exam 1 ch 1,2,3,4,5,6,20

In an attempt to persuade employees to bargain for another type of health insurance, a handout is circulated that describes the present employees' health care insurance as being insensitive, limiting choices of care providers, and providing inferior care. This reflects which aspect of Lewin's planned change? a. Unfreeze b. Move c. Refreeze d. Acceptance

ANS: A Correct: Unfreeze is correct because the change agent promotes problem identification and encourages awareness of the need for change. In alignment with Lewin's stages of change (unfreezing, moving, and refreezing), education and involvement are keys to successful change. People must believe that improvement is possible before they will be willing to consider chang

Managers who exhibit an authoritative behavioral style are most likely to use which source of power? a.Informal b.Expert c.Coercive d.Reward

ANS: C Correct: Seven primary sources of power are known. Coercive power is based on fear of punishment or failure to comply. Coercive power fits well into the authoritative behavioral style because authoritative managers dictate the work with much control, usually ignore the ideas or suggestions of subordinates, and provide little feedback or recognition for work accomplished.

An RN with excellent assessment and psychomotor skills would derive power on the basis of which source? A. Rewards B. Coercion C. Expert D. Legitimate

ANS: C Correct: Seven primary sources of power are known. Expert power is based on knowledge, skills, and information.

Which action is associated with relationship age leadership? Select all that apply. A) Communicates regularly with subordinates B) Encourages teamwork to achieve problem solving C) Includes committee representatives from all areas that will be affected by the change D) Recognizes staff members who have contributed plausible problem-solving solutions

Ans: A, B, C, D Feedback: People skills, cooperation, and valuing staff knowledge are all characteristics of the relationship age leader. Focus on fact gathering rather than finding the meaning of the data is characteristic of an industrial age leader.

Which statement regarding the characteristics of a good leader is true? A) They are totally trustworthy B) They may have character flaws C) They are by nature good intentioned D) Charisma is their strongest attribute

Ans: B Feedback: Leaders may be deceitful and trustworthy, greedy and generous, and cowardly and brave. To assume that all good leaders are good people is foolhardy and makes us blind to the human condition. It is only when we recognize and manage our failings that leaders achieve greatness.

Collecting data about the ethical problem and identifying who should be involved in the decision-making process is accomplished in which phase of the MORAL decision making model?

Massage the dillemma

The only treatment left for a patient diagnosed with advanced cancer is a rare, highly experimental bone marrow transfusion with a 10% success rate. The insurance company refuses to authorize payment for the $200,000 procedure, arguing that the money could be better be spent providing well-baby screening for 2,000 resident in the service area. What does this decision by the insurance company reflect?

D. Utility

Florence Nightingale is attributed with being intelligent (she developed statistical methods to evaluate health care), dependable (she often worked long hours to care for the injured), and ambitious (she fought against society's perception of nursing). Those who depict her as a leader on the basis of these qualities are practicing which leadership theory? A.Trait B. Chaos C. Bureaucracy D. Organizational

ANS: A Correct: Leadership trait theory describes intrinsic traits of leaders and is based on the assumption that leaders were born with particular leadership characteristics. Other traits found to be associated with this leadership theory include intelligence, alertness, dependability, energy, drive, enthusiasm, ambition, decisiveness, self-confidence, cooperativeness, and technical mastery.

nurse manager wants his nursing unit to be a place where all nurses want to work, where patient satisfaction is high, and care is innovative and interdisciplinary. Staff are encouraged to chair taskforces to improve quality of care and he counsels staff in areas of measuring patient outcomes. Other managers want to mimic this manager's approach to improve their own units. This nurse is which type of leader? A. Transformational B. Transactional C. Laissez-faire D. Authoritative

ANS: A Correct: Transformational leaders mentor followers through a vision and are admired and emulated.

According to the unit's policy for call-ins, a nurse is suspended for 3 days because of excessive call-ins that occur within 15 minutes of shift change. The nurse states, "You are unfair to me." Which theory would disprove the nurse's statement? A. Bureaucracy B. Closed systems C. Open systems D. Trait

ANS: A Correct: Weber's concept of bureaucracy revolves around the assumption that authority confers the right to issue commands within an organization on the basis of impersonal rules and rights, by virtue of the management position rather than any trait ascribed to the person who occupies that position. Other characteristics include the following: Impersonal rules govern the actions of superiors over subordinates, all personnel are chosen for their competence and are subject to strict rules that are applied impersonally and uniformly, and a system of procedures for dealing with work situations is in place. Represents the systems theory of the organization.

One difference between a leader and a manager is that a: a.leader has legitimate authority. b.manager motivates and inspires others. c.manager focuses on coordinating resources. d.leader focuses on accomplishing goals of the organization.

ANS: C Correct: The terms leadership and management are often used interchangeably, and it is difficult to discuss one without discussing the other. However, these roles have specific traits unique to themselves. The manager is the coordinator of resources (time, people, and supplies) needed to achieve outcomes.

nurse asks, "What is meant by 'internal' customers?" The correct response is: (Select all that apply.) A. Insurance companies B. Accreditors such as The Joint Commission C. X-ray technicians D. Clinical pharmacist E. Chief financial officer

ANS: C, D, E Correct: c. Internal customers are employees of an organization at all levels. An x-ray technician is an example of an internal customer. d. Internal customers are employees of an organization at all levels. A clinical pharmacist is an example of an internal customer. e. Internal customers are employees of an organization at all levels. A chief financial officer is an example of an internal customer.

Which action represents the key management function of strategic planning? A. Determining that all nurses on the unit understand the current organizational philosophy B. Evaluating the communication process between the pharmacy and the nursing departments C. Monitoring data from the quality management initiative related to the last three orientation programs D. Developing a 5-year plan that will incorporate the clinical nurse leader as a part of all nursing units

ANS: D Correct: A strategic plan is a written document that details organizational goals, allocates resources, assigns responsibilities, and determines time frames. The strategic plan generally looks 3 to 5 years into the future.

clinical nurse leader (CNL) enters the workforce and hopes to use her interdisciplinary skills to participate on a quality improvement committee. The coordinator of the quality group invites the CNL to join the group. Which type of power is demonstrated by the coordinator of the group? A. Coercive B. Transformational C. Laissez-fair D. Legitimate

ANS: D Correct: The coordinator of the committee has an official position within the organizational committee.

Which statement regarding ethical decision making is true?

Accepting some ambiguity and uncertainty are a part of ethical decision making.

Which statement is true regarding criminal law cases? Select all that apply. A) Incarceration is a likely consequence of being found guilty of a criminal offense B) Intentionally giving an overdose of a potent narcotic is a criminal offense C) A guilty verdict requires evidence beyond a reasonable doubt D) Most malpractice cases are tried in criminal court

Ans: A, B, C Feedback: In criminal cases, the individual faces charges generally filed by the state or federal attorney general for crimes committed against an individual or society. In criminal cases, the individual is always presumed to be innocent unless the state can prove his or her guilt beyond a reasonable doubt. Incarceration and even death are possible consequences for being found guilty in criminal matters. Nurses found guilty of intentionally administering fatal doses of drugs to patients would be charged in a criminal court. Most malpractice cases are tried in civil court.

Which action demonstrates appropriate management regarding legal issues? Select all that apply. A) Remains current on all institutional policies and procedures B) Delegates with consideration to appropriate scopes of practice C) Requires physical proof of appropriate professional licensure each year D) Provides yearly in-services on the operation of newly acquired equipment

Ans: A, B, C Feedback: Sound management functions regarding legal issues include understanding and adhering to institutional policies and procedures delegating to subordinates wisely, looking at the managers scope of practice and that of the individuals he or she supervises, and monitoring subordinates to ensure they have a valid, current, and appropriate license to practice nursing. In-services should be held frequently especially when related to issues that affect care delivery. The reliance on peers for advice in such matters is not prudent; the institutions legal advisor is much better prepared for this task.

How many characteristics such as servant leadership does Tabaka suggest is required of an agile organization today? A) 1 B) 5 C) 10 D) 15

Ans: C Feedback: Tabaka suggests that servant leadership is one of the top 10 characteristics of an agile organization today.

verdict of suspension or loss of licensure represents what type of law? A) Criminal B) Civil C) Administrative D) Judicial

Ans: C Feedback: A verdict of suspension or loss of licensure represents administrative law. This type of law is not based on any of the other options.

doctor orders a medical procedure that the staff nurse has reason to believe will harm the patient. Which statement accurately states the legal consequences of carrying out, or refusing to carry out, the procedure? A) The staff nurse cannot be held legally liable for any harm to the patient if the procedure is carried out with due care B) The nurse may lose his or her license by refusing to carry out the procedure C) The nurse can be held legally liable for any harm if the procedure is carried out without question D) The nurse can be held accountable for practicing medicine without a license

Ans: C Feedback: All nurses have personal liability, which means that every person is liable for his or her own conduct. None of the remaining options describes that liability or its outcomes accurately.

Malpractice or professional negligence is the failure of a person with professional training to act in a reasonable and prudent manner. How many components must be present for an individual to be found guilty of malpractice? A) Three B) Four C) Five D) Six

Ans: C Feedback: Five components must be present for a professional to be held liable for malpractice: duty to use care, failure to meet standard of care, foreseeability of harm, direct relationship between failure to meet the standard of care and injury can be proved, and injury.

What element must be included in the process of securing informed consent? A) A timeline of when the treatment is expected to occur B) Written information on what the post procedure outcomes will be C) Information regarding the risks involved in the proposed procedure D) An explanation of the nature of all associated treatment provided by the nurse

Ans: C Feedback: Informed consent can be given only after the patient has received a complete explanation of the surgery, procedure, or treatment and indicates that he or she understands the risks and benefits related to it. Timeline and nursing responsibilities are not components that are included. Outcomes are identified as expected or desired; no guarantees are given.

What statement describes the concept of quantum leadership? A) Ability to use emotions effectively that is required by leader-managers in order to enhance their success B) In order to lead, leaders must be true to themselves and their values and act accordingly C) One individual convinces another to consider a new idea, product, or way of looking at things D) The environment and context in which people work is complex and dynamic and that this has a direct impact on organizational productivity

Ans: D Feedback: Quantum leadership suggests that the environment and context in which people work is complex and dynamic and that this has a direct impact on organizational productivity required by leader-managers in order to enhance their success. Authentic leadership suggests that in order to lead, leaders must be true to themselves and their values and act accordingly. Thought leadership refers to any situation whereby one individual convinces another to consider a new idea, product, or way of looking at things.

Goleman in his best seller Emotional Intelligence built upon work in his identification of five components of emotional intelligence. Which component of emotional intelligence is occurring when a person is proficiently handling relationships and building networks? A) Self-regulation B) Motivation C) Empathy D) Social skills

Ans: D Feedback: Social skills: Proficiency in handling relationships and building networks; an ability to find common ground. Self-regulation: The ability to control or redirect disruptive impulses or moods as well as the propensity to suspend judgment. Motivation: A passion to work for reasons that go beyond money or status; a propensity to pursue goals with energy and commitment. Empathy: The ability to understand and accept the emotional makeup of other people.

How is the legal expansion of nursing roles accomplished? A) The expansion of job descriptions in an agency B) Written contracts between the nurse and the client C) A written agreement between the nurse and the physician D) Revision of the Nurse Practice Act

Ans: D Feedback: RN scope of practice is always determined by the Nurse Practice Act and any expansion of roles must occur through legislated changes in that statute. None of the remaining options are sufficient to expand nursing roles legally.

Even after a lengthy discussion concerning the ramifications, a patient wants to leave the hospital against medical advice (AMA). What would the nurse do in the role of patient advocate? A) Encourage the patient to wait until morning to leave the hospital B) Ask family members to help talk the patient out of the decision C)Call the security guard to escort the patient off hospital property D) Make sure the patient has appropriate follow-up appointments

Ans: D Feedback: As advocate for this patient, you have made sure he is informed of the ramifications of leaving AMA; however, it is a patient's right to refuse treatment. The other options fail to recognize the patient's right to make autonomous choices.

Which term is used to identify a person's feelings of powerlessness to stop unethical behavior in another person or institution?

Moral outrage

Which statement regarding the MORAL decision-making model is true

The identification and analysis of multiple alternatives for action is required.

Much of the difficulty people have in making ethical decisions results from a lack of formal education about problem solving. Research found what percentage of nurses and social workers reported having no ethics training

25%

What does the moral principle of autonomy govern?

A person's right to make his or her own decision

What is an ethical dilemma? 1. A) A problem that can be solved using empirical data 2. B) A situation that has clearly delineated facts for decision making 3. C) A problem that when handled effectively has a mutually agreed-upon solution 4. D) A situation that requires choosing between two or more undesirable alternatives

A situation that requires choosing between two or more undesirable alternatives.

staff nurse provides care based on intuition and always seems to be in control of her personal and professional life—serving on the board of the state nurses association, serving as the nursing unit's representative on the ethics committee, and coaching her daughter's soft ball team. Many of the staff observes how she manages time and provides care. This nurse's power comes from which type of power? A. Referent B.Legitimate C. Information D. Connection

ANS: A Correct: Referent power comes from the followers' identification with the leader Referent leaders are admired and respected and able to influence other nurses because of their desire to emulate her.

An explosion just occurred at the local factory, and hundreds of employees have sustained varying degrees of injury. Which type of nursing leadership is most effective in this situation? a.Autocratic b.Democratic c.Laissez-faire d.Referent

ANS: A Correct: The dynamics of the situation demand that the leader take control and direct employees to specific actions in response to the emergency.

nurse manager is concerned with restocking the emergency cart, creating the staff schedule, requesting floor stock from pharmacy, and checking the orders on patient charts. Which type of leader accurately describes this nurse? A.Transactional B. Situational C. Transformational D. Contemporary

ANS: A Correct: The transactional leader is concerned with the day-to-day operations of the facility.

Registered nurses who are entering the workforce will have expanded leadership responsibilities that include: (Select all that apply.) A. serving on interdisciplinary care teams. being competent to work in several areas independently when dictated by patient census. B. attending a meeting to plan advanced training for unlicensed assistive personnel. C. evaluating outcomes of care that are reported to a standing committee. D. managing units with higher acuity, shorter length of stay, and more diverse patients and staff.

ANS: A, C, D, E Correct: a. The new nurses will be placed in many situations that require leadership and management skills: for example, managing a group of assigned patients, serving on a task force or committee, acting as team leaders or charge nurses, and supervising unlicensed assistive personnel and licensed vocational/practical nurses. Diverse patients have comorbidities and require complex interventions delivered during shorter stays with an ever-increasing diverse staff. c. The new nurses will be placed in many situations that require leadership and management skills, for example, managing a group of assigned patients, serving on a task force or committee, acting as team leaders or charge nurses, and supervising unlicensed assistive personnel and licensed vocational/practical nurses. d. The new nurses will be placed in many situations that require leadership and management skills, for example, managing a group of assigned patients, serving on a task force or committee, acting as team leaders or charge nurses, and supervising unlicensed assistive personnel and licensed vocational/practical nurses. e. The new nurses will be placed in many situations that require leadership and management skills, for example, managing a group of assigned patients, serving on a task force or committee, acting as team leaders or charge nurses, and supervising unlicensed assistive personnel and licensed vocational/practical nurses.

The illustration below identifies which type of chart? A. Productivity B. Organizational C.Resource D. Staffing

ANS: B Correct: An organizational chart is a visual picture of an organization that identifies lines of communication and authority. Incorrect: a. Productivity is the amount of output or work that is produced with a specific quantity of input or resources. c. Resources include personnel, time, and supplies needed to accomplish the goals of an organization. d. Staffing is the manpower needed to complete the work.

first step in the nursing process and in the problem-solving process is to: a. identify the problem. b. gather information. c. consider the consequences. d. implement interventions.

ANS: B Correct: The nursing process, which is familiar to nurses who address patient care needs, can be applied to all management activities that require decision-making and problem-solving. As in the nursing process and the problem-solving process, one must first gather information about the problem or situation.

staff nurse states, "I really enjoyed having dinner with the Chief of Medical Staff and the President of the hospital. We hope to meet again soon." Which source of power does this nurse possess? A. Expert B. Legitimate C. Connection D. Reward

ANS: C Correct: Connection power results from knowing or associating with power people such as the upper administration.

hospital recently learned that their scorecard did not meet the national benchmark for patient satisfaction and brought in a professional change agent to determine what their issues were and how they could improve their score. The agent collected data and recommended that nurses participate in interdisciplinary walking rounds and allow the patient and family to be participants. Nurses now round every shift and perform "huddles to update the team" as needed throughout the shift as part of best practices. Random visits are made to nursing units to ensure all nurses are participating and patients are interviewed for their involvement. This stage of Lewin's change is: A. unfreeze. B. moving. C. refreeze. D. resistance.

ANS: C Correct: In the refreezing stage, change becomes status quo and the agent reinforces until the change is part of the daily process as in the above situation.

director of nursing (DON) asks the staff to list how their nursing unit can help the organization meet its goal to "provide quality patient care with attention to compassion and excellence." An ad hoc committee is formed to develop a timeline of identified actions. The DON coaches the committee to reach desired outcomes. This DON is demonstrating which other role of leadership and management? A. Transactional B. Clinical consultant C. Corporate supporter D. Autocratic

ANS: C Correct: The manager is embracing the mission of the organization by supporting achievement of goals noted in the mission statement.

manager just finished the last annual performance review of the staff, reviews the unexpected expenditures for the month due to use of agency nurses, and shares the latest quality indicators with the staff nurses. This manager is performing which management function? A. Directing B. Planning C. Organizing D. Controlling

ANS: D Correct: Controlling is the final management function. It includes performance evaluations, financial activities, and tracking outcomes of care to ensure quality.

hospital's policy requires that all nurse managers must have a minimum of a bachelor's degree in nursing. A BSN nurse new to the hospital has recently been hired as nurse manager for the oncology unit. An RN who has worked on this unit for many years is unable to be promoted to a nurse manager position because of his educational status and has been commenting to physicians and staff, "The new nurse manager has book sense but no leadership abilities." What is the best approach that can be used by the new nurse manager who is attempting to gain the trust and respect of the nursing staff on the unit? A. Send memos to all staff except the upset nurse to invite them to a luncheon. B. Ask management to transfer the upset nurse to another unit. C. Assign the upset nurse to committees that do not directly affect that nursing unit. D. Acknowledge the clinical expertise of the upset nurse and clearly explain the expectations for teamwork and open, honest communication.

ANS: D Correct: The best way for the new nurse manager to communicate with this employee, who may be an informal leader, is to show respect for the individual's clinical expertise and experience through clear and direct communication. The new nurse manager should attempt to identify the staff nurse's power as an informal leader, should involve him and other staff members in decision-making and change-implementation processes, and should clearly communicate goals and work expectations to all staff members.

nurse is reading about positive reinforcement with the goal of increasing staff motivation. Which action would demonstrate positive reinforcement? A. Every morning at shift change, thank each employee for an excellent job. B. Rotate a monthly "employee recognition award" among all employees on the unit. C. Wait until the annual performance review to recognize accomplishments. D. Give spur-of-the-moment recognition to an employee who has accomplished a goal.

ANS: D Correct: To be effective, positive reinforcement should (1) be specific, with praise given for a particular task done well or a goal accomplished; (2) occur as close as possible to the time of the achievement; (3) be spontaneous and unpredictable (praise given routinely tends to lose value); and (4) be given for a genuine accomplishment.

transition has occurred in the twenty-first-century industrial age leadership to what type of leadership? A) Relationship age B) Quantum C) Authentic D) Thought

Ans: A Feedback: A transition has occurred in the twenty-first-century industrial age leadership to relationship age leadership. Quantum leadership suggests that the environment and context in which people work is complex and dynamic and that this has a direct impact on organizational productivity required by leader-managers in order to enhance their success. Authentic leadership suggests that in order to lead, leaders must be true to themselves and their values and act accordingly. Thought leadership refers to any situation whereby one individual convinces another to consider a new idea, product, or way of looking at things.

Avolio states that there are four factors that cover the components of authentic leadership. What is occurring when analyzing data rationally before making decisions? A) Balanced processing B) Internalized moral perspective C) Relational transparency D) Self-awareness

Ans: A Feedback: Balanced processing refers to analyzing data rationally before making decisions. Internalized moral perspective suggests that the authentic leader is guided by internal moral standards, which then guide his/her behavior. Relational transparency refers to openly sharing feelings and information appropriate to a situation, and self-awareness alludes to a knowing of self so as to make sense of the world.

Goleman in his best seller Emotional Intelligence identifies self-awareness as one of the five components of emotional intelligence. What is self-awareness? A) The ability to recognize and understand one's moods, emotions, and drives as well as their effects on others B) The ability to control or redirect disruptive impulses or moods as well as the propensity to suspend judgment C) A passion to work for reasons that go beyond money or status; a propensity to pursue goals with energy and commitment D) The ability to understand and accept the emotional makeup of other people

Ans: A Feedback: Self-awareness: The ability to recognize and understand one's moods, emotions, and drives as well as their effects on others. Self-regulation: The ability to control or redirect disruptive impulses or moods as well as the propensity to suspend judgment. Motivation: A passion to work for reasons that go beyond money or status; a propensity to pursue goals with energy and commitment. Empathy: The ability to understand and accept the emotional makeup of other people

Which activity supports the principles of strengths-based leadership? A) Tuition reimbursement for LPN to RN transition programs B) Rehab services to staff diagnosed with abuse problems C) Mental health counseling for depression and anxiety D) Smoking cessation support classes

Ans: A Feedback: Strengths-based leadership, which grew out of the positive psychology movement (began in the late 1990s), focuses on the development or empowerment of workers' strengths as opposed to identifying problems, improving underperformance, and addressing weaknesses and obstacles.

What is the conclusion of interactional theories regarding successful leadership? A) Leaders, followers, and the situation were all variables that interacted B) The situation had the most profound effect on success in leadership C) The situation has a greater effect on outcomes than followers do D) Good results would occur if leaders led well

Ans: A Feedback: The successful leader will diagnose the situation before applying strategies from a large repertoire of skills that involve assessing the various variables presented by the leader, the followers and the situation. The remaining options are not related to interactional leadership theory.

Which principle will help increase the likelihood that followers do not mislead their leader? A) Support the followers' right to disagree B) Rely only on facts and discount intuition C) Discourage acceptance until the facts are proved D) Identify who to rely upon and who not to listen to

Ans: A Feedback: There is no guarantee that followers will not mislead leaders, but adhering to certain principles, such as making sure that followers are allowed to disagree, will guard against this happening. The remaining options are flawed in the principles they support.

What concept is servant leadership based upon? A) Trusting and valuing employees B) Genuinely liking your colleagues C) A laissez-faire style of leadership D) A dynamic leadership charisma

Ans: A Feedback: These managers, termed servant leaders, put serving others, including employees, customers, and the community, as the number-one priority. In addition, servant leaders foster a service inclination in others that promotes collaboration, teamwork, and collective activism. The servant leader is not necessarily associated with the concepts identified in the other options.

What is a focus of thought leadership? A) Challenging the status quo B) Learning new technology C) Keeping up with current nursing knowledge D) Being a transformational leader

Ans: A Feedback: Thought leadership applies to a person who is recognized among his or her peers for innovative ideas and who demonstrates the confidence to promote those ideas. Thus, thought leadership refers to any situation in which one individual convinces another to consider a new idea, product, or way of looking at things. None of the other options is a focus of thought leadership.

What document permits a registered nurse to offer special skills and knowledge to the public in a particular jurisdiction when such practice would otherwise be unlawful? A) A state nursing license B) Institutional licensure C) ANA certificate D) ANA practice standards

Ans: A Feedback: In general, a license is a legal document that permits a person to offer special skills and knowledge to the public in a particular jurisdiction when such practice would otherwise be unlawful. A state nursing license allows for the practice of nursing in a specific state. Some professionals have advocated shifting the burden of licensure, and thus accountability, from individual practitioners to an institution or agency. Proponents for this move believe that institutional licensure would provide more effective use of personnel and greater flexibility. The ANA is not capable of permitting a person to practice nursing.

The nurse witnesses a patient sign an operative permit form. Legally, what does the nurses signature imply? A) Observed the client sign the consent form B) Is certain the client understands the proposed procedure C) Believe the client is capable of understanding the proposed procedure D) Assumes the client has had an adequate evaluation to agree to the procedure

Ans: A Feedback: Informed consent is obtained by a physician; therefore, a nurse is not legally responsible for informed consent but is confirming that the client signed the consent form. The other options are the responsibilities of the professional performing the procedure.

What is one way to promote open communication between patients and practitioners? A) Involving health-care consumers as active members of the health-care team B) Promoting the creation of cultures of patient safety in health-care organizations C) Establishing a federal leadership locus for advocacy of patient safety and health-care quality D) Building an evidence-based information and technology system that impacts patient safety and pursue proposals to offset implementation costs

Ans: A Feedback: One way to promote open communication between patients and practitioners is involving health-care consumers as active members of the health-care team. Pursing patient safety initiatives prevent medical injury by promoting the creation of cultures of patient safety in health-care organizations; establishing a federal leadership locus for advocacy of patient safety and health-care quality; and building an evidence-based information and technology system that impacts patient safety and pursue proposals to offset implementation costs.

state Nurse Practice Act is an example of which source of law? A) Statutes B) Constitution C) Administrative D) Judicial

Ans: A Feedback: Statutes are the only laws made by official enactment by the legislative body

How is the question of whether a nurse acted with reasonable care generally proven? A) The expert testimony of nursing witnesses B) The defendants explanation of what the nurse did C) The trial judge, after checking the outcome of prior similar court cases D) The testimony of expert medical witnesses

Ans: A Feedback: The testimony of other nurses in the same specialty as the defendant may be used to prove breach of duty. The other options are not considered qualified to testify to this matter.

What is an example of an unintentional tort? A) Professional negligence B) Assault C) Battery D) False imprisonment

Ans: A Feedback: While professional negligence is considered to be an unintentional tort, assault, battery, false imprisonment, invasion of privacy, defamation, and slander are intentional torts.

How is the action of advocacy described? A) Informing others of their rights and making certain they have sufficient information to make decisions B) Learning about the need for a decision and then making a good decision for other people C)Supporting an individual's right to make a decision even when they do not have accurate information D) Protecting the rights of patients in accordance with the law

Ans: A Feedback: The advocate informs others of their rights and makes certain they have sufficient information to make decisions. The remaining options are incorrect when describing the action associated with advocacy.

lawsuit pertaining to professional negligence must include duty, breach of duty, injury, and a causal relationship between breach of duty and injury. What else must be included? Which element is necessary to prove professional negligence? Select all that apply. A) Breach of duty B) Presence of injury C) Ability to foresee harm D) Causal relationship

Ans: A, B, C, D Feedback: A lawsuit pertaining to professional negligence must include duty, breach of duty, injury, a causal relationship between breach of duty and injury, and the ability to foresee harm. Intent to cause injury is not a requirement.

Which situations is a nurse-manager illegally responsible for reporting? Select all that apply. A) Suspected incidents of elder abuse B) Examples of substandard medical care C) Client-reported incidents of child abuse D) Confirmed case of a communicable disease

Ans: A, B, C, D Feedback: In addition, the manager, like all professional nurses, is responsible for reporting improper or substandard medical care, child and elder abuse, and communicable diseases, as specified by the Centers for Disease Control and Prevention. Disagreements are not mandated reportable situations.

manager demonstrating an understanding of the principles of Human Capital theory will schedule which staff in-service? Select all that apply. A) Effective communication skills B) Financial planning for retirement C) Advanced cardiopulmonary resuscitation D) Meeting the needs of the patient's family

Ans: A, C, D Feedback: Human capital can refer to a group's collective knowledge, skills, and abilities. Human capital theory suggests that individuals and/or organizations will invest in education and professional development if they believe that such an investment will have a future payoff. Communication, meeting family needs, and cardiopulmonary resuscitation are all skills and abilities that will enhance the individual's professional development and ultimately the services of the facility. The other options are related to the personal interests of the staff.

Which characteristics are associated with Collin's Highly Capable Individual level of leadership? Select all that apply. A) Possesses useful knowledge B) Builds effective interdisciplinary teams C) Galvanizes members to achieve goals D) Demonstrates effective organization skills

Ans: A, D Feedback: Level 1: Highly capable individual makes high quality contributions with their work; possesses useful levels of knowledge; and has the talent and skills needed to do a good job. Team building is a Level 2 characteristic. Organizational skills are associated with Level 3 while galvanizing members to achieve goals is demonstrated by Level 4 leaders.

Professional organizations generally espouse standards of care that have what relationship to those required by law? Select all that apply. A) Higher than those required by law B) The same as those required by law C) Are established after those required by law D) Are established prior to those required by law

Ans: A, D Feedback: Professional organizations generally espouse standards of care that are higher than those required by law. These voluntary controls often are forerunners of legal controls. The standards are written by health-care professionals while laws are written by legislatures.

Shirey suggests there are five distinguishing characteristics of authentic leaders. Which characteristic is occurring when authentic leaders link between purpose and passion by having congruence in beliefs and actions? A) Purpose B) Values C) Heart D) Relationships

Ans: B Feedback: Values: Authentic leaders link between purpose and passion by having congruence in beliefs and actions. Purpose: Authentic leaders understand their own purposes and passions as a result of ongoing self-reflection and self-awareness. Heart: Authentic leaders care for themselves and the people they lead, and their compassion is genuine. Relationships: Authentic leaders value building relationships and establishing connections with others, not to receive rewards but rather to strengthen the human connection.

Which response is characteristic of a servant leader? A) I don't think you have the skills necessary to be effective. B) Let me think about that request for 24 hours. C) Do whatever it takes to get it done fast. D) I'll personal handle this situation.

Ans: B Feedback: A servant leader always thinks before reacting. This leader also chooses words carefully so as to not damage those being led, provides directions toward goal achievement, and finds asking for input more important than personally providing solutions.

What is an example of a positive outcome of a leader's emotional intelligence? A) Emotions are held in check B) Emotions are used effectively C) Expression of one's emotions is expected D) Expression of one's emotions is encouraged

Ans: B Feedback: Emotional intelligence refers to the ability to use emotions effectively and is required by leader-managers in order to enhance their success. Holding one's emotions in check can be unhealthy. The remaining options do not address the usefulness of emotions.

What is the responsibility of a charge nurse who discovers that a medication error was made on the previous shift? A) Share that information with the charge nurse on the previous shift B) Document the incident as per hospital policy C) Write a memo to the nurse who made the error requesting incident report be written D) Write a note in the clients chart that an incident report will be completed

Ans: B Feedback: It is the responsibility as manager to immediately document the error according to hospital policy. Since policies concerning such situations vary, it is vital to know and follow established policies. It is not generally appropriate to make such a note on the clients chart.

Which behavior will best minimize a nurses risk for a malpractice claim? A) Always carry a personal liability insurance policy B) Always function with the states nursing practice act C) Ask for assistance when engaged in complicated procedures D) Devote time to establishing an effective nursenpatient relationship

Ans: B Feedback: Nurses can reduce the risk of malpractice claims by practicing within the scope of the Nurse Practice Act. Nurses should purchase their own liability insurance and understand the limits of their policies. Although this will not prevent a malpractice suit, it should help to protect a nurse from financial ruin should there be a malpractice claim. While the other options present reasonable advice, they will not necessarily help in the avoidance of a malpractice claim.

Which statement best describes the impact that the concept of respondeat superior has on the issue of nursing liability? A) It allows for joint liability among physicians, nurses, and health-care organizations B) It supports the sharing of blame among all involved sources of health-care services C) It encourages legal intervention when health care is thought to be substandard D) It implies that the institution is responsible for the acts of its employees

Ans: B Feedback: Nurses must remember that the purpose of respondeat superior is not to shift the burden of blame from the employee to the organization but rather to share the blame, increasing the possibility of larger financial compensation to the injured party. While the other options may be true statements, the correct option describes the more nurse-related implication of the concept.

What defines the legal boundaries of nursing at the state level? A) The states Attorney General B) The Nurse Practice Act C) The ANA standards of practice D) The ANA Code for Nurses

Ans: B Feedback: The 51 Nurse Practice Acts representing the 50 states and the District of Columbia are examples of statutes. These Nurse Practice Acts define and limit the practice of nursing, stating what constitutes authorized practice as well as what exceeds the scope of authority. Although Nurse Practice Acts may vary among states, all must be consistent with provisions or statutes established at the federal level. The other options lack the comprehensiveness and focus of a states Nurse Practice Act

What is the best reason that nurse-managers have an ongoing responsibility to be aware of legislation affecting nursing practice? A) This will prevent them from getting sued B) Laws are fluid and subject to change C) It will protect the agency from a lawsuit D) It will ensure that correct procedure is carried out

Ans: B Feedback: When using doctrines as a guide for nursing practice, the nurse must remember that all laws are fluid and subject to change. Laws are not static. It is the responsibility of each manager to keep abreast of legislation and laws affecting both nursing practice and management practice. While the other options are correct, they do not describe the most encompassing reason that nurse-managers need to keep aware of current legislature affecting nursing practice.

manager has proposed to the hospital board that it hires someone to teach management and leadership classes and that head nurses are paid to attend the classes. What is this an example of? A) Using emotional intelligence B) Transformational leadership C) Building human capital D) Using quantum leadership

Ans: C Feedback: By providing classes in leadership, the manager is investing in the potential of the head nurse staff to become better leaders and managers. Human capital refers to the attributes of a person that are productive in some economic context, although it is normally measured and conceived of as a private return to the individual as well as a social return. None of the remaining options relate to the example provided.

To decrease overtime, the manager of a surgical unit offers nurses who get their work finished on time for an entire 2-month period an extra day off with pay at regular time. What is this an example of? A) Bribing nurses B) Quantum leadership C) Principal agent theory D) Servant leadership

Ans: C Feedback: Principal agent theory suggests that followers may have an informational (expertise or knowledge) advantage over the leader as well as their own preferences, which may deviate from that of the principal. This may lead to a misalignment of goals. To influence the agent, the principal offers an incentive that corrects excessive overtime. The remaining options do not represent the example offered.

Avolio states that there are four factors that cover the components of authentic leadership. What is occurring when one openly shares feelings and information appropriate to a situation? A) Balanced processing B) Internalized moral perspective C) Relational transparency D) Self-awareness

Ans: C Feedback: Relational transparency refers to openly sharing feelings and information appropriate to a situation. Balanced processing refers to analyzing data rationally before making decisions. Internalized moral perspective suggests that the authentic leader is guided by internal moral standards, which then guide his/her behavior, and self-awareness alludes to a knowing of self so as to make sense of the world.

What is the critical leadership skill when attempting to build a cooperative and effective team? A) Showing their true feelings B) Empathizing with followers C) Identifying existing emotions in themselves and others D) Manipulating the emotions of all involved to achieve stated goals

Ans: C Feedback: Theorists studying emotional intelligence posit that the ability to identify emotions in themselves and in others is a critical ingredient of leaders, enabling them to build a cooperative and effective team. While the other options may have value, they do not represent the critical skill related to team building.

Which characteristics are required of a reasonable and prudent nurse? A) Years of clinically focused nursing experience B) Specialized nursing skills C) Average nursing judgment and skills D) Earned advanced nursing degree

Ans: C Feedback: Reasonable and prudent generally means the average judgment, foresight, intelligence, and skill that would be expected of a person with similar training and experience. The other options describe qualifications not required of a reasonable and prudent nurse.

Which statement regarding the responsibility of a manager in advocacy is accurate? A) Advocacy is a management function and not a leadership role B) Managers advocate only as needed to meet organizational goals C) Managers should advocate for patients as well as subordinates D) Professional advocacy is not a primary concern for most managers

Ans: C Feedback: Advocacy is helping others to grow and self-actualize. The manager must be an advocate for patients, subordinates, and the nursing profession. The remaining statements are not accurate descriptions of the manager's role as advocate.

Who plays a primary role in ensuring that workers have reasonable, working schedules? A) Unions B) Top administrators C) Managers D) Federal government

Ans: C Feedback: In workplace advocacy, the manager works to see that the work environment is both safe and conducive to professional and personal growth for subordinates. The other options play a role in such situations but the manager has the primary responsibility.

Which statement is true regarding the implications of a Good Samaritan law for a registered nurse? Select all that apply. A) A nurse has a legal responsibility to provide emergency services B) Such laws are universally worded so as to minimize state-to-state differences C) In order for protection to apply, the nursing care cannot be considered negligent D) A nurse who provided out-of-scope care is not protected by the Good Samaritan law

Ans: C, D Feedback: Nurses are not required to stop and provide emergency services as a matter of law, although most health-care workers feel ethically compelled to stop if they believe they can help. Good Samaritan laws suggest that health-care providers are typically protected from potential liability if they volunteer their nursing skills away from the workplace (generally limited to emergencies), provided that actions taken are not grossly negligent and if the health-care worker does not exceed his or her training or scope of practice in performing the emergency services. However, not being paid for your services alone will not provide Good Samaritan law protection. Good Samaritan laws apply only if the health-care worker does not exceed his or her training or scope of practice in performing the emergency services. Protection under Good Samaritan laws varies tremendously from state to state. In some states, the law grants immunity to RNs but does not protect LVNs or LPNs. Other states offer protection to anyone who offers assistance, even if they do not have a health-care background. Nurses should be familiar with the Good Samaritan laws in their state.

There are current and future paradigm shifts in health care that affect the leadership skills needed by nurses in the twenty-first century. What issue at the organizational and unit levels are nurse-leaders being directed to address? A) Active involvement in greatly needed health-care reform B) Persistent and growing international nursing shortage C) Shortage of qualified first-level nursing managers D) High turnover rates by staff nurses

Ans: D Feedback: At the organizational and unit levels, nurse-leaders are being directed to address high turnover rates by staff, an emerging shortage of qualified top-level nursing administrators, growing trends toward unionization, and intensified efforts to legislate minimum staffing ratios and eliminate mandatory overtime, while maintaining cohesive and productive work environments. At the national level, nurse-leaders and nurse- managers are actively involved in greatly needed health-care reform and in addressing a persistent, and likely growing, international nursing shortage. The other options, while describing noteworthy issues, do not include the issue that affects needed skills.

Which statement concerning nursing leadership functioning at its potential is true? A) The leadership role is most important in nursing today B) Leadership is most important in managing health-care costs C) The most important nursing leadership role is being charismatic D) There is a need to integrate nursing management and nursing leadership

Ans: D Feedback: For managers and leaders to function at their greatest potential, the two roles must be integrated. The other statements are not true.

Which statement best describes ethics? 1. A) How our lives and relationships are led in our reality 2. B) How people make decisions they see as legally and morally appropriate 3. C) The conflict, power, and interdependency associated with the way we live 4. D) What our conduct and actions should be regarding what is right and good

Ans: D Feedback: Ethics is the systematic study of what a persons conduct and actions should be with regard to self, other human beings, and the environment; it is the justification of what is right or good and the study of what a persons life and relationships should be, not necessarily what they are.

An organization has hired six RNs who have recently immigrated to the United States. The manager has noticed they interact very little with other staff, often speaking in their own language during their breaks, although they speak English while on duty. Which intervention would be the most helpful action for the manager to help these new RNs better assimilate? A) Explain to the new nurses the problem that their isolating is causing. B) Arrange to send them to an English language course at the local adult school. C) Ask the established RNs to make an effort to include the new nurses in after-work activities. D) Begin a short sharing session before client report, so all RNs can share information about their cultures and differences in client care.

Ans: D Feedback: Providing an opportunity for both groups of nurses to share their cultural heritage and differences in nursing care is an opportunity to promote acceptance among all members of the staff. It has been established that speaking the language is not a problem since they do so while on duty. Including them in after-work activities may demonstrate willingness on the staff's part but will not address work-related isolation. Merely presenting the problem to the new nurses does not show managing initiative.

What component of professional negligence is represented when a patient experiences a seizure resulting from a medication error? A) Duty to use due care B) Failure to meet standard of care C) Foreseeability of harm D) A causal relationship

Ans: D Feedback: A direct causal relationship between failure to meet the standard of care (breach) and injury can be proved when a patient is harmed because proper care is not given. None of the remaining options are relevant to this criterion.

The practice of allocating organs for transplantation based on a persons iworth to societyi is an example of what ethical principle for decision making? A) Autonomy B) Beneficence C) Utility D) Justice

Ans: D Feedback:Justice: Seek fairness, treat - equally, and treat - according to their differences. Autonomy: Promotes self-determination and freedom of choice. Beneficence: Actions are taken in an effort to promote good. Utility: The good of the many outweighs the wants or needs of the individual.

Which ethical framework would most likely be used to arrive at the nurse's decision to work overtime in spit of previous social plans?

Duty based

What is the role of the ANA Code of ethics and Interpretive Statements?

Functions as a guide to the highest standards of ethical practice for nurses.

What is an example of management function?

Identifies outcomes in ethical decision making that should always be sought or avoided.

Which ethical framework involves an individualized decision-making framework

Intuitionist

Which statement concerning autonomy and the employee is true?

It is a form of personal liberty. Its legal equivalent is self determination. It is based on a person's right to make a choice. It is supported by the process of progressive employee discipline.

Which statement regarding the distinction between legal and ethical obligations in decision making is correct?

Legal controls are clearer and philosophically impartial.

Which activity best demonstrates a nursing unit manager's attention to ethics standard of practice required of that position?

Membership on the institutions ethic board. Ans: A Feedback:ANA standards for ethics related to nurse administrators identifies participants on multidisciplinary and interdisciplinary teams that address ethical risks, benefits, and outcomes as a criteria measurement. The remaining options while addressing ethical behaviors on the administrators part are not as directly identified by the ANA.

Which member of the health care team is often placed in situation where they are expected to be agents for the patients, physicians, and organization all at the same time, all of which may have conflicting wants and/or goals?

Nurses

Which statement describes how moral uncertainty occurs?

Occurs when an individual is unsure which moral principles or values apply and may even include uncertainty as to what the moral problem is.

To make appropriate ethical decisions the nurse-manager must have knowledge of what item to assist in decision making?

Organizational process, proven decision making models, professional approach that eliminates trial and error, ethical principles and framework.

Which factor should be considered when assessing the quality of ethical problem solving?

Outcomes & Decision- making process

Which ethical principle associated with an adult child is legally given the right to make medical decisions for a cognitively impaired parent?

Paternalism

Which characteristic of an organization has influence on the ethical decisions its managers' make?

Purpose, Societal role, Societal constraints

Using both systematic approach and proven ethical tools and technology allows managers to make better decisions and increases the probability that they will feel confident about the decisions they have made. Leadership roles and management functions are involved in management ethics. What is an example of a leadership role?

Role models ethical decision making, which is congruent with the ANA Ethics and interpretive statement and professional standards.

Protecting patient confidentiality respects the client's right to

Self- determination