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Canadian Fundamentals of Nursing 6th Edition Potter Test Bank

Chapter 11: Nursing Leadership, Management, and Collaborative Practice Potter et al: Canadian Fundamentals of Nursing, 6th Edition MULTIPLE CHOICE 1. Which of the following is a requirement for a new nurse in delegating tasks to an unregulated

care provider (UCP)? a. Obtaining the UCP’s voluntary acceptance of the task. b. Communicating the task in understandable terms. c. Functioning with a laissez-faire style of leadership. d. Always supervising the UCP. ANS: B

When delegating, the nurse should always provide unambiguous and clear directions by describing the task, the desired outcome, and the period within which the task should be completed. Tasks should be delegated to UCPs who are capable, not necessarily to those who are willing. A laissez-faire style of leadership is not a requirement for delegation. The nurse does not necessarily have to supervise the UCP, unless it is required by policy or unless the nurse is unsure of the UCP’s ability to perform the task. DIF: Understand REF: 166| 167 OBJ: Discuss principles for the appropriate delegation of patient care activities. TOP: Implementation MSC: NCLEX: Safe and Effective Care Environment 2. To be able to meet the needs of assigned patients and the responsibilities associated with the

position, nurses must be aware of time management techniques. A time management skill for the nurse is which of the following? a. Meeting all of the patients’ needs in the early-morning hours. b. Planning effectively and being aware of competing priorities. c. Conducting patient assessments individually at separate times throughout the day. d. Leaving each day unplanned to allow for adaptations in treatments. ANS: B

Time management skills for nurses include reflecting on how they use their time, planning effectively, and being aware of competing priorities. Learning new technologies, juggling various priorities, and responding to multiple demands are issues to which nurses are required to respond in a timely manner. Meeting all of the patients’ needs in the early-morning hours would be an unrealistic goal because (1) some activities have specific time limits in terms of addressing patient needs, and some activities follow scheduled routines according to hospital policy and (2) the nurse may also have to work around changes in schedules, such as a test that was ordered for the morning. Time management involves using patient goals as a way to identify priorities. The nurse, in reviewing the care requirements, organizes his or her time so the activities of care and patient goals can be achieved. The nurse should complete the activities started with one patient before moving on to another. Because the nurse has a limited amount of time with patients, it is essential to remain goal-oriented and make a plan for using time wisely, which might include conducting patient assessments together rather than at separate times of the day. DIF: Apply REF: 166 OBJ: Discuss ways to apply skills of clinical care coordination in nursing practice.

Canadian Fundamentals of Nursing 6th Edition Potter Test Bank TOP: Implementation

MSC: NCLEX: Safe and Effective Care Environment

3. Nursing management in a facility is considering a nursing care delivery model that involves

the division of tasks, with each nurse assuming the responsibility for particular tasks. What is this model referred to as? a. Total patient care. b. Functional nursing. c. Team nursing. d. Primary nursing. ANS: B

Functional nursing is task-focused, not patient-focused. In this model, tasks are divided, with each nurse assuming responsibility for specific tasks. In the total patient care model, a registered nurse (RN) is responsible for all aspects of care for one or more patients. The RN may delegate aspects of care but retains accountability for care of all assigned patients. In team nursing, an RN leads a team that is composed of other RNs, registered psychiatric nurses or licensed practical nurses, and unregulated care providers (UCPs). The team members provide direct patient care to groups of patients, under the direction of the RN team leader. UCPs are given patient assignments rather than being assigned particular tasks. In the primary nursing model, an RN assumes responsibility for a caseload of patients over time. Typically, the RN selects the patients for his or her caseload and cares for the same patients during their hospitalization or stay in the health care setting. DIF: Understand REF: 162 OBJ: Describe the purpose, elements, and models for quality practice environments and patient safety. TOP: Assessment MSC: NCLEX: Safe and Effective Care Environment 4. The medical centre has changed its overall management philosophy from centralized to

decentralized management. What is one advantage of a decentralized management structure over a centralized structure for the nursing units? a. Staff members are not responsible for defining their roles. b. Nurse managers handle the difficult decisions. c. Communication pathways are simplified. d. Each staff member is actively involved. ANS: D

In decentralized management, decision making is moved down to the level of staff. The advantage of this structure is that managers and staff are actively involved in shaping an organization’s identity and determining its success. If decentralized decision making is in place, professional staff members have a voice in identifying the RN’s role. Each RN on the work team is responsible for knowing his or her role and how it is to be implemented on the nursing unit. Decentralized management is characterized by autonomy (freedom to decide and act). The nurse manager does not necessarily handle the difficult decisions; the staff members who are best informed about a problem or issue make decisions on the basis of their knowledge. Communication pathways are not necessarily simplified in a decentralized management structure. DIF: Understand REF: 163 OBJ: Describe the relationships between nursing leadership and healthy practice environments, patient safety, and quality patient care outcomes. TOP: Implementation MSC: NCLEX: Safe and Effective Care Environment

Canadian Fundamentals of Nursing 6th Edition Potter Test Bank

5. Which of the following is one of the four elements of decision making? a. Justice. b. Responsibility. c. Accessibility. d. Resource allocation. ANS: B

Responsibility is one of the four elements of decision making. The other three elements are autonomy, authority, and accountability. Justice and resource allocation are ethical principles and are not among the four elements of decision making. Accessibility is one of the five principles of the Canada Health Act. DIF: Remember REF: 164| 165 OBJ: Identify strategies for developing entry-level competencies related to management and leadership in nursing. TOP: Planning MSC: NCLEX: Safe and Effective Care Environment 6. The charge nurse asks an experienced nurse to admit a critically ill patient who arrives in the

emergency department. What does this action exemplify? Evaluation. Supervision. Assignment. Delegation.

a. b. c. d.

ANS: C

Assignment is the action taken when the patient or interventions are within a nurse’s scope of practice. The experienced nurse is capable of taking on this patient assignment. Delegation is transferring the responsibility to perform a function or intervention to someone who would not otherwise have the authority to perform it (i.e., the function or intervention is not within the scope of practice or scope of employment of the care provider to whom the care is being delegated). This is not an example of evaluation or supervision. DIF: Understand REF: 167 OBJ: Discuss principles for the appropriate delegation of patient care activities. TOP: Planning MSC: NCLEX: Safe and Effective Care Environment 7. The nursing management team in a facility is investigating a nursing care delivery model that

involves staff members working under the direction of an RN leader. What does this model reflect? a. Team nursing. b. Primary nursing. c. Functional nursing. d. Total patient care. ANS: A

Canadian Fundamentals of Nursing 6th Edition Potter Test Bank In team nursing, an RN leads a team that is composed of other RNs, registered psychiatric nurses or licensed practical nurses, and UCPs. The team members provide direct patient care to groups of patients, under the direction of the RN team leader. Primary nursing is a model of care delivery whereby an RN assumes responsibility for a caseload of patients over time. Typically, the RN selects the patients for his or her caseload and cares for those patients during their hospitalization or stay in the health care setting. Functional nursing is task focused, not patient focused; in a functional nursing model, tasks are divided, with each nurse assuming responsibility for specific tasks. In a total patient care model, an RN is responsible for all aspects of care for one or more patients. The RN may delegate aspects of care but retains accountability for care of all assigned patients. DIF: Understand REF: 162 OBJ: Describe the relationships between nursing leadership and healthy practice environments, patient safety, and quality patient care outcomes. TOP: Implementation MSC: NCLEX: Safe and Effective Care Environment 8. Accountability is a critical aspect of nursing care. Which of the following is an example of a

specific decision-making process of accountability? Selecting the medication schedule for the patient. Implementing discharge teaching plans that meet individual patients’ needs. Evaluating the patient’s outcomes after implementation of care. Promoting participation of all staff members in unit meetings.

a. b. c. d.

ANS: C

Accountability refers to being answerable for actions. It involves follow-up and a reflective analysis of a nurse’s decisions to evaluate their effectiveness. Selecting the medication schedule for the patient is an example of taking responsibility. Implementing discharge teaching plans that meet individual patients’ needs is an example of autonomy. Promoting participation of all staff members in unit meetings is an example both of decentralized management and of promoting authority. DIF: Understand REF: 165 OBJ: Describe entry-level professional nurse competencies related to leadership, management, and collaborative practice. TOP: Evaluate MSC: NCLEX: Safe and Effective Care Environment 9. The student nurse is seeking to learn skills associated with priority setting. Among the

different priorities of care, which of the following is an example of an intermediate priority? a. An obstructed airway. b. The need to urinate. c. Loss of consciousness. d. Activities of daily living in the home environment. ANS: B

The need to urinate is an intermediate priority because it is a nonemergency, non–life-threatening actual or potential need. An obstructed airway is of high priority because it is an immediate threat to a patient’s survival or safety. Loss of consciousness is of high priority because it is an immediate threat to a patient’s survival or safety. Activities of daily living in the home environment are a fourth-order priority; they represent an actual or potential problem with which the patient or family members may need help in the future.

Canadian Fundamentals of Nursing 6th Edition Potter Test Bank DIF: Apply REF: 166 OBJ: Discuss ways to apply skills of clinical care coordination in nursing practice. TOP: Assessment MSC: NCLEX: Safe and Effective Care Environment 10. The nurse on the unit is determining which activities may be delegated to an unregulated care

provider (UCP). A number of factors are included in the nurse’s decision. Assuming that the UCP is competent, the RN may safely delegate which of the following activities? a. Ambulation of stable patients. b. Documenting an admission history for a new patient. c. Performance of the initial transfer of a postoperative patient. d. Administering medications prepared by the RN. ANS: A

An institution’s policies and procedures and job description for a UCP provide specific guidelines with regard to which tasks or activities can be delegated. The nurse should match tasks to the delegate’s skills, such as ambulating stable patients. An admission history for a new patient should not be prepared by a UCP; the RN should perform this task. The initial transfer of a postoperative patient should not be delegated to a UCP, as the patient would be considered unstable; the RN should perform this task. The nurse should not delegate medication administration to anyone, if the nurse prepared it; the UCP is not licensed to administer medication. DIF: Apply REF: 166| 167 OBJ: Discuss principles for the appropriate delegation of patient care activities. TOP: Implementation MSC: NCLEX: Safe and Effective Care Environment 11. UCPs are allowed to perform tasks with patients in which situation? a. When tasks are delegated by another UCP. b. When asked by the patient. c. With another UCP. d. When tasks are delegated by an RN. ANS: D

An institution’s policies, procedures, and job descriptions for UCPs provide specific guidelines regarding which tasks or activities can be delegated. UCPs are not allowed to perform actions authorized for RNs unless these tasks have been properly delegated by an RN, and they can perform such actions only if they are within the UCP’s job description and employer policy. It is not appropriate to perform tasks that are delegated by another UCP, when asked by the patient, or with another UCP. DIF: Understand REF: 166| 167 OBJ: Discuss principles for the appropriate delegation of patient care activities. TOP: Implementation MSC: NCLEX: Safe and Effective Care Environment 12. One type of nursing model is an emerging model among intraprofessional nursing teams and

other health care providers who are members of the interprofessional team. What is this model called? a. Primary nursing model. b. Functional nursing model. c. Team nursing model. d. Collaborative practice model.

Canadian Fundamentals of Nursing 6th Edition Potter Test Bank ANS: D

The Registered Nurses Association of Ontario (2016) has developed evidence-informed Best Practice Guidelines for collaborative practice among nurses, interprofessional health teams, and health professionals. The other models are not considered emerging models: The primary nursing model was popular in the 1970s and 1980s; the functional nursing model was popular during World War II in response to a nursing shortage; and the team nursing model was developed in response to a nursing shortage after World War II. DIF: Understand REF: 162| 163 OBJ: Discuss how a nurse leader can contribute to collaborative practice and best practices implementation. TOP: Implementation MSC: NCLEX: Safe and Effective Care Environment 13. A management structure in which traditional units are reorganized into business units is called

what? Matrix. Centralized. Decentralized. Participatory.

a. b. c. d.

ANS: A

In a matrix management structure, traditional units are reorganized into business units. Staff may report to several managers who may be from a variety of professional practice backgrounds. Traditional units are not reorganized into business units in centralized, decentralized, or participatory management structures. DIF: Understand REF: 164 (Table 11-1) OBJ: Discuss how a nurse leader can contribute to collaborative practice and best practices implementation. TOP: Implementation MSC: NCLEX: Safe and Effective Care Environment 14. Which term characterizes the duties and activities that an individual is employed to perform? a. Autonomy. b. Authority. c. Responsibility. d. Accountability. ANS: C

The duties and activities that an individual is employed to perform reflect responsibility. Autonomy is the freedom of choice and responsibility for choices. Authority is the right to act in areas in which a nurse has been given and accepts responsibility according to legislation, standards, and the code of ethics. Accountability refers to being answerable for one’s actions. DIF: Understand REF: 164| 165 OBJ: Describe entry-level professional nurse competencies related to leadership, management, and collaborative practice. TOP: Implementation MSC: NCLEX: Safe and Effective Care Environment 15. What is a nursing manager’s greatest challenge? a. Delegation. b. Communication. c. Time management.

Canadian Fundamentals of Nursing 6th Edition Potter Test Bank d. Clinical decision making. ANS: B

Communication with staff is one of the nursing manager’s greatest challenges, especially in a large work group in which change is constant. The nursing manager’s greatest challenge is not delegation, time management, or clinical decision making. DIF: Understand REF: 165 OBJ: Discuss how a nurse leader can contribute to collaborative practice and best practices implementation. TOP: Planning MSC: NCLEX: Safe and Effective Care Environment MULTIPLE RESPONSE 1. Creating a culture of patient safety includes which of the following? (Select all that apply.) a. Awareness of health care error. b. Ensuring feedback on safety issues. c. Commitment to a just, punitive environment. d. Promotion of a systems approach to care. e. Reporting of adverse events. ANS: A, B, D, E

Awareness of health care error, ensuring feedback on safety issues, promotion of a systems approach to care, and reporting of adverse events are characteristics of a culture of patient safety. Commitment to a just, nonpunitive (rather than punitive) culture is advocated in this culture. DIF: Understand REF: 168 OBJ: Describe the purpose, elements, and models for quality practice environments and patient safety. TOP: Planning MSC: NCLEX: Safe and Effective Care Environment 2. A nurse has delegated a task to an unregulated care provider (UCP). Which of the following is

the nurse responsible for? (Select all that apply.) a. Performing the task safely. b. Maintaining accountability of the task. c. Ensuring the task is within the UCP’s job description. d. Supervising the UCP if required. e. Providing clear instructions when delegating a task. ANS: B, C, D, E

When delegating a task to a UCP, the nurse is responsible for maintaining accountability for the task, ensuring that the task is within the UCP’s job description, supervising the UCP if required by policy, and providing clear instructions about the task. The UCP is responsible for performing the task safely. DIF: Understand REF: 166 OBJ: Discuss principles for the appropriate delegation of patient care activitie s. TOP: Planning MSC: NCLEX: Safe and Effective Care Environment...