Mock-Chapter 21: Managing Patient Care
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Questions and Answers

A registered nurse (RN) is the group leader of licensed practical nurses (LPNs) and nursing assistive personnel (NAP). Which nursing care model is being implemented?

  • Total patient care
  • Primary nursing
  • Team nursing (correct)
  • Case-management
  • A nurse is overseeing the care of patients diagnosed with either severe diabetes or with heart failure. The purpose of this nursing model is to improve cost-effectiveness and quality of care. Which nursing care delivery model is the nurse using?

  • Team nursing
  • Total patient care
  • Primary nursing
  • Case-management (correct)
  • A nurse assigned to an intensive care unit (critical care) is most likely using what type of nursing care delivery model?

  • Team nursing
  • Total patient care (correct)
  • Primary nursing
  • Case-management
  • A nurse manager discovers that the readmission rate of hospitalized patients is very high on the hospital unit. The nurse manager desires improved coordination of care and accountability for cost-effective quality care. Which nursing care delivery model is best suited for these needs?

    <p>Case-management</p> Signup and view all the answers

    A nurse is working in a facility that has fewer directors which allows for managers and staff to make shared decisions. In which type of organizational structure is the nurse employed?

    <p>Decentralization</p> Signup and view all the answers

    A staff member verbalizes satisfaction in working on a particular nursing unit because of the freedom of choice and responsibility for the choices. This nurse highly values which element of shared decision making?

    <p>Autonomy</p> Signup and view all the answers

    A staff nurse delegates a task to a nursing assistive personnel (NAP), knowing that the NAP has never performed the task before. As a result, the patient is injured, and the nurse defensively states that the NAP should have known how to perform such a simple task. Which element of the decision-making process is the nurse lacking?

    <p>Accountability</p> Signup and view all the answers

    Accountability refers to individuals being answerable for their actions. The nurse in this situation is not taking ownership of the inappropriate delegation of a task. Autonomy is freedom of choice and responsibility for the choices. Responsibility refers to the duties and activities that an individual is employed to perform. Authority refers to legitimate power to give commands and make final decisions specific to a given position.

    <p>Staff education</p> Signup and view all the answers

    A nurse is making a home visit and discovers that a patient’s wound infection has gotten worse. The nurse cleans and redresses the wound. What should the nurse do next?

    <p>Notify the health care provider of the findings before leaving the home.</p> Signup and view all the answers

    A nurse manager conducts rounds on the unit and discovers that expired stock medicine is still in the cabinet despite the e-mail that was sent stating that it had to be discarded. The staff nurse dress code is not being adhered to as requested in the same e-mail. Several staff nurses deny having received the e-mail. Which action should the nurse manager take?

    <p>Place a hard copy of announcements and unit policies in each staff member’s mailbox.</p> Signup and view all the answers

    A novice nurse expresses frustration at not being to complete all interventions for a group of patients in a timely manner. The nurse leaves the rounds report sheets at the nurse’s station when caring for patients and reports having to go back and forth between rooms for equipment and supplies. Which type of skill does the nurse need?

    <p>Organizational</p> Signup and view all the answers

    Which approach will be most appropriate for a nurse to take when faced with the challenge of performing many tasks in one shift?

    <p>Complete one task before starting another task.</p> Signup and view all the answers

    Which assessment of a patient who is 1-day post-surgical repair a hip fracture requires immediate nursing intervention?

    <p>Patient reports severe pain 30 minutes after receiving pain medication.</p> Signup and view all the answers

    A nurse has a transformational leader as a manager. Which finding will the nurse anticipate from working with this leader?

    <p>Increased level of patient satisfaction</p> Signup and view all the answers

    A patient with an indwelling urinary catheter has been given a bed bath by a new nursing assistive personnel (NAP). The nurse evaluating the cleanliness of the patient notices crusting at the urinary meatus. Which action should the nurse take next?

    <p>Asks the nursing assistive personnel to observe while the nurse performs catheter care.</p> Signup and view all the answers

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

    <p>A patient with difficulty breathing</p> Signup and view all the answers

    A nursing assistive personnel (NAP) reports seeing a reddened area on the patient’s hip while bathing the patient. Which action should the nurse take?

    <p>Go to the patient’s room to assess the patient’s skin.</p> Signup and view all the answers

    A nurse is assigned to care for the following patients who all need vital signs scheduled to be taken now. Which patient is most appropriate for the nurse to delegate vital sign measurement to the nursing assistive personnel (NAP)?

    <p>Patient scheduled for a procedure in the nuclear medicine department</p> Signup and view all the answers

    Which staff member does the nurse assign to provide morning care for an older-adult patient who requires assistance with activities of daily living?

    <p>Nursing assistive personnel (NAP)</p> Signup and view all the answers

    A nurse uses the accepted rights of delegation when providing care. Which "rights" did the nurse use? (Select all that apply.)

    <p>Person/Circumstances</p> Signup and view all the answers

    Study Notes

    Nursing Care Models

    • A registered nurse (RN) is the group leader of licensed practical nurses (LPNs) and nursing assistive personnel (NAP), indicating a team nursing care model.
    • A nurse overseeing care of patients with severe diabetes or heart failure is using a case management nursing care model, which aims to improve cost-effectiveness and quality of care.
    • A nurse working in an intensive care unit (critical care) is likely using a functional nursing care model.

    Organizational Structure

    • A nurse working in a facility with fewer directors, allowing for shared decision-making, is employed in a decentralized organizational structure.
    • A nurse who values autonomy highly values freedom of choice and responsibility for the choices.

    Decision-Making and Delegation

    • A nurse who delegates a task to a nursing assistive personnel (NAP) without proper training and supervision lacks accountability in the decision-making process.
    • Accountability refers to individuals being answerable for their actions.
    • Autonomy is freedom of choice and responsibility for the choices.
    • Responsibility refers to the duties and activities that an individual is employed to perform.
    • Authority refers to legitimate power to give commands and make final decisions specific to a given position.

    Nursing Practice

    • A nurse making a home visit and discovering a patient's wound infection has gotten worse should clean and redress the wound, and then notify the physician and update the care plan.
    • A nurse manager should take action to ensure that expired stock medicine is discarded and staff nurses adhere to the dress code policy.

    Time Management and Prioritization

    • A novice nurse who is struggling to complete all interventions for a group of patients in a timely manner needs to develop time management skills.
    • The nurse should prioritize tasks, focus on high-priority interventions, and delegate tasks to other staff members when possible.
    • A nurse should prioritize care for patients based on their acuity and needs, with the most critical patients being seen first.

    Patient Assessment and Care

    • A patient with an indwelling urinary catheter who has been given a bed bath and has crusting at the urinary meatus requires immediate nursing intervention to prevent infection.
    • A nurse should take action to address a reddened area on a patient's hip while bathing, such as documenting the finding and notifying the physician.
    • A nurse should prioritize care for patients based on their acuity and needs, with the most critical patients being seen first.

    Delegation and Leadership

    • A nurse should delegate tasks to nursing assistive personnel (NAP) based on their skills and abilities, and provide proper training and supervision.
    • A transformational leader inspires and motivates staff to work towards a shared vision.
    • The "rights" of delegation include the right task, right person, right direction, right supervision, and right evaluation.

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    Description

    Identify the nursing care model being implemented in a scenario where a registered nurse leads a team of licensed practical nurses and nursing assistive personnel.

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