Final chapters

Which of the following actions best exemplifies advocacy? a. Developing a list of agencies that will provide free services for the homeless b. Working in a needle exchange program for individuals in an inner-city environment c. Acting on behalf of a patient to promote end-of-life wishes to an ethics committee d. Working in a free clinic for immigrant workers

c. Acting on behalf of a patient to promote end-of-life wishes to an ethics committee

At the beginning of the strategic planning processes, Pacific Hospital learns that nursing staff members are uncomfortable with utilizing evidence-based practice, and that staff perceives that only limited resources are available to support translation of evidence into their usual practice. Because this issue has been identified, the management team determines that a plan of action is required to address the issue. Who should be involved at this point? a. Nursing unit managers b. Staff nurses c. All staff d. Administration

c. All staff

To solve a problem, the nurse manager understands that the most important problem-solving step is: a. the implementation phase. b. identification of numerous solutions. c. accurate identification of the problem. d. evaluation of the effectiveness of problem resolution.

c. accurate identification of the problem.

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. negotiation. c. discrepancy. d. internalization.

c. discrepancy.

The new nurse manager feels pulled between the expectations of staff, the demands of hospital administrators, and family obligations. According to the theory by Hardy (1978), unrelieved role stress and strain will lead to: a. frustration and anger. b. alienation of family and friends. c. low productivity and performance. d. physical symptoms and acute illness.

c. low productivity and performance

Before beginning her own nursing agency, a nurse worked with other temporary nursing agencies in nine states and multiple agencies. She had set a personal goal to start her own agency. What type of motivation does this exemplify in career success? a. Linear b. Spiral c. External d. Internal

d. Internal

A cover letter and a résumé together should be no longer than ________ page(s). a. two b. one c. four d. three

d. three

The nurse manager knows that the most serious effect that absenteeism has on the nursing unit is that: a. using replacement personnel with new ideas may be beneficial. b. salary costs are lower because personnel are fewer, and outcome is favorable. c. absence on the part of the rest of the staff is decreased. d. unacceptable patient care may result.

d. unacceptable patient care may result.

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. clarity of Amy's information. b. organizational support for the mentor relationship. c. the congruence of Amy's beliefs with Sarah's beliefs. d. willingness of Sarah to receive feedback.

d. willingness of Sarah to receive feedback.

A new graduate is asked to serve on the hospital's quality improvement (QI) committee. The nurse understands that the first step in quality improvement is to:collect data to determine whether a. standards are being met. b. implement a plan to correct the problem. c. identify the standard.determine whether the findings warrant correction. d. identify the standard.

identify the standard.

A 66-year-old native Chinese patient, hospitalized for a myocardial infarction, asks the nurse manager about seeing his "acupuncture doctor" for treatment of his migraine headache. The best response to this patient would be: a. "How long have you been using acupuncture treatment?" b. "Do you think acupuncture relieves your pain satisfactorily?" c. "What have you told your heart specialist about your migraines and treatment?" d. "Have you tried nonprescription pain medication or been given a prescription drug for your headaches?"

a. "How long have you been using acupuncture treatment?"

As a manager, you are interested in developing behavioral questions for an interview. Knowing that there is team conflict at times on your unit, which of the following questions would satisfy your interest in behavioral questions? a. "Tell me about a time you were involved in a conflict related to a project. What was your role in the conflict? In the resolution of the conflict?" b. "If you were to employ one strategy for managing conflict, what would it be?" c. "What is your preferred style of conflict resolution?" d. "How effective are you in working in a group? In dealing with conflict?"

a. "Tell me about a time you were involved in a conflict related to a project. What was your role in the conflict? In the resolution of the conflict?"

A new graduate nurse wonders about the directions that her preceptor has given her regarding management of incontinent, confusedpatients. The new nurse brings the preceptor evidence-based information she located regarding incontinence interventions forconfused patients and asks to talk about the guidance that given after the preceptor reviews the information in the article. What isthe new nurse demonstrating in this situation? (Select all that apply.) a. Assertiveness b. Followership c. Management d. Insubordination

a. Assertiveness b. Followership

Based on data from the patient satisfaction survey, the nurse manager decides that a change should be made in communication with family members. What would be important for a nurse manager to consider when instituting a change to improve customer service? a. Assess the perceptions of the nursing staff regarding the specific service problem. b. Include community representatives on a planning committee to address the change. c. Involve physicians, other healthcare professionals, and ancillary staff. d. Review all patient complaints with the nursing staff.

a. Assess the perceptions of the nursing staff regarding the specific service problem.

A patient is admitted to a medical unit with pulmonary edema. His primary nurse admits him and then provides a written plan of care. What type of educational preparation best fits the role of primary nurse? a. Baccalaureate b. Associate c. Diploma d. LPN/LVN

a. Baccalaureate

A recent nursing graduate in a busy Emergency Department triages a patient who has sustained a large, deep puncture wound in his foot while working at a construction site. He is bleeding and is in pain. The nurse enters the triage data that she has obtained from the patient into a computerized, standard emergency patient-classification system. After she enters the assessment data, she notices an alert on the computer screen that prompts her to ask the patient about the status of his tetanus immunization. What system of technology is involved in generating the alert? a. Clinical decision support b. WL technology c. Computerized provider order d. Electronic health record

a. Clinical decision support

What patients would be considered "at risk" consumers during a healthcare visit? (Select all that apply.) a. Clyde requires an anticoagulant. He tells the nurse about his medications. He does not include an herbal supplement. b. George is very shy and withdrawn. He asks the nurse to leave him alone. c. Sarah is a new parent who finds that nurses on the children's unit are very helpful.She is eager to accept all suggestions, including those that she does not yet understand. d. Claude is booked for bowel surgery. His doctor explains about the colostomy.Later, Claude tells his wife that he really doesn't know what the doctor meant by colostomy.

a. Clyde requires an anticoagulant. He tells the nurse about his medications. He does not include an herbal supplement. c. Sarah is a new parent who finds that nurses on the children's unit are very helpful.She is eager to accept all suggestions, including those that she does not yet understand. d. Claude is booked for bowel surgery. His doctor explains about the colostomy. Later, Claude tells his wife that he really doesn't know what the doctor meant by colostomy.

To achieve Nurse-Sensitive Care Standards developed by the NQF, you advocate for which of the following in your health facility? a. Evidence-based practice to reduce the prevalence of pressure sores b. Implementation of informatics at the bedside c. Staff-manager conferences to review reporting of adverse medical events d. Patient councils to review food, recreation, and nurse-patient relations

a. Evidence-based practice to reduce the prevalence of pressure sores

During orientation of new nurse managers, the chief nursing officer stresses strategies that help nurse managers to achieve a powerful image. What behaviors best contribute to a powerful image for the nurse manager? a. Greeting patients, families, and colleagues with a handshake and a smile; listening carefully when problems arise b. For men, no facial hair, always wearing a suit and tie; for women, always wearing a suit and high-heeled shoes c. Maintaining a soft voice during times of conflict; making unbroken eye contact during interactions d. Smiling all the time; always wearing a suit, carrying a briefcase, and, if a woman, wearing no jewelry

a. Greeting patients, families, and colleagues with a handshake and a smile; listening carefully when problems arise

Staff at Valley Hospital are concerned that recent staffing cuts will affect their ability to provide quality patient care, and they express their concerns to senior management. The CEO of Valley Hospital makes the following statement: "We need to contain costs because our funding has been decreased." This is a good example of which of the following conditions that propel a situation toward conflict? a. Incompatible goals b. Role conflicts c. Structural conflict d. Competition for resources

a. Incompatible goals

The manager calls the staff together to assess a situation in which the family of a seriously ill patient is anxious and is absorbing a great deal of staff time in consultation, discussion, and questioning of treatment decisions. Staff members are becoming distanced from the family. After inviting the concerns of staff, the manager explains that the organization values patient-centered care and that evidence supports that acting as an advocate and a listener is helpful to families. The manager asks the staff for ideas and strategies that are effectively patient-centered in dealing with families in similar situations. What is the role of the nurse manager in this situation? a. Leadership b. Management c. Follower d. Visionary

a. Leadership

A family is keeping vigil at a critically ill patient's bedside. Distant family members call the unit continuously asking for updates and expressing concern. The nurse speaks with the distant family members and states she is referring them to the hospital social worker, whose role is to work with family in this situation. What role is the nurse assuming through this action? a. Manager b. Leader c. Follower d. Laissez-faire

a. Manager

A nurse manager is implementing strategies to support the steps in the AHRQ document "Five Steps to Safer Health Care." What does the manager include in the implementation? a. Patients are actively encouraged to make decisions related to care. b. Rules and decisions are made through centralized processes. c. You monitor the performance of each staff member closely. d. Preference is given to increasing staff numbers rather than staff credentials.

a. Patients are actively encouraged to make decisions related to care.

Pleasant Valley Hospital has amended its safety practices and policies. What has the hospital elected to emphasize accordance with changes by The Joint Commission (TJC)? a. Safety goals specific to Pleasant Valley b. Decision-making processes c. Sufficient staffing for safe care d. Increased numbers of baccalaureate-prepared RNs

a. Safety goals specific to Pleasant Valley

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

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

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

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

Physicians in a small urban hospital are reluctant to discharge older adult patients because many of the patients lack private insurance and the resources to travel distances for follow-up care. The hospital administration pressures the physicians to discharge patients sooner and to be more consistent with the number of hospitalization days specified within the DRGs. Which of the following would most likely prompt the action of administrators? a. The hospital is incurring a deficit related to a gap between the PPS and the DRGs and costs of care. b. Local home care services are expressing concern about the increased acuity of patients being discharged into their care. c. The resource-based relative scale for physicians does not account for the increased length of stay. d. Acute care patients are being denied entry to the hospital because of the increased stay of patients.

a. The hospital is incurring a deficit related to a gap between the PPS and the DRGs and costs of care.

The nurse manager is aware that conflict is occurring on her unit; however, she is focused on preparing for a state health department visit, so she ignores the problem. What factor can increase stress and escalate conflict? a. The use of avoidance b. An enhanced nursing work force c. Accepting that some conflict is normal d. Managing the effects of fatigue and error

a. The use of avoidance

Of the following, which is the most effective strategy that a nurse manager could employ to reduce unnecessary costs in specific healthcare settings? a. Training nurses on accurate documentation of supplies used for patient care b. Reducing the number of overtime hours worked by staff c. Reducing the number of staff on a unit d. Making decisions for patients about which care is important to their health

a. Training nurses on accurate documentation of supplies used for patient care

As a new manager, you are shocked to learn that your unit is still using heparin in heparin locks. You are aware of evidence related to this practice and want to change this practice as quickly as possible on your unit. You are in which stage of Lewin's stages of change? a. Unfreezing b. Experiencing the change c. Moving d. Refreezing

a. Unfreezing

Which of the following activities would represent a customer-friendly approach in a healthcare setting? SATA a. Using a local anesthetic before inserting a needle into a child's arm b. Repeating patient history information to the admitting clerk, the admitting nurse, and the ultrasound technician c. Ensuring that birthing preferences are on file and available in a laboring mother's chart d. Providing support to families when a family member is brought into trauma

a. Using a local anesthetic before inserting a needle into a child's arm c. Ensuring that birthing preferences are on file and available in a laboring mother's chart d. Providing support to families when a family member is brought into trauma

The nurse on the 7-7 shift is assigning a specific component of care to an unlicensed nursing personnel (UNP) employee. The nightnurse would remain: a. accountable. b. responsible. c. authoritative and liable. d. responsible and task-oriented.

a. accountable.

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. ambiguity. b. transition. c. development. d. negotiation.

a. ambiguity.

In an ICU, you order new devices to measure heart rhythm and rate, respiratory rate, oxygen levels, and intracranial pressure. These devices involve: a. biomedical technology. b. telecommunications. c. retrieval of patient history information. d. Internet.

a. biomedical technology.

A survey of staff satisfaction is conducted. The survey indicates that staff members are satisfied, are loyal to the organization, and feel that they have reasonable control in their individual responsibilities. The findings best exemplify: a. clarity in roles and valuing of contributions. b. satisfaction but not empowerment. c. effective coaching of new staff. d. role attachment.

a. clarity in roles and valuing of contributions.

A unit manager watches a new RN graduate interacting with a patient. When the RN comes out of the room, the unit manager says, "I don't know what they taught you in your nursing program, but if I see you do that again, I will write you up." This example demonstrates: a. coercive use of power. b. appropriate application of control. c. use of informatory power. d. use of power to provide coaching.

a. coercive use of power.

A nurse educator is giving a workshop on conflict. During the sessions, he makes various statements regarding conflict. All of the statements are true except: a. conflict can decrease creativity, thus acting as a deterrent for the development of new ideas. b. horizontal violence involves those with similar status but little power in the larger context. c. interprofessional collaboration reduces unresolved conflicts. d. all conflicts involve some level of disagreement.

a. conflict can decrease creativity, thus acting as a deterrent for the development of new ideas.

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

a. create a résumé.

As a nurse manager, you see an opportunity for patients to be well serviced through the medical home concept. You recognize that the concept of medical homes: a. currently does not include nurses in its vision of multifaceted primary care. b. includes nurses as part of an interdisciplinary and multidisciplinary team. c. restricts nurses to services related to direct care and procedures. d. cannot encompass nurses within this framework.

a. currently does not include nurses in its vision of multifaceted primary care.

The nurse manager frequently interacts with staff and other hospice facility employees. Communication is purposeful because the manager assesses current issues, such as specific satisfactions and dissatisfactions with the newly implemented computerized documentation system. Informally, the manager gathers available staff members to address similar learning needs. Many times, staff members are found coaching other staff about improving use of the new system. According to Senge (1990), the activities demonstrated in this example are: a. dialogue, team learning. b. resilience, personal mastery. c. shared vision, systems thinking. d. mental models, teachable moments.

a. dialogue, team learning.

A nurse manager is discussing with unit staff the repeated lack of staff compliance in documenting exercise activity for post-cardiac surgery clients. The unit's licensed practical/vocational nurses are responsible for ensuring that clients carry out the prescribed exercise regimen and that the activity is documented. Using Drucker's five basic functions of a manager, identify appropriate functions for the nurse manager to use when addressing this situation: (Select all that apply.) a. divide the necessary activities into manageable tasks, so clients adhere to the exercise regimen. b. establish objectives and goals for each area and decide who is accountable for them. c. allow clients to organize the activities. d. engage in activities that motivate the team and communicate effectively with the responsible staff members. e. analyze, appraise, and interpret the performance of responsible staff, and communicate these findings to staff management. f. allow clients to establish objectives and goals.

a. divide the necessary activities into manageable tasks, so clients adhere to the exercise regimen. b. establish objectives and goals for each area and decide who is accountable for them. d. engage in activities that motivate the team and communicate effectively with the responsible staff members. e. analyze, appraise, and interpret the performance of responsible staff, and communicate these findings to staff management.

A functional résumé focuses on: a. experience and skills gained in positions. b. positions held and specific roles in the positions. c. academic qualifications and achievements. d. relating skills and experience to qualifications in a specific position.

a. experience and skills gained in positions.

Knowing your professional strengths is important to: a. find your fit in positions and a career path. b. maintain a professional status. c. act in a manner that is legal and ethical. d. understand the role expectations of a position.

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

The biggest challenge in the recruitment of staff is: a. finding well-qualified candidates who can function well within your particular work culture. b. recruiting individuals with the appropriate qualifications and experience. c. screening out candidates who are unable to function well within a team. d. determining if candidates have had previous negative experiences in a work environment.

a. finding well-qualified candidates who can function well within your particular work culture.

Examples of sentinel events include: (Select all that apply.) a. forceps left in an abdominal cavity. b. patient fall, with injury. c. short staffing. d. administration of morphine overdose. e. death of patient related to postpartum hemorrhage.

a. forceps left in an abdominal cavity. b. patient fall, with injury. d. administration of morphine overdose. e. death of patient related to postpartum hemorrhage.

The risk manager wants to evaluate the reasons for an increased number of falls on the rehab unit. The risk manager devises a fishbone diagram. A fishbone diagram is a useful tool to: a. identify the root causes of problems. b. list possible solutions to problems. c. help leaders select the best options. d. evaluate the outcomes of decisions made.

a. identify the root causes of problems.

In keeping with guidelines of the organization, the nurse manager documents staff problems. Documentation of disciplinary problems should: a. include a plan to correct them and to prevent future occurrences. b. state a detailed history of past problems that are related to the current one. c. be written at the convenience of the manager. d. not be discussed until the formal performance evaluation.

a. include a plan to correct them and to prevent future occurrences.

With the help of a federal grant, the local school nurse has established a spreadsheet that contains relevant nursing data so that she can analyze children's health. School health programs are: a. increasingly seen as primary care sites for children. b. providing only health education programs for children and their parents. c. capable only of providing referrals for health problems to primary care providers. d. funded exclusively by local authorities.

a. increasingly seen as primary care sites for children.

A nurse manager in a for-profit environment finds it difficult to recruit staff. This difficulty may be most related to aggressive profit goals and: a. lower salary compensation for staff. b. rising expectations of impoverished and indigent individuals for services. c. poor orientation and retention practices for staff. d. an overwhelming emphasis on accepting learners from health disciplines.

a. lower salary compensation for staff.

During the performance appraisal session, the manager should: SATA a. maintain a relaxed and professional manner. b. inquire about the employee's personal life and how it is affecting performance. c. allow the employee to express opinions orally and in writing. d. plan to give specific examples only for poor performance.

a. maintain a relaxed and professional manner. c. allow the employee to express opinions orally and in writing.

A nurse manager notices that Nathan, an RN who has been on the unit for approximately 3 years, has an interest in health 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. delegation. c. role negotiation. d. role transition.

a. opportunity.

The nurse manager schedules evaluations of staff members using a newly developed performance appraisal tool. The development of a performance appraisal tool should include: a. organizational mission, philosophy, and position requirements. b. a generalized overview of the duties of a position. c. a skills checklist and accreditation requirements. d. an ordinal scale that ranks all employees.

a. organizational mission, philosophy, and position requirements.

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. plan a social event and include the agency and traveling nurse staff members. b. plan unit-based social events for your remaining permanent staff members. c. request hospital-based "floating" nurses to substitute for the temporary staff. d. implement team nursing.

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

With regard to nursing practice, nurse managers are held responsible for: SATA a. practicing within legal guidelines established under state law and nurse practice acts. b. ensuring that nursing staff under their supervision are currently licensed to practice. c. referring all errors in nursing judgment to state discipline boards. d. ensuring that physicians are properly licensed to provide care on patient care units.

a. practicing within legal guidelines established under state law and nurse practice acts. b. ensuring that nursing staff under their supervision are currently licensed to practice.

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 retention. b. promoting staff attrition. c. developing new role expectations. d. promoting staff supervision.

a. promoting staff retention.

Northwestern Hospital has decided to implement peer review. As a clinical leader in the Emergency Department, you have overall responsibility for ensuring that this is in place by next month. The most important step in this process is to: a. provide an educational session for staff on peer review. b. revise the mission statement, objectives, and performance standards. c. develop objectives and performance standards with employees. d. implement objectives and performance standards.

a. provide an educational session for staff on peer review.

Nurses in an Emergency Department, in an inner-city neighborhood characterized by high levels of violence, are concerned with low levels of security presence in their department. Security levels have recently been decreased and the nurses question why this has occurred. An appropriate action would be to: a. provide nurses with information about rationale for recent changes in security staffing. b. refer the matter to the head of security and let her deal with it. c. provide mentors who can help nurses diffuse aggressiveness. d. accept the security levels as a consequence of funding realities.

a. provide nurses with information about rationale for recent changes in security staffing.

The successful integration of informatics into healthcare settings is key to: a. quality decision making related to management of resources and patient care. b. accessing current information about business practices. c. meeting the modern-day expectations of staff regarding technology use. d. speeding up calculations and decisions in budget development.

a. quality decision making related to management of resources and patient care.

As a nurse manager, you want to institute point-of-care devices on your unit. The rationale that you provide to support the point-of-care devices includes: SATA a. reduction in incidents of medication error. b. immediate documentation of care. c. comparison of patient data with previous data. d. immediate access to staffing schedules.

a. reduction in incidents of medication error. b. immediate documentation of care. c. comparison of patient data with previous data.

In opening a new dialysis unit, the nurse manager has to develop a philosophy for the unit. This philosophy needs to: a. reflect the culture of the unit and its values. b. be developed by the nursing manager on the unit. c. identify the clients that will be served on the unit. d. replicate the organization's philosophy.

a. reflect the culture of the unit and its values.

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

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

An outpatient clinic advertised for RN positions. Before authorizing an open position, the nurse manager should: a. review the position description and performance expectations for the opening. b. place an ad in the local newspaper and on the telephone job line. c. review all current applications on file. d. look for employees within the system who might best fill the position.

a. review the position description and performance expectations for the opening.

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. sponsorship. b. role modeling. c. social interaction. d. mutual positive regard.

a. sponsorship.

An example of a nursing care activity that would not be delegated by an RN to a UNP is: SATA a. teaching self-catheterization to a patient with paraplegia who has limited English. b. basic care for a patient with a head injury who is rapidly deteriorating. c. one-to-one observation with a suicidal patient. d. assessment of patients being admitted through the Emergency Department. e. basic hygienic care for a patient who is post MI and stable.

a. teaching self-catheterization to a patient with paraplegia who has limited English. b. basic care for a patient with a head injury who is rapidly deteriorating. d. assessment of patients being admitted through the Emergency Department.

A staff nurse asks the nurse manager for a few days off for personal reasons. The nurse manager turns in the request to the human resources office with a note indicating that the staff nurse has demonstrated excellent working skills and is a valued employee. The nurse manager has used the influence of her position to help this staff member. Influence is the process of: a. using power. b. empowering others. c. understanding power. d. moving past apathy.

a. using power.

On your unit, despite efforts to build a strong sense of team, conflict between some of the staff is ongoing. Nonetheless, you want to proceed with developing a systematic and effective performance appraisal system. Which of the following approaches would be most appropriate for you to implement? a. Peer review b. A combination of tools c. Anecdotal notes d. Rating scale

b. A combination of tools

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. Opportunities to hone clinical skills that are used most often on the unit that you will manage b. A workshop on conflict management and communication skills c. Attendance at a conference on global healthcare economics d. Attendance at a workshop on survey tool development and statistical measurement

b. A workshop on conflict management and communication skills

Which ethical principle is primarily involved in informed consent? a. Veracity b. Autonomy c. Beneficence d. Nonmaleficence

b. Autonomy

Two nurses on a psychiatric unit come from different backgrounds and have graduated from different universities. They are given a set of new orders from the unit manager. Each nurse displays different emotions in response to the orders. Nurse A indicates that the new orders include too many changes; Nurse B disagrees and verbally indicates why. This step in the process is which of the following in Thomas' stages of conflict? a. Frustration b. Conceptualization c. Action d. Outcomes

b. Conceptualization

As a head nurse, you are concerned about the service orientation on your unit. Which of the following findings and approaches might provide useful information for you? a. Patients find nurses friendly and accessible; data are aggregated for the institution as a whole. b. Data indicate that nurses are responsive to requests for assistance; data are available for the unit and the institution. c. Specific questions related to management of comfort are included for the institution as a whole. d. The survey asks for a range of responses for the unit and the organization, with a focus on facilities, such as cleanliness and responsiveness of administrative services.

b. Data indicate that nurses are responsive to requests for assistance; data are available for the unit and the institution.

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. Ignore messages unless they are labeled as important. b. Determine who is most likely to send useful or important information or requests. c. Check e-mail messages once a day. d. Encourage face-to-face meetings rather than e-mail.

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

The unit manager on 4E is concerned about the performance of Jean, a staff nurse. She is not involved directly with Jean, so she has not been able to determine whether the problem is one of motivation, ability, or both. If Jean lacks ability, which of the following strategies might the head nurse use? a. Dismiss or transfer Jean. b. Document all problem areas and then discuss them with Jean. c. Develop appropriate solutions and make recommendations to human resources. d. Smooth over the problems if they are minor in nature.

b. Document all problem areas and then discuss them with Jean.

A young male nurse began in nursing as a staff nurse at a hospital. After 3 years, he moved to a home healthcare agency for increase in pay and taking a position as a manager in the agency. What type of motivation does this exemplify in career success? a. Internal b. External c. Spiral d. Entrepreneurial

b. External

John is an older adult patient who comes regularly to the multigroup practice in which you are a nurse practitioner. He says that he doesn't understand what he is supposed to be doing about his medications, because every time he comes to the clinic, he sees a different provider. John's experience represents what aspect of the current consumer experience? a. Nurses are well-trusted members of the healthcare team. b. Fragmentation of care results in lack of respect and trust. c. Care providers often have conflicting ideas about care. d. The public does not trust care providers other than nurses.

b. Fragmentation of care results in lack of respect and trust.

A nurse manager understands that the second step in handling an employee with a disciplinary problem is to document the incident. Which of the following is best for documentation of personnel problems? a. Use of the performance appraisal on an annual basis b. Notes made immediately after an incident that include a description of the incident, actions taken, plans, and follow-up c. A tally sheet of medication errors and other specific problems that will be used at annual review d. Copies of reports, placed in his or her file, of all unusual occurrences involving the employee

b. Notes made immediately after an incident that include a description of the incident, actions taken, plans, and follow-up

In a telehealth organization, a nurse who is licensed in New York and Pennsylvania provides teaching to a patient who resides in Pennsylvania. The patient charges that the teaching failed to provide significant information about a potential side effect, which led to delay in seeking treatment and untoward harm. Under which state nurse practice act and standards would this situation be considered? a. New York b. Pennsylvania c. Neither New York nor Pennsylvania d. Both New York and Pennsylvania

b. Pennsylvania

The manager of a nursing unit is having difficulty working with a new graduate nurse. The new graduate nurse is excited and full of ideas she wants to try. The manager decides to journal her feelings regarding the new nurse and her feelings. What is the nurse manager practicing in this situation? a. Leadership b. Reflection c. Knowledge d. Action

b. Reflection

Sue, a nurse manager, discusses her concerns about the hospital's employee appraisal system with her work group, noting that it includes only one rating scale and that it means nothing unless the manager has effective relationship skills. Sue's concerns reflect which best practices associated with performance appraisal? a. Rating scales are too generalized to be considered valid or reliable. b. The effectiveness of appraisal is enhanced by a combination of methods and effective communication skills. c. BARS is considered superior to simple rating scales in terms of performance appraisal. d. Rating scales need to be designed by users to be well accepted.

b. The effectiveness of appraisal is enhanced by a combination of methods and effective communication skills.

John's performance was satisfactory during the first month, but after that time, he was found to be very inconsistent in the provision of nursing care. One month before the end of the rating period, he cared for a very wealthy and influential client, who is best friends with the clinical manager. This client donated new furniture for the staff lounge in John's name to show appreciation for his care. John's subsequent performance appraisal resulted in outstanding ratings in all areas. This is an example of: a. a performance rating based on justifiable evidence. b. a bias related to recent events. c. the impact of personality on the appraisal of performance. d. the effective use of a behaviorally anchored rating scale.

b. a bias related to recent events.

One means of ensuring that the nurses floated to other patient care areas in healthcare organizations are qualified to work in the areas they are floated is: a. employing additional staff to assist with orientation processes. b. cross-educating staff members to other areas of the institution. c. transferring patients to units where the staffing pattern is optimal. d. orienting staff members to all patient care areas as part of their general orientation to the institution.

b. cross-educating staff members to other areas of the institution.

Nurses on the dialysis unit notice that changes in labeling of fluids have meant several alarming near miss in terms of wrong administration of fluids. They take this concern to the unit manager. As an advocate of nurse autonomy, the most appropriate response in this situation would be to: a. ensure that the nurses are aware of the reasons for the change and how the decision was made about the new labels. b. discuss concerns about the labels and develop potential solutions that take into account changes that can be made at the local level and those that need system intervention. c. suggest that the staff wait until they have become more familiar with the labels before taking further action. d. tell the staff that you will notify the pharmacy about these concerns and leave it up to the pharmacy to decide what should be done.

b. discuss concerns about the labels and develop potential solutions that take into account changes that can be made at the local level and those that need system intervention.

Nurses who engage in infighting, seek physician support against nursing colleagues, and avoid political advocacy through membership in nursing organizations: a. refuse to believe that they are acting like members of groups that suffer socioeconomic oppression. b. do not understand how their failure to exercise power can limit the power of the whole profession. c. purposefully choose to exercise their power in the workplace through indirect means. d. suffer from learned helplessness as a result of abuse by powerful nurse executives.

b. do not understand how their failure to exercise power can limit the power of the whole profession.

The chief nursing officer utilizes the hospital's workplace advocacy to help the overwhelmed Emergency Department staff. Workplace Advocacy is designed to assist nurses by: a. creating professional practice climates in their institutions. b. equipping them to practice in a rapidly changing environment. c. negotiating employment contracts. d. representing them in labor-management disputes.

b. equipping them to practice in a rapidly changing environment.

The chief nursing officer plans a series of staff development workshops for the nurse managers to help them deal with conflicts. The first workshop introduces the four stages of conflict, which are: a. frustration, competition, negotiation, and action. b. frustration, conceptualization, action, and outcomes. c. frustration, cooperation, collaboration, and action outcomes. d. frustration, conceptualization, negotiation, and action outcomes.

b. frustration, conceptualization, action, and outcomes.

When interviewing an applicant for an RN position, the nurse manager describes the unit's care delivery system as one in which the nursing assistants are cross-trained to perform specific tasks and the RNs complete all treatment, medication administration, and discharge teaching. The nurse applicant knows this nursing care delivery strategy to be: a. the case method. b. functional nursing. c. primary nursing. d. nurse case management.

b. functional nursing.

In matrix organizational structures, a nurse manager understands that this type of structure: a. is a simplified organizational structure. b. has both a functional manager and a service or product-line manager. c. arranges departments strictly according to function. d. promotes harmony in organizational decision making.

b. has both a functional manager and a service or product-line manager.

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 an opportunity to be interviewed. b. have a listing of facts about your professional life. c. have a tool in place for marketing yourself. d. create a document that lists your skills.

b. have a listing of facts about your professional life.

The education consultant at St. Joseph Hospital is giving a workshop on cognitive reframing. The consultant explains that cognitive reframing reduces stress by: a. aiding individuals in identifying positive stressors. b. helping people realize that negative thinking causes emotional distress. c. eliminating negative stressors. d. replacing positive self-statements with negative irrational beliefs.

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

Martin, the unit manager, receives complaints from community agencies that patients who have been discharged from his unit seem to lack understanding about their disorder and immediate strategies for managing elements of their care. Martin checks the patient teaching sheets and notes that the sheets are initialed by staff. He calls the agencies and indicates that teaching has been done. Martin's follow-up to complaints from the community is: a. appropriate and indicates that he has assumed accountability for the actions of his staff. b. indicative that he does not clearly understand the concept of accountability. c. indicative of strong support for his staff and their autonomy. d. important in clarifying the difference between his accountability and that of the community in patient care.

b. indicative that he does not clearly understand the concept of accountability.

John, a new graduate, reviews the employee evaluation for his new position. The first section requires that he list his own specific objectives to be accomplished. This is an example of: a. the traditional rating scale. b. learning goals, or management by objectives. c. a forced distribution scale. d. a behavior-anchored rating scale.

b. learning goals, or management by objectives.

Two nurses approach their manager about a conflict regarding the next month's schedule. The nurses are talking loudly and at the same time. The manager most effectively uses communication skills to resolve the conflict by: a. taking both nurses aside, separately and then together, and charging them with resolving the problem without her direct intervention. b. listening to each nurse speak to the other without interruption and asking clarifying questions to help them resolve the issue themselves. c. separating the nurses, instructing each to decide how the problem can be resolved, and meeting with them the next day. d. calling an emergency scheduling committee meeting and asking volunteers to resolve the conflict between the two nurses.

b. listening to each nurse speak to the other without interruption and asking clarifying questions to help them resolve the issue themselves.

The chief nursing office of a Magnet® hospital has conducted a study of ways to improve healthcare services. Healthcare services that add value for clients: a. accomplish healthcare goals. b. minimize costs. c. decrease the number of services used. d. use high-technology treatments.

b. minimize costs.

Two staff nurses are arguing about whose turn it is to work on the upcoming holiday. In trying to resolve this conflict, the nurse manager understands that interpersonal conflict arises when: a. risk taking seems to be unavoidable. b. people see events differently. c. personal and professional priorities do not match. d. the ways in which people should act do not match the ways in which they do act.

b. people see events differently.

A group of staff nurses is dissatisfied with the new ideas presented by the newly hired nurse manager. The staff wants to keep their old procedures, and they resist the changes. Conflict arises from: a. group decision-making options. b. perceptions of incompatibility. c. increases in group cohesiveness. d. debates, negotiations, and compromises.

b. perceptions of incompatibility.

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 must update her résumé to include her teaching experience. The goal of creating a curriculum vitae is to: a. have a listing of facts about your professional life. b. provide potential employers with information about where you are in your career. c. respond quickly whenever a position becomes available. d. be certain you can recall facts for a prospective position.

b. provide potential employers with information about where you are in your career.

Joanne, a new nurse manager, writes certain assumptions regarding the organization's objectives into her budget. Her supervisor tells her that the objectives implied in her assumptions are not entirely consistent with the organization, and that she needs to clarify these objectives with her supervisor. Joanne apologizes and says she had more latitude with the budget where she previously worked. This is an example of: a. role complexity. b. role ambiguity. c. role conflict. d. time-dependent roles.

b. role ambiguity.

As a result of Amy's coaching, Sarah, a nursing graduate of 5 years, completes a ROLES assessment. This assessment is helpful in: SATA a. identifying her clinical knowledge. b. role development. c. areas of conflict in expectations. d. expected work time commitments.

b. role development. c. areas of conflict in expectations. d. expected work time commitments.

The chief nursing officer establishes a shared governance model to help empower the nursing staff, thus empowering the organization. Common characteristics of empowered organizations are: a. shared values, high salaries, and a human focus. b. shared values, flexibility, and a human-capital focus. c. commitment to communication, high salaries, and flexibility for evaluations. d. creation of community and of effective stress management in the midst of divergent goals.

b. shared values, flexibility, and a human-capital focus.

In a nurse managers' meeting, the chief nursing officer encourages the managers to brainstorm ways to reduce costs. Nurse managers have the greatest impact on reducing costs by managing: a. supplies. b. staffing. c. fixed costs. d. medication costs.

b. staffing.

During staff-development programs, staff nurses verbalize their frustration about their workloads and having to delegate so many tasks to others. One of the main reasons that delegation has emerged as an issue is because of: a. the amount of paperwork required to complete care. b. the complexity of care required by patients. c. earlier discharge practices. d. the numbers of other disciplines present on a given unit.

b. the complexity of care required by patients.

Technology is integral to a cardiac ICU. Sue, the nurse manager, implements a patient-centered approach that focuses on the meaning of the experience for the patient and family, primary nursing, and a health literacy approach. Sue is: a. using high-tech-low-touch approaches. b. using high-tech-high-touch approaches. c. providing products. d. providing tangible products of satisfaction.

b. using high-tech-high-touch approaches.

During a performance appraisal, Joanne, the nurse manager, indicates that Alysha has difficulty mentoring students on the unit. Alysha responds that this is not her responsibility. In responding to Alysha, Joanne needs to consider: a. Alysha's level of confidence. b. whether mentoring is included in the position description. c. whether mentoring is an essential component of the position description. d. whether mentoring can be accurately observed and measured.

b. whether mentoring is included in the position description.

Which of the following might best conclude an interview? a. "Thank you for your interest. Someone will be in touch with you soon." b. "Before you go, we will make sure that we have your contact information. Thank you for coming." c. "I will be in contact with all candidates by telephone by next Friday. It has been a pleasure to meet you." d. "We have several excellent candidates so I am not sure about the outcome of the interview, but I will let you know. Thank you for coming."

c. "I will be in contact with all candidates by telephone by next Friday. It has been a pleasure to meet you."

In determining the fit of a candidate with the culture on your unit, which of the following interview questions might be asked? a. "Could you review your résumé for us, highlighting your certifications and experience?" b. "If we were to ask your references, what would they list as your strengths? Weaknesses?" c. "We have a number of older adult patients on this unit. If you noticed another staff member addressing one of these patients impatiently, how would you respond?" d. "Tell us about your work and academic experiences and qualifications."

c. "We have a number of older adult patients on this unit. If you noticed another staff member addressing one of these patients impatiently, how would you respond?"

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?"

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. 2002 Mount Rush Health Center Staff Nurse 1997 Cedar Falls Clinic Staff Nurse 2007 Kilkarney Rehab Center Case Manager c. 2007 MN 2005 BScN d. 1997 Sturgeon County Hospital Head Nurse 2002 Sturgeon County Supervisor 2007 Sturgeon County Director

c. 2007 MN 2005 BScN

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. a graduate degree. b. at least a nursing diploma. c. 24 months of experience. d. 5 years of successful experience.

c. 24 months of experience.

A patient refuses a simple procedure that you believe is in the patient's best interest. What two ethical principles are in conflict in this situation? a. Fidelity and justice b. Veracity and fidelity c. Autonomy and beneficence d. Paternalism and respect for others

c. Autonomy and beneficence

Who of the following might be the most appropriate mentor for Becky, a new nurse manager on the cardiac unit who has 4 years of previous clinical experience? a. 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. b. 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. 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. 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.

A family is keeping vigil at a critically ill patient's bedside. The nurse approaches the unit manager with concern over the family dynamics for the patient concerned there are patient-family conflicts based on patient's wishes. The nurse suggests that the patient's provider may need to discuss the treatment plan with the family. The unit manager states he will arrange a discussion with the patient's provider and ask the nurse to support the provider's decisions. What is the role of the nurse in this situation? a. Leadership b. Management c. Follower d. Evidence-based

c. Follower

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.

A nurse manager recognizes the need to expand her professional network as she begins a job search for a middle-management position. What action is least likely to expand her job-searching network? a. Reviewing her address book or card file for names and phone numbers of former colleagues who are now in middle-management positions b. Making an appointment to meet with a former instructor from her graduate program in nursing administration c. Making a long overdue return call to a former colleague who is now a chief nurse executive d. Attending a state-level conferences for nurse managers and executives and volunteering to help with professional organizations' informal luncheons and receptions

c. Making a long overdue return call to a former colleague who is now a chief nurse executive

As a manager, you are responsible for two separate units: a CCU and a cardiac step-down unit. The organization and relationships on these units are distinct and very different from one another. Your decision has been to support the uniqueness of these units because each is effective in different ways in providing patient care. This approach is consistent with which principle? a. Transculturalism b. Cross-culturalism c. Multiculturalism d. Acculturation

c. Multiculturalism

Justin is a nurse manager in a rehabilitation unit in a small urban center. There is a high turnover rate among rehab-assistants because of the heavy work assignments. Despite his need for staff, Justin decides to review each application thoroughly and interview candidates carefully because he recognizes that it is important to hire staff who can best provide high-quality care and who will fit well with the team. Which of the following decision-making models did Justin use in making his decision? a. Subjective model b. Objective model c. Optimizing model d. Satisficing model

c. Optimizing model

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. Résumé b. Annual evaluations c. Portfolio d. Patient advocacy project

c. Portfolio

The nurse manager places a staff member on probation because of reports of chemical dependency. The nurse manager should be aware that which of the following statements is true regarding chemical dependency? a. The chemically dependent employee usually hides any changes in behavior. b. When confronted with the issue, the affected employee is usually relieved to have someone to talk to about the problem. c. The chemically impaired nurse affects the entire healthcare organization. d. Hospital policy, state laws, and nurse practice acts address procedures for the chemically dependent employee in the most general terms.

c. The chemically impaired nurse affects the entire healthcare organization.

A group of patients with early Alzheimer disease and their spouses approach you regarding help with the establishment of a local Alzheimer Society for the support and education of affected individuals and their families. As a manager in an ambulatory care clinic, what suggestion or advice would you offer this group? a. Self-help groups are, by nature, directed, funded, and led by those requiring help, and therefore, the patients and families should need no help from your clinic. b. Your healthcare organization would be pleased to help as long as your organization financially takes over responsibility for direction, leadership, and management. c. Through partnership, you will provide supports, if possible, that the patients and spouses themselves identify as necessary in the establishment of the group. d. The services that the patients and spouses are proposing are likely being offered somewhere else already.

c. Through partnership, you will provide supports, if possible, that the patients and spouses themselves identify as necessary in the establishment of the group.

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

c. Touring the unit

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 file a complaint with human resources about the supervisor's lack of interviewing skills. c. You should send a thank-you note to the interviewer, indicating appreciation for her time. d. You should call and leave a voicemail, indicating your disinterest in the position.

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

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. overwork in the staff nurse position. b. inadequate mentoring in the new role. c. anger as a stage of the grieving process. d. demotion as a threat to personal identity.

c. anger as a stage of the grieving process.

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. ask the nurse if she is okay during report. b. refer the nurse to the employee assistance program. c. ask the nurse to meet with you for a few minutes before she leaves for the day. d. write a note to the nurse advising her that her work attendance must improve.

c. ask the nurse to meet with you for a few minutes before she leaves for the day.

The most important approach that a nurse manager can take with an emotionally troubled employee is to: a. act as a therapist for the employee. b. adjust the standard of care to assist the employee. c. assist the employee in obtaining professional help. d. adjust the employee's work schedule to decrease stress.

c. assist the employee in obtaining professional help.

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

c. assure confidentiality.

In the Unity Healthcare organization, decisions, including those at the unit level, are made by a group of senior executives. Rules for employees are clear, and nursing care is delineated by procedures and protocols. This exemplifies: a. transformational leadership. b. transactional leadership. c. bureaucratic organization. d. Chaos theory.

c. bureaucratic organization.

The complexity of the healthcare environment for consumers is increased by: a. falling levels of education among the public. b. increased levels of poverty. c. complex compensatory systems and a variety of delivery systems. d. increased numbers of uninsured or underinsured.

c. complex compensatory systems and a variety of delivery systems.

The mediator asked each staff member to reflect on his or her communication style. Which of the following best describes communication? Communication: a. is a reflection of self-analysis. b. is a result of thoughtful consideration. c. consists of thoughts, ideas, opinions, emotions, and feelings. d. focuses on the sender of the message.

c. consists of thoughts, ideas, opinions, emotions, and feelings.

An example of a career is: SATA a. employment in short-term contract jobs in business, nursing, and whatever is available. b. involvement in an area of practice that is regulated. 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.

The Emergency Department nurses' decision to organize for the purpose of collective bargaining is being driven by a desire to: a. establish the staffing pattern that will be used. b. determine the hours that one is willing to work. c. create a professional practice environment. d. protect against arbitrary discipline and termination.

c. create a professional practice environment.

You are the nurse manager of a nursing service organization that provides around-the-clock care to clients in their homes. To achieve maximum reimbursement for a client who is recovering from a hip replacement, the nursing staff most likely will follow the nursing care guidelines presented in the: a. nursing care plan. b. physician's orders. c. critical pathway. d. clinical practice guidelines.

c. critical pathway.

A nurse manager discovers that the actual number of visits per patient in a home health service is 3.8 visits per day when the standard is 5 visits per day. Based on this information, the nurse manager: a. concludes that the complexity of care in each visit has arisen. b. concludes that patient volume has been decreased. c. decides that more information is needed before a conclusion can be reached. d. initiates a training session regarding the importance of ensuring that visits are made.

c. decides that more information is needed before a conclusion can be reached.

You anticipate that your region will soon move toward an e-health record system. You begin to discuss this with your staff and are disappointed that you receive little positive response from the staff about this possibility. One staff member, in particular, seems to sum it up by saying "e-health? Won't happen in my working life! There are too many problems with it, like privacy issues." This response is most likely motivated by: a. lack of urgency regarding the need to change. b. lack of evidence to support importance of technology. c. deficits in education and experience. d. lack of organizational support for change.

c. deficits in education and experience.

After beginning her new position, Sarah 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. Sarah is most likely: a. lacking an understanding of the nurse management role. b. attempting to prove her clinical skills to the nursing staff. c. experiencing difficulty in unlearning old roles. d. lacking enjoyment in her new role.

c. experiencing difficulty in unlearning old roles.

A nurse manager at a home healthcare service has resigned to take a position at a local ambulatory care center. She has been hired because of her expertise in TJC accreditation. To initiate the changes, the nurse manager has to be knowledgeable about the differences between a home healthcare institution and an ambulatory care center, which is a primary care institution. Primary care institutions are facilities that provide: a. rehabilitative or long-term care. b. disease-restorative care. c. first access to care. d. only outpatient services.

c. first access to care.

A patient complains to the charge nurse that she has no idea who "her nurse" is on any given day. "I ask one nurse for my pills and she says, 'That's not my job.' I ask the pill nurse about my lab tests and she says that I should ask another nurse." The nursing care delivery model most likely employed in this situation is: a. differentiated practice. b. team nursing. c. functional nursing. d. case management.

c. functional nursing.

Nurses need to know how to operate a computer, compare data across time, and look for patterns in client responses to treatments. These are examples of: a. JCAHO standards. b. information systems. c. informatics competencies. d. requirements for nursing licensure.

c. informatics competencies.

To conduct assessment of the internal environment, the strategic planning team for Pacific Hospital: a. invites community members and staff of the hospital to an evening focus group session. b. discusses what it sees as the primary threats and opportunities in demographic shifts affecting the hospital. c. invites all levels of staff to focus groups on the effectiveness of the hospital environment, including information systems and staffing. d. asks the board to provide a summary of major opportunities for the future.

c. invites all levels of staff to focus groups on the effectiveness of the hospital environment, including information systems and staffing.

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

c. maintain a positive relationship with your former organization and colleagues.

A new CEO has been hired at Valley Hospital who proposes to change the centralized organizational structure that was put in place 10 years ago, based on widespread consultation with staff. The proposed structure involves substantial flattening of the organizational structure, with significant decision making being made at the point-of-care and an emphasis on interprofessional collaboration. There is a great deal of discussion about the balance between hospital-wide budget decision making and unit-based decision making. This discussion represents: a. Chaos theory. b. organizational redesign. c. organizational reengineering. d. restructuring.

c. organizational reengineering.

Professional associations: a. set regulatory requirements and establish entry requirements for nursing. b. offer graduate programs for clinical and career advancement. c. provide opportunities for career networking and support. d. are open to all individuals who meet the criteria for membership.

c. provide opportunities for career networking and support.

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. stress. b. role stress. c. role strain. d. role exploration.

c. role strain.

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. basic knowledge in a specified area. b. advanced practice in functional roles. c. special knowledge beyond basic licensure. d. continued competence as a registered nurse.

c. special knowledge beyond basic licensure.

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. linear. b. spiral. c. steady state. d. entrepreneurial/transient.

c. steady state.

In reviewing the current delivery model, the nurse manager is aware that a demographic change that will have a significant effect on healthcare delivery systems of the future is: a. changes in staffing patterns. b. increasing reports of violence in the workplace. c. the increasing percentage of the population that will be over age 65. d. escalations in the cost of health care.

c. the increasing percentage of the population that will be over age 65.

The clinic nurse has just accessed a client's chart on the computer. The resident comes over and asks her to stay logged on because he needs to add a note to that client's chart. She should say: a. "No problem. Just log me off when you're done." b. "I'll put the note in for you. What do you want to say?" c. "Just make sure that you sign your note because it's under my password." d. "I'm sorry, but you will have to enter the information using your own password."

d. "I'm sorry, but you will have to enter the information using your own password."

In delegating to a UNP in a home health setting, which of the following represents the most appropriate delegation communication? a. "You will be taking care of Mrs. S., who needs assistance with her bath." b. "You will need to help Mrs. S. get into and out of her shower. Ensure that you check the condition of her feet, and let me know if you have any concerns when you check in." c. "I am not sure that you know how to do this, but I am giving you Mrs. S. She is quite obese and needs skin care." d. "Mrs. S. needs help to get into and out of her bathtub. Her bath will need to be completed by 10:00. When you are helping her to dry, please check between her toes and toenails, and phone me by 10:30 if you notice nail discoloration or redness."

d. "Mrs. S. needs help to get into and out of her bathtub. Her bath will need to be completed by 10:00. When you are helping her to dry, please check between her toes and toenails, and phone me by 10:30 if you notice nail discoloration or redness."

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 are pressured to do so by your supervisor. b. The organization has no other suitable candidate for the position. c. You have limited knowledge of information technology and no real interest, but this will increase your knowledge. 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.

A nurse manager is planning to request three new infusion pumps at a cost of approximately $1500 each. This item would typically be included in which budget? a. Operating b. Strategic c. Unit of service d. Capital

d. Capital

You have hired a new RN to replace a well-respected and experienced nurse in your outpatient department. The new RN recently graduated and is nervous about stepping into a role that was previously filled by someone who was so competent. You recognize anxiety and set up regular, frequent meetings during which you explore how she is dealing with her anxiety, provide feedback, and discuss strategies/ideas that will enhance her performance. What development approach are you using? a. Performance appraisal b. Counseling c. Empowerment d. Coaching

d. Coaching

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. Internalization b. Acceptance c. Development d. Discrepancy

d. Discrepancy

Ellen is a novice nurse on your unit. Even though she has come to you highly recommended, as her supervisor, you have noticed some knowledge and skill deficiencies. These deficiencies have been noticed by her peers as well, who cover for her because she is new and they like her. Which of the following is likely to be the greatest asset to Ellen in improving her performance? a. Ignore Ellen's errors until she has more experience. b. Instruct staff to avoid working with Ellen until she learns to how do things herself. c. Ask Ellen to complete a self-assessment, using a standard skills checklist. d. Encourage staff to report every behavior of Ellen's that is different from theirs.

d. Encourage staff to report every behavior of Ellen's that is different from theirs.

Sondra, a new graduate, recently began a position as a registered nurse in a rural hospital, where she is the youngest and newest staff member. Although she has limited experience, she has a strong knowledge base, is confident, and was considered to have strong entry-level skills on graduation. Sondra meets with her former instructor and confides that she is very frustrated that others do not seem to accept her leadership. What might you suggest that would help Sondra to understand what is happening in terms of power and influence? a. As a new graduate, it is unlikely that she has acquired the experience and knowledge of other staff, including aides and practical nurses. b. Rural settings tend to be closed systems and therefore are, not welcoming of those who are not from their community. c. Morale on her unit can be improved by engaging in shared decision making. d. Identify the informal leaders on her unit and how they affect care decisions.

d. Identify the informal leaders on her unit and how they affect care decisions.

What interaction is MOST consistent with the idea of networking? a. Meet with the same colleagues daily to have coffee and share concerns about the workplace and stories about colleagues. b. Join an online workplace forum to gain ideas about how to handle workplace conflict. c. Suggest that you and a new team member meet after work for coffee to review unit guidelines. d. Join a nurse executive interest group to meet other executives for support and for sharing ideas of expertise.

d. Join a nurse executive interest group to meet other executives for support and for sharing ideas of expertise.

What exemplifies the predominant style of conflict management for staff nurses? a. Sarah and Jonas, two RNs, disagree about the best approach to assisting a family that has complex needs. They decide that they will consult with family and together will decide what is best. b. Jennifer needs to switch a shift to attend a family function. She arranges to trade with Nancy, who wants a day off next to a 3-day break. c. Lindsay asks Melody to stay late for the third day in a row. Melody refuses, stating that she has already helped out for 2 days by staying late for Lindsay. d. Lara asks Stacey to switch shifts with her because Lara wants to attend a concert. Stacey would prefer not to but does to enable Lara, who is new in town, to be with her friends.

d. Lara asks Stacey to switch shifts with her because Lara wants to attend a concert. Stacey would prefer not to but does to enable Lara, who is new in town, to be with her friends.

Jane, an experienced head nurse, is given the task of completing the summer vacation schedule for the pediatric unit. She is fully aware of the hospital's restrictions on time off and the number of staff on vacation at any given time, as well as its issues regarding seniority. She weighs the options of allowing staff choice, such as it takes more time but gives employees options. However, if choice is allowed, this could cause arguments. Which of the following is the best alternative? a. Ask for requests for vacation time in advance, and post the times. b. Post the completed vacation schedule. c. Post a tentative schedule, and request feedback. d. Post a blank schedule, and ask staff members to fill in their times by a given date.

d. Post a blank schedule, and ask staff members to fill in their times by a given date.

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

d. Tanya Jones 67 Honeywell Drive City, MO 66907 [email protected]

Incivility is a disruptive behavior or communication that creates a negative environment and interferes with quality patient care and safety. The manager can implement steps that help to alleviate uncivil behavior on a unit. Which of the following would not be an appropriate first step? a. Suspending the staff member from work b. Providing written admonishment that is discussed and placed in the employee's file c. Providing verbal admonishment d. Terminating the staff member

d. Terminating the staff member

On the West Surgery unit, you want to institute a new system for checking armbands that evidence suggests may increase safety in medication administration. The system involves technology. What strategy may assist with rapid adoption of the technology and system? a. Employ a centralized decision-making approach. b. Use simulators for initial practice to build confidence. c. Bring in a nurse consultant who is familiar with the technology. d. Use early adopters among the staff as leaders and role models in implementation.

d. Use early adopters among the staff as leaders and role models in implementation.

The final section of a performance appraisal is a rating scale. This scale is very detailed and relates to competency standards specific to surgical clients. The scale is a summary of performance directly observed or documentation reviewed and is specific to client care situations in which the employee has been involved. This type of evaluation is most commonly known as: a. a traditional rating scale. b. management by objectives/learning goals. c. a forced distribution scale. d. a behaviorally anchored rating scale.

d. a behaviorally anchored rating scale.

The turnover rate for RNs in the ICU is high. You discuss this situation with existing staff and you find out that because of the rapid turnover, new staff are frequently required to assume full responsibilities soon into the position and before training is completed. In considering approaches that will reduce turnover rates, the staff and you decide to implement: a. an employee recognition program. b. coaching for new staff. c. a new performance appraisal system. d. a committed orientation and training program.

d. a committed orientation and training program.

John notes that the next section is specific to the organizational philosophy and has a 4-point ordinal scale that describes performance from "always meets expectations" to "does not meet expectations." This type of evaluation is most commonly known as: a. a behavior-anchored rating scale. b. management by objectives/learning goals. c. the forced distribution scale. d. a graphic rating scale.

d. a graphic rating scale.

In looking at an organizational chart for her institution, Jennifer notes that nursing is led at the senior level by a non-nurse executive. Jennifer expresses concern that this is a reflection of how nursing is viewed within the organization. Jennifer's comments reflect: a. a concern that resource allocation will be made on a business and not a professional model. b. the dissatisfaction that occurs when lack of autonomy is given to nurses. c. concern with the nonadvancement of nursing practice in the institution. d. an awareness of how organizational culture is reflected in organizational structure.

d. an awareness of how organizational culture is reflected in organizational structure.

You are the nurse manager for a not-for-profit health service for the homeless and for drug users in an impoverished neighborhood. As the manager, your concern about sustainability is related to: a. the possibility of violence. b. an increase in prescription drugs available for abuse. c. decisions of the public board. d. an increase in uncompensated care events.

d. an increase in uncompensated care events.

Sarah is a clinical nurse educator in the dialysis unit at Pines Health Center and provides education, consultation, and training support. Sarah has: a. direct responsibility for patient care. b. direct accountability for patient outcomes. c. an authority relationship to staff. d. an influence over patient outcomes.

d. an influence over patient outcomes.

A nurse manager in the ICU works with his staff to develop an appraisal instrument that includes quantitative data and respects standards for an RN working on that unit. This type of appraisal is a: a. rating scale. b. collaboratively based appraisal system. c. narrative instrument. d. behaviorally anchored rating scale.

d. behaviorally anchored rating scale.

The head nurse and a staff nurse are having a conflict over how to use and apply a new procedure for dressings in the medical/surgical area. The staff nurse wishes to use the new procedure based on newly released nursing research. The head nurse wishes to use a protocol that has been used in the department for a number of years. The head nurse later makes comments to other staff on her unit about the credibility of the staff nurse. This behavior is associated with: a. lateral violence. b. horizontal violence. c. confrontation. d. bullying

d. bullying

The night nurse understands that certain factors need to be considered before delegating tasks to others. These factors include the: a. complexity of the task and the age of the delegatee. b. potential for benefit and the complexity of the task. c. potential for benefit and the number of staff. d. complexity of the task and the potential for harm.

d. complexity of the task and the potential for harm.

As part of orientation to your unit, you decide to administer Kolb Learning Style Inventory (LSI) to new staff. The most likely reason for your decision is that the use of Kolb LSI: a. reduces the cost of orientation. b. determines if there is fit between learner and organizational values. c. develops the strengths of the new staff member. d. enables individualization of learning to the learner's needs.

d. enables individualization of learning to the learner's needs.

After the nurses who work on an adolescent psychiatric unit have had a brainstorming session, they are ready to resolve the problem of unmanageable teenage patients. To maximize group effectiveness in decision making and problem solving, the nurse manager has: a. prevented conflict. b. formed highly cohesive groups. c. used majority rule to arrive at decisions. d. encouraged equal participation among members.

d. encouraged equal participation among members.

Thomas has been a nurse in your ICU for 10 years. In facilitating Thomas' professional development, the nurse manager would focus on: a. certification for the ICU environment. b. discussions about how Thomas can fit with role expectations and relationships. c. possible changes to other ICU environments. d. encouraging him to lead changes that leave long-term impacts after his retirement.

d. encouraging him to lead changes that leave long-term impacts after his retirement.

Within a multisite healthcare system, the most appropriate strategy for translation of research would be: a. widespread development of protocols using EBP at unit levels b. dissemination of EBP and recommendations to individuals, units, and the organization c. development of the skills of individual managers on how to build guidelines based on EBP d. establishment of an interdisciplinary center to guide and lead the translation of research findings into practice.

d. establishment of an interdisciplinary center to guide and lead the translation of research findings into practice.

The nursing manager of a surgical unit has been asked by administration to evaluate client outcomes post cardiac catheterization. Using data about client outcomes post cardiac catheterization for the past 6 months in order to modify practice is an example of: a. information. b. cost-effective care. c. meeting standards. d. evidence-based practice.

d. evidence-based practice.

The chief nursing officer works with her nurse managers by helping them understand how to develop and implement a budget. A nurse manager can best describe a budget as a: a. day-to-day plan for operations. b. unit of service. c. statement of revenues and services. d. financial plan.

d. financial plan.

The nurse manager is comparing functional nursing and primary nursing for potential adoption. The nurse manager determines that patient and nurse satisfaction in primary nursing are: a. similar to those in functional nursing. b. not of significance in either model. c. low by comparison with functional nursing. d. high when compared with functional nursing.

d. high when compared with functional nursing.

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. development. b. acceptance. c. symmetry. d. internalization.

d. internalization.

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. expectations. b. opportunities. c. responsibilities. d. lines of communication.

d. lines of communication.

Benchmarks in the strategic marketing planning process are useful in: a. establishing programs. b. setting targets. c. rewarding employees. d. measuring progress.

d. measuring progress.

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. lying about the problems and hoping to resolve them by hiring the applicant. c. denying that the agency has a turnover problem with staff or medical directors. d. minimizing the challenges of the position to make a positive impression on the applicant.

d. minimizing the challenges of the position to make a positive impression on the applicant.

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. engage in clarifying why the hospital did not state its expectations for the unit at the time of hiring. b. hire a lawyer to represent his interests during this unexpected role transition. c. seek counseling to deal with his shock and anger. d. negotiate a reasonable settlement.

d. negotiate a reasonable settlement.

The staff members in a local Emergency Department are experiencing stress and burnout as the result of excessive overtime. The staff decides to unionize to negotiate for better working conditions. The increase in unionization within health care may be attributed to the: a. movement from being "blue-collar workers" to being "knowledge workers." b. excess profits in health care. c. level of risk that exists for health care. d. number of people who are involved in health care.

d. number of people who are involved in health care.

Lucy, head nurse on the surgical unit, works with her staff to find ways in which they can work together with other disciplines to provide more effective care for patients on the unit. Lucy likely knows her power is: a. limited, thereby necessitating involvement of others in implementing ideas. b. restricted, which necessitates finding alternative means to achieve strong patient outcomes. c. directed primarily toward those who are subordinate to her. d. of unlimited capacity when shared with others.

d. of unlimited capacity when shared with others.

The nurse manager on a pediatric intensive care unit wants to evaluate patient satisfaction. The nurse manager understands that ultimately, positive relationships with consumers of care are evaluated by the: a. cultural sensitivity of staff. b. cost-effectiveness of care delivery. c. economic value of service. d. outcomes for clients and their perceptions of care.

d. outcomes for clients and their perceptions of care.

The wound care nurse decided to involve those to be affected by change early in the change management process. This can positively result in: a. coordination. b. resistance. c. anticipation. d. participation.

d. participation.

In an acute care unit, the nurse manager utilizes the functional nursing method as the care delivery model. The nurse manager's main responsibility is the needs of the: a. department. b. unit. c. staff. d. patient.

d. patient.

In preparing for a fair interview process as a hiring manager, you should: a. put water out for the candidates. b. ensure that you know the names of all candidates. c. dress comfortably and professionally. d. prepare a schedule of questions to be asked of all candidates.

d. prepare a schedule of questions to be asked of all candidates.

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. researching clinical literature to maintain her clinical assessment skills for the unit. d. recognizing her strong commitment to care in the management process through journaling.

d. recognizing her strong commitment to care in the management process through journaling.

Leslie, a UNP, transfers a patient while using improper technique. The patient is injured, and as a result, a suit is launched in which both Sarah (the delegator) and Leslie (the delegatee) are named. Sarah is named in the suit because she: a. retains accountability for the care of the patient. b. worked the same shift as Leslie. c. has passive accountability for delegation. d. retains accountability for the outcomes of care for the patient.

d. retains accountability for the outcomes of care for the patient.

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. develop policies consistent with the head nurse's prior workplace. b. attend a workshop on how to deal with difficult people. c. decide to give the position 3 more months and then leave if things do not improve. d. schedule a series of meetings with staff and the administrator to clarify expectations.

d. schedule a series of meetings with staff and the administrator to clarify expectations.

To satisfy duty of care to a patient, a nurse manager is legally responsible for all of the following except: a. notifying staff of changes to policies related to medication administration. b. scheduling and staffing to ensure safe care. c. delegating in accordance with practice acts. d. supervising the practice of the physician.

d. supervising the practice of the physician.

In a nurse managers' meeting, strategies for ways to help retain staff are discussed. One strategy for assisting nurses in developing collective action skills is: a. accepting the practice of "going along to get along." b. attending as many workshops as practical. c. spending as much time as possible in clinical settings. d. taking the opportunity to work with a mentor.

d. taking the opportunity to work with a mentor.

A key advantage that a charge nurse has in terms of delegating is that: a. clients receive less attention because too many staff make it difficult to coordinate care. b. nurses report less pressure to perform necessary tasks themselves. c. administration can predict overtime more accurately. d. team skills can be used more effectively.

d. team skills can be used more effectively.

"I really wish that my supervisor would realize and acknowledge all the things I do well." In nursing, this has been identified as a problem. Which statement is part of the solution? Focus on: a. new staff. b. care assignments with which the individual is not familiar. c. making corrections. d. the strengths of the individual rather than the weaknesses.

d. the strengths of the individual rather than the weaknesses.

As a nurse manager and the leader of the unit, you are aware of multiple avenues for learning leadership traits. Which avenues would you pursue for learning leadership traits? (Select all that apply.) a. Attending professional conferences b. Reading books on leadership c. Joining professional organizations d. Connecting with other leaders in the organization e. Experiences from new nurses

a. Attending professional conferences b. Reading books on leadership c. Joining professional organizations d. Connecting with other leaders in the organization

What facilitate the development of decision-making skills related to safe patient care for a nurse manager? a. Regular reflection on decisions b. A culture of perfectionism c. Recognition of who should be held responsible for individual errors d. A culture of trust between the staff and you

a. Regular reflection on decisions

You are in the process of designing a patient education program that will provide education and monitoring for patients with hypertension. To support your planning, you draw out and present patient data from: a. a clinical database. b. biomedical technologies. c. e-mail. d. Internet sources.

a. a clinical database.

From the information presented in this chapter, which of the following statements best defines an accomplished team? Effective teams: a. can create a form of synergism in which the outcome is greater than the sum of the individual performances. b. do not necessarily need goals, objectives, vision, and a clearly stated purpose. c. do not always have effective communication patterns. d. may or may not have a clear plan that is followed and revisited and has an ongoing evaluation scheme.

a. can create a form of synergism in which the outcome is greater than the sum of the individual performances.

"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. distancing oneself from work. b. using cognitive reframing to change irrational thoughts. c. refusing a request to sit on a committee to evaluate scheduling software. d. exercising regularly.

a. distancing oneself from work.

The validity of comments and ratings related to performance is enhanced by: a. maintenance of anecdotal notes over the entire evaluation period. b. quantity of information gathered for appraisal purposes. c. agreement of the employee with the ratings and comments. d. whether or not other individuals have contributed to the observations.

a. maintenance of anecdotal notes over the entire evaluation period.

You have hired Chelsea as a new staff member on your unit. Although she is an experienced ICU nurse, this is her first educator role. A month into her new position, she confides that she feels really incompetent in her new position and bursts into tears. Your response is based on application of your understanding of: a. role acquisition. b. role conflict. c. role complexity. d. performance appraisal.

a. role acquisition.

"Georgia Hospital will provide care that is a national example of consumer service" is a: a. vision statement. b. statement of philosophy. c. mission statement. d. rationale for care.

a. vision statement.

Which of the following strategies might be effective in empowering staff? a. Communication book in which new information on policies and processes is communicated and mistakes are highlighted. b. Monthly staff meetings during which a portion of the agenda is devoted to sharing ideas and presentations on best practices for implementation on the unit. c. Once-yearly summative evaluations based on what the manager best likes about the individual. d. Focus on discussion of errors in care with direction as to how errors are to be prevented in the future.

b. Monthly staff meetings during which a portion of the agenda is devoted to sharing ideas and presentations on best practices for implementation on the unit.

Anecdotal notes: a. should be completed only when there are performance concerns. b. can be used to support and justify fairness in termination discussions. c. are unnecessary if the evaluation instrument is thorough. d. need to be completed at the end of a performance period.

b. can be used to support and justify fairness in termination discussions.

To enhance team leadership skills for your team leaders, you arrange opportunities for: a. certification. b. continuing education. c. graduate courses. d. volunteerism.

b. continuing education.

The Emergency Department staff members are concerned that working long hours without rest puts patient safety at risk. One staff member decides that she will risk her job and become a whistleblower. Whistle-blowing is an appropriate recourse when management: a. disregards due process when disciplining a nurse. b. delays responding to repeated efforts to provide safe care. c. hires nurses who are not a part of the union during a strike. d. refuses to bargain in good faith with the elected bargaining agent.

b. delays responding to repeated efforts to provide safe care.

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. is natural when assuming a new position. b. diverts energy from internalization of Sarah's new role. c. is justified if practices are deficient on the new unit. d. reflects Sarah's astuteness as a clinician.

b. diverts energy from internalization of Sarah's new role.