Chapter 04: The Leadership Role of the Licensed Practical Nurse(FREE) Nursing School Test Banks

Chapter 04: The Leadership Role of the Licensed Practical Nurse
Linton: Introduction to Medical-Surgical Nursing, 6th Edition

MULTIPLE CHOICE

1. A licensed practical/vocational nurse (LPN/LVN), as a regular staff member, knows all the patients and anticipates many of their needs. Other staff members are comfortable asking for advice. The advice is given freely with a clear explanation or demonstration or both. In what role is this nurse acting?
a. Self-appointed teacher
b. Management-assigned instructor
c. Informal leader
d. Designated supervisor
ANS: C
Informal leaders are not appointed but are recognized by their peers as knowledgeable and skillful.

DIF: Cognitive Level: Comprehension REF: p. 45 OBJ: 2
TOP: Informal Leadership KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

2. A case conference is called to plan for a patient who has caused stress in the staff with constant calls and trivial requests. The nurse leader expresses personal views when leading the discussion about approaches to the problem and then makes the decision for care based on the discussion. What type of leadership style does this exemplify?
a. Autocratic
b. Democratic
c. Laissez-faire
d. Participative
ANS: D
Participative leadership encourages group involvement and suggestion, but the decision is made by the leader.

DIF: Cognitive Level: Comprehension REF: p. 46-47 OBJ: 2
TOP: Leadership Styles KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

3. From what source does an LPN/LVN receive authority to delegate care to unlicensed personnel?
a. Physician or registered nurse (RN) who hired them
b. National Nurse Practice Act
c. 1994 Entry Level Competencies Report
d. Nurse practice act of the individual state
ANS: D
Delegation of responsibilities must be in accordance with the states nurse practice act.

DIF: Cognitive Level: Comprehension REF: p. 52-53 OBJ: 7
TOP: Delegation by LPN/LVN KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

4. When staff members complain about being pulled to other areas to work without prior notice, the leader agrees with their request to develop a more effective system and does so with assistance and input from the entire staff. Which leadership theory does this exemplify?
a. X
b. Y
c. Z
d. T
ANS: C
Theory Z involves all workers in every phase of the operation. Theory X assumes that all workers desire direction. Theory Y assumes that all work gives satisfaction.

DIF: Cognitive Level: Comprehension REF: p. 48 OBJ: 2
TOP: Leadership Styles KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

5. An LPN/LVN in charge of two units on the evening shift notices that two of the nursing assistants (NAs) are constantly bickering. This appears to be interfering with patient care time. Both units are extremely busy with care needs. Which solution best reflects the process of accommodation?
a. Their issues are trivial and do not affect patient care actions. No time is presently available for extended discussions. Send one of the NAs to another area and allow time for both to defuse. Good patient care in an expedient manner is the priority at this time.
b. Call the supervisor to send the arguing dissenters home.
c. Call the dissenters into the office. Listen to their concerns and make a decision about the resolution of their trivial matters.
d. Allow the NAs to leave the building and settle their differences before they come back. Make no notation of their absence on their timesheets or in the report.
ANS: A
Patient care is the main priority. The leader cannot lose two caregivers but may separate them so they can provide needed patient care, accommodating both NAs by separating them.

DIF: Cognitive Level: Application REF: p. 51 OBJ: 4
TOP: Conflict Resolution Styles KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

6. A team leader is preparing to type the evening shift report. Which comment should be included in the report?
a. Patient A complained of a headache until his wife arrived to visit. She was 20 minutes late because of unavoidable traffic.
b. Patient B ate everything on her dinner trayroast beef, mashed potatoes, and green beansand the dessert, too, which is her usual pattern.
c. Patient C was so restless that the dressing on her sacrum came off and had to be replaced. No change occurred in the assessment of the decubitus.
d. Patient D had her usual visitors. She is sleeping after her regular evening medications, which were given as ordered at 2000.
ANS: C
The shift report should contain only clear, concise, and thorough information without extra useless comments.

DIF: Cognitive Level: Application REF: p. 53-54 OBJ: 7
TOP: Shift Report KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

7. A director of nursing in a long-term care facility appoints an LPN/LVN to be project head to coordinate a review of end-of-shift reporting times and to develop a new, more timely format for the entire agency to use. What is the role of the LPN/LVN?
a. Goal-setting organizer
b. Organizing leader
c. Assigned manager
d. Manager-leader
ANS: C
The LPN/LVN has been appointed to manage the implementation of a goal set by the leader.

DIF: Cognitive Level: Comprehension REF: p. 52-53 OBJ: 7
TOP: Management versus Leadership KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

8. A head nurse puts a blank copy of the shift duty schedule on the table in the break room. The staff is permitted to fill in the shifts that they want to work during the next cycle. What leadership style does this reflect?
a. Autocratic
b. Democratic
c. Laissez-faire
d. Participative
ANS: B
Democratic leadership focuses on the individual abilities and problem-solving skills of group members to avoid power struggles. Decisions are made through group consensus.

DIF: Cognitive Level: Comprehension REF: p. 46-47 OBJ: 2
TOP: Leadership Styles KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity

9. A team leader is making out the patient care assignment. A new patient needs several extensive dressing changes for open diabetic wounds, a nasogastric (NG) tube feeding, and irrigation of the Foley catheter as needed. Which member of the care team is best suited for this assignment?
a. Nurse aide A, who has had 10 years experience working at this facility, especially because this room is on the hall area where this NA is usually assigned
b. Nurse aide B, who has just been employed but has recently been through the state nurse aide certificate program and needs the experience of these treatment modalities
c. Nurse aide C, who is always asking for something new to try out and who is attending LPN/LVN school in off-duty hours
d. LPN/LVN C because these treatments are covered under the LPN/LVN state practice act
ANS: D
Invasive procedures may not be carried out by unlicensed personnel.

DIF: Cognitive Level: Analysis REF: p. 52-53 OBJ: 5
TOP: Delegation of Nursing Care KEY: Nursing Process Step: Planning
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

10. The role of the LPN/LVN as a team leader has been developed to broaden and improve patient care. Which statement best reflects this role implementation?
a. As LPN/LVN team leaders, these nurses are totally and only personally responsible, under the terms of licensure, for personal care actions and the nursing actions of the others assigned on their units and shifts.
b. As an LPN/LVN team leader, this nurse, under the supervision and guidance of an RN, is responsible for all aspects of patient care that is assigned to this team.
c. As an LPN/LVN team leader, this nurse uses skills and judgments learned in school to guide and direct the team members in what the nurse believes is correct patient care. The LPN/LVN is accountable only to patients for the care provided.
d. The team leader LPN/LVN decides on patient care assignments, takes care to promote accident prevention and safety, and is accountable only to self-professionalism for the nursing actions of the team.
ANS: B
The LPN/LVN practices under the supervision of an RN but is responsible for her or his own performance and of that of the teams.

DIF: Cognitive Level: Analysis REF: p. 52 OBJ: 7
TOP: LPN/LVN as Team Leader KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

11. A team leader nurse is attending college classes for a degree after work and spends much of the day reading and writing. As a result, the staff is given few directions. They make their own patient assignments and time schedules and solve problems among themselves. Significant confusion is evident on the unit. What leadership style is being practiced?
a. Autocratic
b. Democratic
c. Laissez-faire
d. Participative
ANS: C
The laissez-faire leader gives no direction to the activities of the staff, allowing them to do what they want.

DIF: Cognitive Level: Comprehension REF: p. 46-47 OBJ: 2
TOP: Leadership Styles KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment

12. On the way to the biohazard disposal closet to dispose intravenous (IV) tubing and a bag used on a patient who is positive for human immunodeficiency virus, the LPN/LVN drops the IV tubing and bag on the floor, causing a spill. What is the team leaders most appropriate action?
a. Quickly pick up the dropped supplies and dispose of them in the biohazard bag in the biohazard room. Ask housekeeping to place a small barricade over the spill until it can be mopped up later.
b. Find the floor maintenance person to pick up and dispose of the used equipment and to mop the floor, reminding him or her to wash his or her hands with soap and water. Chart that the IV was infused and discontinued appropriately.
c. Call and report to designated personnel to come and cordon off the area from staff and patients; have the spill cleaned with approved infection and chemotherapy spill control procedures.
d. Chart the spill in the patients chart, inform the RN when convenient, and have housekeeping mop up the spill.
ANS: C
Blood and chemotherapeutic agents are biohazards. Each facility has a policy regarding safety issues, which includes immediate reporting to the designated personnel.

DIF: Cognitive Level: Application REF: p. 53 OBJ: 7
TOP: Safety Issues KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

13. The process of management for the nurse leader consists of the application of steps similar to those of the nursing process. Which scenario contains all the steps of the management process?
a. At the end of the shift report, the team leader tells the staff that charting will be reviewed, medication Kardex checked, and patient rounds made an hour early today to obtain a more detailed patient profile of care provided during that shift.
b. The team leader has been unavoidably late, has missed most of the shift report, and grabs the staffing roster to make out patient assignments. The assignments are scheduled by alphabetical order by the geographic areas of the unit. No incidents appear to have occurred on the unit during the shift.
c. The nurse is perpetually late for duty and frequently leaves before the end of the shift report, asking others to help in completing the patient assignment. The team leader ignores this as long as patient care is completed.
d. The staff member is noted to leave some patients in strange positions on several occasions. On rounds, the team leader notices this and correctly repositions the patients. The team leader thinks that the staff could probably use some in-service training on proper positioning; however, she decides that no time is available to schedule this training.
ANS: A
Planning, organizing, and directing must be done for the provision of effective nursing care to meet standards. Evaluation or controlling is the process that checks delivered care for effectiveness.

DIF: Cognitive Level: Analysis REF: p. 48 OBJ: 4
TOP: Functions of Management KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Management: Coordinated Care

14. Which leadership style allows leadership flow among members of the team according to the task at hand?
a. Democratic
b. Laissez-faire
c. Multicratic
d. Transformational
ANS: D
The transformational style allows leadership to flow among the members of the team, based on the task at hand. Such style indicates a well-functioning team.

DIF: Cognitive Level: Comprehension REF: p. 47 OBJ: 2
TOP: Leadership Styles KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A

15. Leadership is different from management. Which definition best describes this difference?
a. The leadership function comes after the manager decides on it.
b. Management refers to providing the means to inspire people.
c. A leader selects the role, and a manager is appointed.
d. A manager selects goals and the means to achieve them.
ANS: C
As defined in the text, whereas leaders inspire people to strive to accomplish particular goals, management provides the means to achieve these goals.

DIF: Cognitive Level: Comprehension REF: p. 45 OBJ: 1
TOP: Leadership versus Management KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A

16. A newly admitted 35-year-old patient rings the call bell. By the time the nurse arrives, he is found unconscious and barely breathing. The charge nurse calls for a code blue and directs the staff on what to do without discussion. One staff member calls the physician, and some go to other rooms to comfort patients. What type of leadership style is exemplified?
a. Autocratic
b. Democratic
c. Laissez-faire
d. Participative
ANS: A
During an emergency such as a code blue, the person in charge correctly assumes an autocratic leadership role because no time is available for a discussion of choices in activities.

DIF: Cognitive Level: Analysis REF: p. 46 OBJ: 2
TOP: Characteristics of an Effective Leader
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Management: Coordinated Care

17. What characteristic is necessary in both leaders and managers?
a. Motivational skills
b. Sympathy skills
c. Authoritarian style
d. Participative style
ANS: A
Although leaders and managers use different styles and responsibilities, they both must have motivational skills.

DIF: Cognitive Level: Knowledge REF: p. 45 OBJ: 1
TOP: Similarities in Leaders and Managers KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A

18. The recognition and use of the LPN/LVN began because of RN shortages and a reevaluation of LPN/LVNs as team leaders. What is the approximate year of this change in staffing?
a. 1940s
b. 1950s
c. 1960s
d. 1970s
ANS: B
Team nursing with LPN/LVN leadership was introduced in the 1950s as a result of a shortage of RNs and an abundance of auxiliary nursing personnel, whose skills and leadership potential were reevaluated.

DIF: Cognitive Level: Knowledge REF: p. 52 OBJ: 7
TOP: Team Nursing KEY: Nursing Process Step: N/A
MSC: NCLEX: Safe, Effective Care Environment

19. What type of leadership is opposite of laissez-faire leadership?
a. Authoritarian
b. Bureaucratic
c. Democratic
d. Participative
ANS: A
Laissez-faire leadership is a hands-off style; authoritarian leadership is a very directive and controlling style.

DIF: Cognitive Level: Knowledge REF: p. 46 OBJ: 2
TOP: Leadership Styles KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A

20. A nurse tells the other staff members that she works only for the money and simply wants to do the job and go home. With which leadership style would this nurse most likely be comfortable?
a. Autocratic
b. Democratic
c. Laissez-faire
d. Participative
ANS: A
Individuals who simply want to do their job seek a directive style of leadership because it reduces their responsibilities.

DIF: Cognitive Level: Comprehension REF: p. 46 OBJ: 2
TOP: Leadership Styles KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A

21. A team leader assigns LPN/LVN A to patient care in rooms 123 and 129 and explains the special higher level care that these patients require. Nurse aides G and F are assigned to the rest of the hall, splitting the numbers of patients needing total care versus partial care. Their care duties are discussed in detail. What does making assignments according to skill level exemplify?
a. Planning
b. Organizing
c. Evaluating
d. Directing
ANS: D
The management function of directing is evident when the team leader makes assignments according to skill levels and explains what is to be done.

DIF: Cognitive Level: Comprehension REF: p. 49 OBJ: 5
TOP: Directing of Staff by the Team Leader
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Coordinated Care

22. Which task is most likely to be delegated to a certified nurses assistant (CNA)?
a. Updating a nursing care plan
b. Developing a teaching plan
c. Weighing a patient
d. Evaluating pain medication responses
ANS: C
Unlicensed persons may weigh a patient when directed to do so.

DIF: Cognitive Level: Comprehension REF: p. 53 OBJ: 5
TOP: LPN/LVN as Team Leader KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A

23. A professional nurse has skills and knowledge to direct the care provided by other staff. What nursing care organization does this indicate?
a. Primary nursing
b. Functional nursing
c. Rehabilitative nursing
d. Team nursing
ANS: D
In a team nursing situation, the skills of each team member are used to best advantage for efficient nursing care.

DIF: Cognitive Level: Comprehension REF: p. 52 OBJ: 5
TOP: Team Nursing KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A

MULTIPLE RESPONSE

24. What should a team leader be able to do to establish an effective team? (Select all that apply.)
a. Establish a clear purpose and clarify its significance.
b. Be firm to maintain focus on one idea, not sidetracked by the ideas of others.
c. Listen to all input in an active manner.
d. Demonstrate concern for stress of the team members.
e. Be honest concerning own opinions and attitudes.
ANS: A, C, D, E
Besides establishing a clear purpose, listening, and being concerned and honest, the team leader should be flexible and consider the ideas of others.

DIF: Cognitive Level: Comprehension REF: p. 54 OBJ: 7
TOP: LPN/LVN as Team Leader KEY: Nursing Process Step: N/A
MSC: NCLEX: N/A

COMPLETION

25. An LPN/LVN took the responsibility of working with the equipment company representative to learn about some new equipment coming to the facility. The LPN/LVN then developed and presented in-service teaching to the rest of the staff. This LPN/LVN is managing under management theory _____.

ANS:
Y
The management Y theory states that a person who knows what is expected can become self-directed to finish the task.

DIF: Cognitive Level: Knowledge REF: p. 48 OBJ: 4
TOP: Classic Management Theories KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment

26. Planning, organizing, directing, and controlling are major functions of _____.

ANS:
management
The major functions of management are planning, organizing, directing, and controlling.

DIF: Cognitive Level: Knowledge REF: p. 48 OBJ: 1
TOP: Major Functions of Management KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

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