Week 8

improve the efficiency and effectiveness of budgetary expenditures

performance

Choose the method of reimbursement that includes the cost of providing the service plus a markup for profit. Rate based on services rendered Cost-based Charge Flat-rate

charge

Consensus implies that?

each party in a conflict has supported an agreement even if the agreement is not their first priority or preference.

Physician Orders for Life-Sustaining Treatment (POLST)

requires informed consent Without the patient's sound understanding of the content and implications of POLST, its directives are neither legal nor ethical.

negotiation

win-lose

Latent conflict consists of?

antecedent conditions that contribute to conflict. example: staffing shortage, staffing levels and possible solutions that necessitated the use of agency nurses

pedagogy is?

teaching at the student

andragogy is?

teaching with the student

The nurse leader should include a variety of teaching and learning methodologies when developing learning activities for staff members. TRUE FALSE

true

Nonverbal communication is thought to make up what percentage of the communication process? 50%-70% 35%-50% Less than 35% Over 90%

50-70

Effective management of a workplace conflict. After becoming aware of a conflict, what action should a leader-manager prioritize?

Gathering as much information about the conflict as possible. The manager cannot navigate a conflict effectively without the necessary information.

A nurse manager is conducting a meeting with staff. What factors may significantly influence how communication is received and perceived during the meeting? (Select all that apply.) a. Stress levels b. The age of the manager c. The level of the manager d. Gender differences e. The unit mission

a. stress c. level d. gender

A nurse manager is assessing the internal climate of communication with a group of staff members prior to a meeting. What would the manager consider to be a part of the internal climate of communication? Feelings Status Stress Power Values

feelings stress values

can foster overspending and easiest to implement

incremental

Which aspects of creating a successful interprofessional team are addressed by SBAR? (Select all that apply.) a. Offering a recommended plan of action or next steps b. Communicating effectively and efficiently c. Maintaining a shared vision d. Ensuring role clarity e. Determining leadership of the team

a, b, c, d

A nurse manager is evaluating the effectiveness of staff development activities that have occurred in the past year. Which criteria should be included in this evaluation? (Select all that apply.) a. Cost-effectiveness b. Organizational impact c. Learner's reaction d. Time utilized e. Behavior change

a, b, c, e

A nurse manager evaluates the performance of a staff member and provides the following feedback: "When you didn't contact the attending physician after you registered the patient's low blood pressure reading, the patient went into respiratory arrest that might have been prevented. Next time you have a patient with an unexpected change in their vitals and can't get in touch with their doctor, contact the nursing supervisor so we can get help to that patient sooner." What type of feedback has the nurse manager provided? a. Constructive b. Positive c. Negative d. Destructive

a. Constructive feedback doesn't shy away from telling someone they did something wrong, but it differs from negative feedback in that it presents an alternative for what should be done if a similar situation arises in the future.

The new nurse manager is learning about staff development. Which are characteristics of pedagogy? (Select all that apply.) a. Competition is encouraged b. Learners are self-directed c. Learners depend on the teacher d. The teacher evaluates e. The teacher sets the goals

a. competition c. depend on teacher d. teacher evaluates e. teacher sets goals

A new nurse manager is implementing an educational needs assessment. Why is it necessary to conduct this assessment? a. Staff and management may prioritize learning needs differently b. Educational resources in nursing units are usually unlimited c. The manager's perception of educational needs is accurate d. Staff perception of educational needs is a greater priority

a. needs may be prioritized differently between staff/managers

A nurse manager is performing a daily assessment of staffing needs. Which data would be needed to calculate the NCH/PPP? (Select all that apply.) a. Staff on duty for 24 hours from 11 p.m. b. Staff on duty for 24 hours from 12 a.m. c. Patient census as of midnight on day two d. Work hours for each staff member on duty e. Census for the entire calendar year

a. on duty from 11pm b. on duty from 12 am c. patient census on 2nd day d. work hours for each member

A nurse manager is using face-to-face communication when discussing a staff member's performance evaluation. What does the manager determine are the benefits of this method of communication in this situation? (Select all that apply.) a. It will strengthen the connection between the manager and staff member. b. The staff member will agree with all aspects of the evaluation. c. It will combine verbal and non-verbal communication to convey messages. d. The manager can determine if the staff member understands the evaluation. e. It will prevent any misunderstandings from occurring.

a. strengthen the relationship c. combines non-verbal and verbal d. manager determines if understood

A nurse manager is mentoring a new nurse manager regarding strategies for teaching staff. What does the new nurse manager learn is the goal of staff training? a. To transfer new learning to the work setting b. To demonstrate memorization of the concepts c. For training to occur as quickly as possible d. To practice new skills multiple times

a. transfer skills to the workplace quick

In the SBAR model, when giving recommendations, what kinds of things should be communicated? (Select all that apply.) a. The patient's condition and state what you think the problem is. b. Any new treatments or changes ordered The background or context of the situation c. A concise evaluation of the situation in a couple of sentences d. Opinions for further action

b, d

A nurse manager wants to ensure that a staff member attends a particular training session. What is the best way to achieve this? a. Explain that the training session won't be very difficult. b. Communicate the benefits of learning the ideas that will be taught in the training. c. Make attending the training session mandatory. d. Explain that other staff members are also attending the training session.

b. communicate the benefits

Crisham's (1985) MORAL decision-making model

begins with collecting data about the ethical problem

An elderly patient is admitted to the cardiac floor for worsening congestive heart failure. As the nurse is obtaining baseline vital signs, the patient states, "My neighbor is in the ICU on one of those machines that keep people breathing forever. I never want to end up like that." Which response by the nurse is best? a. I can ask the social worker to meet with your family if you would like. b. I will make sure there is a note in your chart that you do not want to be placed on a ventilator. c. It sounds likes you have given this a lot of thought. Would you like me to arrange for you to complete an advance directive and share this with your family? d. Your lawyer can help you fill out the necessary paperwork.

c. arrange for them to complete an advance directive and share with family legal document that will ensure the patient's wishes are carried out

A nurse manager is evaluating the effectiveness of the most recent staff development activity. Which strategy would be most useful in validating competency of each of the staff on the unit after a staff development activity? a. Assessing learning by administering a post-test after the activity b. Assessing the length of time that the staff development activity lasted c. Assessing if the activity provided entertainment for the participants d. Assessing whether the participants can transfer knowledge to practice

d.

When dealing with conflict, what actions are important for the manager to do? (Select all that apply.) a. Suppress the conflict b. Recognize and accepts difference in team members c. Seek a win-win solution d. Avoid getting involved and allow employees to work it out themselves e. Role-model collaborative negotiation

e. role model collaboration b. recognize differences in members c. seek a win-win solution The manager would not want to suppress or avoid the conflict, as it will only fester and may create a more significant conflict than what was first perceived.

collaborative approach to conflict management?

each party setting aside their disparate goals and choosing a common goal that will be prioritized. win-win

A nurse manager is performing a daily assessment of staffing needs. Which types of nursing units can successfully use a predetermined standard of nursing staffing for the patient census? (Select all that apply.) Specialty care units Emergency department Operating room General medical-surgical units Home care

everything except emergency

A nurse leader should not rely on peer learning activities when developing staff development because this can cause confusion among the attendees. FALSE TRUE

false

what is the correct order of learning needs arranged from highest to lowest priority?

fatal fundamental frequent fixed facility

Assets that assist adults in their learning are?

high self-motivation, ability to be self-directed, proven past success, past experience, and individual qualifications.

The overarching principle of the Code of Ethics for Nurses is that?

patient's health, safety, and rights are the highest good

Which of the following refers to the system in which facilities join a payment system, whereby they receive a specified a fixed payment for each Medicare patient's admission, regardless of the actual cost? Prospective payment system (PPS) Diagnosis-related groups (DRGs) Both PPS and DRGs Neither of these

prospective payment system

There are three types of feedback that a nurse leader may use: positive, negative, and constructive feedback. FALSE TRUE

true

Adult learning needs differ in their degree of importance. FALSE TRUE

true Adult learners' needs differ in the degree of importance, they must identify/prioritize learning needs nurse leader need to offer guidance to assist adult learners in selecting the higher priority.

A nurse manager is using a budgeting approach that requires justification for each budgetary need. What approach is being used? Performance Zero-based Flexible Incremental

zero based

A nurse manager is performing a daily assessment of staffing needs. Which statements about calculating the NCH/PPP are most accurate? (Select all that apply.) a. The first step is to calculate the number of staff for the 24-hour period. b. The calculation includes the total staff for any 12-hour shift that day. c. The calculation should include all members of the nursing staff on duty. d. The calculation of the NCH/PPP absolutely determines staffing needs. e. The total staff for 24 hours is divided by the patient census at 12 a.m.

a. 1st step calculate the number of staff for the 24 hrs c. include all members of the nursing staff on duty e. total staff for 24 hrs / patient census at 12 am of the 2nd day

When dealing with conflict among staff, what is the best approach by the nurse manager? a. Create a positive situation b. Discuss the issue with physicians c. Ignore the situation d. Appoint blame e. Relay staff responses to her administrator

a. create a positive situation Conflict, if dealt with negatively, can lead to the destruction of organizational teams. If conflict is utilized with a learning effort to change, conflict can be helpful to bring about transformation.

Select types of adult priority learning needs. (Select all that apply.) a. Frequent b. Fatal c. Fundamental d. Fluctuating e. Fixed

a. frequent b. fatal c. fundamental e. fixed Fatal: skills or knowledge that if not acquired could cause harm fundamental: essential aspect or step of a competency frequent: must be performed repeatedly, fixed: need coincides with a certain timeframe in which the learning must occur Fluctuation: not considered a priority learning need because learning tends to fluctuate depending on the situation

A nurse instructor is teaching a student who often asks for thorough explanations of each new concept. What learning style does this student have? a. Kinesthetic b. Visual c. Tactile d. Auditory

d. auditory auditory: listen to instruction and comprehends new information most effectively through explanation and asking questions visual/spatial learner: needs to see the concept in action, and responds best to color, pictures, and video. tactile/kinesthetically: wants to actually perform the procedure themselves. This type of learner responds to simulations and hands-on experience.

A nurse instructor is creating a lesson plan to help develop the learning needs of a diverse staff. What should the instructor do to make an effective plan? a. Convey each important concept through problem-focused instruction. b. Focus on the predominant learning style in the group of students. c. Incorporate a variety of teaching strategies in the lesson plan. d. Maintain total control over the goals of the lesson plan.

c. incorporate various teaching strategies

A new nurse manager is learning about staff development. What are driving forces or assets that motivate adult learners? (Select all that apply.) a. Institutional barriers b. Family reaction c. Self-motivation d. Self-direction e. Situational obstacles

c. self motivation d. self direction

In the SBAR model, what should be conveyed when explaining the situation? (Select all that apply.) a. Assessment data collected b. in a narrative or story form c. Events currently happening d. Objective statement of the problem e. Recommendations for treatment changes

a, c, d, e NOT info in a narrative story

When you explain what the nurse believes the issue is, which stage of SBAR would the nurse be demonstrating? Situation Assessment Recommendation Background

assessment

A key strategy in preventing and managing anger in the workplace is to?

cultivate insight into the triggers that cause anger. this form of self-regulation and self-awareness can minimize the need to involve others

Which of the following are steps included in the flexible budgeting process? (Select all that apply.) a. Analyze the cost patterns over that period of time b. Determine the time period for the budget c. List all current and proposed objectives and activities in the department d. Separate the costs into fixed, variable, or mixed categories e. Forecast the cost for each of these categories of activities

d, separate the costs e, forecast the cost a, analyze the cost over period of time

A nurse manager is performing a daily assessment of staffing needs. If the current NCH/PPP is greater than the budgeted NCH/PPP for the unit, which action should be implemented to keep staffing on track? a. The nursing staff should be reduced for the coming shift. b. The nursing staff should be increased for the coming shift. c. The nursing staff should remain the same for the current shift. d. The nursing staff should be reduced for the current shift.

d. The nursing staff should be reduced for the current shift.

A nurse manager is instructing a staff member with a pragmatic learning style who is interested in applying information immediately to solve problems in the real world. What would be the best teaching strategy in this situation? a. Ask the staff member to assess the logical flow of the content. b. Invite the staff member to set goals for the lesson plan. c. Present content that is theory-focused rather than problem-focused. d. Present content that is problem-focused rather than theory-focused.

d. present problem-focused content pragmatic learning style is concerned with how the information they are learning can be used practically to solve immediate problems. contextual learning style: inviting this person to set goals for the lesson plan and asking them to judge the flow of the content helps to satisfy the desire for meaningful instruction that fits into a bigger conceptual picture.

Evaluation methods that nurse leaders should include to evaluate the effectiveness of staff education are observation, communication, learner self-evaluation, and pre- and post-testing. FALSE TRUE

true

A new nurse manager is learning about staff development. Which statements about the implications of Knowles' learning theory are accurate? (Select all that apply.) a. Adults learn best by using experiential techniques. b. The adult will not feel rejected if the value of their experience is rejected. c. Mistakes should be viewed as opportunities to learn. d. Assessment of need is absolutely essential. e. Adults do not need to be involved in the evaluation of their progress.

a. learn best with experiential technique c. mistakes are a learning opportunity d. assessment is essential if the value of their experience is rejected, the adult will feel rejected as well, adults should be involved in the evaluation of their progress

A new nurse manager is learning about staff development. Which statements reflect elements of Bandura's social learning theory? (Select all that apply.) a. People learn as a result of direct experiences. b. People evaluate new information from reasoning. c. Learning may occur from judgments of peers. d. Learning requires utilization of pedagogy. e. Knowledge may be gained vicariously.

a. learn from direct experience b. new info from reasoning c. occurs from peer judgement e. gained vicariously (through another persons actions) four elements: 1. People learn as a result of direct experience 2. knowledge is frequently obtained vicariously 3. people learn through judgments of peers in the absence of actual or vicarious learning 4. people evaluate the new information using deductive and inductive reasoning.

The nurse leader should assess which of the following when planning learning activities for their staff? a. Perceived learning needs b. Lack of motivation c. Current work environment d. Burnout

a. perceived learning needs

What is the definition of competency? a. A person's ability to correctly perform a skill or task b. A person's ability to describe the proper procedure c. A person's ability to teach the skill or task d. A person's ability to determine if a task or skill should be performed

a. perform a skill correct

A nurse manager is evaluating the critical thinking competency of a staff member. What method would be most effective in making this evaluation? a. Directly observe the staff member's skills in order to complete validation checklist. b. Request the staff member's rationale for decision making, and share the nurse manager's own rationale. c. Have the staff member draft entries for verification before entering them into permanent documentation. d. Obtain feedback on others' perception of the staff member's communication

b

A new nurse manager is learning about staff development. Which are the most important reasons that staff require education? (Select all that apply.) a. To keep pace with new educational trends b. To ensure the employee's competency c. To learn for the sake of learning d. Staff must learn about new technology e. Staff must keep abreast of current science

b. employees competency d. new technology e. current with science

The nurse must get a consent signed by the patient regarding their upcoming surgery. She notes in the chart that the patient was medicated for pain one hour ago with hydromorphone. Ethically, what should the nurse do? a. Have the patient sign the consent. b. Withhold the consent until another time. c. Ask the provider on call if they can assess the patient. d. Get a second witness and have the patient sign the form.

b. have the patient sign another time obtain a consent form from a patient who is not impaired by medications. If a patient is pre-medicated or using a narcotic, the patient cannot ethically be deemed competent to sign a consent form.

Which reasons would a nurse manager consider for carrying out staff development? (Select all that apply.) a. To test new teaching strategies b. To meet new learning needs c. To satisfy specific interests of staff d. To promote group activity e. To establish competence

b. meet needs c. interest e. competence

What is the best way for a nurse instructor to evaluate whether a staff member has learned an important new procedure as part of an educational development program? a. Require the staff member to recite the key points of the procedure without referencing notes. b. Observe if the staff member has adopted the desired behavior change. c. Have the staff member complete a thorough evaluation form at the end of the training. d. Interview the staff member a month after the training to see if the information was retained.

b. observe them do it

A new nurse manager is learning about fiscal planning. Which are barriers for nurse managers' participation in fiscal planning? (Select all that apply.) a. Nurses are directly involved in fiscal planning. b. Many nurses perceive that fiscal planning is difficult. c. Nursing input in fiscal planning is undervalued. d. Nursing education lacks preparation in fiscal planning. e. Nurses lack the intuition necessary for fiscal planning.

b. perceive fiscal planning as difficult d. education lacks preparation in fiscal planning

Identify the following obstacles that prevent adults from learning. (Select all that apply.) a. High self-motivation b. Self-confidence c. Individual strengths and weaknesses d. Time e. Institutional barriers

b. self confidence d. time e. institutional barriers Obstacles to learning include: -intuitional barriers -time constraints -outside obligations due to career and family -support system reaction -individual obstacles -self-confidence -family resistance

Complete the following sentence: according to adult learning theories, adult learners _____. a. Do not require the need to practice quickly what they have learned b. Should be actively involved in the evaluation of their progress c. Do not need to be ready to learn as they recognize that they must learn d. Do not learn from past mistakes

b. should be active in their progress evaluation Adult learners: -enjoy taking an active role in their learning process -require being involved in the evaluation of their progress - learns from mistakes - wishes to quickly apply their newfound knowledge - are more willing to learn if they are presented with the why or need to learn.

A new nurse manager is learning about staff development. Which statement about either training or education is most accurate? a. Training is designed to develop individuals in the broader sense. b. Training ensures knowledge and skills necessary for the job. c. The words training and education are synonymous. d. Education has immediate use and applicability.

b. training is knowledge/skills necessary for a job

A nurse manager has evaluated a recent staff development activity. Which variables may have limited the transfer of knowledge and ultimately the success of the activity? (Select all that apply.) a. The basic principles underlying the process and how situations may modify the process b. Staff had one opportunity to practice the skill and then were required to return demonstrate c. The training context of the staff development activity was different from the work context d. The training included one example so that the staff could apply information specifically e. Important steps or features of the process were emphasized during the training activity

c. d. The staff must have ample opportunity to practice and overlearning is desirable. The training should include multiple examples so that the knowledge becomes generalized. Important steps or features of the process must be emphasized during the training activity. The basic principles for the process and how situations may modify the process must also be covered in the training.

A new nurse is working in the operating room suite. The nurse notices that the surgeon uses inappropriate humor concerning the patient while the patient is under anesthesia. What is the nurse experiencing? a. Moral indifference b. Moral uncertainty c. Moral outrage d. Moral distress

c. moral outrage Moral outrage occurs when the witness to an immoral act feels powerless to stop it. Moral indifference: an individual questions why morality in practice is necessary. Moral uncertainty (or moral conflict): an individual is unsure which moral principles apply and may include uncertainty as to what the moral issue is. Moral distress: is individual knows the right thing to do but organizational constraints make it difficult to take the right action.

Which nurse likely faces the highest risk of being bullied in the workplace? a. A male registered nurse in a high acuity environment where all the other nurses are female b. A 57-year-old nurse who works in environment where most nurses are in their twenties or thirties c. A registered nurse who graduated from a bachelor of science in nursing program three months ago d. A licensed practical nurse who provides care where most other nurses have degrees

c. recent graduate nurse it is well documented that recently graduated nurses have a particularly high risk for being bullied.

The nurse is caring for a patient whose vital signs are not stable and who seems to be nearing the end of life. The provider orders the patient to be placed on life-sustaining treatments, but the nurse questions this order. The nurse is operating within which type of ethical framework? a. Utilitarian b. Duty based—deontological c. Rights based—deontological d. Intuitionist—deontological

c. rights based -- deontological

A registered nurse (RN) on a busy hospital floor is working alongside an "agency nurse," or supplemental RN (SRN). When working with the SRN, the RN should: a. delegate to the SRN in a similar manner as delegating to a licensed practical/vocational nurse. b. ensure that lower-acuity patients are assigned to the SRN whenever possible. c. recognize that the use of SRNs is associated with decreased patient outcomes. d. collaborate with the SRN in a similar way as with RNs who work on the unit consistently.

d. collaborate with the SRN similar to a regular RN Unless there are extenuating circumstances, the RN should aim to engage with the SRN as with any other RN

A nurse is travelling to work on the highway. The nurse sees a car get hit from the rear. The car spins out of control and hits the median. The nurse stops to help at the scene. Legally, the nurse may do this based on the Good Samaritan Law. What ethical framework is the Good Samaritan Law based upon? a. Utilitarian b. Intuitionist c. Rights based d. Duty based

d. duty based the nurse has a duty to perform within her knowledge base and should act upon that duty. Utilitarian frameworks: the greatest good is for the greatest number of people. rights-based: individuals have inherent rights that should not be interfered with intuitionist: each case is weighed separately from another.

Which activity would the nurse manager expect in the unfreezing stage of change? a. Developing appropriate strategies to implement the change b. Being present to support others through the implementation of the change c. Setting target dates for the implementation of the change d. Making others aware of the need for the change to be implemented

d. making others aware of the need for change

A nurse manager is reviewing current staff development activities. Which is critical to ensure that staff development activities are successful? a. The education department identifies all needs for education and training b. Management is responsible for education and training c. Scheduling education and training as non-paid time d. Communicating shared responsibilities for education and training

d. shared responsibilities about education/training

After a recent departmental reorganization, the nurse manager observes tension in several interactions among the staff. The manager understands that which of the following common causes for conflict in organizations could be at the root of the tension? (Select all that apply.) a. Individual behavior b. Unclear expectations c. Clear communication d. Staffing changes e. Diversity

d. staffing changes b. unclear expectations Reasons for conflict include poor communication, poorly defined organizational structures, individual behaviors, unclear expectations, conflicts of interest, operational/staffing changes, and diversity in gender/culture/age. In this scenario only those 2 apply.

Using the SBAR model, when the nurse is providing the background of a patient to teammates, what information should the nurse include? Select all that apply. Admitting diagnosis Past medical history Issues identified for discussion Patient's name and room number Current medications

diagnosis, past medical hx, name and room #, current meds NOT issues identified for discussion

Education development requires a sequence of steps. Place the steps in the order a nurse leader would follow when planning for staff development. a. identify educational resources b. determine knowledge levels c. evaluate learning outcomes d. provide learning objectives e. assess learner needs

e. assess learner needs b. determine knowledge levels a. identify educational resources d. provide learning objectives c. evaluate learning outcomes