professional nursing mid term

the chief nursing officer at an acute care facility has weekly mandatory meetings with all managers and staff members to discuss what is going well, what could be better, and communication from the executive team. this CNO is part of what type of organization?

Flat flat organizations are characterized by the accessibility of upper management and a flow of information that is both top down and bottom up.

a nurse leader is working in the ER when a patient present with a deep head laceration requiring immediate suturing. the nurse leader went to the medical supply area fro antibacterial ointments, gloves, and bandages. however, the nurse noticed that the medical supply cabinet was extremely disorganized, so it took much longer than it should have to find the necessary supplies. the next morn gin, the nurse leader began to ask team members if they had any input regarding the organization of the medical supplies, and then began to brainstorm a few different ideas, such as rearranging the supples and enabling items. what is the next stage of change the nurse leader should address? A. plan B. integrate C. Implement

A. plan

a nursing staff member who is on a unit committee to bring about a planned change is currently is currently in the integrating phase of change. what actives are associated with the integrating phase (select all that apply) A. asking a lot of question such as what can be done to overcome berries B. investigating the magnitude and complexity of the intended change as it is implemented C. assessing how well the change is working against an established measurement for success D. brainstorming solutions by using your own skills and the skills of those who will be affected by the change E. assessing how well the new process is accepted and becoming the norm

E. assessing how well the new process is accepted and becoming the norm C. assessing how well the change is working against an established measurement for success

a nurse manager notices that supply carts are unorganized and could use some attention. what strategy can the manager use to help implement change in this area? A. encourage input from subordinates for potential options B. proceed slowly in making the change C. allow each individual to decide how he or she will make the change D. ensure that each subordinate knows there are no exceptions

D. ensure that each subordinate knows there are no exceptions

the change nurse of a step down unit is implementing a new procedure a new procedure for charting, which will impact all of the nursing staff. according to lewis model of change, the movement stage can be more successful if certain things are considered by the change agent (select all that apply) A. have flexible target dates B. implement the change C. ignore resistance to change D. set target dates E. include all stakeholders

D. set target dates E. include all stakeholders B. implement the change

nurse practice acts are examples of statutes? true or false

TRUE: legal binding as far as what you can do

kurt lewin

developed a theory which included the stages unfreezing, movement, and refreezing

a nurse on a busy medical surgical unit must delegate some care assignments to an experienced nursing assistant. what factors does the nurse consider prior to delegating the care to the nursing assistant?

state or national standards

the refreezes role

the one who finalizes change that is done

the movement role

the one who keeps change moving

the unfreeze role

the person who gets the change started

a nurse is charged with administering a fatal dose of morphine to a patient to hospice. in which type of court would this nurse be charged? A. civil B. criminal C. adminsitrative D. none of the above

B. criminal

the nurse manager for a medical-surgical unit is implementing a change in unit procedures as it relates to patient discharge. during the fourth phase of change known as action, the manager should incorporate the major component known as: A. communication B. assessment C. intervention D. evaluation

A. communication

the nurse is a member of the nursing staff at a a hospital that is undergoing significant organization change. which factor is the greatest contributor to the resistance encountered with organization change? A. employee mistrust of management B. poor organization leadership C. insufficient staff involvement in the process D. ineffective organizational management

A. employee mistrust of management

a few months ago, anew nurse leader at a hospital discovered via evidence based practice that tablet computers improve accuracy of documentation and decreased patient wait time the leader noted that these outcomes are beneficial to the facility, staff, and patients, as tablets provide portable access to patient electronic medical records. the nurse leader is currently in the planning stage. which activities are part of planning stage? (select all that apply) A. keeping track of the pace and stress change B. determining the scope of the change project, a schedule for its implementation an a budge to submit to administration for approval C. evaluating how the plan unfolds in real-time D. brainstorming the impact, pros and cons and potential challenges to implementation with impacted teammates E. anticipating resistance tot eh change by less tech-savvy staff

B. determining the scope of the change project, a schedule for its implementation an a budge to submit to administration for approval E. anticipating resistance tot eh change by less tech-savvy staff

after attending a health care research seminar, a registered nurse who works in the transplant unit became very interested in the ability of 3D printing to help save lives. The nurse would really like to raise awareness and see the hospital invest in a 3D printer. What the different technical reasons for resistance anthem the nurse may encounter? (selecta ll that apply) A. power B. unqualified personnel C. budget issues D. lack of resources E. public education

B. unqualified personnel C. budget issues D. lack of resources

a newly employed nurse is reviewing the organizational chart of the facility, observing that there is shared governance. what type of organization chart does the nurse recognize the facility follows?

matrix matrix organizations typically have some hierarchy to them, but if there is a change initiative that impacts a nursing procedure across the board, the communication will be more direct. additionally, in matrix organizations the flow of communication even around major change initiative could be both top-down and both up

a new nursing graduate has started working in a hospital unit that has had difficulty in staff retention. which type of resistance may be a result of changes that will occur despite the beliefs of the workforce? A. cultural B. political C. technical D. personal

A. cultural

last month two nursing units were merged to save on staffing costs. the nursing manager is no inquiring among the staff about who the change is working and if any barriers remain. what stage of change is this? A A. plan B. design C. integrate D. implement

A. plan B. design C. integrate

you are the nurse manager of a medical-surgical unit that is in need of a change in staffing rotation patterns, which will lead to major changes in how the unit is staffed. according to Lewins Change Theory, what forces are in play to enact these changes? A. refreezing forces B. driving forces C. freezing forces D. restraining forces

B. driving forces

a nurse manager is assigned to a new unit due to issues of administrative mismanagement which had resulted in staff becoming disillusioned as to the mission of the unit. as the unit manager, you are expected to develop new policies for the staff to follow. what is one of the greatest actors that may contribute to resistance of change on this unit? A. passivity B. resistance C. lack of trust D. anger

C. lack of trust

a nurse leader is thinking about approaching their manger with a new idea. to be properly prepared, the nurse leader should recognize this as a natural and expected response to change: A. blockage B. acceptance C. resistance D. passivity

C. resistance

a nursing staff member in the ED has noted where improvement of a procedure would bring about more efficiency. the staff members wants to share their idea with their supervisor. what would be the best option to facilitate the possibility of change? A. take initiative and implement the change without approval B. minimize the use of grassroots support from other staff C. schedule a meeting with your supervisor and submit a concise plan related to your idea for consideration D. communicate within a vacuum

C. schedule a meeting with your supervisor and submit a concise plan related to your idea for consideration

as the nursing manager of unit, which key steps should be performed before implementing a change effort? select all that apply) A. keep track of the pace and stress of the change B. investigate the magnitude and complexity of the intended change C. delay gathering nut from team members D. encourage input from team members who would be impacted by the change E. use a roadmap as a guide to complete the change

D. encourage input from team members who would be impacted by the change E. use a roadmap as a guide to complete the change B. investigate the magnitude and complexity of the intended change

environmental factors that influence health care can be restraining forces, driving forces, orbit. from the factors given here, identify those that are usually terms as driving forces. (select all that apply) A. education B. generosity C. economy D. medical advances E. technology explosion F. new health care policies

D. medical advances E. technology explosionA. education B. generosity

a single parent raising two children and relying on public transportation, is determined to become a registered nurse. what are the restraining forces in their situation? (select all that apply) A. stress of being away from children B. being a single mother C. student success center established within the nursing department D. relying on public transportation E. an advancement in medicine

D. relying on public transportation A. stress of being away from children B. being a single mother

the unit manager of a medical-surgical unit is transitioning the unit to electronic charting. according to lewis model, which of the following roles describe s you as the change agent? A. the mover B. the role player C. the refreezes D. the unfreezer

D. the unfreezer

the charge nurse for a post op treatment center believes that change needs to take place to make the nursing process smoother and the treatment center safer. the nurses rationale for making change would include which reasons? (select all that apply() A. to solve an existing problem B. to establish leadership power C. to fill work quotas D. to improve staff productivity E. to reduce unnecessary workload

D. to improve staff productivity E. to reduce unnecessary workload A. to solve an existing problem

a nurse leader recently transferred to a different hospital that is much older than the hospital at which the nurse was previously employed. after working in the new hospital for a month, the nurse leader believes it would be a great idea to brighten the rooms with a lighter paint job, obtain newer hospital beds and curtains, and hang some fun artwork. however the nurse leader doesn't want to be perceived as a threat to the team. how could these ideas be presented to minimize resistance? (select all that apply): A. engage other nurses in a discussion about the benefits of exam room aesthetics, then present the idea B. tell the supervisors and demand the change C. send a letter to the supervisors boss and report failure of the unit D. make over one of the exam rooms and use it as a test case to collect data on patient satisfaction, then present the data along with the idea to the team if the experiment was successful E. engage other nurses in a discussion about the benefits of exam room aesthetics, then solicit their ideas to improve aesthetics

E. engage other nurses in a discussion about the benefits of exam room aesthetics, then solicit their ideas to improve aesthetics D. make over one of the exam rooms and use it as a test case to collect data on patient satisfaction, then present the data along with the idea to the team if the experiment was successful A. engage other nurses in a discussion about the benefits of exam room aesthetics, then present the idea

environmental factors that influence health care can be restraining forces, driving forces or both. from the factors given here, identify those that can be termed as restraining forces. select all that apply A. poverty B. government regulation C. rising health care costs D. population demographics E. stress F. workplace shortages

E. stress F. workplace shortages C. rising health care costs A. poverty

the mission of the acute care facility is. "We are dedicated to creating a heathy community, one person at a time." What nursing leadership activities would correlate with that mission? (select all that apply?)

Reviewing health care provider order stop guarantee the nursing staff is appropriately carrying them out Notifying nursing staff of an upcoming CEU seminar on healthy eating for low-income families Mentoring a nursing student who is interested in introdudincing smoking cessation to patients and patient families without being preachy

a nurse leader has an idea for changing the intake flow in the ER to leverage more of the nursing staff. The leader knows that if they could implement the idea as a pilot program, they could prove it effectiveness and then use it in all the ERs in the region. The nurse leader is frustrated, however, because in order to implement even a pilot of the idea, a proposal must be submitted to the ER supervisor with a start to finishing scenario that details not only the process but also the risks, liabilities, and cost estimates. if the supervisor approves, the proposal would then be sent to the chief nursing officer, who would then send it to the administrator and board of directors for review and approval. which of these factors are influencing the nurse leader's ability to implement the pilot program

organizational structure the multiple layers of review characteristic of a hierarchy structure are impacting the nurse leaders ability to implement a pilot program

the oncology unit has recently experienced a higher-than normal patient census, which is requiring that nurses to pick up an additional patient. the hospital CFO has indicated that there are no additional funds available to hire additional full time nurse. as such, the unit manager anticipates some behavioral responses by the stakeholders of change (the nursing staff) within the unfreezing phase. what are some possible behavioral responses? (select all that apply)

withdrawal anger discontentment