Leadership E1

16. What is the primary responsibility of the committee chairperson during a committee meeting? A) Keeping members on task B) Asking questions C) Resolving conflicts D) Providing information on each agenda item

Ans: A Feedback: Although all the items may be something the chairperson does, the primary responsibility is to keep members on task so committee work gets completed.

8. Which statement accurately identifies a concern associated with decentralized staffing? A) It carries risks that employees may be treated unequally or inconsistently B) It uses one individual or a computer to do the staffing C) The manager's role is that of making minor adjustments or providing input D) It provides good control for the organization

Ans: A Feedback: A manager being perceived as granting special treatment to some employees is a risk of decentralized staffing. None of the other options identifies an associated concern.

19. What is the advantage of decentralized scheduling? A) Unit manager understands the needs of the unit and staff intimately B) Employees will be treated equally and consistently C) Manager role is limited to making minor adjustments and providing input D) It allows the most efficient use of resources

Ans: A Feedback: Advantages of decentralized staffing are that the unit manager understands the needs of the unit and staff intimately, which leads to the increased likelihood that sound staffing decisions will be made. In addition, the staff feels more in control of their work environment because they are able to take personal scheduling requests directly to their immediate supervisor. Decentralized scheduling and staffing also lead to increased autonomy and flexibility, thus decreasing nurse attrition.

12. Which characteristics are associated with a constructive culture? 1. Affiliative norms 2. Self-actualization 3. Encouragement of humanism 4. Perfectionist norms A) 1, 2, 3 B) 1, 2, 4 C) 1, 3, 4 D) 2, 3, 4

Ans: A Feedback: Affiliation, self-actualization, and encouragement are all characteristics of a constructive culture, whereas perfectionist norms are a characteristic of destructive organizational cultures.

21. How can the Internet be best used as a means of improving one's personal nursing practice? A) Accessing the latest research and best practice information B) Communicating with other health-care team members C) Minimizing the need for paper documentation D) Securing patient information for confidentially

Ans: A Feedback: As an information source, the Internet allows nurses to access the latest research and best practice information so that their care can be evidence based. The remaining options are not focused on personal nursing practice.

8. An RN is orienting a new graduate nurse to the unit and has found this individual's charting to be inadequate. What is the most appropriate statement to initiate a discussion with the new RN? A) ìTell me in your own words what you intend your charting to convey.î B) ìYour charting is non-descriptive.î C) ìDo you think a refresher course in charting would help you?î D) ìAre you having difficulty assessing your patient?î

Ans: A Feedback: Assertive communication is not rude or insensitive, nor is it passive aggressive.

11. Where did critical pathways originate from? A) Case management B) Functional nursing C) Team nursing D) Primary care nursing

Ans: A Feedback: Critical pathways were developed as a result of the case management system. None of the other options identify that original connection.

7. How does decentralized organizational structure promote decision making? A) Allows problems to be solved at the level at which they occur B) Encourages decisions to be made by top-level hierarchy C) Limits communication to managers at various levels D) Assigns responsibility at the highest practical level

Ans: A Feedback: Decentralized organizational structure allows decision making to be made at the level at which problems occur. None of the other options describes how decentralized organizational structure promotes decision making.

8. Which statement best describes case management? A) Clinical outcomes should occur within a prescribed time frame B) Case managers do not provide direct patient care C) Managed care practice is a unit-based model of care D) The goal is outcome management for every patient

Ans: A Feedback: In case management, clinical outcomes need to occur within prescribed time frames. Case managers do not provide care; neither is managed care unit based. The goal is outcome management for specific patients, but not every patient needs case management.

10. Which statement describes the informal communication referred to as ìthe grapevine? A) Most personnel engaging in the unofficial exchange of information. B) Information exchange is initiated by subordinates and directed upward C) Information is conveyed unofficially by administration through department heads D) The exchange of information initiated by someone in a staff position to someone in a line position

Ans: A Feedback: Informal communication through the ìgrapevineî occurs when most personnel are involved in the unofficial exchange of information. This process is not accurately described by any of the other options.

13. What is needed to change a unit culture that has become firmly entrenched? A) New leadership B) A change agent with management skills C) Identification with a unit that is not entrenched D) Administration support

Ans: A Feedback: It is extremely difficult to change a unit culture without new leadership. The remaining options are directly involved in the change out of entrenchment.

21. What is a leadership role associated with staffing and scheduling? A) Role models the use of evidence in making appropriate staffing and scheduling decisions B) Uses organizational goals and patient classification tools to minimize understaffing C) Periodically examines the unit standard of productivity to determine if changes are needed D) Evaluates scheduling and staffing procedures and policies on a regular basis

Ans: A Feedback: Role modeling is a leadership responsibility. The other options are recognized management responsibilities associated with staffing and scheduling.

3. Which statement accurately reflects self-scheduling? A) Self-scheduling requires greater worker accountability B) The manager has little responsibility in self-scheduling C) Self-scheduling has few or no shortcomings D) Self-scheduling works in most organizations

Ans: A Feedback: Self-scheduling requires greater worker participation in decision making and shared responsibility for adequate staffing. None of the remaining options is accurate.

6. What is the goal of case management? A) Containing health-care costs B) Providing challenging work C) Enhancing professionalism D) Decreasing length of hospital stays

Ans: A Feedback: The ANA maintains that case management is designed to contain health-care costs. None of the other options identify a goal of casement.

18. What is included in an MAP? 1. Critical path 2. Nursing care plan 3. Indication of times when nursing interventions occur 4. Nurses follow the care plan to facilitate expected outcomes A) 1, 2, 3 B) 1, 2, 4 C) 1, 3, 4 D) 2, 3, 4

Ans: A Feedback: The care MAP is a combination of a critical path and a nursing care plan, except that it shows times when nursing interventions should occur as well as variances. All health- care providers follow the care MAP to facilitate expected outcomes.

19. What is the most significant barrier to effective interpersonal communication? A) Incongruence between verbal and nonverbal messages B) Incongruence between telephone and written messages C) Incongruence between verbal and written messages D) Incongruence between telephone and nonverbal messages

Ans: A Feedback: The incongruence between verbal and nonverbal messages is the most significant barrier to effective interpersonal communication.

12. Which assessment must the RN do initially when assigning tasks to non-licensed personnel (NAP)? A) Evaluating the NAP's skills and knowledge level B) Assessing which tasks the NAP is interested in assuming C) Evaluating how patients rate the NAP's performance D) Assessing how team members like working with the NAP

Ans: A Feedback: The manager must be knowledgeable about the skills and knowledge of all members of the health-care team. While the other options are factors regarding general NAP utilization, initially skills and knowledge levels take priority.

13. What is one of the most important differences between case management and disease management? A) Disease management referrals begin in the hospital inpatient setting B) Disease management is a collaborative process to meet patient needs C) High-cost population groups are targeted in disease management D) Disease management treatment is episodic

Ans: C Feedback: Although there are many similarities between disease management and case management, the primary goal of disease management is to target high-cost disease populations.

23. Which action on the part of a manager demonstrates the mark of a great leader? A) Acknowledging the accomplishment of staff members at the unit's staff meeting B) Providing onsite in-services on new equipment for the staff C) Including funds in the unit's budget of staff development D) Stressing the importance of patient safety to all new employees

Ans: A Feedback: The mark of a great leader is when he or she can recognize the excellent performance of someone else and allow others to shine for their accomplishments. While the other options are appropriate, they are not identified as being the mark of a great leader but rather an efficient manager.

16. When was the veteran generation born? A) 1925 to 1942 B) 1943 to early 1960s C) Early 1960s to 1980 D) Late 1970s to 1986

Ans: A Feedback: The veteran generation is typically recognized as those nurses born between 1925 and 1942.

20. An increasingly common staffing and scheduling alternative is the use of supplemental nursing staff such as agency nurses or travel nurses. Which statement is correct about agency nurses or travel nurses? A) Work for premium pay B) Employed directly by the health-care agency C) Result in increased continuity of nursing care D) They receive the standard facility benefits

Ans: A Feedback: These nurses are usually directly employed by an external nursing broker and work for premium pay (often two to three times that of a regularly employed staff nurse), without benefits. While such staff provide scheduling relief, especially in response to unanticipated increases in census or patient acuity, their continuous use is expensive and can result in poor continuity of nursing care.

14. What is the oldest form of organizing patient care that is still widely used today? A) Total patient care B) Functional nursing C) Team or modular nursing D) Primary care nursing

Ans: A Feedback: Total patient care, utilizing the case method of assignment, is the oldest form of patient care organization and is still widely used today.

18. What occurs when a manager has the false assumption that delegation may be interpreted as a lack of ability on the subordinate's part to do the job correctly or completely? A) Underdelegating B) Overdelegating C) Improper delegating D) Inappropriate delegating

Ans: A Feedback: Underdelegating occurs when a manager has a false assumption that delegation may be interpreted as a lack of ability on his or her part to do the job correctly or completely.

2. When does communication have the greatest likelihood of being accurately interpreted? A) More than one mode is used B) Face-to-face communication is used C) Written communication is used D) The sender repeats the message using the same mode

Ans: A Feedback: Using various communication methods in combination increases the likelihood that everyone in the organization who needs to hear the message actually will hear it. The other options are single methods.

17. What was the focus historically for case management? A) Individual patient B) Care for populations C) Group of patients with same chronic illness D) Group of patients with same acute need for surgery

Ans: A Feedback: While the focus historically for case management has been the individual patient, the case manager employed in a disease management program plans the care for populations or groups of patients with the same chronic illness.

5. It is 2 PM. You are calculating the nursing care hours for the 3 to 11 PM shift and must decide whether you need to call in additional help. You have three RNs, three nursing assistants, and one ward clerk scheduled. You have 22 patients with the following acuity and nursing care hours allotted for the evening shift: Category I, 4 patients @ 2.0 hours Category II, 2 patients @ 2.3 hours Category III, 10 patients @ 2.8 hours Category IV, 6 patients @ 3.4 hours What are the needed hours of nursing care? A) 61 hours B) 52.6 hours C) 68.4 hours D) 48.4 hours

Ans: A Feedback: Four category I patients require 8 hours of care; two category II patients require 4.6 hours of care; 10 category III patients require 28 hours; six category IV patients require 20.4 hours; total nursing care hours equal 61.

16. Primary care nursing is organized so that the patient is at the center of the structure. How many nurses have 24-hour responsibility for care planning and coordination? A) One B) Two C) Three D) Four

Ans: A Feedback: Primary care nursing is organized so that the patient is at the center of the structure. One nurse has 24-hour responsibility for care planning and coordination.

16. The Omnibus Budget Reconciliation Act of 1987 established regulations for the education and certification of which health-care worker? A) Nurse aide (NA) B) NAP C) Licensed practical nurse (LPN) D) RN

Ans: A Feedback: Although the Omnibus Budget Reconciliation Act of 1987 established regulations for the education and certification of nurse's aides (minimum of 75 hours of theory and practice and successful completion of an examination in both areas), no federal or community standards have been established for training the more broadly defined NAP. LPNs and RNs are not addressed by this act.

1. Which information is too much in flux to identify on an organizational chart? A) Grapevine lines of communication B) Line and staff authority C) Span of control D) Scalar chains

Ans: A Feedback: The grapevine lines of communication cannot be placed on an organizational chart because they are constantly in flux. The remaining information is stable and so identified on the chart.

25. Which statement is true concerning a bureaucratic organization? A) It is commonly referred to as a line organization B) It is typically found in large health-care organizations C) They resemble Weber's original design of organization D) Its authority is represented by its staff organizational chart

Ans: A, B, C, D Feedback: Bureaucratic organizational designs are commonly called line structures or line organizations. Those with staff authority may be referred to as staff organizations. Both of these types of organizational structures are found frequently in large health-care facilities and usually resemble Weber's original design for effective organizations. Because of most people's familiarity with these structures, there is little stress associated with orienting people to these organizations.

7. Which statement describes assertive communication? A) It makes you respect yourself and allows you to get what you want B) Although it is unfeminine, it is a necessary communication skill for female managers C) It involves rights and responsibilities for all parties in the communication D) Assertive communication will never offend anyone

Ans: C Feedback: Assertive communication allows people to express themselves in direct, honest, and appropriate ways that do not infringe on another's rights. The remaining statements do not correctly describe assertive communication.

23. Which statement demonstrates an understanding of the factors that are considered when a change in the care delivery system is being proposed? Select all that apply. A) We have determined that our level of care would improve if we provided it differently. B) It's questionable whether our current nursing staff is large enough to support the proposed change. C) We will discuss our proposed change with the multidisciplinary team members. D) Administration has been supportive of the planned change in our care delivery system.

Ans: A, B, C, D Feedback: If evaluation of the present system reveals deficiencies, the manager needs to examine available resources and compare those with resources needed for the change. There must be a commitment on the part of top-level administration and a majority of the nursing staff for a change to be successful. Because health care is multidisciplinary, the care delivery system used will have a heavy impact on many others outside the nursing unit; therefore, those affected by a system change must be involved in its planning. The philosophy of the nursing services division must support the delivery model selected. Changing the philosophy is not appropriate.

24. When considering the interprofessional approach to healthcare, to whom does the nurse owe accountability? A) The physician B) Their patients C) Their unit manager D) Their director of nursing

Ans: A, B, C, D Feedback: Nurses frequently feel as though they have many individuals to account to because health care often involves an interprofessional approach. Additional individuals the nurse may need to be accountable to may include the immediate supervisor, the patient, the patient's family, central administration, and the physician. The nurse has no accountability to other nurses in this situation.

21. Which component is considered a part of an organizational structure? Select all that apply. A) Group formation B) Lines of communication C) Decision-making process D) Channels of legitimate authority

Ans: A, B, C, D Feedback: Organizational structure refers to the way in which a group is formed, its lines of communication, and its means for channeling authority and making decisions.

25. Which external and internal forces must a manager adjust for when implementing the PCSs associated with unit staffing? Select all that apply. A) Presence of nursing students on the unit B) The hiring of two graduates as staff C) The increase of scheduled medical students D) Language barriers presented by nursing staff

Ans: A, B, C, D Feedback: Regarding PCS, the middle-level manager must be alert to internal or external forces affecting unit needs that may not be reflected in the organization's patient care classification system. Examples of such forces could be a sudden increase in nursing or medical students using the unit, a lower skill level of new graduates, or cultural and language difficulties of recently hired foreign nurses. The organization's classification system may prove to be inaccurate, or the hours allotted for each category or classification of patient may be inaccurate (too high or too low). An anxious patient is not a force that should affect the staffing process.

24. Which concept should a care delivery system support? Select all that apply. A) Organization B) Nursing process C) Cost effectiveness D) Patient satisfaction

Ans: A, B, C, D Feedback: Each unit's care delivery structure should facilitate meeting the goals of the organization, be cost-effective, satisfy the patient, provide role satisfaction to nurses, allow implementation of the nursing process, and provide for adequate communication among health-care providers. While important, nursing research is not a concept that is considered when selecting a care delivery system.

20. What is the positive patient outcome during a single shift of case method nursing? Select all that apply. A) Clear lines of responsibility B) Nursing autonomy C) Holistic patient care D) Unfragmented care

Ans: A, B, C, D Feedback: This method of assignment is still widely used in hospitals and home health agencies. This organizational structure provides nurses with high autonomy and responsibility. Assigning patients is simple and direct and does not require the planning that other methods of patient care delivery require. The lines of responsibility and accountability are clear. The patient theoretically receives holistic and unfragmented care during the nurse's time on duty. To maintain quality care, this method requires highly skilled personnel and thus may cost more than some other forms of patient care.

24. Which statement is true regarding the float pool nurse? Select all that apply. A) They are classified as per-diem staff B) The nurse trades increased personal flexibility for less pay C) Float pool nurses do not receive usual staff benefits D) They are crossed trained on multiple units

Ans: A, D Feedback: Some hospitals have created their own internal supplemental staff by hiring per-diem employees and creating float pools. Per-diem staff generally have the flexibility to choose if and when they want to work. In exchange for this flexibility, they receive a higher rate of pay but usually no benefits. Float pools are generally composed of employees who agree to cross-train on multiple units so that they can work additional hours during periods of high census or worker shortages. Float pools are adequate for filling intermittent staffing holes but, like agency or registry staff, they are not an answer to the ongoing need to alter staffing according to census since they result in a lack of staff continuity.

5. What is the first step the manager takes when a subordinate is having difficulty carrying out a delegated task? A) Take over the task so the employee will not become demoralized B) Be available to the employee as a role model and resource for the task C) Assign another more experienced employee to help with the task D) Re-assign the employee a different, less complex task

Ans: B Feedback: A manager should be available to the employee to help identify solutions to problems encountered with a delegated task and should encourage the employee to persevere. Taking back a task that was originally delegated is an absolute last resort. Reassigning and co-assigning the task are options that are not initially considered.

3. Which statement concerning nonverbal communication is true? A) It is consistent across cultures B) It is given more credence than verbal communication when the two are incongruent C) It should be minimized because it confuses the receiver regarding the true intent of the message D) It is a significant part of the communication exchange only when it is not congruent with the verbal exchange

Ans: B Feedback: Because nonverbal communication indicates the emotional component of the message, it is generally considered more reliable than verbal communication. None of the remaining options present true statements regarding nonverbal communication.

22. Which statement demonstrates an intervention focused on the primary disadvantage of team nursing? A) We are working with 1 fewer team members today. B) The team will be meeting for a care report update in 5 minutes. C) Our patient assignment is comprised of both males and females D) We will be having a member of the float pool on our team today.

Ans: B Feedback: Disadvantages to team nursing are associated primarily with improper implementation rather than with the philosophy itself. Frequently, insufficient time is allowed for team care planning and communication. This can lead to blurred lines of responsibility, errors, and fragmented patient care. None of the other options address a known disadvantage of team nursing.

22. Which characteristic is most important when the nurse-manager is considering staff for a delegated role? A) Years of experience B) Willingness to grow professionally C) Aversion to risk taking D) Previous experience with similar tasks

Ans: B Feedback: Identify which individuals can complete the job in terms of capability and time to do so. Remember that it is a leadership role to stretch new and capable employees who want opportunities to learn and grow. Also look for employees who are innovative and willing to take risks. It is also important that the person to whom the task is being delegated considers the task to be important. Years of experience and exposure to similar tasks are not as important as interest in professional growth.

17. What is the leadership role when a unit is attempting to overcome the decentralization of patient care? A) Determining what changes will be made to the plan of care B) Facilitating the group's work C) Identifying the patient care problems D) Selecting solutions to problems

Ans: B Feedback: In a patient-centered focused activity, the team leader should facilitate the work of the group and should not be the sole decision maker.

9. What is necessary when implementing care multidisciplinary action plans (MAPs)? A) Caregivers alter the plan as they deem necessary B) Variances be indicated for patient deviations C) Time frames for implementation be left open D) Critical paths not be considered in care planning

Ans: B Feedback: In care MAPs, it is necessary to provide variances when there are patient deviations, because this is a major component to case management. None of the other options identify that connection.

3. A nurse has accepted a position as a staff nurse and will practice primary care nursing. The nurse will be the only RN on the team. What is an appropriate role expectation for role fulfillment? A) Planning nursing care independently of others B) Assigning work according to the expertise of group members C) Being responsible for care planning 24 hours a day D) Carrying out the majority of personal care for your patients

Ans: B Feedback: In primary nursing, the sole RN would not plan the care without others' input or be responsible for care planning for 24 hours. Neither would the RN carry out the majority of personal care.

15. What occurs during implementation of a shared governance model? A) Lines of authority are altered B) Joint practice committees are formed C) Participatory management is initiated D) The roles of first-level managers are stabilized

Ans: B Feedback: In shared governance, the organization's governance is shared among board members, nurses, physicians, and management. Joint practice committees are developed to assume the power and accountability for decision making, and professional communication is egalitarian rather than hierarchical. Shared governance is not associated with the other options.

6. Which behaviors would be associated with a group in the ìnormingî stage? A) Group members actively attempt to impress each other with their credentials B) Group members establish short- and long-term goals for the group to accomplish C) Group members achieve stated goals D) The group terminates and celebrates its accomplishments

Ans: B Feedback: In the norming stage, consensus evolves as group cohesion develops. This is the only option that describes a behavior associated with a group's norming stage.

3. What is the most important consideration for the manager when identifying the appropriate person to whom to delegate a specific task? A) Whose turn it is to delegate a task B) The qualifications of the person regarding the task C) The fiscal cost of delegating the task D) Whether the person has experience with similar tasks

Ans: B Feedback: Managers should ask the individuals to whom they are delegating if they are capable of completing the delegated task.

2. Max Weber, as part of the scientific management era, contributed immensely to the development of organizational theory. Which statement is NOT representative of his beliefs? A) Bureaucracy could provide a rational basis for administrative decisions B) Worker satisfaction was integral to productivity C) Organization charts could depict the hierarchy of authority D) Impersonality of interpersonal relationships should exist in organizations

Ans: B Feedback: Max Weber's theories did not address worker satisfaction. The other options do represent the Weber organizational theory.

5. The hospital is facing low census and downsizing. However, the RNs have been assured that everyone on the unit will keep their jobs and downsizing will occur through normal attrition and voluntary absences without pay. Today, the evening charge nurse reported that last evening the staff was discussing various rumors about mass layoffs. What is the best approach to take? A) Tell an informal leader on the evening shift the truth and let the leader spread the news informally B) Hold a meeting for all staff members and tell them that the rumor is not true C) Ignore the rumor because it will soon pass D) Find out who started the rumor and correct the information

Ans: B Feedback: Nurse-leaders should intervene appropriately when communication problems (in this case, rumors) arise. The remaining options fail to fulfill that responsibility as effectively as the correct option does.

14. Which would suggest that flattening of the organization is occurring? A) There is a collective spirit B) There is reduction in the administration levels C) There are shared work goals across units D) There are formal and informal systems are in place to address conflicts

Ans: B Feedback: Reducing the numbers of administration levels is called flattening the organization. The remaining options are not related to organizational flattening.

20. Which method best provides a structured orderly approach to communicating accurate, relevant information, in emergent patient situations as well as routine handoffs? A) GRRRR listening model B) SBAR tool C) Hospital information system D) Wireless, local area networking

Ans: B Feedback: SBAR provides a structured, orderly approach to provide accurate, relevant information, in emergent patient situations as well as routine handoffs. The other options are not as focused on providing information in all the described situations.

23. Which nursing action demonstrates compliance with the American Nurses Association (ANA) principles for social networking by nurses? A) Strictly avoiding the use of social networking in a professional setting B) Participating in the development of institutional policies governing online conduct C) Ignoring any information that appears to have the potential to harm a patient's welfare D) Realizing that social networking is not related to a nurse's professional boundaries

Ans: B Feedback: The ANA has developed principles for social networking that include participation in policy development, nurse patient boundaries, separating personal and professional online information, and reporting to authorities when patient welfare has been potentially harmed.

23. Since 2008 what is the legal minimum staffing radios for a medicalñsurgical nursing unit? A) 1:4 B) 1:5 C) 1:6 D) 1:7

Ans: B Feedback: The expected legal ratio is 1:5.

22. What is an institutional grapevine? A) Organizational gossip B) An informal channel of communications C) An institution's informal authority chain D) The connecting format used on an organizational chart

Ans: B Feedback: The informal structure also has its own communication channels, often referred to as the grapevine. None of the remaining options accurately describes an organizational grapevine.

6. What is the priority goal for a manager with regard to staffing and scheduling? A) Schedule staff so there is no overtime B) Ensure that there is adequate staff to meet the needs of each patient C) Develop trust in staff by seeing that staffing is carried out in a fair manner D) Ensure that staff members usually have days off and special requests granted

Ans: B Feedback: The manager is tasked with seeing that patient care needs are met first and foremost. While the other options are relevant, they are not the priority goal of the manager.

11. What does the term optimum span of control mean? A) It defines the manager's decision-making authority B) It identifies the manager's abilities and responsibilities C) It refers to a line-and-staff organizational structure model D) It is the number of subordinates and manager is responsible for

Ans: B Feedback: The number of people directly reporting to any one manager represents that manager's span of control and determines the number of interactions expected of him or her. None of the remaining options correctly describes this term.

22. Which behavior by a team member is demonstrated through cynicism and a nonchalance attitude about the group's work? A) Blocker B) Playboy C) Dominator D) Recognition seeker

Ans: B Feedback: The playboy remains uninvolved and demonstrates cynicism, nonchalance, or horseplay. The blocker persists in expressing negative points of view and resurrecting dead issues. The dominator attempts to control and manipulate the group while the recognition seeker works to focus positive attention on himself.

14. There are advantages and disadvantages to each type of scheduling. What is true about extending the workday with 10- or 12-hour shifts? 1. Requires overtime pay 2. Increases nurse satisfaction 3. Decreases cost 4. Increases judgment errors A) 1, 2, 3 B) 1, 2, 4 C) 1, 3, 4 D) 2, 3, 4

Ans: B Feedback: There are advantages and disadvantages to each type of scheduling. Twelve-hour shifts have become commonplace in acute care hospitals even though there continues to be debate about whether extending the length of shifts results in increased judgment errors related to fatigue. Because extending the workday with 10- or 12-hour shifts may require overtime pay, the resultant nurse satisfaction must be weighed against the increased costs.

12. What nursing model provides the foundation for matching patient needs with nursing competencies? A) Primary nursing practice B) Differentiated nursing practice C) Modular nursing D) Case management

Ans: B Feedback: To facilitate the effective use of nursing resources, patient needs and nursing competencies should be matched. None of the other options identify that connection.

7. Which is the most accurate statement regarding staffing and scheduling policies? A) It is more important to communicate policies verbally than in writing B) It is necessary that policies are written in a manner that allows some flexibility C) Policies should focus on the process D) Managers should have autocratic control over scheduling and staffing policies

Ans: B Feedback: To retain employees, the staffing policies must allow some flexibility, which could include job sharing, flextime, a part-time staffing pool for weekends, or allowing employees to exchange hours of work among themselves.

11. What term identifies a system that allows employees to select among variations in work start-time schedules to meet their personal needs? A) Self-scheduling B) Flextime C) Decentralized staffing D) Cyclical staffing

Ans: B Feedback: When a hospital uses flextime, employees arrive at the unit and leave at many different times. The other options are not associated with the system described.

10. Which term is used to identify having official power to act? A) Responsibility B) Authority C) Accountability D) Leadership

Ans: B Feedback: Authority means having the official power to act. None of the other terms is used to identify having official power to act.

16. What is the traditional form of communication in organizations that helps to coordinate activities in various levels of the hierarchy? A) Upward B) Downward C) Horizontal D) Diagonal

Ans: B Feedback: In downward communication, the manager relays information to subordinates. This is a traditional form of communication in organizations and helps to coordinate activities in various levels of the hierarchy. The other forms are not as effective as the various levels of an organization's hierarchy.

2. What is a common cause of a manager to underdelegation? A) A high degree of trust in subordinates B) A democratic leadership style C) A need for perfectionism D) Sufficient time to accomplish unit goals alone

Ans: C Feedback: A manager with a need for perfectionism and control may believe that another person will not complete a task. Trust in subordinates and a democratic leadership style would support effective delegation. Delegating should not be based on the issue of time exclusively.

1. What is the most fiscally responsible method for determining staffing needs for a hospital unit? A) Maximum patient load capacity of the unit B) Numbers of patients present for an upcoming shift C) An agreed-upon staffing formula currently in use D) Total beds on the unit

Ans: C Feedback: A staffing formula is the best way to determine staffing needs, provided it is based on an accurate patient classification system (PCS). The remaining options are not as fiscally responsible since they involve uncontrollable factors.

9. The RN overhears the nurses' aide speaking in a harsh tone to Mrs. Smith, who has some early Alzheimer's memory loss. Which statement will the RN make to begin addressing this issue? A) ìYou must remember to watch your tone of voice with patients. Someone might overhear.î B) ìDo you think it would be a good idea to have an in-service on dealing with Alzheimer's patients?î C) ìI am concerned about your conversation with Mrs. Smith. It seemed short and impatient.î D) ìI have decided to reassign Mrs. Smith to another aide.î

Ans: C Feedback: Assertive communication effectively identifies and addresses an issue without being rude, insensitive, or passive aggressive. None of the remaining options actually identifies the communication problem.

15. What location of the SBAR charting tool states the patient's problem? A) Situation B) Background C) Assessment D) Recommendation

Ans: C Feedback: Assessment is where the nurse states the patient's problem. The problem is not documented in any of the other SBAR locations.

8. Which statement about organizational centrality is true? A) It refers to the decision-making structure in an organization B) It occurs when there is consonance of subunit cultures in the organization C) It is a position on the organizational chart where types of communication occur D) It occurs primarily in line relationships

Ans: C Feedback: Centrality is a position on an organizational chart where it is possible to have many different types of communication (upward, downward, lateral, and diagonal). The other statements do not describe organizational centrality accurately.

19. During a strategic planning committee meeting to develop futuristic technology goals, several unit managers spend a considerable amount of time discussing current staffing problems. What is the primary action of the chairperson of this committee? A) Take the remainder of the meeting time to discuss staffing with all members B) Adjourn the meeting and reschedule at a time when there are no staffing problems C) Request that committee members return to discussing items on the agenda D) Excuse those discussing staffing from the remainder of the meeting

Ans: C Feedback: Committee time is wasted when agendas are not adhered to. The remaining options do not address the issue of wasted time effectively.

23. Research supports that organizational restructure affects nursing in what manner? A) It decreases nursing autonomy B) It decreases nursing's formal authority C) It increases the effectiveness of patient care D) It increases patient autonomy

Ans: C Feedback: Current research suggests that changing an organization's structure in a manner that increases autonomy and work empowerment for nurses will lead to effective patient care. The remaining options failed to describe the research supported effect of organizational restructure on nursing.

7. Which action is considered a leadership role associated with delegation? A) Creating job descriptions for all personnel B) Providing formal recognition or reward for completion of delegated tasks C) Demonstrating sensitivity to how cultural phenomena affect transcultural delegation D) Reprimanding employees who demonstrate overt resistance to the tasks they are delegated

Ans: C Feedback: Factors such as communication, space, social organization, timing, environmental control, and biologic variations affect delegation to a culturally diverse staff and should be modeled as a leadership role. The other choices are all management functions.

1. Which statement best describes functional nursing care delivery? A) Nursing care is holistic and patient centered B) The nurse must be a licensed person C) Emphasis is on getting work done through tasks D) It is also known as total patient care

Ans: C Feedback: Functional nursing is task focused. None of the other options identify that connection.

17. What generational work group values the more flexible part-time and 12-hour shift options? A) Veteran generation B) Baby boomer C) Generation X D) Generation Y

Ans: C Feedback: Generation Xers (born between 1961 and 1981), a much smaller cohort than the baby boomers who preceded them, or the Generation Yers who follow them, may lack the interest in lifetime employment at one place that prior generations have valued, instead valuing greater work hour flexibility and opportunities for time off.

4. Which situation presents an example of inappropriate delegation? A) Temporary authority is given to support completion of a delegated task B) The person to whom a task is delegated considers it a challenge C) The employee is given exact instructions on completing the task D) Regular updates on the task are exchanged with the manager and the employee

Ans: C Feedback: If an employee has the skills necessary to complete a task, that employee should be able to carry out the task with autonomy and be provided with the authority and resources necessary. Depending on the complexity of the project, the manager should meet with the employee for updates. One of the goals of delegation is to challenge employees into learning new skills.

24. Which statement by the nurse-manager demonstrates an understanding of the need to provide effective guidance to those a project has been delegated? A) Don't be afraid to let me know if you feel the project is overwhelming you. B) What do you suggest we do to address the problems that exist with the project? C) I can give you a few solutions for the issues you have been having with the project. D) Do you want more time to complete the project?

Ans: C Feedback: If the worker is having difficulty carrying out the delegated task, the leader-manager should be available as a role model and resource in identifying alternative solutions. Leaders should encourage employees, however, to attempt to solve problems themselves first, although they should always be willing to answer questions about the task or to clarify desired outcomes as necessary. Suggesting solutions or removing the person from the task prematurely does not demonstrate an understanding of effective guidance.

4. Which is an outcome of decentralized staffing? A) Increased fairness to employees through consistent, objective, and impartial application B) Cost-effectiveness through better use of resources C) Greater manager autonomy to control the staffing on the units, resulting in an increase in self-esteem and teamwork D) Increased availability of data for monitoring the effect of staffing size and composition, quality of care, and costs

Ans: C Feedback: In an institution that has no human resources department and no nurse recruiters, the unit manager does the hiring and has greater autonomy in personnel matters. The other options are not associated with decentralized staffing.

18. What must staff and scheduling policies not violate? 1. Local laws 2. Labor laws 3. State or national laws 4. Union contracts A) 1, 2, 3 B) 1, 2, 4 C) 1, 3, 4 D) 2, 3, 4

Ans: D Feedback: Staffing and scheduling policies must not violate labor laws, state or national laws, or union contracts.

25. When a manager appropriately recognizes the successful completion of a delegated team task, what is the primary reward for the manager? A) Less involvement in uncomplicated tasks B) A staff that is familiar with team-related delegated tasks C) Professional recognition as a leader D) Staff that is growing as professional caregivers

Ans: C Feedback: Leaders are often measured by the successes of those on their teams. Therefore, the more recognition team members receive, the more recognition will be given to their leader. Spending less time on uncomplicated tasks is not the primary gain for the nurse- manager. It is the staff that benefit from the exposure to team work and professional growth.

13. Which task would the director of a home health agency not delegate another staff RN? A) Assigning home health aides to specific patient care B) Serving on a diabetic study committee of community resources C) Meeting with the agency's administration regarding budget cuts D) Reviewing staff time cards for completion and accuracy

Ans: C Feedback: Management responsibilities associated with budgeting would not be delegated to another RN on the staff. The other options could be appropriately delegated to another RN.

15. What must managers delegate to another RN in order to assure completion of a task? A) Time and space B) Leadership and creativity C) Authority and responsibility D) Personnel and knowledge

Ans: C Feedback: Managers must delegate the authority and the responsibility necessary to complete the task. Nothing is more frustrating to a creative and productive employee than not having the resources or authority to carry out a well-developed plan. Qualities like leadership, knowledge, and creativity are not transferable. The remaining option choices are resources that are provided rather than delegated.

14. What is important to remember about gender differences in communication? A) Men are more collaborative communicators B) It rarely impacts nursing care C) It affects the quality of organization communication D) Women are more competitive communicators

Ans: C Feedback: Men are usually more competitive and less collaborative than women in their communication patterns, and differences often impact the quality of organization communication.

15. What type of nursing uses mini teams, typically an RN and unlicensed health-care workers, to provide care to a small group of patients who are centralized geographically? A) Total patient care B) Functional nursing C) Modular nursing D) Primary care nursing

Ans: C Feedback: Modular nursing and model RN line use mini teams, typically an RN and unlicensed health-care worker(s), to provide care to a small group of patients, centralized geographically. None of the other options provide that staffing format.

6. What statement concerning the delegating of tasks by the nurse to unlicensed assistive personnel (NAP) is true? A) One can safely assume that the NAP has at least a high school diploma as a minimum hiring criterion B) All unlicensed assistive personnel have achieved at least minimum standardized training pursuant to the Omnibus Budget Reconciliation Act of 1987 C) No federal or community standards have been established for training the broad classification of NAP D) The nurse is protected from liability when allowing the NAP to perform only those tasks the employee includes in the job description

Ans: C Feedback: No federal or community standards have been established for the training of the NAP. The Omnibus Budget Reconciliation Act relates to certified nursing assistants only. The hiring policies of institutions vary regarding the employment qualifications of the NAP and many institutions do not have distinct job descriptions for NAP that define their scope of practice.

20. Which restraining force occurs when a subordinate tests the water to determine what the consequences are of not completing a delegated task? A) Failure of delegator to see subordinate perspective B) Subordinate incapable of completing the task C) Subordinate inherent resistance to authority D) Overdelegation of specificity of the task

Ans: C Feedback: One cause of subordinate resistance to delegation is an inherent resistance to authority. Some subordinates simply need to test the water and determine what the consequences are of not completing delegated tasks. The remaining options do not represent the behaviors described.

5. Which statement is correct concerning primary nursing care? A) Requires minimal RN staffing B) Is easy to implement C) Provides challenging work D) Has proved to be a failure

Ans: C Feedback: Primary care provides challenging work for nurses; however, it is not easy to implement and requires an all-RN staff. None of the other options accurately describes the concept of primary nursing care.

8. Which statement is true regarding the general delegation liability of the registered nurse (RN)? A) It is minimal because subordinates alone are held accountable for practicing within the accepted scope of practice for their job classification B) It is great because the RN is automatically held liable for the tasks delegated to all recognized subordinates C) It is reduced when the RN appropriately assesses what and to whom delegation is appropriate and supervises the completion of the tasks D) It is avoided entirely by delegating tasks to only other licensed personnel

Ans: C Feedback: Proper delegation practices that include assessment and evaluation help protect the RN from liability. The other statements are not true.

17. What portion of GRRRR (greeting, respectful listening, review, recommend or request more information, and reward) is being used when the speaker summarizes the information conveyed to make sure the message was understood correctly? A) Greeting B) Respectful listening C) Review D) Recommend or request more information

Ans: C Feedback: Review occurs when the speaker summarizes the information he/she has conveyed to make sure the message was understood correctly. Once the speaker is finished conveying this summary and the other party has validated or clarified it, the listener has enough information to recommend or request more information. This does not occur in any of the other portions of the model.

13. Which statement is true regarding legislated minimum staffing ratios? A) They are mandated by federal law B) They are required by 28 states C) They are proposed to improve patient care D) They are necessary to reduce costs

Ans: C Feedback: Several states have proposed or passed mandatory staffing ratios for the purpose of improving patient care, although there is no guarantee improved care will result from such legislation. None of the other options are associated with minimum staffing ratios.

10. Which is a true statement about the patterns of patient care management? A) Functional nursing is organized according to the desires of the worker B) Primary nursing and total patient care are synonymous C) Team leading includes the concept of patient care conferences D) Case load nursing provides little autonomy for nurses

Ans: C Feedback: Team leading includes the need for patient care conferences. None of the other options identify that need.

1. What is an inappropriate reason for delegation? A) To empower subordinates by stretching them in their work assignment B) To free the manager to address more complex, higher-level unit needs C) When the task is not a challenge for the manager D) Because someone else is better qualified to do the task that needs to be done

Ans: C Feedback: That the manager is not challenged by a task is not a valid reason for delegating that task to another. The other options are all appropriate reasons to delegate tasks to qualified staff.

1. What is the best combination that characterizes the communication process? A) Sender receiver message B) Receiver message sender C) Sender message receiver D) Message sender receiver

Ans: C Feedback: The combination that best characterizes the communication process is sender message receiver. The other options would result in the likelihood of miscommunication.

21. What is the primary outcome resulting from the implementation of the functional nursing care delivery system? A) A cost-effective method of care delivery B) Another permanent care delivery option C) Ancillary staff with varying levels of training and education D) A care delivery system addressing the needs of the baby boom patient

Ans: C Feedback: The employment of personnel with various levels of skill and education proliferated as new categories of health-care workers were created. Currently, most health-care organizations continue to employ health-care workers of many educational backgrounds and skill levels. None of the other options represent a primary outcome of resulting from the implementation of functional nursing.

12. Regarding group building, what is the responsibility of the gatekeeper? A) Mediating, harmonizing, and resolving conflict B) Accepting and praising the contributions and viewpoints of group members C) Facilitating and promoting open communication of all group members D) Recording the group's process and providing feedback to the group

Ans: C Feedback: The gatekeeper makes sure all voices in the group are heard in order to facilitate and promote open communication. The role of gatekeeper is not accurately described by any of the other options.

9. What outcome is associated with a good PCS? A) It eliminates most staffing problems B) It decreases the amount of overtime C) It provides an understanding of staffing problems D) It eliminates the need for adjustment or review

Ans: C Feedback: The main strength of the PCS is that it provides data with which to make staffing decisions. It will not solve all staffing problems, and it will not replace a manager's judgment.

4. An RN is a team leader for a small module of patients. While listening to a tape- recorded report on Mr. Smith, one of your team members remarks, ìMy mother lives near him and she says his wife is a terrible housekeeper.î As the leader of the team, what will the RN do? A) Ask the informant to be quiet B) Include the information in report for the next shift C) Ask the team member what the purpose was in sharing the information D) Ignore the comment

Ans: C Feedback: The role of the leader is to encourage communication that is appropriate and discourage communication that is inappropriate among staff. The other options fail to convey that responsibility.

4. With modular nursing, who checks the completion of tasks assigned to a team member? A) The charge nurse B) The area manager C) The team leader D) Another team member

Ans: C Feedback: The team leader should check the work of team members. None of the other options identify the role correctly.

10. Periodically during the day the RN checked with the team members to determine whether they are having difficulty completing their assigned tasks. This describes which manager role? A) Skills evaluation B) Patient safety C) Effective delegation D) Micromanagement

Ans: C Feedback: This manager provided the team with the autonomy to complete the work and was available should any need arise. This describes effective delegation. This action is not related to any of the other options.

5. What does the term unity of command mean? A) The number of individuals directly reporting to a manager B) Having a limited number of top-level managers C) Each employee having only one boss D) A flexible structure that encourages participative decision making

Ans: C Feedback: Unity of command means one immediate boss per employee. None of the other options correctly describes the term unity of command.

7. What is the most important component in being well organized and increasing productivity on the unit? A) Adequate resources B) A well-trained staff C) A well-thought-out plan D) Time to carry out your duties

Ans: C Feedback: Unless the plan is well thought out, patient care has the potential to be disorganized. None of the other options identify that connection.

24. Which vocal delivery suggests that a person is asking a question rather than making a statement? A) Loudness B) Slurred words C) Tentativeness D) Rapid delivery

Ans: C Feedback: Vocal clues such as tone, volume, and inflection add to the message being transmitted. Tentative statements sound more like questions than statements, leading listeners to think that you are unsure of yourself, and speaking quickly may be interpreted as being nervous. Loud and slurred speech can be barriers to communication.

21. Which factor has the greatest impact on the need for nurses to possess excellent delegation skills? A) Increase in patient acuity levels B) Decrease in patient hospitalization time C) Increase in the use of NAP D) Decrease in nurse-to-patient ratios

Ans: C Feedback: With the increased use of NAP in patient care, the need for nurses to have highly developed delegation skills has never been greater. The impact of acuity levels, nurse-patient ratios, and hospitalization stays does not have as great an impact as does the correct option.

18. What communication mode is considered most reliable in conveying the emotional component of the message? A) Written B) Verbal C) Nonverbal D) Telephone

Ans: C Feedback: Nonverbal communication is considered more reliable because it conveys the emotional part of the message. The other modes are not as effective with conveying emotion.

22. What is an advantage of centralized staffing? Select all that apply A) It is flexible B) It is staff focused C) It is cost-effective D) It is consistent and impartial

Ans: C, D Feedback: Centralized staffing is generally fairer to all employees because policies tend to be employed more consistently and impartially. In addition, centralized staffing frees the middle-level manager to complete other management functions. Centralized staffing also allows for the most efficient (cost-effective) use of resources because the more units that can be considered together, the easier it is to deal with variations in patient census and staffing needs. Centralized staffing, however, does not provide as much flexibility for the worker, nor can it account as well for a worker's desires or special needs. In addition, managers may be less responsive to personnel budget control if they have limited responsibility in scheduling and staffing matters.

9. Which is a symptom of poor organizational structure? A) Communication follows the chain of command B) The smallest possible number of managers exists to keep units functioning C) The chain of command is fairly short D) There is a heavy reliance on committees to solve unit problems

Ans: D Feedback: A heavy reliance on committees to solve problems is an indication of a poorly structured organization and often results in delays in critical decision making. The other options describe examples of good organizational structure.

15. What occurs when RN hours decrease in a unit's calculation of nursing care hours per patient day (NCH)/(PPD)? A) Adverse patient outcomes generally increase B) Decreased errors C) Decreased patient falls D) Decreased patient satisfaction

Ans: D Feedback: A review of current literature suggests that as RN hours decrease in NCH/PPD, adverse patient outcomes generally increase, including increased errors and patient falls as well as decreased patient satisfaction.

12. Which statement is correct concerning prenegotiated budget management? A) It is incompatible with ethical accountability B) It is only the responsibility of the centralized staffing office C) It is inappropriate with new practice models D) It is a critical responsibility of managers

Ans: D Feedback: Accountability for a prenegotiated budget is a management function. The other options are incorrect regarding this function.

10. What positive impact do new practice models have on the staffing mix? A) Automatically cancel the PCS B) Will result in fiscal savings C) Require no changes in scheduling policies D) Impact patient care assignment methods

Ans: D Feedback: As new practice models are introduced, there must be a simultaneous examination of the existing staff mix and patient care assessments to ensure that appropriate changes are made to the staffing and scheduling policies. They are not associated with the impact suggested by the other options.

2. The nurse is assigned to administer medications to all patients throughout the shift. What is this an example of? A) Team nursing B) Case method nursing C) Primary care delivery D) Functional nursing care

Ans: D Feedback: Being assigned a specific task to do is part of functional nursing. None of the other options identify that connection.

13. What statement about the maintenance of confidentiality is true? A) It must never be breached B) It is made easier with electronic technology C) It is primarily the duty of the medical records staff D) It can be breached when necessary for legitimate professional need

Ans: D Feedback: Confidentiality of patients must be upheld, unless there is a legitimate professional need to know, such as when a provider must share information about a patient with another provider so that the other provider can assume care. None of the other options is an accurate statement regarding confidentiality.

4. Which statement is true regarding depiction of staff positions on an organizational chart? A) They are depicted as unbroken lines B) They are represented by double dotted lines C) They are shown as a solid, vertical line D) They are identified with a dotted line.

Ans: D Feedback: Dotted or broken lines on the organization chart represent staff positions. Formal relationships, lines of communication, and authority are depicted on a chart by unbroken (solid) lines. Double dotted lines are not generally used on an organizational chart.

2. Which statement about PCSs is accurate? A) Classification systems are able to solve staffing problems B) Nursing care hours assigned to a classification system should remain constant C) A good classification system is without fault D) Internal and external forces may affect classification systems

Ans: D Feedback: Examples of internal and external forces that may affect a PCS are a sudden increase in nursing or medical students using the unit, a lower skill level of new graduates, or cultural or language difficulties of recently hired foreign nurses. None of the remaining options is totally accurate because of uncontrollable factors.

20. Which characteristics are associated with Magnet hospital status? 1. Centralized environment 2. Open, participatory management 3. Improved patient outcomes 4. Higher staff nurse satisfaction A) 1, 2, 3 B) 1, 2, 4 C) 1, 3, 4 D) 2, 3, 4

Ans: D Feedback: Magnet designation is conferred by the ANCC to health-care organizations exemplifying well-qualified nurse executives in a decentralized environment, with organizational structures that emphasize open, participatory management. Magnet- designated organizations demonstrate improved patient outcomes and higher staff nurse satisfaction than organizations that do not have Magnet status.

6. Which position is characteristic of a middle-level manager? A) Primary care nurse B) Team leader C) Charge nurse D) Nursing supervisor

Ans: D Feedback: Nursing supervisors are middle-level managers. All the others are first-level managers.

11. Which statement regarding a memo is true? A) A memo makes it main point at least twice B) A memo is written using an authoritative format C) Headings are not used in a memo to avoid confusing the reader D) Only essential information is included in a memo

Ans: D Feedback: Only essential information is included in a memo since extraneous information will detract from the message. None of the other options presents correct information concerning a memo.

3. Which statement concerning organizational culture is true? A) It presents how employees perceive an organization B) It defines how power is used by organizations to direct the work of others C) It describes the predictable stages of group and organizational development D) It is a system of symbols, beliefs, values, history, and communication patterns

Ans: D Feedback: Organizational culture is the symbols and beliefs, values, history, and communication patterns of the organization. It differs from organizational climate, which is how the employees perceive the organization. The other options are not relevant to the term organizational culture.

14. Which organization is actively engaged in clarifying the delegation parameters for RNs? A) American Hospital Association (AMA) B) The federal government C) National League for Nursing (NLN) D) State Boards of Nursing Licensure

Ans: D Feedback: State Boards of Nursing Licensure is responsible for clarifying the delegation parameters for RNs. None of the other options are involved in this process.

9. What managerial action is important when supporting the delegation of a task to a subordinate? A) Always requiring a maximizing quality outcome B) Frequently reassuring the employee that if they are incapable of completing a delegated task, it will be reassigned C) Drafting a preliminary plan of how the task will be redone if the outcome does not meet stated expectations D) Occasionally providing learning or stretching opportunities for employees

Ans: D Feedback: Stretching provides growth opportunities for employees, builds employee self-esteem, and helps prevent boredom and de-motivation. The other options are not actions that are supportive of the staff and the delegation process.

11. A member of the team reports that they have been given too much to do and are not going to be able to complete the work on time. What action will the RN take to effectively manage this situation? A) Assign the work to another team member B) Take on the responsibility of the tasks C) Have the team member perform only the necessary tasks D) Examine the workload and assist the individual in reprioritizing

Ans: D Feedback: The manager should help the overwhelmed employee reprioritize the workload with the goal of making it manageable for that employee. None of the other options realistically assist the team member in managing time and prioritizing effectively.

18. What should the leader remember when forming committees? A) Committees work best when there is an adequate supply of workers, with 10 members being the minimum B) Willingness to work hard is the most important criterion for appointment C) Written agendas provide excessive structure and stifle committee creativity D) There should be sufficient expertise among committee members to accomplish the assigned task

Ans: D Feedback: The most important criterion for committee selection is overall adequate expertise to accomplish the agenda. The remaining options are not as relevant as the correct option.

19. What cultural phenomena must be considered for the biopsychosocial differences between racial and ethnic groups that have susceptibility to disease and physiologic differences? A) Space B) Social organization C) Environmental control D) Biologic variations

Ans: D Feedback: The phenomenon Biologic variations refers to the biopsychosocial differences between racial and ethnic groups, such as susceptibility to disease and physiologic differences. None of the other options are associated with managing these differences.

25. A nurse sits at the foot of a patient's bed during an admission interview. This positioning supports the proxemics concept of which psychological comfort zone? A) Intimate relationships B) Personal interactions C) Social exchange D) Public distance

Ans: D Feedback: The study of how space and territory affect communication is called proxemics. In the United States, between 0 and 18 inches of space is typically considered appropriate only for intimate relationships; between 18 inches and 4 feet is appropriate for personal interactions; between 4 and 12 feet is common for social exchanges; and more than 12 feet is a public distance (Loo). Most Americans claim a territorial personal space of about 4 feet.

17. Who bears the ultimate responsibility for ensuring that the nursing care provided by team members meets or exceeds minimum safety standards? A) The patient's primary healthcare provider B) The facility's Director of Nursing C) The unit's nursing manager D) The team's RN

Ans: D Feedback: The team's RN always bears the ultimate responsibility for ensuring that the nursing care provided by his or her team members meets or exceeds minimum safety standards. This is not the role of any of the other positions mentioned.

19. When work is redesigned, it frequently has consequences for employees that must be considered. What consequences must be considered? 1. Professional interactions 2. Degree of autonomy 3. Employee evaluation 4. Communication patterns A) 1, 2, 3 B) 1, 2, 4 C) 1, 3, 4 D) 2, 3, 4

Ans: D Feedback: When work is redesigned, it frequently has personal consequences for employees that must be considered. Social interactions, the degree of autonomy, the abilities and skills necessary, employee evaluation, and communication patterns are often affected by work redesign.