Leadership Final

Which characteristic is associated with nurses who are change agents? Select all that apply. SATA A. Realism B. Ability to network C. Influence with colleagues D. Minimal knowledge of area of change E. Capacity to facilitate communication

B. Ability to network C. Influence with colleagues E. Capacity to facilitate communication

Place in order the phases of planned change according to Lippitt et al. (1958).

(1) the client system becomes aware of the need for change; (2) the relationship is developed between the client system and change agent, the leader of a change must be committed to the change; (3) the change problem is defined, creating a change team enhances the diversity of thinking about a potential program; (4) the change goals are set and options for achievement are explored; (5) the plan for change is implemented; (6) the change is accepted and stabilized

Which statement by a client reflects their personal health literacy? A. "I was able to view my test results on this app the nurse showed me how to use." B. "My neighbor said her doctor explained her test results to her, but my doctor seemed to be in a hurry, so he didn't." C. "I called my doctor's office yesterday to ask about my ultrasound results from last week, but they still haven't called me back yet." D. "I was hoping to find a way to make my knee pain better without medications, but my doctor said ibuprofen is the only thing that works."

A. "I was able to view my test results on this app the nurse showed me how to use." Personal health literacy is the degree to which individuals can find, understand, and use information and services to inform health-related decisions and actions for themselves. This client's comment that she was able to access an app to view her own test results reflects her ability to find information to inform her health-related decisions.

Which description of a care delivery model is accurate? A. A methodology used to plan and provide patient care B. A strategy undertaken to provide the most cost-effective patient care C. A workflow that focuses on providing quality patient care D. A system of interventions designed to meet the needs of an identified patient population

A. A methodology used to plan and provide patient care Patient-care delivery models describe broadly the methodology, concepts, goals and expected outcomes related to the provision of patient care.

Complexity theory has which characteristic? SATA A. Aligns best with unplanned change B. Describes change as emergent C. Considers change organized and ordered D. Adjusts and realigns, continually recreating itself E. Uses a hierarchy model to describe the change experience

A. Aligns best with unplanned change B. Describes change as emergent D. Adjusts and realigns, continually recreating itself

Which initial reaction would the nurse manager anticipate when sharing with employees that the nursing department is restructuring to save money and positions may be eliminated? SATA A. Anger B. Resistance C. Reluctance D. Acceptance E. Incompetence

A. Anger B. Resistance C. Reluctance

Which information may be found in a position description for a medical-surgical nurse job? SATA A. Assesses comprehensive data B. Provides education to patient and family members C. Develops digital charting programs D. Involves patient, family, and healthcare team members in formulating a plan of care E. Performs wound care for patients in their home F. Provides direct assistance to surgeon for patients undergoing surgery

A. Assesses comprehensive data R: The position description for a medical-surgical nurse job may list that one of the roles/responsibilities of the nurse in that position is to assess comprehensive data. B. Provides education to patient and family members R: A medical-surgical nurse would be expected to be able to provide education to patient and family members; this information would be provided in the position description for this job, so the applicant can understand the roles and responsibilities of that role. D. Involves patient, family, and healthcare team members in formulating a plan of care R: The position description for a medical-surgical nurse job would likely list involvement of the patient, family, and healthcare team members in formulating a plan of care as a role of that position.

The nurse researcher is seeking funding to support an organizational research study to understand how to best address COVID-19. Which program or resource would support evidence-based practice? SATA A. Clinical Effectiveness and Decision Science B. Healthcare Delivery and Disparities Research C. U.S. Preventive Services Task Force (USPSTF) D. Advisory Committee on Immunization Practices (ACIP) E. Practice-Based Research Networks (PBRNs)

A. Clinical Effectiveness and Decision Science B. Healthcare Delivery and Disparities Research C. U.S. Preventive Services Task Force (USPSTF) D. Advisory Committee on Immunization Practices (ACIP) E. Practice-Based Research Networks (PBRNs)

Which method would be most effective when accepting feedback? A. Critically evaluating the feedback and deciding whether to accept or reject it B. Listening to the feedback with an open mind and searching for the positive C. Explaining the reasoning behind the action with the person providing the feedback D> Focusing on how to respond to the feedback that is being received

A. Critically evaluating the feedback and deciding whether to accept or reject it This is the most effective way for a nurse to accept feedback, as it allows them to take the time to assess the information they have received, decide whether it is beneficial, and accept or reject it accordingly.

The nurse manager will focus interview questions on evaluation of which quality of an applicant? SATA A. Desired attributes B. Values C. Critical thinking skills D. Hobbies E. Creativity F. Prioritization of patient needs

A. Desired attributes R: Identification of the attributes wanted in a frontline nurse can help guide the selection of interview questions. B. Values R: Questions should be directed to evaluate values and critical thinking skills. C. Critical thinking skills R: Excellent critical thinking skills is a desired attribute of a potential employee; the nurse manager will direct interview questions to evaluate this quality. F. Prioritization of patient needs R: The nurse manager will focus interview questions on evaluation of an applicant's focus on patient needs; if the applicant and the organization prioritize the patient's needs, their values are similar, and that individual is more likely to fit the culture of the patient care environment.

A strategic plan serves which purpose for an organization? Select all that apply. SATA A. Drives planned change and unplanned change B. Allows an organization to determine how well they are doing C. Leads to goal achievement D. Gives meaning to work life E. Provides direction and improvement for operational activities F. Provides strong and rigid structure for organizational actions

A. Drives planned change and unplanned change B. Allows an organization to determine how well they are doing C. Leads to goal achievement D. Gives meaning to work life E. Provides direction and improvement for operational activities

Which benefit would be achieved by active listening? SATA A. Encourages individuals to explore their ideas B. Assists individuals to clarify their own problems C. Helps listener to respond to people's feelings D. Assists listener to assert their own point of view E. Promotes speaker's ability to empathize

A. Encourages individuals to explore their ideas B. Assists individuals to clarify their own problems C. Helps listener to respond to people's feelings

Which action would the leader take for successful team building? SATA A. Encouraging communication B. Leading by example C. Providing clear direction D. Showing appreciation E. Justifying actions

A. Encouraging communication B. Leading by example C. Providing clear direction D. Showing appreciation

Which action taken by a nurse providing patient care at the bedside reflects a commitment to a person-centered care delivery model? SATA A. Ensuring that the patient has the necessary financial resources to have at home prescriptions filled B. Asking the patient to list the things that are most concerning about their current health situation C. Reminding the patient how dangerous it is to be non-compliant with physical therapy after discharge D. Identifying the patient by the name they have asked to be used E. Including the patient's family when providing discharge teaching

A. Ensuring that the patient has the necessary financial resources to have at home prescriptions filled B. Asking the patient to list the things that are most concerning about their current health situation D. Identifying the patient by the name they have asked to be used E. Including the patient's family when providing discharge teaching

Which strategy helps employees acclimate to a new role and organization? SATA A. General orientation for new hires B. Pairing new employees with a preceptor C. Basic life support (BLS) education for new nurses D. Offering yoga and meditation during orientation E. Providing new hires with department orientation

A. General orientation for new hires R: Strategies used to help new employees acclimate to the organization and new role include general orientation to the facility, department orientation for where the employee will work, and pairing new staff members with a preceptor. B. Pairing new employees with a preceptor R: Strategies used to help new employees acclimate to the organization and new role include general orientation to the facility, department orientation for where the employee will work, and pairing new staff members with a preceptor. E. Providing new hires with department orientation R: Strategies used to help new employees acclimate to the organization and new role include general orientation to the facility, department orientation for where the employee will work, and pairing new staff members with a preceptor.

Which challenge is faced by a healthcare organization when making care more person-centered? SATA A. Health literacy B. Diversity C. Patient satisfaction D. Access to care E. Healthcare costs

A. Health literacy B. Diversity C. Patient satisfaction D. Access to care

Which action is important when incorporating research into practice? SATA A. Identifying the best research evidence B. Ensuring that there is an overabundance of evidence C. Adopting policies into practice based upon research findings D. Encouraging nurses and leaders to take interest in research E. Investigating relevant methods to obtain data

A. Identifying the best research evidence C. Adopting policies into practice based upon research findings D. Encouraging nurses and leaders to take interest in research

Which commitment would be helpful in conflict resolution? SATA A. Identifying the differences B. Hearing the person's perspective C. Pointing out the mistakes D. Listening to the real message E. Seeking solutions creatively

A. Identifying the differences B. Hearing the person's perspective D. Listening to the real message E. Seeking solutions creatively

Which step would be helpful in resolving conflict between two nurses? SATA A. Identifying the triggering event B. Assessing how interdependent they are on each other C. Identifying the issues and resources involved in the situation D. Assessing the impact on the workplace E. Focusing on the person

A. Identifying the triggering event B. Assessing how interdependent they are on each other C. Identifying the issues and resources involved in the situation D. Assessing the impact on the workplace

For which purpose was the TeamSTEPPS program designed? A. Increasing attention to safety within healthcare organizations B. Increasing visibility of quality managers within organizations C. Developing quality improvement programs within healthcare organizations D. Building teams to address safety within healthcare organizations

A. Increasing attention to safety within healthcare organizations TeamSTEPPS increases the attention to safety through multiple different tools and actions using principles of team structure, communication, leadership, situation monitoring and mutual support that members of the healthcare team can implement or take. Examples include utilizing a standard SBAR report to ensure communication between providers.

Which method is utilized to execute planned interventions and strategies in the moving stage of planned change? SATA A. Involving individuals and key stakeholders in planning and making the change B. Measuring the impact of the change C. Conceptualizing change by vision building D. Educating about the need for the change E. Implementing small steps toward the change F. Updating nurses on the progress

A. Involving individuals and key stakeholders in planning and making the change C. Conceptualizing change by vision building D. Educating about the need for the change E. Implementing small steps toward the change

Which goal would high-reliability organizations strive to achieve? SATA A. Lower burnout rates B. Higher levels of job satisfaction C. Higher levels of quality care D. Greater levels of patient satisfaction E. Higher volume of leadership

A. Lower burnout rates B. Higher levels of job satisfaction C. Higher levels of quality care D. Greater levels of patient satisfaction

Achievement of which program's standard would inform prospective nursing applicants that a facility has consistently demonstrated nursing excellence? A. Magnet Recognition Program® B. The Joint Commission C. National Quality Forum D. DNV-GL Healthcare

A. Magnet Recognition Program® The Magnet Recognition Program® is a national designation awarded by the American Academy of Nursing to organizations that demonstrate nursing excellence in several categories focusing on quality and safety. Organizations must apply for each designation and provide evidence about their performance.

Which activity would demonstrate teamwork to achieve quality patient care? SATA A. Morning shift huddles B. Annual employee performance evaluations C. Monthly charge nurse meetings D. Bedside shift report E. Interprofessional rounding

A. Morning shift huddles C. Monthly charge nurse meetings D. Bedside shift report E. Interprofessional rounding

Which example identifies a practice problem that requires investigation? SATA A. Nurse reports increase in blood culture sample contamination. B. Physician suggests nurses develop a script for requesting phone orders. C. Patient complains of noise from construction on the nursing unit. D. Family member reports on a survey that no one updated them daily. E. Nurse from another hospital texts that they heard staffing ratios were bad.

A. Nurse reports increase in blood culture sample contamination. B. Physician suggests nurses develop a script for requesting phone orders. D. Family member reports on a survey that no one updated them daily.

A compassionate workforce would have a positive effect on which aspect of healthcare? SATA A. Patient suffering B. Length of hospitalizations C. Team cohesiveness D. Organizational goals E. Employee retention

A. Patient suffering B. Length of hospitalizations C. Team cohesiveness D. Organizational goals E. Employee retention

To assess an individual nurse's performance related to quality outcomes, which evaluation method may be used? SATA A. Peer review B. Self-reflection C. Observation D. Trended unit data E. Auditing documentation

A. Peer review B. Self-reflection C. Observation E. Auditing documentation

In which way can group healthcare practices have a negative impact on the healthcare consumer? SATA A. The patient is seen by different providers over the course of multiple visits. B. The patient is reassigned to a different primary care provider. C. There are additional services available in the group healthcare setting. D. There are openings in the schedule for urgent needs. E. The group has moved to a new location to accommodate the large number of patients and providers.

A. The patient is seen by different providers over the course of multiple visits. B. The patient is reassigned to a different primary care provider. E. The group has moved to a new location to accommodate the large number of patients and providers.

Which behavior among members would build an unsuccessful team? A. Regular reporting B. Constructive criticism C. Consistent appreciation D. Accountability of actions

A. Regular reporting Regular reporting and criticizing behavior would ruin a team. The members would not put their efforts adequately to accomplish the goal and the team would become unsuccessful.

A nurse manager would like to initiate a quality improvement project to improve patient satisfaction. Which strategy would allow the manager to identify patient needs? SATA A. Rounding on the unit and asking patients about their stay B. Asking the staff what issue is most timely C. Holding small group discussions with former patients D. Reading patient comments on HCAHPS surveys F. Reviewing quality benchmark scores

A. Rounding on the unit and asking patients about their stay C. Holding small group discussions with former patients D. Reading patient comments on HCAHPS surveys F. Reviewing quality benchmark scores

Which element is required when setting a goal for quality improvement? A. Standard of practice B. Staff preferences C. Statistical analyses D. Additional staff training

A. Standard of practice Quality improvement goals always include a standard of practice and a measurable patient-sensitive or nursing-sensitive indicator. The interdisciplinary team would use accepted standards of practice, based on the most current evidence, to guide the goal-setting process.

Which statement by the team leader best explains the benefit of team-building exercises? A. Team building creates an environment of mutual respect. B. Team building is fun and provides a break from work. C. It provides healthy competition that promotes bonding. D. It provides an opportunity for conflict resolution.

A. Team building creates an environment of mutual respect. Team-building exercises build trust, increase collaboration, ease conflicts, and promote effective communication. They create an environment of mutual respect, which can help to reduce tension and conflict and allow the team to work together more effectively.

Clear role expectations and valuing of individual contributions leads to employees who have which quality? Select all that apply. SATA A. Driven to succeed B. Increased personal health C. Commitment to the organization E. Improved job satisfaction and individual performance F. Enhanced patient care provided

ALL

Which statement by the nurse leader demonstrates positive self-esteem? A. "While I am tight on time, I hope I can help you with whatever you need." B. "I am growing with every challenge I face, and my team is as well." C. "I am going to need your help, as I am sure I will be unable to accomplish this." D. "I should be able to increase my team's productivity like the other leaders."

B. "I am growing with every challenge I face, and my team is as well." This type of positivity demonstrates confidence in self and team members, leading to success of the team. This demonstrates the leader values team members and self.

Which response by the nurse demonstrates an effective communication technique when receiving blame for a patient's fall? A. "I think I acted as most other nurses would." B. "I feel that you are holding me responsible for an accident." C. "I want to explain what happened." D. "I will be sure to do better next time."

B. "I feel that you are holding me responsible for an accident." If feeling blamed, an individual can approach the conversation by using an "I feel" message. This type of response allows the individual to own and take accountability for their feelings.

Which statement by a new hire regarding orientation would be of concern? A. "The hospital provides a 6-month orientation process." B. "Preceptors are provided to new hires based upon availability." C. "Orientation includes mandatory organization- and unit-specific content." D. "There are several residency slots open each year for new graduate nurses."

B. "Preceptors are provided to new hires based upon availability." When preceptors are chosen on the basis of availability, the new graduate may end up with multiple different preceptors, leading to frustration and confusion.

Which outcome represents successful evidence-based practice improvement? A. An oncology patient experiences no change in pain level while participating in a clinical trial. B. A patient living with diabetes prevents pressure ulcers due to a new skincare and repositioning protocol. C. A patient diagnosed with congestive heart failure develops dyspnea after trying a high protein diet from the internet. D. Hemoglobin A1c levels increase after the nurse introduces a carbohydrate tracking mobile app.

B. A patient living with diabetes prevents pressure ulcers due to a new skincare and repositioning protocol. The outcome of pressure ulcer prevention is a result of the new skincare and repositioning protocol introduced into practice.

Which behavior would result in a positive, problem-solving approach when facing a situation that is beyond the nurse manger's control?A. Influencing the situation B. Accepting the situation C. Compensating for the situation D. Being passive toward the situation

B. Accepting the situation Accepting the situation and focusing on the positive aspects is the most mature approach and will help to maintain a positive, problem-solving approach. This will allow the nurse manager to move on from the situation and focus on the things that can be controlled.

Which characteristic would align with a team? SATA A. One consistent leader B. Accomplishes common goals C. Mutual accountability D. Interdependent members E. Functions by discussing, deciding, and doing

B. Accomplishes common goals C. Mutual accountability D. Interdependent members E. Functions by discussing, deciding, and doing

Which approach would be most appropriate to capitalize on the differences between team members? A. Establishing a process to share ideas B. Appreciating individual talents C. Creating an environment of trust D. Suppressing open dialogue

B. Appreciating individual talents Appreciating individual talents is the best way to capitalize on the differences between team members, as it allows team members to use their unique skills and abilities to contribute to the team in the most efficient and effective way.

Which action by the nurse reflects the best response to a client who voices concern with taking metformin for their type II diabetes because they read an article about how it can cause cancer? A. Providing a written medication guide for metformin and educating the client about why it works for treatment of type II diabetes B. Asking the client to show where they read the article and explaining how to recognize reputable sources of information C. Informing the client that they must still take metformin to properly manage their blood glucose D. Explaining to the client that the Internet is not a good source of medical-related information and that they should receive all disease-related information from their provider

B. Asking the client to show where they read the article and explaining how to recognize reputable sources of information The public use of the internet for health information is a challenge because people may not be educated about how to differentiate reputable sources from those that spread disinformation. The nurse would best address this client's concerns by reviewing the article in reference and by increasing the client's health literacy by educating the client on reviewing information sources for credibility.

For which reason may frontline nurses be included in the process for selection of new staff for a unit? A. Selecting who they will want to work with B. Bringing diversity in points of view C. Shortening the interview time D. Providing a tour of the patient care area

B. Bringing diversity in points of view The selection of staff is the most important function of nurse managers because they want the most qualified individual who also fits the culture of the patient care environment and organization. Frontline nurse involvement provides diversity in points of view, which can be valuable to a broad view of healthcare.

Which factor is most important to consider when making quality improvement decisions? A. Values of team members B. Data analysis of outcomes C. Leadership preferences D. Time constraints

B. Data analysis of outcomes In quality management and quality improvement, decisions are made based on data. Patient outcomes are described in measurable terms and tracked. These data should be analyzed without preconceived notions or bias and allowed to drive decisions to influence high-quality care.

Which strategy is used by nurses to prevent events leading to permanent disability of a patient? A. Instituting a zero-tolerance policy for errors B. Designing processes that anticipate adverse events and protect patients C. Performing root cause analysis after events that result in severe patient harm D. Avoiding performing interventions that pose risk to the patient

B. Designing processes that anticipate adverse events and protect patients Implementing measures to anticipate complications and reduce harm, such as requiring reversal agents at the bedside during sedation, is the best strategy for nurses to prevent disability.

Which individual factor is a priority for successful teamwork? A. Experience level B. Emotional intelligence C. Educational attainment D. Team member role

B. Emotional intelligence Emotions have a powerful influence on the interactions among team members, thereby affecting productivity and quality of work. Therefore, it is a priority in facilitating successful teamwork.

Which factor would allow team members to capitalize on each individual's talent? A. Medical history B. Expectations C. Family dynamics D. Cultural values

B. Expectations Being aware of each member's roles, responsibilities, expectations, and contributions would help to capitalize on individual skills and support in goal attainment.

Which approach is appropriate for a team-building facilitator to take when dealing with a team member's anxiety about being vulnerable? A. Excusing the affected team member from the team-building exercise B. Interviewing individual members separately to identify critical issues C. Requiring the individual to share with the team their anxiety of vulnerability D. Explaining the goals and benefits of the team-building exercise

B. Interviewing individual members separately to identify critical issues It is helpful for a team-building facilitator to make a thorough assessment of major issues and the willingness on the part of members to work on issues. The facilitator can have a better understanding of how to work with its members.

To effectively promote diversity, which intervention would the manager take? A. Mandating staff's respect for cultural differences B. Inviting a culturally different patient to speak at a staff meeting C. Providing staff lists of common cultural differences D. Including cultures of admitted patients during the morning report

B. Inviting a culturally different patient to speak at a staff meeting Having a patient speak about their experience is effective because it helps nurses become aware of the feelings and difficulties the patient experienced during their care.

Which action would the nurse manager take to prepare for a staff member's annual performance evaluation? SATA A. Mandating a date and time for the evaluation B. Listing the employee's weaknesses C. Listing accomplishments related to last year's goals D. Comparing the employee's job performance with job descriptions from area healthcare facilities E. Correlating performance, job description, and institutional goals F. Listing the employee's strengths

B. Listing the employee's weaknesses R: To prepare for an upcoming performance evaluation, the nurse manager would compile a list of the employee's weaknesses and accomplishments of the last year's goals. C. Listing accomplishments related to last year's goals R: To prepare for an upcoming performance evaluation, the nurse manager would compile a list of the employee's weaknesses and accomplishments of the last year's goals. E. Correlating performance, job description, and institutional goals R: The nurse manager would correlate the performance evaluation with job description and institutional goals. F. Listing the employee's strengths R: The nurse manager would also compile a list of the employee's strengths.

To compensate for healthcare disparities, which group would need the most support? A. Russian immigrants who speak limited English B. Non-English-speaking Guatemalan refugees with a 4th-grade education level C. Iranian immigrants reluctant to seek care due to discrimination D. Haitian immigrants seeking care only after home remedies have failed

B. Non-English-speaking Guatemalan refugees with a 4th-grade education level A combination of not speaking English and having a low education level, along with refugee status, means that this group would most need support since they may not know how to access healthcare and need resources to understand their condition and treatment.

In which stage of group development would the team find a common purpose and sense of belonging? A. Forming B. Norming C. Performing D. Adjourning

B. Norming During norming stage, the group finds a common purpose and cohesion. Members are recognized for their contributions and share leadership responsibilities.

Which person is the chief retention officer of a patient care area? A. New nurse B. Nurse leader C. Physician D. Chief Operating Officer

B. Nurse leader Nurse leaders can directly influence quality, safety, service, and satisfaction for patients and frontline nurses; they are the chief retention officers of a patient care area and help shape the environment and learning milieu for new employees.

Which factor differentiates the unique focus of risk management from other quality activities? A. Prevents severe harm B. Prevents damage to the organization C. Removes unsafe clinicians D. Fulfills requirements of The Joint Commission (TJC)

B. Prevents damage to the organization Risk management identifies and attempts to mitigate situations that put the organization's finances or public image at risk.

Which activity would be expected of permanent QI teams? SATA A. The manager will request staff to form a team whenever a sentinel event occurs. B. Regular meetings will focus on improving specific areas of patient care. C. Each unit will form its own QI team to complete projects with their own resources. D. Staff members could go back to the QI team to discuss new developments after a recent project. E. The permanent QI team will help to promote a QM philosophy in the organization.

B. Regular meetings will focus on improving specific areas of patient care. D. Staff members could go back to the QI team to discuss new developments after a recent project. E. The permanent QI team will help to promote a QM philosophy in the organization.

Which nurse's action enhances quality improvement efforts? A. Educating staff on handoff procedures for helicopter transport occurring two to three times per year B. Reinforcing education for emergency transport to ICU that occurs once or twice times per week C. Providing education for post-mortem care that is performed once or twice times per month D. Inservice organ donation procedure that occurs one to three times per year

B. Reinforcing education for emergency transport to ICU that occurs once or twice times per week Transfers to the ICU are relatively frequent and potentially high-risk and thus would have a strong impact on nurses and patient safety. This is the most appropriate area on which to focus improvement efforts.

Which action would be most helpful in building strong relationships at work? A. Connecting with a nurse colleague on social media B. Responding to another nurse's call light when they are busy C. Asking a nurse to cover during breaks D. Requesting to work with the same nurses consistently

B. Responding to another nurse's call light when they are busy Relationships are built when individuals step in to help one another without being asked. Recognizing that a nurse is busy and stepping in to answer the call light would show that they are willing to support one another and accomplish the common goal.

Which action would the nurse manager take with several nurses who are refusing to accept a new medication charting system after sharing the benefits of the new system? A. Implementing the new charting system, as has been accepted by most of the nurses B. Scheduling a meeting with the nurses who oppose the new charting system to discuss their concerns C. Threatening to discipline the nurses who are opposed to change if they do not adapt to the new charting system D. Transferring the nurses who oppose the new charting system to a unit where the old system is still in use

B. Scheduling a meeting with the nurses who oppose the new charting system to discuss their concerns People who tend to resist change, laggards, and late majority often have a real reason for the resistance. The nurse manager should discuss these concerns with the nurses to address any possible conflicts that could arise and that may not have been considered during initial planning.

Which term is used to describe a written plan of action that anticipates the future so that an organization can adapt and survive in a changing and competitive environment? A. Change agent B. Strategic plan C. SWOT analysis D. Systems theory

B. Strategic plan A strategic plan is a written plan of action that anticipates the future so that an organization can adapt and survive in a changing and competitive environment.

Which outcome is most likely to result when a patient hears themselves being referred to by the secretary in a healthcare provider office as a "frequent flier"? A. The patient will feel embarrassed and go to a different provider the next time. B. The patient will not make a healthcare appointment the next time they have a concern. C. The patient will feel important as being recognized as someone needing frequent health visits. D. The patient will complain to the provider about what was overheard.

B. The patient will not make a healthcare appointment the next time they have a concern. The most likely outcome when a patient overhears themselves being disparaged by healthcare staff is that they will delay or not seek care, even when they should, because they are embarrassed or ashamed.

Which manager's recommendation would likely face resistance from the nursing staff? A. Better staffing ratios are associated with decreased mortality. B. Twelve-hour shifts will increase errors due to fatigue. C. Nurses must function at top of license and avoid work that can be delegated. D. Nurses must use their vacation time to avoid burnout.

B. Twelve-hour shifts will increase errors due to fatigue. Twelve-hour shifts and the associated 3-day workweek are popular among nurses, and proposals to eliminate the 12-hour option for safety will be met with some resistance.

The nursing student is discussing process improvement (PI) teams with their preceptor. Which description about PI teams made by the student is most accurate? A. "I need several years of experience before I join a PI team." B. "PI teams are made of nurse managers and the quality department." C. "I would like to present a new technique for increasing handwashing to the PI team." D. "PI teams for nursing processes should only involve nurses."

C. "I would like to present a new technique for increasing handwashing to the PI team." This statement shows the student understands that they may have new knowledge that can contribute to success and demonstrates the value of every participant.

Which statement by the nurse is related to validity? A. "We will be discussing our study findings at the next state nurses' association conference." B. "Now that we know the results, we have to put a policy in place to ensure that we are implementing the findings of the study." C. "I've spent a great deal of time on this study. Now that I have the results, I'm not sure if they are accurate." D. "If I conducted this study in another setting, would the results be the same?"

C. "I've spent a great deal of time on this study. Now that I have the results, I'm not sure if they are accurate." Validity answers the question of whether the results of the study are true.

Which statement made by a student indicates the need for further education when discussing the role of change agents in the implementation of new policies? A. "Change agents are committed to growth." B. "Change agents advocate for openness and improvement." C. "Only nurse leaders and managers are equipped to be change agents." D. "Change agents often play many roles to implement positive change."

C. "Only nurse leaders and managers are equipped to be change agents." All nurses, including nurse leaders and bedside nurses, can be change agents.

Which question from the student is consistent with the goals of the Choosing Wisely® program? A. "Why do we perform blood pressure every 15 minutes after surgery?" B. "Why do we get patients out of bed for meals?" C. "Why does our protocol have us wake patients at 3 am for vital signs?" D. "Why do we check potassium every day for patients receiving Lasix?"

C. "Why does our protocol have us wake patients at 3 am for vital signs?" This question is consistent with Choosing Wisely® goals since it interrupts the patient's sleep and does not give useful information for a patient who is stable with no changes.

Which attitude is observed in a person who has a dualistic nature? SATA A. Acknowledging people with opposing views B. Being enthusiastic to learn C. Being judgmental of others D. Being a self-proclaimed expert E. Encouraging others to learn

C. Being judgmental of others D. Being a self-proclaimed expert

Which description is an accurate characteristic of debriefing? A. Efficient initiation of a project B. Assessment of group members C. Careful review of a completed task D. Evaluation of organizational policies

C. Careful review of a completed task Debriefing involves watchful evaluation of a task upon completion. It is a structured process to review the actions taken to complete the task.

Which action by the nurse describes the use of nursing research? A. Using sterile gloves when performing urinary catheterizations B. Following organizational policies when providing patient care C. Conducting patient surveys to understand patient preferences related to visitation D. Making changes to the lab collection policy based on information obtained from literature

C. Conducting patient surveys to understand patient preferences related to visitation Nursing research involves the creation of new knowledge, which is what is occurring during the patient survey process. Research involves the collection of information such as through patient surveys to better understand a particular phenomenon.

Which location would be the best option for conducting an interview of an applicant for a new job position? A. Hospital cafeteria B. Nurse's station C. Conference room D. Supply room

C. Conference room A conference room would be the best option for conducting an interview because it is both private and helps to avoid interruptions.

Which practice change is most likely to be sustained for 1 year? A. Hourly patient rounding monitored by random visual audits that are shared at shift change B. Handwashing on room entry monitored by signed logs and submitted daily to the manager C. Daily unit safety huddles attended by the manager and summarized weekly for administration D. Weekly equipment cleaning by any available staff and verbally confirmed with the manager

C. Daily unit safety huddles attended by the manager and summarized This change is most likely to be sustained for 1 year since the huddles are daily and can form a habit, and there are multiple layers of accountability including the manager and administration.

Which action would improve collaboration among nursing staff? A. Avoiding team-building activities B. Increasing the amount of time nurses spend with patients C. Encouraging nurses to share best practices D. Providing nurses with more autonomy

C. Encouraging nurses to share best practices Encouraging nurses to share best practices is the best way to improve collaboration among nursing staff as it helps to foster a sense of team camaraderie, as well as providing nurses with the opportunity to learn from one another.

Which action of the researcher would ensure successful progression of the practice change? A. Providing progress feedback from executives B. Monitoring patient survey comments C. Ensuring that each step of the change is completed D. Taking a break during times of high census

C. Ensuring that each step of the change is completed This step is necessary to keep the project moving forward. The researcher must stay closely engaged and ensure that all intermediate steps of the change are implemented correctly and effectively.

To illustrate the current process of ordering blood products on a nursing unit, which data tool would the quality improvement team utilize? A. Bar chart B. Line graph C. Flowchart D. Fishbone diagram

C. Flowchart A flowchart would be appropriate because it is able to illustrate complex tasks such as ordering blood products. Flowcharts diagram the steps of a process in the correct order using boxes and directional arrows.

Which action by the nurse leader most effectively supports the Quality, Safety, and Education for Nurses (QSEN) competencies? A. Encouraging front-line nurses to conduct research B. Supporting staff in volunteering as study participants C. Helping nurses create a journal club D. Posting a list of QSEN competencies on the unit

C. Helping nurses create a journal club Supporting the development of a journal club will help nurses become familiar with reading and evaluating research studies which may be used as evidence for practice change.

Which action ensures successful and productive development and evaluation of new employees? A. Providing detailed position descriptions B. Conducting biannual performance appraisals C. Hiring the right individual for the right reasons D. Performing behavioral interviews before hiring

C. Hiring the right individual for the right reasons Development and evaluation of a new employee at an organization is more productive and successful if the right individual is selected for the right reasons.

Which nursing strategy most effectively uses National Database of Nursing Quality Indicators (NDNQI) data? A. Improving morale by making nurses see hospitals that perform worse B. Identifying unsafe hospitals so patients can be told about them C. Improving underperforming areas in similar hospitals D. Determining whether improvements made last month are effective

C. Improving underperforming areas in similar hospitals NDNQI benchmarks can be used to self-evaluate performance and identify where efforts should be focused to make the highest impact on improvement.

Which goal is the strongest example of a nursing-sensitive indicator outcome for a nursing unit? A. Improving patient-reported pain control within 3 months B. Reducing bladder catheter days by 10% C. Increasing documentation of admission skin assessments by 15% within 3 months D. Discharging 95% of stroke patients on anti-thrombotic medication within 1 month

C. Increasing documentation of admission skin assessments by 15% within 3 months This goal is nurse sensitive and contains all measurable elements: specific, measurable, realistic, and time-bound.

Which pattern of change acceptance is the nurse who constantly develops new ideas for practice improvement following? A. Laggard B. Rejector C. Innovator D. Late majority

C. Innovator Innovators thrive on change and constantly develop new ideas.

Which information is an example of prescriptive data? A. 73% of patients undergoing abdominal surgery experienced constipation. B. Patients with narcotic dependence are likely to need double or triple normal dose for pain control. C. Modeling shows that volumes will likely double in the next 6 months, so a second CT scanner will be needed. D. Data show that patients on hypertension medication are at higher risk for falls.

C. Modeling shows that volumes will likely double in the next 6 months, so a second CT scanner will be needed. This information is prescriptive data, showing that CT scan volumes are likely to double and what action is necessary to maintain patient care.

Which information would be required before starting a quality improvement project on reducing falls? A. Average daily census B. Nurse vacancy rates C. Monthly fall rates D. Median patient age

C. Monthly fall rates Baseline data is required for a quality improvement project to demonstrate the effect that a change had on the outcome.

Which approach to data management allows patients to be more engaged with their care? A. Patients can request chart copies 10 days after discharge. B. Paper charts must be digitally scanned within 30 days. C. Patients can see electronic notes as soon as they are entered. D. Patients are encouraged to research their condition after discharge.

C. Patients can see electronic notes as soon as they are entered. The ability to view notes immediately empowers the patient to take a more active, engaged role in their care.

Which focus is primary when translating research into practice? A. Informing teaching modalities B. Increasing efficiency of nurses C. Promoting patient-centered care D. Enhancing nurse leaders' effectiveness

C. Promoting patient-centered care The primary focus of nursing research is to improve outcomes for the patient and family.

Which literature review finding would the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system evaluate appropriately? A. A randomized controlled trial (RCT) result that has been disputed by an expert opinion B. A study involving a sample of patients on a nursing unit that questions the results of a critically appraised study C. Randomized control trials from reputable journals that produced conflicting results D. Qualitative studies performed on nursing units at two hospitals

C. Randomized control trials from reputable journals that produced conflicting results Differing findings from two RCTs should be evaluated with a formal tool such as GRADE to give the researcher an objective view of the strength of each.

Which approach would be effective when nurses and nurse researchers collaborate? A. Nurses waiting until peer review is completed to give feedback to the researcher B. Researchers visiting the unit to see the patient population and watch the nurses work C. Researchers and nurses communicating regularly during study design D. Nurses giving feedback to the researcher after they have tried the proposed practice change

C. Researchers and nurses communicating regularly during study design Communication at all phases of the practice change is the most effective method to ensure that all parties contribute from their expertise.

Which application of debriefing is common in nursing? A. Quality assurance B. Rotating shifts C. Simulation D. Clinical placement

C. Simulation Simulation is imitation of an act by using various techniques or devices such as patient simulators, mannequins, and role-playing. Use of simulation is an application of debriefing, which is commonly used in nursing.

Which resource would be best for assisting the new graduate in performing a literature review? A. The nurse manager B. A mentor on the unit C. The hospital librarian D. The Chief Nursing Officer

C. The hospital librarian Hospital librarians have the most knowledge about the process and tools available for searching and accessing journals and articles. In hospitals without a librarian, the local public library can offer the same expertise.

Which statement accurately describes the role of the patient in a person-centered care delivery model? A. They assume all responsibility for healthcare decisions. B. They allow the healthcare provider to prioritize their functional health status as the goal of care. C. They are an equal partner with the healthcare provider when planning and implementing care. D. They trust the healthcare team to work in their best interest and do not seek additional opinions or care elsewhere.

C. They are an equal partner with the healthcare provider when planning and implementing care. Person-centered care prioritizes the preferences and input of the patient and patient's support system when planning and implementing care, and the patient is an equal partner in the care.

Which action would potentially decrease a manager's confidence? A. Reflecting on difficult situations B. Overcoming past mistakes C. Thinking negatively D. Accepting imperfection

C. Thinking negatively A manager must be confident and self-assured. Fear of failure and self-doubt can decrease confidence and effectiveness of a leader. Negative self-talk is one way that doubt can manifest.

Which factor would be instrumental in supporting nurses to introduce evidence-based practice? A. CEO champions innovation across the organization B. Nurse managers stay versed on new technology C. Unit council structure drives change in the organization D. Nursing clinical ladder system gives credit for research activity

C. Unit council structure drives change in the organization Change driven by frontline staff is instrumental for supporting nurses to review research and foster inquiry, which help nurses join together to create change.

Which behavior supports interprofessional collaboration? A. Establishing a hierarchy of roles and responsibilities among the team members B. Focusing on the individual roles of each professional C. Using process improvement strategies to create solutions D. Engaging in individual problem solving with other health professionals

C. Using process improvement strategies to create solutions Using process improvement strategies supports interprofessional collaborative practice because it allows the team to identify areas of improvement and work together to develop solutions that are beneficial for the patient.

Which factor is a key priority for the future of nursing? A. Addressing rising costs through reduction in salary B. Building an infrastructure for the collection and analysis of patient outcome data C. Using technology to maximize reaching vulnerable populations D. Narrowing the nursing scope of practice to reduce workloads

C. Using technology to maximize reaching vulnerable populations Nursing is focused on the use of technology to maximize reaching vulnerable populations because it can be cost-effective and reach the patient in multiple difference ways, not always requiring the patient to come into a clinic or hospital to be seen.

Which information would the National Academy of Medicine's (NAM) report on health professions education provide? A. Partner with university researchers to identify relevant sources. B. Collaborate with researchers to integrate research findings into practice. C. Rely on researchers to identify the best sources of evidence. D. All healthcare professionals should be able to develop concise clinical questions.

D. All healthcare professionals should be able to develop concise clinical questions. The NAM's report on health professions education state that healthcare providers should be able formulate clear clinical questions.

With a goal of improving skills and performance of employees involving a personal approach, which managerial technique would the nurse manager use to motivate the staff? A. Performance appraisal B. Performance C. Peer review D. Coaching

D. Coaching Coaching is a managerial technique used with a goal of improving worker skills and performance. It is not punitive; rather, interaction between the manager and worker is collaborative.

Which recommendation would a mentor provide to the nurse who claims to hate their job? A. Try to make it work at the current position. B. Do the minimum necessary until the feeling passes. C. Accept that work is just a source of income. D. Commit to being present when working.

D. Commit to being present when working. Until the nurse can find a position that they are more committed to, they still should commit to do their best. One way to commit to this is to strive to be present when at work, which allows the nurse to take care of their patients to the best of their ability.

Which team would be described as ineffective? A. Members of the team present different ideas about how to solve the problem. B. Multiple people function as a leader throughout the course of a project. C. The initial team meeting includes specifying individual assignments. D. During meetings, a small number of members talk for most of the time.

D. During meetings, a small number of members talk for most of the time. In an ineffective team, a small number of members dominate conversation and leave others out or minimize their contributions. This can alienate team members and leave them to feel unimportant or resentful.

Which characteristic would the nurse leader associate with the concept of coaching? SATA A. Using it to punish employees who break the rules B. Only useful when addressing individual employees C. Using one-way communication from the manager to the employee D. Encouraging optimal employee performance E. Not useful in promoting team building F. Enhancing communication between the manager and employee

D. Encouraging optimal employee performance R: Coaching encourages optimal employee performance and can enhance communication between the manager and employee. F. Enhancing communication between the manager and employee R: Coaching encourages optimal employee performance and can enhance communication between the manager and employee.

Which action taken by the nurse manager on an acute inpatient care unit aligns with the methodology of person-centered care? A. Coordinating patient care assignments for the upcoming shift B. Ensuring that all staff on the unit are working within their individual scope of practice C. Attending a daily admission meeting with other nurse managers across the institution D. Examining the cost of care delivered on the unit as compared with patient outcomes

D. Examining the cost of care delivered on the unit as compared with patient outcomes A central concept of person-centered care, as well as being one of the "Triple Aims," is to actively engage in cost reduction while maintaining quality of care and positive patient outcomes.

Which action by the nurse manager during a period of change promotes acceptance of the change by staff members? A. Compensating them with raises B. Making major decisions without their input C. Assisting them in completing daily documentation D. Sending weekly emails with up-to-date information

D. Sending weekly emails with up-to-date information Change agents help others transform by advocating for openness and improvement and facilitating communication. One effective strategy to promote acceptance of change is keeping staff informed of decisions.

Which behavior would diminish trust among team members? A. Establishing ground rules and agreements among the team members B. Holding all members accountable for their contribution to the team C. Having a shared belief in the reliability of each member's abilities D. Sharing task-related information with select members of the team

D. Sharing task-related information with select members of the team Transparency with information related to the tasks that are being undertaken by the team to all team members is important to build trust among the members. Therefore, only sharing with a select few is not a trustworthy behavior.

In which way does the Deficit Reduction Act of 2005 incentivize healthcare organizations and providers to work toward improved patient health outcomes? A. The provider bills the patient at a lower rate if they are discharged from the hospital sooner than expected. B. The hospital is penalized if a patient is readmitted less than 30 days following discharge for certain conditions. C. Healthcare providers are rewarded for providing higher quality care. D. The hospital is not reimbursed for care of a patient who develops a new condition as a result of being hospitalized.

D. The hospital is not reimbursed for care of a patient who develops a new condition as a result of being hospitalized. Hospitals do not receive additional payment if a patient acquires a condition because of a complication of the hospitalization. This act incentivizes hospitals to provide comprehensive, coordinated patient care.

Which communication method would be most effective for a nurse manager to announce a policy change on the nursing unit? A. Printed memos left on the unit B. Group text message to employees C. Mass email to all employees D. Verbally during staff meeting

D. Verbally during staff meeting Sharing important information in person would be most effective because it allows for both sides of the conversation to express themselves verbally and nonverbally.