Role & Scope REAL Final

Question 1

1. A nurse manager notices that a nurse in the unit is not delivering care in accordance with a

recent policy change. What is the most effective approach for the nurse manager to take?

Encourage the nurse to openly verbalize the reasons for resistance to the change.

Explain to the nurse the importance of implementing the new policy.

Ignore the resistance and allow peer pressure to facilitate change in the nurse's behavior.

Threaten disciplinary consequences if the nurse does not implement the new policy.

1 points

Question 2

1. A nurse's brother had a lab test performed at the facility where the nurse is employed. The

brother has asked the nurse to look up the result in the computer. In replying, the nurse realizes

that disclosing the result is

Permissible. Because this is an immediate family member, the action is allowable.

Not permissible. The primary physician is the only one allowed to disclose laboratory

results or findings to a client.

Permissible. Because the sibling has paid for the service, the test results are actually the

sibling's property.

Not permissible. Despite the request, there is no nurse-client relationship between the

sibling and the nurse.

1 points

Question 3

1. A nurse is caring for a client who is in a coma, and the client’s brother reports that the family

does not want any heroic measures performed. How should the nurse respond?

"Have you discussed this with the client?"

"I will verify the status of advance directives."

"Does the client have a living partner?"

"The provider will write a DNR order."

1 points

Question 4

1. A nurse is caring for a client. The nurse demonstrates adherence to the ethical principle of

fidelity in practice by doing which of the following?

Confirming that a client going for surgery has signed a consent form.

Refusing to disclose information about a client to the media.

Keeping an appointment with the client.

Allowing a new mother to hold her stillborn infant.

1 points

Question 5

1. A nurse receives a client care assignment that he believes is unfair. Which of the following is an

appropriate action for him to take?

Contact the nursing supervisor and ask her to intervene on his behalf.

Ask another nurse to review the equity of the assignment.

Speak with the charge nurse about the assignment and his concerns.

Accept the assignment and talk with the nurse manager at a later time.

1 points

Question 6

1. A nursing unit has recently implemented new actions designed to reduce medication errors.

Which of the following methods of evaluation is appropriate to measure the results of these new

actions?

The number of medication errors avoided after the actions were implemented

The number of medication errors before and after the actions were implemented.

Results of a staff questionnaire that quantifies staff satisfaction with the changes

Results of a study about the time and money costs of implementing the changes

1 points

Question 7

1. The nurse is working with a group of clients assisted by an assistive personnel (AP). The nurse

should make which of the following determinations before delegating a task to the AP?

The AP's ability to prioritize.

The AP's rapport with the clients.

Whether the nurse can more efficiently complete the task without assistance.

The task is within the AP's scope of practice.

1 points

Question 8

1. The new Unit Manager on the Medical Unit is not satisfied with the patient satisfaction rate of

60% for two consecutive months and staff morale is at its lowest. The decision to plan and 

initiate change has been decided. Prior to implementing any change, which of the following

actions is a priority?

Call for a staff meeting and get input from all members of the team.

Seek help from his manager.

Develop a strategic action on how to deal with these concerns.

Ignore the issues since these will be resolved naturally.

1 points

Question 9

1. A new nurse wants to provide client centered care. Which of the following is the best guarantee

that the patient’s priority needs are met?

Checking with the relative of the patient

Preparing a nursing care plan in collaboration with the patient

Consulting with the physician

Coordinating with other members of the team

1 points

Question 10

1. A charge nurse observes that a staff nurse is not able to meet client needs in a reasonable time

frame, does not problem-solve situations, and does not prioritize nursing care. The charge nurse

has the responsibility to:

supervise the staff nurse more closely so that tasks are completed

ask other staff members to help the staff nurse get the work done

provide support and identify the underlying cause of the staff nurse's problem

report the staff nurse to the supervisor so that something is done to resolve the problem

1 points

Question 11

1. Nursing often has challenges in gaining independence as a profession. What deciding factors

must the nursing profession embrace?

Health and happiness of nurses

Recognition that the doctors know best

Loss of control and negative feedback

Responsibility and accountability

1 points

Question 12

1. Recommendations made by the Robert Wood Johnson Foundation in The Future of Nursing

include:

The Bachelor's Degree in Nursing (BSN) must be the minimum entry point for registered

nurse.

Nurses are not aware that policy making requires better data collection and information

infrastructure .

Nurses with associate's degrees should not be practicing bedside nursing.

Nurses should practice to the full extent of the education and training.

1 points

Question 13

1. As part of quality management, the nurse manager double checks to see that all patient teaching

is documented in the Electronic Health Record. This is because:

She is concerned that nurses are not doing their full share of the work

Joint Commission requires documentation of patient teaching in the charts.

Nurses do not plan teaching interventions based upon outcomes or goals

Discharge teaching should begin when the discharge orders are made by the provider

1 points

Question 14

1. Which of the following statements best describes transformational leadership?

Shares vision and encourages staff to develop professional goals

Serves the followers rather than being served

Maintains full trust and confidence in the subordinates

Possesses innate charisma that makes others feel good in his presence

1 points

Question 15

1. The nurse manager notes that there is an increasing unrest of the staff due to fatigue. Which

action is a priority?

Evaluate the overall result of the unrest.

Initiate a group activity for communication to begin.

Develop a plan and implement it.

Identify internal and external forces causing the fatigue.

1 points

Question 16

1. What is the nurse’s role in Continuity of Care? (Select all that apply).

Facilitate the continuity of care provided.

Diagnose the patient's medical condition.

Coordinate the discharge planning.

Act as the liaison and a client advocate.

Prescribe the recommended treatments before discharge.

1 points

Question 17

1. A nurse manager permits her staff to request which holidays they would prefer to work. This

style of leadership is best described as:

Autocratic

Laissez-faire

Democratic

Authoritarian

1 points

Question 18

1. A nurse manager is called upon to settle a disagreement between two staff nurses. What needs

to be done in order to find a solution to the dispute?

Go up the chain of command

File an incident report

Identify the source of the conflict

Survey the other nurses to see who is at fault

1 points

Question 19

1. Which of the following tasks can safely be delegated to the LPN?

Discharge planning

Diabetes education

Pain medication via IV push

Tracheostomy care

1 points

Question 20

1. Which of the following are elements of effective team building?

Encouraging a workplace that values collaboration and cooperation

Publicly announcing staff problems and issues that are of concern

Discouraging new ideas that may make older nurses feel uncomfortable

Smoothing over potential issues that disturb the patients on the unit

1 points 

Question 21

1. A charge nurse on a medical unit has been informed that one nurse is talking on the cell phone

during her shift. What would be the first step in analyzing the situation?

Have a nurses’ meeting reviewing proper use of cell phones.

Speak with the nurse in question about the cell phone use.

Require all cell phones to be on silent during the shift.

Give the nurse a written warning about her use of the phone.

1 points

Question 22

1. A school bus driving through a small town ran into a train. There are numerous injuries, many of

which are serious. Which type of leadership style would be the most appropriate for the Chief

Nursing Officer in this situation?

Laissez-faire

Authoritative

Directional

Democratic

1 points

Question 23

1. A nurse is planning an educational session for a newly diagnosed diabetic client. Which action

should the nurse take first?

Refer the client to the American Diabetic Association.

Assess the client's abilities and readiness to learn.

Ask a nursing assistant to give the client pamphlets on diabetes.

Demonstrate the measurement of blood sugar to the client.

1 points

Question 24

1. Which task is best suited for the new LPN who is assisting you today?

Administer furosemide 100mg IV

Give discharge instructions to the client and family members

Insert a no. 16 Fr Foley catheter

Draw blood for a potassium level

1 points

Question 25

1. A nurse is caring for a client with a right breast lumpectomy and lymph node dissection. Which

nursing action can be delegated to the UAP?

Teaching the client why blood pressure will be taken on the left arm only

Elevating the client's arm on pillows to promote lymphatic drainage

Assessing the client’s right arm for lymphedema

Reinforcing the dressing if it is saturated

1 points

Question 26

1. Evidence-based practice has been established to advance nursing practice. The goals for this

practice have been to:

reduce health care costs and improve health care.

facilitate the highest quality care and the best client outcomes.

encourage increased research utilization in nursing practice.

evaluate research findings and scientific evidence to a specific clinical question.

1 points

Question 27

1. Which factors have been most clearly identified as major influences on the future of nursing

practice?

Aging of the American population and increases in chronic illnesses

Increasing birth rates coupled with decreased average life expectancy

Increased awareness of determinants of health and improved self-care

Apathy around health behaviors and the relationship of lifestyle to improved health

1 points

Question 28

1. Which of the following nursing actions supports interdisciplinary collaboration? (Select all that

apply.)

Open communication with all team members

Designation of a nurse who will serve as the group leader

Acknowledgement of the knowledge and skill each discipline offers

Invitation to the client to participate in team meetings

Disposition of the client’s valuables to the unit safe

1 points

Question 29

1. A new nurse manager understands that in order to resolve conflicts in difficult crises, he must:

Have decreased self-esteem and motivation

Use established coping skills to resolve future crises

View the experience as personally destructive

Avoid all difficult situations in the future

1 points

Question 30

1. A nurse manager has been called upon to mediate a dispute between two staff nurses. The

manager recognizes that anger is:

Typically negative and usually destructive.

Can someetimes be positively used to produce needed change.

Should be held in as long as possible as controlled rage.

Needs to be expressed immediately.

1 points

Question 31

1. A nurse manager encourages staff to work it out between themselves when conflicts occur

between 2 nurses. What leadership style is this?

Democratic

Autocratic

Laissez-faire

Controlling

1 points

Question 32

1. The nurse manager requests a staff nurse to submit an incident/occurrence report. Select the

statements which describe why this reporting is necessary. (Select all that apply).

The facts about the occurrence are documented

The facility needs to find out who is responsible for causing the incident

Identify systems issues that contributed to the occurrence

Engage in strategies to prevent future occurrences

Assign blame for the problems caused

1 points

Question 33

1. Which statement describes the impacts absenteeism can have on patients and health care

workers?

Replacement nurses are capable of working in any unit assigned.

The unit saves money and patient care is still accomplished.

Managers are prepared to staff units and expect some absenteeism.

High rates of absenteeism may lower morale of fully engaged nurses.

Short staffing can be linked to poorer patient outcomes

1 points

Question 34

1. The electronic health record (EHR) has advantages and disadvantages to health-care workers.

Select the statements which describe the advantages to EHR. (Select all that apply.)

Multiple care providers can access the client's record

Provide reminders about completing information

Reduces redundancy of patient information

Steep learning cures are involved

Improves interdepartment collaboration

1 points

Question 35

1. A nurse is caring for a dying patient. Which is an indication that the needs of the terminally ill

nonverbal client is not well-managed?

Hyperactive bowel sounds

Crackles in the lungs

Unwillingness to eat

Constant restlessness

1 points

Question 36

1. The freedom to make decisions that affect self and to take action for self is called:

Advocacy

Authority

Autonomy

Autocracy

1 points

Question 37

1. A nurse volunteers for the hospital quality improvement team and has been asked to evaluate

nursing care on the unit. What would be most appropriate for the nurse to initially ask the staff

to do?

Track the number of supplies used by clients on the unit

Document the time spent on direct client care

Administer a client and family satisfaction survey

Assess clients and report acuity daily

1 points

Question 38

1. After receiving a shift report, the nurse (RN) has many tasks to complete during the next 12

hours. Which tasks would the nurse delegate to an unlicensed assistant person (UAP)?

Flushing a nasogastric tube on a client who has had a colectomy

Irrigating a clogged urinary catheter on an older adult client

Measuring and recording hourly urine output for a client who had a nephrectomy

Changing a dressing on a client with an infected foot ulcer

1 points

Question 39

1. The primary nurse is assigned to four clients on the unit. Of the following, which one should the

nurse assess first?

45 year old client scheduled for a chest x-ray

29 year old client needing a daily dressing change

72 year old postoperative client being discharged today

33 year old client on oxygen for recent shortness of breath

1 points

Question 40

1. A nurse is working with a female client interested in complementary and alternative medical

(CAM) treatments for a chronic health condition. The nurse should:

Recommend the herbal remedies that the client should be using

Provide education about the therapies she is most interested in using

Discourage the client from using any form of alternative therapies

Advise the client about “good” vs “bad” therapies

1 points

Question 41

1. The novice nurse is experiencing a difficult transition from student to registered nurse, finding

that the hospital environment is much different than the one previously envisioned. This is

known as:

Reality shock

Role disparity

Clinical incompetence

Theory-Practice let down

1 points

Question 42

1. A state of emotional exhaustion that results from the accumulative stress of an individual's life,

including work, personal, and family responsibilities is known as:

Case management

Downtime

Burnout syndrome

Cognitive disfunction

1 points

Question 43

1. Which of the following factors have contributed to the nursing shortage? (Select all that apply).

Shortage of qualified nursing faculty

An ever-increasing demand for health care

Working conditions such as short staffing and long hours

Equitable pay for equitable work

The unprofessional image of nurses portrayed in the media

1 points

Question 44

1. Research is showing the growing elderly population in the United States has major health care

consequences. Some of them include: (Select all that apply).

As more of the elderly seek health care, the nursing shortage will only become more

pronounced.

There is an increasing need for practitioners who specialize in elderly care.

Resources such as fresh fruits and vegetables are becoming scarce.

Mental disorders and cognitive function problems are the leading cause of compromised

self-care and self-management of the elderly at home.

Nurses are not taught to deal with elderly patients.

1 points

Question 45

1. The nurse practitioner has ordered 180 mg of Dilantin po q8h. Your patient weighs 98 lb. The

label of the drug reads 250 mg per 5 mL. How many milliliters will you adminster to this patient

per dose?

3.9 mL

6.2 mL

3.6 mL

5 mL

1 points

Question 46

1. The type of leadership style that can be used many times is dependent on the situation at hand.

Reflect on the 3 different types of leadership styles that you have learned.

In 100-400 words, define each leadership style. Be complete and thorough using key words that

help understand the thoughts and ideas of a particular type of leader. Each description must be

in detail, but clear and concise.