330 Midterm
A model of population care management would include: A. population needs assessment, identification of health services, targeted health planning, wellness and prevention, care management, and case management. B. population needs assessment, prioritization of needs, community wellness resources, provider prevention services, and health education services. C. population needs surveys, community funding, emergency medical services, medical home clinic services, school health programs, and occupational health for workers. D. population needs surveys, community engagement, community planning, emergency medical services, medical home clinic services, school health programs, and occupational health education services
A
A situational leader can best be described by which of the following statements? A. This leader tailors his or her leadership style based on the employee, experience, and circumstances. B. This leader requires minimal participation and directing, resulting in high productivity. C. This leader is one who motivates employees to their full potential. D. This leader advances innovative changes and sustains good care delivery processes.
A
In one research-based model, which of the following behaviors were core to leadership success? A. Visioning, interactive planning, workload complexity analysis, interdisciplinary team building, work process analysis, stakeholder analysis, and trust B. Interdisciplinary team building, strategic planning, data mining, motivating workers, developing culture, and trust C. Analysis of process and outcomes, trust and honesty, performance management, continuous improvement, and communicating the vision D. Interdisciplinary team building, trust and honesty, motivating workers, performance management, analysis of processes and outcomes, stakeholder analysis, and strategic planning
A
Management is often described in three core roles. Select the statement that is true. A. Allocating resources, negotiating contracts, handling disturbances, and proposing new services are decision-making roles. B. Monitoring processes, disseminating guidelines, and motivating nurses in organizations, states, and nationally or internationally are interpersonal roles. C. Representing nurses, leading nurses, and associating information technologies are informational roles. D. Providing care, coordinating time for patients, and interacting with physicians, pharmacists, and clients are caregiving roles.
A
Which is the statement that best defines management? A. A process of coordination and integration of resources through group activities of planning, organizing, coordinating, directing, and controlling to accomplish specific institutional goals and objectives B. A process of planning and directing human effort to attain established objectives C. A process by which organizational goals are met through the use of the right resources D. A process of working with executives to allocate capital, technology, and equipment resources to accomplish organizational goals
A
Conflict is a natural and inevitable outcome in any group or organization. Select the correct statement from the following statements. A. A defensive framework for conflict resolution includes winning some resources and losing others. B. To build effective interdisciplinary teams, conflict must be present, and managers must not interfere with conflict resolution. C. Conflict can be a positive force in a group, but conflict should be avoided most of the time in a group to get work done. D. Conflict arises when job descriptions are clear, policies and procedures are written, and uniform behaviors are fostered in an organization.
A. A defensive framework for conflict resolution includes winning some resources and losing others.
Chief nursing officers (CNOs) are accountable for establishing systems to assess, monitor, verify, and communicate ongoing competence requirements related to delegation, for both RNs and delegates. Which statements are correct (select all that apply)? A. A key element in delegation is to assess the competency level of the staff. B. When an RN delegates a task, he or she is responsible for supervision but is not accountable for the outcome. C. A state's nurse practice act consists of rules that govern how RNs delegate to competent staff. D. The National Council of State Boards of Nursing is opposed to delegation to unlicensed assistive personnel (UAP).
A. A key element in delegation is to assess the competency level of the staff. C. A state's nurse practice act consists of rules that govern how RNs delegate to competent staff.
Nurses and nurse managers are guided by both legal and ethical considerations in making decisions. Which of the following is the correct statement regarding this fact? A. Administrative rules include those regulations promulgated and adopted by federal or state agencies to implement statutory law adopted by Congress or state legislatures. B. Physicians govern the legal practice of nurses. C. As professional autonomy and responsibility increase, the level of accountability and liability decreases. D. When conflict exists between federal and state statutes, the state statute will usually, but not always, take precedence.
A. Administrative rules include those regulations promulgated and adopted by federal or state agencies to implement statutory law adopted by Congress or state legislatures.
The decision to delegate is not an easy one. There were five factors identified by the critical care nurses specialty organization that should be considered to make the best decisions. Which of the following identifies all five factors? A. Care is complex and requires adaptation in approach, with some risk that the activity may cause potential harm, and the level of patient interaction and the patient's response to the activity are unpredictable. B. The complexity of the intervention or task, the skill of the registered nurse's (RN's) delegation, the competencies of unskilled assistive caregivers, the risk of harm to patients, and the criticality of the outcome. C. The care requires special attention, adaptation, or an innovative approach, the skill of the RN's delegation, and the competencies of unskilled assistive caregivers. D. A patient's risk for potential harm, the skill of the RN's delegation, the competencies of assistive caregivers, the difficulty of the intervention, and the fact that a patient's response to the activity is unknown or unpredictable.
A. Care is complex and requires adaptation in approach, with some risk that the activity may cause potential harm, and the level of patient interaction and the patient's response to the activity are unpredictable.
A nurse manager and a nurse are liable for which of the following (select all that apply)? A. Delegating to unlicensed assistive personal B. Supervising completion of appropriate tasks and functions C. Decisions and actions D. Skills of licensed and unlicensed personal
A. Delegating to unlicensed assistive personal B. Supervising completion of appropriate tasks and functions C. Decisions and actions D. Skills of licensed and unlicensed personal
In nursing, group process theory relates to how to work as an employee within an organization that is often large and complex. Which statement best reflects the need for teams and groups? A. Interdisciplinary work teams are necessary for complex situations. B. The major reason for individuals to join groups is to gain information. C. In all groups, decision making is a joint process, with all members participating. D. Group decision making is cost-effective in all situations.
A. Interdisciplinary work teams are necessary for complex situations.
All nurses must know how to be effective team players, which includes a variety of skills such as technical and functional expertise, problem-solving and decision-making skills, and interpersonal skills. Which of the following statements best reflects this? A. Leaders and managers must be able to function both independently as well as interdependently with others. B. The formation of a well-functioning group or team is often the work of the leader. C. Nursing staff members must be able to function interdependently with others. D. Members need skills to give input, participate in decision making, share responsibility, and hold the manager accountable for the outcomes of the group.
A. Leaders and managers must be able to function both independently as well as interdependently with others.
Research has shown which two of these statements are correct (select all that apply)? A. Nurses need to be responsible for beliefs, values, meanings, goals, and relationships. B. Experienced leaders feel comfortable with the star pattern communication style. C. In crisis situations, members work in a team that capitalizes on the skills and strengths of each team member. D. Less experienced leaders feel most comfortable with the circle pattern communication style.
A. Nurses need to be responsible for beliefs, values, meanings, goals, and relationships. C. In crisis situations, members work in a team that capitalizes on the skills and strengths of each team member.
he advantages of group problem solving over individual problem solving are best described by which of the following? A. Obtaining a wider range of knowledge and information from group members stimulates thinking. Strength in diversity, more individual perspectives, and members' commitment to the decision save time. B. Groups can be positive and constructive, and costs are more because more ideas are generated over an individual effort to solve the problem. C. People with the expertise get together in a group to talk about issues and resolutions, so alternative approaches or options can be planned, and consequences discussed. D. Groups that include ideas from both inside and outside the unit will understand the different aspects of the problem, plan a series of tasks with options to resolve the problem, and together implement the solution faster with role assignment.
A. Obtaining a wider range of knowledge and information from group members stimulates thinking. Strength in diversity, more individual perspectives, and members' commitment to the decision save time.
What habits are characteristic of critical thinking by nurses (select all that apply)? A. Questioning, reflection, contextual perspective B. Confidence, creativity, flexibility C. Open-mindedness, perseverance D. Purposeful, systematic, within a frame of reference, grounded in information
A. Questioning, reflection, contextual perspective B. Confidence, creativity, flexibility C. Open-mindedness, perseverance
Team dynamics will need to be addressed to form an effective team. Select the best strategy to help address the challenges in forming effective teamwork. A. Set group norms on how team members treat each other, how support is demonstrated, how conflict is handled, and the decision-making process to help team members operate with disruptive behaviors. B. Lead group members through just-in-time training to work together to overcome lack of trust and commitment to the team. C. Organize appropriate representation and delegation of authority to the group to help team members avoid confusion about the team's work, accountability, and inattention to results. D. Keep the number of members in groups between 10 and 14, build a structural team, and coach the team to avoid conflict.
A. Set group norms on how team members treat each other, how support is demonstrated, how conflict is handled, and the decision-making process to help team members operate with disruptive behaviors.
Ethical dilemmas encountered as a result of the clash between clinical and organizational ethics differ from those encountered in clinical practice. Budget cuts, the inability to replace equipment that is failing, and lost time to complete services would be examples. Proactive strategies by managers would include: A. developing an organizational culture of respecting each other's ethical standards and not asking nurses to compromise their ethics. B. communicating what is inappropriate ethical behavior. C. listening to staff and others' concerns about unresolved dilemmas arising from the ongoing conflict between clinical and organizational ethics. D. assessing situations in which a client's needs are beyond a nurse's qualifications and competencies
A. developing an organizational culture of respecting each other's ethical standards and not asking nurses to compromise their ethics.
Disadvantages of group decision making over individual decision making would include (select all that apply): A. premature decisions. B. delayed decisions. C. individual domination. D. disruptive conflicts.
A. premature decisions. C. individual domination. D. disruptive conflicts.
People are often unaware of exactly how they are spending their time. The best strategy is to: A. take control of your calendar using a time journal to see precisely where all one's time is spent in 30-minute increments. B. use every minute possible in the day to accomplish work-related activities. C. simply analyze the workday and prioritize the workload around routine habits to reduce stress. D. use checklists, delegate, plan ahead, and divide large projects or tasks into smaller, more manageable undertakings.
A. take control of your calendar using a time journal to see precisely where all one's time is spent in 30-minute increments.
Identify the statements about organizational culture that impact nursing practice (select all that apply). A. Organizational culture affects the quality of nursing care and patient outcomes. B. Mission statements provide a view of strategic priorities for a nursing organization and work setting. C. Culture is developed over time with the shared values that guide members on how to problem solve and manage relationships. D. Organizational culture means there are hidden assumptions about care that should not be questioned.
ABC
Multiple unique goals are achieved with case management services that are different from the goals of managed care. Nurses as case managers contribute to which of these goals (select all that apply)? A. Coordinating client-focused care by planning and arranging access to appropriate services and interventions B. Providing nursing interventions to meet diagnosed client needs in the most cost-effective manner C. Seeking to reduce costs, conserve resources, and maximize the value of services D. Tracking outcomes and guiding services across time and settings through ongoing evaluation of assessments
ABD
The research leading to the gold standard for nursing excellence has produced which of the following findings (select all that apply)? A. The effects of nursing interventions are facilitated by organizational characteristics at the unit level. B. A health care administrator can nurture a professional nursing environment and advocate for excellence in nursing practice. C. Mortality rates in Magnet hospitals had a significantly lower mortality rate for Medicare patients than that of control hospitals. D. Magnet hospitals' cultures provided lower levels of autonomy and control of practice and fostered stronger professional relationships among nurses and physicians than did those of non-Magnet-designated hospitals
AC
Hersey and colleagues identified three skills needed for leading or influencing workers. Identify three skills leaders must possess to influence people (select all that apply). A. Diagnosing B. Directing C. Adapting D. Communicating
ACD
The 14 Forces of Magnetism has directed research on Hospital Magnet Standards which measure certain characteristics. Select the answers that best reflect those measures of Magnet standards (select all that apply). A. Clinically competent peers, education support, adequate staffing, and nurse manager support B. Perceptions of work environment, nursing hours per patient day, and medication errors and near misses C. Customer satisfaction, patient discharge disposition, and patient complaints D. Clinical autonomy, control of nursing practice, and collaborative nurse-physician relationships
AD
The areas where leadership and management overlap are explained by which of the following statements (select all that apply)? A. Bring teams together. B. Spark innovation. C. Inspire a vision. D. Direct activities.
AD
The culture of patient care must transition from care that is driven by providers to care that is patient-centered and family-centered in which patient and family norms, values, and preferences are respected. This direction in health care services has been sited within (select all that apply): A. the Affordable Care Act (2009). B. The Future of Nursing: Leading Change, Advancing Health (2011). C. the Institute of Medicine's Crossing the Quality Chasm (2001). D. National Healthcare Quality Report from the Agency for Healthcare Research and Quality (2002).
ALL
Culture is a concept that is best portrayed in nursing with which of the following statements? A. Culture provides a common bond so members know how to relate to one another and what is valued. B. A relationship-based nursing care model is used, which represents a belief in patient-centered care. C. Culture is a multifaceted phenomenon, difficult to comprehend. D. Culture is a set of values, beliefs, and assumptions that are shared by members of an organization.
B
Effective leadership is exemplified by values, confidence in employees, and a sense of security in the face of uncertainty. This aspect of leadership is known as: A. relationship management. B. self-awareness. C. social awareness. D. self-management
B
Five competencies were identified by nurse leaders in recent research. What are those competencies? A. Building effective teams, empowering workers, decision making, communicating, and managing conflict B. Communicating vision and strategy internally, translating vision into strategy, building effective teams, managing patient-centered customer focus, and managing conflict C. Managing conflict, analyzing performance, guiding and empowering workers, sharing a vision with workers, and directing operations D. Focusing on patient and customer, directing and guiding workers, building effective teams, managing conflict, and analyzing performance
B
Nurse leaders must possess competency in five domains: (1) leadership, (2) communication and relationship management, (3) professionalism, (4) knowledge of the health care environment, and (5) business skills and principles. Which of the following statements best describes the domain of professionalism? A. Guiding, directing, teaching, and motivating to set and achieve goals B. An approach to an occupation that distinguishes it from being merely a job, focuses on service as the highest ideal, follows a code of ethics, and is seen as a lifetime commitment C. Coordination and integration of resources to accomplish specific goals D. Ethical fitness and moral courage form the backbone of making necessary and hard—but right and unpopular—decisions
B
The research of which team states that the leader needs to be flexible in behavior, able to diagnose the leadership style appropriate to the situation, and able to apply the appropriate style? A. Fiedler's contingency model B. Hersey and Blanchard's model C. Blake and Mouton's attitudinal model D. Ohio State model
B
Effective communication can best be described by which one of the following statements? A. The major part of any communication is the words that we say to others. B. Conversation that is clear, direct, straightforward, and offers frequent message transmission is most effective. C. To respond effectively to communication, place responsibility on others. D. Feedback should be used carefully and only when absolutely necessary, because it inhibits effective communication
B. Conversation that is clear, direct, straightforward, and offers frequent message transmission is most effective.
Cultural differences are characteristics that define individuals beyond unique numbers and names. Which statement is true? A. Each generation possesses unique characteristics that are associated with race and ethnicity values, behaviors, and practices. B. Cultural differences in ways of doing things and in beliefs about health and illness are learned and transmitted via cultural environments. C. Cultural differences do not include eye contact norms, gender issues, touching and physical contact, and food practices. D. Cultural differences do not generally impact communication, so standard safety and quality of care practices can be sustained.
B. Cultural differences in ways of doing things and in beliefs about health and illness are learned and transmitted via cultural environments.
Any decision in a chaotic health care delivery environment may cause an unanticipated future problem. Identify the true statement about decision making. A. Decision-making strategies are interchangeable and can be used effectively in any situation. B. Decision making is used to solve problems. C. Decision making must be even more deliberative when problems require urgent action. D. Decision making is not a behavior but rather a method in selecting and implementing a course of action from alternative courses of action for dealing with a situation or problem.
B. Decision making is used to solve problems.
A transformative leadership style influences the effectiveness of group decision making. The rational group decision-making model is based on which of the following? A. Power, influence, negotiation, bargaining, and interest group influence B. Economic perspective of decision making and maximum utility C. Difficulty identifying and resolving problems due to ambiguity, complexity, and illogical step taking D. Use of standard operating procedures and guidelines
B. Economic perspective of decision making and maximum utility. The correct answer is that a rational model is based on the economic perspective of decision making and maximum utility. The first answer is incorrect because it is the political model that is based on power, influence, negotiation, bargaining, and interest group influence. The third answer is incorrect because it is the garbage model that involves difficult problem identification and problem resolution under circumstances of ambiguity, complexity, and illogical step taking. The fourth answer is incorrect because it is the process model that is based on using standard operating procedures and guidelines
Which time management strategies are the best strategies to re-energize people to handle the activities of the workplace and decrease the stress response? A. Dividing up a project into manageable parts and setting deadlines for each part B. Having time to think C. Becoming skillful with technology to manage deadlines and tracking project progress online D. Utilizing the management team (assistants, charge nurses, clinical nurse specialists, educators) to strategize timing for all team members to schedule people time
B. Having time to think
Placing someone from a high-context workplace culture into a setting dominated by leaders from a low-context culture will increase the likelihood of perceptions of inequity and workplace conflicts. What are the differences between low-context and high-context cultures? Select the two statements that are correct (select all that apply). A. In high-context cultures, often found in the Western world, that which is written or stated rarely carries the meaning, because the meaning of the message is understood by reading between the lines for what is not written or stated, whereas low-context cultures require extensive detailed explanations and information because they are making up for what is missing in a situation. B. In high-context cultures, often found in the non-Western world, that which is written or stated rarely carries the meaning, because the meaning of the message is understood by reading between the lines for what is not written or stated, whereas the low-context cultures in the Western world require extensive detailed explanations and information because they are making up for what is missing in a situation or the context. C. The cultural context of the Western world is low context, and in low-context cultures the meaning is assumed to exist by the nature of the situation that is the context, while in high-context cultures most of the explicit verbal or written message carries the meaning. D. The cultural context of the Western world is low context, and in low-context cultures the explicit verbal or written message carries the meaning, while in high-context cultures, most of the meaning is assumed to exist by the nature of the situation that is the context.
B. In high-context cultures, often found in the non-Western world, that which is written or stated rarely carries the meaning, because the meaning of the message is understood by reading between the lines for what is not written or stated, whereas the low-context cultures in the Western world require extensive detailed explanations and information because they are making up for what is missing in a situation or the context. D. The cultural context of the Western world is low context, and in low-context cultures the explicit verbal or written message carries the meaning, while in high-context cultures, most of the meaning is assumed to exist by the nature of the situation that is the context.
Important decisions are made by nurses. Which of the following are examples of collaborated decisions (select all that apply)? A. Devise an array of plans to optimize client recovery, mobility, and self-care; maintain airway patency and hemodynamic stability; and prevent the development of decubitus ulcers B. Plan steps to achieve organizational goals, implement multisystem change processes, and improve service delivery and client outcomes C. Address complicated and difficult client care risks and problems regarding infection, injury, and contamination D. Diagnose and document client needs for health promotion, risks, and problems
B. Plan steps to achieve organizational goals, implement multisystem change processes, and improve service delivery and client outcomes C. Address complicated and difficult client care risks and problems regarding infection, injury, and contamination
Levels of job stress that are either too low or too high have which consequence? A. They manifest in emotional and physical exhaustion. B. They decrease individual productivity. C. They increase tension related to the person-in-environment demands. D. They intensify acute and chronic health problems.
B. They decrease individual productivity. The first answer is not seen with low job stress but is a consequence of when job stress is high. It is also known as burnout, and this will lower job productivity. The third answer is an aspect related to job stress from tension between a person's environments within the job; home, family, and professional responsibilities; and health and social status. The fourth answer is a consequence that may occur with prolonged chronic stress over time.
Critical thinking is central to decision making. Which of the following is a true statement? A. Critical thinking and creative problem solving are the same. B. Two cognitive processes, intuition and analysis, are used in critical thinking for nursing judgments. C. A critical thinker sustains the norm or status quo. D. Clinical decision making is the same thing as diagnostic reasoning.
B. Two cognitive processes, intuition and analysis, are used in critical thinking for nursing judgments. The first statement is incorrect because critical thinking is a set of cognitive skills that include interpretation, analysis, evaluation, inference, explanation, and self-regulation. The third statement is incorrect because a critical thinker challenges and questions the norm and considers potential unintended consequences in the context of decision making. The fourth statement, "Clinical decision making is the same thing as diagnostic reasoning," is incorrect because reasoning is based on aspects of thinking skills, such as inductive or deductive reasoning for diagnosing.
The accountable care organization (ACO) will need to measure progress toward optimized population health. The measures for the ACO would include: A. benchmarks that provide frames of reference against which an organization can compare itself relative to others. B. population health measures on clinical process and outcome indicators, patient satisfaction, functional status, quality of life, economic and utilization indicators, and changes in health disparities. C. structured care methodologies, such as critical pathways or streamlined interdisciplinary tools, identification of best practices, facilitated standardization of care, quality enhancement, and outcomes measurement. D. variances identifying positive and negative differences between what was expected from a standard and what actually occurred with client- and family-related, systems-related, or provider-related factors.
B. population health measures on clinical process and outcome indicators, patient satisfaction, functional status, quality of life, economic and utilization indicators, and changes in health disparities.
Global research on nurses by Dr. Aiken has determined which of the following statements (select all that apply)? A. The number of nurses may have more influence on patient outcomes than the organization and structure of the work environment itself. B. The number of nurses may have less influence on patient outcomes than the organization and structure of the work environment itself. C. The number of nurses may have less influence on patient outcomes than the perceived level of autonomy, the amount of control over their practice, and the effective collaboration with physicians. D. The number of nurses with bachelor's degrees may have more influence on patient outcomes than a larger staff of less-skilled nurses and caregivers.
BC
Leaders and managers should know the many aspects of case management. Two statements are correct and two statements are incorrect. Identify the two correct statements (select all that apply). A. Case management focuses on continuity of the plan. B. Case management entails providing holistic care, conservation of resources, and care across episodes and settings. C. A current trend is the push for accountability and accreditation for case management organizations. D. Case management frequently is associated with health maintenance organizations and preferred provider organizations.
BC
The Institute of Medicine (IOM) identified five areas of management practice for leaders to attend to during turbulent times. Which of the following are included in those areas (select all that apply)? A. Maintaining and sustaining quality and safety in service delivery B. Balancing reliability and efficiency in service delivery C. Creating and sustaining a trustworthy, learning, and evidence-based organization D. Managing change through manager involvement and bi-directional communication
BC
8. Although all clients need coordinated care, disease management best serves the needs of targeted, high-risk populations for: A. coordinating the care of the individual client in relation to one or more diseases or health conditions after hospitalization. B. coordinating rehabilitative services, financial assistance, and teaching regarding rehabilitative expectations. C. a specific disease or health condition of a population group, with subsequent application to individuals over time. D.managing services for patients using beyond what is typically expected in order to reduce cost and focus on only necessary medical services.
C
Diversity assists with team effectiveness, improves retention of the best people, capitalizes on out-of-the-box thinking, lays the groundwork for future business growth, and provides more supportive work environments. Which of these are benefits to the nursing workforce? A. Each generation possesses unique characteristics, and often the values and behaviors of an older cohort of nurses help younger colleagues. B. Communication style, work style, organizational role/level, economic status, and geographic origin are uniform factors helping team effectiveness among nurses. C. A diverse workplace allows synergy of diverse viewpoints to improve nursing's knowledge base and care strategies. D. In the health care setting, diversity among employees helps the awareness of diverse patient and family values, beliefs, and practices.
C
The difference between the focus of managers and leaders is best described by which one of the following statements? A. The processes and strategies look similar and are employed for different goals. B. The manager focuses on people, and the leader focuses on systems and structure. C. The manager focuses on systems and structure, and the leader focuses on people. D. Management and leadership are not equally important processes to accomplish outcomes.
C
Which process best describes leadership? A. Giving people the authority, responsibility, and freedom to act on their expert knowledge and skills B. Planning, organizing, coordinating, directing, and controlling resources to accomplish specific institutional goals C. Influencing behavior of either an individual or a group in an effort to achieve goals in a given situation D. Working with and through individuals and groups and other capital and technology resources to accomplish organizational goals
C
Marshall discussed several approaches to prevent and manage conflict. One such approach was to adopt the AVID approach. What are nurses engaged in with this approach? A. Avoid conflict; verify the information associated with the conflict; investigate what others think; decide how to prevent future situations B. Advocate the views for both sides; values to each side disclosed, information obtained; decide C. Assume the positive about others; validate the situation; ignore it and let it go; do something D. Assist others who are difficult to deal with; view the ideas as having potential; identify outside resources; discuss options
C. Assume the positive about others; validate the situation; ignore it and let it go; do something
The roles of sender and receiver must be assumed in interpersonal communication. This is reflected within which description of communication? A. Communicating with diagnosing and adapting is one of the basic competencies of influencing, effectiveness in engaging and motivating people, and in getting work done through others. B. When humanistic or democratic values are upheld in an organization, then trusting, authentic relationships become the norm in a nurturing, productive work environment. With humanistic values, intergroup cooperation, flexibility, and organizational effectiveness tend to improve. C. Interpersonal communication is a two-way level of communication involving face-to-face interactions between people who are consistently aware of each other. D. Skillful, positive questioning by a leader or manager can persuade people to willingly commit themselves to see personal benefits and accept change.
C. Interpersonal communication is a two-way level of communication involving face-to-face interactions between people who are consistently aware of each other.
Management must understand and address aspects of generational workforce diversity. Which of the following statements best describes aspects of the generations? A. Nexters matured in a world with manipulation of people and limited ethical code to reign. X'ers found the need to be resourceful at an older age. Boomers thrived with efficiency, teamwork, quality, and service. The Silent Generation prefers limited government. B. Nexters are shallow on advanced skills because technology takes care of every step. X'ers share with boomers the need to push authority aside. Boomers blur gender roles and attempt to push systems toward their conveniences. The Silent Generation likes individualism. C. Nexters can create solutions that other generations could not have imagined. X'ers prefer a balanced life and protect themselves from the capriciousness of business challenges, constraints, and rules. Boomers ignore or break rules and will still be successful. The Silent Generation treasures and exhibits conformity. D. Nexters are problem solvers who grew up in a flourishing economy. X'ers desire traditional practices and beliefs. Boomers prefer a participative and more authoritarian workplace. The Silent Generation respects authority.
C. Nexters can create solutions that other generations could not have imagined. X'ers prefer a balanced life and protect themselves from the capriciousness of business challenges, constraints, and rules. Boomers ignore or break rules and will still be successful. The Silent Generation treasures and exhibits conformity.
Criteria can be used to assess co-workers' competency for delegation. Which of the following methods can be used to assess the competency of nursing assistive personnel (select all that apply)? A. Micro-managing and being able to step in and take over tasks B. Educating and training for the required role function C. Supervising with periodic review and performance feedback D. Orienting to the job description and evaluating tasks within a designated time frame
C. Supervising with periodic review and performance feedback D. Orienting to the job description and evaluating tasks within a designated time frame
Healthy work environments increase patient satisfaction, support patient outcomes, and avoid errors. Healthy work environment standards to adopt would include: A. setting expectations and controlling behaviors within the workplace. B. establishing transparency of information and setting strict communication patterns. C. acknowledgement, awareness, and assessment of workplace stress. D. knowing what the executive boss wants as a priority.
C. acknowledgement, awareness, and assessment of workplace stress.
.Role strain means: A. expectations are incompatible with the professional values of the nurse. B. one cannot possibly complete all assigned activities in the scheduled time frame. C. expectations of the multiple responsibilities of the manager can produce stress. D. expectations are unclear to the nurse.
C. expectations of the multiple responsibilities of the manager can produce stress. Role strain is when the expectations of the multiple responsibilities of the manager can produce stress. Role incongruity means the role expectations are incompatible with the professional values. Role overload is when one cannot possibly complete all assigned activities in the scheduled time frame. Role ambiguity is when role expectations are unclear to the nurse.
Great leaders possess four essential skills. Identify two statements that describe those skills (select all that apply). A. Great leaders possess popularity to establish followers to engage. B. Great leaders are visible, set examples, and share responsibility. C. Great leaders possess a sense of integrity with a distinctive and compelling vocal tone to engage others in shared meaning. D. Great leaders possess a combination of hardiness and the ability to grasp context, called "adaptive capacity."
CD
Quality and Safety Education for Nurses (QSEN) was initiated to accomplish which of the following (select all that apply)? A. Implementing patient-centered care, teamwork, and collaboration that support quality improvement, safety, and informatics on nursing units B. Geared toward nurses who have been practicing 20 years and need new competencies through continuing education C. Creating nursing curriculum that emphasizes evidence-based practices, quality improvement, safety, and informatics D. Preparing future nurses with the knowledge, skills, and attitudes necessary to continuously improve the quality and safety of the health care system
CD
You must rearrange the room assignments for several clients. Which two clients would be best to put in the same room? 43 year old woman who underwent cholecystectomy 2 days ago 62 year old woman with colon cancer receiving chemotherapy and radiation 35 year old woman with copious intractable diarrhea and vomiting 53 year old woman with pain related to alcohol-associated pancreatitis
Correct! 43 year old woman who underwent cholecystectomy 2 days ago Correct! 53 year old woman with pain related to alcohol-associated pancreatitis
Which client should you, as charge nurse, assign to a new RN graduate who is on orientation to the neurologic unit? 85 year old with dementia who is to be transferred to long-term care today 67 year old who had a stroke 3 days ago and has left-sided weakness 28 year old newly admitted client with a spinal cord injury (SCI) 54 year old with Parkinson disease who needs assistance with bathing
Correct! 67 year old who had a stroke 3 days ago and has left-sided weakness
You are mentoring a student nurse in the intensive care unit (ICU) while caring for a client with meningococcal meningitis. Which action by the student requires that you intervene most rapidly? Checking the client's pupil response to light every 30 minutes. Entering the room without putting on a mask and gown. Giving the client a warm blanket when he says he feels cold. Instructing the family that visits are restricted to 10 minutes.
Correct! Entering the room without putting on a mask and gown.
You would be most concerned about an order for total parenteral nutrition (TPN) fat emulsion for a client with which condition? Gastrointestinal (GI) obstruction Chronic diarrhea and vomiting Severe anorexia nervosa Fractured femur
Correct! Fractured femur
You are supervising a senior nursing student who is caring for a client with a right hemisphere stroke. Which action by the student nurse requires that you intervene? Combining the hair on the left side of the client's head when the client always combs his hair on the right side. Moving the client's food tray to the right side of his over-bed table. Instructing the client to sit up straight, and the client responding with a puzzled expression. Assisting the client with passive range-of-motion (ROM) exercises.
Correct! Instructing the client to sit up straight, and the client responding with a puzzled expression.
Clients who are undernourished or starved for prolonged periods are at risk for re-feeding syndrome when nourishment is first given. What is the priority nursing assessment to prevent complications associated with this syndrome? Assess for alternating constipation and diarrhea and pale clay colored stools. Observe for signs of secret purging and ingestion of water to increase weight. Monitor for peripheral edema, crackles in the lungs, and jugular vein distention. Monitor for decreased bowel sounds, nausea, bloating, and abdominal distention.
Correct! Monitor for peripheral edema, crackles in the lungs, and jugular vein distention.
A deliberate and cognitive process of becoming responsive and sensitive to the client's culture and values and learning to avoid imposing on them is: A. cultural knowledge. B. cultural diversity. C. cultural skill. D. cultural awareness.
D
Case managers were deployed to decrease fragmentation; reduce expense by streamlining care; and control costs by linking, advocating, coordinating, negotiating, educating, and monitoring. Today the model that guides hospitals and clinics to case manage is best described in which of the following statements? A. Social services, rehabilitation, and public health have addressed coordination of care for the ill and the poor to manage catastrophic injury or illness. B. Traditional public health nursing has addressed the coordination of client-centered care within the community setting. C. Tertiary care has addressed the treatment of acute, episodic health care conditions. D. Public health guides the health care organization to coordinate and integrate services across the continuum from hospital to community to reduce costs and eliminate redundancy of services.
D
Climate is often confused with culture. Which statement best describes aspects of climate? A. Culture is the perceptions of the work environment, and climate is the personality of the organization. B. Climate is the shared beliefs, values, and assumptions that exist in an organization. C. Climate enhances the stability of a social system, and culture is the voice of the organization. D. Culture and climate can both be measured.
D
Given the interdisciplinary nature of case management, who would be best in the case manager role? A. Associate degree nurses are skilled in the coordination of client care. B. Geriatric advanced practice nurses are skilled in the coordination of client care for specialized services. C. Registered nurses after five years possess expert knowledge, experience, and education and are qualified to be case managers. D. Advanced practice nurses draw on a wealth of knowledge to lead and coordinate the health care team.
D
Nurses who challenge assumptions, consolidate a purpose, build the culture, and move a vision forward are more likely within which role? A. Nurses B. Nurse managers C. Clinical nurse leaders D. Nurse executives
D
Principles of leadership and management are best described by which of the following statements? A. Followership is a process whereby leaders participate in group decisions. B. Empowerment is the ability to lead a group successfully. C. Important skills for leading include diagnosing, adapting, and directing. D. Critical skills in leadership are interpersonal, decision making, and problem finding and solving.
D
Research on leadership attitudes identified that which approach emphasized attention to the people's needs to affect the satisfaction of relationships? A. Authority-obedience B. Team C. Organization man D. Country club
D
When the group decision-making procedure is that the entire group decides, whether by a two-thirds vote, simple majority, consensus, or some other process, this is known as: A. delegated decision procedure. B. autocratic decision procedure. C. consultative decision procedure. D. joint decision making.
D
Which management theory's principle is to consider the situation and all elements when making a management decision? A. Complexity theory B. Chaos theory C. Systems theory D. Contingency theory
D
The integration and coordination of health services to a specified population of patients or to individual patients has been described as case management. Select the best statement to describe this approach. A. A comprehensive, integrated approach to care and reimbursement based on the natural course of a disease B. A systematic integration and organized way to finance and deliver health care to achieve specific client outcomes, given fiscal and other resource constraints C. A documented plan that identifies a predictable process of diagnoses and/or treatment for a condition based on practice guidelines D. A comprehensive collaborative process of assessment, planning, facilitation, and communication to organize and evaluate patient care activities and advocate for services and available resources that will promote quality, cost-effective outcomes
D. A comprehensive collaborative process of assessment, planning, facilitation, and communication to organize and evaluate patient care activities and advocate for services and available resources that will promote quality, cost-effective outcomes
Select the statement that describes how clinical decision making differs from managerial decision making. A. Professional nurses in clinical practice are making clinical decisions about client diagnoses and care plan orders, but the technical nurses are making managerial decisions about containment of costs and maximizing health care delivery. B. Clinical decision making involves the collection of information, selection, and evaluation of an action, whereas managerial decision making involves the processing of existing information to select an action. C. Clinical decision making by nurses is far less sophisticated than managerial decision making by nursing executives, nurse managers, and directors. D. Clinical decision making focuses on diagnosing client health issues, risks, or problems and planning or coordinating nursing interventions, but managerial decision making focuses on resolution of organizational problems and the plans to achieve organizational goals.
D. Clinical decision making focuses on diagnosing client health issues, risks, or problems and planning or coordinating nursing interventions, but managerial decision making focuses on resolution of organizational problems and the plans to achieve organizational goals.
4. Decision-making tools and strategies support the process for decisions. Select the one statement that is true A. Group decision making tends to be more ineffective for system problems. B. All decision tree questions have a yes or no answer. C. Managers who use trial and error as the usual strategy for decision making often are effective. D. Critical pathways are a type of decision tree.
D. Critical pathways are a type of decision tree. The correct statement is that critical pathways are a type of decision tree; they are used for clinical care and other industry decisions. The first statement is incorrect because group decision making tends to be more reflective and include more information and experts to effectively solve system problems with fewer consequences. The second statement is incorrect because only simple decision trees use questions that must be answered yes or no to direct the flow of thinking for making a decision. Algorithms for emergent care scenarios are an example of yes/no trees. The third statement is incorrect because managers using evidence-based strategies for decision making will be effective, and those using trial and error are ineffective more often.
Select the best statement for why communication processes are important to organizations. A. Horizontally decentralized organizations are more efficient than centralized organizations. B. Positive communication techniques include agreeing uncritically and reassuringly. C. Individual communication is more complex than group communication because it is so intensive. D. Human interaction issues are the general area in which leaders and managers spend most of their time.
D. Human interaction issues are the general area in which leaders and managers spend most of their time.
Which of the following statements correctly describes case management? A. Primary therapists have therapeutic relationships with the clients and provide primary case management functions. B. Physicians must document the effects of interventions on client outcomes to demonstrate that they can provide cost-effective services. C. Social workers can coordinate care for all patients and provide case manager functions to coordinate health care services for high-risk populations across community, acute, and long-term care settings. D. Registered nurses (RNs) have emerged as the large majority of case managers, especially in hospitals, because of their specialized expertise for the function of determining medical necessity for health care payment and because of care coordination for complex medical discharge planning needs.
D. Registered nurses (RNs) have emerged as the large majority of case managers, especially in hospitals, because of their specialized expertise for the function of determining medical necessity for health care payment and because of care coordination for complex medical discharge planning needs.
Complexity and chaos theory has application to leadership and management decision making. Which of the following statements apply to this theory (select all that apply)? A. A web of interdependence and mutual interconnection among nurses, physicians, and support staff results in an adaptive system with open boundaries, multiple levels of organization, and rule sets that serve as the organization's operating procedures. B. Organizational behaviors emerge from personal changes creating ever-changing feedback loops and new ways for health care delivery. C. Changes in external and internal environments from manager changes result in system changes over time. D. The behavior of nurses is governed by the rules (formal and informal), information flow, diversity, and interconnectedness of the organization.
D. The behavior of nurses is governed by the rules (formal and informal), information flow, diversity, and interconnectedness of the organization. A. A web of interdependence and mutual interconnection among nurses, physicians, and support staff results in an adaptive system with open boundaries, multiple levels of organization, and rule sets that serve as the organization's operating procedures.
Nurses may communicate using humanizing and dehumanizing attitudes which impact the outcome of communication: Select the most humanizing option below. A. In a small group session, there were varying opinions, with two individuals quite vocal about their viewpoints on how to proceed with a project. B. The manager handles the nurses on the unit with tolerance, judgment, and role playing. C. In a unit-based group session, there was disregard for conversation offered by 10 group members with steps to change the agenda item to another topic. D. The manager engaged nurses to share their concerns and ideas openly and their fears about the developing project.
D. The manager engaged nurses to share their concerns and ideas openly and their fears about the developing project.
Personal conflict can arise when trying to ingratiate another person because there is the use of: A. influencing an individual or group to gain a scarce resource. B. providing a pay raise, promotion, or advancement. C. threats, discipline, or negative consequences. D. lavishing praise on another to make him or her feel important to gain favor.
D. lavishing praise on another to make him or her feel important to gain favor.
Duty of care owed by the nursing professional to the client is the minimum requirements that define an acceptable level of care. The minimum requirements are best located in: A. the Social Policy Statement and Washington Manual. B. published standards by the American Nurses Association, nursing textbooks, and databases. C. federal agency guidelines and regulations and the Care Standards Act 2000. D. state nurse practice acts, standards published by nursing professional organizations and specialty practice groups, and/or a facility's policy and procedure manuals.
D. state nurse practice acts, standards published by nursing professional organizations and specialty practice groups, and/or a facility's policy and procedure manuals.
How can nurses be aware of and avoid lateral violence (LV)?
Discuss and write about important topics develops supportive cohesive relationships. group writing decreases negative workplace behavior Cognitive rehearsal. Talk with person you have a problem with, dont spread rumors, or stop someone if they are spreading always cover yourself always be supportive of others Keep trust, be honest treat others the way you want to be treated be careful what you say and who you say it to speak kindly
You are helping a client with an SCI to establish a bladder retraining program. Which strategies may stimulate the client to void? Select all that apply. To receive full points all correct must be selected. Initiating intermittent straight catheterization Stroking the client's inner thigh Pulling on the client's pubic hair Pouring warm water over the client's perimeum Tapping the bladder to stimulate the detrusor muscle
Stroking the client's inner thigh Pulling on the client's pubic hair Pouring warm water over the client's perimeum Tapping the bladder to stimulate the detrusor muscle
Resolving conflict requires interventions. One intervention is to initiate a timely private discussion to respect individual differences and be empathetic to both sides, yet have an assertive dialogue about facts and feelings to frame the main issue on some common principles in order to agree on a solution that satisfies all. Which of the following is this type of conflict management? A. Creative problem solving B. Smooth or finesse the issue through an organizational change C. Restrict or isolate the conflict D. Compromise
The correct answer is creative problem-solving, which produces feelings of gain and no feelings of loss for all conflict participants. This technique is the most effective but often not the first approach. The second answer involves smoothing or finessing the issue through an organizational change by restructuring around the issue. The third answer refers to restricting or isolating the conflict so the parties can agree to disagree about the conflict and move on to only items that they do agree about. Compromise is incorrect because this technique has the parties achieve some wins and losses, where each side gives up a part of its demands.
List the four categories of collaboration and give a 1-2 sentence description of each.
Your Answer: Nurse-Patient: Nurse and patient talking, working together and deciding together on cares. Nurse-Nurse: Developing a nursing team, nurses working together, learing from eachother, deciding together, on cares for other patients. Mentoring, shared governance. interprofessional: Working across profesonal boundaries. partnership between a team of health providers and patient (could include nursing occupational, physical therapist, pharmicy, patient, family, law, social worker ect.) Interorganizational: Resources and information between organizations. Often takes place in forms of coalitions or consortiums
The determinant for the decision to delegate is the legal scope of delegation rules described within: A. an institutional policy. B. a nurse practice act. C. the American Nurses Association (ANA) Code of Ethics. D. The Joint Commission (TJC) Patient Care Standards.
a nurse practice act
The degree to which a client or population with common personal or environmental characteristics continues a negotiated treatment is a parameter. To measure this indicator in a community or interdependent organizations, such as ACOs, would be: A. compliance. B. adherence. C. maintenance. D. noncompliance.
adherence
Cost-benefit analysis
an appropriate strategy to use when deciding budgetary issues and may include listing the positive and negative aspects of a given outcome to assist with decision making
Place the steps for performing colostomy care in the correct order.
clean gloves color and appearance wash soap dry skiin apply barrier pouch
1. Effective delegation skills are important for leaders and managers whose function is to get work done through the efforts of others. The individual who accepts this work is called: A. delegate. B. adaptor. C. supervisor. D. delegator.
delegate
type of power exhibited when providing the opportunity for others to take responsibility and accountability for their work is: A. referent power. B. empowerment. C. expert power. D. legitimate power.
empowerment
5. __________ is being loyal and faithful to commitments and accountable for responsibilities. A. Autonomy B. Veracity C. Fidelity D. Values
fidelity
7. A number of decision-making strategies have been identified for clinical and managerial decision making. An effective strategy for nurse managers to select in examining possible causes related to production would be: A. pilot projects. B. cost-benefit analysis. C. scenario planning. D. fish bone charts.
fish bone charts
Which is a perceived antagonistic process at the individual-organization level of interaction that affects productivity, morale, and teamwork in organizations? A. Interpersonal conflict B. Organizational conflict C. Job conflict D. Social conflict
job conflict
Pilot projects
limited experimental trials used to develop an optimal and alternative solution to a problem.
Leaders who give and take exchanges aimed at resolving issues are doing which of the following? A. Bargaining B. Effective communication C. Persuasion D. Negotiation
negotiation
List the 10 most common common forms of lateral violence (LV) in nursing
nonverbal innuendo, verbal affront, undermining activities, withholding information, sabotage, infighting, scapegoating, backstabbing, failure to respect privacy, and broken confidences
When the leader engages in dialogue with the nurse to share ideas and help in making decisions, what style of Situational Leadership® communication is being used? A. Selling B. Delegating C. Telling D. Participating
participating
1. Which of the following statements is true about problem solving? A. Problem solving is a high-level skill used only by health care professionals. B. Critical thinking and problem solving are the foundation of effective decision making. C. The team problem-solving method is a slow process and is a poor method for making decisions. D. Problem solving is a rational and logical thought process.
problem solving is a rational and logical thought process.
What is a wrongful act committed against another person or organization or their property that causes harm and can be remedied by a civil lawsuit? A. Malpractice B. Legal liability C. Tort D. Negligence
tort
Scenario planning
used in a group setting to brainstorm about the future and is a beneficial strategy to use in a constantly changing environment.
