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Which of the following would not be considered one of the five rights of delegation?
- A. Educational level
- B. Task
- C. Circumstances
- D. Person
Correct Answer: A
Rationale: The NCSBN (2019) identified the five rights of delegation: right task, right circumstances, right person, right direction/communication, and right supervision/evaluation. Educational level is not one of the five rights of delegation.
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A new client charting system is in the education phase at a healthcare facility. Much discussion has been prompted regarding the new system. With which statement does the nurse best exhibit the integrated leader/manager traits?
- A. Let's look at the daily benefits of using the new technology on the clinical unit.'
- B. I am not used to the new technology, but if it better serves the client and enables easy sharing of client authorized records, I see a benefit.'
- C. New technology may be costly up front but will serve us well in the future.'
- D. I do not believe that this technology will be helpful in caring for a client because it often is down during peak use times and is difficult to train for.'
Correct Answer: B
Rationale: The traits of an integrated leader/manager combine understanding the daily operations on a clinical unit while seeing the big picture, thinking in the long term, and embracing change. Better serving the client and sharing records as needed demonstrates the willingness to think positively and take risks on improvement for the future. Focusing only on the daily benefits or only on the future impact of using the new technology each only look at one aspect of leadership and management. Stating that the new technology will not be helpful in client care is a negative statement and does not show that the manager is able to embrace change.
Which of the following roles of a nurse is an example of legitimate power?
- A. Director of nursing
- B. Team leader making assignments
- C. Head nurse scheduling vacations
- D. Shift supervisor
Correct Answer: A
Rationale: Legitimate power is power by virtue of the management position. Director of nursing is an example of legitimate power. Team leader making assignments is an example of reward power. Head nurse scheduling vacations is an example of coercive power. Shift supervisor is an example of referent power.
During which client-nurse interaction would the nurse most appropriately use the authoritarian leadership style?
- A. The nurse is assisting the client to the bathroom when wound dehiscence occurs.
- B. The nurse is presenting meal options to a resistant diabetic client.
- C. The nurse is instructing on how to obtain blood glucose readings.
- D. The nurse is preparing discharge instructions per physician's prescription.
Correct Answer: A
Rationale: During an emergency, such as when a wound dehiscence occurs, an authoritarian leadership style with one person in tight control of the situation is best. At this time, the focus is on accomplishing the tasks of client safety, wound care, and physician notification. All of the other interactions would best be managed with a therapeutic nurse client interaction.
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.
Which statement best demonstrates a combination of leadership and management skills when teaching a client with uncontrolled diabetes?
- A. Although you have learned to check your blood sugar every morning, it is also important to recognize its overall effect on your health.'
- B. Once you have the lancet in the device, hold it against the finger and press the button.'
- C. Because Thanksgiving is next week, evaluate the amount of simple sugars in the desserts and eat those in moderation.'
- D. I will notify your health care provider of your blood glucose reading and request a referral for a dietitian to improve your knowledge of calorie-controlled diets.'
Correct Answer: A
Rationale: It is important for the nurse to acknowledge that the client has learned to check their blood sugar but also to stress the importance of recognizing the blood sugar level's overall effect on the client's health. Teaching the client how to obtain a glucose level and providing feedback uses management but not leadership. Providing teaching about simple sugars, notifying the client's health care provider, and requesting a referral for a dietitian are all examples of managing the client's care but do not address seeing the big picture, which is characteristic of leadership.