You’re just like all the other young people…you think you know more than you do.” What behavior is the older nurse exhibiting? judgmental
13. A nurse finds himself working in an ineffective team. Which factor may be to blame for the problem? criticism
14. The chief nursing officer (CNO) recognizes that if a nurse is not paid a salary that would meet the needs for food, transportation, and housing, those needs will become the nurse’s primary concern rather than delivering high-quality client care. What theory of motivation is the CNO describing? Maslow's hierarchy
15. A nurse has just assumed the position of nurse-manager. During orientation, the nurse is questioned about the roles of effective unit management. Which statement by the new nurse-manager requires correction? Manager must know everything about each staff member personal problems to prevent issues
16. A client has had a stroke and is having a hard time feeding herself using eating utensils. With which member of the interprofessional healthcare team should the nurse initiate a referral? occupational therapist
17. A clinical nurse-educator has taught the nursing staff the basics of Nursing Informatics. Which statement made by the staff indicates the need for further education?
if a nurse does not have computer competencies a nurse must be fully competent in informatics
18. Nurses often need to plan and coordinate collaborative interdisciplinary care for the client. Which of the following must they keep in mind when working with the healthcare team? avoid an authoritative style of leadership
19. A nurse is interested in learning more about advocating for safe staffing ratios. The hospital educator asks the nurse to name the key elements to be considered when staffing a hospital unit. Which response by the nurse needs correction? medical reimbursement
20. An experienced nurse is telling a new nurse about diversity in their workplace. A nurse manager overhears the conversation. Which of the following statements would need correction? diversity does not affect most of the people lives..
21. Which of the following are barriers to clear communication? SATA confusions about the task low self esteem anxiety
22. The nurse is studying for a management certification exam about team leading. Which principle does the nurse need to understand as the definition for the recognition of the importance of all human beings? Civility 23. An experienced nurse with a bachelor’s degree in nursing (BSN) is asking a novice nurse about an associate’s degree in nursing (ADN) program. The novice nurse explains the function of the ADN program. Which statement by the ADN nurse is correct? ADN RN program provides knowledge shorter than the BSN
24. A novice nurse is working with a preceptor and says, “I am a brand new registered nurse (RN). I cannot think of myself as a leader!” How should the preceptor best respond? all RN lead teams of LPNs and nursing assistants are responsible for clients
25. A nurse-manager has made a decision to transfer to case-management. In training, the nurse-manager is asked to list the duties of the case-manager. Which statement by the nurse-manager requires correction? there's still no known nationally recognized educational preparedness or certificate for the nurse case manager
26. The nurse receives report on four clients on a medical-surgical unit. Which client should the nurse first assess? 55 yr old with o2 88%
27. One of the tenets of the Patient Protection and Affordable Care Act (ACA) was to focus interdisciplinary care on producing better client outcomes, especially for chronically ill and high-risk clients. What term is used to describe this effort to make maintenance of healthy environments the responsibility of all health care professionals? environmental health care model 28. Which of the following actions violates a patient’s legal right to privacy and confidentiality? looking at a neighbors diagnosis chart
29. A nurse-manager in a long-term care facility has noticed that one of the experienced licensed practical nurses (LPN) has recently been having problems with tardiness. The LPN often looks messy and spends long periods off the floor. Recently, the clients have been complaining of pain even after medication pass has been completed. What is the nurse-manager’s best option? focus on performance problem and urge the nurse to seek counseling or treatment
30. The client has used the call-light several times in the past hour. The nurse enters the client’s room. What action by the nurse could the patient interpret as negative? SATA
Nurse immediately comes into the room and crosses her arm the nurse comes into the room with her mouth tightly shut and does not give eye contact Nurse comes in a rolls her eye at the patient
31. The new nurse-manager recently implemented a training program for staff members who show signs of leadership. There will be no monetary reward, so the staff are not eager to apply for the program. The manager tells the staff that if someone does not apply, one will be forced to do so or risk extra shift time. What type of management is the nurse manager employing? Autocratic 32. A charge nurse gently corrects a new nurse’s technique during a sterile procedure. The new nurse gets angry and defensive, saying she should never have come to work on that unit. What factor of communication is the new nurse experiencing? Stress results when someone is threaten which can lead to anger
33. A new nurse is having a disagreement with an older, more experienced nurse. The new nurse crosses her arms over her chest and looks away. What behavior is the new nurse exhibiting? defensiveness
34. Which of the following is part of the Joint Commission (JC) goal to improve patient safety by reducing medical errors? using appropriate abbreviations
35. Match the correct term with its appropriate definition. a. Information - computer software, consists of data that have been given form and have been interpreted b. Computer science - a branch of engineering that studies computation computer technology, hardware, and software as well as the theoretical foundations of information and computation techniques.
c. Health information technology - the application of information processing involving both computer hardware and software. d. Health informatics- a field in which health data are stored analyzed, and delivered through the usage of information and communication technologies. Computer science and information science, nursing science combined e. Technology - the knowledge and use of tools, machines, materials, and processes to help solve human problems.
36. A new RN is working on a unit in which he was once an LPN. The charge nurse has never liked him and she assigns him strenuous tasks and difficult clients. What type of workplace incivility is this? Covert vertical violence 37. Staff nurses have been complaining that new certified nurses’ aide (CNA) is lazy and that she creates more work for them. The charge nurse understands that there are three communication styles from which to choose when speaking with the CNA. Which one would be best? Assertive the charge nurse must be honest, direct, and accurate
38. Health care brings people of different ages, gender, ethnic groups, educational levels, and professions together for the purpose of caring for the patient. Sometimes conflicts arise. Which of the following is considered to be a task-related conflict? UAP refuses to mop up a spill saying it’s a housekeeping job
39. The nurse manager is made aware of a problem on the unit with a novice nurse who occasionally acts immaturely and tells inappropriate jokes. How should the nurse manager best approach this problem? take her aside and let her know that behavior is unacceptable
40. A charge nurse is learning about communicating with the staff nurses. Sometimes the nurses do not seem to understand what the assignments are. What are the known barriers to communication? SATA distractions such as background noise, ringing phones, others talking
unclear directions about the assignments difference in perception about what should be done stressful situation at home or in the workplace organization and clear thinking
41. The nurse has assessed a new admission to the unit. She heard scattered rhonchi on the right side of the patient’s chest and calls the physician to request a chest x-ray. Which part of the SBAR is she using? recommendation
42. A nurse from the neonatal intensive care unit (NICU) is floated to the telemetry unit. During the shift, one of the clients in the NICU nurse’s care fell out of bed. The charge nurse questioned the NICU nurse to see what happened. The NIU nurse said “I don’t know! All of my patients stay in their cribs!” What part of the delegation process did the charge nurse fail to enact? the delegator must know the skills and competence of the person
43. A nurse joins a Health Care Cooperative group to promote better health care practices on a global level. This is an example of what type of collaboration? Interorganizational
44. The nurse from the emergency department is giving report to another nurse on a client who is being transferred to the intensive care unit. Of which type of collaborative care is this an example of? INTRA-professional
45. A charge nurse overhears a novice nurse say she does not like teamwork and asks her why. Which statement about effective teams by the novice nurse requires correction? effective teams are not effective
46. A nurse from the neonatal intensive care unit (NICU) is floated to the telemetry unit. During the shift, one of the clients in the NICU nurse’s care fell out of bed. The charge nurse questioned the NICU nurse to see why hourly rounding was not done. the NICU
nurse said i didn't know we had to do hourly rounding, all my patients stay in their crib. what part of the assignment did the nurse fail to recognize? the NICU nurse is responsible for her own level of practice according to facility policy
47. The nurse is evaluating a patient in the emergency department (ED) who is experiencing severe chest pain. Suddenly the patient stops breathing and is unresponsive. A code blue is called. What type of leadership style is best used in this situation? authoritative
48. A nurse manager wants to decrease the number of medication errors that occur in her department. What steps should the manager take? root cause of errors 49. A nurse states to a client, “Things will look better tomorrow after a good night’s sleep.” This is an example of which communication technique? giving false reassurance
50. The nurse (RN) and the respiratory therapist (RT) are arguing about the timing of a nebulizer treatment. The nurse argues that because the client is the nurse’s responsibility, nursing will be making all the decisions about timing. What important piece of interdisciplinary care did the nurse forget? team members need to respectfully work together providing positive outcome for the client
Nurse to nurse is INTRA-professional Nurse to doctor is INTER-professional Nurse to organization is inter-ORGANIZATIONAL Intrapersonal conflict - within a person Interpersonal- with other people (patients, family members, nurses, physicians, other departments)
Organizational conflict- discord about policies, procedures, codes of conduct, and accepted norms of behavior/patterns of communication
Know Nurse to nurse is INTRAprofessional Nurse to organization is interORGANIZATIONAL know what the ACA (patient protection and affordable care act) is and their main thing-I got that wrong When an older nurse is saying the younger nurses are all the same that judgmental Know what the CNO is all about... I got that wrong Know about the types of bullying I got that wrong- it isn't overt transactional so idek And know what type of ways nurses handle conformation- a question said a nurse was yelling at her and she just crossed her arms and turned away