Leadership Test 3

) The nurse manager identified that the census was higher than anticipated and the client acuity level was also high; however, fewer nursing hours are paid. This variance is an example of which budgetary variance? 1. Efficiency 2. Nonsalary expenditure 3. Rate 4. Volume

1

A candidate has arrived for an interview. The interview is conducted with various personnel within the organization. This is an example of an attempt to ensure which result? 1. Interrater reliability 2. Intrarater reliability 3. Validity 4. Construct validity

1

A chief nurse officer (CNO) of a rural hospital is meeting with department directors and the human resources officer to discuss the hospital's recruitment strategies. A newly promoted director suggests a recruitment fair at a metropolitan city 100 miles away. The CNO rejects this proposal. Which option is likely the CNO's rationale for this decision? 1. The CNO would prefer to focus on the local area initially. 2. A metropolitan area is not a good area in which to recruit for a rural hospital. 3. Metropolitan nurses' skills are too advanced for a rural hospital. 4. The director is new to the role and the CNO does not respect the nurse's opinion.

1

A medical intensive care unit has a registered nurse position open. The qualifications for the position require a minimum of 1 year of acute-care nursing experience, BLS and ACLS certification, and the ability to administer intravenous cardiac drips. Which fact in an applicant's application would be sufficient reason to decline the applicant's request for an interview? 1. The candidate graduated from nursing school 9 months ago. 2. The candidate does not have ACLS certification. 3. The candidate does not have experience with cardiac drips. 4. The candidate was an LPN for 10 years prior to being an RN.

1

A newly hired nurse is asked to join a group working on unit protocols. This nurse is verbal and dominates the conversation of the group. The group leader identifies the disruption this nurse causes as being from which phenomenon? 1. Status incongruence 2. Group isolates 3. Emergence 4. Deviation

1

A nurse has been asked to teach newly hired nurses how to operate some client care equipment that the unit has just received. The nurse says, "I'd love to do this, but someone else will need to take my clients today." How should the manager respond? 1. "You will need to work the education into your day as you take care of clients." 2. "This will be a good break for you." 3. "You can use the classroom in the hospital basement for your instruction." 4. "I will authorize your additional salary for the next pay period."

1

A nurse manager is interviewing a candidate who has much experience in other industries. The candidate was recently licensed and is interviewing for a registered nurse charge position. Which consideration is most important for the manager to bear in mind when regarding this candidate? 1. Can the candidate perform the job? 2. Will the candidate perform the job? 3. Will the candidate apply past work experience? 4. How long will the candidate retain this position if hired?

1

A nurse manager writes the following note: "Over personnel budget by $1,250 in April due to late snowstorm. Nurses unable to get to work. Overtime wages paid." Why is this note important? 1. It will help the manager create the budget for the next year. 2. It is required by the Joint Commission. 3. All variances must be documented and forwarded to the hospital attorney. 4. It ensures that there is no question of diversion of hospital funds.

1

A staff nurse is not meeting job expectations. The manager has followed some standard strategies such as counseling to try to motivate the nurse, but they have not been successful. When discussing the situation with the supervisor, the manager says, "I think I will try shaping strategies." What can the supervisor expect of the staff nurse's performance? 1. It should gradually move toward the expected behaviors. 2. The behaviors will likely get worse before they get better. 3. The nurse will probably get frustrated and resign. 4. Performance should be at expected levels within a week.

1

A task force leader says, "At the beginning of our next meeting we are going to do some team-building exercises." Which comment by a group member indicates a need for further education about team building? 1. "I don't see anything wrong with the way our team works. Why do we have to go through team building?" 2. "That should help us meet the goals we have written." 3. "I did some team-building work a long time ago. I probably need a refresher." 4. "I hope the men on our task force will cooperate."

1

After shift change the nurse discovers that a client's IV heparin has been turned off at the IV controller. The amount of fluid left in the IV bag indicates that the client received half of the dose ordered. Which statement should be documented in the client's medical record? 1. IV heparin restarted. Physician notified. Client's vital signs unchanged. 2. IV heparin restarted at a rate to catch up dosage accidentally deleted. 3. IV heparin turned off by previous shift. Restarted. 4. IV heparin restarted and incident report completed.

1

An emergency department (ED) manager interviews and hires a candidate who reports having several years of ED experience. Soon after hire, the nurse makes a series of errors and harms several clients. When investigating these errors, the nurse manager discovers the nurse falsified his experience and credentials. Is the hospital liable for this nurse's actions? 1. Yes, the hospital could be liable for negligent hiring if credentials were not checked. 2. Yes, the hospital could be liable but only if it did not properly train the nurse. 3. No, the nurse is liable because information about experience was falsified in the interview. 4. Yes, the hospital is liable for all errors committed by nursing staff.

1

As part of the process of promoting quality improvement, the nursing manager is comparing data between two hospitals on average length of stay for a total hip replacement. This comparison is an example of which process or step? 1. Benchmarking 2. Outcome standard 3. Indicator 4. Process standard

1

In an attempt to decrease tardiness, a hospital gives employees an extra hour's pay for each wage period that the employee has not been late for work. This incentive program is an example of which theory? 1. Expectancy 2. Shaping 3. Equity 4. Goal-setting

1

The nurse has attended a "how to" refresher course on successful delegation. Which statement indicates successful learning has taken place? 1. "I knew that effective delegation made my job easier, but I never thought about how it could benefit the hospital." 2. "The clients on our unit come and go so frequently that delegation is of little benefit." 3. "I just don't understand why people think delegation is difficult; all you have to do is tell other people what to do." 4. "Now I know that effective delegation means telling my nursing staff when they need to have their regular work done."

1

The nurse manager of a critical care unit creates the operating budget with the knowledge that a minimum of two professional nurses must be paid per shift regardless of the patient census. Which group determines this standard? 1. Hospital administration 2. Nursing administration of the hospital 3. The Joint Commission 4. Nursing personnel of the special care units

1

The nurse manager's goal is to adequately staff the unit and use minimal supplementary staff. The manager has added the cost of this supplementary staff to the unit's operating budget. A colleague informs the manager it should have been added to which budget? 1. The personnel budget 2. The operating budget 3. The revenue budget 4. The fixed budget

1

The staff nurse job description states that the nurse is responsible for attending hospital committee meetings as assigned. The nurse manager asking the staff member to attend a risk management meeting is an example of which concept? 1. Work assignment 2. Overdelegation 3. Ineffective delegation 4. Transfer of authority

1

The unpredictability of the labor and delivery area requires a set staff mix for every shift. Which type of staffing pattern should the manager use to ensure this mix? 1. Block staffing 2. Creative scheduling 3. Flexible scheduling 4. Self-staffing

1

There is substantial unrest among the staff of an intensive care unit that has resulted in negative client outcomes. Which employee factors should the manager assess first? 1. Motivation and ability to be effective in the job 2. The age of employees and their social background 3. Gender and educational preparation of staff 4. Experience base of employees and their attitude toward the job

1

Which is the most effective method of creating a blame-free environment? 1. Work to develop a just culture within the organization. 2. Make sure all nurses agree to report every mistake. 3. Set up a self-reporting board so that all employees will know that everyone makes mistakes. 4. Ensure nurse managers keep a list of how often each employee makes a mistake.

1

Which situation best exemplifies the nurse manager as a team leader? 1. The nurse manager posts the unit's positive accomplishments from the past month in the break room. 2. The nurse manager controls the staff meetings so the staff can get back to work quickly. 3. Every year the nurse manager does staff member evaluations to determine pay raises. 4. The nurse manager encourages conjunctive task performance on the unit.

1

Which statement represents a situation is which delegation is ineffective or inappropriate? 1. The RN asks the LPN to assist with admissions by assessing the clients as they get to their rooms. 2. The RN delegates administration of oral medications for a group of clients to the LPN. 3. The LPN directs the unlicensed assistant to report vital sign changes on a postoperative client to the RN. 4. The nurse manager asks the RN to act as chairperson for today's unit council meeting because the charge nurse went home sick.

1

A client has been told that chemotherapy must be postponed until he is hydrated. The client refuses the IV hydration and demands to go home. How would the nurse best categorize this situation? 1. Non-reportable incident 2. Medical-legal incident 3. Client dissatisfaction with care 4. Medication error

2

A client has been told that chemotherapy must be postponed until he is hydrated. The client refuses the intravenous hydration and demands to go home. How would the nurse best categorize this situation? 1. As a nonreportable incident 2. As a medical-legal incident 3. As client dissatisfaction with care 4. As a medication error

2

A hospital has used capital funds to purchase a new piece of diagnostic equipment. The hospital's chief financial officer (CFO) says, "The cost of this equipment will be expensed out across all units that use it." How should the nurse manager interpret this statement? 1. The equipment is jointly owned by all units that use it. 2. If clients on the manager's unit require the use of this equipment, a portion of the cost will be charged to the unit. 3. The equipment will be rented to the units for use. 4. The nurse manager will ask physicians to refrain from using the equipment.

2

A newly hired nurse manager is being mentored in this new role. How should the mentor advise this manager regarding staffing for the next shift? 1. "First you must determine the nursing care hours needed." 2. "First you must become familiar with the classification system we use." 3. "First consider how to modify the schedule to meet client needs." 4. "First consider the need to supplement the current nursing staff so that arrangements can be made."

2

A nurse asks an unlicensed assistant to help with discharging clients because so many are going home at one time. The nurse states, "Can you help get these clients ready to go home by helping them pack?" Which option best describes the statement with regard to effective delegation? 1. The delegation is ineffective because the nurse has no responsibility to pack the client's belongings. 2. Delegation would have been more effective had the nurse been more specific about which clients and when it should be completed. 3. The delegation is ineffective because the nurse has no authority to ask the unlicensed assistant to help with client discharge. 4. Delegation could have more effective had the nurse gone with the assistant to ensure the assistant did the packing as requested.

2

A nurse manager is aware that U.S. citizenship is required by a job position being filled. How should the manager handle this requirement during the job interview? 1. Ask the applicant to provide proof of citizenship before the interview is scheduled. 2. Ask the applicant if he or she is an U.S. citizen. 3. Do not ask unless the applicant mentions citizenship. 4. Ask if the applicant's family is from the United States.

2

A nurse manager is conducting her first interview. The manager is provided interview guidelines by the human resources (HR) director. Which advice from the HR director is most effective? 1. "Follow these guidelines and do not ask personal questions." 2. "If you are unsure of a question, ask yourself if the question applies to job performance." 3. "You may ask any question as long as it's stated in third person." 4. "You may ask only the questions that are provided."

2

A nurse manager wishes to use a model of job performance to help match employees and tasks to achieve the greatest effectiveness. What should the manager do first? 1. Evaluate each employee's educational and experiential background. 2. Establish, in writing, the expectations of each task. 3. Consider how much variation from standard is acceptable. 4. Review unit statistics for incidents, errors, and accidents.

2

A nurse manager would like to add the statement "Provide ongoing education to the client and the client's family" to the position description of RNs. Where would this statement be placed in this document? 1. In the job qualifications 2. In the job responsibilities 3. In the job overview 4. In the job benefits

2

A nursing assistant tells a nurse, "I am going to have to call in sick tomorrow because I don't have a babysitter." How should the nurse respond to this information? 1. The assistant's sick time is earned and should be used in any way the assistant wishes. 2. The assistant should use personal time, not sick time, for this situation. 3. The assistant's absence will not be a major problem for the unit as long as only one day is missed. 4. It will be okay for the assistant to miss a day because it will help another assistant get overtime wages.

2

A nursing group cannot complete a task assignment because information from another group has not been provided. Because the nursing group cannot complete its task, a group from physical therapy will not be able to complete its task. This is an example of breakdown in which task format? 1. Pooled interdependence 2. Sequential interdependence 3. Reciprocal interdependence 4. Reverse interdependence

2

An emergency department (ED) manager has an interview scheduled for 8:00 the next morning. The manager's usual hours are 8:00 a.m. to 4:00 p.m. This manager has been working as staff due to an increased volume of clients. What action should the manager take to prepare for this interview? 1. Reschedule the interview to a later time. 2. Arrive to work early in the morning to prepare for the interview. 3. Arrive at the usual time and conduct the interview. 4. Have a human resources representative conduct the interview.

2

During an interview the candidate informs the manager of a difficult experience between a client and a physician. The nurse had to negotiate between an unhappy client and a difficult physician. Which notation by the manager would describe this situation? 1. The candidate has good initiative. 2. The candidate has good conflict resolution skills. 3. The candidate is a client advocate. 4. The candidate is adaptable.

2

During an interview with a potential employee, the nurse manager tells the individual that an additional 10% of the hourly rate will be paid for working the 7:00 p.m. to 7:00 a.m. shift. What is another way the manager could have described this difference in pay? 1. "You will receive an additional 10% for overtime." 2. "The night shift differential is 10%." 3. "Your evening premium is 10%." 4. "You will get a 10% cost-of-living raise for working the night shift."

2

Every month the chief financial officer (CFO) reviews the budget with the hospital's board of directors. The CFO requests a million dollars to purchase a new MRI (magnetic response imaging) unit for the radiology department. Which category best describes this request? 1. Non-revenue expense 2. Capital expense 3. Variable cost 4. Allocation of funds

2

In a group meeting, one of the members always arrives early and places the chairs in a circle so all members can interact. This person is responsible for confirming that the room is available for the monthly meetings. Which person does this describe? 1. Gatekeeper 2. Procedural technician 3. Coordinator 4. Initiator-contributor

2

The chairperson of the nursing faculty leads the monthly meetings of the curriculum committee. This permanent group, which is designed to meet organizational goals, is which type of group? 1. Competing group 2. Command group 3. Task force 4. Informal group

2

The daughter of a hospitalized client comes to the nurse manager's office with a complaint about the care provided on the previous shift. What is the manager's first action? 1. Call the nurse from the last shift to participate in a conference call about the complaint. 2. Ask the daughter to explain what happened. 3. Tell the daughter that the last shift was understaffed and apologize for any problems that might have occurred. 4. Ask the daughter what can be done to improve the situation.

2

The director of quality improvement reports that the hospital will soon be using "dashboards" as part of the quality management process. How should the staff interpret this information? 1. Surveyors are driving to clients' homes to collect data on hospital visits. 2. This electronic tool makes it easy to aggregate and display data. 3. "Dashboard" is an acronym for the topics covered in client satisfaction surveys. 4. The "dashboard" is a screen on the electronic medical record that can be accessed for quality improvement information.

2

The following documentation was entered in the client's medical record: "The client was found lying on the floor. Dr. X was notified. Apparently the restraints were improperly applied." Which statement best describes this documentation? 1. Appropriately written 2. Inappropriate because it places blame on an individual 3. Inappropriate because it does not include that the client's family was notified 4. Appropriately written because it only documents the facts

2

The following documentation was entered in the client's medical record: "The client was found lying on the floor. Dr. X was notified. Apparently, the restraints were improperly applied." Which statement best describes this documentation? 1. Appropriately written 2. Inappropriate because it places blame on an individual 3. Inappropriate because it does not include that the client's family was notified 4. Appropriately written because it only documents the facts

2

The hospital has elected to use the demand management staffing system instead of the client classification system. Because of this decision, the nurse manager who is staffing must focus on which of the following? 1. Immediate client needs 2. Historical data of expected client outcomes 3. Using hospital-wide data to staff individual units 4. Reduction of nursing care hours

2

The hospital is caring for more high-acuity clients due to the recent flu endemic. The chief nurse officer (CNO) reviews the census from last year's flu season and instructs the manager to schedule more RNs for the weekend. Which system has the CNO used? 1. Client classification systems management 2. Demand management system 3. The Baylor plan 4. Automated staffing

2

The hospital organization has developed a philosophy based on the client, organizational involvement, quantitative measurement of outcomes, and processes for improvement. In which quality management process are these characteristics typically seen? 1. Continuous quality improvement (CQI) 2. Total quality management (TQM) 3. Plan, Do, Check, Act (PDCA cycle) 4. Six Sigma

2

The human resources (HR) director is planning on attending a career fair and has asked the director of nursing to attend as well. The nursing director replies, "I really don't have time to attend. Do you really need a nurse to go with you?" Which response by the HR director is most appropriate? 1. "Your attendance is necessary to assist me with managing the booth." 2. "Your attendance is necessary to answer specific nursing questions." 3. "I need your assistances in answering questions about our benefit package and nurses wages." 4. "I would like another person from the organization to assist in representation."

2

The medical-surgical nursing manager notices the education expenditure for the month is over budget. How should the manager deal with this difference? 1. Complete an expenditure report for the month. 2. Complete a variance report for the month's budget. 3. Forward a non-revenue-producing report to the administration. 4. Forward the expense line budget to the administration.

2

The medical-surgical unit's census has decreased since the previous shift. The manager is reviewing the staffing grid. Which factor is used to determine staffing mix? 1. Average daily census of the hospital 2. Client care needs 3. Number of staff on vacation 4. Financial productivity of the unit

2

The newly hired nurse manager is involved in the first budgetary cycle since being hired. The manager lists some capital equipment needs and is surprised when they are not available for staff use two months after the request. What is the reason for this? 1. The equipment was not approved by the manager's supervisor. 2. The budgetary cycle takes up to 1 year to occur. 3. The hospital has experienced a downturn in revenue and is not fulfilling promises. 4. The nurse manager failed to complete the correct request.

2

The nurse has expressed job dissatisfaction to the unit manager. The manager assigns another staff member as a coach for this nurse. What is the most important aspect of the coach's job? 1. Get the nurse to explain the cause of the dissatisfaction. 2. Conduct the relationship in a confidential manner. 3. Encourage the nurse to stay in the organization. 4. Help the nurse increase bedside skill competency.

2

The nurse is acting as team leader for a client care conference. Which opening statement is best for this meeting? 1. "We are all here to discuss the issues with this client's discharge. What issues are we facing?" 2. "The issue with this client is the time limit for Medicare to pay has almost expired, and we aren't ready for discharge." 3. "I don't really have time for this meeting today; is there anything I can do to expedite this meeting?" 4. "I will let you all decide what might be best, as I am not really as familiar with this client as I should be."

2

The nurse manager asks staff members to work as a group in planning the activities for Nurses' Week. The nurse manager should report to the supervisor that which type of group has been formed? 1. Command group 2. Task group 3. Competing group 4. Informal group

2

The nurse manager gave the unit secretary complete responsibility for the unit's staffing, including finding replacements for call-ins and disciplining nurses with excessive call-ins. This is an example of which type of delegation? 1. Effective delegation 2. Overdelegation 3. Reverse delegation 4. Underdelegation

2

The nurse manager is creating the budget for the next fiscal year. Because the client census has been higher in the past year, more supplies were used. Which type of cost does this reflect? 1. Fixed costs 2. Variable costs 3. Direct costs 4. Zero-based costs

2

The nurse manager is explaining her staffing budget to the hospital administration. The manager has developed a flexible staffing pattern. The administration questions the manager as to why this pattern was developed. Which answer is most correct? 1. Staff members would prefer to make out their own schedules. 2. Nursing shortages and salary constraints have affected staffing patterns. 3. Lower client acuity has contributed to the need for more flexibility. 4. Flexible pattern staffing is the easiest method available.

2

The nurse manager is reviewing the current staff to determine who should precept a newly licensed nurse. Which nurse is the most logical choice? 1. A nurse who needs the temporary pay increase that accompanies precepting 2. A nurse who is clinically competent and has the desire to assume the responsibility to train new staff 3. A nurse who has expressed the desire for additional training and unit responsibilities 4. The nurse who needs to work an 8-hour schedule for a few weeks while recovering from a work-related accident

2

The nurse prepares the medication ordered for the client. The nurse asks the nurse assistant to give the medication when the client receives breakfast and to report on the task at its completion. The nurse assistant agrees. Which component of the steps of delegation was violated by this request? 1. Defining the task 2. Deciding on the delegate 3. Determining the task 4. Reaching agreement

2

The nursing administration has instituted a "horizontal promotion" system within the nursing department. What benefit is this program to the staff nurse? 1. The most competent nurses will rise to managerial positions. 2. It rewards the nurse's clinical excellence. 3. Over time the nurse will move steadily upward through the levels. 4. The process is practice based rather than research based.

2

The unit has open shifts even after staff members have signed up for overtime. The chief nurse officer (CNO) does not want to hire agency nurses to cover these shifts. The nurse manager does not understand why the CNO is offering staff an incentive versus hiring agency nurses. Which would be a reasonable conclusion? 1. It takes a significant amount of time to orient agency nurses. 2. The agency nurses are costly. 3. There is a significant amount of documentation required for agency nurses. 4. The physicians are not comfortable with agency nurses.

2

What should a nurse manager consider when including a staff nurse in an interview of an applicant? 1. Restricting the number of questions the nurse can ask 2. Providing the nurse with an orientation program on interviewing techniques 3. Allowing the nurse to provide information but not the ability to ask the applicant questions 4. Allowing the nurse to ask and answer all questions freely

2

Which question is considered appropriate to ask during an interview? 1. "What is the country of your national origin?" 2. "Do you speak any language in addition to English?" 3. "Will child care be a problem if you are hired?" 4. "Are there any holidays on which you would not work?"

2

Which situation indicates that the nurse needs additional training on effective delegation? 1. The charge nurse tells the unlicensed assistant to help prepare rooms for new clients. 2. The office nurse calls in orders for admission on a client following a surgical complication. 3. A rehabilitation nurse asks a physical therapy assistant to assist a client with ambulation around the facility. 4. A home health nurse calls the office and asks another nurse to make the visit to her next client.

2

Which statement reflects a characteristic common to all methods of quality management? 1. Each method uses all staff members in the organization. 2. None of the methods are designed to place blame on an individual. 3. All methods provide clinical information. 4. Most methods focus on cost containment.

2

Which statement regarding the use of electronic medical records (EMR) is accurate as associated with quality improvement? 1. EMR has strong linkage to improving quality. 2. Much more research must be done before the impact of EMR on quality can be determined. 3. EMR does not affect the quality of care provided. 4. Although no research into the impact on quality exists, EMR must continue as it is federally mandated.

2

Which step should be taken first when recruiting and selecting nursing staff? 1. Develop a structured interview guide. 2. Become familiar with the position description for the jobs available. 3. Develop a recruitment strategy to attract qualified applicants. 4. Identify potential applicants who would meet the job description.

2

While providing continuing education about group dynamics and team building, the nurse manager attempts to explain the difference between a group and a team. Which statement by the manager is most effective? 1. A team is bigger than a group. 2. Teams have authority; groups may be informal. 3. A group has similar goals, whereas a team's goals are dissimilar. 4. Groups are formally designated by the organization, while teams are generally informally organized.

2

With the current healthcare industry focus on managed care, nurses must be more cost conscious. Which option is an example of a nurse being cost conscious? 1. The nurse reviews the client's itemized bill each day. 2. The nurse's decides to use fewer supplies when changing a dressing. 3. The nurse manager reviews client costs on a daily basis. 4. The nurse manager requests that the materials management director obtain quotes for less expensive items.

2

A chief nurse officer (CNO) is considering a collaborative effort with a school of nursing to offer externships to students. The chief financial officer (CFO) rejects the proposal because it will entail a cost to the organization. Which statement by the CNO would influence the CFO to reconsider this proposal? 1. "Nursing is the foundation of this hospital and we have to get nurses into the organization." 2. "We could hire students as nurse's aides, which would save costs." 3. "An externship will allow the nursing students to work with nurses, learn about the organization, and create a positive impression of our facility." 4. "Offering a nurse externship would allow the organization to create the types of nurses we would like to hire."

3

A critical care nurse has reported off because of an illness. Which choice of replacement for this nurse would provide the best continuity of quality nursing care? 1. A nurse from an outside agency 2. A nurse from a hospital unit that has a low census today 3. A nurse from a decentralized internal float pool 4. A nurse from the centralized internal float pool

3

A hospital has open shifts on its medical-surgical unit. The manager has listed open shifts on the hospital's intranet. This is an example of which type of scheduling? 1. External pools 2. Internal pools 3. Open shift management 4. Float pools

3

A human resources (HR) manager knows which method of recruitment is most likely to be productive and inexpensive? 1. Internet websites 2. Advertisements in professional journals 3. Employee referrals 4. Job fairs

3

A new nurse manager asks to see the Joint Commission manual in order to determine adequate staffing for the next shift. How should the supervisor respond to this request? 1. "The Joint Commission manual is kept with the other unit manuals." 2. "For that information you will need to refer to the human resources department's policy on employment manual." 3. "You need to look at the policy and procedure manual for the organization, not the Joint Commission manual." 4. "Before you look any further, refer to the unit's current schedule."

3

A new nurse manager has conducted a series of interviews, but did not use an interview guide. Why would the manager's director be dismayed that no interview guide was used? 1. Each organization has standardized interview questions that must be used. 2. The director has selected questions to ask the interviewee. 3. A list of standardized questions allows for reliability in comparing candidates. 4. The director was not included in the interview process.

3

A newly licensed nurse is concerned about the legal aspects of delegation. What is the most important question for the nurse to consider prior to delegating a task? 1. Do other nurses in the facility delegate similar tasks? 2. How long has the assistant worked at the facility? 3. Does this task involve nursing judgment? 4. How busy is the delegate?

3

A nurse educator is asked by the chairperson of the department to submit a list of equipment that could be used to meet the department's goals. The list includes projectors, computers, office supplies, and computer-assisted programs. How would the educator categorize the materials? 1. As an expense 2. As part of revenue 3. As part of the capital budget 4. As part of the operating budget

3

A nurse manager has been appointed leader of a large task force charged with a complex assignment. What strategies should the manager use? 1. Limit full task force meetings to an initial meeting, a middle meeting, and a final meeting. 2. Lead one of the subgroups established at the first full task force meeting. 3. Develop a work plan with interim deadlines. 4. Set deadlines that are at least 1 week earlier than necessary to give subgroups time to be late.

3

A nurse manager has just posted the membership list for a newly formed quality management task force. Which statement, overheard by the manager, indicates the most potential for problems on the team? 1. "I'm glad I didn't get chosen for this task force. I'm so busy with my kids right now." 2. "I was on one of these teams at my last hospital." 3. "This is certainly an interesting choice of people to put together." 4. "She is such a good nurse; I hope she doesn't work herself too hard."

3

A nurse manager is trying to educate the staff regarding efficiency and how it affects the unit's costs. Strategies to increase efficiency could include which of the following? 1. Increasing the number of unlicensed assistants providing direct nursing care 2. Limiting dressing supplies on the nursing unit 3. Labeling the cost of each item in the clean supply closet 4. Eliminating staff education sessions

3

A nursing executive is comparing the entire hospital financials for the month and notes that the medical laboratory's revenue is higher than environmental services. What is a possible explanation? 1. The laboratory has increased charges for its services. 2. Environmental services is a non-revenue-producing cost center. 3. The laboratory is a non-revenue-producing cost center. 4. The nursing units affect the laboratory charges.

3

A registered nurse is dissatisfied with the wages and health benefits available in his current position and decides to seek other employment. This employee's frustration is most linked to which motivational theory? 1. Reinforcement theory 2. Process theory 3. Content theory 4. Equity theory

3

A staff nurse asks the nurse manager, "What assignment are you delegating to me today? I would like to begin to organize my day before shift report begins." What is the error inherent in this statement? 1. There is no way for the nurse to know how to organize until the assignment is clear. 2. The nurse manager would not make assignments. 3. The nurse manager is not delegating but rather making daily assignments. 4. Assignment occurs after shift report.

3

A unit requires a great deal of staffing flexibility. To fill this need, the manager should use which strategy? 1. Maximizing the availability of nursing staff 2. Good communication among staff 3. A high RN-skill mix 4. Overlap between shifts

3

After the second week of orientation the new nurse witnesses the death of a child in the ED. Which role should this nurse's preceptor focus on at this time? 1. Orientation of the nurse to protocols associated with this death 2. Socialization of the nurse to the staff 3. Counseling the new nurse 4. Serving as a role model

3

An emergency department manager is looking over the next month's schedule and decides to supplement the schedule due to vacations. The manager decides to use decentralized pool staffing to lower costs and provide quality care. Which group of nurses is a part of this manager's decentralized staffing? 1. PRN staff from the external pool of nurses 2. Agency nurses 3. PRN staff from the emergency department nurses 4. PRN staff from the nurses who work on medical-surgical units

3

As a member of the budgeting committee, the nurse manager reviews the salaries for file clerks in the accounting department. These salaries should be included in which budget item? 1. The fixed cost 2. The variable cost 3. The indirect cost 4. The direct cost

3

During an interview, the manager has a strong impression that the applicant is a good "fit" for the position. How should the manager proceed? 1. Offer the applicant the job. 2. Cancel the remaining interviews for the position. 3. Keep this feeling in mind but do not make a hasty decision. 4. Tell the applicant that he or she is the strongest candidate for the position.

3

For the nurse to effectively and legally delegate, which document must be consulted and followed to reduce the likelihood of liability? 1. The American Nurses Association Bylaws 2. The National Council of State Boards of Nursing 3. The regulations of the state nurse practice acts 4. The rules of the governing specialty organization

3

Hospital administration has elected to use TeamSTEPPS as a method of team building. What should the nurse manager tell staff about this training? 1. "This program was developed by a nurse to use specifically in small hospitals." 2. "Teams of nurses will be sent to national training seminars." 3. "You can expect additional efforts to help us keep on track." 4. "This is a simulation-based training similar to the old disaster drills we used to do."

3

Immediately following a barium swallow, a client noticed hives and a feeling of shortness of breath. Although there were no known allergies to food or drugs prior to this incident, the diagnosis was allergic reaction to the preservatives in the barium. Which is the correct risk category for this incident? 1. Medication error 2. Medical-legal incident 3. Procedure complication 4. This incident does not fall into a risk category.

3

Immediately following a barium swallow, a client noticed hives and a feeling of shortness of breath. Although there were no known allergies to food or drugs prior to this incident, the diagnosis was an allergic reaction to the preservatives in the barium. Which is the correct risk category for this incident? 1. Medication error 2. Medical-legal incident 3. Procedure complication 4. This incident does not fall into a risk category.

3

On two recent occasions, the experienced nurse manager has found it nearly impossible to discuss upcoming events with all the staff on the unit. What is a common reason for this problem? 1. The hospital is experiencing a nursing shortage, so staff members are very busy. 2. The client mix on the unit is much more varied. 3. The unit has just adopted combined staffing patterns. 4. There is a 1-hour overlap of staff between shifts.

3

The State Board of Health requests the employee file of all agency nurses employed within the past year. At the end of the review, the organization receives a sanction associated with these nurses. What is the most likely cause of this sanction? 1. No current address on file for the nurse 2. Past employment history not documented in file 3. Evaluation of the nurse's performance missing from file 4. No documentation of past certifications in file

3

The chief nurse officer (CNO) receives a call that the candidate for a nurse opening has arrived, but that the unit manager who was to have interviewed the candidate had to work an unscheduled night shift and is unavailable. Which action by the CNO is appropriate? 1. Inform the candidate the interview will have to be rescheduled. 2. Have the HR department refer the candidate to a nurse on the unit. 3. The CNO should conduct an initial interview and arrange for a second interview with the manager. 4. The CNO should call the manager and conduct an interview via a conference call.

3

The group leader often arrives several minutes late to meetings with excuses about workload, telephone calls, or traffic. Today's meeting was scheduled to begin 5 minutes ago and the leader has not arrived. What should the group members do? 1. Call the leader's cell phone to see when arrival is expected. 2. Wait until the leader is 10 minutes late and then cancel the meeting. 3. One of the members should start the meeting. 4. Wait for the leader to arrive.

3

The hospital has initiated a new fall risk assessment tool. The nurse manager would like to reward those staff members who use the tool regularly. Which method of reinforcement would be most successful in getting long-term compliance? 1. A coupon for free lunch for staff members each time they use the tool 2. A counseling session with the nurse manager when the assessment tool has not been used 3. A coupon for a free lunch for staff members who, according to a medical record review of nursing documentation, consistently use the tool correctly 4. A pizza party for the staff when there is 100 percent compliance

3

The nurse is working on a unit with a blame-free environment and makes an error that puts a client at risk. What should the nurse do first? 1. Discuss it with the other nurses on duty. 2. Immediately report the incident to the supervisor. 3. Ensure the client's safety as fully as possible. 4. Say nothing as no one saw the incident.

3

The nurse manager has completed a series of team-building exercises with a command group. Which statement by a group member indicates that cohesiveness is occurring? 1. "I think I understand the work of the group now." 2. "I have gotten to know my group members better during these exercises." 3. "We have so much work to do in this group." 4. "I like the members of the group."

3

The nurse manager is concerned about the apparent lack of staff motivation to improve client care on a unit. How should this manager use motivational theories to help improve this situation? 1. Choose one theory that the manager thinks best suits the situation. 2. Review several theories but use no more than two. 3. Combine theories to develop a plan for this specific unit.

3

The nurse manager needs to delegate specific tasks to the charge nurse of the unit. Which action is an appropriate use of delegation? 1. Instructing the charge nurse to assume a client team 2. Asking the charge nurse to discipline a nurse on the unit 3. Having the charge nurse lead a nursing quality assurance task force 4. Evaluating all unlicensed personnel assigned to the unit

3

The nurse manager tells a newly licensed nurse that having a mentor is a benefit to career development. What should the new nurse expect from a mentor-protégé relationship? 1. The protégé will select the mentor. 2. Once established, this relationship lasts forever. 3. The relationship will develop through stages. 4. Mentors are generally of the opposite gender as the protégé.

3

The nurse manager tells the staff that this year's budget numbers will not change, even if census drops over the rest of the year. How should the staff interpret this information? 1. The budget is a fixed one. 2. The hospital uses incremental budgets. 3. The hospital uses a variable budget. 4. The hospital starts the budgeting process with a zero-based budget.

3

The staff development nurse has elected to use coaching as a staff development technique. Which situation is an example of this technique? 1. Pairing a newly licensed nurse with a nurse who has worked on the unit for 5 years 2. Matching a newly hired male nurse with a newly hired female nurse 3. Pairing a nurse with conflict management experience with an employee who has expressed dissatisfaction with the job 4. Matching nurses who have similar educational and cultural backgrounds when selecting participants for an educational offering

3

The staff nurse has been appointed to a task force. What can the nurse expect regarding this group? 1. There will be no official leader for the group. 2. The nurse will be working with people from several different departments within the hospital. 3. The assignment will be time limited. 4. The group members will compete for resources for their own units.

3

What action is necessary by a delegate accepting delegation? 1. Accept all aspects of the task delegated. 2. Assume the delegator will serve as a mentor. 3. Clarify the time line and expectations. 4. Realize the delegate and delegator share responsibility.

3

Which data would be of most interest to an organization using Lean Six Sigma as a means of quality improvement? 1. Almost 85% of call lights are answered within 4 minutes. 2. Results of pain medication administration are documented 95% of the time. 3. Nursing overtime hours increased by 25% in the last quarter. 4. In the last 6 months, overall client satisfaction scores have increased by 15%.

3

Which data would be of most interest to an organization using Lean Six Sigma as a means of quality improvement? 1. Eighty-five percent of call lights are answered within 4 minutes. 2. Results of pain medication administration are documented 95 percent of the time. 3. Nursing overtime hours increased by 25 percent in the last quarter. 4. In the last 6 months, overall client satisfaction scores have increased by 15 percent.

3

Which group determines the level of nursing care and hours of care necessary to meet the needs of the hospitalized client? 1. American Nurses Association (ANA) 2. The Joint Commission 3. Nurse managers 4. Hospital administrators

3

Which is the most important reason that practicing and mastering effective delegation skills is essential for nurses? 1. Higher job satisfaction 2. Greater confidence in skills 3. Higher client satisfaction 4. Increased time for other tasks

3

Which part of Six Sigma is vastly different from other quality management programs? 1. Six Sigma has a client focus. 2. Data drive the program. 3. Failure is tolerated. 4. Management is proactive.

3

Which situation is an example of reverse delegation? 1. The nurse manager asks the staff nurse to attend an in-service on a new product. 2. The nursing supervisor asks the nurse manager to attend a meeting with the physicians. 3. The licensed practical nurse asks the nurse manager to administer insulin to a client. 4. The staff nurse asks the licensed practical nurse to record intake and output in his client's charts.

3

Which situation represents an obstacle to delegation? 1. Most of the nursing staff deliver highly skilled care. 2. The entire organization has a team-centered culture. 3. There is a budget shortfall for the current fiscal year. 4. Each employee knows and executes job responsibilities.

3

Which statement made by the nurse manager is an example of the first step of delegation? 1. "I must choose a person with good time management skills to be the delegate for this task." 2. "I plan to evaluate the outcomes of your work in 6 months." 3. "I am going to delegate the responsibility for creating the vacation schedule." 4. "I have some additional information that will help you in this task."

3

Which statement may reveal that the team member making the comment has a hidden agenda? 1. "I don't understand the second of the goals we are discussing." 2. "Are we voting on this outcome or has it already been decided?" 3. "I have to remember to add membership on the team to my resume." 4. "Are there other teams working on similar projects on other units in the hospital?"

3

Which statement reveals the most dangerous result of using measured standards as part of the CQI process? 1. A nurse complains, "Collecting this data takes so much time." 2. A radiology technician says, "CQI is lots of work." 3. A nurse manager says, "I'm not going to change this process, because I'd have to change the CQI monitors." 4. The laboratory technician says, "Writing these CQI reports is boring."

3

A client's spouse is concerned about the cost of hospitalization. The nurse says, "Because your spouse is on Medicare, the hospital will be paid according to the DRG." What does the nurse mean by this statement? 1. Medicare will pay the total cost for the care provided. 2. Medicare will pay an average of the total costs. 3. Medicare will pay based on the usual cost of the treatments provided. 4. Medicare will pay based on a set amount for the specific condition for which the client was hospitalized.

4

A medical unit nurse manager is conducting an interview of a potential employee. Which strategy should the manager use? 1. Document first impressions of the applicant. 2. Review the résumé during the interview. 3. Use closed questions to elicit more information. 4. Use work sample questions to determine knowledge.

4

A new graduate nurse is preparing for an interview by the nurse recruiter. The applicant should be ready to be asked questions about which topic? 1. General state of health 2. Availability of transportation to work 3. Previous military service 4. Willingness to work all shifts

4

A nurse manager has planned orientation activities for a new registered nurse. The new nurse is required to observe shift report and UAP delegation for a week. Then the new nurse is required to take shift report and delegate UAP assignments for a week. What is the rationale for making this orientation assignment? 1. Delegation is not taught at all nursing schools. 2. Shift report differs in all hospitals. 3. Shift report and UAP delegation are minimal tasks and good for novice nurses. 4. The manager should focus on those skills specific to the new nurse's role.

4

A nurse manager needs to supplement the staff for the next schedule. Which option would be the most significant drain on the unit's staffing budget? 1. PRN nurse 2. Internal float nurse 3. Part-time nurse 4. Agency nurse

4

A nurse manager tells the human resources (HR) director, "I would really like to hire someone of another race to balance out the team." The HR director tells the manager recruiting and hiring based on race is in violation of which statute? 1. The Equal Pay Act of 1963 2. Age Discrimination Act 3. Americans with Disabilities Act 4. Title VII of the Civil Rights Act

4

A nurse says, "I am always worried that I will be liable if someone I delegate a task to does something that hurts the client." What is the manager's best response to this concern? 1. "You have lots of liability in your position as an RN." 2. "The hospital will support you as long as you follow your job description." 3. "You are at greater liability if you try to do everything yourself." 4. "As long as you follow the five rights of delegation, your liability is minimal."

4

A nursing supervisor is setting up a new unit and must make a blanket decision about whether the unit will be staffed on 12-hour shifts or 8-hour shifts. What should this supervisor keep in mind when making this decision? 1. Staffing 8-hour shifts uses slightly more full-time equivalents (FTEs). 2. Staffing 12-hour shifts uses more full-time equivalents (FTEs). 3. Staffing 12-hour shifts uses significantly fewer full-time equivalents (FTEs). 4. There is no difference in the full-time equivalents (FTEs) required.

4

An OB manager is interviewing a registered nurse for a labor and delivery position. The manager asks the interviewee, "Tell me about the most challenging delivery experience in your nursing career," and learns the candidate has experienced several challenges that required quick action. Which nursing skill will this exchange best assess? 1. Adaptability 2. Negotiation skills 3. Initiative 4. Decision-making skills

4

An experienced nurse often answers less experienced nurses' questions about client care and teaches hemodynamics during orientation to the unit. The nurse has also participated in research into hemodynamic monitoring of ICU clients. Which clinical ladder designation does this nurse best exemplify? 1. Clinical colleague 2. Clinical mentor 3. Clinical leader 4. Clinical expert

4

During the first meeting of a newly created task force, the nurse manager notices that individuals tend to cluster with members of their specific nursing units. The nurse manager begins the meeting with an explanation of the focus of this group. These behaviors are characteristic of which stage of Homans's group process? 1. Norming 2. Storming 3. Performing 4. Forming

4

In which situation would a "meeting before the meeting" be advisable? 1. The nurse is managing a standing committee on the unit. 2. The nurse is meeting with a social group to establish a plan for weight loss by walking. 3. The nurse has written information to distribute to members before the meeting. 4. The nurse expects the disagreement that started in the last meeting to carry over into this meeting.

4

The OB manager is looking at staffing for the night shift. The postpartum unit is busy and the labor-delivery unit has four clients in labor. The manager collects data from the nursing staff regarding the acuity of their clients. These data assist the manager in determining the staff for the next shift. This is an example of which type of system? 1. Demand management 2. Block scheduling 3. Organizational related 4. Client classification

4

The leader of the task force group announces that tentative plans for Nurses' Week activities have been approved by the hospital administration. The task force has also been given a new task of developing criteria for the nursing awards. What must the group accomplish now? 1. Forming 2. Adjourning 3. Rebuilding 4. Re-forming

4

The medical-surgical unit is at capacity and the clients have a high acuity, requiring care such as turning, bathing, toileting, and feeding. Which level of supplementary staff would be cost-effective? 1. Additional RNs 2. Additional unit clerks 3. Additional licensed practical nurses 4. Additional unlicensed assistive personnel

4

The newly licensed nurse is delighted to have been hired at a Magnet hospital and says, "They even assigned me a mentor." What is erroneous about this statement? 1. Magnet hospitals do not hire new graduates. 2. Magnet hospitals do not use mentor programs. 3. Mentors are only assigned to experienced nurses. 4. Preceptors are assigned; mentors choose protégés.

4

The novice nurse manager is hesitant to delegate tasks to competent, experienced staff nurses. Fear of which factor is most likely to explain this hesitancy? 1. Overburdening others 2. Decreased personal satisfaction 3. Increased liability 4. Competition and criticism

4

The nurse manager has been asked to assemble several groups to work on tasks to improve the unit's performance and client satisfaction scores. This manager would put the fewest people in a group working on which type of task? 1. Additive 2. Disjunctive 3. Divisible 4. Conjunctive

4

The nurse manager has identified physical assessment skills lacking in a new registered nurse. Using goal-setting theory, which statement by the manager would be the most effective in enhancing the nurse's assessment skills? 1. "You need to work on your health assessment skills before your next employee evaluation." 2. "Get someone to help you with your health assessment skills by the end of the month." 3. "Read a health assessment book and practice your skills." 4. "Plan to study one body system a week and demonstrate your assessment skills to me every week."

4

The nurse manager of a postsurgical unit is preparing the next month's schedule. The manager has reviewed the surgery schedule for the corresponding month and notes there are several high-acuity surgeries. Which staffing adjustment would the manager make to best provide the care needed by these postoperative clients? 1. Increase the number of unlicensed assistive personnel (UAP). 2. Increase the number of licensed practical nurses (LPN). 3. Increase the number of nonnursing support personnel. 4. Increase the number of RNs.

4

The nurse manager orienting newly hired nurses has explained the organization's blame-free environment. Which remark by one of the nurses indicates understanding of the policy? 1. "If I make a mistake and report it, I will not be reprimanded or punished." 2. "When I make a mistake, I should immediately fill out an incident report." 3. "It is left up to each employee to self-monitor so we do not report others' mistakes." 4. "When I make a mistake, I should report it and look for ways to prevent it from recurring."

4

The nursing staff of a medical-surgical unit would like to work four 10-hour shifts each week. For which reason would the unit nurse manager probably deny this request? 1. There is no overlap of staff. 2. There are not enough nurses working during a 24-hour period. 3. This would create discord and confusion with other healthcare departments. 4. This staffing pattern would not be cost-efficient.

4

The nursing supervisor states, "I really don't have the time to delegate this task to a nurse manager. I can do it faster!" What is the most likely basis for this statement? 1. The nursing supervisor does not have time to delegate. 2. The nursing supervisor's job description needs to be redefined. 3. The nursing supervisor feels that he or she can do the job faster. 4. The nursing supervisor is concerned that staff is ill-prepared to assume additional responsibilities.

4

The nursing supervisor would like to delegate an information-gathering task. All the people listed have the ability to perform the task. In general, whom should the supervisor ask to do this work? 1. A nurse manager 2. A staff nurse 3. A licensed practical nurse 4. An unlicensed nursing assistant

4

The nursing task force is developing measurable goals for each client on the orthopedic unit. The statement "Each client will have a written assessment and plan of care document within eight hours of admission" is an example of which component of quality management? 1. Indicator 2. Structure standard 3. Benchmark 4. Process standard

4

This is the first meeting of a task force. What should be the leader's primary objective of this meeting? 1. Determining when the task force has to complete the assignment 2. Identifying the expected outcomes in terms of measurable objectives 3. Asking members if they have time to serve on the task force 4. Establishing a standard of total participation

4

Which situation is an example of the overall goal of quality management in today's health care activities? 1. The nurse manager realizes a policy was ineffective in reducing incidents. 2. The administrator walks around making a list of potential problems. 3. The human resources department fires nonproductive employees. 4. The nurse wipes up a spilled drink before clients are allowed to enter a room.

4

Which situation is an example of the overall goal of quality management in today's healthcare activities? 1. The nurse manager realizes a policy was ineffective in reducing incidents. 2. The administrator walks around making a list of potential problems. 3. The human resources department fires nonproductive employees. 4. The nurse wipes up a spilled drink before clients are allowed to enter a room.

4