Management assessment
Henry is a Unit Manager I the Medical Unit. He is not satisfied with the way things are going in his unit. The patient satisfaction rate is 60% for two consecutive months and staff morale is at its lowest. He decides to plan and initiate changes that will push for a turnaround in the condition of the unit. Which of the following actions is a priority for Henry? Call for a staff meeting and take this up in the agenda. Seek help from her manager. Develop a strategic action on how to deal with these concerns. Ignore the issues since these will be resolved naturally.
Call for a staff meeting and take this up in the agenda.
The nurse manager at a cardiac rehabilitation unit was asked to select a care delivery model. Which of the following methods would be the most cost-effective? Functional method Case management method Primary care method Team method
Case management method
During times of nursing shortages and increased nursing costs in health care, which of the following nursing care delivery models might come under greatest scrutiny? Case method Team nursing Functional nursing Nurse case management
Case method
Jill is the head nurse on a unit in a large hospital. Two of the staff nurses are constantly arguing and blaming each other, and a resolution has not occurred in months. To solve the existing conflict, which is the most creative conflict resolution? Avoiding Competing Compromising Collaborating
Collaborating
As a leader on a rehab unit, the manager encourages all staff members to see themselves as having a role in decision making and quality care. The manager sees their role as involving particular responsibilities in decision making but not as a hierarchal role. What is this view of the role consistent with in this situation? Trait theories Complexity theory Situated theory Emotional intelligence
Complexity theory
Which of the following is true about functional nursing? Concentrates on tasks and activities. Emphasizes the use of group collaboration. One-to-one nurse-patient ratio. Provides continuous, coordinated, and comprehensive nursing services.
Concentrates on tasks and activities.
Alexandra is tasked to organize the new wing of the hospital. She was given the authority to do as she deems fit. She is aware that the director of nursing has substantial trust and confidence in her capabilities, communicates through downward and upward channels, and usually uses the ideas and opinions of her staff. Which of the following is her style of management? Benevolent -authoritative Consultative Exploitive-authoritative Participative
Consultative
As a nurse manager, you are a leader in health care and on the unit you manage. Looking at the larger picture of health care and patient environment on the unit, what is your primary role when evaluating the care provided on your nursing unit? Focus on cost outcomes. Assess staff for contentment on unit. Ensure quality patient care on unit. Provide education to the staff of the unit.
Ensure quality patient care on unit.
She finds out that some managers have a benevolent-authoritative style of management. Which of the following behaviors will she exhibit most likely? Have condescending trust and confidence in their subordinates. Gives economic or ego awards. Communicates downward to the staff. Allows decision-making among subordinates.
Have condescending trust and confidence in their subordinates.
Centralized organizations have some advantages. Which of the following statements is true? Highly cost-effective Makes management harder Reflects the interest of the worker Allows quick decisions or actions.
Highly cost-effective
What exemplifies the predominant style of conflict management for staff nurses? Sarah and Jonas, two RNs, disagree about the best approach to assisting a family that has complex needs. They decide that they will consult with family and together will decide what is best. Jennifer needs to switch a shift to attend a family function. She arranges to trade with Nancy, who wants a day off next to a 3-day break. Lindsay asks Melody to stay late for the third day in a row. Melody refuses, stating that she has already helped out for 2 days by staying late for Lindsay. Lara asks Stacey to switch shifts with her because Lara wants to attend a concert. Stacey would prefer not to but does to enable Lara, who is new in town, to be with her friends.
Lara asks Stacey to switch shifts with her because Lara wants to attend a concert. Stacey would prefer not to but does to enable Lara, who is new in town, to be with her friends.
He opts to use a self-report method. Which of the following is not true about this method? Most direct means of gathering information. Versatile in terms of content coverage. Most accurate and valid method of data gathering. Yields information that would be difficult to gather by another method.
Most accurate and valid method of data gathering.
Based on Elizabeth's insights and suggestions, you involve pharmacy, only to discover that the change in practice involves practice committees, a medical practice committee, and concerns from administration about potential costs and safety of the proposed change to the IV protocols. The change process at this point is:a. linear. Nonlinear. Sabotaged. neutralized.
Nonlinear.
Stephanie is a new Staff Educator of a private tertiary hospital. She conducts orientation among new staff nurses in her department. Joseph, one of the new staff nurses, wants to understand the channel of communication, a span of control, and lines of communication. Which of the following will provide this information? A. Organizational structure B. Policy C Job description D. Manual of procedures
Organizational structure
Ms. Valencia prepares the process standards. Which of the following is not a process standard? Initial assessment shall be done to all patients within twenty-four hours upon admission. Informed consent shall be secured prior to any invasive procedure. Patients report a 95% satisfaction rate prior to discharge from the hospital. Patient education about their illness and treatment shall be provided for all patients and their families.
Patients report a 95% satisfaction rate prior to discharge from the hospital.
The case method of care delivery could be best justified in which of the following scenarios? Stable patient population with long-term care and family needs. Acute care surgical unit with predictable postsurgical outcomes and many technical procedures. Pediatric intensive care unit that heavily involves families as well as patients. Home healthcare environment with patients at varying levels of acuity.
Pediatric intensive care unit that heavily involves families as well as patients.
As a new nurse manager, you are aware of leadership, management, and followership principles. The concept of followership is rather new as relating to leadership. What is the role of the follower in followership? Leading the group in task Submission position in organization Person who may influence team Negative meaning for worker
Person who may influence team
Which of the following is the best guarantee that the patient's priority needs are met? Checking with the relative of the patient. Preparing a nursing care plan in collaboration with the patient. Consulting with the physician. Coordinating with other members of the team.
Preparing a nursing care plan in collaboration with the patient.
She decides to have a decentralized staffing system. Which of the following is an advantage of this system of staffing? Greater control of activities. Conserves time. Compatible with computerization. Promotes better interpersonal relationships.
Promotes better interpersonal relationships.
Functional nursing has some advantages, which one is an exception? Psychological and sociological needs are emphasized. Great control of work activities. Most economical way of delivering nursing services. Workers feel secure in a dependent role.
Psychological and sociological needs are emphasized
He checks if his instruments meet the criteria for evaluation. Which of the following criteria refers to the consistency or the ability to yield the same response upon its repeated administration? Validity Reliability Sensitivity Objectivity
Reliability
Which criteria refer to the ability of the instrument to detect fine differences among the subjects being studied? Sensitivity Reliability Validity Objectivity
Sensitivity
Her former manager demonstrated passion for serving her staff rather than being served. She takes time to listen, prefers to be a teacher first before being a leader, which is characteristic of: Transformational leader Transactional leader Servant leader Charismatic leader
Servant leader
He thinks of an appropriate theoretical framework. Whose theory addresses the four modes of adaptation? Martha Rogers Sr. Callista Roy Florence Nightingale Jean Watson
Sr. Callista Roy
According to the complexity theory, what would be the focus of measurement? Cost per hospital day Bed utilization Infection rates Staff morale and budgets
Staff morale and budgets
Which of the following guidelines should be least considered in formulating objectives for nursing care? A. Written nursing care plan B. Holistic approach C. Prescribed standards C. Staff preferences
Staff preferences
One staff suggests that they review the pattern of nursing care that they are using, which is described as a: Job description System used to deliver care Manual of procedure Rules to be followed
System used to deliver care
The core of leadership is awareness. The text by Don Miguel, The Four Agreements, presents a set of agreements to enhance personal growth and awareness. What is not one of the four agreements? Be impeccable with your word Take things personally. Do not make assumptions. Always do your best.
Take things personally.
There are times when Katherine evaluates her staff as she makes her daily rounds. Which of the following is not a benefit of conducting an informal appraisal? The staff member is observed in a natural setting. Incidental confrontation and collaboration are allowed. The evaluation is focused on objective data systematically. The evaluation may provide valid information for the compilation of a formal report.
The evaluation is focused on objective data systematically.
The nurse manager is aware that conflict is occurring on her unit; however, she is focused on preparing for a state health department visit, so she ignores the problem. What factor can increase stress and escalate conflict? The use of avoidance An enhanced nursing work force Accepting that some conflict is normal Managing the effects of fatigue and error
The use of avoidance
A nurse is participating in a baccalaureate course. For the class, she has to attend the legislative session regarding the new role of medication assistants. Why is it important for nurses to be involved in shaping public policy? Involvement will enable nurses to take over the healthcare system at some point in the future. Other healthcare professions are less concerned about the essential needs of clients. Such activities are important career builders for nurses who seek top-level executive positions. They are closest to the front line of health care and see how it affects clients and families.
They are closest to the front line of health care and see how it affects clients and families.
Which of the following is an example of a formal leadership position on a nursing unit? Staff nurse Unit secretary Unit manager Nursing assistant
Unit manager
He likewise stresses the need for all the employees to follow orders and instructions from him and not from anyone else. Which of the following principles does he refer to? Scalar chain Discipline Unity of command Order
Unity of command
Which of the following terms refer to the degree to which an instrument measures what it is supposed to be measured? Validity Reliability Meaningfulness Sensitivity
Validity
What has the literature on oppression in nursing demonstrated? Verified the presence of behaviors associated with oppression within nursing. Suggested that oppression leads to bullying but has little or no effect on patient outcomes. Failed to establish that oppression is present in nursing groups. Indicated that nurses use oppression negatively.
Verified the presence of behaviors associated with oppression within nursing.
The risk manager informs the nurse manager of an orthopedic unit that her unit has had an increase in incident reports related to patients falling during the 11-7 shift. The nurse manager knows that the best way to resolve the problem is to: use creativity. obtain support from the 7-3 shift. use institutional research. identify the problem.
identify the problem.
A unit manager watches a new RN graduate interacting with a patient. When the RN comes out of the room, the unit manager says, "I don't know what they taught you in your nursing program, but if I see you do that again, I will write you up." This example demonstrates: coercive use of power. appropriate application of control. use of informatory power. use of power to provide coaching.
coercive use of power.
The staff development educator presents a series of programs on stress management to the nurse managers. Research has indicated that an individual's ability to deal with stress is moderated by psychological hardiness. Psychological hardiness is a composite of: commitment, control, and challenge. commitment, powerlessness, and passivity. commitment, control, and passivity. decreased isolation, challenge, and passivity.
commitment, control, and challenge.
The home health agency hired an expert in financial management to evaluate and propose a plan for reversing growing expenses and decreasing revenues. The expert is well respected, both personally and professionally, by members living in this small community. To be effective, staff will need to perceive this change agent as: trusted, quiet. flexible, informal. credible, enthusiastic communicative, personable.
credible, enthusiastic
During a fire drill, several psychiatric patients become agitated. The nurse manager quickly assigns a staff member to each patient. This autocratic decision style is most appropriate for: routine problems. crisis situations. managers who prefer a "telling" style. followers who cannot agree on a solution.
crisis situations.
She tries to design an organizational structure that allows communication to flow in all directions and involves workers in decision-making. Which form of organizational structure is this? Centralized Decentralized Matrix Informal
Decentralized
In nursing theory, one theorist developed the theory of self-care of patients. In the theory, the nursing action of providing care and educating the patients can be interpreted in the form of followership for the patient. Who was their theorist?a. b. c. Dorothea Orem Patricia Benner Ida Jean Orlando Robert E. Kelley
Dorothea Orem
At a second negotiation session, the unit manager and staff nurse are unable to reach a resolution. What is the appropriate next step? Arrange another meeting in a week's time so as to allow a cooling-off period. Elevate the next negation session to the next manager, one level above. Insist that participants continue to talk until a resolution has been reached. Back the unit manager's actions and end the dispute.
Elevate the next negation session to the next manager, one level above.
At the end of a shift, the charge nurse shares with the new nurse she had done an excellent job with a difficult patient that day. The new nurse was upset by the way the family of the patient had treated her. She shared her feeling with the charge nurse. The charge nurse offered to change the assignment the following day. What is the charge nurse displaying? Emotional intelligence Comportment Compassion Management of conflict
Emotional intelligence
In matrix organizational structures, a nurse manager understands that this type of structure: is a simplified organizational structure. has both a functional manager and a service or product-line manager. arranges departments strictly according to function. promotes harmony in organizational decision making.
has both a functional manager and a service or product-line manager.
Which of the following articles would Kevin least consider for his review of literature? "Story-Telling and Anxiety Reduction Among Pediatric Patients" "Turnaround Time in Emergency Rooms" "Outcome Standards in Tertiary Health Care Institutions" "Environmental Manipulation and Client Outcomes"
"Story-Telling and Anxiety Reduction Among Pediatric Patients"
The nurse manager was upset with the staff nurse and said, "You did not understand what I said." Which element in the communication process was she referring to? Feedback between receiver and sender A message channel A receiver who decodes the message A set of barriers that may occur between sender and receiver
A set of barriers that may occur between sender and receiver
As the unit manager on the unit that is leading changes to heparin locks, you find that Elizabeth is very valuable in terms of her observations about other units and her knowledge of organizational processes, and now in discussing the new procedure with others. Elizabeth might be considered an: engager. Innovator. informal change agent. informant.
informal change agent.
The oncology clinical manager and the educational coordinator asked nursing staff to complete a brief written survey to assess their attitudes and knowledge related to having used the new infusion equipment for 6 weeks. The stage of change in this situation is: developing awareness. experiencing the change. integrating the change. perceiving awareness.
integrating the change.
Kevin is a member of the Nursing Research Council of the hospital. His first assignment is to determine the level of patient satisfaction with the care they received from the hospital. He plans to include all adult patients admitted from April to May, with an average length of stay of 3-4 days, first admission, and with no complications. Which of the following is an extraneous variable of the study? Date of admission Length of stay Age of patients Absence of complications
Age of patients
The manager of a nursing unit is having difficulty working with a new graduate nurse. The new graduate nurse is excited and full of ideas she wants to try keeps pushing the manager to make changes. The manager decides to provide the new nurse with an opportunity to present an idea to the staff at the next meeting. What is the manager providing the new nurse? Leadership opportunity Working to improve patient care Input to the unit All of the above
All of the above
As the RN charge nurse on the night shift in a small long-term care facility, you've found that there is little turnover among your LPN and nursing assistant (NA) staff members, but they are not very motivated to go beyond their job descriptions in their work. Which of the following strategies might motivate the staff and lead to greater job satisfaction? Ask the director of nursing to offer higher wages and bonuses for extra work for the night LPNs and NAs. Allow the LPNs and NAs greater decision-making power within the scope of their positions in the institution. Hire additional staff so that there are more staff available for enhanced care, and individual workloads are lessened. Ask the director of nursing to increase job security for night staff by having them sign contracts that guarantee work.
Allow the LPNs and NAs greater decision-making power within the scope of their positions in the institution.
A new graduate nurse has accepted a position in an intensive care unit. The nurse is assigned a preceptor with several years of experience. The new nurse also notices the other staff seek this nurse out for answers to questions and as a resource to the unit. What does the new nurse consider the role of the mentor nurse? A formal leader A positional leader An official leader An informal leader
An informal leader
He raised the issue of giving priority to patient needs. Which of the following offers the best way for setting priority? A.Assessing nursing needs and problems. B.Giving instructions on how nursing care needs are to be met. C. Controlling and evaluating the delivery of nursing care. D. Assigning a safe nurse: patient ratio.
Assessing nursing needs and problems.
Factors that influence the ease with which conflict is resolved include all except which of the following? Level of interdependence of the parties Interprofessional collaboration Expression of one's own needs and ideas Avoidance of the issue or concern
Avoidance of the issue or concern
Regardless of the size of a workgroup, enough staff must be available at all times to accomplish certain purposes. Which of these purposes is not included? A. Meet the needs of patients. B. Provide a pair of hands to other units as needed. C. Cover all time periods adequately. D. Allow for growth and development of nursing staff.
B. Provide a pair of hands to other units as needed.
The education consultant at St. Joseph Hospital is giving a workshop on cognitive reframing. The consultant explains that cognitive reframing reduces stress by:a. b. c. d. aiding individuals in identifying positive stressors. helping people realize that negative thinking causes emotional distress. eliminating negative stressors. replacing positive self-statements with negative irrational beliefs.
helping people realize that negative thinking causes emotional distress.
The staff development educator developed strategies to help nurse managers actively listen. Guidelines for active listening include which of the following? Speed up your internal processes so that you can process more data. Realize that the first words of the sender are the most important. Be prepared to make an effective judgment of the communication sender. Cultivate a desire to learn about the other person.
Cultivate a desire to learn about the other person.
A nurse manager of a 20-bed medical unit finds that 80% of the patients are older adults. She is asked to assess and adapt the unit to better meet the unique needs of the older adult patient. Using complexity principles, what would be the best approach to take for implementation of this change? Leverage the hierarchical management position to get unit staff involved in assessment and planning. Engage involved staff at all levels in the decision-making process. Focus the assessment on the unit and omit the hospital and community environment. Hire a geriatric specialist to oversee and control the project.
Engage involved staff at all levels in the decision-making process.
The nurse manager is comparing functional nursing and primary nursing for potential adoption. The nurse manager determines that patient and nurse satisfaction in primary nursing are: similar to those in functional nursing. not of significance in either model. low by comparison with functional nursing. high when compared with functional nursing.
high when compared with functional nursing.
As a nurse manager, you observe a staff nurse who over the past few weeks has become withdrawn and has had several absences due to minor ailments. Your best action would be to: ask the nurse if she is okay during report. refer the nurse to the employee assistance program. ask the nurse to meet with you for a few minutes before she leaves for the day. write a note to the nurse advising her that her work attendance must improve.
ask the nurse to meet with you for a few minutes before she leaves for the day.
A clinic nurse has observed another nurse deviating from agency policy in performing wound care. The best approach for the clinic nurse to take is to: stay out of it. inform the nursing supervisor. fill out a notification form (incident report). assess the risk to the client and the agency before proceeding.
assess the risk to the client and the agency before proceeding.
Nurses who engage in infighting, seek physician support against nursing colleagues, and avoid political advocacy through membership in nursing organizations: refuse to believe that they are acting like members of groups that suffer socioeconomic oppression. do not understand how their failure to exercise power can limit the power of the whole profession. purposefully choose to exercise their power in the workplace through indirect means. suffer from learned helplessness as a result of abuse by powerful nurse executives.
do not understand how their failure to exercise power can limit the power of the whole profession.
When interviewing an applicant for an RN position, the nurse manager describes the unit's care delivery system as one in which the nursing assistants are cross-trained to perform specific tasks and the RNs complete all treatment, medication administration, and discharge teaching. The nurse applicant knows this nursing care delivery strategy to be: the case method. functional nursing. primary nursing. nurse case management.
functional nursing.
The manager calls the staff together to assess a situation in which the family of a seriously ill patient is anxious and is absorbing a great deal of staff time in consultation, discussion, and questioning of treatment decisions. Staff members are becoming distanced from the family. After inviting the concerns of staff, the manager explains that the organization values patient-centered care and that evidence supports that acting as an advocate and a listener is helpful to families. The manager asks the staff for ideas and strategies that are effectively patient-centered in dealing with families in similar situations. What is the role of the nurse manager in this situation? Leadership Management Follower Visionary
leadership
"At Thoroughcare, we provide health care for women and children in transition" is an example of a: vision statement. mission statement. goal statement. statement of philosophy.
mission statement.
The nurse manager is implementing a shared governance model to help with communication and decision making. Although staff members like the concept, change is difficult. Staff nurses feel: more empowered. more communicative. less stressed. more powerless and devalued.
more powerless and devalued.
The chief nursing officer and the dean of the School of Nursing create a partnership based on belief that by establishing rules and regulations and controlling the environment, this partnership will: promote professional medical authority, autonomy, and responsibility. need a degree of flexibility to engender success. be essential for self-governance. provide for the establishment of medical committees.
need a degree of flexibility to engender success.
After using a mediator to resolve a conflict between the nurse manager and two staff nurses, the chief nursing officer decides to: observe to make sure the conflict has been resolved. fire both staff nurses. reassign both staff nurses. reassign the nurse manager.
observe to make sure the conflict has been resolved.
Lucy, head nurse on the surgical unit, works with her staff to find ways in which they can work together with other disciplines to provide more effective care for patients on the unit. Lucy likely knows her power is: limited, thereby necessitating involvement of others in implementing ideas. restricted, which necessitates finding alternative means to achieve strong patient outcomes. directed primarily toward those who are subordinate to her. of unlimited capacity when shared with others.
of unlimited capacity when shared with others.
A statement such as "We believe in the right of patients to make choices and to have care that is sensitive to their preferences and needs" is a _____ statement. mission Goal Vision philosophy
philosophy
The nurse manager of a unit has lost many staff members, and the unit is now staffed with a large number of agency and traveling nurses. She knows that the agency and traveling nurses are all contracted to stay on the unit for the next 3 months. One way to improve morale and decrease stress in the unit would be to: plan a social event and include the agency and traveling nurse staff members. plan unit-based social events for your remaining permanent staff members. request hospital-based "floating" nurses to substitute for the temporary staff. implement team nursing.
plan a social event and include the agency and traveling nurse staff members.
He plans for his sampling method. Which sampling method gives an equal chance to all units in the population to get picked? Random Accidental Quota Judgment
random
In a rural hospital, the unit for which you are charge nurse has a particularly busy morning. A 52-year-old patient is complaining of left-sided chest pain and a multiparous patient is about to deliver. A child with asthma is experiencing early signs of an attack. The other RN on the unit is a recent graduate who has not yet been orientated to the labor room and has limited cardiac nursing experience. An unlicensed assistant is available to assist. You must decide which patient situation you will take and where the new graduate RN's skills can best be used. Given the limitations in skills and experience, number of staff available, and time constraints, you must make a decision that involves: a higher order thinking process. selecting the best option for reaching a predefined goal. Optimizing. satisficing.
satisficing.
After staff meetings lately, Sharon, the head nurse, observes her staff in small groups, having animated discussions that end abruptly when she approaches. Sharon reflects on this observation and realizes that: two very outspoken members tend to dominate discussions in meetings. this behavior is indicative of a high level of communication among her staff. staff members are very committed to the team and have strong opinions. ongoing discussion outside of meetings is conducive to creativity.
staff members are very committed to the team and have strong opinions.
To effectively achieve a change goal/outcome in a change situation, the wound care specialist will: preserve the status quo. diminish facilitators and reinforce barriers. weigh the strength of forces. strengthen facilitating forces.
strengthen facilitating forces.
Sally (RN) and Melissa (RN) have shared an ongoing conflict since the first day that Melissa worked on the unit. Sally has confided to another colleague that she doesn't even know why the conflict started or what it was about. This is an example of: how expectations and objectives need to be made clear in team situations. the need to encourage open discussion of disagreements in opinions. the importance of involving all staff in discussions in group settings. the enduring nature of first impressions.
the enduring nature of first impressions.
"Georgia Hospital will provide care that is a national example of consumer service" is a: vision statement. statement of philosophy. mission statement. rationale for care.
vision statement.
The mediator noticed that tension was still evident between the nurse manager and staff members. He informed the chief nursing officer that to begin team building, it would be important that everyone: work together in a respectful, civil manner. use avoidance techniques when confronted with a conflict. develop a personal friendship with each other. socialize frequently outside of work.
work together in a respectful, civil manner.
