Leadership Exam 2
·Two registered nurses have disagreed about their scope of practice regarding medication administration. What resource should the nurse consult? o A) The attorney general's office o B) The Nurse Practice Act o C) The nursing standards of practice o D) The code of ethics
B - The nurse practice act
Determine the nursing care hours per client day (NCH/PPD) if the following staffing existed for a 24-hour period (unit census = 10):12 midnight to 12 noon, 1 registered nurse, 1 licensed vocational nurse12 noon to 12 midnight, 1 registered nurse, 1 licensed vocational nurse, 1 unit clerk (8 hours only) A) 5.6 NCH/PPD B) 4.8 NCH/PPD C) 5.0 NCH/PPD D) 6.2 NCH/PPD
A - 5.6 NCH/PPD
Which statement concerning a budget is true? A) A budget's reliability decreases if it is prepared significantly in advance of the funding period. B) Budgets should be created as far in advance is possible. C) A budget is revised every 3 months during a fiscal year. D) Budgets are reliable only when expenses are fixed.
A - a budgets reliability decreases if it is prepared significantly in advance of the funding period
A state Nurse Practice Act is an example of which source of law? o A) Statutes o B) Constitution o C) Administrative o D) Judicial
A - statutes
Which statement is true regarding criminal law cases in the context of nursing? Select all that apply. o A) Incarceration is a likely consequence of being found guilty of a criminal offense. o B) Intentionally giving an overdose of a potent narcotic is a criminal offense. o C) A guilty verdict requires evidence beyond a reasonable doubt. o D) Most malpractice cases are tried in criminal court. o E) A serious, inadvertent drug error is likely to bring criminal charges.
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 reasonable doubt
Which characteristic of a planned change is most likely to threaten its success? o A) The suggested change is introduced to staff after the plan has been formalized. o B) Individuals affected by the change are involved in planning for the change. o C) The change agent is aware of the organization's internal and external environment. D) An assessment of resources to carry out the plan is completed before unfreezing.
A- the suggested change is introduced to staff after the plan has been formalized
The manager of a clinic is considering a change in the scheduling of vacation time in which nurses would self-schedule their vacation rather than having the manager respond to their submitted requests. A nurse has pointed out that it is possible that newer nurses may feel intimidated by more experienced nurses on the unit when scheduling their vacation. This observation constitutes what component of a SWOT analysis? A) S B) W C) O D) T
B - W
Which action should the nurse prioritize when trying to prevent malpractice claims? A) Always carrying a personal liability insurance policy B) Always functioning with the scope of the nursing practice act C) Asking for assistance when engaged in complicated procedures D) Devoting time to establishing an effective nurse-client relationship
B - always functioning with the scope of the nursing practice act
The nurse-manager oversees the care of several dozen nurses. With which nurse should the manager review the provisions of the Health Insurance Portability and Accountability Act (HIPAA)? A) A nurse who has discussed a client's status with a physician over the telephone B) A nurse who confirmed a new client's admission to the unit to a relative who telephoned C) A nurse who completed a client's documentation outside of the client's room D) A nurse who has initiated contact with the social worker to discuss a client's discharge planning
B - a nurse who confirmed a new clients admission to the unit to a relative who telephoned
A nurse-manager is having difficulty finishing the necessary tasks for each day. When implementing the time management process, what should the manager do first? o A) Complete the highest priority task. o B) Allow enough time for sufficient daily planning. o C) Reprioritize based on new information received. o D) Delegate work that cannot be accomplished in a day.
B - allow enough time for sufficient daily planning
What is the best response for a nurse-manager to handle someone who has a pattern of lengthy chatter? A) "We'll need to make it brief since my schedule is tight today." B) "I can't speak with you now, but I'm going to have free time at 11 AM." C) "Stop by and we can talk during your lunch break." D) "I am sorry but I do not have anytime today to talk with you."
B - "I can't speak with you right now, but Im going to have free time at 11 am"
A charge nurse has discovered that a medication error was made on the previous shift. What is the nurse's best action? A) Share that information with the charge nurse on the previous shift. B) Document the incident and follow it up as per hospital policy. C) Write a memo to the nurse who made the error requesting an incident report be written. D) Document in the client's chart that an incident report will be completed.
B - Document the incident and follow it up as per hospital policy
A recent switch to a new laundry provider at a long-term care facility has been described as "cost-effective." What does this imply about the change in laundry service? A) It is the least expensive service available. B) It is worth the cost. C) It is reimbursable. D) The cost was anticipated
B - It is worth the cost
What changed the structure of Medicare payments from a retrospectively adjusted cost reimbursement system to a prospective, risk-based one? A) Zero-based budgets B) Diagnosis-related groupings C) Prospective payment system D) Incremental budgets
B- diagnosis related groupings
A society that highly values social equity and equality is likely to support a health-care system which: A) prioritizes the role of the free market in providing health-care services. B) entitles all citizens to similar levels of health-care services. C) relies on the private sector to organize and provide health care. D) is cost-effective and efficient.
B- entitles all citizens to similar levels of health care services
Which statements accurately describe 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 differences between o jurisdictions. C) To be protected, nurses must provide care that is within their legal scope of practice. D) A nurse who provided out-of-scope care is not protected by the Good Samaritan law. E) A nurse can be held responsible for a person's injuries if he or she does not intervene.
C- to be protected, nurses must provide care that is within their legal scope of practice D- a nurse who provided out of scope care is not protected by the Good Samaritan law
A nurse-manager has identified the following objective for the care on the unit: "At least 95% of new clients' health records will contain a completed assessment for intimate partner violence." How should the manager improve this objective? o A) Increase the objective to 100% of health records. o B) Include the rationale for the objective. o C) Focus on client actions rather than documentation. o D) Include a time frame in the statement.
D - Include a time frame in the statement
When applying the principles of complex adaptive systems (CAS) theory, the nurse-manager should consider what principle? o A) Change must occur by organized, linear steps. o B) Change should be guided by intuition instead of being constrained by planning. o C) Change is easier in small organizations than large organizations. o D) Small variations in the change process can have major effects.
D - small variations in the change process can have major effects
A client has a managed care program that is organized on the basis of capitation. What is a characteristic of this client's health care? A) Health-care providers earn a bonus if the client remains free of disease for a predetermined length of time. B) The client pays a fixed percentage of the cost of any health care, usually between 10% and 20%. C) The program uses a "gatekeeper" to ensure appropriate utilization of services. D) The client's providers are paid the same amount each month, regardless of the client's use of services.
D - the clients providers are paid the same amount each month, regardless of the clients use of services
A nurse-manager has set a goal of addressing external time wasters. What phenomenon should the manager address? A) Difficulty in setting clear, achievable objectives B) The manager's inability to say no to coworkers' and subordinates' requests C) The fact that the manager has a tendency to procrastinate D) The large quantity of paperwork that the manager must complete
D - the large quantity of paperwork that the manager must complete
Which activity associated with the unfreezing state of change will have the greatest impact on the success of the movement stage of the change process? o A) Accurate identification of the problem requiring change o B) Effective information gathering concerning the problem o C) Key personnel voicing their opinions regarding the need for change o D) The need for change is perceived by those affected by the problem
D - the need for change is perceived by those affected by the problem
Nurses on a hospital unit have been informed that a change to the documentation system is being proposed. What factor surrounding this change is most likely to cause unfreezing? A) The proposed documentation system has been introduced in many hospitals in the region. B) The leader-manager supports a change in the documentation system. C) An influential nurse has extensive experience with different documentation systems. D) The nurses find the current documentation system unwieldy and inefficient.
D - the nurses find the current documentation system unwieldy and inefficient
The manager is using a decision package to set funding priorities for a hospital unit. What type of budgeting is the manager most likely using? o A) Flexible o B) Operating o C) Capital o D) Zero based
D - zero based
·A recent nursing graduate has not performed a dressing change on a central catheter for several months and is unsure of how to correctly perform this. The nurse should refer to the: o A) documentation. B) practice rules. C) organization policy. o D) procedure manual.
D- procedure manual
A nurse is considering applying for employment at a new health-care facility. How should the nurse best identify the aims and priorities of the organization? o A) Review the organization's mission statement. o B) Speak with as many front-line workers as possible. o C) Ask interviewers about recent responses to consumer satisfaction surveys. o D) Review the organization's policy and procedures documents.
A - review the organizations mission statement
What was the primary reason for the development of the prospective payment system? o A) Skyrocketing health-care costs following the advent of Medicare and Medicaid o B) The passage of the Health Maintenance Act of 1973 o C) The introduction of the Health Security Act to Congress o D) A coalition held by the three largest private insurers in 1975
A - skyrocketing health care costs following the advent of medicare and medicaid
A nurse-manager has introduced a proposed change to the operations of an ambulatory clinic and has been met with resistance. How should the manager best interpret this resistance? o A) Resistance is an expected component of a proposed change. o B) Resistance confirms that the proposed change is necessary. o C) The presence of resistance suggests that the change may be unsuccessful. o D) The presence of resistance indicates a need to implement power-coercive strategies.
A - resistance is an expected component of a proposed change
The leader-manager has successfully implemented a change and is now entering the refreezing stage of the change process. During this stage, the leader-manager should prioritize: o A) restoring stability to the workplace. o B) rewarding the employees who embraced the change early. o C) communicating the specific benefits of the change. o D) addressing the concerns of resistors.
A - restoring stability to the workplace
A manager has been experiencing challenges during a planning process and must implement strategies to overcome barriers that impede planning. What is the manager's best action? o A) Reevaluate whether the goals and objectives are appropriate and achievable. o B) Establish a fixed goal that is unaffected by changes in the organization. o C) Limit membership in the planning team to administrators, leaders, and o executives. D) Make the goals of the plan more general so that they can be more easily achieved.
A - reevaluate whether the goals and objectives are appropriate and achievable
The nurse-manager at a long-term care facility is participating in fiscal planning for the first time. What is fiscal planning? o A) A learned skill that improves with practice o B) A job role of the facility business manager o C) Part of the organizing phase of the management process o D) Reactive, based on political, social, and economic forces
A - a learned skill that improves with practice
What is the primary reason for documenting nursing interventions as soon as possible after an activity is completed? o A) Decreasing the risk of inaccurate documentation o B) Implementing effective time management skills o C) Demonstrating professional nursing behavior o D) Observing an established nursing principle
A - decreased the risk of inaccurate documentation
In planning strategies to prevent stagnation and promote renewal, which action would most likely result in the desired outcome? o A) Developing a program for recruitment of young talent o B) Rewarding employees by promoting from within o C) Having set pay increases mandated annually o D) Using length-of-service to determine committee selection
A - developing a program for recruitment of young talent
Which statement is an example of a process objective? o A) "Every nurse will screen newly admitted clients for alcohol abuse." o B) "The falls rate on the unit will decrease by 50% compared with 2016 rates." o C) "The health-care facility will achieve accreditation within the next 24 months." o D) "The new bowel care protocol will be fully implemented by the end of thecalendar year."
A - every nurse will screen newly admitted clients for alcohol abuse
A new nurse on the unit has been criticized for deviated from the accepted model of end-of-shift report, even though there is no written policy about the content or format for report. Which term is used for this type of policy? o A) Implied policies o B) Expressed policies o C) Understood precedents o D) The organizational culture
A - implied policies
An organization is considering the adoption of flexible budgeting. What advantage will this type of budgeting provide to the organization? A) Increased ability to adapt to changing circumstances throughout the year B) Increased reimbursement from state and federal agencies C) Longer budget cycles D) Increased opportunities for staff to participate in the budget process
A - increases ability to adapt to changing circumstances throughout the year
A nurse is facing a malpractice suit after a client was injured in a fall. When establishing whether the nurse committed a breach of duty, the court will consult with: o A) other nurses who practice in similar settings and specialties. o B) members of public who have been treated in similar care settings. o C) the administrators of the health facility where the fall occurred. o D) medical experts from the same area of specialty.
A - other nurses who practice in similar settings and specialties
A change in the skills mix has been proposed at a care facility. What action by the nurse-manager would best support a rational-empirical change strategy? A) Presenting the research evidence that supports the change B) Publicizing the change to generate enthusiasm C) Appointing "champions" to ensure communication throughout the change process D) Ensuring that employees know the consequences of resisting
A - presenting the research evidence that supports the change
Which statements regarding fiscal planning are true? Select all that apply. o A) Social influences affect fiscal planning. o B) A successful fiscal planner must be creative. o C) An understanding of economic forces is necessary to perform fiscal planning. o D) Practical experience is a key to being a good fiscal planner. o E) Subordinates should be excluded from fiscal planning.
A - social influences affect fiscal planning B - a successful fiscal planner must be creative C- an understanding of economic forces is necessary to perform fiscal planning D- practical experience is a key to being a good fiscal planner
Which statement is true concerning the refreezing phase of the change process? Select all that apply. A) The focus of this phase is to integrate the change into the status quo. B) Stabilization of change requires a 6- to 9-month period of time. C) If refreezing is incomplete, prechange behavior will be resumed. D) The change agent must remain involved until the refreeze stage is complete. E) The priority in this phase is to identify resistance.
A - the focus of this phase is to integrate the change into the status quo C- if refreezing is incomplete, prechange behavior will be resumed D - the change agent must remain involved until the refreeze stage is complete
The preoperative admitting nurse witnessed a client sign an operative consent form. The nurse then cosigned the same document as a witness. The client suffered an injury during surgery and names the nurse in the suit because the nurse witnessed the consent form. What is the most likely outcome? A) The nurse is not likely liable because the signature only specifies that the nurse witnessed the client signing the consent form. B) The nurse is likely not liable because surgery is beyond the nurse's scope of practice. C) The nurse may be liable because cosigning the consent form makes the nurse an equal member of the surgical team. D) The nurse is liable because cosigning the consent form confirms that the client fully understood the risks of surgery.
A - the nurse is not likely liable because the signature only specifies that the nurse witness the client signing the consent form
Many nurses at an ambulatory clinic have expressed frustration about the low quality of care that clients have been receiving. How should a manager best interpret this situation? o A) The nurses may be in the unfreezing phase of change. o B) The clinic is likely an aged organization. o C) The movement phase of change will be difficult to initiate. o D) There is a need for the manager to demonstrate power-coercive strategies.
A - the nurses may be in the unfreezing phase of change
The nurse-manager of a community health clinic is participating in budget planning for the next year. The manager will most likely assign the most money to what expenditure category. o A) The personnel budget o B) Short-term capital acquisitions o C) The operating budget o D) Supplies and equipment
A - the personnel budget
The nurse-manager of a hospital unit has categorized some tasks in the "do now" category. The tasks most likely reflect: o A) the unit's day-to-day operational needs. o B) issues related to long-term goals. o C) large, time-consuming tasks. o D) problems that cannot be safely delegated.
A - the units day to day operational needs
What is the reason that first- and middle-level managers experience more interruptions than higher level managers? A) They generally interact directly with a greater number of individuals in daily planning. B) They seldom have the clerical and secretarial help assigned to higher level managers. C) They often lack the time management skills that more experienced managers possess. D) They generally have heavier workloads than higher level managers.
A - they generally interact directly with a greater number of individuals in daily planning
The manager on a hospital unit has highlighted some of the large gaps between desired client outcomes and actual client outcomes. What component of Lewin's change theory is the manager demonstrating? o A) Unfreezing o B) Movement o C) Refreezing o D) Resistance
A - unfreezing
·Which nurse could face discipline for committing an intentional tort? Select all that apply. o A) A nurse who slapped a client when the client became verbally abusive o B) A nurse who applied restraints to a client as a punitive measure o C) A nurse who increased a client's analgesia dosage without a prescription o D) A nurse who neglected to supervise a client, leading to a fall o E) A nurse who threatened an elderly client when the client did not participate in care
A- a nurse who slapped a client when the client became verbally abusive B- A nurse who applied restraints to a client as a punitive measure E- A nurse who threatened an elderly client when the client did not participate in care
Which client would be most likely to qualify for Medicaid? A) An adult client who earns $750.00 per month B) A veteran who sustained injuries in combat C) A Native American client who lives on a reservation D) A child who requires physical therapy to recover from traumatic injuries
A- an adult client who earns $750.00 per month
A nurse is facing a malpractice suit after an incident where a client received the wrong dose of medication. Which elements must be present to prove malpractice? Select all that apply. o A) Breach of duty o B) Presence of injury o C) Ability to foresee harm o D) Causal relationship between inadequate care and injury o E) Intent to cause harm
A- breach of duty B- Presence of injury C-Ability to force harm D- Causal relationship between inadequate care and injury
A team has been formed to consider a change in medication delivery. How can the team leaders best promote a successful change? o A) Implement the change as rapidly as possible in order to diffuse resistance. o B) When planning, involve as many people who will be affected by the change as o possible. C) Bring in outside experts to implement the change. D) Enforce compliance with the change fairly and consistently.
B - when planning, involve as many people who will be affected by the change as possible
Which statements regarding a budget are true? Select all that apply. A) Personnel costs are normally considered to be an uncontrollable expense. B) A budget contains an estimate of both expenses and income for a fixed period. C) It allows for an institution to plan for the effective use of its resources. D) The cost of supplies is an example of a variable expense. E) A mortgage is an example of a fixed expense.
B- a budget contains an estimate of both expenses and income for a fixed period C- it allows for an institution to plan for the effective use of its resources D- the cost of supplies is an example of a variable expense E - a mortgage is an example of a fixed expense
The nurse is caring for a client who has health insurance that is a form of managed care. What are likely characteristics of this client's health-care plan? Select all that apply. o A) Clients as gatekeepers of their health-care services o B) A focus on prevention of illness o C) Decreased emphasis on inpatient hospital care o D) Capitation o E) Unlimited choice of health-care providers
B- a focus on prevention of illness C - decreased emphasis on inpatient hospital care D- capitation
A leader-manager plans to implement normative-reeducative strategies to facilitate change in a community health clinic. What action will the leader-manager most likely choose? A) Addressing likely points of resistance before they can be stated by nurses who are reluctant to change B) Communicating the fact that the majority of nurses are enthusiastic supporters of the change C) Publicizing the benefits of the proposed change and the research that supports it D) Providing incentives to nurses who are willing to adopt the change early
B - communicating the fact that the majority of nurses are enthusiastic supports of the change
A nurse-manager is beginning a day and is responsible for completing numerous tasks, including one high-priority task, three medium-priority tasks, and several lower priority tasks. How should the manager plan the day? A) Complete some low-priority tasks first to make room for focusing on the high-priority task. B) Complete the high-priority task as early in the day as possible. C) Arrange the tasks according to the amount of time that they will require. D) Complete the low-priority tasks first, then a medium-priority task, and then focus exclusively on the high-priority task.
B - complete the high priority task as early in the day as possible
·A nurse-manager is reviewing a backlog of correspondence and reads an e-mail asking for feedback from a manufacturer about a piece of equipment that is used at the facility. The manager reads that the sender asked for all feedback to be submitted by the end of last week. In what category of prioritizing should this task be placed? o A) Squeaky wheel o B) Don't do o C) Do later o D) Do now
B - dont do
A manager is trying to get in the habit of creating a daily list of tasks. The manager should: o A) avoid changing the list once initial planning is completed. o B) include flexibility in the implementation of the list. o C) include all relevant short-term, intermediate, and long-term goals. o D) keep the list highly structured, thus decreasing the possibility of procrastination.
B - include flexibility in the implementation of the list
the leader-manager of several inpatient units is participating in fiscal planning. During this process, the leader-manager should: o A) assume primary responsibility for the organization's budgetary planning goals. o B) monitor and evaluate all aspects of the unit's budget control. o C) encourage broad participation of subordinates in the budgetary process. o D) control unpredictable census variations that may undermine the personnel budget.
B - monitor an evaluate all aspects of the units budget control
A nurse is ostracizing a staff member who dresses "unprofessionally" and is encouraging other nurses to treat the staff member in the same way. This most closely represents which change strategy? o A) Power-coercive o B) Normative-reeducative o C) Rational-empirical o D) Resistance-withdrawal
B - normative - reeducative
During the budgetary process, a nurse-manager and the other members of the fiscal planning team are considering factors that may affect the accuracy of the budget. What factor should the team prioritize? o A) Legislation regarding client safety o B) Possible changes in reimbursement policies o C) Depreciation of capital equipment o D) Establishment of new HMOs in the region
B - possible changed in reimbursement policies
A nurse-manager is creating an organizational plan. What characteristic of the plan is more likely to promote success? o A) A midterm evaluation of the planning process o B) Several predefined evaluation checkpoints o C) The rejection of any earlier plans that did not succeed o D) Overplanning to accommodate predicted lapses in the planning process
B - several predefined evaluations checkpoints
The unit manager is calculating the NCH/PPD for a 24-hour period. The manager will need what data to calculate this? Select all that apply. o A) The acuity level of the clients on the unit o B) The total number of hours worked by nursing personnel o C) The average hourly wage of the nurses on the unit o D) The complexity of nursing care that was provided on a particular unit in a 24-hour time span E) The unit census
B - the total number of hours worked by nursing personnel E - the unit census
A nurse-manager is prioritizing tasks. Which tasks should the manager put into the "do now" category? A) Adding follow-up comments to an incident report from the previous day B) Covering sick calls for the upcoming shift to ensure there are enough nurses C) Conducting a new employee's initial performance review D) Meeting with the chairperson of the hospital's strategic planning committee
B- covering sick calls for the upcoming shift to ensure there are enough nurses
A planned change has been imposed by upper management at a large hospital and will greatly affect the delivery of care on inpatient units. What is an appropriate role for the leader-manager in this time of change? o A) Mobilizing resistance in a respectful but assertive way o B) Demonstrating a positive attitude toward the prospect of change o C) Implementing the change as rapidly as possible o D) Dialoguing with staff about the benefits of maintaining the status quo
B- demonstrating a positive attitude toward the prospect of change
A nurse-manager has recognized that unproductive socialization is making it difficult to complete each day's tasks. What action should the manager take to prevent this cause of inefficiency? A) Maintain an open-door policy so employees can have more rapid interactions with the manager. B) Schedule appointments so that interactions can be predicted and controlled. C) Request a transfer to a site where the manager knows fewer coworkers and employees. D) Ban socialization on the unit during working hours.
B- schedule appointments so that interactions can be predicted and controlled
A nurse is off-duty, in the community, and witnesses an adult suddenly collapse. The individual appears to be unconscious. How should the nurse apply Good Samaritan laws to this situation? o A) The nurse should intervene because of the legal obligation to do so. o B) The nurse is not required to intervene, even though intervening is an ethical act. C) The nurse should attempt to contact emergency services before intervening. o D) The nurse attempt to determine if the individual has an advance directive before intervening.
B- the nurse is not required to intervene, even though intervening is an ethical act
A nurse-manager can implement the principles of preactive planning by: A) responding quickly to emergent problems. B) using new technologies to accelerate change. C) preferring the status quo as a stable environment. D) directing planning in response to a crisis.
B- using new technologies to accelerate change
What is the name for a provision of health care in an organized system to subscribing members in a geographical area with an agreed-on set of basic and preventive supplemental health maintenance and treatment services for a fixed, prepaid charge? o A) Preferred provider organizations (PPOs) o B) A traditional third-party payer indemnity plan o C) A health maintenance organization (HMO) o D) Diagnosis-related groupings (DRGs)
C - a health maintenance organization (HMO)
The nurse-manager is creating a list in order to promote efficiency and productivity. What is the manager's best action? o A) Use long-term goals as the framework for creating the list. o B) Include slightly more activities than can be completed in a day, in order to o motivate. C) Begin by ranking the priority of tasks that need to be accomplished. o D) Keep each day's list as similar as possible to each other day's lists.
C - begin by ranking the priority of tasks that need to be accomplished
The nurse-manager is frustrated by the quantity of paper clutter. How should the manager best deal with this time waster? A) Require face-to-face communication between staff members rather than written documentation. B) Set aside a block of time once per week to process documents. C) Deal with paper correspondence as soon as possible after it arrives. D) Place additional recycling and trash receptacles throughout the unit.
C - deal with paper correspondence as soon as possible after it arrives
A client has provided informed consent for surgery and is being assessed by the nurse. What statement by the client should prompt the nurse to contact the surgeon? o A) "Why am I not allowed to eat and drink before the surgery?" o B) "How long do you think I'll stay in the recovery room?" o C) "Do you think this surgery is actually safe and necessary?" o D) "What is the difference between the surgeon and the anesthesiologist?"
C - do you think this surgery is actually safe and necessary
The nurse is participating in a planning process in a large health-care organization. The nurse and the other members of the team should: A) avoid specifics so that the plan can be applied in any health-care setting. B) ensure that long-term priorities are always prioritized over short-term priorities. C) ensure that evaluation occurs at several points during the process. D) begin to engage employees in the process after the plan has been implemented.
C - ensure that evaluation occurs at several points during the process
The novice nurse can reduce the likelihood of being sued for malpractice by: o A) beginning his or her career in a lower acuity setting. o B) avoiding performing interventions without a witness present. o C) establishing positive, therapeutic relationships with clients and families. o D) engaging in lifelong learning.
C - establishing positive, therapeutic relationships with clients and families
One of the most commonly used tools in health-care organizations is SWOT analysis. What is the definition of the "O" component of this model? o A) Internal attributes that help an organization achieve its objectives o B) Internal attributes that challenge an organization in achieving its objectives o C) External conditions that promote achievement of organizational objectives o D) External conditions that challenge or threaten the achievement of organizational objectives
C - external conditions that promote achievement of organizational objectives
A nurse is being sued for malpractice after a client completed suicide on the medical-surgical unit. The nurse's attorney has pointed out that the client had no history of suicide attempts, had no history of mental illness, and denied suicidality on the standard intake assessment. This argument calls into question what component of a malpractice suit? o A) Breach of duty o B) Failure to meet standard of care o C) Foreseeability of harm o D) A causal relationship
C - foreseeability of harm
How should the nurse-manager most effectively deal with the ever-changing nature of the nursing work environment? o A) Evaluating the management skills of the nursing team leaders o B) Providing time management classes for staff members o C) Frequently reassessing personally established priorities o D) Encouraging staff to engage in daily planning
C - frequently reassessing personally established priorities
The nurse-manager is on a team that is performing a SWOT analysis of the staffing system at a community clinic. What should the manager do when addressing the "S" component of the SWOT analysis? A) Identify stakeholders in the current staffing system. B) Examine the factors indicating that a change in the staffing system is necessary. C) Identify any characteristics of the staffing system that currently help the clinic meet its goals. D) Strategize about ways that the staffing system could possibly be improved.
C - identify any characterisitcs of the staffing system that currently help the clinic meet its goals
A nurse failed to supervise a confused client, and the client fell while transferring to the bathroom. The client was unharmed, but the client's family has launched a malpractice suit, citing the nurse's breach of duty. What is the most likely outcome of this case? A) The outcome will depend on the extent to which the client was responsible for the incident. B) It will likely be successful, provided the family can prove the event was reasonably foreseeable. C) It will likely be unsuccessful because the client was not injured. D) The outcome will depend on how the nurse's actions compare to the established standard of care.
C - it will likely be unsuccessful because the client was not injured
A leader-manager has recognized the need to be more consistent with time management? What skill should the nurse develop in order to facilitate time management? o A) Enlisting the help of an administrative assistant o B) Recognizing the need for goal setting o C) Prioritizing tasks accurately o D) Handling emergency situations quickly
C - prioritizing tasks accurately
A client is a member of an HMO and has chronic shoulder pain from an old injury. The client has decided to pursue shoulder surgery and the HMO has required a utilization review. What will this review focus on? o A) The circumstances surrounding the client's original injury o B) The client's baseline level of functioning o C) The costs and benefits of the proposed surgery o D) The profit to be made from the surgery
C - the costs and benefits of the proposed surgery
What characteristic of a health-care organization most clearly suggests that is an aged organization? o A) The organization was established more than 75 years ago. o B) The organization used to be the largest in the region but is now smaller than o several similar organizations. C) The organization has a history of stifling innovation. D) The organization is having difficulty attracting new graduates.
C - the organization has a history of stifling innovation
Which element should influence the nurse executive most heavily when assessing the organization's philosophy of nursing services for possible revision? o A) Consumer surveys o B) Input from other health disciplines o C) The organization's mission statement o D) Policy statements
C - the organizations mission statement
A health-care organization has adopted a new philosophy statement. What observation best shows that the philosophy is being implemented? o A) The philosophy is displayed prominently in client care areas and staff areas. o B) The philosophy aligns with the organization's vision and mission. o C) The philosophy is reflected in the care that clients and families receive. o D) The philosophy was created by an interdisciplinary group that included nurses.
C - the philosophy is reflected in the care that clients and families receive
A nurse-manager has been required to justify each item of the following year's proposed budget. The manager has been instructed that referring to the previous year's expenditures is not a sufficient justification. What type of budgeting is being used in this facility? o A) Incremental budgeting o B) Perpetual budgeting o C) Zero-based budgeting o D) Managed care
C - zero based budgeting
A nurse-manager is responsible for implementing a large and complex plan that will require much time and effort. How should the manager address this large task? o A) Work on the task with few breaks in order to finish as quickly as possible. B) Delegate as much of the task as possible to employees and focus on evaluation. o C) Break the task into smaller, less intimidating units. D) Delay beginning the task until it has the manager's undivided attention.
C- break the tasks into smaller, less intimidating units
A unit manager has been instructed to complete a comprehensive audit of the unit's use of resources. The manager is daunted by the size of the task, which will likely take several weeks to complete. The manager should: o A) set aside low- and medium-priority tasks until the project is complete. o B) delegate the project to subordinates and ask for weekly updates. o C) divide the project into smaller components that can be more easily completed. o D) request clerical or secretarial assistance.
C- divide the project into smaller components that can be more easily completed
How can subordinates be discouraged from taking up a nursing manager's time unproductively? Select all that apply. o A) Having the manager be accessible in the nursing station o B) Instituting an open-door policy o C) Having limited office seating available o D) Refocusing conversations as needed o E) Work in a public area
C- having limited office seating available D- refocusing conversations as needed
The nurse at a long-term care facility became frustrated with a client who has dementia and is unable to be redirected from wandering. The nurse applied restraints to keep the client in bed during a night shift despite there being no order to do so. How should this nurse's actions be best interpreted? A) The nurse is guilty of malpractice. B) The nurse's action is permissible if it was in the client's best interest. C) The nurse could face charges of false imprisonment. D) The nurse's action may be grounds for an assault charge.
C- the nurse could face charges of false imprisonment
A nurse-manager is having an exceptionally busy day and tells a colleague, "There's no way I can take a lunch break today. I've got too much to do." What is the colleague's best response? A) "It's important to take breaks, so there's never any valid reason for skipping lunch." B) "I know that happens sometimes. Let me know if you need help with organizing your day." C) "You probably just need to reorganize your day. Do you need help with that?" D) "Let's take a quick break and get something to eat, even if we have to come back a bit early."
D - "lets take a quick break and get something to eat, even if we have to come back a bit early."
Which is a true statement about planning? o A) All plans should be defined at the outset so that changes are not necessary. o B) Long- and short-range plans should be kept separate so priorities do not become confused. C) Objectives and goals must be established before the philosophy is written. o D) All plans should be flexible to accommodate changing circumstances.
D - all plans should be flexible to accommodate changing circumstances
Which activity should a change agent perform in order to best assure a successful implementation of a change? o A) Helping followers arrive at total consensus regarding the change o B) Encouraging subgroup opposition to change so many viewpoints can be heard o C) Using change by drift if the resistance to change is too strong o D) Being available to support those affected by a change until the change is complete
D - being available to support those affected by a change until the change is complete
A client belongs to an HMO that is a preferred provider organization (PPO). When requiring health care, this client will most likely: A) prove that he or she has received preventive care from a provider at some point. B) pay out of pocket for care and then submit for reimbursement. C) be assessed by a nurse before being referred to a physician. D) choose between the health-care providers that are in the PPO.
D - choose between the health care providers that are in the PPO
The nurse-manager has begun the movement stage of a proposed change. What is the manager's most appropriate activity? A) Gather data about the need for change. B) Accurately diagnose the problem. C) Decide whether change is needed. D) Collaborate with stakeholders to develop a plan.
D - collaborate with stakeholders to develop a plan
The nurse who provides oversight to a large health-care organization can best demonstrate leadership during a time of change by: A) clearly and assertively reminding nurses of their responsibilities to accept change. B) asking permission of nurses before proposing a change process. C) acknowledging that there is going to be resistance during the change process. D) communicating a vision that change is an opportunity to be embraced.
D - communicating a vision that change is an opportunity to be embraced
A nurse-manager is applying chaos theory to a proposed change in the structure of care at a clinic. What skills will best facilitate the manager's application of this theory? o A) Creating "buy-in" from the stakeholders o B) Finding solutions to resistance to change o C) Changing attitudes more than increasing knowledge o D) Finding underlying order in seemingly random data
D - finding underlying order in seemingly random data
A disease outbreak in the local community caused an unprecedented increase in staffing costs. In what category of expenses should the nurse-manager place these costs? o A) Controllable o B) Fixed o C) Capital budget o D) Noncontrollable
D - non controllable
An older adult client has been admitted to the hospital with pneumonia and has been placed on a critical pathway. This tool will allow the care team to: o A) minimize the client's out-of-pocket expenses for care. o B) decrease the amount of paperwork required for reimbursement. o C) minimize administrative costs. o D) standardize the client's care.
D- standardize the clients care
At the unit level, what time frame may be considered long-range planning? o A) 3 months o B) 6 months o C) 12 months o D) 18 months
I NEED TO LOOK THIS ONE UP
What is an implication of responsibility accounting for a nurse who manages a hospital unit? o A) The manager is accountable for the way that resources on used on the unit. o B) The manager has a responsibility to submit the unit budget on time each year. o C) The organization's financial officer works with manager regarding budget o approval. D) The budgeting process must be transparent and data must be made publicly available.
The manager is accountable for the way that resources on used on the unit
