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A nurse is caring for a client with stage IV colon cancer and multiple-stage two wounds on the coccyx area. The client confides feeling very weak and wanting to discontinue further aggressive treatment. Which nursing action best demonstrates the nurse in the role of the client advocate?
- A. The nurse relays the message to the physician and requests an antidepressant.
- B. The nurse asks the client how might their family feel with this decision.
- C. The nurse sits with the client and suggests that the client reconsider.
- D. The nurse offers to be present to support the client at a family meeting.
Correct Answer: D
Rationale: Advocacy means promoting the cause of another person. The nurse functions as a client advocate by supporting the client and the client's decisions. Offering to support the client as the client expresses healthcare decisions is the best example of a client advocate. Relaying the message to the physician and asking for an antidepressant does not demonstrate supporting the client. Opening conversation related to family response is appropriate for discussion but is not the best choice to support the client. The nurse would not ask the client to reconsider because this is a block to communication.
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The nurse is planning care for the day for a client with multiple diagnoses. Which of the following criteria should the nurse consider first when setting priorities for the care of the client?
- A. Consider the priority of maintaining vital signs.
- B. Consider the priority of symptom management.
- C. Consider the priority of management of pain.
- D. Consider the priority of preventing spread of disease.
Correct Answer: A
Rationale: When prioritizing, vital signs provide data on maintaining life and are considered first. All other options come after.
An LPN is a team leader for three nursing assistants covering a unit in a long-term care facility. At the beginning of each shift, the LPN instructs the nursing assistants to decide among themselves their client assignments. The LPN administers the clients' medications and some treatments but rarely checks in with the nursing assistants during the shift. The LPN's behavior reflects which managerial style?
- A. Authoritarian
- B. Laissez-faire
- C. Democratic
- D. Multicratic
Correct Answer: B
Rationale: Laissez-faire leadership involves the least structure and control. In this scenario, the LPN allows the nursing assistants to make their own assignments and rarely checks in with them during the shift. This allows for minimal communication, which is one of the characteristics of the laissez-faire leadership style. Authoritarian leadership entails strong control by the manager over the work group, which is not demonstrated in this scenario. Democratic leadership involves more participation in decision-making by the work group. Although the nursing assistants decided among themselves about the client assignments, the LPN did not participate in the decision-making at all. There is also no communication between the nursing assistants and the LPN, which is not a characteristic of the democratic leadership style. Multicratic leadership allows a leader to determine which approach is best for a particular circumstance. This characteristic is not demonstrated in the scenario.
The LPN is assigning clients on a rehabilitation unit. Which of the following nursing actions should the LPN complete prior to assigning any delegated task?
- A. Complete nursing report
- B. Review physician notes
- C. Assess the clients
- D. Obtain feedback from the CAN
Correct Answer: C
Rationale: Assessing the client prior to delegation assures the right person, task, and circumstance. The licensed nurse should assess the appropriateness of assignment to meet the skills of the person being delegated to. Completing nursing report provides information about the client, which the assessment phase confirms. Reviewing physician notes provides updated information regarding medical prescriptions. Obtaining feedback on the assignment from CNA provides information on skill level.
Which of the following is an advantage of democratic leadership?
- A. Tasks are accomplished without staff input.
- B. Leaders see themselves as coworkers.
- C. Quick decision making occurs.
- D. Managers provide support and freedom for employees.
Correct Answer: B
Rationale: Democratic leadership involves more participation in decision-making by the work group. Leaders with this style often see themselves as coworkers. Authoritarian leadership allows little input from staff for decisions. In laissez-faire leadership, the manager leaves the work group to set goals, make decisions, and take responsibility for their own management.
A nurse at a long-term care facility is receiving an admission to a skilled medical unit with a full census. Which nursing situation is the best example of a nurse demonstrating appropriate time management skills in the care of a client?
- A. The nurse is arranging the room to best accommodate the client's medical equipment.
- B. The nurse is obtaining the needed paperwork to begin the admission process.
- C. The nurse is delegating client orientation to the room while obtaining contact information from the family.
- D. The nurse is obtaining a urinary collection hat for the toilet.
Correct Answer: C
Rationale: The best example of time management is for the nurse to delegate orientation to the room while the nurse obtains information from the family. Arranging the room to accommodate medical equipment, obtaining paperwork, or obtaining a urinary collection hat are tasks that can be delegated to unlicensed assistive personnel allowing the nurse time for something that cannot be delegated, such as an assessment or obtaining information from the client's family.