NURS336 Exam 3 Collab change delegation conflict
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Free NURS336 Exam 3 Collab change delegation conflict Questions
Which community-focused nursing intervention will provide the greatest impact in meeting the needs of the community?
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Performing a community assessment and developing a plan.
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Ensuring all homes have a smoke detector.
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Providing transportation for medically fragile clients.
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Monitoring health conditions for environmental exposures.
Explanation
Correct Answer: (A) Performing a community assessment and developing a plan.
Performing a community assessment and developing a plan addresses the entire population's needs and enables the nurse to focus on the most critical health concerns in the community. It helps identify health risks, environmental factors, and the specific needs of the community, providing a foundation for appropriate interventions.
Why Other Options are Incorrect:
- B. Ensuring all homes have a smoke detector: While ensuring homes have smoke detectors is a great preventive health measure, it focuses on a smaller issue rather than addressing the broader, overall needs of the community.
- C. Providing transportation for medically fragile clients: This option addresses a specific need, but it does not have the same wide-reaching impact as a community-wide assessment and plan.
- D. Monitoring health conditions for environmental exposures: Monitoring is important but is reactive and addresses the situation after problems have been identified. A community assessment helps prevent and manage health issues proactively by identifying them early.
Which of the following are responsibilities of the registered nurse when delegating tasks? (Select all that apply.)
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Providing clear instructions and expectations
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Ensuring the task is completed correctly
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Determining if the delegatee is competent
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Evaluating patient outcomes after the task is done
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Assigning tasks within the provider's scope of practice during emergencies
Explanation
Correct Answers: (A), (B), (C), and (D)
Providing clear instructions and expectations is a fundamental responsibility of the delegating nurse. Clear communication ensures the delegatee understands exactly what is required, the expected outcome, and any relevant precautions, which reduces the risk of error.
Ensuring the task is completed correctly reflects the registered nurse's ongoing accountability for delegated tasks. Delegation transfers the performance of a task but not the ultimate nursing responsibility for the outcome.
Determining if the delegatee is competent is a critical step in the delegation process. The nurse must assess whether the individual has the knowledge, skills, and experience necessary to safely perform the delegated task before assigning it.
Evaluating patient outcomes after the task is done is the follow-through component of delegation. The nurse must assess whether the task was performed correctly and whether it achieved the desired outcome for the patient.
Why Option E is Incorrect:
E. Assigning tasks within the provider's scope of practice during emergencies The registered nurse delegates tasks within the delegatee's scope of practice, not the provider's scope. Scope of practice for delegation refers to what the assistive personnel or other staff member is legally and competently authorized to perform, which is determined by their role and training, not the provider's scope.
Which members of the interdisciplinary team should the nurse anticipate being included in the plan of care? Select all that apply.
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Radiologist
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Speech Therapist
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Gastroenterologist
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Pharmacist
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Registered Dietitian
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Occupational Therapist
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Physical Therapist
Explanation
Correct Answer: (A) Radiologist, (C) Gastroenterologist, (D) Pharmacist, and (E) Registered Dietitian
Each of these team members is directly indicated by the provider prescriptions and the patient's clinical presentation.
The Radiologist is needed to perform and interpret the MRE (magnetic resonance enterography) of the pelvis and abdomen ordered in the prescriptions. The Gastroenterologist is essential given the gastrointestinal evaluation ordered and the complexity of managing an active Crohn's disease exacerbation with perianal abscess. The Pharmacist plays a critical role in managing corticosteroids, immunosuppressive therapies, and ensuring safe medication administration and counseling. The Registered Dietitian is necessary given the prescription for nutritional screening and management, as the patient is unable to keep food down and is at risk for malnutrition.
Why Other Options are Incorrect:
B. Speech Therapist — Speech therapy is typically indicated for swallowing difficulties, communication disorders, or cognitive-linguistic issues, none of which are present or prescribed in this case.
F. Occupational Therapist — Occupational therapy focuses on helping patients perform activities of daily living, which is not a priority concern identified in this patient's current presentation or prescriptions.
G. Physical Therapist — While physical therapy may be considered later in recovery, there is no current indication in the prescriptions or assessment findings that necessitates physical therapy at this stage of care.
A nurse is working with a patient's family who constantly complains about the hospital experience. To improve communication with this family, which strategy would be most appropriate for the nurse to use?
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Discuss situation with house supervisor.
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Schedule a time for a family meeting.
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Keep communication open and honest.
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Make a referral to Social Work.
Explanation
Correct Answer: (B) Schedule a time for a family meeting.
Scheduling a formal family meeting provides a structured, dedicated opportunity for the nurse and healthcare team to address the family's concerns directly, improve communication, and work collaboratively toward resolution. This proactive approach demonstrates respect for the family's concerns and facilitates a productive dialogue.
Why Other Options are Incorrect:
A. Discuss situation with house supervisor — Escalating to a supervisor before attempting direct communication with the family is premature and does not address the family's concerns in a timely or personal manner.
C. Keep communication open and honest — While this is always important, it is a general principle rather than a specific actionable strategy for addressing a family that is actively and consistently complaining.
D. Make a referral to Social Work — A social work referral may be appropriate later, but the immediate priority is to directly engage the family through a structured meeting rather than redirecting them to another department.
Which of the following patients would be the best candidate for nursing case management?
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Diabetes Mellitus Type 2 with A1C of 4.8
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New episode of Atrial fibrillation since 2022
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A new case of the flu for a 70 year old golfer
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Congestive Heart Failure with EF 35-40%
Explanation
Correct Answer: (D) Congestive Heart Failure with EF 35-40%
Nursing case management is most appropriate for patients with complex, chronic conditions that require coordinated, multidisciplinary care and frequent monitoring to prevent hospital readmission. A patient with congestive heart failure (CHF) and an ejection fraction of 35–40% has significantly reduced cardiac function, placing them at high risk for acute decompensation, repeated hospitalizations, and complex medication management. Case management ensures continuity of care, patient education, medication adherence, and timely follow-up to optimize outcomes and reduce costly readmissions.
Why Other Options are Incorrect:
A. Diabetes Mellitus Type 2 with A1C of 4.8 An A1C of 4.8 is within the normal range, indicating well-controlled diabetes. This patient does not currently have the level of complexity or instability that would necessitate intensive case management.
B. New episode of Atrial fibrillation since 2022 A new episode of atrial fibrillation may require monitoring and treatment, but it is not as chronically complex or high-risk for repeated hospitalization as decompensated heart failure. This patient can generally be managed through routine outpatient follow-up.
C. A new case of the flu for a 70 year old golfer While older adults require monitoring during acute illness, an otherwise healthy and active 70-year-old with influenza typically recovers with standard care and does not require the intensive coordination of nursing case management.
The effective change agent knows that involving the recipients of change early in the change process can positively result in which outcome?
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Identification of desire for status quo
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Communication of predetermined decisions
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Resistance by recipient group
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Acceptance of a proposed change
Explanation
Correct Answer: (D) Acceptance of a proposed change
When recipients of change are involved early in the change process, they develop a sense of ownership and investment in the outcome. This participation reduces fear and resistance, increases understanding of the rationale for change, and fosters cooperation, ultimately leading to greater acceptance of the proposed change.
Why Other Options are Incorrect:
A. Identification of desire for status quo — Early involvement is intended to move people away from the status quo, not reinforce it. Engaging stakeholders helps shift their perspective toward embracing change.
B. Communication of predetermined decisions — Involving recipients early implies collaborative participation, not simply informing them of decisions already made. Predetermined decisions undermine the purpose of early engagement.
C. Resistance by recipient group — Resistance is more likely when change is imposed without input. Early involvement is specifically used as a strategy to reduce resistance, not create it.
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The staff nurse reports feeling that the new staffing assignments are unfair.
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The staff nurse prefers to have the ability to self-schedule.
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The staff nurse does not understand the new policy due to its complexity.
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The staff nurse feels as though there is a lack of autonomy in decision making.
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The staff nurse's readiness to change according to the new staffing policy.
Explanation
Correct Answer: (A) The staff nurse reports feeling that the new staffing assignments are unfair, (B) The staff nurse prefers to have the ability to self-schedule, (C) The staff nurse does not understand the new policy due to its complexity, and (D) The staff nurse feels as though there is a lack of autonomy in decision making.
Resistance to change is commonly driven by perceived unfairness, loss of control, lack of understanding, and reduced autonomy. Each of these factors represents a recognized barrier that can cause a staff nurse to resist a newly implemented policy.
Why Other Options are Incorrect:
E. The staff nurse's readiness to change according to the new staffing policy — Readiness to change reflects a positive disposition toward accepting the new policy, which would reduce rather than contribute to resistance. This is a facilitating factor, not a barrier.
The nurse is working in a department with several less experienced nurses. Which attribute would this nurse possess if the leadership is to be perceived as effective?
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Visionary
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Authority
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Efficiency
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Accountability
Explanation
Correct Answer: (A) Visionary
An effective leader working among less experienced nurses must be visionary — able to inspire, guide, and set a clear direction for the team. A visionary leader motivates others by articulating goals, fostering growth, and helping less experienced nurses understand the bigger picture of patient care and professional development.
Why Other Options are Incorrect:
B. Authority — While authority may be necessary in some situations, relying primarily on authority does not constitute effective leadership, particularly in a team of developing nurses who need guidance and inspiration rather than control.
C. Efficiency — Efficiency is a valuable work trait but does not define effective leadership. A leader focused solely on efficiency may overlook the developmental needs of less experienced team members.
D. Accountability — Accountability is an important professional attribute for all nurses, but it is a baseline expectation rather than the defining characteristic of an effective leader among less experienced staff.
The nurse is aware that HCAHPS stands for?
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Hospital Clinical Accreditation of Patient Services
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Health Care Accountability and Hospital Patient System
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Healthcare and Community Assessment for Patient Safety
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Hospital Consumer Assessment of Healthcare Providers and Systems
Explanation
Correct Answer: (D) Hospital Consumer Assessment of Healthcare Providers and Systems
HCAHPS is a nationally standardized survey tool used to measure patients' perspectives on hospital care. It collects data on patient experiences related to communication, responsiveness, cleanliness, and overall care quality, and results are publicly reported to promote transparency and accountability in healthcare.
Why Other Options are Incorrect:
A. Hospital Clinical Accreditation of Patient Services — This is not a real acronym or recognized healthcare term.
B. Health Care Accountability and Hospital Patient System — This is an incorrect expansion of the acronym and does not correspond to any recognized healthcare framework.
C. Healthcare and Community Assessment for Patient Safety — This is also an incorrect expansion and does not reflect the actual meaning or purpose of HCAHPS.
In order to remain a patient advocate, a nurse may seek assistance when dealing with a patient’s end-of-life situation from which resource?
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National league for nursing
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Ethics committee
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Administrative assistant
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State board of nursing
Explanation
Correct Answer: (B) Ethics committee
When a nurse faces complex end-of-life care decisions, seeking guidance from an ethics committee is appropriate. The ethics committee provides guidance on ethical issues, especially in challenging situations like end-of-life care.
Why Other Options are Incorrect:
- A. National league for nursing: While this organization offers resources for nurses, it does not focus specifically on addressing end-of-life care issues.
- C. Administrative assistant: The administrative assistant plays an essential role in operations but does not provide ethical or clinical guidance on end-of-life care.
- D. State board of nursing: The state board of nursing is more focused on regulating nursing practice and providing licensure support, rather than providing direct guidance on end-of-life ethical dilemmas.
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