Test Bank For Fundamental Concepts and Skills For Nursing 4th Edition Dewit

Test Bank for Fundamental Concepts and Skills for
Nursing, 4th Edition : deWit
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Test Bank for Fundamental Concepts and Skills for Nursing, 4th Edition : deWit
deWit: Fundamental Concepts and Skills for Nursing, 4th Edition

Test Bank
Chapter 10: Delegation, Leadership, and Management
MULTIPLE CHOICE
1. Which statement best defines leadership?

1. A process that motivates people to accomplish set goals
2. A process that provides a framework for health care delivery systems
3. A comprehensive process that guides staff to use resources to meet patient needs
4. A comprehensive process that uses advanced management training
ANS: 3
A comprehensive process that guides staff to use resources to meet patient needs best defines
leadership.
DIF: Cognitive Level: Knowledge REF: Page 127 OBJ: Theory #1

TOP: Leadership KEY: Nursing Process Step: Implementation
MSC: NCLEX: N/A
2. The best description of an autocratic leader is a leader who

1. is permissive.
2. has confidence in the staff.
3. tightly controls team members.
4. accepts all responsibility for the team.
ANS: 3
An autocratic leader tightly controls team members and closely monitors the work of each staff
member.

MSC: NCLEX: N/A
3. The most accurate definition of a laissez-faire leader is a leader who

1. consults staff members.
3. allows team members to function independently.
4. sets goals that are task oriented.
ANS: 3
A laissez-faire leader does not attempt to control the team and offers little direction. The leader
allows the team members to function independently.

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MSC: NCLEX: N/A
4. Which of the following examples best illustrates effective communication?

1. Discussing the day’s work plan with all team members
2. Giving specific information in a tactful, friendly manner
3. Accepting responsibility for poor outcomes with two-way communication
4. Establishing eye contact and allowing people to clarify instructions
ANS: 2
Effective communication needs to be concise and delivered in a tactful and friendly manner.
DIF: Cognitive Level: Application REF: Page 128 OBJ: Theory #4

MSC: NCLEX: N/A
5. Which of the following is the most important characteristic of a nurse leader?

1. Great training skills
2. Competency in nursing skills
3. Positive demeanor and personality
4. Unsurpassed knowledge base in all areas
ANS: 2
A nurse leader must be able to demonstrate competency in nursing skills. Staff will have respect
and confidence in a leader who is proficient at nursing skills.

MSC: NCLEX: N/A
6. An effective leader needs to demonstrate good organizational skills. When a leader has to
address a problem, he should first
1. define the problem.
2. identify persons to address the problem.
3. know the legal implications of the problem.
4. look to alternatives to address the problem.
ANS: 1
The nurse leader must first be clear about what a problem involves before attempting to address
the situation.

TOP: Problem Solving KEY: Nursing Process Step: Assessment
MSC: NCLEX: N/A
7. Which of the following is the best way to evaluate a nursing assistant’s ability to perform
a skill or task?
1. Verbal confirmation from another nurse that the nursing assistant is proficient
2. Reviewing documentation that the nursing assistant is competent in skills
3. Observing the nursing assistant performing the skill or task
4. Demonstrating the skill to the nursing assistant before his demonstration
ANS: 3
The best way to evaluate a person’s ability to perform a skill is to observe him. Documentation
and information from another nurse support a nurse’s decision to delegate the task to the nursing
assistant but are not the best means for evaluation of competency.

TOP: Delegation KEY: Nursing Process Step: Assessment MSC: NCLEX: N/A
8. Which of the following is an appropriate task for a nurse to delegate to a nursing

assistant?
1. Checking a physician’s new orders
2. Changing a patient’s wound dressing
3. Taking a blood pressure of a patient who has fallen
4. Toileting a patient on a bladder-training regimen
ANS: 4
Transcribing physicians’ orders, changing a patient’s wound dressing, and assessing a patient
require interventions by licensed personnel. Toileting a patient on a routine basis is appropriate
to delegate to a nursing assistant.
DIF: Cognitive Level: Application REF: Page 130; Box 10-2

OBJ: Theory #5 TOP: Delegation KEY: Nursing Process Step: Implementation
MSC: NCLEX: N/A
9. When a nurse delegates tasks to another person, he is

1. no longer responsible to that patient.
2. responsible to communicate outcome to appropriate senior staff.
3. responsible for overall patient care.
4. liable for all adverse outcomes.
ANS: 3
Nurses are responsible for all patients’ care, regardless of tasks they have delegated to other staff
members.

TOP: Delegation KEY: Nursing Process Step: Evaluation MSC: NCLEX: N/A
10. Which of the following responsibilities is that of a charge nurse as opposed to a team
leader?
1. Evaluating members of the health care team
2. Training unlicensed assistive personnel
3. Making rounds and assessing all patients
4. Collaborating with other disciplines
ANS: 3
The nurse needs to be able to identify responsibilities of the charge nurse and team leader.

TOP: Advanced Leadership Roles KEY: Nursing Process Step: Implementation
MSC: NCLEX: N/A
11. When transcribing a physician’s orders, the nurse must

1. ensure that medications have both generic and trade names written.
2. ensure that narcotics are renewed every 24 to 48 hours.
3. review unclear orders with the charge nurse.
4. transfer orders to the Medication Administration Record (MAR).
ANS: 4
Transcribing orders means to transfer them to the Kardex and/or MAR.
DIF: Cognitive Level: Application REF: Page 133

OBJ: Clinical Practice #5 TOP: Written Orders
KEY: Nursing Process Step: Implementation MSC: NCLEX: N/A
12. Which of the following statements is not true of physicians’ orders?

1. All orders must have a date, time, and physician’s signature.
2. Verbal orders are accepted from a physician only in emergency situations.
3. Physicians’ orders written before surgery are valid when the patient is
postsurgical.
4. A physician may write specific times he desires the medications to be given.
ANS: 3
All physicians’ orders must have a date, time, and physician’s signature to be valid. Verbal
orders can be taken by a nurse when the physician is not available to write an order. Many
facilities have policies for receiving verbal orders. A physician may indicate times for
medication administration on the order sheet. Preoperative orders are automatically canceled
unless they are reordered by a physician postoperatively.

OBJ: Clinical Practice #7 TOP: Transcribing Orders
13. Minimum Data Set (MDS) forms must be filled out correctly for
1. patients to receive vital equipment and supplies.
2. documentation requirements to meet quality improvement.
3. facilities to receive Medicare and Medicaid payments.
4. risk management to evaluate injured patients.
ANS: 3
MDS sheets must be filled out correctly for facilities to receive the maximal Medicare or
Medicaid payment for services rendered.

OBJ: Clinical Practice #6 TOP: Documentation for Reimbursement KEY:
Nursing Process Step: Implementation
MSC: NCLEX: N/A
14. A key tool for risk management is

1. reviewing Minimum Data Set forms.
2. practicing nursing by accepted standards.
3. minimizing the number of lawsuits against the facility.
4. maintaining adequate insurance coverage for facilities.
ANS: 2
Nurses need to be knowledgeable about the role and responsibilities of risk management.

OBJ: Clinical Practice #7 TOP: Risk Management
15. The best description of a laissez-faire leader is a leader that

1. attempts to control the team.
2. offers a lot of direction.
3. offers little direction.
4. encourages dependence.
ANS: 3
A permissive or laissez-faire leader does not attempt to control the team and offers little if any
direction. This leader assumes that the members of the team are competent and self-directed and
will do what needs to be done correctly and efficiently. This leader often has a need to be liked
by everyone and therefore avoids any blame for things that go wrong by allowing members to
function completely independently.

TOP: Leadership KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A
16. The best description of an autocratic leader is a leader that

2. often consults staff when making decisions.
3. loosely controls team members.
4. sets rules based on staff input.
ANS: 1
The autocratic leader tightly controls team members. Staff are rarely consulted when decisions
are to be made. Rules are set without input from the staff, and directives and orders are given out
constantly. This type of leadership style has been described as "my way or the highway." The
leader closely supervises the work of each staff member. When mistakes are made, they are
quickly pointed out. The goal of this leader is accomplishment of tasks without regard to the
effect on the people.
MSC: NCLEX: N/A
17. The best description of a democratic leader is a leader that

1. disregards staff participation in decision making.
2. takes little responsibility for the actions of the team.
3. frequently consults with staff members.
4. uses only his own skills and knowledge.
ANS: 3
The democratic leader frequently consults with staff members and seeks staff participation in
decision making. The skills and knowledge of the team members are readily used to ensure that
the team functions efficiently. Team members are respected as individuals, and there is an open
and trusting attitude overall. The democratic leader is part of the team, not sitting above it, and
accepts responsibility for the actions of the team.

MSC: NCLEX: N/A
18. The nurse is delegating to a member of the facility’s unlicensed assistive personnel
(UAP). Which of the following activities would be inappropriate to delegate to the UAP?
1. Applying a condom catheter
2. Assessing a patient's pain
3. Giving a sitz bath
4. Giving an enema
ANS: 2
Assessment or aspects of the analysis, planning, or evaluation phases of the nursing process must
be performed by the registered nurse. These functions cannot be delegated to unlicensed assistive
personnel.

MSC: NCLEX: N/A
1. Repositioning a patient
2. Analyzing a patient's vital signs
3. Collecting a urine specimen
4. Recording intake and output
ANS: 2
personnel.
MSC: NCLEX: N/A
1. Developing a plan of care
2. Providing skin care
3. Measuring height and weight
4. Feeding a patient
ANS: 1
personnel.

MSC: NCLEX: N/A
21. A nurse is delegating to a member of the facility’s unlicensed assistive personnel (UAP).
Which of the following activities would be inappropriate to delegate to the UAP?
1. Toileting a patient
2. Assisting with ambulation
3. Evaluating a patient's pain
4. Applying a hearing aid
ANS: 3
personnel.

MSC: NCLEX: N/A
(UAP). Which of the following activities would be appropriate to delegate to the UAP?
1. Evaluating a patient's discomfort
2. Assessing a patient's knowledge level
3. Developing a plan of care
4. Assisting with ambulation
ANS: 4
personnel.
MSC: NCLEX: N/A
23. A nurse is delegating to a member of the facility’s unlicensed assistive personnel (UAP).
Which of the following demonstrates the best communication given by the nurse to the UAP?
1. “Let me know if my patient’s temperature is high.”
2. “Let me know if my patient’s blood pressure is high.”
3. “Let me know if my patient’s temperature is above 101º F.”
4. “Let me know if my patient’s blood pressure is low.”
ANS: 3
In order to have effective communication with the UAP, a nurse must send clear, concise
messages and listen carefully to feedback.

TOP: Communication KEY: Nursing Process Step: Implementation
MSC: NCLEX: N/A
24. A nurse is prioritizing the care of his patients. Which of the following patients should the
nurse see first?
1. A patient who has a scheduled medication due
2. A patient who requires dressing changes three times a day
3. A patient who is experiencing acute chest pain
4. A patient who is confused and disoriented
ANS: 3
Unstable patients take precedence over stable patients. Scheduled medications and treatments
must be done before tasks that are ordered “three times a day.”

OBJ: Clinical Practice #7 TOP: Prioritization
nurse see first?
1. A patient who needs her morning medications
2. A patient who needs to ambulate three times a day
3. A patient who is awaiting discharge instructions
4. A patient who is experiencing acute dyspnea (shortness of breath)
ANS: 4
Unstable patients take precedence over stable patients. Scheduled medications and treatments
must be done before tasks that are ordered “three times a day.”

nurse see first?
1. A patient who is refusing to take her scheduled morning medications
2. A patient who refuses to participate in activities of daily living
3. A patient whose blood pressure has decreased from 122/82 to 90/60
4. A patient whose blood pressure has increased from 98/70 to 126/84
ANS: 3
Unstable patients take precedence over stable patients. A patient with a significant drop in blood
pressure would take precedence over stable patients.

27. Which of the following is factual about orders written for a patient who enters surgery?
1. All orders written preoperatively are considered valid at the time a patient enters
surgery.
2. It is acceptable for a physician to write “resume previous orders” after a patient
has surgery.
3. All orders written preoperatively are considered canceled when a patient enters
surgery.
4. It is not necessary to write brand new orders in their entirety for the postsurgical
patient.
ANS: 3
All orders written preoperatively are considered canceled at the time the patient enters surgery.
Brand new orders must be written in their entirety for the postsurgical patient. “Resume previous
orders” is not acceptable by most institutional policies.

OBJ: Clinical Practice #7 TOP: Physician Orders
28. The nurse is receiving a telephone order from a physician. Which of the following actions
would warrant concern by the nurse supervisor?
1. The nurse receives the order from the physician, transcribes the order to the
chart, and tells the physician he must read back the order.
2. The nurse receives the order from the physician, reads back the order to the
physician, then transcribes the order to the chart.
3. The nurse receives the order from the physician, transcribes the order to the
chart, then reads back the order to the physician.
4. The nurse writes the telephone order verbatim as the physician gives it to him,
then reads it back to the physician as written.
ANS: 2
The Joint Commission requires institutions to verify verbal or telephone orders by having the
person receiving the order “read back” the order to the person initiating the order, usually the
physician. This “read back” requires that the person accepting the order actually write the order
down in the chart in order to be reading it back.

TOP: Risk Management KEY: Nursing Process Step: Implementation
MSC: NCLEX: N/A
COMPLETION
29. Staff nurses have many responsibilities to their patients throughout their shift. However,
the ______ _______ is responsible for the total nursing care of patients during a shift, as well as
being responsible for giving reports to the oncoming shift and evaluating members of the health
care team.
ANS:
charge nurse
All nurses need to know the responsibilities of each person on the health care team.
DIF: Cognitive Level: Analysis REF: Page 132 OBJ: Theory #6

TOP: Charge Nurse Role KEY: Nursing Process Step: Planning
MSC: NCLEX: N/A
MULTIPLE RESPONSE
30. Which of the following are characteristics of effective communication? (Select all that
apply.)
1. Using eye contact
2. Using concise statements when giving information
3. Addressing conflicts before delegation of duties
4. Obtaining feedback about directions given
ANS: 1, 2, 4
Effective communication includes using direct eye contact between the persons involved, using
concise statements for clarity, and obtaining feedback to ensure that information has been
understood. Conflict resolution may or may not pertain to communication and may be addressed
following instructions.
DIF: Cognitive Level: Application REF: Pages 128-129

OBJ: Theory #4 TOP: Effective Communication
31. Which of the following are true statements regarding delegation of duties to others by a
licensed nurse? (Select all that apply.)
1. The LPN/LVN in charge must be familiar with the competency of staff.
2. The LPN/LVN must be familiar with the job descriptions of unlicensed assistive
personnel.
3. An LPN/LVN may delegate any skill or task to a nursing assistant once the
nursing assistant has demonstrated proficiency.
4. A nurse must be familiar with the nurse practice act.
ANS: 1, 2, 4
Items 1, 2, and 4 are true statements regarding delegation of duties. An LPN may delegate a skill
or task to a nursing assistant if the task does not require a license and the nursing assistant has
demonstrated competency performing the skill.

OBJ: Theory #5 TOP: Delegation KEY: Nursing Process Step: Assessment MSC:
NCLEX: N/A
32. Which of the following are important characteristics of delegation? (Select all that
apply.)
1. Use effective communication.
2. Provide constructive criticism immediately.
3. Include desired result and time for completion.
4. Provide feedback tactfully.
ANS: 1, 3, 4
The nurse needs a clear understanding of the appropriate interventions for effective delegation.

OBJ: Theory #5 TOP: Delegation KEY: Nursing Process Step: Evaluation MSC:
NCLEX: N/A
33. Which of the following are common to an LPN/LVN team leader in both health care
facilities and medical clinics? (Select all that apply.)
1. Organizes staff meetings
2. Writes policies and procedures
3. Helps in resolving staff conflicts
4. Prepares the schedule for patient activities
ANS: 2, 3
Writing policies and procedures and assisting to resolve staff conflicts are duties common to
LPN/LVN team leaders in health care facilities and medical clinics. LPNs/LVNs generally attend
staff meetings and oversee scheduling of patients.
DIF: Cognitive Level: Application REF: Page 131 OBJ: Theory # 6 TOP:
Team Leader Responsibilities KEY: Nursing Process Step: Implementation
MSC: NCLEX: N/A
34. Which of the following are true statements about an upper GI series diagnostic study?
(Select all that apply.)
1. The patient must have taken nothing by mouth (be NPO) for the study to be
Test Bank for Fundamental Concepts and Skills for Nursing, 4th Edition : deWit
performed.
2. A physician must order the study.
3. The order needs to be transcribed by a nurse to be received by the appropriate
department.
4. The dietary department will not send the patient’s food tray once the order is
received in the radiology department.
ANS: 1, 2, 3
The nurse needs to be knowledgeable about the process involved in obtaining, transcribing, and
effectively implementing physician’s orders.

OBJ: Clinical Practice #5 TOP: Transcribing Orders
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Test Bank for Fundamental Concepts and Skills for

Nursing, 4th Edition : deWit

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deWit: Fundamental Concepts and Skills for Nursing, 4th Edition

Chapter 10: Delegation, Leadership, and Management

1. Which statement best defines leadership?

DIF: Cognitive Level: Knowledge REF: Page 127 OBJ: Theory #1

2. The best description of an autocratic leader is a leader who

DIF: Cognitive Level: Knowledge REF: Page 128 OBJ: Theory #1

3. The most accurate definition of a laissez-faire leader is a leader who

DIF: Cognitive Level: Knowledge REF: Page 127 OBJ: Theory #1

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4. Which of the following examples best illustrates effective communication?

DIF: Cognitive Level: Application REF: Page 128 OBJ: Theory #4

5. Which of the following is the most important characteristic of a nurse leader?

DIF: Cognitive Level: Application REF: Page 129 OBJ: Theory #2

DIF: Cognitive Level: Application REF: Page 129 OBJ: Theory #2

DIF: Cognitive Level: Application REF: Page 130 OBJ: Theory #5

8. Which of the following is an appropriate task for a nurse to delegate to a nursing

DIF: Cognitive Level: Application REF: Page 130; Box 10-2

9. When a nurse delegates tasks to another person, he is

DIF: Cognitive Level: Application REF: Page 130 OBJ: Theory #5

DIF: Cognitive Level: Application REF: Page 132 OBJ: Theory #6

11. When transcribing a physician’s orders, the nurse must

DIF: Cognitive Level: Application REF: Page 133

12. Which of the following statements is not true of physicians’ orders?

DIF: Cognitive Level: Application REF: Page 134

DIF: Cognitive Level: Application REF: Page 135

14. A key tool for risk management is

DIF: Cognitive Level: Application REF: Page 135

15. The best description of a laissez-faire leader is a leader that

DIF: Cognitive Level: Knowledge REF: Page 127 OBJ: Theory #1

16. The best description of an autocratic leader is a leader that

17. The best description of a democratic leader is a leader that

DIF: Cognitive Level: Knowledge REF: Page 128 OBJ: Theory #1

DIF: Cognitive Level: Application REF: Page 130 OBJ: Theory #5

DIF: Cognitive Level: Application REF: Page 130 OBJ: Theory #5

DIF: Cognitive Level: Application REF: Page 130 OBJ: Theory #5

DIF: Cognitive Level: Application REF: Page 130 OBJ: Theory #4

DIF: Cognitive Level: Application REF: Page 132

DIF: Cognitive Level: Application REF: Page 132

DIF: Cognitive Level: Application REF: Page 132

DIF: Cognitive Level: Application REF: Page 134

DIF: Cognitive Level: Application REF: Page 134 OBJ: Theory #8

DIF: Cognitive Level: Analysis REF: Page 132 OBJ: Theory #6

DIF: Cognitive Level: Application REF: Pages 128-129

DIF: Cognitive Level: Application REF: Pages 129-131

DIF: Cognitive Level: Application REF: Pages 129-131

DIF: Cognitive Level: Application REF: Page 134

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