Ch.

4
A primary care provider's orders indicate that a surgical form needs to be signed. Since the
nurse was not present when the primary care provider discussed the surgical procedure,
which statement best illustrates the nurse fulfilled the client advocate role?
a) the doctor has asked that you sign this consent form.
b) do you have any questions about the procedure?
c) what were you told about the procedure you are going to have?
d) remember that you can change your mind and cancel the procedure.
c) what were you told about the procedure you are going to have?
Ch. 4
Although the client refused the procedure, the nurse insisted and inserted a nasogastric tube
in the right nostril. The administrator of the hospital decides to settle the lawsuit because
the nurse is most likely to be found guilty of which of the following?
a) an unintentional tort
b) assault
c) invasion of privacy
d) battery
d) battery
Ch. 4
A nurse discovers that a primary care provider has prescribed an unusually large dosage of a
medication. Which is the most appropriate action?
a) Administer the medication
b) Notify the prescriber
c) Call the pharmacist
d) Refuse to administer the medication
b) Notify the prescriber
Ch. 4
A primary care provider prescribes 1 tablet, but the nurse accidentally administers 2. After
notifying the Dr, the nurse monitors the client carefully for untoward effects of which there
are none. Is the client likely to be successful in suing the nurse for malpractice?
a) No, the client was not harmed
b) No, the nurse notified the primary care provider
c) Yes, a breach of duty exists
d) Yes, foreseeability is present
a) No, the client was not harmed
Ch. 4
A is nursing student working as an unlicensed assistive personnel (UAP). The nurses know
the UAP is graduating from a nursing program soon. The UAP is asked to help by doing a
urinary catheterization on a postsurgical client. Select the best response?
a) "Let me get permission from the client first"
b) "Sure, Which client is it?"
c) "I can't do it unless you supervise me"
d) "I can't do it. Is there something else I can help you with?"
d) "I can't do it. Is there something else I can help you with?"
Ch. 4
The Dr. wrote a DNR order. The nurse knows that which applies in the planning of nursing
care?
a) The client can't make decisions about care
b) The client and family know that the client will most likely die within the next 48 hours
c) The nurses will continue to implement all tx focused on comfort & symptom management
d) A DNR order from a previous admission is valid for the current admission
c) The nurses will continue to implement all tx focused on comfort & symptom management
Ch. 4
The nurse's partner/spouse undergoes exploratory surgery at the hospital where the nurse is

employed. Which practice is most appropriate?

a) Because the nurse is an employee, access to the chart is allowed
b) The relationship with the client provides the nurse special access to the chart
c) Access to the chart needs a signed release form
d) The nurse can ask the surgeon to discuss the outcome of the surgery
c) Access to the chart needs a signed release form
Ch. 4
After a motor vehicle crash, a nurse stops to help. Which actions is/are most appropriate?
SATA
a) Should know the Good Samaritan Act for the state
b) The nurse is not held liable unless there is gross negligence
c) After assessing, the nurse can leave to get help
d) The nurse can expect compensation for helping
e) The nurse offers to help but cannot insist on helping
a) Should know the Good Samaritan Act for the state
b) The nurse is not held liable unless there is gross negligence
e) The nurse offers to help but cannot insist on helping
Ch. 4
The nurse notices that a colleague's behaviors have changed the past month. Which could
indicate signs of impairment? SATA
a) Increasingly absent from the unit during shift
b) Interacts well with others
c) Doesn't logout after admin. controlled substances
d) Offers to give prn opiods for other nurses' clients
e) Is able to say "no" to requests to work more shifts
a) Increasingly absent from the unit during shift
c) Doesn't logout after admin. controlled substances
d) Offers to give prn opiods for other nurses' clients
Ch. 4
Which nursing actions could result in malpractice? SATA
a) Learns about a new piece of equipment
b) Forgets to complete the assessment of a client
c) Does not follow up on client's complaints
d) Charts client's drug allergies
e) Questions primary care provider about an illegible order
b) Forgets to complete the assessment of a client
c) Does not follow up on client's complaints
Ch. 5
When an ethical issue arises, one of the most important nursing responsibilities in managing
client care situations is which of the following?
a) be able to defend the morality of one's own actions
b) remain neutral and detached when making ethical decisions
c) ensure that a team is responsible for deciding ethical questions
d) follow the client and family's wishes exactly
a) be able to defend the morality of one's own actions
Ch. 5
Which is a clear violation of the principles of professional nursing ethics?
a) policy allows internal fetal monitors for labor, there are articles to support and refute the
value
b) when asked about a medication, a nurse says, "I never look them up I just give what is
prescribed"
c) The nurses agree to fundraise to support a labor strike proposed by nurses at another
facility
d) a client says he didn't tell the Dr the truth when asked about his therapeutic diet
b) when asked about a medication, a nurse says, "I never look them up I just give what is

prescribed"
Ch. 5 After a motor vehicle crash, the parents refuse withdrawal of life support from the child
with no brain function. The nurse thinks the child should be allowed to die and organ
donation considered, but supports their decision. Which moral principle is the basis for the
nurse's actions?
a) Respect for autonomy
b) Nonmaleficence
c) Beneficence
d) Justice
a) Respect for autonomy
Ch. 5 Which statement would be most helpful when a nurse is helping clients clarify values?
a) "That was a poor decision. Why would it work?"
b) "The most important thing is to follow the plan of care. Did you follow all your doctor's
orders?"
c) "Some people might have made a different decision. What led you to make your
decision?"
d) "If you had asked me, I would have given you my opinion about what to do. Now, h0w do
you feel about your choice?"
c) "Some people might have made a different decision. What led you to make your
decision?"
Ch. 5 After recovering from her hip replacement, an elderly client wants to go home. The
family wants her to go to a nursing home. If the nurse were acting as a client advocate, the
nurse would perform which of the following actions?
a) Tell the family the client can decide on her own
b) Ask the Dr. to discharge the client home
c) Suggest the client hire a lawyer
d) Help the client and family communicate their views to each other
d) Help the client and family communicate their views to each other
Ch. 5
Values, moral frameworks, & codes of ethics influence the professional RN's moral decisions
in which of the following ways?
a) the nurse will provide direct client care that is consistent with the nurse's personal values
b) the nurse will seek to ensure that the client's values and the nurse's are the same
c) the choice of moral framework determines what the client outcome will be
d) the nurse is bound to act accordingly to the nurses' code of ethics even if the nurse's
values are different
d) the nurse is bound to act accordingly to the nurses' code of ethics even if the nurse's
values are different
Ch. 18
The major factor contributing to the increased emphasis on the need for proficiency in
cultural nursing practice in the United States is which of the following?
a) an increased birth rate
b) increased access to health care services
c) demographic changes
d) a decreasing rate of immigration
c) demographic changes
Ch. 18
Which behavior is an initial step in cultural responsive nursing practice?
a) help the client recognize the need to adapt health practices to fit commonly accepted
practices
b) discuss the meaning of the medical regimen with the client
c) inform the client that lack of adherence to the medical regimen may be detrimental
d) ask a cultural broker to explain the relevance of the intervention
b) discuss the meaning of the medical regimen with the client
Ch. 18

In initiating care for a pt from a different culture than the nurse, which of the following would
be an appropriate statement?
a) "Since, in your culture, people dont drink ice water, I will bring you hot tea."
b) "Do you have any books I could read about people of your culture?"
c) "Please let me know if I do anything that is unacceptable in your culture."
d) "You will need to set aside your usual customs and practices while you are in the
hospital."
c) "Please let me know if I do anything that is unacceptable in your culture."
Ch. 18
Which behavior is most representative of a culturally competent nurse?
a) helps clients of Native American heritage identify ways to relate more to their culture
b) helps parents of Latino heritage recognize that their children need to speak English
c) interprets and validates beliefs of a client with African American heritage
d) asks a nurse of Japanese heritage to teach others dosage calculations since Asians are
good at math
c) interprets and validates beliefs of a client with African American heritage
nursing action primarily supports restoring HEALTH using traditional methods
a) herbal teas
b) prayer
c) wearing symbolic objects
d) exercise
a) herbal teas
Ch. 18
A client with strong preferences for folk healing methods would prefer which of the following
to treat a sinus infection?
a) hospitalization
b) steam humidifier
c) antibiotic therapy
d) watch and wait
b) steam humidifier
Ch. 18
Which of the following factors are most likely to be influenced by culture as opposed to
personal characteristics? SATA
a) value of older people in society
b) gender roles
c) nonverbal gestures
d) skill and technology
e) intelligence
f) diet
a) value of older people in society
b) gender roles
c) nonverbal gestures
f) diet
Ch. 18
What is the most productive method of gathering assessment data regarding heritage?
a) physical exam
b) medical history
c) blood analysis
d) traditional beliefs and practices checklist
d) traditional beliefs and practices checklist
Ch. 18
A client who speaks limited English requires instructions for a test. No one at your agency
speaks the person's language. What is the nurse's best approach?
a) provide the instructions in writing.
b) locate a professional interpreter.

c) ask a family member to translate on the phone

d) document that the required instruction is not possible
b) locate a professional interpreter.
statements is not true of ethics in nursing? SATA
a) it deals with issues of human conduct
b) it is concerned with actions, motives, and outcomes
c) it prescribes the right answer when an ethical dilemma is present
d) it defines processes to explore factors that constitute proper conduct
a) it deals with issues of human conduct
b) it is concerned with actions, motives, and outcomes
d) it defines processes to explore factors that constitute proper conduct
Ch. 3
Which of the following choices is a core nursing value that involves promoting good,
preventing harm, and removing the patient from harm?
a) malfeasance
b) beneficence
c) autonomy
d) veracity
b) beneficence
Ch. 3
Which of the following choices is one possible indication that a situation poses an ethical
dilemma?
a) a personal injury attorney has filed a lawsuit
b) scientific information alone does not provide the answer
c) government agencies have been unable to agree on a course of action
d) legislation has been proposed but not enacted into law
b) scientific information alone does not provide the answer
Ch. 3
Which of the following laws has been enacted primarily to protect patient confidentiality
a) tort law
b) DNR (do not resuscitate) orders
c) Health Insurance Portability and Accountability Act (HIPAA)
d) Model Nurse Practice Act (MNPA)
c) Health Insurance Portability and Accountability Act (HIPAA)
Ch. 3
Who is able to give legal consent to his or her own treatment?
a) a 17-year-old honor student who has been accepted to the nursing program at a local
college
b) a recently retired man who is showing unexplained signs of confusion
c) a known drug user who says she does not understand the procedure but trusts the nurse's
judgment
d) a pregnant woman who says she does understand the proposed procedure and trusts the
nurse's judgment
d) a pregnant woman who says she does understand the proposed procedure and trusts the
nurse's judgment
Ch. 3
Which of the following statements about DNR orders is true?
a) the orders should be reviewed regularly in case the patient's status changes
b) even if a written order exists, the physician on call may legally choose to resuscitate a
patient if he or she thinks survival is likely
c) if a patient is especially ill or is an older adult, the health care team may decide to initiate
a "slow code"
d) the health care institution cannot be held liable for ignoring DNR orders if its staffing falls
below a predetermined minimal level
a) the orders should be reviewed regularly in case the patient's status changes

the following choices is a core nursing value that involves promoting good, preventing harm,
and removing the patient from harm?
a) malfeasance
b) beneficence
c) autonomy
d) veracity
b) beneficence
Ch. 3
Which of the following choices is one possible indication that a situation poses an ethical
dilemma?
a) a personal injury attorney has filed a lawsuit
b) scientific information alone does not provide the answer
c) government agencies have been unable to agree on a course of action
d) legislation has been proposed but not enacted into law
b) scientific information alone does not provide the answer
Ch. 3
Which of the following laws has been enacted primarily to protect patient confidentiality
a) tort law
b) DNR (do not resuscitate) orders
c) Health Insurance Portability and Accountability Act (HIPAA)
d) Model Nurse Practice Act (MNPA)
c) Health Insurance Portability and Accountability Act (HIPAA)
Ch. 3
Who is able to give legal consent to his or her own treatment?
a) a 17-year-old honor student who has been accepted to the nursing program at a local
college
b) a recently retired man who is showing unexplained signs of confusion
c) a known drug user who says she does not understand the procedure but trusts the nurse's
judgment
d) a pregnant woman who says she does understand the proposed procedure and trusts the
nurse's judgment
d) a pregnant woman who says she does understand the proposed procedure and trusts the
nurse's judgment
Ch. 3
Which of the following statements about DNR orders is true?
a) the orders should be reviewed regularly in case the patient's status changes
b) even if a written order exists, the physician on call may legally choose to resuscitate a
patient if he or she thinks survival is likely
c) if a patient is especially ill or is an older adult, the health care team may decide to initiate
a "slow code"
d) the health care institution cannot be held liable for ignoring DNR orders if its staffing falls
below a predetermined minimal level
a) the orders should be reviewed regularly in case the patient's status changes
According to the Standards of Practice and Educational Competencies of Graduates of
Practical/Vocational Nursing Programs, graduates of LVN/LPN programs are able to: SATA
a) incorporate interpersonal and therapeutic communication skills
b) collect holistic assessment data from multiple sources
c) independently plan or revise patient plans of care
d) demonstrate a caring and empathetic approach to care of each client
a) incorporate interpersonal and therapeutic communication skills
b) collect holistic assessment data from multiple sources
d) demonstrate a caring and empathetic approach to care of each client
Ch. 3
Select the options that describe a focused assessment as performed by an LVN/LPN. SATA
a) supports ongoing data collection

b) yields a comprehensive evaluation of all available patient data

c) replaces the registered nurse's assessment
d) appraises an individual's status and situation at hand
a) supports ongoing data collection
d) appraises an individual's status and situation at hand
Ch. 3
In a state where the law permits LVNs/LPNs to delegate to nursing assistive personnel, what
factor or factors determine the tasks, functions or activities that can be delegated? SATA
a) the willingness of the nursing assistive personnel to perform the task
b) the knowledge and skill of the nursing assistive personnel
c) nursing assistive personnel functions as defined by the board of nursing
d) patient consent for the nursing assistive personnel to perform the task
b) the knowledge and skill of the nursing assistive personnel
c) nursing assistive personnel functions as defined by the board of nursing
Ch. 3
According to HIPAA, which of the following actions violates a patient's privacy? SATA
a) having patient's names on their odor
b) providing patient information to a relative with the patient's permission
c) having clinic patients sign in on a sheet with no sensitive information
d) posting patients' name, diagnosis, and physician where staff and visitors can see it
d) posting patients' name, diagnosis, and physician where staff and visitors can
see it
1. As a nurse manager, you observe a staff nurse who over the past few weeks has become
withdrawn and has had several absences due to minor ailments. Your best action would be
to:
a. Ask the nurse if she is okay during report.
b. Refer the nurse to the employee assistance program.
c. Ask the nurse to meet with you for a few minutes before she leaves for the day.
d. Write a note to the nurse advising her that her work attendance must improve
ANS: C
Stress can lead to emotional symptoms such as depression and a variety of ailments.
Meeting with the nurse privately may assist in identifying stress and possible solutions.
2. The nurse manager of a unit has lost many staff members, and the unit is now staffed
with a large number of agency and traveling nurses. She knows that the agency and
traveling nurses are all contracted to stay on the unit for the next 3 months. One way to
improve morale and decrease stress in the unit would be to:
a. Plan a social event and include the agency and traveling nurse staff members.
b. Plan unit-based social events for your remaining permanent staff members.
c. Request hospital-based "floating" nurses to substitute for the temporary staff.
d. Implement team nursing.
ANS: A
Social support, in the form of positive work relationships, can be an important way to buffer
the effects of a stressful work environment. Including all staff in the social event enables
those who are not normally part of the team to experience this support and provides an
opportunity for the staff as a whole to develop supportive relationships.
3. As a nurse manager, the one activity you should not overlook is:
a. Posting the yearly rotation schedule.
b. Reviewing vacation requests.
c. Scheduling staffing for holidays 6 months in advance.
d. Anticipating staff sick days.
ANS: B
Free time and vacation time are needed for individuals to recharge. If time for work is more
than 60% of wake time, or when self-time is less than 10% of wake time, stress levels
increase.

4. A nurse manager has decided that she must institute some personal time management
steps to survive work and home life. Her first step should be to:
a. Determine what takes up so much of her time and energy.
b. Organize her personal and work spaces.
c. Purchase a handheld personal digital assistant to help remind her of important meetings.
d. Determine her personal and professional goals.
ANS: D
Personal time management refers, in part, to "the knowing of self." Self-awareness is a
critical leadership skill, and being self-aware and setting goals helps managers determine
how their time is best spent.
5. A hospice nurse has been feeling very stressed at work because of both the physical
strain and the emotional drain of working with clients with AIDS. She tries to walk 1 to 2
miles three times a week and to talk regularly with her husband about her work-related
feelings. One reasonable stress management strategy would be to:
a. Start taking yoga lessons.
b. Make an appointment to meet with a psychiatrist.
c. Start jogging 5 to 6 miles every day.
d. Plan to go out for a drink with fellow nurses after work every day. ANS: A
Stress relief techniques include 30 minutes of exercise five times a week, as well as
techniques such as yoga that relieve mental stress.
6. The nurse manager is implementing a shared governance model to help with
communication and decision making. Although staff members like the concept, change is
difficult. Staff nurses feel:
a. More empowered.
b. More communicative.
c. Less stressed.
d. More powerless and devalued.
ANS: D
Change can lead to feelings of being overwhelmed and powerless, especially if complexity
compression or rapid, intense changes have been involved.
7. The chief nursing officer listens to nurse managers verbalize their feelings of internal
stress. One common source of internal stress seems to be:
a. The death of a loved one.
b. Perfectionism.
c. Getting married.
d. Losing a job.
ANS: B
Losing a job, the death of a loved one, and getting married are examples of external stress.
8. The staff development educator presents a series of programs on stress management to
the nurse managers. Research has indicated that an individual's ability to deal with stress is
moderated by psychological hardiness. Psychological hardiness is a composite of:
a. Commitment, control, and challenge.
b. Commitment, powerlessness, and passivity.
c. Commitment, control, and passivity.
d. Decreased isolation, challenge, and passivity.
ANS: A
Some people have the capacity to accept changes in life with good humor and resilience,
which, in turn, influences behavior that prevents illness. Hardiness involves the capacity to
manage time and stress, to reframe situations positively, and to commit.
9. The chief nursing officer understands that a nurse manager can exhibit stress that is
related to management mistakes. An example of a management mistake is:
a. Achieving excellence on the job.
b. Following others' expectations.
c. Organizing the desktop.

d. Organizing the calendar of events. ANS: B

Following the expectations of others is attributed to role strain. Role strain involves a
subjective state that occurs when social stress is present.
10. In helping nurse managers to manage their time, the chief nursing officer suggests that
they:
a. Maintain a perfectionistic attitude.
b. Set up a complaint list.
c. Have good negotiation skills.
d. Have good information literacy skills.
ANS: D
Time can be saved by using information technology effectively, as it assists with effective
data retrieval and information gathering and with communication related to a variety of
needs in the management setting.
11. Which of the following statements would best define stress? Stress is:
a. The comfortable gap between how we like our life to be and how it actually is.
b. Everyday life, both the highs and the lows.
c. A consequence or response to an event or stimulus that can be positive or negative.
d. Identical to distress.
ANS: C
Stress is defined as a consequence or response to an event or stimulus. It is not inherently
bad (distress), and whether highs and lows are seen as distress or eustress is dependent on
each individual's interpretation of the event.
12. In a job interview for a nursing position, Joa can be assured that which of the following
will occur?
a. Both eustress and distress
b. Only eustress
c. Only distress
d. Neither eustress nor distress
ANS: A
Eustress is defined as stress that is pleasant in nature, and distress is defined as stress of an
unpleasant nature. One can assume that every interview has both of these stresses.
13. Which one of the following statements has been proven to be true?
a. Recent research has found that women do not have a unique physiologic response to
stress.
b. Both men and women interpret the same stressor in the same manner without regard to
past experiences.
c. Stress influences the immune system in one complex manner.
d. Stressors that are identical do not have the same effect on each individual.
ANS: D
Research has shown that what is perceived as a stressor is unique for all individuals.
14. An example of role conflict occurs when:
a. The director of ICU and the manager of the surgical unit wish to hire the same new
employee.
b. Two part-time staff members are hired to work in a unit, but the job expectations for them
are not clear, and the head nurse expresses disappointment in their performance.
c. The nurse manager for ICU believes he does not receive as many resources as the nurse
manager for nephrology.
d. Line managers believe that support staff use their technical knowledge to intrude on their
authority.
ANS: B
Failure to comply with expectations can lead to role conflict. Role conflict and role ambiguity
are major sources of conflict for nurses.
15. A staff nurse approaches the unit manager and indicates to her that because of her
father's death in the previous month, she is now finding it very difficult to do her work

effectively. This would be considered a(n) ________ stress.

a. Internal source
b. Familial
c. Burnout
d. External
ANS: D
External stress is outside and removed from the work setting, but it is considered workrelated stress because of the impact it has on the worker.
16. Sources of occupational stress in nursing include all except which of the following?
a. Authoritarian leadership
b. Concern about moral wrong doing by colleagues
c. Multiple changes in a short time
d. Job insecurity
ANS: A
Ethical distress, complexity compression, job insecurity, high acuity levels, rotating shifts,
and workload are all sources of work-related stress for nurses.
17. Mr. T. Jones and Mr. R. Smith are both going to become residents in Sunny Haven Lodge.
Mr. Jones views it as an opportunity to socialize and meet new friends. Mr. Smith views this
as abandonment by his family and is worried that the care will be inadequate. Each senior
perceives the situation differently. This is a good example of stress that is:
a. Both a positive stressor and a negative stressor.
b. Occurring only because of age.
c. Positive in both cases.
d. Harmful in both cases.
ANS: A
Some researchers have determined that stress is a person-environment process in which the
personal appraises the situation as taxing or not. Appraisal is an important concept that
explains why two people react in different ways to the same situation.
18. Jeff, an RN in his 30s, has lost a parent, just purchased a new home, and is laid off with 6
months' severance pay. A the same time, Jerry, an RN in his 50s, is financially secure and is
asked to take early retirement with a buyout. How will the two men react to the emotional
and physical influences and the sequence of stress?
a. The younger man will feel more stress.
b. The two men may or may not feel the same amount of stress.
c. The older man will feel more stress.
d. Neither man will experience any stress..
ANS: B
The amount of stress is unpredictable. Responses to stress are affected by factors such as
age, gender, personality, culture, lifestyle, health, and life experiences
19. Social stressors are considered a major factor in the stress nurses experience in the
healthcare system. Which of the following is not considered to be a social stressor?
a. High amounts of stress in the nurse home environment
b. Changes in the current healthcare system such as nursing strategies
c. Disruptive behavior coming from physicians and other healthcare workers
d. Personal stress triggers such as self-criticism and overanalyzing
ANS: D
Personal stress triggers such as self-criticism are considered intrapersonal stressors;
environmental factors such as change, work environment, and interactions with others are
considered social stressors.
20. Angel, a psychiatric nurse, is assigned to four patients. The patient that would be at

greatest risk for psychological compromise is the patient who has experienced:
a. The death of a spouse.
b. The death of a distant friend.
c. A recent job layoff.
d. A divorce.
ANS: A
Most studies that have been concerned with "life stressors" have found that the death of a
spouse produces the greatest stress.
21. "Stress-buffering" behaviors can be elicited to reduce stress. All of the following
behavioral coping responses can be used by nurse managers to reduce and manage stress
except:
a. Distancing oneself from work.
b. Using cognitive reframing to change irrational thoughts.
c. Journaling and keeping an informal diary of daily events and activities.
d. Exercising regularly.
ANS: A
Achieving balance between work and leisure is a useful strategy for stress reduction.
Distancing, however, can be a sign of depersonalization that includes negative attitudes as
well and is a characteristic of burnout.

22. The education consultant at St. Luke's Hospital is giving a workshop on

Cognitive Reframing. The consultant explains that Cognitive Reframing reduces
stress by:
a. Aiding individuals in identifying positive stressors.
b. Helping people realize that negative thinking causes emotional distress.
c. Eliminating negative stressors.
d. Replacing positive self statements with negative irrational beliefs.
ANS: B
Cognitive Reframing is a therapy that aids individuals in discovering that their
irrational thoughts can be replaced with responses that are more rational. It enables
individuals to gain a sense of control over the situation and can change "I'll
never ..." to "I can ..." or "She always ..." to "Sometimes she ..." It is an approach
that allows individuals to replace negative thoughts and statements with others that
are more realistic and helpful.
23. Time management is very essential for the nurse manager. Which of the
following is not a good time-management technique?
a. Decide what not to do.
b. Learn to say "No."
c. Learn to delegate.
d. Break down your workload into large manageable tasks.
ANS: D
To manage time successfully, it is important to break down your workload into
smaller, manageable tasks. Developing PERT and Gantt charts will aid in dealing
with larger, complex projects. Both charts can be used to outline how an individual
will approach a large project.
24. As a unit manager, you chair the unit meetings. For each meeting, you consider
and establish the purpose of the meeting. Second, you prepare an agenda. Arrange
the following steps in an order that would make the meetings productive and
successful.
1. Distribute an agenda.
2. Control the flow of interactions.

3. Select team members.

4. Start on time.
5. Keep the meeting focused and directed toward accomplishing the set objectives.
Select the correct order from the following options:
a. 1, 2, 4, 5, 3
b. 4, 1, 2, 5, 3
c. 3, 1, 4, 5, 2
d. 3, 4, 2, 1, 5
ANS: C
Planning, organizing, and keeping the group on task are critical in ensuring that
meetings are productive and that time is managed well.
MULTIPLE RESPONSE
1. High levels of work-related stress affect all but which of the following? (Select all
that apply.)
a. Job satisfaction
b. Absenteeism and turnover
c. Nurses' health
d. Client welfare
ANS: A, B, C, D
Many writers and researchers have found that these work-related areas are
adversely affected by stress.
The manager in the coronary care unit believes that the most important ethical
considerations in performance evaluations are that they include the employees
good qualities and that they give positive direction for professional growth. This
belief is an example of:
Nonmaleficence.
2. A staff nurse in the area that you manage has excelled in the delivery of client
education. You are considering implementing a new job description that would
broaden her opportunity to teach client and orient new staff members to the
value of client education. The ethical principle that you are most directly
reinforcing is:
Paternalism
3. A client refuses a simple procedure that you believe is in the clients best
interest. The two ethical principles that are directly in conflict in such a situation
are:
Autonomy and beneficence
4. An applicant in a wheelchair is applying for the position of receptionist in an
outpatient clinic. The nurse manager understands that the Americans with
Disabilities Act of 1990 requires that employers:
Make reasonable accommodations for persons who are disabled.
5. A staff nurse who was fired for reporting client abuse to the appropriate state
agency files a whistleblower lawsuit against the former employer. Reasons that
the court would use in upholding a valid whistleblower suit claiming retaliation
include that the nurse:
Had previously reported the complaint, in writing, to hospital administration.
6. In keeping with standards of The Joint Commission (TJC), the nurse manager

organizes an orientation for new staff members. As part of the orientation, the
nurse manager reviews the employee handbook. Employers may be bound to
statements in the employee handbook:
Based on the employees or the employers expectations.
7.
7. To reduce the incidence of falls in a skilled nursing unit, the nurse manager
contacts the risk manager. Risk management is a process that attempts to
identify potential hazards and:
Eliminate these risks before anyone else is harmed.
8.
8. One means of ensuring that nurses floated to other patient care areas in
healthcare organizations are qualified to work in those areas is:
Cross-educating staff members to other areas of the institution.
9.
9. A colleague asks you to give her your password access so that she can view
her partners healthcare record. This request violates the patients right to:
Privacy
10.
10. On your nursing unit, you employ LPNs, RNs, and advanced practice nurses.
You will need to be familiar with at least:
One nursing practice act and a medical act.
11.
11. A nurse on your inpatient psychiatric unit is found to have made sexually
explicit remarks toward a patient with a previous history of sexual abuse. The
patient sues, claiming malpractice. Which of the following conditions would likely
not apply in this situation?
Injury
12.
12. As a charge nurse, you counsel your RN staff member that he has satisfied his
duty of care by notifying a childs physician of his concerns about deterioration in
the childs status at 0330 hours. The physician does not come in. The child dies at
0630 hours. As the charge nurse, you could be held liable for:
Professional negligence.
13.
13. The parents of a toddler who dies after being brought to the ER launch a
lawsuit, claiming that the failure of nurses to pursue concerns related to their
sons deteriorating condition contributed to his death. The senior nurse executive
is named in the suit:
Under the doctrine of respondeat superior.

14.
14. During a staff shortage, you hire an RN from a temporary agency. The RN
administers a wrong IV medication that results in cardiac arrest and a difficult
recovery for the patient. Liability in this situation:
May depend on the patients belief regarding the employment relationship.
15.
15. You volunteer at a free community clinic. A 13-year-old girl claims to have
been diagnosed with SLE and presents with chlamydia. The team leader at the
clinic advises that:
Care can be provided as long as consent is voluntary and information about
treatment and options is provided.
16.
16. Three gravely ill patients are candidates for the only available bed in the ICU.
As the supervisor, you assign the bed to the patient with the best chance of
recovery. This decision reflects which of the following ethical principles?
Beneficence
17.
17. Which ethical principle is primarily involved in informed consent?
Autonomy
18.
18. The principle that requires nurses to uphold a professional code of ethics, to
practice within the code of ethics, and to remain competent is which of the
following?
Fidelity
19.
19. Mr. M. complains to you that one of your staff asked him details about his
sexual relationships and financial affairs. He says that these questions were
probing and unnecessary to his care, but he felt that if he refused to answer, the
nurse would be angry with him and would not provide him with good care. Mr.
M.s statements reflect concern with:
Privacy
20.
20.
To satisfy duty of care to a patient, a nurse manager is legally responsible
for all except:
Supervising the practice of the physician.
22.
MULTIPLE RESPONSE

1. One of your staff nurses asks for your advice because a patient refuses to sign
a consent for surgery. The patient says that he wont sign because he doesnt
understand the nature of the surgery. You advise that (select all that apply):
Consent must not be coerced.

The patient has a right to choose not to consent.

Witnessing a consent is related only to the voluntary nature of the signature.

23.
2. With regard to nursing practice, nurse managers are held responsible for
(select all that apply):
Practicing within legal guidelines established under state law and nurse practice
acts.

Ensuring that nursing staff under their supervision are currently licensed to
practice.
24.
MULTIPLE CHOICE

1. The risk manager informs the nurse manager of an orthopedic unit that her
unit has had an increase in incident reports about patients falling during the 11-7
shift. The nurse manager knows that the best way to resolve the problem is to:
Identify the problem.
25.
2. The nurse manager of a rehab unit wants to purchase a new anti-embolic
stocking. To make a high-quality decision, the nurse manager would:
Involve the rehab staff in the decision.
26.
3. Several nurses on an adolescent psychiatric unit complain that the teens are
becoming unmanageable on the 11-7 shift. To resolve this problem, the nurse
manager decides that the staff should have a brainstorming session. The goal of
brainstorming is to:
Generate as many solutions as possible.
27.
4. During a fire drill, several psychiatric patients become agitated. The nurse
manager quickly assigns a staff member to each patient. This autocratic decision
style is most appropriate for:
Crisis situations.

28.
5. After the nurses who work on an adolescent psychiatric unit have had a
brainstorming session, they are ready to resolve the problem of teenagers who
are unmanageable. To maximize group effectiveness in decision making and
problem solving, the nurse manager has:
Encouraged equal participation among members.
29.
6. To solve a problem, the nurse manager understands that the most important
problem-solving step is:
Accurate identification of the problem.
30.
7. A clinic nurse has observed another nurse deviating from agency policy in
performing wound care. The best approach for the clinic nurse to take is to:
Assess the risk to the client and the agency before proceeding.
31.
8. The clinic nurse understands that problem solving is best defined as:
Identifying the gap between what is and what should be.
32.
9. The risk manager wants to evaluate the reasons for an increased number of
falls on the rehab unit. The risk manager devises a fishbone diagram. A fishbone
diagram is a useful tool to:
Identify the root causes of problems.
33.
10. An outpatient surgery manager is evaluating infusion pumps for the operating
room. The manager should:
Use a decision-making tool to evaluate brands.
34.
11. Select the statement that best defines the difference between problem
solving and decision making:
Decision making is a goal-directed effort, problem solving is focused on solving an
immediate problem.
35.
12. Sue, a nurse manager, has a staff nurse that has been absent a great deal for
the past three months. A whistleblower gives some information to Sue indicating
that the staff nurse will be resigning and returning to school. Because of this, Sue
decides to do which of the following?

Do nothing.
36.
13. The maintenance department wishes to have the nursing lounge renovated, so
the lounge will be more user-friendly. The department asks the nursing staff to
make a wish list of everything that they would like to see in the new lounge. This
process is an example of which part of the decision-making process?
Assessment/Data collection
37.
14. A good nursing decision maker is one who:
Uses various models to guide the process based on the circumstances of the
situation.
38.
15. From the information supplied in this chapter, which statements best defines
critical thinking? Critical thinking is a:
High-level cognitive process that includes creativity, problem solving, and
decision making.
39.
16. Decision making is described by the nursing educator as the process one uses
to:
Choose between alternatives.
40.
17. Justin is a nurse manager in a rehabilitation unit in a small urban center. There
is a high turnover rate among rehab-assistants because of the heavy work
assignments. Justin decides to hire new staff in the order that applications are
received until all vacant positions are filled. Which of the following decisionmaking models did Justin use in making his decision?
Satisficing model
41.
18. Which of the following decision-making solutions should Justin (Question 17)
consider to have a more efficient department?
Consider all the options listed.
42.
19. When confronted with the controversy and the apparent poor morale of the
evening staff, the unit manager decided the staff needed to take some time off.
He scheduled holidays for the staff without consulting them. A couple of the staff
nurses approached the manager and indicated that the problem was not
scheduling, but rather the team leader and her patient assignments. What was
the unit managers first missed step in problem solving?
Incorrect problem identification

43.
20. John Smith, one of three managers at BSG Labs, drafted a policy that would
allow his department to do more testing in his lab. This policy included the times
for regular collection as well as a new process for emergency laboratory testing.
The policy and procedures were never followed. The reason was that:
The policy made decisions for other departments in the company.
44.
21. High-quality decisions are most likely to be made in nursing situations when:
Group size is neither too small nor too large.
45.
22. Knowing when to have the entire team participate in the decision-making
process or when to have only the team leader make the decisions depends upon
the situation and the desired outcomes. The autocratic process is used in which of
the following situations?
The task and the outcome are relatively simple.
46.
23. Jane, an experienced head nurse, is given the task of completing the summer
vacation schedule for the pediatric unit. She is fully aware of the hospitals
restrictions on time off and the number of staff on vacation at any given time, as
well as its issues regarding seniority. She weighs the options of allowing staff
choice, such as it takes more time but gives employees options. However, if
choice is allowed, this could cause arguments. Which of the following is the best
alternative?
Post a blank schedule, and ask staff members to fill in their times by a given date.
47.
24. When decision making, critical thinking, and problem solving are considered,
which of the following statements are accurate and valid points?
The nursing decision maker who is successful recognizes that only those with
similar experiences should be involved in decision making.
48.
1. In a busy rehabilitation unit, the team manager decided that the best way to
reward the staff was to give them a monetary bonus rather than time off. The
staff was very concerned about the decision and went to the administration with a
number of complaints. Critical thinking is a process that entails a number of
steps. What steps did the manager omit? She should have (select all that apply):

Identified the assumptions that were underpinning the issues.

Considered the context of the present problem or situation.

Gathered data before making her decision and evaluated all possible outcomes.
49.
MULTIPLE CHOICE

1. According to Leininger, cultural imposition is a major concern in nursing

because nurses have a tendency to impose their values, beliefs, and practices on
those of other cultures. The discussion topic most likely to be without cultural
imposition would be:
Wound management.