Leadership Exam 2 practice questions
The first stage of planned change involves: a. accepting the need for change b. cognitive redefinition c. integration and stabilization d. problem solving
a
**** is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.
Evidence-based practice
A nursing manager recognizes that the changes that she is expected by administration to implement will be met with staff resistance. She is committed to determining the root of the resistance and communication positively with her staff. The nurse manager's actions characterize her as an: a. change agent b. implementation expert c. restructuring motivator d. supervisory threat
a
A rapid response team within an acute care hospital is comprised of critical care physicians, nurses, and respiratory therapists. The team assists staff throughout the hospital with detecting and managing imminent patient deterioration. This is an example of a **** organizational form. a. parallel b. functional c. modified program d. metrix
a
A small critical care unit forms team of nurses to implement bedside rounds at shift change. the nurses have researched the efficacy of bedside rounds and have determined that this evidence-based practice will lead to improved communication of patient status. Which type of change does this demonstrate? a. transforming care at the bedside b. second-order change c. emergent change d. organizational change
a
According to the **** organizational approach, organizations are logical and predictable with identifiable and scientifically measurable characteristics that can be predicted, observed, or manipulated. a. objective b. subjective c. postmodern d. realistic
a
Effectiveness research: a. is the study of relationships among health care problems b. provides solutions to serious global health care issues c. reflects sound, reliable, and valid data that can be examined closely d. supplies data that are critical and worthy of gathering
a
Management information systems describe a broad scope of ativities that includes but is not limited to the managment of: a. decision support systems b. merchandise c. products d. nursing services
a
Mercy Hospital compares its surgical site infection rate to General Heart Hospital, which is known as a best-in-class hospital for its surgical site infection rates. Mercy Hospital studies General Heart Hospital's methods for reducing surgical site infection rates and uses that information to improve its own performance. This quality performance method is called: a. benchmarking b. evidence-based practice c. enterprise risk management d. continuous quality improvement
a
Patient surveys convey that they are uncertain about who is the registered nurse (RN). The CEO makes a decision that mandates that white nursing caps will be worn by all RNs and blue nursing caps by all licensed practical nurses to differentiate professional nurses and occupational nurses from nurses' aids and other ancillary staff. Which type of structure does this represent? a. Centralized b. Decentralized c. Nonparticipative d. Participative
a
Sentinel Event Alerts are published by TJC to do which of the following? a. Allow facilities to learn from sentinel events that have occurred in other facilities and incorporate recommendations for prevention into their policies. b. Notify hospitals that if a sentinel event occurs during an alert, the hospital will be subject to withdrawal of Medicare and Medicaid certification and reimbursement. c. Prevent a near-miss from occurring d. Assist hospitals to find national standardized performance measures to benchmark themselves against other similar hospitals.
a
The data analysts within a health care organization pull core meaure data from patient records on a quarterly basis. This data is then analyzed and collated into a report that is uploaded to TJC for analysis of adherence to core measure requirements. This is an example of: a. health information exchange (HIE) b. effectiveness research c. health information management d. management information systems
a
The division of work by occupation or function is a form of : a. specialization b. interdependence c. uncertainty d. technology
a
The implementation of an electronic health record (EHR) could enhance patient care by facilitating: a. communication across the health care continuum b. diabetes mellitus education and ongoing care delivery c. one-on-one counseling between the provider and the client d. physical and occupational therapy dispensing errors
a
The phrase "the buck stops here" best describes which of the following terms? a. Accountability b. Authority c. Responsibility d. Trustworthiness
a
According to organization theories, there are three perspectives regarding the nature of reality and knowledge within an organization. Which of the following are those perspectives? (SATA) a. Objectivism b. Subjectivism c. Postmodernism d. Realism e. Idealism
abc
What are some of the expected outcomes in the client domain of nursing data? (SATA) a. Patient satisfaction b. Achieved care outcomes c. Continuity of care d. Level of dependency e. Intensity of nursing care
abc
Which of the following statements describe the benefits of specialization in the health care setting? (SATA) a. Improved work performance b. Increase in expertise c. Improved efficiency and outcomes d. Increased workload e. Increased error reporting
abc
A framework for understanding health care improvement has been proposed by the IOM Committee on Quality of Health Care in America. The aims for health care quality improvement propose that health care systems ensure that care is: (SATA) a. safe b. timely c. efficient d. cost-controlled e. patient-centered
abce
The goals of meaningful use include: (SATA) a. improve quality of care and safety b. engage patients and their families in care c. improve population health d. reduce costs associated with health care e. improve care coordination
abce
TJC requires accredited organizations to participate in their core measure initiative. The current core measure sets include: (SATA) a. stroke b. tobacco treatment c. pneumonia measure d. iatrogenic pneumothorax e. venous thromboembolism f. acute myocardial infarction
abcef
An organizational chart is used to depict: (SATA) a. a visual display of the organizations positions b. the intentional relationships among positions c. open positions within human resources d. flow of authority e. advisory committees
abd
The Baldrige National Quality Award (BNQA) establishes a set of performance standards that define a total quality organization. The standards in areas of excellence include: (SATA) a. leadership b. strategic planning c. environment of care d. human resource focus e. medication management
abd
Which of the following statements are true regarding health information technology (HIT) applications in nursing services? (SATA) a. HIT involves nursing administration, clinical informatics, and effectiveness research b. Health information data allow nursing leaders to make informed decisions regarding patient care c. HIT is used primarily for financial decision making d. Clinical decision support utilizes tools for downloading, collecting, organizing, and analyzing data. e. HIT is used by senior leaders only
abd
Nurses managers utilize outcomes data to make decisions about nursing care effectiveness. Which NMMDS data elements would be most effective in evaluating nursing care? (SATA) a. Nursing diagnosis b. Turnover c. Population served d. Client accessibility e. Intensity of nursing care
abe
What are the primary purposes and benefits of EHRs? (SATA) a. Single source of clinical, financial, and legal record b. Electronic format supports the storge and exhange of continuity of care c. Available within the health care facility to ensure confidentiality d. Originate from a single place e. Virtual record of retrospective, concurrent, and prospective information
abe
Quality planning established the design of a product, service, or process that will meet customer, business, and operational needs to produce the product before it is produced. Quality planning follows a universal sequence of steps. List the universal sequence of steps in order. a. Identify customers and target markets b. Discover hidden and unmet customer's needs c. Develop a service or product that exceeds customer's needs. d. Transfer these designs to the organization and the operating forces to be carried out e. Translate these needs into product or service requirements: a means to meet their needs f. Develop the processes that will provide that service, or create the product, in the most efficient way
abecfd
A successful enterprise risk management (ERM) program will: (SATA) a. identify risks b. improve quality c. prevent damage d. control occurrences e. control legal liablility
acde
According to the ANA, what elements are viewed as a relationship continuum as nurses apply them in decision making? (SATA) a. Data b. Technology c. Information d. Knowledge e. Wisdom
acde
Successful implementation of a health information system requires a great deal of time, education, and support. The process will require which of the following expertise within the organization? (SATA) a. Quality experts b. Marketing specialists c. Clinical nurse leaders d. Nurse informaticians e. Nurse managers
acde
An organization wit a flat structure has minimal layers of management. What are some of the advantages of a flat organizational structure? (SATA) a. Fewer divisions facilitating streamlining of goals and problem solving b. Greater supervisory capability c. Greater innovation d. Layers of accountability for completion of work e. Enhanced responsiveness to consumers
ace
Nursing's data needs fall into four domains. Which of the following statements accurately describe the sources for data in each of the domains? (SATA) a. Client data is located in each of the domains? b. Provider data refers to physicians and is located within the medical board c. Administrative data is located in registry and regulatory performance data d. Research data is only available with informed consent. e. Existing and newly gathered data can be a source of obtaining research information
ace
Principles of a fair and just culture include: (SATA) a. zero-tolerance for reckless behavior b. reduction of personal accountability and discipline c. recognition that competent professionals make mistakes d. error and unintended events being reported unless no patient harm occurs e. acknowledgment that even competent professionals develop unhealthy norms
ace
**** is an expected part of change and is often related to fear and anxiety. a. depression b. resistance c. acceptance d. denial
b
**** was recognized by the American Nurses Association (ANA) as a nursing specialty in 1992 and is one of the fastest growing practice areas in health care. a. Nurse anesthesia b. Nursing informatics c. Nurse-midwifery d. Clinical nurse specialist
b
A hospital system is implementing an electronic health record. The facility conducts education and training for nursing staff, medical staff, and ancillary staff over a period of 6 months. This is an example of: a. emergent change b. planned change c. transformation d. innovation
b
A nursing quality improvement supervisor is proposing to enhance the current quality improvement program. One of the most important themes that a nursing quality improvement supervisor should consider is: a. budgetary considerations b. collaboration between health care teams c. regular staff training programs d. suggestions from patients
b
According to the **** people move through a series of states when modifying their behavior. a. organizational change-readiness scale (OCRS) b. transtheoretical stages of change model c. rapid cycle change paln-do-study-act model
b
Almost all changes encounter: a. attitudes. b. resistance. c. knowledge. d. communication.
b
An experienced nurse has recently taken a position on a telemetry unit in the local hospital. After 2 weeks on the job, he finds that the staffing is not what was discussed during his employment interview with the nurse manager. Which approach would be most appropriate for the nurse to take? a. give 2 weeks' notice and begin seeking employment at another hospital b. discuss the situation with the nursing manager who interviewed him c. talk to other employees about the staffing situation d. notify the change nurse that this was not what was explained to him prior to employment
b
An organizational chart with one line of management and one line of staff reflects which of the following types of organizational structures? a. Authoritarian structure b. Flat structure c. Power structure d. Vertical structure
b
Hospitals must submit specific quality performance data regarding Medicare patients or risk: a. an increase in federal tax b. decreased payments c. fewer physician referrals d. sanctions by The Joint Commission (TJC)
b
Nursing informatics includes the: a. coding and billing of hospital and physician services b. management and communication of data, information, knowledge, and wisdom in nursing practice c. organization and selection of quality medical information d. support and troubleshooting of computer software issues
b
Standardization of **** provides a uniform structure for information delivery and flow in order to facilitate exchange among those involved in common work processes. a. physician orders b. communication c. work processes d. work outputs
b
The Office of National Coordinator for Health Information Technology (HIT) was created by: a. President Barack Obama b. President George W. Bush c. Hillary Clinton d. President Bill Clinton
b
The charge nurse of a small nursing unit would like to gain staff acceptance of a time-intensive, budget-imposed change required by the hospital administration. She plans to emphasize several evidence-based research projects that have shown improved patient health outcomes as a result of implementing this change. This is an example of which of the following organizational change concepts? a. budget-oriented change b. transformation c. resistance d. emergent change
b
The formal process of using patient data for providing evidence for the design of care protocols is termed: a. evidence-based practice b. practice-based evidence c. data analysis d. effectiveness research
b
The identification of forces that drive and restrain change is called an: a. equilibrium evaluation b. force field analysis c. status quo analysis d. refreezing system
b
The patient is a 69-year-old woman who has a history of diabetes mellitus, peripheral vascular disease, and myocardial infarctions. She was admitted to the hospital with a stroke and is being transferred to a subacute facility and then to a rehabilitation facility. At every transfer she must review her entire history, provide telephone numbers of family members, list all 30 of her medications, and list all home care and medical supply companies. Which of these processes could improve the fragmentation in work flow? a. Departmentalization b. Standardization c. Specialization d. Subdivision
b
The use of a new idea or method is the definition of: a. change b. innovation c. resistance d. stereotyping
b
The ways in which work is divided and coordinated among members and the resulting network of relationships, roles, and work groups is the: a. organization b. organizational social structure c. structure d. formal relationship
b
To provide the best care to every patient every day through integrated clinical practice, education, and research is an example of a: a. accountability agreement b. mission statement c. organizational standard d. vision and value proposal
b
Which of the following is an example of a nurse-sensitive indicator? a. Cardiac patient mortality b. Hospital-acquired pressure ulcers c. Pulmonary embolus after knee surgery d. Iatrogenic pneumothorax after central line placment
b
Managers apply their leadership skills to their reporting relationships to release energy and talents of people in a manner that adds value to the work they perform. What are some examples of the effects of added value? (SATA) a. Increased compensation b. Improved productivity c. Organizational commitment d. Organizational citizenship behaviors
bcd
Which of the following are never events? (SATA) a. A minor medication error b. A foreign object left in the body during surgery c. Surgery on the wrong body part d. A mismatched blood transfusion e. Hip fracture acquired in the hospital f. Pressure ulcer acquired in the home g. Catheter-associated urinary tract infection h. Surgical site infection
bcdegh
Tenets embraced by health care professionals and promoted by health care leaders and organizations such as TJC and the IOM include which of the following? (SATA) a. People and systems are the problems, not processes b. Quality measurement and monitoring is everyone's job c. Quality cannot be enhanced by non-punitive work cultures d. Standardization of processes is key to managing work and people e. The impetus for quality monitoring is not primarily for accreditation or regulatory compliance
bde
What are the roles of nursing informatics specialists? (SATA) a. Data analysis and reporting to governmental agencies b. Participation in education of nursing staff c. Providing direct patient care d. Providing information and evidence-based knowledge e. Supporting clinical decision making
bde
The improvement process in which an organization measures its strategies, operations, or internal process performance against that of best-in-class organizations within or outside its industry determines how those organizations achieved their performance levels, and uses that information to improve its own performance is known as ****.
benchmarking
A clearly recognizable process of providing care that has an evidence base demonstrating that it reduces the likelihood of harm is: a. risk adjustment b. a sentinel event c. a patient safety practice d. a performance measure
c
A nurse manager is responsible for a unit consisting of 40 nurses who report to two clinical supervisors. In addition, there are 10 support staff who report to an administrative supervisor. The subordinates reporting to this manager are known as which dimension of organizational design? a. Division of labor b. Hierarchy c. Span of control d. Decentralization
c
A staff nurse has been working in the neonatal critical care unit for 10 years. She believes that a professional nurse is a lifelong learner. Many staff members come to her for clinical problem solving and advice. This nurse has: a. decisional authority b. formal power c. informal power d. quantum authority
c
Nursing data need to include which of the following domains? a. Fiduciary data b. Outcome data c. Client data d. Tertiary data
c
The chief nursing officer (CNO) of a hospital system works with senior leadership for approval to initiate an electronic health system. He recruits a nursing informaticist and a chief medical informatics officer to begin the process of planning the education and rollout of the new electronic system. The CNO could be viewed as the: a. resister b. innovator c. change agent d. strategist
c
The collection of data to measure performance is required by: a. the Health Insurance Portability and Accountability Act (HIPAA) b. the Centers for Medicare & Medicaid Services c. The Joint Commission (TJC) d. Health Information Technology
c
The degree to which health services for individuals and populations increases the likelihood of desired health outcomes that are consistent with current professional knowledge is known as the: a. care delivery quotient b. excellence index c. quality of healthcare d. standard of care
c
The development of new practices in response to new evidence is called: a. altered direction b. organizational flux c. planned change d. status revision
c
The first person to analyze patient outcomes associated with nursing care delivery was: a. Clara Barton b. Dorothea Dix c. Florence Nightingale d. Luther Christman
c
The industry-based model for quality management and measurement whose premise is that operational waste needs to be eliminated is: a. Six Sigma b. ISO 9000 c. Lean Enterprise d. Baldrige National Quality Award Program
c
The network of pattern of social relationships and friendship circles within an organization is known as the: a. clique b. formal structure c. informal structure e. hierarchy
c
The nurse manager on a medical-surgical unit wants to change to "walking rounds" in the patients' rooms for change of shift report. In the past, it has been "face to face" at the nurses' station. The nurse manager is meeting resistance form the staff, because they think that it will take longer, and the nurses will not finish their shift on time. What could the manger do to increase the nurses' acceptance of this change? a. inform all shifts that there have been some lapses in communication regarding patient needs and that involving the patient in the report will help alleviate this. b. inform all nurses that to reach Magnet status, this type of change of shift report is required. c. ask the nurses to participate in the planning and implementation of the change. d. ask the nurses to try this type of change of shift report for 1 week and then have them evaluate it.
c
The nursing chief executive officer (CEO) works in a major rehabilitation and subacute facility network. Her span of control refers to the number of: A. miles in which the network resides. B. ancillary staff accountable to her. C. nurses and non-nurses reporting to her. D. inpatients that the facilities service.
c
The risk manager wants to illustrate the causes that have been leading to an increase in patient misidentification. The most appropriate tool to use is a: a. pareto chart b. control chart c. fishbone diagram d. detailed flowchart
c
Which comment by the nurse manager would indicated that the hospital places a high value on patient safety? a. We have safety posters throughout the hospital that encourage people to report problems b. We have monthly safety in-services c. We encourage patients and families to participate in their care. d. All employee are required to update their knowledge of safety practices each year.
c
Which of the following factors influences the structure of an organization? a. Age of the building b. Brand of computer system c. Number of employees d. Square footage of the facility
c
Which of the following statements best describes a desirable characteristic of a good management information system? a. Data should be sorted and labeled within 2 weeks b. For accurate interpretation, data should reflect a health bias c. Information gathering should be comprehensive and cost-effective d. The management information system operating system should be Windows-based
c
According to the contingency theory of organizational performance, an organization must structure and adapt its nursing units to complement which two factors? (SATA) a. Skill set b. Patient population c. Environment d. Technology e. Finances
cd
The nursing staff on a critical care unit thought that professional growth could be enhanced. Which of the following interventions would support empowerment of the nursing staff? (SATA) a. Eliminating computers and reverting back to paperwork b. Increasing pay wages for ancillary and professional staff c. Providing various methods for ongoing education and continuing education units d. Working to make equipment and medications readily available
cd
Attributes of a total quality organization according to BNQA include: (SATA) a. accreditation by TJC b. a commitment to obtaining Magnet designation c. strategic planning d. focus on patients, other customers, and markets e. organizational performance results
cde
Dividing work by occupation leads to a functional organization where services are arranged by the type of work performed. What are some benefits of the functional form within the health care organization? (SATA) a. Professional silo b. Fragmented care deliver c. Cost reduction d. Enhanced performance and quality
cde
In the provider domain, what are some of the variables that are used to measure variability in nursing? (SATA) a. Certification b. Hours of work c. Education level d. Years of experience e. Attitudes and beliefs
cde
Nurse managers can create an environment that is devoted to health care safety by doing which of the following? (SATA) a. Adopting and embracing the concept of disciplining staff who commit errors b. Learning the concepts and tools related to quality improvement and quality assurance c. Becoming a role model for staff and peers in practicing health care safety concepts d. Encouraging staff to be constantly vigilant in identifying potential risks in the care environment e. Creating a sense of partnership wit patients and families to promote communication about safety concerns and soliciting their suggestions to correct and prevent potential risks
cde
Which of the following statements are accurate when describing responsibility and accountability? (SATA) a. The assignment of responsibility by a subordinate b. A manager is assigned responsibility by a subordinate c. Accountability is the liability for task performance d. The assignment of responsibility and the ranting of authority create accountability e. Accountability flows upward or outward
cde
A medical-surgical unit utilizes a group of nurses and patient care assistants to determine ways to reduce the number of falls in the unit. They conduct Internet research to locate best practice interventions. They create fall risk alerts in the unit, and they implement hourly rounding to assess the need for toileting. After putting these small changes into place, they will evaluate the data to determine effectiveness. This project is an example of: a. rapid response teams b. failure modes and effects analysis c. root cause analysis d. rapis cycle change
d
A memo sent to the unit nurse manager reads that beginning next week; all nursing staff will be expected to conform to a new dress code selected by the hospital board of directors. The nurse manager understands that change will be more effective through which manner of communication? a. storytelling b. e-mail c. discussion d. open communication
d
A nurse manager recognizes that her staff's emotional responses to organizational change are similar to: a. adaptation techniques b. integrative tactics c. symptoms of mental illness d. the grief model
d
An organization has encountered a serious patient safety event that was reported to the state, The Joint Commission, and the Centers for Medicaid Services (CMS). An extensive plan of correction was received, and the organization had to make some immediate changes in practice. Additionally the organization anticipates a costly lawsuit. What is the best method of educating staff about the practice changes that were issued? a. these changes need to be made because the state and CMS require it b. we understand this is a knee-jerk reaction, but please change the practice while the surveyors are the building c. we need to make this change because it will help our lawsuit d. this change is being made so that their is no further harm to another patient
d
How is the refreezing stage of change similar to the nursing process? a. refreezing is similar to the assessment phase of the nursing process. b. refreezing is similar to the problem identification phase of the nursing process c. refreezing is like the planning and implementation phase of the nursing process d. refreezing is like evaluation in the nursing process
d
Individual members of a group will adapt to change at different rates. Which of the following groups would take the longest to accept change? a. early adopters b. late majority c. innovators d. laggards
d
It is estimated that nurses spend approximately **** of their time documenting information in the EHR. a. 7% b. 17% c. 20% d. 35%
d
Nurses utilize **** through critical thinking and clinical reasoning skills to determine when and how to apply evidence-based knowledge. a. orders b. data c. information d. wisdom
d
Nursing outcome databases are critical because nurses must be able to: a. assess the differences between an associate degree in nursing and a bachelor's of science degree in nursing b. compare interventional care strategies between physicians c. evaluate nurse's aide and licensed practical/vocational nurse sensitive outcomes d. measure how nurses influence patient outcomes
d
Responding to a code called in the psychiatric unit where she works, a staff nurse finds that a patient has committed suicide. The staff nurse correctly identifies this as a: a. benchmark incident b. quality improvement issue c. performance breach d. sentinel event
d
The Nursing Minimum Data Set (NMDS) was designed to: a. determine differences in care delivery between the holder of an associate degree in nursing and a bachelor's of science in nursing. b. evaluate the nursing language of NANDA, Nursing Interventions Classification, and Nursing Outcomes Classification c. provide data for leaders to make decisions about staffing patterns d. standardize the collection of nursing data across populations
d
The purpose of a root cause analysis (ACA) is to: a. discipline the staff involved in the patient safety event b. disclose the medical error to the patient/patients family c. identify the person(s) responsible for committing the error d. identify the systems issues that led to a sentinel event
d
The structure of authority in a organization is known as the: a. authority b. centralization c. bureaucracy d. hierarchy
d
Which of the following factors is used to describe the degree to which successful planned change is thought to be better than the status quo? a. complexity b. compatibility c. trialability d. relative advantage
d
Which of the following responses from the nurse manager is consistent with a culture that promotes patient safety? a. We make sure that we don't have any errors on this unit. b. We identify who make the error and take corrective action. c. We provide remedial training for all staff on the unit when there is an error. d. We report any medical error or near-miss to help us find the root cause of the problem.
d
Which organizational theory emphasized the informal aspects of organization social structure and was influenced by the Hawthorne experiments? a. Bureaucratic theory b. Scientific management school c. Classical management theory d. Human relations schoool
d
Within nursing practice, the use of advanced practice roles is an example of: a. cross-training. b. departmentalization. c. fragmentation. d. specialization.
d
A Healthcare Failure Modes and Effects Analysis (HFMEA) for a new bar-coding systems is being conducted by an interdisciplinary team. List the steps of the HFMEA in the correct order. a. Identifying prevention strategies b. Endorsing action plans for implementation c. Assessing risk points within the process steps d. Flowcharting the steps of the process being studied e. Designing out the most critical of the potential failures f. Recommending process improvements for prevention of the failures g. Ranking key risk points in terms of their impact on the potential failure of the system h. Reporting action plans for implementing prevention strategies to the enterprise leaders
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