Implementing Leadership and Management into Nursing Practice

Every question here, with the answer

1. An older adult is admitted after an injurious fall. The patient has multiple chronic conditions, takes several medications, sees more than one provider, and has mild cognitive limitations. Which care coordination action should the nurse manager prioritize for discharge planning?

   1. Delay involving family members until after discharge teaching is completed.
   2. Include providers, allied healthcare professionals, community resources, and family members in the plan.
   3. Focus the plan on the fall injury because acute needs take priority over chronic needs.
   4. Coordinate only with the primary care provider because chronic conditions are already being managed.

   Answer: Include providers, allied healthcare professionals, community resources, and family members in the plan.

   Older adults may need coordination that extends beyond providers because chronic illness, medications, physical or cognitive limitations, transportation, and caregiver needs can affect outcomes. The other options narrow the plan too much and do not reflect the section’s emphasis on comprehensive coordination for older adults.

2. A primary care provider identifies that a patient needs specialty care beyond the provider’s expertise. Which actions should the nurse manager take to facilitate the interdisciplinary referral? Select all that apply.

   1. Wait for the specialist to request information before sharing relevant patient details.
   2. Ensure the specialist has the necessary information to provide targeted care.
   3. Maintain a communication loop among all parties, including the patient.
   4. Verify that the referral is appropriate for the patient’s need.
   5. Send the referral without involving the patient to keep the process efficient.

   Answer: Ensure the specialist has the necessary information to provide targeted care., Maintain a communication loop among all parties, including the patient., Verify that the referral is appropriate for the patient’s need.

   The nurse manager’s role includes making sure the referral is appropriate, information is complete, and communication is seamless among everyone involved, including the patient. Excluding the patient or withholding information until asked would interfere with the coordinated referral process described in the section.

3. A nurse manager is considering delegating wound care for a patient with diabetes to unlicensed assistive personnel (UAP). Which factors should the nurse manager assess before delegating? Select all that apply.

   1. Whether additional training or support is needed and available for the UAP.
   2. Whether the task can be performed without supervision after one explanation.
   3. Whether delegation will transfer accountability for the task from the nurse manager to the UAP.
   4. The complexity of the patient’s care needs and whether the UAP has demonstrated proficiency in similar tasks.
   5. The UAP’s current workload and how added responsibilities may affect safe, quality care.

   Answer: Whether additional training or support is needed and available for the UAP., The complexity of the patient’s care needs and whether the UAP has demonstrated proficiency in similar tasks., The UAP’s current workload and how added responsibilities may affect safe, quality care.

   Before delegating, the nurse manager must evaluate clinical ability, workload, and the need for training or support. Delegation does not remove the delegating nurse’s accountability, and proper supervision remains one of the rights of delegation.

4. An RN delegates a task to UAP and states, “Since I delegated it, the UAP is now responsible for the outcome.” What is the best response by the nurse manager?

   1. Clarify that the delegating nurse retains accountability for the delegated task.
   2. Advise the RN to avoid delegation because UAP cannot accept delegated tasks.
   3. Agree, because delegation transfers responsibility for the task to the person performing it.
   4. Tell the RN that only nurse managers, not staff nurses, are accountable for delegated tasks.

   Answer: Clarify that the delegating nurse retains accountability for the delegated task.

   The section states that the delegating nurse always retains accountability for the delegated task. UAP can accept delegated tasks within the guidelines, but delegation must include appropriate communication and supervision.

5. A new nurse in a clinical rotation needs hands-on guidance, real-time feedback, and evaluation while learning to monitor vital signs and respond to changing patient data. Which professional development role best fits this need?

   1. Professional organization committee member
   2. Policy advocate
   3. Preceptor
   4. Mentor

   Answer: Preceptor

   A preceptor directly coaches and supervises students or new nurses in clinical settings with hands-on learning and feedback. A mentor provides longer-term career guidance, while committee membership and policy advocacy are professional organization roles rather than direct clinical supervision roles.

6. A nurse manager wants to support continuing education (CE) and foster lifelong learning on the unit. Which actions are appropriate? Select all that apply.

   1. Limit CE support to nurses who are already in formal leadership roles.
   2. Offer reimbursement for educational courses.
   3. Organize in-house training sessions on emerging healthcare trends.
   4. Discourage online courses because CE must occur only at conferences.
   5. Provide time off for staff to attend CE events.

   Answer: Offer reimbursement for educational courses., Organize in-house training sessions on emerging healthcare trends., Provide time off for staff to attend CE events.

   The section lists time off, reimbursement, and in-house training as ways nurse leaders can support CE. CE is for nursing professionals broadly, not only formal leaders, and it may include online courses as well as workshops, seminars, conferences, and academic programs.