Leadership and Management in Nursing Flashcards

A nurse is preparing to delegate a task to an LPN. Which task is appropriate for delegation to an LPN?

Answer: Administering a routine oral medication to a stable patient

LPNs can administer routine medications to stable patients; initial assessments, care planning, and complex teaching require RN-level skill.

Which action demonstrates appropriate use of the chain of command?

Answer: Expressing concern to the charge nurse, then the supervisor, when a physician does not respond to a safety concern

The chain of command requires escalating safety concerns through the organizational hierarchy — charge nurse → supervisor → higher leadership.

A nurse discovers a patient fell while under the care of another nurse. Which document should never be referenced in the medical record?

Answer: Incident/variance report

Incident reports are internal quality documents; referencing them in the medical record makes them discoverable in litigation, violating their protected status.

A hospital is implementing a new electronic health record (EHR) system. Which change management strategy is most effective?

Answer: Involve frontline nurses in the design and rollout process

Involving end-users in design and implementation increases buy-in, identifies workflow issues early, and improves adoption success.

A nurse manager uses a 'just culture' framework. This means:

Answer: Accountability is balanced between individual behavior and system failures

Just culture distinguishes between human error (system fix), at-risk behavior (coaching), and reckless behavior (discipline), balancing accountability with learning.

Which strategy is most effective for improving HCAHPS (patient satisfaction) scores related to nurse communication?

Answer: Use hourly rounding to proactively address patient needs

Hourly rounding proactively addresses patient needs, reduces call lights, and improves communication scores on HCAHPS surveys.