Leadership Exam 3

Differences in status and authority within the health-care team can generate conflict. What is the most common cause of conflict? 1. Disrespect and incivility 2. Inappropriate language and sarcasm 3. Blaming and finger pointing 4. Physical violence

1

One disadvantage of using collective bargaining to resolve conflicts between nurse managers and staff is that it can create an adversarial relationship between staff and management. 1. True 2. False

1

There are numerous sources of power in an organization. Several are available to nurses. Which one is not? 1. Authority 2. Reward 3. Control of information 4. Coercion

1

What is brainwriting? 1. A strategy to encourage the free flow of ideas 2. A mutually beneficial negotiation result 3. A winning approach to formal negotiation 4. A devaluation reaction to negotiation

1

A client who does not have sufficient skills to access and use health information is experiencing which barrier to effective communication in health care? 1. Cultural incompetence 2. Low health literacy 3. Cultural diversity 4. Communication skills of health care providers

2

Nursing leaders understand that which of the following issues CANNOT be addressed in a collective bargaining agreement? 1. Shift differentials 2. Holiday schedules 3. Safe working environments 4. Grievance procedures

2

Nursing management and the nursing union are having differences on several issues. There may be a need for negotiation. Which of the following is a serious disadvantage to using collective bargaining to resolve this conflict? 1. Protecting the right to fair treatment 2. Creating an adversarial relationship between staff and management 3. Lacking professionalism on the part of the collective bargaining unit members 4. Failing to uphold important standards of care

2

TJC attributes 80% of all medical errors to: 1. Poor hygiene and hand washing 2. Poor hand-off communication 3. Poor work environment 4. Lack of care

2

The EMR has many advantages compared with paper charting. It helps track data through time and can help monitor things such as preventative care in primary care practices. Jane is the office nurse in a local practice. She is meeting a new patient for the very first time who informs her that he was recently hospitalized. Jane pulls up the patient's EMR and sees no information regarding his recent hospital stay. How could this have happened? 1. The patient's discharge was so recent that it is not available yet. 2. EMRs are usually practice or hospital specific, so the patient's information would not be accessible to Jane. 3. The patient was hospitalized out of state. 4. The patient has not signed the necessary consents to give Jane access.

2

Bedside shift report is one of the things that Jane reviews at the staff meeting. She stresses the way she would prefer the report to start. Which of these would be the LEAST important to share with the oncoming nurse? 1. Telling the oncoming nurse what happened on the unit during the shift 2. Introducing the client and his or her diagnosis to the oncoming nurse 3. Sharing the nurse's personal opinion of the client 4. Reviewing new medication orders and the medication administration record (MAR)

3

What is the most desirable result of a problem resolution? 1. Win-lose 2. Lose-lose 3. Win-win 4. None of the above

3

As Jane speaks with the team, she learns why the staff members have had difficulty following policies. Which of these would be considered barriers to effective communication? 1. The charge nurse is unavailable to help the nurses when they have questions about policies. 2. Some staff are afraid to ask particular charge nurses for help for fear of retribution. 3. The use of acronyms is confusing to staff members who are new to the unit. 4. All of the above

4

Implicit bias affects our understanding in an unconscious manner. A person's ability to recognize these biases can improve communication with patients and colleagues alike. Which of the following statements is true about implicit bias? 1. Implicit bias forms during a lifetime. 2. Implicit bias can influence clinical decision making and treatment. 3. Implicit bias contributes to an individual's social behavior. 4. All of the above

4

Nursing and respiratory departments both experienced job cuts. The nurse manager notices that members of his staff are having more trouble getting a fast response from a respiratory therapist. What source of conflict is probably operating here? 1. Union-management conflict 2. Interpersonal problem 3. Cultural differences 4. Work intensification

4

What is the best explanation of authority? 1. It is position dependent. 2. It is based upon the ability to lead others. 3. It is expertise-driven. 4. It resides primarily in the clients served.

1

Which of the following benefits of using an EMR is most specifically designed to reduce medication errors? 1. Data tracking 2. Barcode scanning of laboratory labels 3. Barcode scanning of client identification bracelets 4. Connection to monitoring equipment, such as telemetry and blood pressure cuffs

3

Which of the following best indicates that an interprofessional health care team can work together effectively? 1. Each team member understands his or her role. 2. Team members create goals for the client according to their specialty and then share with the team. 3. The team has a process in place for sharing information. 4. Members provide care to a diverse group of clients.

3

Who is responsible for accepting, transcribing, and implementing physician orders? 1. Unit clerk 2. Medical intern or resident 3. Professional nurse 4. Medical assistant

3

Organizational culture is best defined as: 1. The stated vision and mission of an organization 2. Policies and procedures 3. The type of décor that was chosen for the facility 4. An enduring set of shared values and beliefs

4

Several of your colleagues are going to join the American Nurses Association (ANA). You know the annual dues are a little more than you can afford right now, but you want to learn more. Your friends think that joining the ANA will help empower them. How do professional organizations empower nurses? 1. They represent nurses in the political arena. 2. They equalize power between employees and staff . 3. They provide opportunities for promotion. 4. They provide health insurance.

1

A registered nurse who voices support for a client's decision NOT to undergo treatment for a life-threatening illness (despite the family's resistance) is engaging in: 1. Interpersonal communication 2. Assertive communication 3. Aggressive communication 4. All of the above

2

Which of the following is a characteristic of a bureaucratic organization? 1. Organic structure 2. Flexible teams 3. Rigid unit structures 4. Self-correction and self-control

3

Which of the following issues may be addressed in a collective bargaining agreement? 1. Shift differentials 2. Safe working environment 3. Grievance procedures 4. All of the above

4

A hospital merger has recently taken place, and several nursing units have been combined, resulting in changes in workloads. The nurse manager is aware that workflow changes can cause conflicts. An effective nurse manager will do all EXCEPT which of the following, in order to reduce the possibility of conflict among the team members? 1. Make sure that supplies and equipment are ordered and available. 2. Advise staff that negative comments will not be tolerated. 3. Monitor the quality of client care. 4. Assess the fairness of nursing assignments.

2

Jane is a new nurse manager who will be holding her first staff meeting tomorrow. She has learned that the staff members have not been following important patient care policies. What is the most important communication skill that she should use at the meeting? 1. Talking to the staff 2. Laughing with them 3. Listening 4. Crying

3

Social media is commonly used to update friends and groups on things we have going on in our lives. Health-care organizations routinely use social media to promote medical facts, services, and recognitions. What is important for nurses to remember when deciding to post something work related on a social media site? 1. Nurses should never post protected health information on a social media site. 2. Stories with good outcomes can be posted to your media page. 3. Stories and photos can always be shared if the patient's name or face is not visible. 4. Posting stories on personal time is OK because the nurse is not working.

1

The hospital has recently reorganized; therefore, several departments were closed. The patient census on the unit has increased. The staff have always had a strong team spirit, but the nurse manager knows that workflow changes can cause conflict. What can the nurse manager do to reduce the possibility of conflict among her team? 1. Monitor the quality of patient care. 2. Ensure that supplies and equipment are readily available. 3. Assess the equity of nursing assignments. 4. All of the above

4

You are working on the trauma unit today, and your new patient with a femur fracture complains of leg pain and seems a little diaphoretic and short of breath. You assess the patient and prepare to contact the surgeon. In preparation for contacting the physician, you: 1. Immediately page the MD; it could be a pulmonary embolism, and time is of the essence. You will give him the particulars when the MD arrives. 2. Wait for the MD to round on his patient because it should be within the next hour or so. 3. Medicate the patient for pain and plan to contact the MD when he rounds. 4. Jot down notes about the situation as it is presented to you, review the patient's history, focus your assessment, and determine what you need for the patient.

4

A nurse manager has two team members who continually criticize each other despite being told to stop. Which approach is the most appropriate for this situation? 1. Refer each of them to HR for employee counseling. 2. Engage in problem resolution. 3. Bring in a union representative. 4. Engage in a formal negotiation process.

2

Nurses who feel empowered can make significant contributions to a health-care organization. Feeling empowered includes feeling as if you make a difference, that colleagues value your opinion, and that your voice is important. What is essential to nurse empowerment? 1. Belonging to a professional organization 2. Participating on a unit practice council 3. Reasonable work assignments 4. A rewards and recognition program

2

The purpose of learning how to negotiate conflict is to: 1. Eliminate conflict entirely 2. Resolve conflicts more effectively 3. Win 4. Reduce stress

2

Creating a culture of safety requires organizational commitment to preventing harm. Which of the following is not a key feature of a culture of safety? 1. Provision of adequate resources to provide care and service 2. Use of interprofessional collaboration to solve problems and assess risk 3. Adherence to staffing ratios 4. Encourages the reporting of errors and near misses

3

ISBARR provides a framework for communicating critical client information. ISBARR is an acronym for: 1. Identify, Study, Background, Assess, Recognize, Readback 2. Issue, Situation, Better, Advise, Refer with Recommendations 3. Introduce, Situation, Background, Assess, Recommend, Readback 4. None of the above

3

If an informal negotiation session becomes too highly emotional, what should the nurse manager do? 1. Let the feelings flow. 2. Cancel the negotiation. 3. Deal with the feelings first. 4. Tell them to ignore the feelings and deal with the issues.

3

If you are employed at a hospital owned by a corporation listed on the stock market, in which category does your facility belong? 1. Publicly (government) supported 2. Voluntary, not-for-profit 3. For-profit 4. All of the above

3

You have been asked to serve on your unit practice council. Th is is an important role and one that you are excited to perform. What should you know about professional governance so that you are prepared for this work? Professional governance in nursing involves: 1. Working longer hours 2. Attending a lot of meetings 3. Nurses setting nursing standards for daily practice 4. Changing the organization's culture

3

Communities and regulatory agencies continually challenge hospitals, skilled nursing facilities, and home health companies to enhance, improve, or change care delivery and the care environment to ensure safe, high-quality care. Which factors are important in improving a hospital's care environment? 1. Adequate staffing 2. Collegial relationships among staff 3. Emphasis on staff development 4. All of the above

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