FINAL - ALL

15. In a job interview for a nursing position, Marley can be assured that which of the following will occur? a. Neither eustress nor distress b. Only eustress c. Both eustress and distress d. Only distress

c. Both eustress and distress

6. A functional résumé focuses on: a. Positions held and specific roles in the positions. b. Academic qualifications and achievements. c. Experience and skills gained in positions. d. Relating skills and experience to qualifications in a specific position.

c. Experience and skills gained in positions.

3. The chief nursing officer develops a mentoring program to help new staff members adjust to their new jobs. The main purpose of mentoring is: a. Promoting staff supervision b. Developing new role expectations c. Promoting staff retention d. Promoting staff attrition

c. Promoting staff retention

2. As a nurse manager, the one activity you should not overlook is: a. Anticipating staff sick days. b. Posting the yearly rotation schedule. c. Scheduling staffing for holidays 6 months in advance. d. Reviewing vacation requests.

d. Reviewing vacation requests.

6. As a unit manager, you chair the unit meetings. For each meeting, you consider and establish the purpose of the meeting. Second, you prepare an agenda. Arrange the following steps in an order that would make the meetings productive and successful. Correct order: ...

1. Select team members. 2. Distribute an agenda. 3. Start on time. 4. Keep the meeting focused and directed toward accomplishing the set objectives. 5. Distribute minutes.

13. The nurse manager of a unit was demoted to staff nurse 6 months ago. Because of being near retirement, the former nurse manager wanted to be employed at the hospital and was offered a position on the same unit. The former nurse manager complains often about how infrequently the current nurse manager is available on the unit and argues with physicians and co-workers. Clients have complained about the attitude of the nurse. The behavior of the former nurse manager can be best explained as being caused by: a. Anger as a stage of the grieving process. b. Inadequate mentoring in the new role. c. Overwork in the staff nurse position. d. Demotion as a threat to personal identity.

a. Anger as a stage of the grieving process.

18. Sources of occupational stress in nursing include all except which of the following? a. Authoritarian leadership b. Multiple changes in a short time c. Rotating shifts d. Concern about moral wrongdoing by colleagues

a. Authoritarian leadership

19. Mr. T. Jones and Mr. R. Smith are both going to become residents in Sunny Haven Lodge. Mr. Jones views it as an opportunity to socialize and meet new friends. Mr. Smith views this as abandonment by his family and is worried that the care will be inadequate. Each senior perceives the situation differently. This is a good example of stress that is: a. Both a positive stressor and a negative stressor. b. Harmful in both cases. c. Positive in both cases. d. Occurring only because of age.

a. Both a positive stressor and a negative stressor.

12. The chief nursing officer understands that a nurse manager can exhibit stress that is related to trying to keep up with the number of electronic messages that arrive, as well as trying to remain accessible to staff. What is a strategy that would assist the manager to manage the information overload effectively? a. Determine who is most likely to send useful or important information or requests. b. Check e-mail messages once a day. c. Ignore messages unless they are labeled as important. d. Encourage face-to-face meetings rather than e-mail.

a. Determine who is most likely to send useful or important information or requests.

23. After several months in the role of manager of a dialysis unit, Maryanne finds herself still questioning the gap in expectations between her and her staff and management and is also questioning if she can reconcile her concerns about quality care with the strong cost containment orientation of the facility. At this point, Maryanne is in which stage of role transition? a. Discrepancy b. Acceptance c. Development d. Internalization

a. Discrepancy

18. Sarah is a nursing graduate of 5 years who is very confident in her clinical skills. She has taken some certificate courses in leadership and management and has considered beginning a graduate degree with this focus. She is excited about being able to use her knowledge and interest by being hired as a nurse manager. Before beginning her new position, Sarah spends time with her nurse executive to clarify the executive's expectations of her and of the unit that she has been hired to manage. Sarah finds that she has begun to think negatively about the way nursing care is delivered on her nursing unit. She often wishes that she was back on her old unit and in her familiar staff nurse role. This behavior: a. Diverts energy from internalization of Sarah's new role. b. Is natural when assuming a new position. c. Reflects Sarah's astuteness as a clinician. d. Is justified if practices are deficient on the new unit.

a. Diverts energy from internalization of Sarah's new role.

11. Before beginning her own nursing agency, a nurse worked with other temporary nursing agencies in nine states. This career style is known as: a. Entrepreneurial/transient. b. Steady state. c. Spiral. d. Linear.

a. Entrepreneurial/transient.

8. As a result of Amy's coaching, Sarah, a nursing graduate of 5 years, completes a ROLES assessment. This assessment is helpful in (select all that apply): a. Expected work time commitments. b. Identifying her clinical knowledge. c. Role development. d. Areas of conflict in expectations.

a. Expected work time commitments. c. Role development. d. Areas of conflict in expectations.

17. A staff nurse approaches the unit manager and indicates to her that because of her father's death in the previous month, she is now finding it very difficult to do her work effectively. This would be considered a(n) ________ stress. a. External b. Burnout c. Familial d. Internal source

a. External

15. Knowing your professional strengths is important to: a. Finding your fit in positions and a career path. b. Understand the role expectations of a position. c. Maintain a professional status. d. Act in a manner that is legal and ethical.

a. Finding your fit in positions and a career path.

10. The nurse executive at the local hospital began working there 20 years ago and has risen to the highest designation in nursing. This career style is known as: a. Linear b. Steady state c. Spiral d. Entrepreneurial/transient

a. Linear

23. A well-written letter of resignation is critical to: a. Maintain a positive relationship with your former organization and colleagues. b. Fulfill your legal obligations as a departing employee. c. First announce your intent to resign. d. Formally signal discontent in your current position.

a. Maintain a positive relationship with your former organization and colleagues.

1. Based on studies of workplace environments for nurses and future projections, the workplace of the future will be: a. More intense because of more technology. b. Less intense because of more technology. c. About the same as it is now. d. Fluctuating between intense periods and less intense periods.

a. More intense because of more technology.

9. The nurse manager is implementing a shared governance model to help with communication and decision making. Although staff members like the concept, change is difficult. Staff nurses feel: a. More powerless and devalued. b. More communicative. c. Less stressed. d. More empowered.

a. More powerless and devalued.

17. As a nurse manager, it is important to become a "future thinker." Which is an example of a "future thinker"? a. Moving toward evidence-based practices b. Believing that macro marketing will be a necessity c. Finding less need for more knowledge d. Keeping traditional practices

a. Moving toward evidence-based practices

20. The starfish analogy is exemplified in which of the following? a. Nurses try to establish a clinic that provides ambulatory care to parents and young children in an impoverished neighborhood. Community members advocate for funding from political leaders and insurers. b. Alana, a new graduate, promotes continence care based on evidence. When she presents her ideas, senior staff refuses to consider it. c. A unit manager resigns after continued tension between the administration and her regarding implementation of primary nursing. The primary nursing project dies. d. The head of a community health service moves on to another position. Programs are disbanded.

a. Nurses try to establish a clinic that provides ambulatory care to parents and young children in an impoverished neighborhood. Community members advocate for funding from political leaders and insurers.

25. High levels of work-related stress negatively affects which of the following? (Select all that apply.) a. Nurses' health b. Absenteeism and turnover c. Client welfare d. Job satisfaction

a. Nurses' health b. Absenteeism and turnover c. Client welfare d. Job satisfaction

15. A nurse manager notices that Nathan, an RN who has been on the unit for approximately 3 years, has a particular interest in technology and seems to be very enthused about working with software and hardware at home. She speaks with Nathan and asks him if he would lead investigation of software applications on the unit. This is an example of: a. Opportunity. b. Role negotiation. c. Delegations. d. Role transition.

a. Opportunity.

10. A number of changes are introduced to a unit, including changes to familiar clinical procedures and the use of PDAs to enable bedside documentation. You, as unit manager, anticipate which of the following will contribute most to complexity compression? a. Pace of changes b. Meaning of the change c. Previous experiences with change d. Confidence of the leader in the value of the change

a. Pace of changes

4. An experienced staff nurse applies for a distinct position of patient advocate at a new clinic. Based on the various tools available to her, which of the following should she bring to her interview to best present her skills? a. Portfolio b. Résumé c. Patient advocacy project d. Annual evaluations

a. Portfolio

26. Professional associations: a. Provide opportunities for career networking and support. b. Are open to all individuals who meet the criteria for membership. c. Set regulatory requirements and establish entry requirements for nursing. d. Offer graduate programs for clinical and career advancement.

a. Provide opportunities for career networking and support.

13. A nurse is applying for a new position. This position is one in which she will serve as a liaison between a hospital and a school of nursing. The nurse has to update her résumé to include her teaching experience. The goal of creating a curriculum vitae is to: a. Provide potential employers with information about where you are in your career. b. Be certain you can recall facts for a prospective position. c. Have a listing of facts about your professional life. d. Respond quickly whenever a position becomes available.

a. Provide potential employers with information about where you are in your career.

22. John, a new nurse manager, complains to his colleague that he feels very uncomfortable with the conflict between what he thinks he should be doing as the manager and what his supervisor thinks he should be doing. According to Hardy's role theory, John is experiencing: a. Role strain. b. Role exploration. c. Role stress. d. Stress.

a. Role strain.

12. A unit manager recently graduated as a clinical nurse specialist with a focus in gerontology. She applied to take a certification exam. Certification is designed to recognize: a. Special knowledge beyond basic licensure. b. Advanced practice in functional roles. c. Continued competence as a registered nurse. d. Basic knowledge in a specified area.

a. Special knowledge beyond basic licensure.

2. A young male nurse began in nursing as a staff nurse at a hospital. After 3 years, he moved to a home healthcare agency. After 2 years, he was promoted to a managerial position and now has returned to another hospital as a new director of nursing. This career style is known as: a. Spiral. b. Linear. c. Entrepreneurial/transient. d. Steady state.

a. Spiral.

19. Which of the following needs revision on a résumé or CV? a. Tanya Jones 67 Honeywel l Drive City, MO 66907 beerhog@hotm ail.com b. Dr. L. Jones 99 Carway Drive City, NY 84003 (H) 999-999-00 00 (Cell) 999-000-9999 c. John Jones 87 Highway Drive City, MI 79110 [email protected] d. M. Howes Anyway Highway City, MO 77700 (H) 777-777-0000 e-mail: mh@gmail .com

a. Tanya Jones 67 Honeywel l Drive City, MO 66907 beerhog@hotm ail.com

14. A nurse is interviewing for a manager's position. Which of the following actions is considered a role preview? a. Touring the unit b. Disillusionment about the expectations of the job c. Improving role performance d. Formal commitment of the employment contract

a. Touring the unit

5. Sarah is a nursing graduate of 5 years who is very confident in her clinical skills. She has taken some certificate courses in leadership and management and has considered beginning a graduate degree with this focus. She is excited about being able to use her knowledge and interest by being hired as a nurse manager. Before beginning her new position, Sarah spends time with her nurse executive to clarify the executive's expectations of her and of the unit that she has been hired to manage. Sarah finds a mentor, Amy, who has been in the role of unit manager for 3 years and has a similar interest in clinical excellence. During their frequent meetings, Amy provides assistance with learning aspects of the manager's role, including technical aspects, such as how to interpret budget printouts and to achieve budget outcomes. The success of Amy's coaching depends on: a. Willingness of Sarah to receive feedback. b. Organizational support for the mentor relationship. c. Clarity of Amy's information. d. The congruence of Amy's beliefs with Sarah's beliefs.

a. Willingness of Sarah to receive feedback.

14. Which of the following statements would best define stress? Stress is: a. The comfortable gap between how we like our life to be and how it actually is. b. A consequence or response to an event or stimulus that can be positive or negative. c. Identical to distress. d. Everyday life, both the highs and the lows.

b. A consequence or response to an event or stimulus that can be positive or negative.

16. Sarah is a nursing graduate of 5 years who is very confident in her clinical skills. She has taken some certificate courses in leadership and management and has considered beginning a graduate degree with this focus. She is excited about being able to use her knowledge and interest by being hired as a nurse manager. Before beginning her new position, Sarah spends time with her nurse executive to clarify the executive's expectations of her and of the unit that she has been hired to manage. Sarah's actions are important in avoiding role: a. Development. b. Ambiguity. c. Negotiation. d. Transition.

b. Ambiguity.

7. As a nurse manager, you observe a staff nurse who over the past few weeks has become withdrawn and has had several absences due to minor ailments. Your best action would be to: a. Write a note to the nurse advising her that her work attendance must improve. b. Ask the nurse to meet with you for a few minutes before she leaves for the day. c. Ask the nurse if she is okay during report. d. Refer the nurse to the employee assistance program.

b. Ask the nurse to meet with you for a few minutes before she leaves for the day.

9. A new graduate is seeking a new position in nursing and wants to "sell" herself effectively. The best strategy is to: a. Create a curriculum vitae. b. Create a résumé. c. Practice interviewing. d. Call the personnel offices.

b. Create a résumé.

13. In helping nurse managers to manage their time, the chief nursing officer suggests that they: a. Maintain a perfectionistic attitude. b. Have good information literacy skills. c. Set up a complaint list. d. Have good negotiation skills.

b. Have good information literacy skills.

23. The education consultant at St. Joseph's Hospital is giving a workshop on cognitive reframing. The consultant explains that cognitive reframing reduces stress by: a. Eliminating negative stressors. b. Helping people realize that negative thinking causes emotional distress. c. Replacing positive self-statements with negative irrational beliefs. d. Aiding individuals in identifying positive stressors.

b. Helping people realize that negative thinking causes emotional distress.

11. During an employment interview for the manager's position in a home health agency, the applicant asks questions about the medical director and about retention of staff. The nurse executive assures the applicant that the agency has few personnel problems and receives excellent support from the medical director. The applicant knows that the agency has a 50% turnover rate and has had three medical directors in the past year. The nurse executive is: a. Unaware of the turnover rate and difficulties with the medical director. b. Minimizing the challenges of the position to make a positive impression on the applicant. c. Denying that the agency has a turnover problem with staff or medical directors. d. Lying about the problems and hoping to resolve them by hiring the applicant.

b. Minimizing the challenges of the position to make a positive impression on the applicant.

12. In developing curricula that will address needs based on forecasts for the future, nursing educators need to contemplate (select all that apply): a. Strategies for job security. b. Prevention strategies. c. Violence de-escalation strategies d. Leadership skills and knowledge.

b. Prevention strategies. c. Violence de-escalation strategies d. Leadership skills and knowledge.

12. The new head nurse on telemetry has been in the position for 3 months. The head nurse and the administrator disagree on how much time the head nurse should allot to various aspects of the role. Staff members on the unit complain that the head nurse is unavailable for clinical concerns because of being off the unit while attending meetings. To facilitate the process of role transition, the head nurse should: a. Decide to give the position 3 more months and then leave if things do not improve. b. Schedule a series of meetings with staff and the administrator to clarify expectations. c. Attend a workshop on how to deal with difficult people. d. Develop policies consistent with the head nurse's prior workplace.

b. Schedule a series of meetings with staff and the administrator to clarify expectations.

17. Steady state styles would be most likely in which of the following situations? a. Large urban teaching hospital b. Small hospital, in an isolated rural setting, with limited hierarchy c. Travel nurse agency d. Health network with several organizations

b. Small hospital, in an isolated rural setting, with limited hierarchy

16. Your organization is in the middle of re-designing patient care units, with decisions based on best practices and various other sources of evidence. In the middle of the transition, there is a temporary halt called to the transition because of a re-design of the health care system and greater emphasis on primary care. As a manager in this situation, your staff experience a gap between what they expected the original re-design of the units) and what is actually happening (a need to integrate primary care in some way). According to Selye, the nurses on your nursing team are likely experiencing what? a. Distress b. Stress c. Compression d. Eustress

b. Stress

16. Which one of the following statements has been proven to be true? a. Stress influences the immune system in one complex manner. b. Stressors that are identical do not necessarily have similar effects on each individual. c. Both men and women interpret the same stressor in the same manner without regard to past experiences. d. Recent research has found that women do not have a unique physiologic response to stress.

b. Stressors that are identical do not necessarily have similar effects on each individual.

7. A stroke unit experiences numerous changes related to implementation of new technology, a changed nursing care delivery model, and staff turnover within a period of 6 months. Staff members begin to show signs of reluctance to implement any more changes. This exemplifies: a. Lack of knowledge regarding the importance of changes. b. Striving to achieve stability in the midst of great disequilibrium. c. A poor relationship between leaders and staff. d. The importance of chaos in promoting adherence with established practices.

b. Striving to achieve stability in the midst of great disequilibrium.

4. An example of role stress occurs when: a. Line managers believe that support staff use their technical knowledge to intrude on their authority. b. Two part-time staff members are hired to work in a unit, but the job expectations for them are not clear, and the head nurse expresses disappointment in their performance. c. The nurse manager for the ICU wants to advocate for more staff and finds it difficult to find data to substantiate his proposal. d. The director of the ICU and the manager of the surgical unit wish to hire the same new employee.

b. Two part-time staff members are hired to work in a unit, but the job expectations for them are not clear, and the head nurse expresses disappointment in their performance.

11. Nathan tells you that he has selected nursing as a career because many jobs are available and he will have job security. Your best response to Nathan is: a. "It is unlikely that nursing will survive in the long term with funding cuts and a declining population of seniors." b. "The job market for nurses will be diminished with funding cuts to hospitals." c. "The employment prospects for nurses are positive with many options to choose from. Flexibility and adaptability are essential to income security." d. "With many young people going overseas, many jobs and options will be available. Stable jobs and job security will be part of the nursing employment market."

c. "The employment prospects for nurses are positive with many options to choose from. Flexibility and adaptability are essential to income security."

5. During performance appraisal interviews, Joanne's nurse manager notices Joanne's excitement when she talks about how she has helped patients on a rehab unit understand the complexities of their regimens. When Joanne's nurse manager asks her about her career path plans, Joanne says that she wants to become a nurse administrator. The best response to Joanne would be: a. "Nursing administration is rewarding. What experiences would help you along this path?" b. "You do not appear excited about nursing administration. Unless you are excited by that career path, I wouldn't advise going in that direction." c. "You seem to find teaching others very rewarding. Have you considered that as a possible career path?" d. "You are too inexperienced to consider administration. Work for a few years, and then consider administration."

c. "You seem to find teaching others very rewarding. Have you considered that as a possible career path?"

18. On your curriculum vitae, which of the following is the recommended approach for listing employment and educational history information? a. 1979 RN Diploma 1985 BScN 2002 MN b. 1997 Sturgeon County Hospital Head Nurse 2002 Sturgeon County Supervisor 2007 Sturgeon County Director c. 2007 MN 2005 BSc N d. 2002 Mount Rush Health Center Staff Nurse 1997 Cedar Falls Clinic Staff Nurse 2007 Kilkarney Rehab Center Case Manager

c. 2007 MN 2005 BSc N

6. Sarah is a nursing graduate of 5 years who is very confident in her clinical skills. She has taken some certificate courses in leadership and management and has considered beginning a graduate degree with this focus. She is excited about being able to use her knowledge and interest by being hired as a nurse manager. Before beginning her new position, Sarah spends time with her nurse executive to clarify the executive's expectations of her and of the unit that she has been hired to manage. After a year, Sarah successfully transitions into the nurse manager role and considers taking the examination to become a certified nurse executive. Amy advises her that this is not possible because Sarah will need: a. 5 years of successful experience. b. At least a nursing diploma. c. 24 months of experience. d. A graduate degree.

c. 24 months of experience.

21. As a new manager, you reflect on what professional development would be most valuable to assist you in taking on this role. Which of the following would you most likely identify? a. Attendance at a workshop on survey tool development and statistical measurement. b. Opportunities to hone clinical skills that are used most often on the unit that you will manage. c. A workshop on conflict management and communication skills. d. Attendance at a conference on global health care economics.

c. A workshop on conflict management and communication skills.

19. In addition to providing coaching, a nurse mentor may provide counseling to the mentee. For counseling to be successful, the mentor must: a. Keep the focus on technical and management responsibilities. b. Present assignments that stretch the intellectual and technical ability of the mentee. c. Assure confidentiality. d. Provide a quiet environment away from the unit.

c. Assure confidentiality.

21. Which of the following will require greater attention in the future? a. Team conflict resolution strategies b. Obstetrical outcomes c. Chronic disorders d. Prevention of hospital-based errors

c. Chronic disorders

11. The staff development educator presents a series of programs on stress management to the nurse managers. Research has indicated that an individual's ability to deal with stress is moderated by psychological hardiness. Psychological hardiness is a composite of: a. Commitment, powerlessness, and passivity. b. Commitment, control, and passivity. c. Commitment, control, and challenge. d. Decreased isolation, challenge, and passivity.

c. Commitment, control, and challenge.

8. A stroke unit experiences numerous changes related to implementation of new technology, a changed nursing care delivery model, and staff turnover within a period of 6 months. Staff members begin to show signs of reluctance to implement any more changes. The phenomenon experienced by the staff is termed: a. Care process. b. Stereotypical thinking. c. Complexity compression. d. Eustress.

c. Complexity compression.

8. An example of a career is (select all that apply): a. Involvement in an area of practice that is regulated. b. Employment in short-term contract jobs in business, nursing, and whatever is available. c. Continuous employment in the same position and the same arrangement for 20 years. d. Moving into and out of nursing positions in various cities while pursuing travel and education that develop understanding of global health.

c. Continuous employment in the same position and the same arrangement for 20 years. d. Moving into and out of nursing positions in various cities while pursuing travel and education that develop understanding of global health.

25. Who of the following might be the BEST mentor for Becky, a new nurse manager on the cardiac unit who has 4 years of previous clinical experience? a. Leslie, who has been a clinical educator at the institution for a number of years. She has tired of her role and aspires to become a nurse manager. She looks at mentorship as an opportunity to understand the role better. b. Ben, who was nurse manager for 3 years, soon after graduation. He left the role because he was uncomfortable with the expectations and has been a team leader on surgery for 15 years. c. Courtney, who has been a nurse manager for 3 years. Her staff and supervisor value her skills and her leadership acumen and championship of innovation. d. Sam, near retirement. He has 20 years of clinical nursing and recently assumed role of head nurse in an interim capacity because of the incumbent's illness.

c. Courtney, who has been a nurse manager for 3 years. Her staff and supervisor value her skills and her leadership acumen and championship of innovation.

22. After several months of heavy patient loads in the Emergency Department and inability to secure sufficient and experienced staff, the department is especially taxed by a train accident that brings in many seriously injured individuals. You observe that Rama ignores the requests of several of the injured, even when time is available to care for them and is rude to two elderly patients. You are concerned that Rama is evidencing which state? a. Role ambiguity b. Depression c. Depersonalization d. Hardiness

c. Depersonalization

7. Thomas has been a nurse in your ICU for 10 years. In facilitating Thomas' professional development, you would focus on (select all that apply): a. Certification for the ICU environment. b. Discussions about how Thomas can fit with role expectations and relationships. c. Encouraging him to lead changes that leave long-term impacts after his retirement. d. Possible specializations within the ICU environment.

c. Encouraging him to lead changes that leave long-term impacts after his retirement. d. Possible specializations within the ICU environment.

19. The chief nursing officer has been developing her portfolio for years. What is the chief nursing officer modeling? a. Her busy professional life b. Her clinical expertise c. Her employability d. Affection for tradition

c. Her employability

13. Nursing professionals in the twenty-first century will accomplish most of their work: a. Through teams of internationally prepared professionals. b. In competitive environments and work groups. c. In teams and through group work. d. Through long-term, secure jobs.

c. In teams and through group work.

25. A necessary leadership strength for nurses of the future is: a. Guarding the tendency of other professions to encroach on nursing roles. b. Understanding the nuances of fundraising to make up funding shortfall. c. Inspiring others to work their best to create the future. d. Adapting work life to an aging nursing workforce.

c. Inspiring others to work their best to create the future.

20. Sarah is a nursing graduate of 5 years who is very confident in her clinical skills. She has taken some certificate courses in leadership and management and has considered beginning a graduate degree with this focus. She is excited about being able to use her knowledge and interest by being hired as a nurse manager. Before beginning her new position, Sarah spends time with her nurse executive to clarify the executive's expectations of her and of the unit that she has been hired to manage. Sarah finds that she is comfortable with the expectations of staff and her supervisor regarding her management role and responsibilities and has been able to effect a strong commitment to quality clinical care on the unit. At this point, Sarah has likely attained this role: a. Acceptance. b. Development. c. Internalization. d. Symmetry.

c. Internalization.

10. An interviewee for a nurse manager position asks for a copy of the organizational chart. Organizational charts provide information about the role component of: a. Responsibilities. b. Expectations. c. Lines of communication. d. Opportunities.

c. Lines of communication.

3. Which of the following situations is most likely to result in a productive, whole work situation? a. Amy, RN, 5 years of experience in the emergency department. Amy accepts a position working with older clients in a home health agency because she has relocated, and this is the only full-time position available. b. Adam, RN, 8 years of experience in various nursing positions, including that of a nurse manager. Adam accepts a new nurse manager position because he has a family and wants more regular hours. He is most comfortable working in direct client care. c. Louise, RN, 10 years of experience in an emergency department. She accepts a position as a case manager in home health care, working with older clients. She especially enjoys working with older adults and wants to take on leadership and management challenges. d. Courtney, RN, a new graduate. Courtney is getting comfortable with delivering nursing care as an RN. She is offered a position on surgery as a permanent team leader. The unit has had a great deal of turnover recently, and only limited mentorship is available.

c. Louise, RN, 10 years of experience in an emergency department. She accepts a position as a case manager in home health care, working with older clients. She especially enjoys working with older adults and wants to take on leadership and management challenges.

10. The chief nursing officer listens to nurse managers verbalize their feelings of internal stress. One common source of internal stress seems to be: a. Losing a job. b. Getting married. c. Perfectionism. d. The death of a loved one.

c. Perfectionism.

1. The nurse manager of a unit has lost many staff members, and the unit is now staffed with a large number of agency and traveling nurses. She knows that the agency and traveling nurses are all contracted to stay on the unit for the next 3 months. One way to improve morale and decrease stress in the unit would be to: a. Implement team nursing. b. Request hospital-based "floating" nurses to substitute for the temporary staff. c. Plan a social event and include the agency and traveling nurse staff members. d. Plan unit-based social events for your remaining permanent staff members.

c. Plan a social event and include the agency and traveling nurse staff members.

24. In preparing for a fair interview process as a hiring manager, you should: a. Ensure that you know the names of all candidates. b. Put water out for the candidates. c. Prepare a schedule of questions to be asked of all candidates. d. Dress comfortably and professionally.

c. Prepare a schedule of questions to be asked of all candidates.

17. Sarah is a nursing graduate of 5 years who is very confident in her clinical skills. She has taken some certificate courses in leadership and management and has considered beginning a graduate degree with this focus. She is excited about being able to use her knowledge and interest by being hired as a nurse manager. Before beginning her new position, Sarah spends time with her nurse executive to clarify the executive's expectations of her and of the unit that she has been hired to manage. A strategy that may help to make the transition to her management role and to respond to relationships and situations in her new position is: a. Avoiding discussion of her personal beliefs with staff until she is ready to do so. b. Finding a network of clinicians with interests similar to her own. c. Recognizing her strong commitment to care in the management process through journaling. d. Researching clinical literature to maintain her clinical assessment skills for the unit.

c. Recognizing her strong commitment to care in the management process through journaling.

3. A hospice nurse has been feeling very stressed at work because of both the physical strain and the emotional drain of working with clients with AIDS. She tries to walk 1 to 2 miles three times a week and to talk regularly with her husband about her work-related feelings. One reasonable stress management strategy would be to: a. Make an appointment to meet with a psychiatrist. b. Plan to go out for a drink with fellow nurses after work every day. c. Start taking yoga lessons. d. Start jogging 5 to 6 miles every day.

c. Start taking yoga lessons.

21. Social stressors are considered a major factor in the stress nurses experience in the healthcare system. Which of the following is not considered to be a social stressor? a. Changes in the current healthcare system such as nursing strategies b. Disruptive behavior coming from physicians and other healthcare workers c. Stress triggers such as self-criticism and overanalyzing d. High amounts of stress in the nursing home environment

c. Stress triggers such as self-criticism and overanalyzing

16. You are offered an opportunity to take a temporary leave from your position as a nurse manager to lead a technology implementation project. Which of the following reasons for accepting the opportunity is most consistent with developing a solid career path? a. You have limited knowledge of information technology and no real interest, but this will increase your knowledge. b. You are pressured to do so by your supervisor. c. The organization has no other suitable candidate for the position. d. Accepting a position outside of your established skill set may establish you organizationally as an innovative, adaptable leader.

d. Accepting a position outside of your established skill set may establish you organizationally as an innovative, adaptable leader.

9. A business condition that may assist forecasting but add to the complexity of change is: a. Consulting with professional groups about change. b. Researching about trends on futuristic sites. c. Building profit projects and sustainability into planning. d. Asking patients to examine options for change.

d. Asking patients to examine options for change.

5. Which of the following strategies is most important in developing a strong vision? a. Spending time with others with whom we discuss ideas b. Setting up focus groups to provide information on current realities c. Seeking out evidence to support trends and out-of-the-box thinking d. Being honest and open about what we think for the future

d. Being honest and open about what we think for the future

24. Time management is very essential for the nurse manager. Which of the following is not a good time management technique? a. Decide what not to do. b. Learn to delegate. c. Learn to say "No." d. Break down your workload into large manageable tasks.

d. Break down your workload into large manageable tasks.

22. To move beyond stereotypical thinking and toward thinking about the future, which of the following would be most consistent with thinking wildly in the Wise Forecast Model? a. Asking someone with a great deal of experience to share ideas about best practice b. Defining which practices will remain unchanged and which will change c. Listing everything that we know about our current situation d. Challenging current and future practices with questions of "what if?"

d. Challenging current and future practices with questions of "what if?"

3. As a team, you and the staff have determined that there is a need to reduce medication errors on your unit. Together, you developed the questions that you would like addressed and searched the literature for relevant research studies. Based on the evidence, you suggested a change to your practices and now are involved in implementation of these changes. Today, there was a major study released that would significantly change what you have decided to do. What are you and your staff experiencing? a. Technology advancement b. Distress c. Information Lag d. Compression complexity

d. Compression complexity

8. A nurse manager has decided that she must institute some personal time management steps to survive work and home life. Her first step should be to: a. Purchase a handheld personal digital assistant to help remind her of important meetings. b. Organize her personal and work spaces. c. Determine what takes up so much of her time and energy. d. Determine her personal and professional goals.

d. Determine her personal and professional goals.

5. "Stress-buffering" behaviors can be elicited to reduce stress. All of the following behavioral coping responses can be used by nurse managers to reduce and manage stress except: a. Using cognitive reframing to change irrational thoughts. b. Exercising regularly. c. Refusing a request to sit on a committee to evaluate scheduling software. d. Distancing oneself from work.

d. Distancing oneself from work.

15. Your organization is in the middle of re-designing patient care units, with decisions based on best practices and various other sources of evidence. In the middle of the transition, there is a temporary halt called to the transition because of a re-design of the health care system and greater emphasis on primary care. What would be a healthy response to this situation? a. Salvage as much of the original planning as possible so as to reduce expenditures. b. Abandon the current planning in favor of addressing the new trends. c. Continue with the current planning because trends come and go. d. Engage in consultation to create innovative solutions that bridge the existing plans and the new directions.

d. Engage in consultation to create innovative solutions that bridge the existing plans and the new directions.

4. Melissa is a nursing graduate of 5 years who is very confident in her clinical skills. She has taken some certificate courses in leadership and management and has considered beginning a graduate degree with this focus. She is excited about being able to use her knowledge and interest by being hired as a nurse manager. Before beginning her new position, Melissa spends time with her nurse executive to clarify the executive's expectations of her and of the unit that she has been hired to manage. After beginning her new position, Melissa finds that she spends a great deal of time in direct patient care. Her staff begins to complain that they are never able to find her when they need her, and that some aspects of her responsibilities fall behind, such as scheduling. Melissa is most likely: a. Lacking an understanding of the nurse management role. b. Attempting to prove her clinical skills to the nursing staff. c. Lacking enjoyment in her new role. d. Experiencing difficulty in unlearning old roles.

d. Experiencing difficulty in unlearning old roles.

6. Which aspect of our tradition and history in nursing may impede our movement towards future-oriented thinking? a. Focus on the discipline of nursing b. Lack of confidence c. Mistrust of trends and new evidence d. Focus on details in the everyday practice

d. Focus on details in the everyday practice

14. To develop a curriculum vitae, or résumé, a nurse must develop a personal data file. The goal of a personal data file is to: a. Create a document that lists your skills. b. Create an opportunity to be interviewed. c. Have a tool in place for marketing yourself. d. Have a listing of facts about your professional life.

d. Have a listing of facts about your professional life.

4. Your unit has a number of patients who have undergone limb amputation. In working with the clients, you begin to think beyond therapies such as pharmaco-therapeutics and surgery and you explore biomechanics, robotics, mind-body approaches, and cognitive behavioral therapies as possibilities in working with these clients. You begin to amass information in a number of areas with which you previously had little familiarity. According to the Wise Forecast Model, you are a. Acting wildly. b. Engaging in interprofessional care. c. Increasing your complexity compression. d. Learning wildly.

d. Learning wildly.

2. The new nurse manager feels pulled between the expectations of staff, the demands of hospital administrators, and family obligations. According to Hardy (1978), unrelieved role stress and strain will lead to: a. Frustration and anger. b. Physical symptoms and acute illness. c. Alienation of family and friends. d. Low productivity and performance.

d. Low productivity and performance.

23. In order to plan long term, you consider what the client of the future will look like. Which of the following client profiles would best capture shifting demographics and trends in health care? a. Female, uses emergency care services for parents and children b. Younger, knowledgeable about health options c. Male, various occupationally generated disorders, diverse ethnic background d. Older, one or more chronic disorders, diverse background

d. Older, one or more chronic disorders, diverse background

2. Which of the following actions is most representative of how health care of the future might be delivered? As a nurse leader, you: a. Work together with a local agency to set up a free clinic in which addicts and the homeless can receive free health care and prescriptions for immediate needs. b. Address the health of those who are overweight and obese on your unit by ensuring that hospital meals offer nutritious, healthy food choices that are satisfying. c. Ensure that individuals who are admitted to your unit are asked about their smoking history and that preoperative and postoperative planning takes into account how smoking will affect status during and after surgery. d. Refer families who require immediate help to a local food bank. You also work with local agencies and families to establish a mother's collective in which mothers learn about nutrition and prepare low cost, nutritious meals that are shared with the mothers in the collective.

d. Refer families who require immediate help to a local food bank. You also work with local agencies and families to establish a mother's collective in which mothers learn about nutrition and prepare low cost, nutritious meals that are shared with the mothers in the collective.

20. The primary difference between a résumé and a CV is that a résumé: a. Offers a detailed listing of positions held and where positions were held. b. Includes a long and detailed explanation of academic and work experience. c. Provides contact information and focuses on your background, in general. d. Reflects your skills, knowledge, and background in relation to a specific position.

d. Reflects your skills, knowledge, and background in relation to a specific position.

24. In assisting new graduates to make the role transition to graduate nurse, Ted, the unit manager initiates which of the following? a. Fixed target dates for acquisition of competency and transition to RN role b. Frequent formal meetings to provide feedback on performance and areas to be strengthened c. Discussions that focus on what the new graduates have yet to learn d. Self-check list to assess competencies that have been strengthened

d. Self-check list to assess competencies that have been strengthened

1. A nurse manager in one hospital values a colleague who is a few years older and has more experience in nursing management. The colleague works in another hospital, but they meet for lunch once a month. In these meetings, they share their feelings about nursing management and their lives. The function of a mentor that is missing in the relationship is: a. Social interaction b. Mutual positive regard c. Role modeling d. Sponsorship

d. Sponsorship

24. You have just hired a recent graduate. The graduate is thrilled with the opportunity that she has been given, as well as with the idea that "working means no more essays, tests, or assignments!" She indicates that she has no intention of touching a book, journal, or health information Website for a "long time." Which of the following would be your best response? a. The expectations and design of educational programs means that new graduates are better prepared for the workforce. b. An ideal learning plan for nurses emphasizes followership. c. The new graduate will still have to learn, but it will be job-specific learning. d. The amount and intensity of knowledge demands lifelong learning that includes assessment of relevancy of knowledge for practice.

d. The amount and intensity of knowledge demands lifelong learning that includes assessment of relevancy of knowledge for practice.

20. Jeff, an RN in his 30s, has lost a parent, just purchased a new home, and is laid off with 6 months' severance pay. At the same time, Jerry, an RN in his 50s, is financially secure and is asked to take early retirement with a buyout. How will the two men react to the emotional and physical influences and the sequence of stress? a. The older man will feel more stress. b. Neither man will experience any stress. c. The younger man will feel more stress. d. The two men may or may not feel the same amount of stress.

d. The two men may or may not feel the same amount of stress.

14. You notice that wait times in your Emergency Department are growing longer, because of factors such as increases in the numbers of persons with chronic disorders, discharge of patients into the community at a higher level of acuity, and limited resources for transfer of inpatients. You begin to think about an application that would use your knowledge of the Emergency Department but also software and business applications and wonder if this would reduce wait times. You have not encountered anything similar to this idea. According to the Wise Forecast Model, you are in what phase? a. Act widely. b. Learn widely. c. Wild thinking. d. Think Wildly

d. Think Wildly

22. During an interview for a manager's position, you find the supervisor and staff unfriendly. Responses to questions are met with vague responses. After the interview, you decide not to pursue the position. What follow-up, if any, is most appropriate? a. There is no need for you to do anything further. You likely will not be offered the position anyway. b. You should call and leave a voicemail, indicating your disinterest in the position. c. You should file a complaint with Human Resources about the supervisor's lack of interviewing skills. d. You should send a thank-you note to the interviewer, indicating appreciation for her time.

d. You should send a thank-you note to the interviewer, indicating appreciation for her time.

21. A cover letter and a résumé together should be no longer than ____ page(s).

3 pages

25. To enhance team leadership skills for your team leaders, you arrange opportunities for: a. Continuing education. b. Certification. c. Volunteerism. d. Graduate courses.

a. Continuing education.

9. The unit leader on an inpatient psychiatric unit of a large hospital has been in the position for 3 months. The unit leader is frustrated by how little time is available to work with clients and how few changes have been implemented in that time. The phase of role transition being experienced is the role of: a. Acceptance. b. Discrepancy. c. Internalization. d. Negotiation.

b. Discrepancy.

7. Seth is hired as the nurse manager for a surgical unit. After a year, the hospital reorganizes, and his position is lost. In leaving the unit, it is important for Seth to: a. Hire a lawyer to represent his interests during this unexpected role transition. b. Negotiate a reasonable settlement. c. Engage in clarifying why the hospital did not state its expectations for the unit at the time of hiring. d. Seek counseling to deal with his shock and anger.

b. Negotiate a reasonable settlement.

1. A nurse manager has been employed in the same facility for 20 years and has held the same position. This career style is known as: a. Entrepreneurial/transient. b. Steady state. c. Spiral. d. Linear.

b. Steady state.

18. Nursing research has indicated that the foundation for becoming a nursing leader is the ability to: a. Speak two or three languages. b. Think futuristically. c. Focus on day-to-day priorities. d. Write effectively.

b. Think futuristically.