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A nurse is asked to act as a mentor to a new nurse. What action will the mentor expect to perform?
- A. Accepting payment to introduce the new nurse to their responsibilities
- B. Hiring the new nurse and assigning duties related to the position
- C. Enabling the new nurse to participate in professional organizations
- D. Advising and assisting the new nurse to adjust to the work environment of a busy emergency department
Correct Answer: D
Rationale: Mentorship is a relationship in which an experienced person (the mentor) advises and assists a less experienced person (prot?©g?©). This is an effective way of easing a new nurse into leadership responsibilities. An experienced nurse who is paid to introduce an employee to new responsibilities through teaching and guidance describes a preceptor, not a mentor. The nurse mentor does not hire or schedule new nurses. Nurses do not need mentors to join professional organizations.
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A nurse manager who is working to institute the SBAR communication process for all health care providers is meeting resistance to the change. How does the manager best approach the resistance?
- A. Containing the anxiety in a small group and moving forward with the initiative
- B. Explaining the change and listing the advantages to the person and the organization
- C. Reprimanding those who oppose the new initiative and praising those who willingly accept the change
- D. Quickly introducing the change and involving staff in implementation of the change
Correct Answer: B
Rationale: Change is ubiquitous, as is resistance to change. The manager should explain the proposed change to all affected, list the advantages of the proposed change for all parties, introduce the change gradually, and involve everyone affected by the change in the design and implementation of the process. The manager should not use the reward/punishment style to overcome resistance to change.
A nurse who is considered a servant leader is working in an economically depressed community setting up a free mobile health clinic. Which actions best exemplify a servant leader? Select all that apply.
- A. Motivating coworkers to solicit funding to set up the clinic
- B. Setting only realistic goals that are present oriented and easily achieved
- C. Forming an autocratic governing body to keep the project on track
- D. Spending time with supporters to help them grow in their roles
- E. Ensuring that other's lowest priority needs are served
- F. Prizing leadership because of the need to serve others
Correct Answer: A,D,F
Rationale: To serve as servant leaders, nurses need to invest in those who support the organization's values, show passion, can play to their strengths, and demonstrate a positive attitude. They should develop their vision to see the future related to a current anticipated need and motivate others to follow and engage. They also need to provide ongoing opportunities for collaborations, sharing, reflection, encouragement, and celebration as well as hard work. The servant leader allows others to have a voice, to exercise control, and to practice leading themselves. The servant first makes sure that other people's highest priority needs are being served.
Nursing students enrolled in a leadership and management course attend clinical on a surgical unit. As they are planning their day, they note one student has a complex patient with multiple medications and the need for frequent turning, pressure injury wound care, and tube feedings. Which action by the group best reflects effective teamwork and coordination?
- A. Asking patients to prioritize what they want to accomplish each day
- B. Including a 'nice to do' for every 'need to do' task on the list
- C. Front loading' their schedules with 'must do' priorities
- D. Scheduling times to assist the student with the complex patient
Correct Answer: D
Rationale: The students use teamwork and collaboration to appropriately coordinate patient care; this is the best response. By asking the patient to prioritize what they want to accomplish each day, the nurse is demonstrating an effective time management technique. To manage time, the nurse should establish goals and priorities for each day, differentiating 'need to do' from 'nice to do' tasks; the nurse should include the patient in this process. The nurse should also establish a time line, allocating priorities to hours in the workday in to keep track of falling behind and correct the problem before the day is lost.
A nurse manager is planning to update a health care provider's office from paper to electronic health records (EHR) by using the eight-step process for planned change. Place the following actions in the order in which they should be initiated:
- A. The nurse devises a plan to switch to EHR.
- B. The nurse records the time spent on written records versus EHR.
- C. The nurse attains approval from management for new computers.
- D. The nurse analyzes all options for converting to EHR.
- E. The nurse installs new computers and provides an in-service for the staff.
- F. The nurse explores possible barriers to changing to EHR.
- G. The nurse follows up with the staff to check compliance with the new system.
Correct Answer: B,F,D,C,A,E,G
Rationale: Planned change involves the following steps: (1) recognize symptoms that indicate a change is needed and collect data, (2) identify a problem to be solved through change, (3) determine and analyze alternative solutions, (4) select a course of action from possible solutions, (5) plan for making the change, (6) implement the change, (7) evaluate the change, and (8) stabilize the change.
A nurse erroneously administered two tablets of acetaminophen totaling 650 mg to their patient. When reporting this to the nurse manager, the nurse states, 'there are two tablets in a package labeled '325 mg, acetaminophen.' The prescription reads 'administer 325 mg of acetaminophen;' therefore, I administered what was in the package.' Based on a philosophy of just culture, what should happen next?
- A. The nurse should be found at fault for not clarifying the order.
- B. The package labeling should be reviewed with the pharmacy.
- C. The nurse should be disciplined.
- D. No follow-up is needed as the medication is over the counter.
Correct Answer: B
Rationale: A just culture is committed to accountability and safety. Nurses are encouraged to disclose clinical errors and potential error situations without the fear of punitive actions, allowing others to learn from this experience. Health care workers within the organization discuss concerns and challenges related to patient care, turning them into opportunities for improvement. Reviewing the package labeling with the pharmacy addresses the root cause of the error, which is unclear labeling, rather than solely blaming the nurse.