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
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
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
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
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.
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 tray—roast beef, mashed potatoes, and
green beans—and 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.
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
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
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
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.
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
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 leader’s 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 patient’s chart, inform the RN when convenient, and have
housekeeping mop up the spill.
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.
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
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.
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
17. What characteristic is necessary in both leaders and managers?
a.
Motivational skills
b.
Sympathy skills
c.
Authoritarian style
d.
Participative style
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
19. What type of leadership is opposite of laissez-faire leadership?
a.
Authoritarian
b.
Bureaucratic
c.
Democratic
d.
Participative
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
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
22. Which task is most likely to be delegated to a certified nurse’s assistant (CNA)?
a.
Updating a nursing care plan
b.
Developing a teaching plan
c.
Weighing a patient
d.
Evaluating pain medication responses
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
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.
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 _____.
26. Planning, organizing, directing, and controlling are major functions of _____.