Leadership Final

The nurse has just been promoted to unit manager. Which advice, offered by a senior unit manager, will help this nurse become inspirational and motivational in this new role? 1. "If you make a mistake with your staff, admit it, apologize and correct the error if possible." 2. "Never get into a disagreement with a staff member." 3. "Don't be too soft on the staff. If they make a mistake, be certain to reprimand them immediately." 4. "Give your best nurses extra attention and rewards for their help."

1. "If you make a mistake with your staff, admit it, apologize and correct the error if possible."

The staff nurse is considered to be a leader by nursing peers on the unit. What characteristics does this nurse likely possess? Select all that apply. 1. Adaptability 2. Awareness of happenings throughout the hospital 3. Ability to encourage newly hired nurses 4. Collaboration skills 5. Skepticism about using technology for standard nursing tasks

1. Adaptability 2. Awareness of happenings throughout the hospital 3. Ability to encourage newly hired nurses 4. Collaboration skills

The nurse manager is aware of a significant change that will occur sometime in the next six months. How can this manager begin to prepare the staff for this change? Select all that apply.1. Attempt to keep the unit staffing as stable as possible during the time of change2. Insist that all discussion about the change be conducted in a respectful manner3. Keep the staff apprised of as much information about the change as possible4. Avoid surprises by telling the staff about how the change will increase workload very early in the process

1. Attempt to keep the unit staffing as stable as possible during the time of change2. Insist that all discussion about the change be conducted in a respectful manner3. Keep the staff apprised of as much information about the change as possible

Which statements are true about the evaluation step of the decision making process? Select all that apply.1. Evaluation needs to be incorporated in all steps of the change process2. Management is usually not involved in the evaluation phase3. Only the change agent is responsible for the evaluation phase4. Neglecting this step has long-term consequences

1. Evaluation needs to be incorporated in all steps of the change process4. Neglecting this step has long-term consequences

The nurse has become concerned about the ethics of the way medical procedures are charged for in the Emergency Department. Which questions should the nurse consider when making the decision about pursuing this concern? Select all that apply. 1. How would I feel if I were on the other side of this dilemma? 2. How does this issue relate to the overall values and mission of the health care facility? 3. Do I have enough information to make this decision? 4. How can I keep my involvement in this secret from the other Emergency Department staff?

1. How would I feel if I were on the other side of this dilemma? 2. How does this issue relate to the overall values and mission of the health care facility? 3. Do I have enough information to make this decision?

Which nursing action is the best example of the ethical principle of veracity? 1. Informing the patient that the pain medication to be given is not the same as what was administered the previous day 2. Supporting the patient's right to refuse any part of planned nursing care 3. Supporting the patient when ambulating and instructing the patient on the use of a walker 4. Maintaining the privacy of the patient's personal medical information

1. Informing the patient that the pain medication to be given is not the same as what was administered the previous day

The nurse manager is developing a staff education session on change in health care. Which concepts should be included in this information? Select all that apply.1. Sometimes multiple changes occur together in health care2. Change has been the normal state for health care providers for some time3. Oftentimes, before one change in health care is completed, another is taking place4. Change disturbs the organization's equilibrium

1. Sometimes multiple changes occur together in health care2. Change has been the normal state for health care providers for some time3. Oftentimes, before one change in health care is completed, another is taking place4. Change disturbs the organization's equilibrium

The risk manager is reviewing these events that occurred over the weekend. Which scenario should the risk manager be most concerned would represent malpractice? 1. The nurse did not obtain an apical pulse on a patient prior to administering Digoxin 0.25 mg orally 2. The nurse did not raise the bed when changing linens for a patient who was up in the chair 3. The nurse continued to assess the blood sugar of a patient with diabetes before each meal 4. A nurse did not obtain consent before drawing blood

1. The nurse did not obtain an apical pulse on a patient prior to administering Digoxin 0.25 mg orally

Which scenario is an example of informed consent? 1. The patient understands the surgical procedure that will occur in the morning 2. The nurse applies restraints to a patient who is trying to remove the nasogastric tube 3. The patient asks the nurse for pain medication 4. The nurse omits diabetic education for a patient who has had diabetes for 10 years

1. The patient understands the surgical procedure that will occur in the morning

What statement made in the morning shift report, would help an effective manager develop trust on the nursing unit? 1. "I can't believe you need help with such a simple task. Didn't you learn that in school?" 2. "I'm sorry, but I do not have a nurse to spare today to help on your unit. I cannot make a change now, but we should talk further about schedules and needs." 3. "I know I told you that you could have the weekend off, but I really need you to work." 4. "The others work many extra shifts, why can't you?"

2. "I'm sorry, but I do not have a nurse to spare today to help on your unit. I cannot make a change now, but we should talk further about schedules and needs."

A problem has been identified in the health care facility. What should the nurse who has been assigned the task of change agent do first?1. Collaborate with others2. Gather data3. Empower staff4. Develop an alternative plan

2. Gather data

A new management company has acquired a hospital. Since the acquisition the hospital's name has been changed, a new vision statement has been distributed, the department structure has changed, and the staff's cafeteria discount has been eliminated. Management has plans for many additional changes. What should happen at this point?1. Management should abandon plans for any additional changes2. Management should refrain from making any additional changes for a few months3. Management should continue to make changes, but at a rate no faster than 1 change a month4. Management should institute the remaining changes as quickly as possible

2. Management should refrain from making any additional changes for a few months

Choose the statements that are correct about non-for-profit health care organizations. Select all that apply.1. These organizations do not have to make a profit to survive2. Organizations are called voluntary or public health organizations3. These organizations experience more ethical and legal problems4. Typically these organizations are funded by charitable institutions, the government, or churches, as well as by the typical reimbursement sources

2. Organizations are called voluntary or public health organizations4. Typically these organizations are funded by charitable institutions, the government, or churches, as well as by the typical reimbursement sources

Which statements correctly apply to the process of developing public policy? Select all that apply. 1. Since public policy supports the general population, decisions regarding policy are typically straightforward and easy to make 2. Public policy may benefit some at the expense of others 3. Often, in order to pass a policy, deals have to be made 4. The two types of public policy are regulatory and allocative

2. Public policy may benefit some at the expense of others 3. Often, in order to pass a policy, deals have to be made 4. The two types of public policy are regulatory and allocative

Which strategy could the nurse use to avoid disparity in health care delivery? 1. Care for more patients even if quality suffers 2. Recognize the cultural issues related to patient care 3. Campaign for fixed nurse-patient ratios 4. Request more health plan option

2. Recognize the cultural issues related to patient care

The patient is being discharged from the hospital after having a coronary artery bypass graft (CABG). Which level of the health care system will best serve the needs of this patient at point?1. Public health care2. Tertiary care3. Primary care4. Secondary care

2. Tertiary care

The staff nurse has been invited to become a member of the hospital policy and procedure committee. What should the nurse expect in regard to this committee?1. The committee will be comprised of 10 or more members, with a chairperson2. The first step the committee will take to develop the policies and procedures is to ask the administration to identify the overall objectives for the committee3. The committee will meet on an ad hoc basis but will have designated meeting times, will keep minutes, make decisions, and develop reports4. The decisions that the committee makes will be the final authority for policy and procedures in the facility

2. The first step the committee will take to develop the policies and procedures is to ask the administration to identify the overall objectives for the committee

The hospital has announced the intention to achieve Magnet Nursing Services Recognition. What information do staff nurses need about this goal?1. This goal will require that staff nurses return to school to earn a master's degree2. This program began in the 1980s to recognize hospitals that provide quality nursing care of excellence in nursing practice3. This program is designed to recognize Emergency Department nurses who provide quality, cost-effective nursing care4. This program does not affect staff nurse, but recognizes nursing administrators for their excellence in leadership

2. This program began in the 1980s to recognize hospitals that provide quality nursing care of excellence in nursing practice

What is the first step in coping with changes that occur in the health care environment?1. Identifying the change agent2. Understanding personal response to change3. Identify the purpose of the change4. Investigate the facility's history of change

2. Understanding personal response to change

Typically the nurse manager of a unit uses a participatory style of leadership. Today a patient suffered a cardiac arrest; the manager took over the patient's care, issuing orders, and expecting staff to obey them immediately. Which type of leadership did this manager exhibit today? Select all that apply. 1. Transformational. 2. Bureaucratic. 3. Authoritarian. 4. Permissive.

3. Authoritarian.

The organizational analysis documentation describes the organization as one with centralized leadership with a clearly defined organization chart hierarchy. The organization is divided into departments and follows detailed rules and regulations. This organization follows which theories? Select all that apply.1. Integrated delivery system2. Systems3. Bureaucratic4. Classical

3. Bureaucratic4. Classical

The nurse executive wishes to be a transformational leader. What should this nurse focus on to become effective in this role? 1. Advancing personal formal education. 2. Becoming an expert clinician. 3. Creating a vision for the future of nursing in the facility. 4. Identifying mentors.

3. Creating a vision for the future of nursing in the facility.

The health care organization is undergoing reorganization to a service-line structure. What are the benefits of this structure?1. There is a clear delineation of the organization's rules2. Each staff member reports to only one supervisor3. Departments are less likely to place blame on one another4. Staff members are not encouraged to use creative problem solving

3. Departments are less likely to place blame on one another

The situation calls for multiple alternatives to a problem and the manager has only a small amount of data regarding the problem. Which style of decision making should this manager employ?1. Integrative2. Decisive3. Flexible4. Hierarchic

3. Flexible

A very young nurse has been promoted to nurse manager of an inpatient surgical unit. The nurse is concerned that older nurses may not respect the manager's authority because of the age difference. How can this nurse manager best exercise authority? 1. Maintain an autocratic approach to influence results. 2. Use critical thinking to solve problems on the unit. 3. Give assignments clearly, taking staff expertise into consideration. 4. Understand complex health care environments.

3. Give assignments clearly, taking staff expertise into consideration.

A nurse manager has asked that all staff nurses develop effective leadership competencies. How should the staff nurses interpret this request? 1. Unless the staff nurses posses the traits of a natural born leader, this is an unrealistic expectation. 2. In order to become leaders, the staff nurses will have to emphasize control, competition, and getting the job done. 3. If the nurses learn about and use relevant leadership and management theories and styles this is possible. 4. This is an unrealistic expectation because only managers are leaders.

3. If the nurses learn about and use relevant leadership and management theories and styles this is possible

There have been several patient complaints that the staff members of the unit are disorganized and that "no one seems to know what to do or when to do it." The staff members concur that they don't have a real sense of direction and guidance from their leader. Which type of leadership is this unit experiencing? 1. Bureaucratic. 2. Authoritarian. 3. Laissez-faire. 4. Autocratic

3. Lassiez-faire.

The nurse manager is coping with a staff member who is very resistant to change. Which strategy would be beneficial for this nurse manager?1. Take over all of the processes of the change2. Help the staff member focus on parts of the change rather on the whole change at one time3. Maintain open communication with this staff member to establish trust4. Ignore any hidden agendas brought by this staff member

3. Maintain open communication with this staff member to establish trust

The manager of a maternal-child health unit announces that the unit will be redesigned to help meet the Institute of Medicine health care competencies. What scenario is one that the staff of this unit might expect?1. The unit will be closed for remodeling2. The nurses will be expected to participate in telehealth throughout a three state region3. Nursery, labor and delivery, and postpartum nurses will be cross trained to work in each of these areas4. There will be a reduction in staff numbers

3. Nursery, labor and delivery, and postpartum nurses will be cross trained to work in each of these areas

Which behavior demonstrates the nurse's competency as an emotionally intelligent leader? 1. The nurse is proficient in technical skills. 2. Productivity is not a major concern. 3. The nurse supports team members. 4. The nurse relies on policies, not options.

3. The nurse supports team members.

Which situation illustrates the ethical concept of autonomy? 1. The patient is instructed on the technique of insulin administration 2. The patient is informed of privacy rights 3. The patient is asked to choose from which arm to have blood drawn 4. The patient's information can be sued for research purposes

3. The patient is asked to choose from which arm to have blood drawn

On admission the patient states, "My son can make health care decisions for me if it is necessary." Which does this statement imply? 1. The patient has a living will 2. This patient has violated the Patient Self Determination Act 3. The son has durable power of attorney 4. The patient wishes a do-not-resuscitate status

3. The son has durable power of attorney

What has caused some concern about the use of unlicensed assistive personnel (UAP)?1. Home health aides are not supervised2. UAPs do not provide quality care3. There is variability of education and training of all types of UAPs4. Supervision is provided by the registered nurse

3. There is variability of education and training of all types of UAPs

The nurse has taken an employment position in a health care facility that advertises itself as being part of a network. What can the nurse expect in this organization?1. This hospital is part of a vertically integrated corporation that owns and manages a group of health care facilities2. This hospital has agreed to provide a continuum of services to a defined population and to be accountable for the outcomes and health status of that population3. This hospital is an independent organization, but is in agreement with a number of other health care facilities that agree to deliver specific services4. This hospital has joined with another hospital to become one organization

3. This hospital is an independent organization, but is in agreement with a number of other health care facilities that agree to deliver specific services

The obstetrics department, which is composed of labor and delivery, postpartum, nurseries and the neonatal intensive care unit, operates under what organizational structure?1. Decentralized structure2. Line authority3. Matrix organizational structure4. Departmentalization

4. Departmentalization

Which statement is true about hospital classification?1. To provide services, a hospital must be accredited but not necessarily licensed2. For a hospital to receive Medicare and Medicaid reimbursement, it must be a not-for-profit hospital3. Licensure of hospitals is provided by the Joint Commission4. Hospital accreditation is voluntary

4. Hospital accreditation is voluntary

Which option best illustrates a positive outcome for managed care? 1. Cost-benefit analysis 2. Involvement in the political process 3. Reshaping current policy 4. Increase in preventative services

4. Increase in preventative services

The nurse assistant left a side rail down upon exiting the room of a patient who had just returned from the recovery room postoperatively. What does this scenario most closely illustrate? 1. Malpractice 2. Criminal intent 3. Personal injury 4. Negligence

4. Negligence

The director of nursing education for a hospital has been asked to provide continuing education on safety precautions to physicians, nurses, and all other disciplines providing patient care. Although the director is responsible for providing this education, the director is not responsible for assuring that physicians and health care managers adhere to the procedures. What type of health care organizational structure is present in this hospital?1. Span of control2. Horizontal structure3. Vertical structure4. Staff authority

4. Staff authority

Peter Drucker's view of management stimulated the shift toward the realization of the importance of participatory organizations. Which option provides a scenario that is an example of a participatory organization? 1. The control of the organization is centralized, and decisions are made by upper-level management. 2. Staff nurses are expected to provide support and nurturing for management's decisions. 3. The organization's approach to leadership is autocratic and bureaucratic. 4. Staff nurses provide input into planning and changes for their own unit.

4. Staff nurses provide input into planning and changes for their own unit.

The unit has been so understaffed that the nurse has been unable to attend education sessions on new medications that physicians will be prescribing for the treatment of hypertension. This situation is likely to result in a medication error resulting from which contributing factor?a. Management.b. Work environment.c. Task.d. Individual staff member.

The unit has been so understaffed that the nurse has been unable to attend education sessions on new medications that physicians will be prescribing for the treatment of hypertension. This situation is likely to result in a medication error resulting from which contributing factor?a. Management.b. Work environment.c. Task.d. Individual staff member.

The newly licensed nurse asks a more experienced nurse if it is advisable to carry personal malpractice insurance. Which reply, made by the experienced nurse, is the most accurate? a. "Every nurse should carry personal independent malpractice insurance."b. "Carrying insurance is a good way to get sued."c. "It is not necessary since the hospital carries a blanket policy."d. "It is necessary only for advanced practice nurses like nurse midwives and certified registered nurse anesthetists."

a. "Every nurse should carry personal independent malpractice insurance."

Analyze these statements and choose the response that best reflects paraphrasing.a. "You are saying you didn't sleep well last night because the unit was so noisy."b. "Can you tell me why you didn't sleep well last night?"c. "You should have told the night nurse you needed medication to help you sleep."d. "Did you talk to your doctor about not sleeping last night?"

a. "You are saying you didn't sleep well last night because the unit was so noisy."

From this list of patients, choose the ones that would be eligible to receive Medicare Part A benefits without paying premiums. Select all that apply.a. A 66 year old woman who never worked outside the home, but whose husband had Medicare-covered government employmentb. A 35 year old man who can no longer work due to end stage renal diseasec. A 75 year old retired postal worker who receives Social Security benefitsd. A 45 year old father of three children receiving governmental financial assistancee. An unemployed 16 year old mother of a 6 month infant

a. A 66 year old woman who never worked outside the home, but whose husband had Medicare-covered government employmentb. A 35 year old man who can no longer work due to end stage renal diseasec. A 75 year old retired postal worker who receives Social Security benefits

The nurse notices that there are four boxes of 18 gauge IV start catheters in the supply room even though the standard IV start on the unit is done with a 20 gauge IV catheter. What should the nurse do?a. Consult with the nurse manager about the situationb. Send the catheters back to central supplyc. Start using 18 gauge catheters for IV starts on the unitd. Send the catheters to a unit that uses this size

a. Consult with the nurse manager about the situation

The risk manager of a health care organization is concerned about the amount of violence against health care workers that is occurring nationwide and would like to offer education sessions to staff. Which groups of staff are at most risk for experiencing violence and therefore should receive this education earlier rather than later in the schedule? Select all that apply. a. Emergency Department staff.b. Long-term care staff.c. Mental health unit staff.d. Neurological Intensive Care staff.e. Cardiac telemetry unit staff.

a. Emergency Department staff.b. Long-term care staff.c. Mental health unit staff.

Failure to rescue (FTR) is most commonly a result of which other failure?a. Failure to monitor patient status.b. Failure to follow physician orders.c. Failure to understand the purpose of an intervention or treatment.d. Failure to understand the disease process.

a. Failure to monitor patient status.

The nurse answers a "nurse call" line for a hospital. Which resources will this nurse use to guide patients using this technology? Select all that apply. a. Protocolsb. Research articlesc. Guidelinesd. Algorithms

a. Protocolsc. Guidelinesd. Algorithms

Understanding the microlevel of healthcare financing is most important to which nurse?a. The nurse managerb. The staff nursec. The nursing studentd. The new graduate

a. The nurse manager

The nurse made a medication error. Which statement reflects the traditional "blame game" approach to such errors?a. The nurse thinks, "The patient is okay, so I won't tell anyone this happened."b. The physician says, "Is there some way we can prevent this type of error from happening again?"c. The nurse manager says, "You have to complete the incident report and notify the patient's physician. You made the error, not me."d. The nurse says, "Why did I make this error?"

a. The nurse thinks, "The patient is okay, so I won't tell anyone this happened."c. The nurse manager says, "You have to complete the incident report and notify the patient's physician. You made the error, not me."

The medical center quality improvement director issues a report on the "opportunity" costs of errors occurring in the organization. Which situation would be included in this report? Select all that apply. a. a laboratory test must be repeated because the technician ran the specimen incorrectlyb. a patient sustained a fracture when he fell after being incorrectly restrainedc. the patient says, "A nurse nearly let me die, so I don't trust nurses anymore."d. a medicine error necessitates that the patient be dialyzed

a. a laboratory test must be repeated because the technician ran the specimen incorrectlyd. a medicine error necessitates that the patient be dialyzed

Select the appropriate interventions to discourage verbal abuse between physicians and nurses. Select all that apply.a. approach those involved in private and identify a need for change in behaviorb. gain a better understanding of each profession's viewpointc. appoint a professional from another discipline to take charge of training and education programs for physicians and nursesd. encourage nurses who are involved in this behavior to find employment elsewheree. disseminate code-of-conflict policies and reporting guidelines to both nurses and physicians

a. approach those involved in private and identify a need for change in behaviorb. gain a better understanding of each profession's viewpointe. disseminate code-of-conflict policies and reporting guidelines to both nurses and physicians

Select the options that illustrate guidelines for consistency in effective delegation. Select all that apply.a. be positive about assignmentsb. give only indirect care tasksc. be fair about unpleasant activitiesd. be sure directions are cleare. indicate priorities

a. be positive about assignmentsc. be fair about unpleasant activitiesd. be sure directions are cleare. indicate priorities

A nurse has just been promoted to team leader for a nursing unit and wishes to experience a smooth transition into this job. What is a common mistake made by new team leaders?a. being authoritarian due to lack of self-confidence, lack of trust, and fear of poor outcomesb. using a "hands-off" approach due to idealism, a naive sense of trust, and lack of belief in their own judgmentc. adapting a highly cooperative approach due to lack of experience and clinical skillsd. easily extending an openness to input and participation from team members because of their freedom from negative experiences with this approach

a. being authoritarian due to lack of self-confidence, lack of trust, and fear of poor outcomes

Which payment method offers to pay the provider a specific percentage of the provider's usual charge?a. discounted fee for serviceb. capitationc. diagnosis related groupsd. per diem rates

a. discounted fee for service

The newly hired nurse must decide which assistant to delegate a particular task. What is the nurse's first consideration?a. is the task one that can be delegated?b. what are the assistants' educational backgrounds?c. how much time does the task require?d. which assistants possess the required experience and skills?

a. is the task one that can be delegated?

The staff nurse has been asked to assume leadership of a work team. Which strategies should this nurse use to increase the team members' trust? Select all that apply.a. keep promises that are madeb. give honest feedbackc. create a logical excuse for not keeping promises maded. reward followerse. ask followers to defer feedback until the end of the project

a. keep promises that are madeb. give honest feedbackd. reward followers

The nurse is planning care for a group of patients and is deciding upon which activities to delegate to an experienced UAP. Which activities should the nurse plan to do, rather than delegate to the UAP? Select all that apply.a. monitoring vital signs on a newly admitted patient who is diagnosed with myocardial infarctionb. feeding a patient who had a cerebral vascular accident 3 years agoc. deciding to use an as needed order to administer an over-the-counter medication for a patient complaint of a headached. helping the patient get up in the chair at bedsidee. monitoring an intravenous line for infiltration

a. monitoring vital signs on a newly admitted patient who is diagnosed with myocardial infarctionc. deciding to use an as needed order to administer an over-the-counter medication for a patient complaint of a headachee. monitoring an intravenous line for infiltration

Choose the situations that represent the qualities of a team rather than those of a group. Select all that apply.a. nurse recruiters and nurse educators gather to explore and implement a program to recruit males into the profession.b. three nurses, a respiratory therapist, two residents, and a nursing assistant all are fully involved in a "code blue."c. nurses at a unit meeting attempt to address and resolve interpersonal differences that they have assessed as interfering with nursing care.d. nurses meet with a representative of a master's degree program

a. nurse recruiters and nurse educators gather to explore and implement a program to recruit males into the profession.b. three nurses, a respiratory therapist, two residents, and a nursing assistant all are fully involved in a "code blue."c. nurses at a unit meeting attempt to address and resolve interpersonal differences that they have assessed as interfering with nursing care.

The nursing unit is adopting the "self-directed work team" model. What benefits are likely to occur because of this decision? Select all that apply.a. services will be focused on the patientb. centralization will create cost efficiencyc. cost savings related to the use of one RN to team lead a small group of nonprofessional nursing staffd. staff retention and productivity will improve

a. services will be focused on the patientd. staff retention and productivity will improve

The nurse finds it necessary to monitor the progress of a task delegated to a UAP. What intervention is appropriate in this situation?a. tell the UAP that you want to ensure he/she does not need any assistance during the task then intervene only if it becomes absolutely necessaryb. plan to choose a more senior UAP for the task next timec. plan to delegate only to those who are well experienced with the task next timed. tell the UAP, "I am not certain you can do this task."

a. tell the UAP that you want to ensure he/she does not need any assistance during the task then intervene only if it becomes absolutely necessary

Which option reflects a key legal issue related to delegation?a. the nursing board of each state regulates nursing practice, including issues of delegationb. laws regarding nursing and delegation are very specific in each state's Nurse Practice Actc. nurses are protected by their job descriptions and what it says about delegationd. safe nursing practice regarding delegation is governed by the hospital board of practice

a. the nursing board of each state regulates nursing practice, including issues of delegation

The nurse says to the UAP, "I am worried about Ms. Smith's blood pressure. Check it throughout the afternoon." What critical factors have the nurse left out of this delegation instruction? Select all that apply.a. whether the UAP should use an electronic or manual cuffb. nothing, the UAP should understand what the nurse meansc. how often the blood pressure should be takend. what are reportable parameters

a. whether the UAP should use an electronic or manual cuffc. how often the blood pressure should be takend. what are reportable parameters

The patient expresses concern about the confidentiality of his medical information since, "so much of it gets faxed around nowadays." How should the nurse respond to this concern? a. "Since computers have moved away from linear thinking to a greater systems approach, concerns about information confidentiality have decreased."b. "The hospital follows the Health Insurance Portability and Accountabilty Act, which identifies steps we must take to keep your information confidential."c. "This is a really big concern. You never know who could be reading those faxes we send. There is no way to be sure that they are really going to the person they are sent to."d. "We use point-of-care, a documentation system that will not allow your information to be shared."

b. "The hospital follows the Health Insurance Portability and Accountabilty Act, which identifies steps we must take to keep your information confidential."

The nursing student states, "I use information and technology all the time to keep in touch with my friends and family. I didn't know it was used in health care, too." Which statements, made by a fellow student, would explain the health care uses of information and technology? Select all that apply. a. "Information and technology have allowed nurses better ability to connect emotionally with their patients."b. "The simulations we use in lab practice are a result of information and technology improvements."c. "The textbook says that information and technology have improved efficiency and effectiveness of interprofessional practice."d. "I read that information and technology have improved patient safety and quality of care."

b. "The simulations we use in lab practice are a result of information and technology improvements."c. "The textbook says that information and technology have improved efficiency and effectiveness of interprofessional practice."d. "I read that information and technology have improved patient safety and quality of care."

The large health care organization is determined to develop and support technological processes and structures to help nursing staff members manage the data generated in the direct care of patients. Which person wold be best for the organization to hire to achieve this goal? a. A computer programmerb. A nursing informatics specialistc. A software analystd. An information technology specialist

b. A nursing informatics specialist

Which part of the nursing process is key to successful telephone nursing?a. Implementationb. Assessmentc. Diagnosisd. Evaluation

b. Assessment

The parent of a child with a serious health problem has an opportunity to take a new job but is concerned about insurance coverage. Which statements are true concerning this situation and the Healthcare and Education Reconciliation Act of 2010? Select all that apply.a. Families will receive a $1,000,00 rebate to help provide care until new insurance is validb. Children with preexisting conditions cannot be excluded from coveragec. Young adults will be able to stay on their parent's insurance until their 30th birthdayd. Annual limits on coverage are less restrictive

b. Children with preexisting conditions cannot be excluded from coveraged. Annual limits on coverage are less restrictive

One of the strategies used by insurers to control costs and quality is the delineation of the services that will and will not be covered. Choose the services that would typically be covered by most insurance plans. Select all that apply.a. Elective abortionsb. Diagnostic testsc. Nursing servicesd. Cosmetic surgerye. Outpatient and inpatient surgery

b. Diagnostic testsc. Nursing servicese. Outpatient and inpatient surgery

The nurse has taken a position in the utilization review (UR) department of a hospital. This nurse can expect to be involved in evaluating which care components? Select all that apply.a. How much medication did the patient receive?b. How efficiently was care provided?c. Was the care provided necessary?d. How much did each procedure cost to provide?e. How appropriate was the care provided?

b. How efficiently was care provided?c. Was the care provided necessary?e. How appropriate was the care provided?

Which organizations are subject to accreditation by the Joint Commission? Select all that apply.a. Schools of nursing.b. Office-based surgical practices.c. Hospitals.d. Long term care facilities.e. Home care agencies.

b. Office-based surgical practices.c. Hospitals.d. Long term care facilities.e. Home care agencies.

Based on data presented in the textbook, which HAC is the most costly based on 2012-2013 data?a. Fallsb. Pressure ulcersc. Adverse drug eventsd. Catheter associated urinary tract infections

b. Pressure ulcers

Today's healthcare is generally financed through a third party payer system. Who is second party in this system?a. Medicareb. Providerc. Patient/enrolleed. Insurance company

b. Provider

Which factors influence the financing of healthcare in the United States? Select all that apply.a. Public indifferenceb. Social expectationsc. Political factosd. The national economye. Increasing length of stay

b. Social expectationsc. Political factosd. The national economy

If you were explaining Medicare and Medicaid, which of the following statements would you include? Select all that apply.a. DRGs were developed to improve Medicare reimbursementb. The Affordable Care Act of 2010 has had an impact on Medicare and Medicaidc. Poverty levels impact enrollment in Medicaidd. Social security payments impact Medicaree. Medicare is funded by the state and federal government

b. The Affordable Care Act of 2010 has had an impact on Medicare and Medicaidc. Poverty levels impact enrollment in Medicaidd. Social security payments impact Medicare

What is the difference in the healthcare customer and the healthcare consumer?a. The employer may be the customer and the consumerb. The customer contracts with the insurer and the consumer receives the carec. The customer pays for all services the patient receivesd. The healthcare provider is the customer and the patient the consumer

b. The customer contracts with the insurer and the consumer receives the care

During a meeting with nurse managers the risk manager for the hospital says, "Approximately 60% of our patient care errors can be directly attributed to poor handoffs." What situation should the nurse managers address to improve these statistics?a. More care should be taken in interpreting physician orders.b. The staff should work on clarity of information communicated when a patient is transferred from one care setting to another.c. One person per shift should be responsible for receiving medications that are delivered from the pharmacy.d. The nursing staff must complete admission history and physicals in a timelier manner.

b. The staff should work on clarity of information communicated when a patient is transferred from one care setting to another.

One of the patients on a nurse's team has become very ill and is requiring more of the nurse's time than was anticipated. The nurse must delegate some patient care activities in order to have time to care for this critically ill patient. Which activity can this nurse only delegate to another nurse?a. delivering a specimen to the labb. assessment of a newly admitted patientc. checking the blood pressure of a patient who had blood pressure elevation yesterdayd. helping a patient with a shower

b. assessment of a newly admitted patient

The Institute of Medicine (IOM) uses two dimensions in the quality matrix to describe quality. Which factors are included in the first dimension? Select all that apply.a. end-of-life careb. effectivenessc. patient centerednessd. staying healthye. timeliness

b. effectivenessc. patient centerednesse. timeliness

Which activities are appropriate for the nurse to delegate to unlicensed assistive personnel (UAP)? Select all that apply.a. postoperative wound careb. hygienic carec. routine vital signsc. sterile dressing changed. diabetic diet teaching

b. hygienic carec. routine vital signs

Which phase of the nursing process can be delegated?a. diagnosisb. implementationc. evaluationd. planninge. assessment

b. implementation

The staff nurse approaches the nurse manager with a complaint about a physical therapy assistant and states, "She doesn't do the same amount of work as the nursing assistants." After investigating, the manager believes the staff nurse does not understand the PT assistant's role and that is causing stress for the nurse. Which kind of conflict has this situation caused the nurse?a. organizational conflictb. individual conflictc. interpersonal conflictd. repressive conflict

b. individual conflict

hat is a major difference between formal teams and informal teams?a. formal team members have much in commonb. informal teams are formed by the membersc. formal teams are rarely formed by the organizationd. informal teams are often called committees

b. informal teams are formed by the members

The staff at a primary care office is asked to document the time the patient checks in, the time the patient is called into the exam room, and the time the patient is checked out. This is an example of what managed care strategy?a. length of stay managementb. provider performancec. capitationd. formularies

b. provider performance

Analyze these statements and choose the response that indicates reflection.a. "Did you receive your test results?"b. while the nurse is nodding, she says, "Um, I see."c. "You seem very sad about your test results."d. "Did you understand the instructions?"

c. "You seem very sad about your test results."

The hospital has adopted a medication administration system that has a series of checks and balances designed for patient safety. The system works well, but is time consuming. Nurses have discovered short cuts around the safeguards. This is an example of which situation?a. A "never event."b. An effects analysis.c. A workaround.d. A handoff.

c. A workaround.

What area of healthcare has the highest percentage of the nation's healthcare dollar (2011)?a. Prescriptionsb. Physicians and clinicsc. Hospital cared. Nursing care facilities and continuing care retirement communities

c. Hospital care

The pharmacist tells a patient that the insurance company will pay for a new medication, but that the patient will have to pay an additional co-pay of $45. What type of formulary does this insurance company maintain?a. Openb. Exclusionaryc. Incentived. Closed

c. Incentive

The hospital is considering implementation of the following technology upgrades. Which one will have the most direct implications for patient confidentiality?a. Point-of-care clinical documentation systemsb. Handheld communication systemsc. Medical e-maild. Remote telemetry monitoring

c. Medical e-mail

What is an important result of trying to lower hospital admissions that impacts acute care nursing?a. The goal is to reduce Medicare readmissions within 40 days of dischargeb. There is more staffing to care for patients in acute carec. Patients are sicker on admission requiring more cared. Primary care has increased in the system

c. Patients are sicker on admission requiring more care

Emotional connectivity between nurses and patients is endangered by the use of technology. By focusing solely on this issue, which other issue is often overlooked? a. The cost of implementing technological advancesb. The cost of not implementing technological advancesc. The isolationalism that can occur through using technologyd. Third party payer's demands for demonstration of outcomes

c. The isolationalism that can occur through using technology

Which situation is most likely to result in the nurse making a medication error?a. The nurse uses an online program to access medication information.b. The nurse prepares medications for administration in a secluded area.c. The nurse has worked three 12-hour shifts in three days.d. The nurse insists on documenting medication administration immediately after giving the medication.

c. The nurse has worked three 12-hour shifts in three days.

The hospital's strategic building plan calls for the nursing unit to double in size within the next year. How can planning for this increase best be accomplished?a. a consultant who can gather ideas from all involved while avoiding the confrontations and clashes that would occur if all parties gathered to plan togetherb. the nursing manager who then can offer direct feedback to team members regarding their active roles in the change processc. a well-coordinated team to represent all involved, to ensure that all difficult aspects of the change process are consideredd. an open forum of all staff, so that no workplace teamwork issues go unaddressed

c. a well-coordinated team to represent all involved, to ensure that all difficult aspects of the change process are considered.

The Institute of Medicine (IOM) includes communication in the core competency of providing patient-centered care. Which option reflects the IOM's position on communication?a. disclosure of patient information should be done only if the patient has a need to knowb. information should always be provided in a written formatc. communication should be done in a language the patient understandsd. using medical terminology is the most accurate method of providing patient information

c. communication should be done in a language the patient understands

What is often the newly licensed nurse's greatest barrier to delegation?a. not knowing what can be delegatedb. not wanting to overburden staff members who are already busyc. fear of loss of controld. denying that delegation is possible

c. fear of loss of control

The hospital has established a nursing work team to develop a new system for delivering shift reports information. Which line of communication will be used for most of this team's work?a. upwardb. downwardc. laterald. diagonal

c. lateral

The quality improvement director is explaining that different disciplines sometimes focus on different aspects of quality care. As an example, the director mentions the competency listed by the Quality and Safety Education for Nurses (QSEN) initiative that is not listed in the Institute of Medicine (IOM) core competencies for health care professionals. Which competency has the QI director discussed?a. teamworkb. quality improvementc. safetyd. use of informatics

c. safety

Choose the unlicensed assistive personnel tasks that are considered indirect patient care activities. Select all that apply.a. talking with a patient's familyb. reporting intake and output to the nursec. taking a defective blood pressure machine to maintenanced. stocking a dressing carte. cleaning an IV pump

c. taking a defective blood pressure machine to maintenanced. stocking a dressing carte. cleaning an IV pump

The nurse manager smiles constantly during a staff meeting in which changes to the holiday work schedule are announced. What is the probable result of this presentation?a. the nurses will feel the manager is concerned about their interestsb. the nurses will think the manager likes the changesc. the nurses will not be confident that the manager is being truthfuld. the nurses will appreciate the manager's support

c. the nurses will not be confident that the manager is being truthful

Which statement regarding the authority of a team leader is accurate?a. the team leader in a health care organization has authority equal to those individuals who comprise the administrative staffb. the team leader has only as much authority as the team members will allowc. the team leader relinquishes authority and control as the team gains strengthd. the team leader has control of the team, but no real authority

c. the team leader relinquishes authority and control as the team gains strength

Which statement, made by a staff nurse, indicates that the nurse understands the meaning of Medicare "never" events?a. "Thankfully, most nurses will never see a patient experience one of these events."b. "I am a very good nurse, so it is unlikely that one of my patients would experience one of these events."c. "It is so hard when a patient experiences one of these events since they are not survivable."d. "I am working on the safety committee to help prevent the occurrence of these events."

d. "I am working on the safety committee to help prevent the occurrence of these events."

After four nurses retire, the small hospital has insufficient nurses to staff the hospital 24 hours a day, seven days per week. A nursing assistant begins to assume many nursing activities to help with the staffing problem. Who is breaking the law in this case? a. The hospital, but not the nursing assistant.b. Neither the nursing assistant nor the hospital.c. The nursing assistant, but not the hospital.d. Both the nursing assistant and the hospital.

d. Both the nursing assistant and the hospital.

The quality improvement director is scheduling education sessions for new employees about Joint Commission Accreditation visits. The director should explain that which group is most likely to be interviewed during the accreditation visit?a. Department managers.b. Nurse managers.c. Hospital Administration.d. Direct patient care providers.

d. Direct patient care providers.

Which statement best describes the impact diagnosis related groups (DRGs) have on the healthcare systema. The focus has changed from how much it costs to provide the care required to how much a provider will be paidb. Coordination of all aspects of care has become less critical with this systemc. The system requires nurses to document care accuratelyd. Hospitals face a strong financial incentive to reduce the length of stay and minimize procedures performed

d. Hospitals face a strong financial incentive to reduce the length of stay and minimize procedures performed

Which statement best describes the Institute of Medicine's (IOM) position on the use of North America Nursing Diagnosis Association (NANDA) approved nursing diagnosis (NDX) statements?a. IOM supports the use of three-part NDX statementsb. IOM states that the use of NANDA nursing diagnoses along with Nursing Intervention Classifications (NIC) is the clearest way to explain a patient's plan of carec. IOM supports the use of Nursing Intervention Classifications (NIC) rather than NANDA diagnosesd. IOM states that the use of these NDX statements is confusing to students, practicing nurses, physicians, and other health care providers

d. IOM states that the use of these NDX statements is confusing to students, practicing nurses, physicians, and other health care providers

The health care provider is aware that an error was made in the care of a hospitalized patient. The provider is aware that information about the error would make it less likely that the same or a similar error would happen to another patient. However, the provider is fearful of retribution regarding the error. To which group should the provider consider reporting this information?a. Joint Commissionb. Health Resources and Services Administration (HRSA)c. National Institute of Health (NIH)d. Patient Safety Organization (PSO)

d. Patient Safety Organization (PSO)

Which strategy started by managed care is now the most important strategy used to try to manage outcomes?a. Provider panelsb. Formulariesc. Efficiency managementd. Provider performance

d. Provider performance

The nurse manager has been asked to provide numbers associated with productivity to the hospital chief financial officer. Which components should the manager report?a. The ratio to staff to patientsb. The department input divided by its outputc. The number of patients to the number of FTEsd. The ratio of department output to the resources consumed

d. The ratio of department output to the resources consumed

The vice president of nursing for a multi-hospital organization is planning a project team. The team will include members from nursing, medicine, and allied health who will plan the work jointly and will carry it out collaboratively. Each member of the team will be expected to provide the expertise of each profession. Which approach to teamwork is this administrator planning?a. a multidisciplinary teamb. team nursingc. total patient cared. an interprofessional team

d. an interprofessional team

The patient, the nurse, and the physician have discussed treatment options and nursing care and have come to an agreement on the patient's plan of care. Which principle does this illustrate?a. educationb. conflict resolutionc. emotional intelligenced. collaboration

d. collaboration

The nurse says to the nursing assistant, "Please bathe this patient first today." This message is delivered in the hallway as the nursing assistant is unloading breakfast trays for the unit. Which element of communication is most likely to result in miscommunication in this scenario?a. senderb. messengerc. receiverd. context

d. context

An effective nursing leader can foster positive followership by rewarding team members who exhibit which behavior?a. respect the need to do their jobs well, and leave evaluation and change to managementb. place primary importance on interpersonal relationships and communication among team membersc. limit attention to organizational and environmental factors in favor of completing their assigned tasksd. demonstrate individual initiative in meeting nursing care goals while being willing to contribute to ongoing improvement of the organization

d. demonstrate individual initiative in meeting nursing care goals while being willing to contribute to ongoing improvement of the organization

The nurse works with breast cancer survivors in a "Reach for Recovery" program. Which portion of the Institute of Medicine's (IOM) focus on quality care does this work represent?a. staying healthyb. living with illness or disabilityc. coping with palliative care or end-of-life issuesd. getting better

d. getting better

The nurse commits an error while caring for a patient who receives Medicare benefits. The error results in a complication that is on the Centers for Medicare and Medicaid Services "never list." What is the implication of this error?a. the nurse will be investigated by the state's Board of Nursingb. the patient will have to share the cost of the care for the complication with Medicarec. the nurse's employment will be terminatedd. medicare will not pay for the cost of the complication

d. medicare will not pay for the cost of the complication

The nurse manager has done an excellent job of creating a team atmosphere for patient care. Patients receive excellent care, staffing needs of the unit are met internally, and all employees of the unit are valued for their contributions. Which type of teamwork has this manager facilitated?a. interprofessional teamworkb. multidisciplinary teamworkc. total patient cared. microsystem

d. microsystem

The nurse managers of a hospital are working to identify the physical skills and actual nursing time spent to accomplish specific procedures. This work is most closely associated with which type of reimbursement strategy?a. capitationb. diagnostic related groupc. discounted fee for serviced. resource based relative value scale

d. resource based relative value scale

The vice president of nursing services is completing a budgetary report for the governing board meeting this week. In which category should this nurse place the total expenditure for health benefits for nursing employees?a. accounts receivableb. operationsc. capitald. salary and wages

d. salary and wages

Which option illustrates the manager's role in supporting effective communication?a. the manager should always use reassuring statements with the staffb. the manager should use selective listening when talking to staff about positionsc. the manager should always reach forward and touch the staff member when delivering feedbackd. the manager should inquire further into situations that seem vague or confusing

d. the manager should inquire further into situations that seem vague or confusing

The nursing student has developed a poster presentation regarding delegation. Which statement, made by this student, would be evaluated as correct?a. there is a sharing of authority between the person delegating the work and the person who accepts the delegationb. the nurse who delegates work should dictate exactly how the work should be accomplishedc. employers decide which work the nurse can delegate and should document this list in the nurse's job descriptiond. the nurse retains accountability for nursing work assigned to others

d. the nurse retains accountability for nursing work assigned to others

Select the option that reflects the focus of the "U" portion of the Joint Commission's "Speak up" program.a. undergo as few medical procedures as possibleb. use education to remain healthyc. understand your medication regimend. use accredited health care organizations

d. use accredited health care organizations