Managing Patient Care

1.A registered nurse works as a case manager in the local hospital. What primary role will the nurse be fulfilling?

a.
Coordinating care for patients with a specific condition
b.
Only working with primary health care providers
c.
Directing care of all patients in the hospital setting
d.
Providing direct care to specific patients

ANS: A

What is unique about case management is that clinicians, either as individuals or as part of a collaborative group, oversee the management of patients with specific case types, focusing on length of stay and improving clinical outcomes (e.g., patients with specific diagnoses presenting complex nursing and medical problems such as heart failure or diabetes). Case managers work with social services, dietitians, and physical therapists to name a few. Case managers do not care for all patients, just a specific case type. Case managers do not provide direct care. Instead they collaborate with and supervise the care that other staff members deliver.

PTS:1DIF:Cognitive Level: Applying (Application)

REF: 228 OBJ: Differentiate among the types of nursing care delivery models.

TOP: Nursing Process: Implementation MSC: NCLEX: Management of Care

2.A nurse manager is interested in supporting more involvement of the staff nurses on the unit. What is one approach the nurse manager can take to facilitate this involvement?

a.
Inform the staff of decisions made.
b.
Use decentralized management.
c.
Avoid unit goals.
d.
Discourage input from other personnel.

ANS: B

Decentralized management, in which decision making is made at the staff level, is very common within health care organizations. Advantages of decentralization include increased morale and improved interpersonal relationships among staff. Staff members feel more important and are more willing to contribute. The staff should be making the decisions, not being informed of decisions made. To make decentralized decision making work, managers need to move it down to the staff level. On a nursing unit it is important for all staff members (RNs, LPNs, and LVNs), nursing assistive personnel (NAP), and unit secretaries to feel involved, particularly with issues affecting their ability to care for patients. One of the responsibilities of a nurse manager is to help the staff establish annual goals for the unit. Avoiding unit goals will decrease involvement, not increase the participation.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:228

OBJ: Discuss the ways in which a nurse manager supports staff involvement in a decentralized decision-making model. TOP: Nursing Process: Implementation

MSC: NCLEX: Management of Care

3.A primary nurse caring for a patient with kidney failure develops a plan of care for the patient after consulting with the patient on the best way to manage the patient’s diet. As the staff delivers the plan of care the primary nurse evaluates whether the plan is working. Which attribute is the primary nurse displaying?

a.
Responsibility
b.
Interprofessional collaboration
c.
Delegation
d.
Staff involvement

ANS: A

Responsibility refers to the duties and activities that an individual is employed to perform. For example, a primary nurse is responsible for completing a nursing assessment of all assigned patients and developing a plan of care that addresses each of the patient’s nursing diagnoses. As the staff delivers the plan of care, the primary nurse is responsible for evaluating whether the plan is successful and what to do when it is not successful. Staff involvement is not the attribute the primary nurse is displaying. This is the nurse’s responsibility. Delegation is the process of assigning part of one person’s responsibility to another qualified person in a specific situation. The nurse developed the care plan and followed up, which is responsibility, not delegation. Interprofessional collaboration involves bringing representatives of the various disciplines together to work with patients and families to deliver quality care. This scenario did not use other health professionals; it involved just the nursing aspect.

PTS:1DIF:Cognitive Level: Applying (Application)

REF: 228-229 OBJ: Describe the elements of decentralized decision making.

TOP: Nursing Process: Assessment MSC: NCLEX: Management of Care

4.A registered nurse delegates vital signs on a patient to the unlicensed assistive personnel (UAP). The nurse reviews the documented vital signs from the UAP to determine if they are within normal parameters for the patient. The nurse in this example is demonstrating which attribute when following up on the vital signs?

a.
Interprofessional collaboration
b.
Staff education
c.
Accountability
d.
Delegation

ANS: C

Accountability refers to liability or individuals being answerable for their actions. It involves follow up and a reflective analysis of your decisions to evaluate their effectiveness. A primary nurse delegates responsibility but is accountable for his or her patients’ outcomes. Interprofessional collaboration involves bringing representatives of the various disciplines together to work with patients and families to deliver quality care. A nurse and a UAP are not from different disciplines. Following up is not an example of delegation; the nurse did it. Delegation is the process of assigning part of one person’s responsibility to another qualified person in a specific situation. When the nurse assigned the vital signs that is delegation. Staff education involves planning in-service training sessions, sending staff members to professional conferences, and having staff members present case studies or practice issues during staff meetings.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF: 229 OBJ: Describe the elements of decentralized decision making.

TOP: Nursing Process: Evaluation MSC: NCLEX: Management of Care

5.A nurse is using SBAR. Which information will the nurse report for the “B”?

a.
The patient had a broken right leg with a cast applied 2 days ago.
b.
The toes are cool and pale.
c.
The patient is reporting severe pain—10 out of 10—even after pain medication was given.
d.
The nurse requests that the primary health care provider examine the patient.

ANS: A

“B” stands for background. The information for the patient’s background is the following: the patient had a broken right leg with a cast applied 2 days ago. Structured communication techniques used by health care teams that improve communication include: briefings or short discussions among team member; group rounds on patients; and use of Situation-Background-Assessment-Recommendation (SBAR) when sharing information. “S” is the situation. The patient is reporting severe pain—10 out of 10—even after pain medication was given. “A” is assessment. The patient’s toes are cool and pale. “R” is the recommendation. The nurse requests that the primary health care provider examine the patient.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:233

OBJ:Describe the process of interprofessional collaboration among nurses and health care providers.TOP:Nursing Process: Implementation

MSC: NCLEX: Management of Care

6.A patient admitted to the intensive care unit was placed on ventilator support. The nurse caring for this patient identified on the plan of care that one of the outcomes was that the patient would not develop ventilator-acquired pneumonia (VAP). To achieve this outcome, the nurse delegates the following to the unlicensed assistive personnel: “Please perform oral care on the patient every 2 hours. In this situation oral care would include using the special swabs we have for our patients on VAP precautions so we can prevent pneumonia.” Which of the five rights of delegation did the nurse use?

a.
Right route
b.
Right direction/communication
c.
Right dose
d.
Right supervision

ANS: B

The nurse used right direction/communication. Give a clear, concise description of the task, including its objective, limits, and expectations. Communication must be ongoing between the nurse and nursing assistive personnel during a shift of care. The nurse did not use right supervision in this scenario. To provide right supervision, provide appropriate monitoring, evaluation, intervention as needed, and feedback. Nursing assistive personnel should feel comfortable asking questions and seeking assistance. There is no right dose or route in the five rights of delegation; right dose and route are included in the rights of medication administration.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:234

OBJ: Discuss principles to follow in the appropriate delegation of patient care activities.

TOP: Nursing Process: Implementation MSC: NCLEX: Management of Care

7.A patient is admitted to the hospital for hip replacement surgery after falling at home and breaking a hip. The patient has developed pneumonia while in the hospital and has required frequent suctioning from the tracheostomy. The nurse decides to delegate I&O to the unlicensed assistive personnel but does not delegate suctioning. This is an example of which of the five rights of delegation?

a.
Right task
b.
Right direction/communication
c.
Right intervention
d.
Right supervision

ANS: A

This is the right task because the nurse delegated I&O, but not tracheostomy suctioning. The right task is one that you can delegate for a specific patient, such as tasks that are repetitive, require little supervision, are relatively noninvasive, have results that are predictable, and have minimal potential risk. Right direction/communication involves the following: Give a clear, concise description of the task, including its objective, limits, and expectations. Communication must be ongoing between the nurse and nursing assistive personnel during a shift of care. There is no “right” for an intervention. Right supervision includes the following: Provide appropriate monitoring, evaluation, intervention as needed, and feedback. Nursing assistive personnel should feel comfortable asking questions and seeking assistance.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:234

OBJ: Discuss principles to follow in the appropriate delegation of patient care activities.

TOP: Nursing Process: Assessment MSC: NCLEX: Management of Care

8.A nurse is in the acute care unit caring for a 67-year-old patient with a varicose ulcer in the right lower leg. The wound has been healing well but will require a dressing change during the shift. What priority level should the nurse classify this problem?

a.
High priority
b.
Low priority
c.
Mid priority
d.
Intermediate priority

ANS: D

Intermediate priority problems are nonemergency, non–life-threatening actual or potential needs that the patient and family are experiencing. Anticipating teaching needs of patients related to a new drug or taking measures to decrease postoperative complications are examples of intermediate priorities. High priority is an immediate threat to a patient’s survival or safety, such as a physiological episode of obstructed airway, loss of consciousness, or a psychological episode of an anxiety attack. Low priority problems are actual or potential problems that may not be directly related to the patient’s illness or disease. They are often related to the patient’s developmental and/or long-term health care needs (e.g., teaching for self-care in the home before discharge of a patient who has just been admitted to the hospital). There is no mid priority label.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:231

OBJ: Discuss ways to apply clinical care coordination skills in nursing practice.

TOP: Nursing Process: Assessment MSC: NCLEX: Management of Care

9.A new nurse would like to work where clinical performance is valued and in an environment that uses evidence-based practice. Given the new nurse’s goals, which organization would be the best for this nurse?

a.
Private hospitals
b.
Community hospitals
c.
Not-for-profit hospitals
d.
Magnet-designated hospitals

ANS: D

A magnet-designated hospital will fit this new nurse’s goals better than a private, community, or not-for-profit hospital. Typically a magnet hospital has a system to recognize and reward nurses for clinical performance, has research programs, and uses evidence-based practice.

PTS:1DIF:Cognitive Level: Applying (Application)

REF: 226 OBJ: Differentiate among the types of nursing care delivery models.

TOP: Nursing Process: Evaluation MSC: NCLEX: Management of Care

10.A nurse has worked in a variety of nursing areas and would like to find a unit within the hospital that mirrors the nurse’s own professional values. The best way for the nurse to find a unit that would be a good fit is for the nurse to examine which document?

a.
Hospital mission statement
b.
Unit policies and procedures
c.
Unit philosophy of care
d.
Hospital vision statement

ANS: C

A philosophy of care incorporates the professional nursing staff’s values and concerns for the way that they view and care for patients. For example, a philosophy addresses the nursing unit’s purpose, how staff will work with patients and families, and the standards of care for the work unit. A philosophy is a vision for how to practice nursing. A hospital’s mission statement and/or philosophy are for the entire hospital, not just the specific nursing unit. Unit policies and procedures will not give the nurse a good idea about the unit’s values and beliefs.

PTS:1DIF:Cognitive Level: Applying (Application)

REF: 226 OBJ: Differentiate among the types of nursing care delivery models.

TOP: Nursing Process: Evaluation MSC: NCLEX: Management of Care

11.A registered nurse (RN) works on a unit with other registered nurses, licensed practical nurses (LPN), and nursing assistive technicians. Usually a RN, LPN, and nursing assistive technician provide direct care for a group of patients. The RN coordinates all of the care the others provide. Which type of nursing care delivery models is the RN using?

a.
Team nursing
b.
Case management
c.
Primary nursing
d.
Total patient care

ANS: A

In team nursing the RN leads a team of other RNs, practical nurses, and unlicensed assistive personnel (UAP). Team members provide direct patient care under supervision of the RN. The team leader develops patient care plans, coordinates care among team members, and provides care requiring complex nursing skills. Total patient care is a nurse delivering total care to one or two patients. Case management is one nurse managing care for a specific type of patient from admission to discharge to home. The case management nurse does not provide direct patient care. When one primary RN assumes responsibility for a caseload of patients with the help of associate nurses, primary nursing is being implemented.

PTS:1DIF:Cognitive Level: Applying (Application)

REF: 227 OBJ: Differentiate among the types of nursing care delivery models.

TOP: Nursing Process: Implementation MSC: NCLEX: Management of Care

12.A nurse works in a critical care area caring for two patients during a day shift and is accountable for all their care. Which type of nursing care delivery model is the nurse using?

a.
Team nursing
b.
Case management
c.
Primary nursing
d.
Total patient care

ANS: D

During total patient care, a registered nurse is responsible for all aspects of care for one or more patients during an assigned shift. In team nursing the RN leads a team of other RNs, practical nurses, and unlicensed assistive personnel (UAP). Team members provide direct patient care under the supervision of an RN. The team leader develops patient care plans, coordinates care among team members, and provides care requiring complex nursing skills. Case management is one nurse managing care for a specific type of patient from admission to discharge to home. The case management nurse does not provide direct patient care. When one primary RN assumes responsibility for a caseload of patients with the help of associate nurses, primary nursing is being implemented.

PTS:1DIF:Cognitive Level: Applying (Application)

REF: 227 OBJ: Differentiate among the types of nursing care delivery models.

TOP: Nursing Process: Implementation MSC: NCLEX: Management of Care

13.A registered nurse who works in a women’s hospital assumes care for the same patients from the time they are admitted to the time they are discharged home. The nurse has associate nurses helping with the care. Which type of nursing care delivery model is the nurse using?

a.
Team nursing
b.
Primary care nursing
c.
Case management
d.
Total care

ANS: B

Primary nursing is a model of care delivery in which a registered nurse assumes responsibility for a caseload of patients over time (e.g., a length of stay in a hospital or a series of home care visits). Typically the registered nurse selects the patients for his or her caseload and cares for the same patients during their hospitalization or stay in the health care setting. Associate nurses help with patient care. During total patient care, a registered nurse is responsible for all aspects of care for one or more patients during an assigned shift. In team nursing the RN leads a team of other RNs, practical nurses, and unlicensed assistive personnel (UAP). Team members provide direct patient care under the supervision of the RN. The team leader develops patient care plans, coordinates care among team members, and provides care requiring complex nursing skills. Case management is one nurse managing care for a specific type of patient from admission to discharge to home. The case management nurse does not provide direct patient care.

PTS:1DIF:Cognitive Level: Applying (Application)

REF: 227 OBJ: Differentiate among the types of nursing care delivery models.

TOP: Nursing Process: Implementation MSC: NCLEX: Management of Care

14.A registered nurse has a patient assignment of caring for six postoperative patients in the orthopedic unit. The nurse completes the patient assessments, distributes medications, and provides care to the patients as outlined within the job (position) description. Which term best describes the nurse’s behavior?

a.
Interprofessional collaboration
b.
Responsibility
c.
Interprofessional rounding
d.
Case management

ANS: B

Responsibility refers to the duties and activities that an individual is employed to perform. A position description outlines a professional nurse’s responsibilities in patient care and in participating as a member of the nursing unit. Interprofessional collaboration involves bringing representatives of the various disciplines together to work with patients and families to deliver quality care. Members of the health care team round on patients and share patient information, answer questions asked by other team members, discuss patients’ clinical progress, plan of discharge, and focus all team members on the same patient goals during interprofessional rounding. What is unique about case management is that clinicians, either as individuals or as part of a collaborative group, oversee the management of patients with specific case types.

PTS:1DIF:Cognitive Level: Applying (Application)

REF: 228 OBJ: Describe the elements of decentralized decision making.

TOP: Nursing Process: Evaluation MSC: NCLEX: Management of Care

15.A nurse works in a trauma intensive care unit in a busy urban hospital. Once a week, staff members from all the disciplines caring for the trauma patients get together to discuss their progress. The patient’s family can be included in the discussion if it is approved by the patient. This is best described as which of the following?

a.
Nursing practice
b.
Staff communication
c.
Interprofessional collaboration
d.
Staff education

ANS: C

Interprofessional collaboration involves bringing representatives of the various disciplines together to work with patients and families to deliver quality care. This brings different points of view to the table to identify, clarify, and solve complex patient problems. Nursing practice is all nursing areas involved in one’s professional career. Staff communication involves sending a clear, accurate, and timely message to all members of the nursing staff; it focuses on nurses. Staff education involves planning in-service training sessions, sending staff members to professional conferences, and having staff members present case studies or practice issues during staff meetings.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:229

OBJ:Describe the process of interprofessional collaboration among nurses and health care providers.TOP:Nursing Process: Planning

MSC: NCLEX: Management of Care

16.A nursing student is seeing a patient for the first time this morning. Which action should the nursing student perform first?

a.
Focused patient assessment
b.
Patient health history
c.
Medication administration
d.
Documentation

ANS: A

When beginning a patient assignment, always conduct a focused but complete assessment of the patient’s condition and ask what outcomes the patient expects in his or her care. A patient health history is usually taken upon admission. Medication administration and documentation will occur after an assessment.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:231

OBJ: Discuss ways to apply clinical care coordination skills in nursing practice.

TOP: Nursing Process: Implementation MSC: NCLEX: Management of Care

17.A registered nurse is prioritizing care for four patients. Which patient should the nurse see first?

a.
A 44-year-old woman 1 day postoperative
b.
A 64-year-old man who had a stroke 2 days ago
c.
A 56-year-old woman with an acute asthma attack
d.
A 67-year-old man with a fractured hip

ANS: C

An acute asthma attack is a disruption in oxygen and must be addressed first. According to Maslow, meet the patient’s physiological needs such as oxygen, food, water, sleep, and elimination first. After meeting the physiological needs, meet the patient’s higher-level needs of safety, security, belonging, esteem, and self-actualization. A postoperative patient, a stroke, and a fractured hip are not as important as an acute asthma attack.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:231

OBJ: Discuss ways to apply clinical care coordination skills in nursing practice.

TOP: Nursing Process: Planning MSC: NCLEX: Management of Care

18.A new nurse is learning how to prioritize time. One of the best ways that this can be accomplished is for the new nurse to focus on which of the following?

a.
Nursing tasks
b.
Patient priorities
c.
Medication schedule
d.
Ancillary procedures

ANS: B

Because nurses have a limited amount of time with patients, it is essential to remain goal oriented and focused on patients’ priorities. For example, priorities of care help you determine which procedures you perform first, patient assessments that you will do on an ongoing basis, and the anticipated response of your patient to care activities. The better you manage yourself leads to better management of your time. Patient priorities take precedence over nursing tasks, medication schedules, and ancillary procedures.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:232

OBJ: Discuss ways to apply clinical care coordination skills in nursing practice.

TOP: Nursing Process: Assessment MSC: NCLEX: Management of Care

19.A staff nurse is caring for six patients and is working with nursing assistive personnel. Which task can the nurse safely delegate to the nursing assistive personnel?

a.
Patient assessment
b.
Patient discharge teaching
c.
Patient bed bath
d.
Patient medication administration

ANS: C

Daily, repetitive tasks of care such as basic hygiene, specimen collection, and feeding patients can be delegated. Delegation is the process of assigning part of one person’s responsibility to another qualified person in a specific situation. The nurse cannot delegate assessments or discharge teaching. Some medication administration can be delegated to licensed practical nurses, but not to nursing assistive personnel.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:234-235

OBJ: Discuss principles to follow in the appropriate delegation of patient care activities.

TOP: Nursing Process: Implementation MSC: NCLEX: Management of Care

20.A registered nurse requests that a nursing assistant give a patient a bath in the morning because the patient is going to surgery. As the nurse prepares the patient for surgery, the nurse notes that the patient has not received the bath, and it is too late to give one because surgery is calling for the patient. The nurse needs to give feedback to the nursing assistant. Where would be the most appropriate place for the nurse to provide the nursing assistant this feedback?

a.
In the hallway
b.
At the nurse’s station
c.
In the patient’s room
d.
In a private conference room

ANS: D

Give feedback in private to preserve the staff member’s dignity. If the staff member’s performance is not satisfactory, give constructive and appropriate feedback. Feedback given should be specific in regard to any mistakes that the staff members make, explaining how to avoid the mistake or a better way to handle the situation. When giving feedback, make sure to focus on things that are changeable, choose only one issue at a time, and give specific details. The hallway, nurse’s station, and patient’s room are too public for effective constructive feedback.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:235

OBJ: Discuss principles to follow in the appropriate delegation of patient care activities.

TOP: Nursing Process: Evaluation MSC: NCLEX: Management of Care

21.A nurse is teaching a patient the side effects of a medication as the nurse is giving the medication to the patient. Which attribute did the nurse display?

a.
Efficient care
b.
Effective care
c.
Using resources
d.
Using team communication

ANS: A

The nurse used efficient care. Efficient care conserves effort and minimizes interruptions. One way to be efficient is by combining various nursing activities (i.e., doing more than one thing at a time). This takes practice. For example, during medication administration or while obtaining a specimen, combine therapeutic communication skills, teaching interventions, and assessment and evaluation. Effective care is doing the right things, whereas efficient care is doing things right. The nurse did not use resources (equipment, other staff nurses) or team communication (talking to other nursing personnel) in this scenario.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:231-232

OBJ: Discuss ways to apply clinical care coordination skills in nursing practice.

TOP: Nursing Process: Implementation MSC: NCLEX: Management of Care

22.Which action indicates the new nurse is fulfilling entry-level competencies?

a.
Acts as a patient advocate
b.
Develops a theoretical framework for how to practice
c.
Manages care of one patient
d.
Establishes a quality improvement plan for the unit

ANS: A

One of the competencies of an entry-level nurse is to be a patient advocate. Developing a theoretical framework is not a competency of a new nurse; that comes with experience and advanced education. An entry-level nurse should be able to care for several patients, not one. Establishing a quality improvement plan for the unit is a nurse manager’s role, not an entry-level competency.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:226

OBJ: Discuss ways to apply clinical care coordination skills in nursing practice.

TOP: Nursing Process: Evaluation MSC: NCLEX: Safety and Infection Control

23.A nurse is assuming responsibility for a caseload of patients over a period of time. Which type of nursing care delivery models is the nurse practicing?

a.
Team nursing
b.
Primary nursing
c.
Interprofessional collaboration
d.
Decentralized management

ANS: B

Primary nursing is a model of care delivery in which a registered nurse assumes responsibility for a caseload of patients over time (e.g., a length of stay in a hospital or a series of home care visits). In team nursing, licensed vocational nurses/licensed practical nurses and assistive personnel work under the direction of the registered nurse. Interprofessional collaboration involves bringing representatives of the various disciplines together to work with patients and families to deliver quality care. Decentralized management includes decision making, which is moved down to the level of staff, involving all employees at all levels of activities.

PTS:1DIF:Cognitive Level: Applying (Application)

REF: 227 OBJ: Differentiate among the types of nursing care delivery models.

TOP: Nursing Process: Implementation MSC: NCLEX: Management of Care

24.A nurse must give feedback to a nursing assistant that did not take vital signs. How should the nurse give feedback?

a.
“How can I trust you when things don’t get done like I asked?”
b.
“You are a bad assistant because you didn’t do your tasks.”
c.
“The vital signs were not taken. What happened?”
d.
“Where did you learn to take vital signs?”

ANS: C

The best approach is: “The vital signs were not taken. What happened?” When you give feedback, make sure to focus on things that are changeable, choose only one issue at a time, and give specific details. Feedback given should be specific regarding any mistakes that staff members make, explaining how to avoid the mistake or a better way to handle the situation. Saying, “How can I trust you?” and “You are a bad assistant.” are both derogatory and they do not tell what specific task was not done. Where did you learn to take vital signs is not something that can be changed.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:235

OBJ: Discuss principles to follow in the appropriate delegation of patient care activities.

TOP: Nursing Process: Implementation MSC: NCLEX: Management of Care

MULTIPLE RESPONSE

1.A newly graduated nurse has been assigned to work with one assistive personnel staff member. When delegating skills, which guidelines should the nurse use? (Select all that apply.)

a.
Assign just bed making skills and feeding tasks.
b.
Assess the knowledge of the assistive personnel.
c.
Match tasks to the assistant’s skills.
d.
Have the nursing assistant document assessment findings.
e.
Assess skill levels of assistive personnel.

ANS: B, C, E

The guidelines for delegation include the following: assess the knowledge and skills of the person to whom you are delegating; match tasks to the assistant’s skills; and provide feedback. It is the nurse’s responsibility, not the assistant’s, to complete documentation of assessment findings. The nurse can assign/delegate more than just bed making skills and feeding tasks.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:235

OBJ: Discuss principles to follow in the appropriate delegation of patient care activities.

TOP: Nursing Process: Implementation MSC: NCLEX: Management of Care

2.Nurses working at a progressive health care organization participate in a decentralized decision-making framework where they are actively involved in nursing unit decisions. These nurses know that decentralization decision making includes which key elements? (Select all that apply.)

a.
Autonomy
b.
Prioritization
c.
Responsibility
d.
Authority
e.
Accountability

ANS: A, C, D, E

Decentralized decision making includes responsibility, autonomy, authority, and accountability. Prioritization is not a key element but does help with organizing care.

PTS:1DIF:Cognitive Level: Applying (Application)

REF: 228 OBJ: Describe the elements of decentralized decision making.

TOP: Nursing Process: Evaluation MSC: NCLEX: Management of Care

3.Which leadership skills should a nursing student use when caring for patients? (Select all that apply.)

a.
Priority setting
b.
Time management
c.
Case management
d.
Delegation
e.
Team communication

ANS: A, B, D, E

Priority setting, time management, delegation, and team communication are all leadership skills. Student nurses do not perform case management and case management is not a leadership skill but an approach to delivery of patient care.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:230-234

OBJ: Discuss ways to apply clinical care coordination skills in nursing practice.

TOP: Nursing Process: Implementation MSC: NCLEX: Management of Care

4.Which competencies should the nurse follow to be an effective team member in interprofessional collaboration? (Select all that apply.)

a.
Work to maintain a climate of mutual respect.
b.
Use your role specific knowledge to address health care needs.
c.
Apply relationship-building values and principles of team dynamics.
d.
Use a top-down communication strategy.
e.
Support a team approach to the maintenance of health.

ANS: A, B, C, E

Competencies needed for effective interprofessional collaboration include:

1. Work with individuals of other professions to maintain a climate of mutual respect and shared values.

2. Use the knowledge of one’s own role and those of other professions to appropriately assess and address the health care needs of patients and populations served.

3. Communicate with patients, families, communities and other health care professionals in a responsive and responsible manner that supports a team approach to the maintenance of health and treatment of disease.

4. Apply relationship-building values and the principles of team dynamics to perform effectively in different team roles to plan and deliver patient- and population-centered care that is safe, timely, efficient, effective, and equitable.

Using a top-down communication strategy does not apply as a team approach, but is needed for interprofessional collaboration.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:230

OBJ:Describe the process of interprofessional collaboration among nurses and health care providers.TOP:Nursing Process: Implementation

MSC: NCLEX: Management of Care