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(Leadership test 1) Leadership test 1 Test sobre Chapter 2, creado por Esmeralda Espitia el 05/02/2020.

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Chapter 2

Pregunta 1 de 25

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1. In an effort to control costs and maximize revenues, the Rehabilitation Unit at Cross Hospital reduced the number of its managers and increased the number of units for which each manager was responsible. Within a year, the number of adverse events on the units had doubled. This may be attributable to:

Selecciona una de las siguientes respuestas posibles:

  • a. The overload of staff nurses.

  • b. Resistance to change by staff.

  • c. A change in reporting systems.

  • d. Fewer clinical leaders to remove barriers to care.

Explicación

Pregunta 2 de 25

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2. The Rehabilitation Unit at Pleasant Valley Hospital has a high number of falls. Which of the following interventions might assist to reduce the number of falls on the unit?

Selecciona una de las siguientes respuestas posibles:

  • a. Determining who is responsible for the falls

  • b. Strengthening unit policies to avoid inappropriate admissions

  • c. Encouraging involvement of nurses in education related to falls and safety

  • d. Ensuring that patients are appropriately restrained if they are at risk for falls

Explicación

Pregunta 3 de 25

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3. To increase safety in patient care areas of the Valley Hospital, the executive begins by:

Selecciona una de las siguientes respuestas posibles:

  • a. Asking the community what the safety issues are.

  • b. Consulting with a management expert about staffing schedules.

  • c. Ensuring that the senior nursing officer attends the board meetings.

  • d. Instituting improved practices to reduce needle-stick injuries.

Explicación

Pregunta 4 de 25

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4. During review of back injuries, it is determined that a large number of injuries are occurring in spite of mechanical lifts being used. Furthermore, it is determined that some lifts are outdated. In addressing this concern, the unit manager:

Selecciona una de las siguientes respuestas posibles:

  • a. Meets individually with nurses who are observed to be using the lifts incorrectly to review the correct procedure.

  • b. After consultation with the staff about the review, orders new lifts to replace older ones that are malfunctioning.

  • c. Blames the system for inadequate funding for resources.

  • d. Reviews the system of reporting incidents to ensure that appropriate reporting is occurring.

Explicación

Pregunta 5 de 25

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5. The IOM Health Professions Education report highlighted patient safety concerns as:

Selecciona una de las siguientes respuestas posibles:

  • a. A normal risk in professional practice.

  • b. A result of disciplinary silos.

  • c. A reflection of frontline staff.

  • d. Related to systems errors.

Explicación

Pregunta 6 de 25

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6. If you are supporting the steps in the AHRQ document Five Steps to Safer Health Care, you would ensure that:

Selecciona una de las siguientes respuestas posibles:

  • a. Patients are actively encouraged to make decisions related to care.

  • b. Rules and decisions are made through centralized processes.

  • c. You monitor the performance of each staff member closely.

  • d. Preference is given to increasing staff numbers rather than staff credentials.

Explicación

Pregunta 7 de 25

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7. After consulting with practice environments about quality and safety concerns in health care, the Dean of Health Programs at U.S. University develops:

Selecciona una de las siguientes respuestas posibles:

  • a. A nursing program that emphasizes the development of a strong disciplinary identity.

  • b. Programming that stresses discipline-based research.

  • c. Partnerships with health care to develop software for the reporting of adverse events.

  • d. An interdisciplinary program for nurses, pharmacists, and medical practitioners that emphasizes collaborative learning teams.

Explicación

Pregunta 8 de 25

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8. In designing a quality, safe healthcare environment, the primary emphasis needs to be on:

Selecciona una de las siguientes respuestas posibles:

  • a. Evidence-based practice.

  • b. Informatics.

  • c. Staffing.

  • d. The patient.

Explicación

Pregunta 9 de 25

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9. As a patient care advocate, you regularly coach patients on how to stay safe in health care by educating them about:

Selecciona una de las siguientes respuestas posibles:

  • a. The need to understand and record all medications being taken.

  • b. Bringing their own linens and other personal items to the hospital.

  • c. Washing hands frequently while in a healthcare environment and using a hand sanitizer.

  • d. Following closely the directions and orders of healthcare providers.

Explicación

Pregunta 10 de 25

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10. As a nurse manager on the West Surgery Unit, you are interested in increasing patient safety and reducing morbidity and mortality on your unit. Which of the following recommendations would be consistent with the IOM The Future of Nursing report?

Selecciona una de las siguientes respuestas posibles:

  • a. Careful screening of nursing staff for substance use and abuse

  • b. Increased RN staffing on the unit

  • c. Salary and benefits that reflect nursing accountabilities

  • d. Increase in the percentage of baccalaureate-prepared nurses to 80%

Explicación

Pregunta 11 de 25

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11. On the West Surgery unit, you want to institute a new system for checking armbands that evidence suggests may increase safety in medication administration. The system involves technology. Which of the following strategies may assist with rapid adoption of the technology and system?

Selecciona una de las siguientes respuestas posibles:

  • a. Employ a centralized decision-making approach.

  • b. Use simulators for initial practice to build confidence.

  • c. Bring in a nurse consultant who is familiar with the technology.

  • d. Use early adopters among the staff as leaders and role models in implementation.

Explicación

Pregunta 12 de 25

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12. To achieve nurse-sensitive care standards developed by the NQF, you advocate for which of the following in your health facility?

Selecciona una de las siguientes respuestas posibles:

  • a. Evidence-based practice to reduce the prevalence of pressure sores

  • b. Implementation of informatics at the bedside

  • c. Staff-manager conferences to review reporting of adverse medical events

  • d. Patient councils to review food, recreation, and nurse-patient relations

Explicación

Pregunta 13 de 25

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13. You notice that Sally, a student on your unit, is giving information to an anxious young teen who seems very uncertain about preparation for an upper GI series. After Sally leaves the room, you ask her how she thought her conversation with the patient went and:

Selecciona una de las siguientes respuestas posibles:

  • a. Encourage her to ask the patient if he has questions or concerns about the procedure.

  • b. Advise her to consider providing the patient with more information.

  • c. Suggest that she leave some brochures on the procedure with the patient.

  • d. Suggest that she also provide teaching to the adolescents parents.

Explicación

Pregunta 14 de 25

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14. The NQF provides a model for advancement of healthcare quality that could be used in healthcare organizations. The use of this model by the Centers for Medicare & Medicaid Services specifically affects the interaction between adverse events and:

Selecciona una de las siguientes respuestas posibles:

  • a. Staffing.

  • b. Funding.

  • c. Composition of executive councils.

  • d. Composition of consumer-based councils.

Explicación

Pregunta 15 de 25

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15. In accordance with changes by the Joint Commission (TJC), Pleasant Valley Hospital amends its safety practices and policies to emphasize:

Selecciona una de las siguientes respuestas posibles:

  • a. Safety goals specific to Pleasant Valley.

  • b. Decision-making processes.

  • c. Sufficient staffing for safe care.

  • d. Increased numbers of baccalaureate-prepared RNs.

Explicación

Pregunta 16 de 25

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16. Which of the following would managers and staff review annually in order to ensure compliance with the Joint Commission (TJC) to improve patient safety?

Selecciona una de las siguientes respuestas posibles:

  • a. Appropriateness of charting terms and abbreviations

  • b. Nursing hours per patient

  • c. Acuity of patient admissions

  • d. Wait times for care

Explicación

Pregunta 17 de 25

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17. In preparation for redesignation as a MagnetTM Hospital, how would you prepare?

Selecciona una de las siguientes respuestas posibles:

  • a. Commit staff resources over a 6-month period to updating procedure manuals.

  • b. Educate staff through meetings and training sessions regarding appropriate answers to questions.

  • c. Prepare a manual that outlines orientation procedures and ensure that all safety issues are addressed.

  • d. Ensure that there are empirical data to support review of patient outcomes, actions taken, and results of actions.

Explicación

Pregunta 18 de 25

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18. Sarah is a second-year nursing student. The clinical instructor overhears Sarah telling a patient that she always checks patients bracelets before giving medication and she is not sure how the nurses on the unit get away with not making more errors than they do. The clinical instructor pulls Sarah aside and explores with her how her communication might affect the patient and what it reflects about her beliefs related to the team. The actions of the clinical instructor reflect competencies outlined by:

Selecciona una de las siguientes respuestas posibles:

  • a. QSEN.

  • b. IHI.

  • c. DNV/NIAHO.

  • d. AHRQ.

Explicación

Pregunta 19 de 25

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19. The SBAR approach to patient safety encourages:

Selecciona una de las siguientes respuestas posibles:

  • a. Consistency in assessment and practices.

  • b. Continuing education.

  • c. Multidisciplinary approaches.

  • d. Patient feedback.

Explicación

Pregunta 20 de 25

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20. As a manager in a new nursing home, where might you consult for guidance and evidence to support the development of safe patient practices?

Selecciona una de las siguientes respuestas posibles:

  • a. Hospitals

  • b. Business

  • c. Industry

  • d. Outpatient clinics

Explicación

Pregunta 21 de 25

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21. As a manager, the development of your decision-making skills related to safe patient care is facilitated by:

Selecciona una de las siguientes respuestas posibles:

  • a. Regular reflection on decisions.

  • b. A culture of perfectionism.

  • c. Recognition of who should be held responsible for individual errors.

  • d. A culture of trust between the staff and you.

Explicación

Pregunta 22 de 25

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22. Mary, an 85-year-old patient with cognitive impairment and gross instability, wanders continuously. Lately, she has fallen twice, and the family demands that she be restrained. As the unit manager, you have initiated a least restraint practice. An appropriate action in this situation would be:

Selecciona una de las siguientes respuestas posibles:

  • a. Setting up a nursing team meeting to review practices.

  • b. Calling the family to inform them of the practice.

  • c. Initiating a multidisciplinary and family meeting to focus on Marys needs.

  • d. Restraining Mary to satisfy the familys wishes.

Explicación

Pregunta 23 de 25

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23. A client requires an appendectomy. The surgeon explains the procedure and asks the client to sign the consent. The patient speaks very little English and looks worried. As a nurse, you would:

Selecciona una de las siguientes respuestas posibles:

  • a. Suggest that an interpreter explain the procedure to the client and answer any questions.

  • b. Ask the client if he has any questions.

  • c. Draw a picture to show the incision.

  • d. Not intervene.

Explicación

Pregunta 24 de 25

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24. As the manager on an acute care medical unit, you note that the incidence of medication errors has increased since the implementation of staffing changes. As part of your strategy to reduce errors, it is important to

Selecciona una de las siguientes respuestas posibles:

  • a. Re-visit reporting standards for medication errors in your organization.

  • b. Ensure that medication errors are consistently reported.

  • c. Provide staff with additional education related to safe practice in medication administration.

  • d. Involve RN staff in determining reasons for errors and practice solutions to increase the safety of medication administration.

Explicación

Pregunta 25 de 25

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1. Which of the following patients would be at greatest risk in a healthcare visit (select all that apply)?

Selecciona una o más de las siguientes respuestas posibles:

  • a. Clyde requires an anticoagulant. He tells the nurse about his medications. He does not include an herbal supplement.

  • b. George is very shy and withdrawn. He asks the nurse to leave him alone.

  • c. Sarah is a new parent who finds that nurses on the childrens unit are very helpful. She is eager to accept all suggestions, including those that she does not yet understand.

  • d. Claude is booked for bowel surgery. His doctor explains about the colostomy. Later, Claude tells his wife that he really doesnt know what the doctor meant by colostomy.

Explicación