CH 7-9

What is the primary reason for documenting nursing interventions as soon as possible after an activity is completed? a. Decreasing the risk of inaccurate documentation b. Implementing effective time management skills c. Demonstrating professional nursing behavior d. Observing an established nursing principle

a. Decreasing the risk of inaccurate documentation

In planning strategies to prevent stagnation and promote renewal, which action would most likely result in the desired outcome? a. Developing a program for recruitment of young talent b. Rewarding employees by promoting from within c. Having set pay increases mandated annually d. Using length-of-service to determine committee selection

a. Developing a program for recruitment of young talent

A nurse has been asked to join the health-care organization's strategic planning committee. What actions should the committee perform in order to create an efficient and evidence-based planning process? Select all that apply. a. Enlist members with expertise in health-care economics. b. Carefully consider political issues related to health care. c. Prioritize the role of intuition in the planning process. d. Identify and implement a planning theory. e. Include as many stakeholders as possible in the planning process.

a. Enlist members with expertise in health-care economics. b. Carefully consider political issues related to health care. d. Identify and implement a planning theory. e. Include as many stakeholders as possible in the planning process. Feedback: Strategic planning requires managerial expertise in health-care economics, human resource management, and political and legislative issues affecting health care, as well as planning theory. Stakeholders should be engaged in the process. Intuition is not assigned a high value in organizational planning processes and is not normally prioritized over other decision-making processes.

The nurse-manager is participating in organizational planning. Which factors should the team consider when identifying variables that may complicate the planning process? Select all that apply. a. Government regulations b. Rapidly changing technologies c. Decreased acknowledgement of the importance of planning d. Changing population demographics e. Public mistrust of the nursing profession

a. Government regulations b. Rapidly changing technologies d. Changing population demographics Feedback: Because of the rapidly changing technology, increasing government regulatory involvement in health care, changing population demographics, and reduced provider autonomy, health-care organizations are finding it increasingly difficult to appropriately identify long-term needs and plan accordingly. Nurses are generally well trusted by the public, and there is acknowledgment that planning is important in health-care organizations

Nurses on a hospital unit have been informed that a change to the documentation system is being proposed. What factor surrounding this change is most likely to cause unfreezing? a. The proposed documentation system has been introduced in many hospitals in the region. b. The leader-manager supports a change in the documentation system. c. An influential nurse has extensive experience with different documentation systems. d. The nurses find the current documentation system unwieldy and inefficient.

d. The nurses find the current documentation system unwieldy and inefficient.

The manager on a hospital unit has highlighted some of the large gaps between desired client outcomes and actual client outcomes. What component of Lewin's change theory is the manager demonstrating? a. Unfreezing b. Movement c. Refreezing d. Resistance

a. Unfreezing

The leader-manager has successfully implemented a change and is now entering the refreezing stage of the change process. During this stage, the leader-manager should prioritize: a. restoring stability to the workplace. b. rewarding the employees who embraced the change early. c. communicating the specific benefits of the change. d. addressing the concerns of resistors.

a. restoring stability to the workplace.

The nurse-manager of a hospital unit has categorized some tasks in the "do now" category. The tasks most likely reflect: a. the unit's day-to-day operational needs. b. issues related to long-term goals. c. large, time-consuming tasks. d. problems that cannot be safely delegated.

a. the unit's day-to-day operational needs.

A multidisciplinary team has been assigned responsibility for managing the change process in a large health-care organization. What goal should this team set for their activities? a. Resistors will face workplace discipline. b. Employees will not sabotage the change process. c. Change will happen as quickly as possible. d. Change will become a constant state in the organization.

b. Employees will not sabotage the change process.

The manager of a clinic is considering a change in the scheduling of vacation time in which nurses would self-schedule their vacation rather than having the manager respond to their submitted requests. A nurse has pointed out that it is possible that newer nurses may feel intimidated by more experienced nurses on the unit when scheduling their vacation. This observation constitutes what component of a SWOT analysis? a. S b. W c. O d. T

b. W Feedback: Weaknesses are those internal attributes that challenge an organization in achieving its objectives. In this case, possible intimidation within the culture of the unit would be considered an internal attribute that could complicate the proposed system. Threats are also potential confounding factors, but these are external, not internal, factors. Strengths and opportunities are positive attributes.

A team has been formed to consider a change in medication delivery. How can the team leaders best promote a successful change? a. Implement the change as rapidly as possible in order to diffuse resistance. b. When planning, involve as many people who will be affected by the change as possible. c. Bring in outside experts to implement the change. d. Enforce compliance with the change fairly and consistently.

b. When planning, involve as many people who will be affected by the change as possible.

A society that highly values social equity and equality is likely to support a health-care system which: a. prioritizes the role of the free market in providing health-care services. b. entitles all citizens to similar levels of health-care services. c. relies on the private sector to organize and provide health care. d. is cost-effective and efficient.

b. entitles all citizens to similar levels of health-care services. Feedback: Values strongly influence the formation of health-care policy. A society that values equality of access and social equity is likely to create a health-care system in which each citizen has similar access to services. In many cases, the roles of the free market and the private sector are eclipsed by government, which provides or coordinates services accessible to all. This type of system may or may not be cost-effective, depending on numerous variables.

The nurse is participating in a planning process in a large health-care organization. The nurse and the other members of the team should: a. avoid specifics so that the plan can be applied in any health-care setting. b. ensure that long-term priorities are always prioritized over short-term priorities. c. ensure that evaluation occurs at several points during the process. d. begin to engage employees in the process after the plan has been implemented.

c. ensure that evaluation occurs at several points during the process. Feedback: Planning can be short term or long term but should always include built-in evaluation checkpoints so there can be a midcourse correction if unexpected events occur. Excessive generalization (vagueness) can make a plan difficult to implement because of the lack of specifics. Employee engagement should occur early in the process. Short-term and long-term interests must be balanced; long-term priorities do not always supersede short-term priorities.

A nurse-manager is having an exceptionally busy day and tells a colleague, "There's no way I can take a lunch break today. I've got too much to do." What is the colleague's best response? a. "It's important to take breaks, so there's never any valid reason for skipping lunch." b. "I know that happens sometimes. Let me know if you need help with organizing your day." c. "You probably just need to reorganize your day. Do you need help with that?" d. "Let's take a quick break and get something to eat, even if we have to come back a bit early."

d. "Let's take a quick break and get something to eat, even if we have to come back a bit early."

Which statement is an example of a process objective? a. "Every nurse will screen newly admitted clients for alcohol abuse." b. "The falls rate on the unit will decrease by 50% compared with 2016 rates." c. "The health-care facility will achieve accreditation within the next 24 months." d. "The new bowel care protocol will be fully implemented by the end of the calendar year."

a. "Every nurse will screen newly admitted clients for alcohol abuse." Feedback: Objectives can focus on either the desired process or the desired result. Process objectives are written in terms of the method to be used, whereas result-focused objectives specify the desired outcome. The statement "Every nurse will screen newly admitted clients for alcohol abuse" states how (i.e., the process) each client will be screened. Each of the other listed statements focuses on results or outcomes.

Time management can be reduced to cyclic steps that include which of the following? Select all that apply. a. Allow time for planning and establish priorities. b. Complete tasks according to their difficulty, from easiest to most difficult. c. Complete the highest priority task, and whenever possible, finish one task before beginning another. d. Reprioritize based on remaining tasks and new information that may have been received. e. Divide each day into 1-hour blocks.

a. Allow time for planning and establish priorities. c. Complete the highest priority task, and whenever possible, finish one task before beginning another. d. Reprioritize based on remaining tasks and new information that may have been received.

Which activity is associated with a leadership role in time management? a. Assisting followers in working cooperatively to maximize time use b. Prioritizing day-to-day planning to meet short-term and long-term unit goals c. Building time for time management planning into the work schedule d. Utilizing technology to facilitate timely communication and documentation

a. Assisting followers in working cooperatively to maximize time use

What is the reason that first- and middle-level managers experience more interruptions than higher level managers? a. They generally interact directly with a greater number of individuals in daily planning. b. They seldom have the clerical and secretarial help assigned to higher level managers. c. They often lack the time management skills that more experienced managers possess. d. They generally have heavier workloads than higher level managers.

a. They generally interact directly with a greater number of individuals in daily planning.

The nurse-manager would be justified in making a change for which reasons? Select all that apply. a. To solve an existing problem b. To test workers' abilities to adapt c. To increase staff efficiency d. To reduce unnecessary workload e. To improve staff productivity

a. To solve an existing problem c. To increase staff efficiency d. To reduce unnecessary workload e. To improve staff productivity

A manager is trying to get in the habit of creating a daily list of tasks. The manager should: a. avoid changing the list once initial planning is completed. b. include flexibility in the implementation of the list. c. include all relevant short-term, intermediate, and long-term goals. d. keep the list highly structured, thus decreasing the possibility of procrastination.

b. include flexibility in the implementation of the list.

A nurse-manager can implement the principles of preactive planning by: a. responding quickly to emergent problems. b. using new technologies to accelerate change. c. preferring the status quo as a stable environment. d. directing planning in response to a crisis.

b. using new technologies to accelerate change. Feedback: Preactive planners utilize technology to accelerate change and are future oriented. Unsatisfied with the past or present, preactivists do not value experience and believe that the future is always preferable to the present. Their focus is not necessarily crisis response

The nurse-manager is creating a list in order to promote efficiency and productivity. What is the manager's best action? a. Use long-term goals as the framework for creating the list. b. Include slightly more activities than can be completed in a day, in order to motivate. c. Begin by ranking the priority of tasks that need to be accomplished. d. Keep each day's list as similar as possible to each other day's lists.

c. Begin by ranking the priority of tasks that need to be accomplished.

The nurse-manager is frustrated by the quantity of paper clutter? How should the manager best deal with this time waster? a. Require face-to-face communication between staff members rather than written documentation. b. Set aside a block of time once per week to process documents. c. Deal with paper correspondence as soon as possible after it arrives. d. Place additional recycling and trash receptacles throughout the unit.

c. Deal with paper correspondence as soon as possible after it arrives.

A unit manager has been instructed to complete a comprehensive audit of the unit's use of resources. The manager is daunted by the size of the task, which will likely take several weeks to complete. The manager should: a. set aside low- and medium-priority tasks until the project is complete. b. delegate the project to subordinates and ask for weekly updates. c. divide the project into smaller components that can be more easily completed. d. request clerical or secretarial assistance.

c. divide the project into smaller components that can be more easily completed.

A new nurse on the unit has been criticized for deviating from the accepted model of end-of-shift report, even though there is no written policy about the content or format for report. Which term is used for this type of policy? a. Implied policies b. Expressed policies c. Understood precedents d. The organizational culture

a. Implied policies Feedback: Implied policies are neither written nor stated verbally and have developed over time. The other options fail to meet this description

The nurse-manager is describing the forces that are driving change in today's health-care environment. What phenomena should the nurse describe? Select all that apply. a. Increased cost of health-care services b. Shortages of health-care professionals and providers c. Decreased third-party reimbursement for health-care services d. Decreased use of technology due to high cost of implementation e. Increased need to update health-care-related technologies

a. Increased cost of health-care services b. Shortages of health-care professionals and providers c. Decreased third-party reimbursement for health-care services e. Increased need to update health-care-related technologies

A nurse is participating in the process of values clarification. What are the characteristics of a true value? Select all that apply. a. It is freely chosen from among alternatives. b. It aligns with the dominant values of society. c. It is prized and cherished. d. It is positively affirmed. e. It is acted upon.

a. It is freely chosen from among alternatives. c. It is prized and cherished. d. It is positively affirmed. e. It is acted upon. Feedback: McNally identified the fact that a value is prized and cherished, positively affirmed and acted on, and chosen freely from among alternatives. It is possible for a value to be true while not aligning with the dominant values of the society

A change in the skills mix has been proposed at a care facility. What action by the nurse-manager would best support a rational-empirical change strategy? a. Presenting the research evidence that supports the change b. Publicizing the change to generate enthusiasm c. Appointing "champions" to ensure communication throughout the change process d. Ensuring that employees know the consequences of resisting

a. Presenting the research evidence that supports the change

A nurse-manager makes lists of tasks for each day. What should the manager do in order to ensure that lists accurately reflect changes in priorities? a. Reevaluate the lists on a regular basis and adjust them as needed. b. Ensure that each day's list is significantly different from the previous day's list. c. Make lists as detailed as possible in terms of the time allocated and the specifics of each task. d. Have the lists reviewed by a trusted colleague on a regular basis.

a. Reevaluate the lists on a regular basis and adjust them as needed.

A manager has been experiencing challenges during a planning process and must implement strategies to overcome barriers that impede planning. What is the manager's best action? a. Reevaluate whether the goals and objectives are appropriate and achievable. b. Establish a fixed goal that is unaffected by changes in the organization. c. Limit membership in the planning team to administrators, leaders, and executives. d. Make the goals of the plan more general so that they can be more easily achieved.

a. Reevaluate whether the goals and objectives are appropriate and achievable. Feedback: The organization can be more effective if movement within it is directed at specified goals and objectives. Because a plan is a guide to reach a goal, it must be flexible and allow for readjustment as unexpected events occur. Reevaluation is often necessary to ensure this happens. The manager should include in the planning process all people and units that could be affected by a plan, not just administrators and executives. A plan that is too global or unrealistic discourages rather than motivates employees because attainment of the goals can never be clearly determined.

A nurse-manager has introduced a proposed change to the operations of an ambulatory clinic and has been met with resistance. How should the manager best interpret this resistance? a. Resistance is an expected component of a proposed change. b. Resistance confirms that the proposed change is necessary. c. The presence of resistance suggests that the change may be unsuccessful. d. The presence of resistance indicates a need to implement power-coercive strategies.

a. Resistance is an expected component of a proposed change.

Which statements are true regarding planned change? Select all that apply. a. Resistance to change should be expected as a natural part of the change process. b. Change should be viewed as a chance to do something innovative. c. Technical changes are more resisted by staff than social changes are. d. Change affects the homeostasis of a group. e. Careful planning can guarantee the success of a change initiative.

a. Resistance to change should be expected as a natural part of the change process. b. Change should be viewed as a chance to do something innovative. d. Change affects the homeostasis of a group.

A nurse is considering applying for employment at a new health-care facility. How should the nurse best identify the aims and priorities of the organization? a. Review the organization's mission statement. b. Speak with as many front-line workers as possible. c. Ask interviewers about recent responses to consumer satisfaction surveys. d. Review the organization's policy and procedures documents.

a. Review the organization's mission statement. The purpose or mission statement is a brief statement identifying the reason that an organization exists. The mission statement identifies the organization's position regarding ethics, principles, and standards of practice. The nurse should be able to infer the organization's aims and priorities from this statement. Consumer feedback will not necessarily reveal the organization's aims and priorities. Similarly, workers are often unable to identify these priorities. Policies and procedures identify the preferred ways of completing tasks but not the organization's aims and priorities

The nurse-manager is reviewing the rules that the previous manager had put into place. When reviewing these rules, what principles should guide the manager's actions? Select all that apply. a. Rules should be flexible. b. The number of rules should be kept to a minimum. c. Rules should be changed on a regular basis. d. Enforcement of the rules supports staff morale. e. Consistent rule enforcement supports organizational structure.

a. Rules should be flexible. b. The number of rules should be kept to a minimum. d. Enforcement of the rules supports staff morale. e. Consistent rule enforcement supports organizational structure. RULES SHOULD NEVER BE CHANGED ON A REGULAR BASIS! The fewer rules the better and existing rule should be enforced!

Which statement is true concerning the refreezing phase of the change process? Select all that apply. a. The focus of this phase is to integrate the change into the status quo. b. Stabilization of change requires a 6- to 9-month period of time. c. If refreezing is incomplete, prechange behavior will be resumed. d. The change agent must remain involved until the refreeze stage is complete. e. The priority in this phase is to identify resistance.

a. The focus of this phase is to integrate the change into the status quo. c. If refreezing is incomplete, prechange behavior will be resumed. d. The change agent must remain involved until the refreeze stage is complete.

Which statements concerning the role of the leader-manager in organizational planning are true? Select all that apply. a. The leader-manager must be future-oriented. b. The leader-manager has to be willing to take risks. c. The leader-manager should possess human resource management skills. d. The leader-manager must evaluate the social climate that affects the organization. e. The leader-manager must be the most experienced clinician in the organization.

a. The leader-manager must be future-oriented. b. The leader-manager has to be willing to take risks. c. The leader-manager should possess human resource management skills. d. The leader-manager must evaluate the social climate that affects the organization. Feedback: Planning requires managerial expertise in health-care economics, human resource management, political and legislative issues affecting health care, and planning theory. Planning also requires the leadership skills of being sensitive to the environment, being able to appraise accurately the social and political climate, and being willing to take risks. A leader-manager can give effective oversight without being the most experienced clinician on the unit.

A nurse-manager recognizes the role that individual values play on decision making. How should the manager best address this fact during a period of organizational planning? a. The manager should carefully reflect on his or her most important values. b. The manager should make every attempt to set values when making decisions. c. The manager should seek individuals who have similar values when creating a decision-making team. d. The manager should seek individuals who claim to have flexible values when creating a decision-making team.

a. The manager should carefully reflect on his or her most important values. Feedback: All people should carefully examine their value system and recognize the role that it plays in how they make decisions and resolve conflicts and even how they perceive things. Therefore, the nurse-leader must be self-aware and provide subordinates with learning opportunities or experiences that foster increased self-awareness. In most cases, teams are not chosen on the basis of their personal values. It is unrealistic for a person to expect that he or she can set aside values or alter them when making decision.

Many nurses at an ambulatory clinic have expressed frustration about the low quality of care that clients have been receiving. How should a manager best interpret this situation? a. The nurses may be in the unfreezing phase of change. b. The clinic is likely an aged organization. c. The movement phase of change will be difficult to initiate. d. There is a need for the manager to demonstrate power-coercive strategies.

a. The nurses may be in the unfreezing phase of change.

Which characteristic of a planned change is most likely to threaten its success? a. The suggested change is introduced to staff after the plan has been formalized. b. Individuals affected by the change are involved in planning for the change. c. The change agent is aware of the organization's internal and external environment. d. An assessment of resources to carry out the plan is completed before unfreezing.

a. The suggested change is introduced to staff after the plan has been formalized.

The manager is leading a team to develop a unit-level philosophy statement. What guidelines should the team use during this process? a. The unit philosophy should align with the larger organization's philosophy. b. The unit's philosophy should include a mission statement and vision statement. c. The statement should reflect the values and priorities of the specific unit manager. d. The statement should be consistent with that of other similar health-care agencies.

a. The unit philosophy should align with the larger organization's philosophy. Feedback: The unit philosophy will be congruent with the organizational philosophy. Vision and mission are distinct from philosophy statements. The statement should transcend any one particular manager and does not necessarily have to align with other organizations

Which statement identifies a common mistake made related to daily planning? a. "Crises always come up so my plan is always changing." b. "I always handle each client's needs as they arise." c. "Sometimes it's difficult to reserve time for daily planning." d. "Client care requires a lot of reassessment by nursing."

b. "I always handle each client's needs as they arise."

What is the best response for a nurse-manager to handle someone who has a pattern of lengthy chatter? a. "We'll need to make it brief since my schedule is tight today." b. "I can't speak with you now, but I'm going to have free time at 11 AM." c. "Stop by and we can talk during your lunch break." d. "I am sorry but I do not have anytime today to talk with you."

b. "I can't speak with you now, but I'm going to have free time at 11 AM."

Which statements demonstrate adherence to habits that supports good personal time management skills? Select all that apply. a. "It's important to me to be professional." b. "I'm learning to trust the members of my team." c. "I've learned that I'm most energetic in the morning." d. "I'll adjust my sleep schedule now that I'm on night shift." e. "I never quit a task that I've decided to do."

b. "I'm learning to trust the members of my team." c. "I've learned that I'm most energetic in the morning." d. "I'll adjust my sleep schedule now that I'm on night shift."

A nurse intends to enroll in graduate school and has informed a colleague of this intention. What response suggests that the colleague is in the precontemplation stage of change? a. "I haven't decided, but I might start looking into doing that as well." b. "That's a good idea for you, but I'm just thankful that I'm done with school." c. "I suppose that will open up some new opportunities for you." d. "That's my plan as well. When will you start?"

b. "That's a good idea for you, but I'm just thankful that I'm done with school."

At the unit level, what time frame may be considered long-range planning? SATA a. 3 months b. 6 months c. 12 months d. 18 months

b. 6 months c. 12 months d. 18 months Feedback: At the unit level, any planning that is at least 6 months in the future may be considered long-range planning.

Which statement regarding nursing policies and procedures is most important to their successful application in achieving goals? a. The policies and procedures are created by staff representatives. b. All policies and practices are based on current evidence related to practice. c. Policies and procedures are reviewed at fixed times, every 5 years. d. One hundred percent of the staff adheres to established policies and procedures 100% of the time.

b. All policies and practices are based on current evidence related to practice. Feedback: Policies and procedures should be evidence-based. It is unrealistic to expect 100% compliance, 100% of the time. A policy that is created by staff representatives but which is not evidence-based is not appropriate because it may be unsafe. Ongoing, cyclical review should be implemented.

A nurse-manager is having difficulty finishing the necessary tasks for each day. When implementing the time management process, what should the manager do first? a. Complete the highest priority task. b. Allow enough time for sufficient daily planning. c. Reprioritize based on new information received. d. Delegate work that cannot be accomplished in a day.

b. Allow enough time for sufficient daily planning.

A manager has identified the need to spend more time planning in order to accomplished each day's tasks. When should the manager do this planning? a. Whenever a block of time is available b. At the beginning of each day c. In the middle of the day, after high-priority tasks have been completed d. At the end of the day, in preparation for the next day

b. At the beginning of each day

Frequent turnover in leadership at a health-care organization has meant that change has often occurred by drift. What are characteristics of this mode of change? Select all that apply. a. Changes are planned by teams. b. Changes occur accidentally. c. Changes take place even though they are unplanned. d. Changes take place only as the result of threats. e. Change takes place democratically.

b. Changes occur accidentally. c. Changes take place even though they are unplanned.

A leader-manager plans to implement normative-reeducative strategies to facilitate change in a community health clinic. What action will the leader-manager most likely choose? a. Addressing likely points of resistance before they can be stated by nurses who are reluctant to change b. Communicating the fact that the majority of nurses are enthusiastic supporters of the change c. Publicizing the benefits of the proposed change and the research that supports it d. Providing incentives to nurses who are willing to adopt the change early

b. Communicating the fact that the majority of nurses are enthusiastic supporters of the change

A nurse-manager admits to feeling frustrated and confused by the fact that each day "just slips away," leaving many important tasks undone. How should this manager begin develop better time management skills? a. Identify a mentor who can plan the manager's schedule. b. Complete a time inventory to identify how time is used. c. Experiment with adjustments to the daily schedule. d. Request a temporary reduction in workload.

b. Complete a time inventory to identify how time is used.

A nurse-manager is beginning a day and is responsible for completing numerous tasks, including one high-priority task, three medium-priority tasks, and several lower priority tasks. How should the manager plan the day? a. Complete some low-priority tasks first to make room for focusing on the high-priority task. b. Complete the high-priority task as early in the day as possible. c. Arrange the tasks according to the amount of time that they will require. d. Complete the low-priority tasks first, then a medium-priority task, and then focus exclusively on the high-priority task.

b. Complete the high-priority task as early in the day as possible.

A workplace health initiative has been launched in which subsidies are being offered for gym memberships and exercise equipment. This initiative is most likely to affect individuals who are in which phase of the stages of change model? a. Precontemplation b. Contemplation c. Action d. Maintenance

b. Contemplation

A nurse-manager is prioritizing tasks. Which tasks should the manager put into the "do now" category? a. Adding follow-up comments to an incident report from the previous day b. Covering sick calls for the upcoming shift to ensure there are enough nurses c. Conducting a new employee's initial performance review d. Meeting with the chairperson of the hospital's strategic planning committee

b. Covering sick calls for the upcoming shift to ensure there are enough nurses

Which activity associated with the unfreezing state of change will have the greatest impact on the success of the movement stage of the change process? a. Accurate identification of the problem requiring change b. Effective information gathering concerning the problem c. Key personnel voicing their opinions regarding the need for change d. The need for change is perceived by those affected by the problem

d. The need for change is perceived by those affected by the problem

A planned change has been imposed by upper management at a large hospital and will greatly affect the delivery of care on inpatient units. What is an appropriate role for the leader-manager in this time of change? a. Mobilizing resistance in a respectful but assertive way b. Demonstrating a positive attitude toward the prospect of change c. Implementing the change as rapidly as possible d. Dialoguing with staff about the benefits of maintaining the status quo

b. Demonstrating a positive attitude toward the prospect of change

A nurse-manager is reviewing a backlog of correspondence and reads an e-mail asking for feedback from a manufacturer about a piece of equipment that is used at the facility. The manager reads that the sender asked for all feedback to be submitted by the end of last week. In what category of prioritizing should this task be placed? a. Squeaky wheel b. Don't do c. Do later d. Do now

b. Don't do

A nurse is ostracizing a staff member who dresses "unprofessionally" and is encouraging other nurses to treat the staff member in the same way. This most closely represents which change strategy? a. Power-coercive b. Normative-reeducative c. Rational-empirical d. Resistance-withdrawal

b. Normative-reeducative

Which statement about time management is true?a. Most people have an accurate perception of the time they spend on a particular task or the total amount of time they are productive during the day. b. Nurses with clearly identified personal goals and priorities have greater control over how they spend their time. c. Writing goals down is not usually necessary if the goals are limited to fewer than five in number. d. Keeping a time inventory for a day will allow the manager to identify a time management pattern.

b. Nurses with clearly identified personal goals and priorities have greater control over how they spend their time.

Which factor is the greatest contributor to the resistance encountered with organizational change? a. Poor organizational leadership b. Presence of employee mistrust c. Ineffective organizational management d. Insufficient staff involvement in the process

b. Presence of employee mistrust

Which task should the team leader perform first when planning care for a group of clients? a. Plan so that each client on the team receives equal amounts of nursing care. b. Prioritize the amount and type of nursing care each client requires. c. Identify the staff who will comprise the individual care teams. d. Assign clients to the specific nursing teams.

b. Prioritize the amount and type of nursing care each client requires.

A nurse-manager has recognized that unproductive socialization is making it difficult to complete each day's tasks. What action should the manager take to prevent this cause of inefficiency? a. Maintain an open-door policy so employees can have more rapid interactions with the manager. b. Schedule appointments so that interactions can be predicted and controlled. c. Request a transfer to a site where the manager knows fewer coworkers and employees. d. Ban socialization on the unit during working hours.

b. Schedule appointments so that interactions can be predicted and controlled.

A nurse-manager is creating an organizational plan. What characteristic of the plan is more likely to promote success? a. A midterm evaluation of the planning process b. Several predefined evaluation checkpoints c. The rejection of any earlier plans that did not succeed d. Overplanning to accommodate predicted lapses in the planning process

b. Several predefined evaluation checkpoints Feedback: Good plans have several built-in evaluation checkpoints so that there can be a midcourse correction if unexpected events occur. A single midterm evaluation is likely insufficient. If goals were not met, the plan should be examined to determine why it failed. However, this does not necessarily mean that similar plans cannot be reattempted. Overplanning can result in an excessive and inefficient commitment to minor details.

An organization is considering a revision to its philosophy. What characteristic of the current philosophy would most clearly indicate a need for revision? a. The philosophy is more than 5 years old. b. Staff claim the stated unit philosophy is in contrast to the care that is being given. c. The philosophy was appropriated from a different health-care facility. d. The philosophy was created after the organization's vision and mission were determined.

b. Staff claims the stated unit philosophy is in contrast to the care that is being given. Feedback: An organizational philosophy that is not or cannot be implemented is useless. An old philosophy is not necessarily obsolete, and it is possible to adopt a philosophy from another facility if it is appropriate in a different setting. It is acceptable for an organization's philosophy to flow from the vision and mission statements.

A nurse-manager is on a strategic planning team that is applying the balanced scorecard while strategic planning. The team should specifically consider what variables when creating the scorecard? Select all that apply. a. Legislation that governs the organization's operations b. The health-care organization's budget c. Goals identified by similar organizations d. The existing processes that are in place e. Opportunities for learning and growth f. Feedback that clients and families have provided

b. The health-care organization's budget d. The existing processes that are in place e. Opportunities for learning and growth f. Feedback that clients and families have provided Feedback: Strategic planners using a balanced scorecard develop metrics, collect data, and analyze that data from four organizational perspectives: financial, customers, internal business processes (or simply processes), and learning and growth. This particular model does not explicitly include other organizations' goals or legislation as major components of planning

A nurse-manager is responsible for implementing a large and complex plan that will require much time and effort. How should the manager address this large task? a. Work on the task with few breaks in order to finish as quickly as possible. b. Delegate as much of the task as possible to employees and focus on evaluation. c. Break the task into smaller, less intimidating units. d. Delay beginning the task until it has the manager's undivided attention.

c. Break the task into smaller, less intimidating units.

One of the most commonly used tools in health-care organizations is SWOT analysis. What is the definition of the "O" component of this model? a. Internal attributes that help an organization achieve its objectives b. Internal attributes that challenge an organization in achieving its objectives c. External conditions that promote achievement of organizational objectives d. External conditions that challenge or threaten the achievement of organizational objectives

c. External conditions that promote achievement of organizational objectives Feedback: Opportunities are external conditions that promote achievement of organizational objectives. Strengths are internal attributes that help an organization achieve its objectives. Weaknesses are internal attributes that challenge an organization in achieving its objectives. Threats are external conditions that challenge or threaten the achievement of organizational objectives.

How should the nurse-manager most effectively deal with the ever-changing nature of the nursing work environment? a. Evaluating the management skills of the nursing team leaders b. Providing time management classes for staff members c. Frequently reassessing personally established priorities d. Encouraging staff to engage in daily planning

c. Frequently reassessing personally established priorities

How can subordinates be discouraged from taking up a nursing manager's time unproductively? Select all that apply. a. Having the manager be accessible in the nursing station b. Instituting an open-door policy c. Having limited office seating available d. Refocusing conversations as needed e. Work in a public area

c. Having limited office seating available d. Refocusing conversations as needed

A nurse-manager has been asked for the first time to join the health-care facility's strategic planning committee. What action should the manager take first? a. Approach potential mentors on the committee. b. Perform a SWOT analysis of the issues facing the committee. c. Identify and examine his or her own planning style. d. Review the committee's most recent Balanced Scorecard.

c. Identify and examine his or her own planning style. Feedback: Self-reflection is a necessary first step when a nurse is becoming involved in strategic planning. This should precede efforts such as finding mentors. Performing SWOT analysis and creating balanced scorecards constitute the work of the committee.

The nurse-manager is on a team that is performing a SWOT analysis of the staffing system at a community clinic. What should the manager do when addressing the "S" component of the SWOT analysis? a. Identify stakeholders in the current staffing system. b. Examine the factors indicating that a change in the staffing system is necessary. c. Identify any characteristics of the staffing system that currently help the clinic meet its goals. d. Strategize about ways that the staffing system could possibly be improved.

c. Identify any characteristics of the staffing system that currently help the clinic meet its goals. Feedback: After identifying the issue, SWOT analysis begins with identifying strengths, which are the internal attributes that help an organization achieve its objectives. The "S" does not denote stakeholders or strategizing. It is important to identify the rationale for a change, but this is not a component of the SWOT model of analysis.

A leader-manager has recognized the need to be more consistent with time management? What skill should the nurse develop in order to facilitate time management? a. Enlisting the help of an administrative assistant b. Recognizing the need for goal setting c. Prioritizing tasks accurately d. Handling emergency situations quickly

c. Prioritizing tasks accurately

A novice nurse-manager is frequently late for appointments. This manager's colleagues are likely to have what perception of the manager? a. The manager is overworked with too many responsibilities. b. The manager needs additional management training. c. The manager does not value other people's time. d. The manager lacks the skill necessary for the job.

c. The manager does not value other people's time.

What characteristic of a health-care organization most clearly suggests that is an aged organization? a. The organization was established more than 75 years ago. b. The organization used to be the largest in the region but is now smaller than several similar organizations. c. The organization has a history of stifling innovation. d. The organization is having difficulty attracting new graduates.

c. The organization has a history of stifling innovation.

Which element should influence the nurse executive most heavily when assessing the organization's philosophy of nursing services for possible revision? a. Consumer surveys b. Input from other health disciplines c. The organization's mission statement d. Policy statements

c. The organization's mission statement ANS: C Feedback: The philosophy flows from the mission statement, the highest priority in the planning hierarchy. Each of the other sources may be considered, but none should be as influential as the mission statement of the organization

A health-care organization has adopted a new philosophy statement. What observation best shows that the philosophy is being implemented? a. The philosophy is displayed prominently in client care areas and staff areas. b. The philosophy aligns with the organization's vision and mission. c. The philosophy is reflected in the care that clients and families receive. d. The philosophy was created by an interdisciplinary group that included nurses.

c. The philosophy is reflected in the care that clients and families receive. Feedback: A philosophy is being implemented if it is evident in the care that clients and families receive. Displaying the philosophy prominently, aligning it with vision and mission, and collaboratively creating the philosophy do not guarantee that the philosophy is actually being implemented.

Which is a true statement about planning? a. All plans should be defined at the outset so that changes are not necessary. b. Long- and short-range plans should be kept separate so priorities do not become confused. c. Objectives and goals must be established before the philosophy is written. d. All plans should be flexible to accommodate changing circumstances.

d. All plans should be flexible to accommodate changing circumstances. Feedback: Every plan should be flexible because unexpected events are inevitable. It is impossible to identify every aspect of the plan at the outset because circumstances are always changing. Short- and long-range plans should be complementary and integrated, not separate. The philosophy should form the foundation of objectives and goals

Which activity should a change agent perform in order to best assure a successful implementation of a change? a. Helping followers arrive at total consensus regarding the change b. Encouraging subgroup opposition to change so many viewpoints can be heard c. Using change by drift if the resistance to change is too strong d. Being available to support those affected by a change until the change is complete

d. Being available to support those affected by a change until the change is complete

Which statement best describes the philosophy of nonlinear change theories? a. Change occurs in sequential steps of varying speed. b. Change is predictable with proper analysis. c. Change success relies on clear policies and hierarchies. d. Change is necessary because organizational stability is brief.

d. Change is necessary because organizational stability is brief.

The nurse-manager has begun the movement stage of a proposed change. What is the manager's most appropriate activity?a. Gather data about the need for change. b. Accurately diagnose the problem. c. Decide whether change is needed. d. Collaborate with stakeholders to develop a plan.

d. Collaborate with stakeholders to develop a plan.

Which statement best describes an emerging paradigm that is likely to influence strategic planning for health care in the 21st century? a. Reduced emphasis on cost containment b. Reduced regulatory oversight of health-care organizations c. A shift from interdependence of health-care professionals to greater autonomy d. Continued increases in the cost of pharmaceuticals

d. Continued increases in the cost of pharmaceuticals Feedback: The rising cost of pharmaceuticals and ongoing drug shortages will continue to be a problem for US hospitals for at least the next 3 years. Cost containment, regulatory oversight, and interdependence of health-care providers are predicted to continue.

A nurse-manager set a goal early in the year take better control of time management. Upon achieving this goal, the manager is likely to experience what benefits? Select all that apply. a. Increased learning b. Increased influence on coworkers c. Increased knowledge d. Enhanced productivity e. Decreased stress

d. Enhanced productivity e. Decreased stress

A nurse-manager is applying chaos theory to a proposed change in the structure of care at a clinic. What skills will best facilitate the manager's application of this theory? a. Creating "buy-in" from the stakeholders b. Finding solutions to resistance to change c. Changing attitudes more than increasing knowledge d. Finding underlying order in seemingly random data

d. Finding underlying order in seemingly random data

Which action represents a management function in planned change? a. Inspiring group members to be involved in planned change b. Visionary forecasting c. Role modeling high-level interpersonal communication skills in providing support for individuals undergoing rapid or difficult change d. Identifying the options and resources available to implement change

d. Identifying the options and resources available to implement change

A nurse-manager has identified the following objective for the care on the unit: "At least 95% of new clients' health records will contain a completed assessment for intimate partner violence." How should the manager improve this objective? a. Increase the objective to 100% of health records. b. Include the rationale for the objective. c. Focus on client actions rather than documentation. d. Include a time frame in the statement.

d. Include a time frame in the statement. Feedback: For objectives to be measurable, they should have certain criteria. There should be a specific time frame in which the objectives are to be completed, and the objectives should be stated in behavioral terms, be objectively evaluated, and identify positive outcomes rather than negative outcomes. It is appropriate for an objective to include references to documentation and it may or may not be appropriate to expect 100% compliance, depending on many factors. The rationale is not normally included in an objective statement.

A leader has launched an organizational planning process that requires the development of new policies. How should the leader utilize subordinates during this process? a. Delegate the evaluation phase of organizational planning to subordinates. b. Ask subordinates to brainstorm alternatives and then have industry experts evaluate each alternative. c. Limit the involvement of subordinates to developing unit-level policies and procedures. d. Include subordinates early in the process and include them in all aspects of policy formation.

d. Include subordinates early in the process and include them in all aspects of policy formation. The leader should encourage subordinates to be involved in policy formation, including developing, implementing, and reviewing unit philosophy, goals, objectives, policies, procedures, and rules. The leader should work alongside the subordinates, not just delegate to them. Subordinates should contribute to evaluation rather than this role limited to experts. The role of subordinates should not be limited to policies and procedures at a unit level.

When applying the principles of complex adaptive systems (CAS) theory, the nurse-manager should consider what principle? a. Change must occur by organized, linear steps. b. Change should be guided by intuition instead of being constrained by planning. c. Change is easier in small organizations than large organizations. d. Small variations in the change process can have major effects.

d. Small variations in the change process can have major effects.

A nurse-manager has set a goal of addressing external time wasters. What phenomenon should the manager address? a. Difficulty in setting clear, achievable objectives b. The manager's inability to say no to coworkers' and subordinates' requests c. The fact that the manager has a tendency to procrastinate d. The large quantity of paperwork that the manager must complete

d. The large quantity of paperwork that the manager must complete

The nurse who provides oversight to a large health-care organization can best demonstrate leadership during a time of change by: a. clearly and assertively reminding nurses of their responsibilities to accept change. b. asking permission of nurses before proposing a change process. c. acknowledging that there is going to be resistance during the change process. d. communicating a vision that change is an opportunity to be embraced.

d. communicating a vision that change is an opportunity to be embraced.

A recent nursing graduate has not performed a dressing change on a central catheter for several months and is unsure of how to correctly perform this. The nurse should refer to the: a. documentation. b. practice rules. c. organization policy. d. procedure manual.

d. procedure manual. Feedback: Procedures delineate a series of specific steps of a required action, such as performing a specific type of dressing change. Policies are plans reduced to statements or instructions that direct organizations in their decision making, not specific nursing actions. Procedures are not synonymous with documentation of "practice rules."