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NURS-2811 EXAM 2 TB QUESTIONS AND VERIFIED
ANSWERS FOR 2024-
Ch 13: Conflict Management
- A newborn has several congenital anomalies incompatible with living beyond a month. He cannot retain formula, and his temperature drops when he is removed from the warmer. Two nurses who alternate caring for the baby argue about whether or not to attempt bottle feedings and whether he should be removed from the warmer to be held. What is the origin of the conflict described?
a. Ethical values
b. Nursing role concerns c. Personal goals for advancement d. Personality differences
- Of the following common areas of conflict between nurses and their clients and families, which is most easily resolved?
a. Issues of concern about quality of care
b. Issues surrounding treatment decisions c. Issues of family involvement d. Issues about quality of parental care
- What is the best strategy for resolving the conflict in a situation in which two staff nurses request the same vacation weeks? a. Accommodation
b. Collaboration
c. Competition d. Avoidance
- On the unit in which you work, one nurse’s aide is usually pleasant and helpful; the other is often abrasive and angry. What is the most important basic guideline to be observed by a nurse who must resolve a conflict between the two nurse’s aides?
a. Deal with issues, not personalities.
b. Require the aides to reach a compromise. c. Weigh the consequences of each possible solution. d. Encourage ventilation of anger and use humor to minimize the conflict.
- One of your peers, a staff nurse, is a “potshot artist.” She often makes you the butt of innuendo or teasing digs. You are fed up and decide to take action the next time it happens. What strategy should be considered as an effective way of dealing with a “sniper”? a. Clam up and allow the individual to fully ventilate her concern. b. Confront the individual, saying that she is wrong. c. Coldly withdraw from the individual.
d. Obtain group confirmation or denial of criticism raised by the
individual.
- A staff nurse who has worked on the unit for 6 months voices the following concerns to another nurse: “The clinical nurse leader of the unit often follows me into the supply room, where she stands blocking the doorway and chats. She makes opportunities to mention my good looks, muscular physique, or strength in the context of daily work. She says things like, ‘You’re so handsome, no wonder your clients like you.’ As she talks to me, she frequently touches me on the arm, the shoulder, chest, or the hair, and if I’m sitting, she touches my leg. Yesterday, she patted my arm and said, ‘You know, if we were dating, I might be able to give you lighter assignments.’ I don’t want to date her. I just want her to leave me alone! What should I do?” What is the best reply? a. “Don’t be quite so honorable. Date her and see if you get better assignments.”
b. “Confront her with a description of her behavior and tell her that
you want her to stop.”
c. “Go directly to the human relations office at the agency and tell them what you just told me.” d. “Contact your lawyer and get advice ASAP, in case she decides to turn the tables and accuse you of advances.”
- When a nurse manager uses employment seniority to resolve a scheduling conflict between two nurses, this is an example of a: a. Win-win strategy b. Win-lose strategy
c. Lose-lose strategy
d. Compromise strategy
- The nurse manager understands that the first step in attempting to resolve an interpersonal conflict between two nurses is to:
- Which task could a staff nurse delegate to a certified nursing assistant (CNA)? a. Evaluating a client’s response to pain b. Making rounds with a physician
c. Feeding a stroke client who has minimal dysphagia
d. Assessing a client’s central venous line site
- The nurse has just given a client a narcotic for pain relief. Because the nurse must leave the unit for lunch and a 1-hour meeting, he must delegate the task of evaluating the client’s response to the pain medication. To whom should he delegate this responsibility? a. A nursing assistant b. A student nurse c. A licensed practical nurse
d. A nurse manager
- The nurse has a full assignment. The charge nurse adds a newly admitted client who will require close monitoring. Which task can the nurse delegate to the CNA who is co- assigned to her clients? a. Teaching Mr. Z insulin self-administration b. Updating Mrs. W’s care plan c. Evaluating goal attainment for Mr. Y, who is learning to walk with a below-the-knee prosthesis
d. Bathing Miss X, an unconscious client
- Based on the goal of making optimal use of the level of preparation of the licensed practical nurse (LPN), which task should the RN delegate to the LPN?
a. Assisting with a lumbar puncture
b. Transporting a client to the radiology department c. Restocking the sterile supplies d. Passing afternoon nutrition supplements
- There is a temporary agency nurse assigned to the nursing unit. You have no knowledge of this nurse’s skills, and you want to assign the nurse to a client who has a fresh tracheostomy. How should you handle this situation? a. Assign the nurse to the client with the tracheostomy and hope for the best.
b. Ask the nurse about her competency to care for the client with the
tracheostomy.
c. Assign the client to another nurse and use the temporary agency nurse to do simple care tasks. d. Call the agency and ask for a nurse skilled in the care of a client with a tracheostomy.
- What would be the best example of delegation?
a. Transferring to another RN the responsibility of caring
for a client requiring a blood transfusion
b. Providing guidance to an LPN to hang blood on a client c. Assigning a series of nursing unit tasks to the certified nursing assistant d. Assisting a new nurse to understand the rules and regulations of the Nurse Practice Act
- What would be the best example of supervision?
a. Assigning nursing care for a group of five clients to an RN
b. Following up with a CNA on the assigned task of ambulation and
feeding of two clients
c. Assigning a urinary catheterization and collection of sterile culture to an LPN d. Scheduling the LPN to administer medications on the unit for the afternoon
- What are potential causes of performance inadequacies? a. The person to whom the task was assigned had appropriate educational qualifications to complete the task. b. The task was assigned to a person capable of carrying out the assignment. c. The person who delegated the task confirmed the recipient’s ability to perform the task.
d. The person to whom the task was assigned did not understand
what the task involved.
- Which of the following represents appropriate feedback for an assignment to an LPN? a. “Did you understand the assignment that you received in the staff report?” b. “Have you completed the urinary catheterization and care of the new client?”
c. “The client in Room 430 looks much better, and you
did a good job of making her comfortable.”
d. “I know you are busy; however, you need to get caught up with your pain medications.”
- The RN needs to discuss a problem with the nursing assistant. The nursing assistant has left several rooms cluttered with trash and not cleaned appropriately. Which comment by the RN would be the best way to approach the problem? a. “I checked on the four rooms you were assigned, and they are really a mess.”
b. “Have you had a problem completing your work assignment
today?”
c. “All four of the client rooms assigned to you today are messy with a lot of trash in them.” d. “Family members have been really upset today. Why have you not cleaned up the rooms assigned to you?”
- Which of the following statements made by the charge nurse indicates appropriate delegation? Select all that apply. a. The LPN can delegate dressing changes to the nursing assistant.
b. The LPN can administer a DPT immunization to a child.
c. The LPN can add a dose of Bleomycin to an existing IV infusion.
d. The nursing assistant can transfer a paraplegic client from a
wheelchair to the bed using a lift, as long as he or she has
received training and demonstrated competency.
e. The nursing assistant can assess vital signs on a client 15 minutes after the transfusion has been started.
- What are the “five rights of clinical delegation”? ANS: ➢ The right task—determining whether the task can be
a. Clinical pathways and client classifications b. Clinically oriented and business-oriented pathways
c. Clinical pathways and disease management
d. Centralized and decentralized system models
- A delivery of nursing care organized around tasks is known as:
a. Functional nursing
b. Team nursing c. Primary nursing d. Case management
- A system in which a nurse plans and directs the care of clients over a 24-hour period is known as: a. Functional nursing b. Team nursing
c. Primary nursing
d. Case management
- Which statement is true about the case management model of nursing care?
a. It is based on previously defined client outcomes.
b. It is used to reduce resource utilization only. c. To be effective, it requires case managers to provide direct client care. d. It eliminates the need for other caregivers (LPN/LVNs, nursing assistants).
- What is the primary work environment of nurses who are case managers? a. They work most often in acute care institutions. b. Their work is focused on community activities and is based within the community. c. They typically work for insurance companies, providing coordination of care.
d. All types of health care organizations, as well as
organizations with health- related functions, hire case
managers.
- Which statement is true about client classification systems?
a. They measure all the needs of clients. b. They provide an absolute formula for unit staffing. c. They should not be used to make client care assignments because acuity systems are more accurate.
d. They provide historical data of the usage of nursing time, which
is helpful when developing the department budget.
- Which of the following best describes the concept of evidence-based practice? a. It is a method of improving nursing care and effectively maintaining cost containment. b. Insurance companies review the evidence of the health care practice for reimbursement. c. It achieves large-scale economics while providing cost-effective care.
d. It provides for the use of recent research in current nursing
practice.
- A client is admitted to the labor and delivery unit where she is assigned a registered nurse who will manage her care for the duration of her hospitalization. What type of nursing care delivery model is represented in this nursing unit? a. Functional care
b. Primary care
c. Patient-focused care d. Case management
- Which type of nursing delivery models would be appropriate in a rural area that would require fewer numbers of registered nurses? Select all that apply.
a. Functional nursing
b. Team nursing
c. Primary care nursing
d. Patient-focused care
e. Transitional care Ch 16: Economics in the Health Care Delivery System
- What was the primary reason diagnostic-related groupings (DRGs) were introduced into the health care system? a. To improve the quality of health care b. To prevent misuse of health care agencies
c. To reduce health care costs
d. To standardize health care treatments
- What is the major factor occurring in the provision of health care that has resulted in the statement, “The cost of health care is out of control”?
a. Health care expenditures are exceeding the cost of the
gross domestic product (GDP) in excess of 14%.
d. The implementation of the Oregon Health Policy for reimbursement of the cost of health care services led to the Rand Health Insurance Experiment.
- What is the nurse’s fiscal responsibility to the client? a. To provide the best health care that the client can afford b. To provide the best health care that the insurance company will allow
c. To use the most cost-efficient resources to provide maximum
health care to the client
d. To use the most efficient method of providing nursing care to clients whose resources are limited
- What is the most important way that a nurse can be fiscally responsible to the employing institution?
a. By providing quality, safe nursing care
b. By considering client needs and prioritizing appropriately c. By accurately documenting the client’s condition d. By maintaining accurate charges for supplies used in client care
Operating Budget: The statement of the expected expenses for the
coming year Personal Budget: The estimation of how many nurses
will be needed to care for the clients Capital Budget: The estimation
of items that must be purchased or expenses for the coming year
Ch 17: Political Action in Nursing
- Which of Sanford’s laws of power is relevant to the following situation? The state nurses association writes a new version of the Nurse Practice Act, secures a sponsor in the legislature, and lobbies legislators to adopt the bill. a. Power is invariably personal. b. Power invariably fills any vacuum.
c. Power is exercised through and depends on institutions.
d. Power is best exercised via large financial donations to individual legislators.
- A nurse plans to lobby a state senator regarding a particular health care bill. Which action would be appropriate?
a. The nurse should be specific about what action she wants
the senator to take early in the contact or letter.
b. The nurse should tell the senator that she will vote for him or her only if her advice is followed. c. The nurse should use a form letter to express her opinion and encourage as many as possible to mail in the form letter. d. The nurse should avoid making contact by phone and only submit her views in writing.
- The clinical nurse leader makes out the daily assignments. One staff nurse tells another, “Last week the clinical nurse leader asked me to change my days off so that she could go to a play in another city. I told her I couldn’t do it. Ever since then, she’s given me the most difficult clients on the unit for my assignment.” If the observations of the staff nurse are accurate, the clinical nurse leader may be making use of the type of power called: a. Inherent power.
b. Referent power.
c. Legitimate power.
d. Expert power.
- The nurses at Community General Hospital are concerned about violence involving children in their community. They wish to propose to the city government that drug-free and weapons-free zones and corridors be instituted near each school. The nurses send liaisons to the city school board and the parent-teachers association to ask them to join the effort. What is the term for this type of strategy?
a. Forming a coalition
b. Displaying legitimate power c. Collective bargaining d. Seeking compromise
- Which strategy is least effective in formulating political action? a. Ability to communicate information in concise terms
b. Living and practicing in several different states
c. Determining who should be contacted and for what political action d. Having the ability to use different channels of information
- A nurse has recently moved from one state to another and wishes to write lawmakers to urge them to vote against a change in the Nurse Practice Act that would replace individual licensure with institutional licensure. What lawmakers should the nurse contact? a. The city council members b. The county (parish) legislators
c. The state legislators from the district
d. The federal legislators from the district
- What is an example of the weakest source of power? a. Several nursing students talk with a head nurse regarding a problem they are having on the unit; the head nurse then discusses this problem with the chief nursing officer. b. The clinical nursing instructor sends a student to the skills lab for further practice.
c. A nurse shares knowledge regarding nursing in a confident
manner and style.
d. The head nurse tells staff members that as soon as all the care plans are completed, they may have some additional compensation time.
- What is the best definition of politics?
a. Influencing the allocation of scarce resources
b. Identifying those in a public office that can be influenced c. Attempting to get people in government positions to think the way you want them to d. Lobbying for state and federal legislation to improve the quality of nursing care
- Which of the following would best represent the definition of a political action committee (PAC)?
a. A vehicle for nurses across the country to organize
collectively to endorse and support candidates for
national offices
Referent (mentor) power
- Identify the type of power base associated with each of the following: Reward: A political action committee’s endorsement or financial contribution Coercive (Punishment): Organizing nurses to work for the opponent in the next election Expert (Informational): Testifying before a committee on a bill Legitimate: The dean of the school discussing the educational program Referent (Mentor): Joining a coalition to lobby for a national health insurance plan Ch 18: Collective Bargaining: Traditional (Union) and Non- Traditional Approaches
- Which statement best describes when collective bargaining by nurses can occur? a. Only when the nurses in the group are members of a union
b. Whenever nurses see a need to organize to take collective action
c. Only when the state nurses association is willing to represent nurses at a specific agency d. Whenever the state nurses association agrees that both wages and working conditions are inappropriate
- What is advocated in this chapter regarding how nurses who wish to participate in collective bargaining, traditional or nontraditional, should choose their representative? a. Service Employees International Union b. The National League for Nursing
c. Their state nurses association
d. The American Federation of Teachers
- In which situation would the traditional type of collective bargaining (union) help nurses attain their goals? a. Management has agreed to no nursing layoffs for 1 year after reorganization. b. Nursing has received a 4% salary increase this year and next year.
c. Nurses have identified workplace safety issues and health hazards.
d. Management has arranged for nurse practitioners to have admitting privileges.
- Which provision—if labor management included it in a contract—would not be to nursing’s advantage? a. A workforce retraining provision b. Seniority rights c. A grievance procedure
d. Wage adjustments based on bed occupancy
- What would the nurse identify as a primary difference between traditional and nontraditional collective bargaining?
a. Traditional collective bargaining is not organized through the state nursing association.
b. Traditional collective bargaining units are organized and
members of the AFL- CIO.
c. Nontraditional collective bargaining units are not recognized by health care organizations as a collective bargaining agency. d. Nontraditional collective bargaining has a long history and is based on the support of organizations throughout the country.
- Which statement about arbitration through the traditional collective bargaining unit is true? a. Arbitration is a management technique to discharge an employee.
b. Arbitration is useful to resolve conflicts having a basis in the
labor-management contract.
c. Arbitration is always used before the formal grievance process. d. Arbitration is a process used to establish nursing standards.
- A staff nurse is scheduled to work 3 to 11 pm in the cardiac step-down unit. When he reports for work, he realizes he is the only RN who will be on duty. He calls the supervisor to say that he will need help. He is told there are no available nurses to assign to his unit. What should he do? a. Leave and go home rather than assume this responsibility.
b. Protect himself by filing a written objection to the assignment.
c. Call a temporary agency and arrange for coverage by a registered nurse. d. Call the state health department to investigate the staffing issue.
- What is one of the primary concerns of the proponents for a nontraditional collective bargaining unit versus the
d. To identify acts that are legal for the nurse to perform
- Which statement best describes the Code of Ethics of the American Nurses Association? a. A moral statement of accountability for practicing nurses and for student nurses
b. A legal document describing the responsibilities of the nurse
c. A statement regarding nursing care that outlines principles for the hospital to use to evaluate quality of care d. A document that is used as a guide for the nurse to consider in the decision-making process in legal situations
- Which ethical principle is applied when the nurse acts to safeguard the client and the public by reporting poor nursing practice? a. Autonomy b. Fidelity c. Justice
d. Veracity
Veracity—the duty to tell the truth—is represented in this situation. 5.What ethical principle is implemented, or supported, when the nurse encourages a client to be involved in planning and implementing his or her own care?
a. Autonomy
b. Fidelity c. Justice d. Veracity
- The ethical principle of autonomy is not applicable in which client situation? a. The client does not speak or understand the English language.
b. The client is unaware of who he is and where he is.
c. The client has been in a long-term care facility for 10 years. d. The client has values that conflict with the caregiver’s values.
- Confidentiality will be maintained by a nurse who believes in and values the ethical principle of: a. Veracity b. Autonomy c. Justice
d. Fidelity
Fidelity involves keeping information confidential and maintaining privacy and trust.
- The health care team responsible for deciding whether to move a critically ill client out of the ICU so that a new client may be admitted to the unit is faced with what principle of an ethical dilemma? a. Veracity
b. Justice
c. Autonomy d. Deontology The principle of justice is involved in the allocation of scarce and/or expensive health care resources. 9.The nurse is very busy caring for a large case load. A client mentions that because he is slow, people just do things for him rather than allowing him to do as much as he is able. To solve the dilemma of needing to conserve time versus supporting the client’s involvement in his care, what principle may help the nurse? a. Veracity b. Fidelity c. Justice
d. Autonomy
- What element in health care is most responsible for the ethical dilemma of whether health care is a privilege or a right?
a. Cost
b. Technology c. Consumerism d. Worker shortage
International Council of Nursing (ICN), the Patient’s Bill of Rights,
the Nuremberg Code, and the relevant hospital’s ethical
committee are some of the resources available to the nurse faced
with an ethical dilemma.
Ch 20: Legal Issues
- What elements must be present for a malpractice claim?
a. Duty, breach of duty, client injury
b. Negligent nursing care, failure to follow standards c. Failure to report, defamation, discrimination d. Error in judgment, invasion of privacy
- In transcribing orders for a client, the nurse finds a new order for aspirin, 500 mg, qid. The client has a long history of gastrointestinal bleeding. What is the best nursing action? a. Give the medication. b. Withhold the medication and chart why it was not given.
c. Call the physician and question the order in light of the client’s
history.
d. Ask the client whether he is allergic to aspirin.
- The nurse enters a client’s room to complete the discharge paperwork and finds the client in tears. The client reports that someone from the business office told her she could not leave the hospital until the bill was paid. What is the best nursing action?
a. Comfort the client and continue the preparations for discharge.
b. Call the social worker for a financial evaluation. c. Call the family to arrange for the payment. d. Cancel the discharge plans and notify the physician of the situation.
- What is a correct statement regarding a nurse who acts beyond the scope of practice? a. Demonstrates what a good nurse she or he can be b. Provides enriched services to clients who would not otherwise receive them c. May make other nurses angry because of the increased expectations created
d. May be disciplined by the board of nursing
- Which error in judgment would be the most serious for the nurse defendant in a legal case? a. Discussing the case with the plaintiff
b. Tampering with the chart
c. Hiding information from the plaintiff’s attorney d. Being discourteous on the witness stand
- What is the best legal safeguard for a nurse?
a. Competent practice
b. A legal contract c. A valid license d. Following management policies
- A nurse is providing care to a 6-year-old boy with a broken arm. She notices multiple bruises. The boy says that his father got mad because he was bad and that he hit him and broke his arm so that he would remember to be good. What is the best nursing action? a. Chart that the child is a victim of abuse. b. Do nothing because you cannot prove he was abused.
c. Report the situation to the appropriate authorities.
d. Ignore what the child said because little boys often lie.
- What would be the most effective way for a nurse to validate “informed consent”? a. Check the chart for a completed and signed consent form. b. Determine from the physician what was discussed with the client. c. Ask the family whether the client understands the procedure.
d. Ask the client what he understands regarding the procedure.
- A nurse who commits an infraction of the Nurse Practice Act is always subject to discipline by what group? a. A court of law
b. The state board of nursing
c. The local chapter of the state nurses association d. The National League for Nursing
