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Leadership Exam 2

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10. Which statement describes the induction phase of employee indoctrination? A) It occurs after hiring but before performing the role. B) It includes the activities performed by the personnel department. C) It relates to the information included in the employee's handbook. D) It is the responsibility of the staff development department.

11. Before starting an educational session, the nurse-manager has determined that participants possess readiness to learn. What does this imply about the participants? A) They have acquired the skills necessary for what is to be learned. B) They are motivated to learn the necessary material. C) The participants are contributing to a positive atmosphere. D) The participants are mature individuals with much experience.

11. The majority of patients whose care is organized by case management have contact with the health-care system in what acute care setting? A) Emergency department B) Ambulatory clinics C) Primary care provider offices D) Perioperative settings

12. A health-care organization has advertised a position that requires a doctoral degree and several years of experience. These high standards for education and experience may have what unintended consequence? A) The position may remain unfilled for longer than desired. B) Applicants may lack applicable skills. C) Applicants' credentials may be difficult to verify. D) Applicants may find it difficult to collaborate with subordinates.

13. When do nursing shortages historically occur? A) When the economy is on an upswing B) When the economy is in recession C) When nursing salaries decline D) When client acuity increases

14. A large health-care organization is reconsidering the model of patient care delivery. What factor should be prioritized in this decision? A) Patient needs B) Staff expertise C) Cost D) Physical layout of the facility

14. When evaluating the risk of a nursing shortage, the nurse-manager should prioritize which of the following variables? A) The economy B) Infectious disease prevalence C) Continuing education offerings D) Political climate

16. A nurse-manager's immediate supervisor is a member of the veteran generation. What generational characteristic is the supervisor most likely to possess? A) Strong loyalty to the employer B) A high value on workplace flexibility C) High individualism D) Social consciousness

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 for a particular patient? A) One B) Two C) Three D) Four

17. A nurse can directly address one of the Institute of Medicine's points for patient-centered health-care redesign by: A) centering every decision around the patient's care around the patient's and family's best interests. B) advocating for caps on the maximum allowable nurse-patient ratio. C) adopting a functional nursing model whenever the setting allows. D) becoming a nurse navigator who is centered on patients' needs.

17. The nurses and managers of a clinic have agreed on a commitment to becoming a learning organization. What change in practice would suggest progress toward this goal? A) Recognizing that mistakes are an inevitable part of the learning process B) Exclusively hiring RNs with baccalaureate degrees C) Encouraging a variety of individual visions among the nursing staff D) Stressing the need for individual learning

19. The manager of a hospital unit is frustrated that the centralized staffing department does not understand the unique staffing needs of the unit. What is the manager's best action? A) Advocate for a change to decentralized staffing B) Introduce a self-scheduling system C) Temporarily increase the use of agency nurses D) Increase the use of overtime to meet the unit's staffing needs

25. A small health-care organization has had a static group of employees for almost 2 years. The manager should identify what potential advantage of having some staff turnover in the organization? A) Fresh ideas B) Younger staff C) Cost containment D) Increased groupthink

26. The emergency room nurse is assessing a patient who has presented with an exacerbation of recently diagnosed irritable bowel syndrome. The patient states that he is "overwhelmed" and "bewildered" by the mix of diagnostic tests, appointments, and consultations since he was diagnosed. What is the nurse's best action? A) Acknowledge the difficulty of the patient's circumstances and arrange for a nurse navigator B) Validate the patient's concerns and liaise with the clinical nurse-leader C) Offer to mediate between the patient and the case manager D) Offer to accompany the patient to any upcoming appointments

3. A self-scheduling system has been proposed at a health-care facility. What potential benefit of this system should the manager recognize? A) Self-scheduling increases employees' autonomy over their work lives. B) The manager no longer has to participate directly in staff scheduling. C) Self-scheduling ensures an equitable distribution of benefits to employees who participate. D) Self-scheduling can be more easily implemented and sustained than other alternative systems.

30. A murse-manager works on a unit that has a decentralized self-scheduling system. When managing with this scheduling option, the manager should: A) oversee the system carefully to ensure sufficient staff coverage at all times. B) avoid becoming involved with the system so that staff remain autonomous. C) advocate for the most senior staff to receive the most desirable shifts. D) refer any disputes to the organization's personnel department.

30. A nurse with more than 15 years of experience in an adult medical setting has just transitioned to a job in the day surgery department. What should the manager of this department do to aid the resocialization of this experienced nurse? A) Avoid making assumptions about the nurse's ability to perform the job roles B) Encourage the nurse to mentor new graduates as a gesture of respect for the nurse's experience C) Emphasize the importance of evidence-based practice in the culture of the unit D) Arrange for a nurse residency to help the nurse transition to a new site

8. A community health unit is transitioning from centralized staffing to decentralized staffing. The manager should recognize what possible consequence of this change? A) It carries risks that employees may be treated unequally or inconsistently. B) One individual or a computer will perform the staffing functions. C) The manager's role is that of making minor adjustments or providing input. D) The change will increase control over personnel by the organization.

9. A nurse-manager has organized a 1-day workshop that is open to all the staff members on the unit. What characteristic of the workshop would most clearly suggest that it is an educational workshop rather than a training workshop? A) The workshop is focused on the broad intellectual development of the participants. B) Participants will be able to apply the material from the workshop immediately completing it. C) The workshop provides skills for performing a specific task. D) The workshop specifically addresses a common deficiency in the work performance of participants.

20. An applicant has accepted a position in the health-care organization and has begun the indoctrination process. This process should include what activities? Select all that apply. A) Educating the employee about the policies and procedures B) Orienting the employee to the specifics of the job role C) Socializing the employee to the workplace culture D) Scheduling the employee's continuing education activities E) Verifying the employee's references and credentials

ABC

21. Health disparities in the client care population are likely to occur when the health-care workforce lacks diversity in which areas? Select all that apply. A) Age B) Gender C) Ethnicity D) Education E) Personality type

ABC

14. A health-care facility is considering whether to move from 8-hour shifts to 12-hour shifts. What potential consequences of this change should be considered? Select all that apply. A) Increased overtime pay B) Increased nurse satisfaction C) Decreased cost D) Increased judgment errors E) Increased need for continuing education

ABD

29. A nurse-manager is in charge of a unit that has a large proportion of recent graduates, most of whom are members of Generation Y (Millennials). The manager should anticipate that many of these nurses will have what characteristics? Select all that apply. A) Technologically savvy G comiteat B) Adept at teamwork C) Loyal to a single, long-term employer D) Comfortable with multiculturalism E) Committed to environmental issues

ABDE

18. A nurse is preparing for a job interview. The nurse should prepare responses to what types of interview questions because they are difficult to respond to without advance thought? Select all that apply. A) Personal philosophy of nursing B) Professional organizations membership C) Individual strengths and weaknesses D) Career goals E) Days and times of availability

ACD

20. An experienced registered nurse has begun a position as a clinical nurse-leader (CNL). In this role, what tasks should the nurse perform? Select all that apply. A) Collaborating with the interdisciplinary team B) Guiding patients and families through the health-care system at various sites C) Coaching nurses to provide evidence-based care D) Introducing quality improvement initiatives E) Preceptoring senior nursing students

ACD

27. An applicant has disclosed a criminal record during an interview. When considering the implications of this disclosure on the hiring decision, the manager should consider what factors? Select all that apply. A) The time that has elapsed since the offense B) The geographic location where the offense occurred C) The severity or gravity of the criminal offense D) The relationship of the offense to the job duties E) The applicant's collaboration with other persons during the offense

ACD

19. A nurse-manager's interactions with a staff member suggest that the person is experiencing difficulties with resocialization. What potential causes should the manager consider? Select all that apply. A) Role ambiguity B) Lack of a dedicated coach, mentor and preceptor simultaneously C) Inability to meet job demands D) Role overload E) Lack of motivation

ACDE

7. Which interview questions would be considered illegal? Select all that apply. A) "What is your current marital status?" B) "Which languages are you able to speak or write?" C) "What university did you attend?" D) "What city do you live in?" E) "In what year were you born?"

1. A nurse-manager is implementing strategies to maintain adequate staff in the health-care organization. What action by the manager will best achieve this goal? A) Proactively plan to hire two RNs for each unit each year B) Use knowledge of turnover rates on their units for planning and hiring C) Look at staff-to-client ratios at other health-care organizations in the area D) Hire consultants to study national turnover rates to determine recruitment needs

1. Which statement best describes a characteristic of mentorship? A) The intensity and duration of relationships are similar in mentorship and preceptorship B) Staff cannot be assigned to become mentors. It is a role voluntarily chosen by the mentor C) Mentees must be willing to put aside their personal goals and beliefs in an effort to identify more closely with their mentor sbirb. D) Most nurses will have the opportunity for many mentor relationships during their careers

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

12. Which patient would be most likely to benefit from a disease management approach within the context of case management? A) A client who is being treated for a ruptured tympanic membrane B) A client who has chronic obstructive pulmonary disease (COPD) C) A client who has been diagnosed with a postpartum hemorrhage (PPH) D) A client being treated for a transfusion reaction after receiving packed red blood cells

13. New intravenous pumps are being introduced in a health-care organization. How can educators best implement social learning theory into the necessary education and training? A) Encouraging each learner to give feedback about other learners' performance B) Demonstrating the use of the pump to groups of learners and then letting them practice C) Organizing an informal teaching session that allows learners to socialize with each other D) Maximizing the size of the group that attends each teaching session

15. The nurse-manager is developing an educational program for an órganization. What action should the manager perform first? A) Identifying the facilities available to meet the needs B) Identifying the desired skills or knowledge the staff should have C) Explaining to the team the benefits that will result from the program D) Assessing the staff who is willing to learn new skills

21. A clinical site has a diverse skill mix that includes registered nurses, practical nurses, and unlicensed assistive personnels (UAPS). Senior management is proposing a shift from team nursing to primary nursing. What effect will the skills mix have on this transition? A) Implementation of primary nursing will likely require hiring more UAPS and laying off some RNs. B) Implementation of primary nursing will likely require hiring more RNs, and laying off some UAPS. C) With adequate resources, primary nursing can be successfully implemented with the existing skills mix. D) Primary nursing is most successful if every member of the team providing direct patient care is an RN

22. Which statement demonstrates an intervention focused on the primary disadvantage of team nursing? A) "We are working with one fewer team member 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."

24. Which statement best demonstrates understanding of the concept of knowledge of results? A) "These are the goals for today's lecture." B) "Today you clearly demonstrated an understanding of client focused care." C) "As RNs on this unit, you will need to be proficient in assessing for depression." D) "There will be a short quiz on today's material at the end of the session."

25. A nurse-manager is part of a committee that has been commissioned to change the care delivery model at a health-care facility. When planning this change, the nurse and the other committee members should be aware that this process will: A) be difficult to implement without hiring staff who have experience with the new model. B) affect social relationships and group functioning in the workforce. C) require equal input from every staff member during the planning stage. D) be best conducted by objective consultants from outside the organization.

26. The nurse-manager responsible for personnel is checking the references of an applicant. The reference offers unsolicited information about the applicant's personal history. What should the nurse-manager do with this information? A) Contact the applicant to disclose this violation of confidentiality B) Disregard the information unless it has a direct bearing on the applicant's ability to do the job C) Document the information and note the fact that it was offered unsolicited D) Corroborate the information with the applicant without mentioning the source of the information

28. The integrated leader-manager has recognized a need to promote evidence-based practice on the unit. What action is most appropriate? A) Requiring staff to research the evidence base for each of their nursing actions B) Supporting staff who are trying to change old practices that are not evidence-based. C) Implementing the principles of andragogy whenever possible D) Expanding the role of mentors within the organization

17. The manager of a clinic is creating a system for career development for all employees. What should be included in this program? Select all that apply. A) Quarterly performance reviews for employees B) Appropriate use of transfers between work locations C) Policies and processes for handling promotions D) Long-term coaching E) Mandatory specialty certifications for all staff

BCD

18. The policies around scheduling and staffing are being amended in a health-care facility. Managers must ensure that the policies to not violate which of the following? Select all that apply. A) Local laws B) Labor laws C) State laws D) Union contracts E) Federal laws F) Local norms

BCDE

22. A team of nurse-managers are attempting to make accurate predictions about variables that will impact future staffing decisions. What pieces of data should the team seek to identify? Select all that apply. A) Client satisfaction levels B) When staff resignations historically occur C) How long new hires usually stay employed D) Education of current nursing staff members E) Third-party insurer reimbursement levels

BCDE

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 based on client acuity D) Total beds on the unit

10. The nurse-manager is applying the principles of andragogy during an educational offering. What is the manager's most appropriate action? A) Competition is prioritized over collaboration during learning activities. B) The manager seeks to establish a highly structured learning environment. C) The manager openly values participants' life experiences. D) The manager leads the majority of learning activities.

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 specifically targeted in disease management. D) Disease management treatment is episodic.

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 client care. D) They are necessary to reduce costs.

14. What is the emphasis for the manager in the coaching role? A) Solving problems for the employee B) Showing employees how to work within the system C) Helping employees reach an optimum level of performance D) Redirecting employees to meet organizational goals

15. A registered nurse is paired with a practical nurse and the two nurses are working to together to provide all the needs for a group of patients. What type of nursing care delivery are these nurses demonstrating? A) Total patient care B) Functional nursing C) Modular nursing D) Primary care nursing

17. What type of interview is the best predictor of job performance and overall effectiveness? A) Unstructured B) Semistructured C) Structured D) Informal

17. What was the first generational work group that tended to value work hour flexibility and opportunities for time off? A) Veteran generation B) Baby boomer C) Generation X D) Generation Y

19. A team of nurse-managers have finished interviewing qualified candidates for a position and have now begun the selection process. During this process, the managers should: A) review the results of the applicants' physical examinations. B) schedule times for induction and orientation. C) carefully verifying the chosen applicant's references and credentials. D) reflect on the overall efficiency of the hiring process.

2. A nurse-manager is helping a newly graduated RN adjust to the professional nursing role. What is the manager's most appropriate action? A) Advise the new RN to avoid confrontations with health-care providers whenever possible B) Advise the new RN that the "real world" of nursing is fundamentally different from the one described in textbooks C) Be alert to signs and symptoms of the shock phase of the nurse's role transition D) Be alert to signs that the new RN has not shed nursing school values

23. What factor contributed significantly to the beginning of the acute RN shortage that originated in the late 1990s? A) Closing of nursing programs B) Lack of interest in nursing C) Hospital downsizing D) Poor nursing salaries

25. The nurse-manager stresses the benefits of learning a new skill to achieving the unit's goal of client satisfaction. The manager will break the skill down into its component parts and teach the subskills in sequence. This demonstrates understanding of which concept of education? A) Readiness B) Motivation C) Task learning D) Transfer of learning

26. A nurse-manager is in charge of a unit that serves an ethnically diverse community. As well, many of the staff members of the unit were born in, or educated in, other countries. What is an appropriate action by the manager to address this situation? A) Advocate for centralized staffing so the manager can control the cultural staff mix. B) Assign a preceptor to each staff member who is from another country. C) Arrange continuing education on managing communication challenges D) Adjust the patient classification system (PCS) that is used on the unit.

28. A nurse-manager sits on the hospital's board of directors and there has been repeated discussion about the possibility of changing the care delivery model. What action should be performed first? A) Elicit support from internal and external stakeholders B) Perform a cost-benefit analysis of the major alternatives for care delivery C) Assess the strengths and weaknesses of the current delivery model D) Plan a pilot project where the delivery model will be changed on one subacute unit

28. The personnel department at a health-care organization has recently mandated preemployment personality testing for all applicants. How should a nurse-manager best interpret the results of this testing when making hiring decisions? A) Testing results should be disregarded until their legal status becomes more clear. B) Testing results should be prioritized over subjective data such as interviews and references. C) Testing results should be considered alongside interview results and reference checking. D) The applicant should be invited to review the results of the testing with the interviewers,

8. What should selectors do when processing employment applications? A) Reject applicants who have a criminal record B) Require a physical examination before making a hiring decision C) Always follow up on references and verify employment history D) Use unsolicited personal information about an applicant in the decision-making process

9. A nurse-manager is applying the facility's patient classification system (PCS) to the unit's staffing needs before the beginning of a shift. What task should the manager perform first? A) Identify the number of staff members scheduled for the shift B) Create a preliminary work assignment based on the unit norms C) Appraise the care needs of each client D) Assign three clients to each nurse and then adjust according to client needs

18. A nurse is following a multidisciplinary action plan (MAP) when caring for a new patient. The nurse should identify what components within the MAP? Select all that apply. A) Cost analysis of major interventions B) Identity of the nurse navigator C) Critical path D) Nursing care plan E) Indication of times when nursing interventions occur

CDE

11. Which question asked during an interview is acceptable? A) "Are you married?" B) "Have you ever been arrested?" C) "What is your religious preference?" D) "What professional organizations do you belong to?"

12. A busy medical unit has been increasing the use of agency nurses. The nurse-manager should anticipate what consequence of this staffing alternative? A) Increased reliance on unlicensed assistive personnel by nurses B) A need for 8-hour rather than 12-hour shifts C) Short-tem cost savings D) Decreased continuity of nursing care

12. The staff at a community health clinic will require training on the use of the new electronic health record system. How should the nurse-manager organize the necessary education in order to enhance learning? A) Schedule a long, uninterrupted session B) Explain the most complicated part of the system first C) Use a dynamic lecture technique D) Teach in several short, frequent sessions

15. A health-care organization has achieved a decrease in RN hours in the total nursing care hours per patient-day (NCH/PPD). What is a potential outcome of this change? A) Increased interprofessional collaboration B) Decreased numbers of errors C) Decreased client fall rate D) Decreased client satisfaction

15. What action most directly addresses the projected nursing shortage? A) Increasing the number of unlicensed assistive personnel B) Increasing the number of nursing internships for recent graduates C) Expanding the nursing scope of practice D) Creating incentives for nurses to enter faculty roles

2. Which statement about patient classification systems is accurate? A) Classification systems are able to solve staffing problems if applied consistently. B) Nursing care hours assigned to a classification system should remain constant. C) A good classification system can resolve all staffing challenges. D) Internal and external forces may affect classification systems.

20. Training and education are important parts of staff development. Responsibility for these activities lies with: A) preceptors. B) the education department. C) the manager and preceptor. D) the manager and the education department.

24. Which historical event is known that have had a major effect on the delivery model of nursing care? A) Emergence of antibiotic resistant microorganisms in the 1990s B) Increases in patient empowerment during the 1970s and 1980s C) High rates of infection, death and disability during the Civil War D) Shifts from home-based care to hospital-based care in the early 20th century

24. Which of the following factors is most likely to benefit a health-care organization's recruitment and retention efforts? A) Being located in a rural area distant from major urban centers B) Dedicating several weeks to induction for new employees C) Offering incentives to employees with more than ten years of service D) Ensuring high levels of employee engagement and satisfaction

27. An experienced nurse is applying for a position as a clinical nurse-leader (CNL). In addition to the nurse's clinical experience, what characteristic best qualifies the nurse for this position? A) The nurse currently sits on the hospital's ethics board. B) The nurse has consistently adhered to the standards of practice. C) Specialty certification in a specific area of practice. D) The nurse has a master of science in nursing degree.

27. Mandatory minimum staffing ratios are being considered in the jurisdiction where a nurse-manager works. Based on experiences of other states, the nurse should identify what possible result of this legislation? A) There may be a backlash from clients and families. B) Predicted cost savings may take many years to realize. C) Health care organizations may be more reluctant to hire new graduates. D) Increased numbers of staff may not necessarily improve client care.

28. A flextime system has been introduced at a health-care facility. The nurse-manager should take what action to address the consequences of this staffing system? A) Limiting flextime to those staff members who have at least 2 years experience on the unit B) Ensuring that overtime can be used to fill times when there is insufficient staffing C) Providing incentives to ensure daytime weekday shifts are sufficiently staffed D) Working to promote continuity of care when there are multiple start times and end times for staff

29. A primary health-care teams (PHCT) has been established to coordinate the care of a patient with complex health-care needs. What should be the nurse's primary role in this team? A) Communicate the wishes of the patient to the other team members B) Weigh the benefits of suggested interventions with their costs C) Provide the patient's direct bedside care, whenever possible D) Advocate for high-quality, patient-centered care

3. Which statement best describes the manager's main role in socialization of a new nurse? A) Providing the employee with organizational rules and regulations B) Providing the new employee with a good preceptor C) Ensuring that there are sufficient numbers of good role models D) Sharing organizational values, expected attitudes, and behaviors

5. The nurse-manager is attempting to promote closer adherence to the principles of evidence-based practice. What is the manager's best action? A) Stress the need to base practice on research findings during orientation of new graduates B) Include a statement of the need for evidence-based practice in the unit vision statement C) Impose sanctions on nurses who do not use research during the annual evaluations. D) Arrange for easy online access to academic databases

5. What should a nurse-manager do to reduce the potential for bias when interviewing candidates? A) Conduct single, rather than multiple, interviews B) Trust his or her first impressions of an applicant C) Avoid taking notes during the interview D) Have at least one other colleague join in the interview

6. An experienced nurse has accepted a half-time management position on the unit. As well, the nurse works half-time providing direct client care on the unit. This nurse's immediate supervisor should identify the nurse's risk of: A) exhaustion. B) negative sanctions. C) role overload. D) role ambiguity.

8. The manager is organizing a class to prepare nurses to function in the neonatal ICU. What is the manager's initial action? A) Identify available learning resources that will assist with role transition B) Evaluate the professional attributes of the nurses who already work on the unit C) Evaluate the educational background and credentials of the new nurses D) Identify the learning needs of the new nurses

7. A health-care organization utilizes decentralized decision making. What will most likely happen when there is need for decisions to be made in the organization? A) A decision can be made at the lowest practical managerial level. B) The decision will be made by top-level managers. C) There is a potential that the decision will be made too quickly. D) It will be unclear who is ultimately accountable for the decision.

7. Which strategy should the manager adopt when attempting to empower staff? A) Role model the characteristics of an empowered nurse B) Follow a rigid but consistent rule enforcement policyb.comtest C) Arrange for all employees to get an annual cost-of-living raise D) Encourage staff to establish a strong unit culture

8. What task should the nurse prioritize when implementing case management? A) Assessing each client's needs individually B) Minimizing costs to the organization C) Minimizing costs to the patient D) Applying the principles of team nursing

10. The nurse-manager of a clinic has launched a career development program for nurses. The manager should anticipate what benefits? Select all that apply. A) Increased retention of staff B) Decreased staff turnover C) Increased skill level of nurses D) Enhanced quality of work life for nurses E) Increased interdisciplinary cooperation

ABCD

21. Which components are considered a part of an organizational structure? Select all that apply. A) The individuals included in the group B) Lines of communication C) Decision-making process D) Channels of legitimate authority E) Organizational culture

ABCD

24. The nurse-manager is designing a transition program for new nursing graduates. When planning this program, the manager should aim to address what issues? Select all that apply. A) Supporting practice autonomy B) Strengthening new clinical skills C) Introducing time management skills D) Socializing nurses to the clinical environment E) Enforcing adherence to institutional policies and procedures

ABCD

14. Which characteristic of an organization would suggest that flattening is occurring? A) There is a collectivę 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.

15. How can a nursing professional best demonstrate advanced achievement of competencies? A) Participating in career planning B) Achieving a new specialty certification C) Transfer to a new department D) Maintaining ethical standards of practice

1. A nurse is currently in the "promise" phase of career development. What goal should the nurse prioritize during this stage? A) Acting as a role model to recent graduates B) Gaining exposure to a variety of experiences C) Avoiding obsolescence D) Graduating from nursing school

1. Which of the following nurses would be considered to have expert power? A) A nurse-manager who dispenses favors to nurses who are willing to work overtime B) A nurse with extensive experience and specialized training in perioperative nursing C) A nurse whose dynamic and engaging personality makes it easy to create alliances D) A nurse who is positioned high on the hospital's organizational chart

10. The nurse-manager is chairing a committee, most of whose members are subordinates. When communicating with the members during meetings, the manager should: A) ensure their contributions are recorded for performance B) avoid overt demonstrations of power or authority. C) reserve the right to impose decisions on the committee. appraisal purposes. D) avoid informality in speech or writing.

11. A manager has accepted a new position and there are more than 20 people who directly report to the manger. What description of this manager's role is most accurate? A) The manager's workload is unrealistic. B) The manager has a large span of control. C) The manager has a top-level management position. D) The manager is working in a poorly designed organization.

10. An experienced nurse has been assigned to a management position. What task will this new manager most likely have to accomplish in order to address a common reluctance among women to hold positions of power? A) Seeking frequent counsel from other women who are leaders B) Limiting the influence of men on the unit whenever possible C) Organizing an educational inservice about gender in the workplace D) Challenging any negative preconceptions of power that she may have learned while growing up

4. A clinical nurse specialist (CNS) is included on a hospital department's organizational chart. However, there are no solid lines leading to or from the nurse's position on the chart. What does this imply? A) The CNS lacks productive relationships with colleagues. B) Any member of staff may exercise authority over the CNS. C) The CNS is not accountable for his or her practice. D) The CNS does not have formal authority over other staff members,

23. A health-care organization has undergone an organizational restructure that increases nurses' autonomy and empowerment. What effect is most likely? A) Increased interdisciplinary collaboration B) Increased communication C) Increased effectiveness of client care D) Increased client autonomy

11. A nurse-manager is launching career coaching program in the workplace. What is the manager's best initial action? A) Observe employees to see who would most benefit from coaching B) Publicize the program to elicit as many participants as possible C) Arrange a meeting to present the learning objectives for the program D) Link participation in the program to emlloyees' performance appraisals

1. After starting a new job, a nurse-manager has been surprised at the amount of grapevine communication that happens. The manager should recognize what characteristic of this type of communication? A) It is difficult to control or stop. B) It always involves verbal, face-to-face communication. C) It consists of negative and subversive messages. D) Strong organizations have policies that prohibit it.

16. The manager may be greatly or minimally involved with recruiting, interviewing, and selecting personnel. What factors can determine to the extent of the manager's involvement? Select all that apply. A) Size of the institution B) Existence of a separate personnel department C) Presence of a nurse recruiter within the organization D) Centralization or decentralization of nursing management in'the organization E) The preferences of subordinates

ABCD

27. New mechanical lifts for client transfers are being introduced at a health care facility. The manager plans to implement the principles of social learning theory in the necessary training. What actions should the manager facilitate? Select all that apply. A) Having an expert demonstrate the correct use of the mechanical lift B) Uploading a video for staff to watch on their own time C) Providing opportunities for hands-on practice D) Distributing an information packet to staff 1 week before education sessions E) Encouraging staff to work in groups during education sessions

ACE

23. A nurse-manager has begun in a new position and has quickly perceived that the nurses in the organization need to be empowered. How can the nurse empower the nurses? Select all that apply. A) Role model the way that an empowered nurse behaves B) Delegate as many management tasks as possible C) Minimize the amount of scrutiny and supervision that the manager provides D) Teach nurses strategies for increasing their personal power E) Seek nurses' input into proposed changes

ADE

15. A manager is participating in introducing a shared governance model to a health-care organization. What is the manager's best action? A) Remove lines of authority B) Form joint practice committees C) Eliminate performance appraisals D) Increase the number of first-level managers

17. A nurse-manager has been commissioned to create a new workplace committee that will focus on client safety issues. When forming this committee, the manager should: A) meet at least twice per week for the first month to create momentum. B) aim for diversity of genders and cultures among the membership. C) ensure that half of the members are the manager's subordinates and half are the manager's superiors. D) give members permission to attend meetings as often or as rarely as they wish in order to accommodate their schedules.

18. A new nurse-manager has set a goal of building a personal power base. What strategy should the manager choose? A) Exercise overt displays of power to subordinates whenever possible B) Seek to become highly visible in the organization iro.comtest C) Take every opportunity to collaborate with physicians D) Initiate dialogues with colleagues about the relationship between gender and power

19. The manager has been experiencing challenges working with a nurse who has a history of making unsympathetic comments about clients to other nurses. The manager has tried various strategies for changing the nurse's behavior with little effect. The manager feels that an application of coercive power is now appropriate. What action will the manager most likely take? A) Change the nurse's client care assignment B) Implement disciplinary action C) Offer sensitivity training to the nurse D) Dialogue with the nurse about the effects of these comments

2. An experienced nurse-manager describes a recently hired nurse as "very promising." The manager can best promote this nurse's career development by: A) asking other nurses to model their behavior on the new nurse's behavior. B) providing the nurse with increasingly challenging work assignments. C) removing the nurse from client care responsibilities and assigning management tasks, D) providing the nurse with positive feedback.

20. A nurse is deseribed by peers and colleagues as having expert knowledge, skills, abilities, credentials, and education base. What career stage is this nurse most likely in? A) Promise B) Momentum C) Harvest D) Legacy

25. A recent nursing graduate has begun working full-time and is committed to career planning. What action will be most likely to advance the nurse's career? A) Changing jobs every 12 to 18 months B) Obtaining professional certification C) Adhering to standards of ethical practice D) Participating actively in performance appraisals

26. A nurse-manager has been overseeing the care at a clinic for several weeks and has noted that staff members are reluctant to follow instructions. How should the manager attempt to resolve this problem? A) Consult with the person who previously managed the clinic B) Make more of an effort to get to know each of the employees individually C) Reduce expectations on the employees in order to improve compliance D) Remind the nurse about their obligation to follow standards of practice

20. The nurse-manager works in a health-care facility that has applied for Magnet status. What characteristics of the organization will support the application? Select all that apply. A) Centralized decision-making environment B) Open, participatory management C) Improved patient outcomes D) High staff nurse satisfaction E) Large number of registered nurses and an absence of practical nurses

BCD

22. A centralized staffing department is being created at a health-care facility. What attributes of this system should the nurse-manager expect? Select all that apply. A) Increased individual flexibility B) Improved client care C) Cost savings D) Increased consistency in staffing practices E) Increased impartiality in staffing decisions

CDE

10. A health-care organization is changing from a functional nursing model to a team nursing model. How should the nurse-manager best address the impact on staffing and scheduling? A) More unlicensed assistive personnel will need to be hired. B) A self-scheduling system will need to be adopted. C) No changes in scheduling policies will likely be necessary. D) The client assignment method will need to be adjusted.

12. A nurse is selecting areas to focus on for continuing education and personal growth over the next year. During this process, the nurse should: A) prioritize learning that can take place in a college or university setting. B) ask the manager to perform this task, if possible. C) prioritize areas of study that are new to the nurse. D) engage in reflective practice.

16. A manager has issued a directive to nursing staff about improving the timeliness of their documentation. Most nurses have failed to make a change in their practice, however. The manager should consider what potential cause of this failure to act? A) Leadership-subordinate conflict abirb.comtest B) Manager-subordinate gap C) Administrator-power differential D) Authority-power gap

24. Which statements are true regarding float pool nurses? 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. E) They are internal, not external, employees.

26. A nursing supervisor has been given the responsibility for increasing the frequency and thoroughness of nursing assessments on a hospital unit. However, the supervisor does not have the authority to enforce new guidelines for assessment or assign consequences for noncompliance. What is the most likely outcome of this scenario? A) The desired outcome will not be achieved. B) The assessments will improve, but the nurses will be resentful. C) The supervisor will need to use unauthorized enforcement. D) The assessments will improve as a result of collaboration.

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 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

21. Which action by the nurse-leader best demonstrates the leadership role to the socialization and education of new nursing staff during their orientation? A) Discusses organizational values and unit culture B) Addresses all questions regarding the responsibilities of the RN C) Schedules orientation sessions at times when client acuity is at its lowest D) Applies sanctions appropriately so new staff become socialized

23. The nurse-manager can begin to promote the needs of a culturally diverse staff by: A) viewing diversity as an opportunity rather than a threat. B) clustering staff members according to their culture whenever possible. C) focusing educational activities on the needs of staff from minority groups. D) adopting a neutral teaching style that is equally accessible to all cultures.

30. A nurse-manager has proposed an expansion of the organization's indoctrination program to the organization's board of directors. What potential advantage of expanding the indoctrination program should the manager describe? A) Enhanced retention rates B) More efficient recruitment C) Higher proportion of internal applicants D) Reduced burden on unit managers

5. It is 2 PM and the nurse-manager is calculating the nursing care hours for the 3 to 11 PM shift. There are three RNs, three nursing assistants, and one ward clerk scheduled and there are 22 clients with the following acuity and nursing care hours allotted for the evening shift: Category I, 4 clients at 2.0 hours Category II, 2 clients at 2.3 hours Category III, 10 clients at 2.8 hours Category IV, 6 clients at 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

6. A nurse-manager has recently learned that the health-care facility will be moving toward a case management approach. What factor is most likely driving this change? A) The need to contain costs B) The need to provide challenging work for nurses and other members of the care team C) The need to enhance professionalism throughout the organization D) The need to obtain magnet designation

6. A nurse-manager is implementing proactive political strategies. What activity by the nurse is most consistent with this type of strategy? A) Assuming authority to do something if it is not expressly prohibited B) Using competitive approaches to the decision-making process C) Attempting to appear as a victim so future gains can be made D) Verbalizing discontent with the politics of an organization

6. A nurse-manager is preparing to interview an applicant for a position. What is the most appropriate strategy for planning, conducting, and controlling the interview? A) If the applicant clearly lacks qualifications for the position, the manager should promptly and tactfully tell this to the applicant. B) Personal questions should be asked early the interview so rapport can be established between the manager and the applicant. C) The manager should develop questions that can be answered with a yes or no answer. D) The manager should assess an applicant's perceptive skills by sending nonverbal cues to the applicant during his or her responses.

9. A nurse-manager is required to make decisions about the proper placement of employees within the organization. What practice should the manager follow? A) Attempting to place employees in units where they have the greatest chance of success B) Avoiding overemphasizing the match between the employee and the unit in order to prevent discrimination suits C) Placing new employees on units that have the greatest need for new staff D) Helping employees modify their personal values and beliefs to coincide with that of the unit on which they are placed

23. Which statements demonstrate an understanding of the factors that should be 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. E) "We're going to make our decision based on which option is newest in the literature."

ABCD

25. A manager is implementing a patient classification system (PCS). Which external and internal variables should the manager address when implementing the PCS? Select all that apply. A) The 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 E) The hospital's accreditation status

ABCD

20. The increased use of agency nurses has been proposed by a health-care organization's personnel department. What implications of this practice should be considered? Select all that apply. A) Increased costs B) Consequences of unfamiliarity with the unit C) Liability from the use of unlicensed nurses D) Decreased continuity of client care E) Increased need for overtime

ABD

29. A nurse-manager has made a selection to fill a staff opening. When finalizing this selection, the manager should: A) identify the successful applicant's long-term career goals. B) inform the unsuccessful applicants that the position has been filled. C) negotiate the successful applicant's salary. D) inform the successful applicant about when he or she will be give promotions.

3. What is the relationship between the national and local economy and an organization's ability to maintain an adequate workforce? A) When the economy is on an upswing, many unemployed nurses return to work and recruitment becomes easier. B) When a recession occurs it causes many part-time nurses to return to full-time employment and others to delay their retirement. C) Although the economy tends to affect the size of the blue-collar workforce, professions such as nursing remain fairly stable regardless of economic changes. D) When there is an economic downturn, many nurses reduce their work hours from full time to part time.

4. Interviews at a large health-care organization are conducted by various individuals and groups, due to the high number of positions and applicants. What action will best ensure interrater reliability when different individuals are conducting interviews? A) Use a semistructured format and have interviewers practice with one another B) Create a structured interview format and adhere to it closely C) Have at least two, but not more than four, interviewers conduct each interview D) Use yes-no questions whenever possible, rather than open-ended questions

4. The manager overheard an experienced nurse say to a new nurse, "Sorry you won't be able to join us for our weekly get-together at the yogurt shop. I see you are going here charting for a while yet." How should the manager best interpret this nurse's statement? A) The experienced nurse's positive sanction has the ability to affect the new nurse's behavior. B) The experienced nurse has applied a negative sanction regarding group norms. C) The experienced nurse is giving constructive feedback about expected group norms. D) Desired behavior is being role modeled for the new nurse.

6. What goal should the nurse-manager prioritize when organizing staffing and scheduling? A) Schedule staff so there is a minimum of overtime B) Ensure that there is adequate staff to meet the needs of each client C) Develop trust in staff by seeing that staffing is carried out in a fair manner D) Ensure that staff members achieve a healthy work-life balance

7. A nurse-manager is working with a team of colleagues to update the organization's staffing and scheduling policies. What principle should the manager follow during this process? A) It is more important to communicate policies verbally than in writing. B) Policies should be written in a way that allows some flexibility. C) Each employee should be given the right to opt into the type of system that he or she wishes. D) Each unit manager should be granted full control over scheduling and staffing.

7. The unit supervisor is working with an RN who has just been promoted to charge nurse. What action by the supervisor will best help the RN adjust to this new role? A) Take the RN out to lunch to congratulate the nurse on the promotion B) Arrange for the RN to meet with staff peers in the organization C) Explain to the RN on the need for underling respect D) Inform the RN of the past performance of employees that he or she will manage

30. A nurse has more than four decades of experience, In order to ensure that the nurse is not seen as obsolete by peers and colleagues, the nurse should: A) seek a leadership position. B) offer to mentor newly-graduated nurses C) change jobs as frequently as possible. D) continually seek new knowledge and experience.

2. Which statement about the role of unit managers in recruitment and selection is accurate? A) The more centralized nursing management is and the more complex the personnel department, the greater the involvement of the unit manager. B) Unit managers should always leave such decisions to a centralized personnel department so consistency can be maintained. C) Regardless of the extent of their involvement, all managers must be aware of recruitment and selection constraints within their organization. D) Unit managers should assume total responsibility for recruitment and selection of personnel on their units.

22. The responsibilities for staff development have recently been decentralized in a large health care organization. The nurse-manager should take action to prevent what possible consequence of this change? A) Poor staff retention B) Deficient nursing care C) Increased role ambiguity D) Decreased nursing autonomy

29. One year ago, a hospital implemented a 6-month internship program for new hires who are recent graduates. When evaluating the success of this transition to practice program, what piece of data should leaders and managers prioritize? A) Rates of absenteeism in participants compared with more experienced staff B) The incidence of sentinel events (safety violations) in periods before and after the program C) Retention rates among participants of the program compared with nonparticipants D) Response rates to the personnel department's recruitment campaigns

4. A health-care organization is transitioning from a centralized staffing system to a decentralized staffing system. A nurse-manager should anticipate what outcome of this change? A) Increased fairness to employees through consistent, objective, and impartial application B) Increased cost-effectiveness through better use of resources C) Greater manager autonomy, 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

9. An experienced nurse-manager is organizing management development classes for some of the nurses in the organization. What principle should the manager follow when planning the classes? A) They should be offered to every employee in the organization. B) They should be limited to employees with university degrees. C) The classes should include social learning activities. D) The classes should be offered in an online format.

18. What goal is most congruent with being a learning organization? A) Staff development is the main priority in the organization. B) The organization employs a dedicated staff member for providing in-house education. C) There is dedicated time each shift for staff to pursue education. D) Continuing education for staff exceeds the requirements for licensure.

16. The nurse-manager needs to determine the effectiveness of a staff workshop on establishing IV access. What is the manager's best method for determining this? A) Having class participants evaluate the instructor and the class B) Giving participants an examination or test at the conclusion of the course C) Having a documented decrease in the unit's IV site infections D) Observing staff implement and document the practice

19. A patient who has just been diagnosed with lung cancer has been assigned a nurse navigator. What task should the nurse prioritize in this role? A) Providing evidence-based guidance on treatment options and treatment decisions B) Providing clinical leadership and ensuring quality for the patient's care C) Guiding the patient in an effort to provide high-quality managed care D) Guiding the patient and family through their various interactions with the health-care system

23. A hospital unit has an exceptionally high census for several weeks and mandatory overtime is being routinely required. What is the priority consequence of this practice? A) Ethics violations B) Increased continuity of care C) Temporary cost savings D) Decreased client safety

26. The leadership of a health-care organization have declared their intention to make the facility a learning organization (LO). What action is most likely to achieve this goal? A) Assigning mentors to each new employee and to employees who have relocated in the organization. B) Requiring each employee to prove that he or she has met the continuing education requirements for license renewal. C) Offering the facility to university researchers as a site for conducting health-care research. D) Acknowledging and rewarding employees who participate in continuous learning.

30. Which nurse is experiencing the effects of coercive power? A) A nurse who has been granted an extra vacation day after willingly working overtime for several days. B) A nurse who has completed a master's degree in nursing. C) A nurse who has great influence from being "well-connected." D) A nurse who was terminated after assaulting a client.

6. A nurse has recently graduated from nursing school and is transitioning into a nursing career. Which activity is the nurse's personal responsibility for career management? A) Developing career ladders B) Establishing career paths C) Providing challenging assignments D) Developing career goals

12. A nurse-manager is working with a committee that is showing evidence of groupthink. What characteristic of the committee would show evidence of this phenomenon? A) Members of the committee are unwilling to take risks with new ideas. B) The committee prefers to make decisions by consensus. C) The committee members want to take turns chairing the meetings. D) Membership in the committee is frequently changing.

13. The nurse is working on a unit whose culture has become firmly entrenched? What solution should the nurses on the unit best propose? A) New leadership B) A decrease in workload C) Collaboration with a unit that is not entrenched D) Increased administration support

13. What a nurse has asked a colleague for assistance with a complex wound dressing change. What response suggests that the colleague is at a novice level of nursing experience? A) "Sure. Can you give me directions and then I'll do what you say?" B) "I'm really busy right now. Can we do it sometime this afternoon?" C) "I can do it for you later, if that helps." D) "Definitely. I'll go and get the supplies and meet you at the bedside."

14. A nurse-manager can best expand political resources by: A) networking with individuals who are politically influential. B) making decisions proactively. C) initiating discussions about political power while at work. D) delegating decisions as much as possible.

15. What is the primary influence that shapes a person's response to authority? A) Power figures in the family unit B) Work experiences in each job held C) Administrative figures in the workplace D) Experiences in the spiritual dimension of life

16. A nurse-manager is chairing a workplace committee. What should the manager prioritize in this role? A) Keeping members on task and promoting productivityt B) Promoting members' career development C) Resolving interpersonal conflicts and preventing groupthink D) Providing information on each agenda item

17. A new manager is confused why nurses are not heeding her directions in the workplace. What strategy is most appropriate when attempting to resolve this problem? A) Assure the nurses that she has their best interests in mind B) Ignore the issue and reintroduce the directions in 6 to 8 weeks C) Hold a meeting to remind staff that they are under the manager's authority D) Bring in an outside consultant to have one-on-one conversations with staff

20. A group of nurses have formed an action group that has the goal of increasing professional power of the nursing profession. What strategy should the group adopt? A) Seek formal positions where members can influence public policy B) Make a formal commitment to providing family-centered care C) Increase interactions with recent nursing students and recent nursing graduates D) Ask clients and families to publicize the high-quality care they have received

22. A nurse at a community health clinic has no formal position of authority but exercises great influence over staff because many of them perceive the nurse as being powerful. What type of power does this nurse possess? A) Referent power B) Legitimate power C) Personality power D) Coercive power

22. A nurse-manager is appraising employees' competency levels during performance reviews. What goal should the manager set when performing competency assessments? A) Helping nurses identify ways to exceed minimal licensing requirements B) Fulfilling state requirements for minimal nursing practice C) Facilitating each nurse's advancement up the facility's career ladder D) Satisfying institutional employment requirements

28. A nurse-manager is reviewing the organizational chart of a health-care facility before accepting a job offer. When reviewing the organizational chart, the nurse should: A) be aware that the informal structure of the organization cannot be discerned from the chart. B) confirm the accuracy of the chart with the human resources department. C) try to meet with the people at the top of the chart, if possible. D) review the qualifications of each person on the chart.

29. A nurse will soon be creating a plan for continuing competence. What activity should the nurse prioritize when making this plan? A) Reflecting on his or her own practice B) Eliciting input from trusted nursing colleagues C) Eliciting input from members of other health disciplines D) Setting 3-year and 5-year career goals

9. What is one of the most politically serious errors one can make? A) Dispensing untrue information B) Promoting the advancement of subordinates C) Withholding or refusing to divulge information D) Delaying decision making until there is additional information

22. The leadership of a large health-care organization has arranged a series of meetings with stakeholders. What individuals or groups would be included in this category? Select all that apply. A) A community group that advocates for the rights of people addicted to drugs B) Representatives from the labor union that represents many staff members, an external organization, or individual C) A community group that promotes client safety in health care D) Members of the local media E) The surgeons and anesthetists who work in the operating room

ABCE

14. A nurse is applying for a job and is now writing a cover letter. The nurse should integrate what characteristics of a cover letter? Select all that apply. A) Introduce the applicant B) Briefly highlight key points of the resume C) List the contact information for the nurse's references D) Make a positive first impression E) Always used when submitting a resume

ABDE

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

ABDE

4. A new employee is attempting to implement appropriate power-building strategies. What actions should this employee perform? Select all that apply. A) Maintaining a sense of humor B) Gaining additional nursing certifications C) Suggesting major changes to the unit's workflow D) Learning the institution's organizational culture E) Attending a training seminar on a new piece of unit equipment

ABDE

3. A nurse-manager is arguing for the establishment of a formal career development program in the health-care facility. What potential benefits should the manager describe? Select all that apply. A) Employee attrition can be reduced. B) Personnel can be used more effectively. C) Employees can increase earning power. D) Employment benefits are increased. E) New skills are brought into the organization.

ABE

2. Max Weber, as part of the scientific management era, contributed immensely to the development of organizational theory. Which statements are representative of his beliefs? Select all that apply. 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 relationships should exist in organizations. E) Advancement and placement should be based on relationships.

ACD

16. A nurse is considering certification in an area of specialty. What potential benefits of certification should the nurse consider? Select all that apply. A) A personal sense of accomplishment B) Exemption from continuing education requirements C) Increased career options D) Increased potential for advancement and promotions E) Higher salaries

ACDE

12. The nurse-manager has held an educational workshop about the need for nurses to be more comprehensive with their client assessments. What outcome would suggest that there is a wide authority-power gap? A) The nurses respond by improving their assessments because of the respect they hold for the manager. B) The nurses do not make significant changes to the way that they assess clients. C) The nurses improve their assessments out of fear for the consequences of not doing so. D) The nurses seek an extended dialogue about the issue.

21. A nurse has applied for a new position and has presented a nursing portfolio to the human resources department. This portfolio will allow the nurse to: A) present his or her specific career goals. B) justify salary expectations. C) give examples of professional growth D) showcase his or her academic credentials.

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 only during the shift when he or she works D) Carrying out the majority of personal care for assigned patients

30. The top-level managers of a hospital have chosen to apply for magnet designation. The decision to grant this designation will be largely based on what factor? A) Input from local nursing educators and academics B) The findings from an onsite visit by assessors C) The results of a local public opinion survey D) Review of the organizational chart

8. A nurse who has transferred to a new workplace setting self-identifies as "competent" on Benner's continuum from novice to expert. What characteristic does this nurse most likely possess? A) A Bachelor of Science in Nursing degree B) Two to 3 years of clinical experience C) Basic health-care management skills D) A well-defined career plan

9. A nurse is practicing in a case management context and a patient has been following a multidisciplinary action plan (MAP). In the last 24 hours it has become clear that the patient's health status is not improving as quickly as expected and the patient is deviating from the MAP. What is the nurse's best action? A) Cancel the patient's current MAP and call a meeting to select a new one B) Document the presence of a variance in the MAP C) Collaborate with the care team to arrange a transfer to a new setting D) Cancel the current MAP and adopt customized, rather than standardized care

21. In order to minimize the potentially negative effects of organizational politics in the workplace, the nurse-manager should: A) limit interpersonal interactions to people the manager can trust. B) role model being an empowered nurse to subordinates. C) develop skills in handling information and communication. D) ensure that overt displays of power are visible to colleagues.

23. A nurse had made a renewed commitment to career planning. What activities should the nurse perform in order to meet this goal? Select all that apply. A) Accepting more overtime shifts B) Introducing evidence-based practice changes regarding wound dressings C) Discussing the health needs of the homeless with local politicians D) Earning a bachelor's degree in nursing E) Working with a seasoned mentor

BCDE

25. Which statements support the manager's commitment to staff empowerment? Select all that apply. A) "I need you to know that I won't accept any substandard nursing care." B) "A staff committee will be formed to address that unit issue." C) "We can arrange for you to spend 2 months working on another unit to expand your skills." D) "I've got funding to support staff who are interested in earning certifications." E) "There's talk of acquiring new mechanical lifts, but I'd like to get your input."

BCDE

1. Which aspect of care at a long-term care facility most clearly suggests that a functional model of care delivery is being used? A) One nurse is assigned to provide all of a resident's care during a shift. B) Unlicensed assistive personnel coordinate each resident's care and occasionally delegate to practical nurses. C) Registered nurses perform all assessments while unlicensed assistive personnel provide all feeding and hygiene. som/test D) A pairing of one registered nurse and one practical nurse provide all the care for a designated pool of residents.

10. The nurse is providing care in a setting that uses a team nursing approach. What should be integrated into the routines in the health-care facility? A) Inclusion of the patient and family as members of the team B) Opportunities for UAP and practical nurses to increase their education level C) Frequent communication between team members D) Use of multidisciplinary action plans (MAPS)

11. A nursing administrator believes that the organization supports an inadequate distribution of power. What is an appropriate action to combat this situation? A) Bring the issue to the state board of nursing B) Propose a plan to the CEO for organizational restructuring C) Seek entry into an informal power group D) Seek employment in a new setting

13. The nurse-manager is working in a facility where two of the organizational goals are to increase physician satisfaction and reduce costs. A unit goal is to increase professional RN staffing. Which statement best supports all the stated goals? A) Increasing the RN staff will cut down on nursing errors, prevent burn out, and decrease the cost associated with staff turnover. B) Increasing the use of unlicensed assistive personnel will result in increased patient safety and quality care, and thus improve physician satisfaction. C) Increasing the RN staff will free more nurses to be available to address doctors' concerns during their rounds and will reduce our costly use of overtime. D) Increasing the RN staff will lead to improved patient education and a reduction in costly patient stays.

19. During a strategic planning committee meeting to develop 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

24. A staff member asks the manager for a particular day off on the next schedule. Which response demonstrates the concept of underpromising and help the manager retain the staff's trust? A) "I'd like to, but that would be unfair to the other nurses." B) "Be sure to get the written request in early." C) "I can't guarantee it right now but I will try to find a solution for you." D) "If you don't take any sick time before then, I'll give it to you."

27. An organization has proposed a policy stating that no more than five people should report to any single manager in the organization. What is the most likely outcome of this change in organizational structure? A) Decision making will become unpredictable. B) Workplace satisfaction will increase. C) Efficiency will decrease in the organization. D) Worker autonomy and empowerment will increase.

27. What activity is most likely to promote a nurse's continued competence? A) Working in a variety of clinical settings B) Meeting minimal standards for relicensing C) Acquiring new knowledge and skills on a regular basis D) Submitting to regular performance reviews

29. An experienced nurse has been hired to manage an inpatient unit at a hospital in a different city. What is an appropriate activity for building the manager's personal power base when beginning this new job? A) Take every opportunity to describe personal accomplishments B) Offer to lead a high-visibility committee within the hospital C) Determine which people are most powerful in the hospital D) Seek to openly display authority when colleagues are present

4. A recent graduate's mentor is explaining the importance of career planning. What should the mentor teach the recent graduate about carcer planning? A) It is ultimately the employer's responsibility. B) It should begin once the nurse has at least 12 months of clent care experience. C) It requires development and implementation of a long-term plan. D) It functions best when the planning is episodic in nature.

4. A registered nurse is providing care in a setting that uses modular nursing. What task should the nurse perform during a shift? A) Providing every aspect of care to one-half to one-third of the mini-team's assigned patients B) Collaborating with another registered nurse to plan the care of all the mini-team's assigned patients C) Confirming that each member of the mini-team is completing his or her assigned tasks D) Providing total patient care to the most acutely ill patients that the mini-team is assigned

5. A nurse-manager is advocating for a switch from team nursing to primary nursing care? What characteristic of primary nursing care should the manager describe to decision makers? A) It requires minimal RN staffing. B) It is comparatively easy to implement. C) Many nurses find it stimulating and challenging. D) It eliminates the need for UAP or practical nurses.

5. There is one vertical, solid line connecting a middle manager and a top-level manager on a clinic's organizational chart. What should a nurse conclude from this aspect of the organizational chart? A) The middle- and top-level manager share equal authority. B) The middle manager is in a permanent position. C) The middle manager has only one boss. D) The top-level manager was originally promoted from being a middle-manager.

5. What determines the size of the authority-power gap between a manager and an employee? A) The organizational philosophy B) The degree of rigidity in the organizational chart C) How credible the manager is perceived to be D) How much informal power the manager possesses

7. A change in the patient care delivery system has been mandated on a hospital unit. The manager can best ensure the successful introduction of a new delivery system by: A) assigning a senior registered nurse to lead the implementation. B) explaining the implications of the proposed change to patients and families C) carefully studying the best method for implementing the planned change. D) hiring nurses who have experience in providing the new delivery system.

8. A female manager has worked hard in her career to reach a high position in the organization. What action by the manager will directly prevent her from developing the queen bee syndrome? A) Emphasizing formal demonstrations of power rather than informal demonstrations B) Aiming for an equal number of male and female subordinates C) Working with other women to help them achieve similar success D) Increasing accountability to subordinates

8. A middle-manager who oversees the operations of several nursing units has a high degree of organizational centrality. What is most likely true about this manager? A) The manager is isolated from top-level managers. B) The manager interacts with a comparatively small number of coworkers. C) The manager receives much communication from varied directions. D) There are more middle-level managers than first-level managers in the organization.

18. What characteristic of a nurse best indicates the attainment of an "expert" level of nursing experience? A) The nurse has more than 3 years of clinical experience. B) The nurse is learning from experience how best to react in clinical situations. C) The nurse identifies long-term goals for career advancement. D) The nurse possesses an intuitive grasp of complex clinical situations.

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.

19. A nurse is currently in the "momentum" career phase. What activity is most appropriate during this stage of the nurse's career? A) Adjusting from the student role to the professional role B) Avoiding obsolescence C) Beginning to participate in continuing education D) Being a role model to other nurses

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

2. Which statement about power is correct? A) It is a finite quality and, once gained, is very difficult to lose. B) It is destructively manipulative but is necessary for effective management. C) Women generally view power more positively than do men. D) Having powver generally results in the gain of additional power.

24. The organization of work in a large health-care facility reflects Weber's theories around bureaucracies. What characteristic is most likely to exist in this facility? A) High flexibility in the way that work is structured B) Promotion and advancement on the basis of relationships C) Absolute autonomy of each employee D) A clear division of labor among employees

26. A manager is conducting career coaching for an employee who is new to the organization. When coaching this employee, the manager should: A) conduct the coaching in a group of no more than six to eight nurses. B) encourage the nurse to share his or her plans with the other nurses in the organization. C) help the nurse establish goals and make the attainment of the goals a condition of employment. D) make sure not to intimidate the employe during questioning.

27. The nurse-manager has just begun a new assignment in a new health-care organization. What action should the manager prioritize in order to be seen as credible by subordinates? A) Share her doubts about her abilities with the employees B) Maintain an open-door office policy C) Ask for input from staff on decision making D) Avoid any and all forms of dishonesty

28. A nurse has joined a group that has a goal of increasing the power base of the nursing profession. What is the nurse's best initial action to help achieve the group's goals? A) Recruit nursing students to join the group as auxiliary members B) Present a powerful picture to others in the group C) Recruit among the nurse's peers and colleagues D) Become familiarized with relevant public policy issues

28. The manager of a busy medical-surgical wants to establish a transition-to-practice program. The manager should cite what benefit of the proposed program to the hospital's administrators? A) More experienced nurses will be likely to apply for jobs. B) Nurses on the unit will be more motivated. C) Staffing costs will be reduced. D) Turnover of new staff will likely be reduced.

29. A rural hospital is considering a sharp reduction in the range and availability of the services it provides. Before making this change, the hospital's leadership should: A) decentralize its decision-making model. B) implement shared governance. C) review its organizational chart. D) consult with local stakeholders.

3. A nurse has begun working in a new health-care facility and is beginning to understand the organizational culture. When seeking to understand the organizational culture, the nurse should: A) carefully examine the demographic characteristics of the workforce. B) ask the middle- and upper level managers about potential for the advancement, C) ask coworkers at various levels to interpret the organizational chart. D) try to perceive the dominant values, traditions, and beliefs in the organization.

3. A nurse-manager is aiming to project a powerful image of a team leader who empowers subordinates. What statement is most appropriate to this goal? A) "Tm in charge here, and so all requests need to come to me. Please let me know if you have any questions." B) "I'm too tired to deal with Dr. Jones today. When he gets here, tell him I've gone to lunch." C) "Is it okay with the rèst of you if I do all the charting and you do the direct patient care?" D) "We have a great deal to accomplish today, but I am confident that we can do it by working together."

5. A nurse is constructing a resumé before beginning to search for a new job. When creating a resumé, the nurse should: A) give equal weight to strong and weak points. B) aim for at least four to five pages in length. C) use complex, scholarly language to demonstrate competence. D) ensure that the document is concise and easy to read.

6. Which employee of a health-care organization would likely be considered a middle-level manager? A) An experienced primary care nurse who mentors other nurses B) The team leader of the hospital's wound care specialists est C) The charge nurse who oversees day shifts on a medical unit D) The hospital's nursing supervisor

7. A nurse is interviewing for a position in a health-care facility. The interviewer identifies a long-term coaching program for career development as one of the benefits in the organization. The nurse should identify what characteristic of this program? A) It occurs annually at performance appraisal reviews. B) It focuses on employee performance deficits. C) It requires the same intensity as a mentoring relationship. D) It occurs over the entire employment tenure of an employee.

9. A nurse-manager has established a new committee and will be chairing the committee. The committee consists of six representatives from various departments, at various levels within the organization. What goal should the committee members set? A) Creating a new organizational chart B) Adding four to six new members C) Emphasizing formal communication D) Implementing shared decision making

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