Leadership Test 1 Sample NCLEX from Pearson
The nurse wants to become more involved in healthcare decision making. Which is the nurse's best strategy for achieving this goal? a. By active participation in nursing organizations b. By keeping up with new healthcare developments c. By electing officials with minimal interest in healthcare d. By charging for nursing care services
a. By active participation in nursing organizations Active participation in nursing organizations gives every nurse a voice because nursing organizations are often represented on committees that develop healthcare policy. This is the best way for an individual nurse to impact policy development. It is important for nurses to be aware of new healthcare developments, but simply being aware is not the best way to impact healthcare decision making. The nurse should try to elect officials that understand and are interested in healthcare. Nursing care services are a valuable commodity, and nurses should be reimbursed for delivering quality care. However, this is not the best strategy for impacting healthcare decision making.
The nurse is meeting with a state senator regarding healthcare policy issues in the state. How can this nurse best impact the development of healthcare policy during this meeting? a. By demonstrating that nurses provide cost-effective, high-quality, measurable care b. By suggesting the creation of new titles and licensure requirements to indicate various levels of preparation c. By encouraging the legislator to vote for laws that have nurses remaining at the bedside, giving total care to patients d. By suggesting legislation that requires the nurse to work longer under mandatory overtime requirements to meet patient care needs
a. By demonstrating that nurses provide cost-effective, high-quality, measurable care Legislators may have an unrealistic view of the role of the nurse. This nurse should explain how the profession provides cost-effective, high-quality, measurable care and why this is important. This is a suggestion that is still being debated within nursing and is not currently the best use of the nurse's influence. Bedside care is only one of the important types of work done by nurses. This suggestion limits the profession's impact on healthcare policy. Nurses should be working against mandatory overtime.
The nurses are concerned that clinical pathways will lead to more malpractice issues. What are the legal issues surrounding the use of clinical pathways? a. Clinical pathways can be introduced as evidence in court to demonstrate a standard of care or what the outcomes should be for a patient. b. Clinical pathways can conflict with each other, thus relieving the provider of responsibility. c. Clinical pathways prevent negligent care. d. Clinical pathways cannot be applied incorrectly.
a. Clinical pathways can be introduced as evidence in court to demonstrate a standard of care or what the outcomes should be for a patient. Clinical pathways can be introduced as evidence in court to demonstrate a standard of care or what the outcomes should be for a patient. The provider is never relieved of the responsibility of using clinical judgment and reasoning. Even if the provider follows the clinical pathway, the provider can still be guilty of negligence. Even though the clinical pathway should be clearly understandable, it is possible to apply it incorrectly.
Which skills must be exhibited by non-manager nurses working in today's healthcare environment? Select all that apply. a. Exhibiting personal ethics b. Working alone c. Focusing on one area of care d. Focusing on chronic care and prevention e. Using technology
a. Exhibiting personal ethics; e. Using technology Personal ethics is a skill essential for nurses in today's healthcare environment. Today's nurse must have the skills needed to use technology in the provision of client care. Today's nurse must be able to work in a team. Today's nurse must be multi-skilled with focus on numerous areas of care. There is greater emphasis on understanding the impact of chronic care and prevention and health maintenance rather than on curing.
The clinical pathway committee wants to create pathways for the target population. What criteria should be used to identify the target population? a. High-volume, high-risk, and high-cost conditions b. Low-volume, low-risk, and low-cost conditions c. Conditions that meet the "norm" or benchmarks d. Conditions that are unusual for the patient population
a. High-volume, high-risk, and high-cost conditions High volume, high risk, complex care requirements, high cost, variations in length of stay compared with the "norm" or benchmarks, variations in practice patterns, payer request of interest in the illness or condition, and opportunity for improved care are criteria for choosing the target population. The committee should focus on high-volume, high-risk, and high-cost situations. Situations that meet the norm are not problematic. The committee should focus on high-volume situations, which are usual conditions, not unusual conditions.
What are the primary concerns of patient consumers regarding healthcare services? a. Increased costs, decreased access and quality, and lack of competence of caregivers b. Increased communication with healthcare providers, improved trust in the system, and increased quality of care c. Increased access to care, decreased costs, and improved communication with providers d. Better communication with third-party payers, improved quality of care, and decreased costs
a. Increased costs, decreased access and quality, and lack of competence of caregivers Consumers are particularly concerned with increasing access problems, increasing costs, decreasing quality, confusion over the role of third-party payers, caregiver competence and ethics, impersonal care, and decreased communication. They are losing their trust in the healthcare system and its providers. Consumers are concerned about losing the ability to communicate with their selected healthcare provider and are losing trust in the system and its ability to provide quality care. The concern is that access to care will be more difficult, that care will cost more, and that it will be more difficult to communicate with a chosen provider. Better communication with third-party payers, improved quality of care, and decreased costs.
Which is the rationale for why nurses should participate in healthcare policy discussion? a. It determines what health care services are provided, who receives them, and who pays for them. b. It allows legislators to control healthcare. c. It keeps the cost of healthcare down. d. It keeps healthcare from becoming a monopoly.
a. It determines what healthcare services are provided, who receives them, and who pays for them. Healthcare policy is critical because it determines what healthcare services are provided, who provides the services, who can receive the services, reimbursement, quality care, improvements, and requirements. Legislators are voted for by the public and their input into healthcare policy should reflect the public's wishes. Policy is not written to allow legislators to control healthcare. Changes in healthcare policy may, in fact, cause an increase in the cost of healthcare. If healthcare policy is not written correctly, it might encourage the development of monopolies.
During orientation to a new position, the new nurse receives a copy of the ANA's Code of Ethics. What is the significance of this code for nurses? a. It sets forth the primary goals, values, and obligations of the profession. b. It determines who can enter the profession of nursing. c. It sets forth the practice guidelines for developing clinical pathways. d. It differentiates between the practice of nursing and the practice of medicine.
a. It sets forth the primary goals, values, and obligations of the profession. A code of ethics makes explicit the primary goals, values, and obligations of the profession. Individuals who become nurses are expected not only to adhere to the ideals and moral norms of the profession, but also to embrace them as part of what it means to be a nurse. This is determined by law, not the ANA Code. This is not part of the ANA Code, but may be part of standards of practice of some specialties. This differentiation is a matter of law.
The nurse manager has determined that a system variance exists for one critical pathway being used on the care area. Which option is an example of this type of variance? a. Lack of supplies b. Misread orders c. Care provided by a nurse who is ill-prepared d. Mislabeled medications
a. Lack of supplies System or operational variances focus on hindrances in the system or the organization that prevent the achievement of client outcomes. Examples are delay in laboratory results, lack of bed space or hours of service, delayed transfers to a long-term care facility, and lack of supplies. Other choices are a provider variance.
The clinical pathway committee needs data to assist with the creation of the pathways. What is the most important type of data this committee will require? a. Length of stay, common admission diagnoses, laboratory tests, and incident data b. Infection control data and quality improvement records c. Average census data, staffing grids, and unit-specific diagnoses d. Frequency of admissions, medication error reports, and readmission data
a. Length of stay, common admission diagnoses, laboratory tests, and incident data The teams that develop the content for specific pathways need access to data such as length of stay, common admission diagnoses, laboratory tests, and incident data. Lists in other choices are not inclusive of all the types of data needed.
The documentation committee at an organization is planning to create clinical pathways. What is the purpose of these pathways? a. Pathways provide direction in the coordination of care and ensure that outcomes are met within a designated time frame. b. They do not restrict timelines for interventions. c. They increase cost without increasing quality of service. d. They do not take into account the use of new technology.
a. Pathways provide direction in the coordination of care and ensure that outcomes are met within a designated time frame. Pathways provide for efficient use of resources and controlling cost. Pathways set specific timelines for interventions and evaluation. Pathways have been shown to help control cost and to increase quality. New technology is considered when creating pathways.
The quality improvement committee is reviewing practice guidelines and written standards of care. What is the difference between these two items? a. Practice guidelines provide information and options. b. Practice guidelines define treatment. c. Standards of care pull together research information from the literature. d. Standards of care save money for the healthcare system.
a. Practice guidelines provide information and options. Practice guidelines are different from standards of care in that guidelines do not define treatment but rather provide information and options. Standards of care define treatment. Both standards of care and practice guidelines use research information. Both practice guidelines and standards of care have the potential to save money for the system.
The organization is reviewing the private and public healthcare policies. How do these two types of policies differ? a. Private policy is healthcare policy that is developed by either healthcare organizations or a profession. b. Private policy provides the greatest good for the greatest number of people. c. Private policy is developed by politicians. d. Private policy has no input from healthcare organizations.
a. Private policy is healthcare policy that is developed by either healthcare organizations or a profession. Private policy is healthcare policy that is developed by either healthcare organizations or a profession, such as nursing. Public policy should reflect the needs of the public, but often is influenced by politics. Public policy should provide the greatest good for the greatest number of people. Public policy is developed by politicians. Healthcare organizations have strong influence on the development and implementation of private policy.
During a seminar, health care executives discuss the high-priority ethical dilemmas that they face in their organizations. Which are the highest-priority ethical dilemmas? a. Staffing levels and mix situations, developing/maintaining standards of care, and allocating/rationing of scarce resources b. Incompetent physicians, demotion/termination of employees, and employee relations c. Incompetent nurses, selection/hiring of employees, and treatment versus nontreatment d. Promotion of employees, diversification of services, and downsizing services
a. Staffing levels and mix situations, developing/maintaining standards of care, and allocating/rationing of scarce resources The top three ethical dilemmas identified by nursing administrators are staffing levels and mix situations, developing/maintaining standards of care, and allocating/rationing of scarce resources. While others are important factors, they are not the top three ethical dilemmas today.
A staff nurse provides patient care under the ethical principle of beneficence. How does this principle affect nursing practice and ethical decision making? a. The patient is discharged at the time expected and has no complications. b. Patients have the right to determine their own rights. c. Patients have the right to be treated fairly. d. Patients have the right to be told the truth.
a. The patient is discharged at the time expected and has no complications. The ethical principle of beneficence, or doing something good, is interpreted to mean that nurses inflict no harm and are to safeguard the patient. A patient who is able to be discharged with no complications probably has received quality care. (b) is the ethical principle of autonomy. (c) is the ethical principle of justice. (d) is the ethical principle of veracity.
Several staff nurses are disappointed to learn that their patient care area will begin using clinical pathways. What are the disadvantages of clinical pathways? a. They are costly to develop and implement, in both time and money. b. They are highly individual for each patient. c. They do not give direction to the staff for implementation. d. They are used to identify staff performance problems.
a. They are costly to develop and implement, in both time and money. They are costly to develop and implement, in both time and money. Staff may have a negative attitude toward them and not implement them as intended. Clinical pathways are written in a general form and must be individualized to each patient. The purpose of the clinical pathway is to provide direction in the care of the patient. This is not the intention of clinical pathways. Variances are tracked to help improve system performance.
The nurse manager is trying to find critical pathways to use for the patient care area but is unsuccessful. Why are pathways difficult to share between institutions? a. They are often individualized for a specific HCO to meet the practice concerns of the provider, the HCOs and patient populations. b. They focus on the general treatment for a specific illness or condition. c. They are not comprehensive because of their lack of emphasis on interdisciplinary care. d. They do not use case management.
a. They are often individualized for a specific HCO to meet the practice concerns of the provider, the HCOs and patient populations. Pathways are specific and unique to the healthcare agency or managed care organization in which they are used. One of the primary benefits of pathways is that they are interdisciplinary. Case managers often use clinical pathways to coordinate care.
The nursing student does not understand why each state has a separate Board of Nursing. Which is the primary mission of the Board of Nursing in each state? a. To protect the public b. To determine criteria for admission to schools of nursing c. To determine where nurses should practice d. To lobby for nursing rights
a. To protect the public Each state's Board of Nursing has the responsibility to protect the public in its state. State Boards of Nursing do not determine criteria for admission of schools of nursing, determine where nurses should practice, or lobby for nursing rights.
An attorney for a healthcare organization is sponsoring an educational seminar about legal issues affecting nurses. What type of cases involving nurses fall under the category of criminal law? a. Negligence, personal injury, and medical malpractice b. Assault and battery, murder, robbery, and rape c. Informed consent, confidentiality, and DNR d. Living wills and durable power of attorney for healthcare
b. Assault and battery, murder, robbery, and rape Civil law concerns the rights of individuals, usually involving payment of money or some type of compensation. Of most concern to nurses is tort law because it includes negligence, personal injury, and medical malpractice. Choices in option (b) are criminal offenses. Choices in option (c) are personal rights issues that could result in civil suits if not followed. Choices in option (d) are personal rights issues that could result in civil suits if not followed.
The nurse manager for the emergency department (ED) is preparing the staff for the arrival of multiple trauma patients. Which type of leadership will the nurse manager implement? a. Laissez-faire b. Autocratic c. Democratic d. Bureaucratic
b. Autocratic Different situations call for different types of managing style. An emergency is best handled with one person in control, delegating activities, which describes an autocratic style. The "laissez-faire" approach would be ineffective in this situation. There would be little or no direction to the staff. In an emergency, leading by majority rule would be ineffective. The bureaucratic leader strictly follows rules and regulations. This would not be an effective means of leading in an emergency.
An RN staff nurse in the intensive care unit has acquired a significant amount of personal power within the hospital organization. This acquisition of power is due in part to regularly attending local meetings of the Association of Critical Care Nurses and reading the American Journal of Critical Care. Which factor is increased for this nurse based on the participation in these activities? a. Communication network b. Credibility c. Interpersonal relations d. Persuasion
b. Credibility Credibility is gained through hard work, gaining skill and becoming competent in your work, and being very honest in your relationships with other people. This credibility gives the nurse expert power on the unit. While this nurse's communication network has likely increased, this is not the most likely factor to increase power on the unit. The nurse has likely improved interpersonal relations through this work, but this is not the most likely factor to increase power on the unit. The nurse may have learned persuasion strategies during this work, but this is not the factor most likely to increase power on the unit.
Which are examples of modern leadership theories and/or styles? Select all that apply. a. Personal quality leadership b. Knowledge management theory c. Contingency theory d. Transformational leadership e. Emotional intelligence leadership
b. Knowledge management theory; d. Transformational leadership; e. Emotional intelligence leadership The knowledge management theory is evolving as nurses are identified as knowledge workers. Transformational leadership is an important leadership theory today. Emotional Intelligence leadership is a modern theory. Personal quality leadership was a style in the 1940s and has since been replaced. Contingency theory is an older theory of leadership, but components of it exist in some modern theories.
Which statement regarding the major difference between managers and leaders will the nurse include in a presentation to fellow nurses regarding management of care? a. "Managers are seldom leaders." b. "Leaders do not make good managers." c. "Managers have legitimate power within the organization." d. "Leaders are tasked with accomplishing the work of the organization."
c. "Managers have legitimate power within the organization." Managers always will have legitimate power that belongs to them from holding the manager position. Managers are often also leaders. Some leaders are excellent managers. Managers, not leaders, are tasked with accomplishing the work of the organization.
The nurse manager is talking with the unlicensed assistive personnel (UAP) about time management. Which statement exemplifies the nurse manager in the role of coach? a. "You must get the vital signs taken on time or you will be disciplined." b. "You never report AM blood sugar levels on time." c. "Your timely response to patients' call lights is exemplary." d. "Your appearance is seldom professional."
c. "Your timely response to patients' call lights is exemplary." Telling the UAP that his or her timely response to the patients' call lights is exemplary is an example of the nurse manager as coach. Telling the UAP that he or she must get the vital signs taken on time or there will be disciplinary measures is a nurse manager who is punishment-reward driven. Telling the UAP that he or she never reports morning blood sugar levels on time is accusatory and does not provide coaching. In order for the statement regarding the UAP's appearance to reflect coaching, the manager should provide suggestions to the nursing assistant.
The nurse's neighbor asks, "Who do you think is a good pediatrician for my new baby?" The nurse replies, "Here is a website that will give you information on many pediatricians to help you choose." This is an example of which attribute of patient-centered care? a. Superb access to care b. Patient engagement in care c. Publicly available information d. Integrated and comprehensive team care
c. Publically available information Superb access to care is focused on being able to make appointments easily with short wait times, the provision of e-mail and telephone consultation, and availability of off-hours service. Patient engagement in care focuses on provision of information on treatment options, access to medical records, assistance with self-care, and counseling. Publicly available information focuses on patients' having accurate, standardized information on physicians to help them choose a practice that will meet their needs. Integrated and comprehensive team care focuses on a free flow of communication among physicians, nurses, and other health professionals with avoidance of duplication of tests and procedures.
What is the central purpose of cost-effectiveness analysis (CEA) as it pertains to provision of healthcare services? a. To save money b. To understand the costs associated with new technologies c. To choose intervention for a specific patient d. Creating better health and longer life
d. Creating better health and longer life Cost savings is not the primary purpose of CEA, nor are choices (b) or (c). All of the components and other benefits of CEA are directed toward creating better health and longer life.
The unit manager of a 32-bed medical-surgical unit allows the staff nurses to do self-governance for scheduling, client care assignments, and committee work. This sometimes leads to confusion, which the staff must correct. Which type of leader would the nurse manager be considered? a. Bureaucratic b. Autocratic c. Democratic d. Laissez-fair
d. Laissez-faire The laissez-faire type of manager exerts very little control. Bureaucratic leadership is a leadership style that assumes that individuals are motivated by external forces; the leader trusts neither followers nor self to make decisions, and therefore relies on organizational policies and rules. Autocratic leadership is a leadership style that assumes that individuals are motivated by external forces; therefore, the leader makes all the decisions and directs the followers' behavior. Democratic leadership is a leadership style that assumes that individuals are motivated by internal forces; the leader uses participation and majority rule to get work done.
Which concept related to transformational leadership allows the nurse manager to change staff attitudes and behaviors towards meeting an expected outcome? a. Vision b. Influence c. Values d. Power
d. Power Power enables the leader to influence others, and by doing this, the leader can change staff attitudes and behavior, preferably moving toward meeting expected outcomes. A vision is a view of the organization in the future. Leaders use influence, which is the informal strategy of cooperation combined with formal authority of a position to develop trust. The leader needs to be persuasive and use productive communication. Values, the importance that is attached to something that guides action, are more important today in understanding effective leadership.
The complexities of the current healthcare delivery system require a variety of leadership styles. Which leadership style is the one that has emerged in response to these changes? a. Autocratic b. Democratic c. Consultative d. Transformational
d. Transformational The transformational leadership theory has emerged in response to the complexities of today's healthcare systems. Autocratic leadership follows an old theory. Democratic leadership emerged from an old leadership theory. Consultative leadership is an approach often followed by new managers until they develop confidence in their abilities.
The nurse manager is aware of the changing healthcare environment. Which situation is an important emerging challenge to changes in healthcare? Select all that apply. a. Nursing staff shortages b. Increased surgical procedures c. Decrease in immigration d. Use of advanced practice nurses e. Need to create a culture of safety
d. Use of advanced practice nurses; e. Need to create a culture of safety Use of advanced practice nurses is an emerging challenge to changes in healthcare. This need for a culture of safety is a recommendation of the Institute of Medicine. Nursing staff shortages have been prominent in health care for many years. The simple increase in surgical procedures is not a driving force for changes in healthcare. Immigration is increasing, which will change the demographics of the patient population and will present a challenge.
