NURS 424
___ is an informal process that uses ongoing, face-to-face collaboration and influence to improve skills and performance.
Coaching
What is the administrative, systematic, environment-related future-oriented, and sensitive to the correct positioning of the organization known as?
Strategic management
The informal performance appraisal process includes: a. coaching b. mentoring c. precepting d. teaching
a. coaching
The process of putting scientific knowledge into practice is...
applied science
The major responsibility for upholding patient care standards belongs to the: a. chief executive officer of the facility b. nurse manager c. on-call physician d. staff nurse providing patient care
b. nurse manager
A(n) ___ is a written financial plan aimed at controlling the allocation of resources.
budget
The costs or prices of activities undertaken in the organization's operations are called: a. budget b. income c. expenses d. revenue
c. expenses
Most strategic plans result in a written document. Strategic plan documents generally contain which of the following sections? (select all that apply) a. forward b. glossary c. goals and strategies d. executive summary e. mission, vision, and values
c. goals and strategies d. executive summary e. mission, vision, and values
Performance management includes the processes of human resources management. The purpose of this system as related to the employee includes job productivity, compensation, job performance recognition, and: a. compensation administration b. job analysis c. planning for professional development d. structuring educational programs for staff
c. planning for professional development
The provision of guidance or direction, evaluation, and follow-up by the licensed nurse for accomplishment of a nursing task delegated to unlicensed assistive personnel (UAP) is:
supervision
The nurse manager on a medical-surgical unit wants to change to "walking rounds" in the patients' rooms for change of shift report. In the past, it has been "face to face" at the nurses' station. The nurse manager is meeting resistance from the staff because they think that it will take longer, and the nurses will not finish their shift on time. What could the manager do to increase the nurses' acceptance of this change?
Ask the nurses to participate in the planning and implementation of the change.
Family members of a dying patient are arguing about terminating life support. The nurse educates the two opposing groups individually about terminating life support and discusses the dying process. This is an example of:
Clinical judgement
Which of the following problem definitions is matched with an accurate example?
Critical thinking: A nurse is counseling a woman with breast cancer about terminating her pregnancy and receiving chemotherapy or completing the pregnancy and possibly not surviving.
Similarities between the nursing process and the strategic planning process allow nurses to shortcut the learning curve and begin to move forward with the implementation phase. Strategic management involves:
Developing a strategic mission or vision, setting objectives, developing strategies to achieve the objectives, implementing the strategies, and evaluating the results.
An experienced nurse has recently taken a position on a telemetry unit in the local hospital. After 2 weeks on the job, he finds that the staffing is not what was discussed during his employment interview with the nurse manager. Which approach would be most appropriate for the nurse to take?
Discuss the situation with the nursing manager who interviewed him.
Evidence based practice is the process that health care utilizes to ensure that untrained individuals do as instructed.
False
A nursing theory used to describe the manner of communicating that acknowledges the unique characteristics of the holistic human being is the...
Humanizing Nursing Communication Theory (HNCT)
Implementation of a strategic plan can be accomplished when a priority order for achieving the strategic objectives or outcomes exists, responsibility for achieving these objectives has been determined, and some available financial support is provided within an expected timetable. The role of nurses would include:
Integrating the strategy into daily activities and keeping the strategy a major agenda item for their nursing department or service.
Which of the following is true about negotiation?
It is aimed at solving problems, conflicts, or disputes.
A business approach that ensures a competitive advantage over similar enterprises involves conducting an environmental scan, knowing the competition, establishing goals, setting targets, developing an action plan, implementing the plan, and evaluating success. Which of the following statements is correct?
Strategic management involves strategic planning and implementation.
How is leadership at the staff nurse level exemplified?
The staff nurse adapts to a challenging patient assignment.
The health care system environment where a proposed EBP is to be implemented is the organization context.
True
A statement designed to assist providers and clients in making decisions about appropriate health care for specific clinical circumstances is referred to as?
a clinical practice guideline
The 14 Forces of Magnetism has directed research on Hospital Magnet Standards which measure certain characteristics. Select the answers that best reflect those measures of Magnet standards. (select all that apply) a. Clinically competent peers, education support, adequate staffing, and nurse manager support. b. Perceptions of work environment, nursing hours per patient day, and medication errors and near misses. c. Customer satisfaction, patient discharge disposition, and patient complaints. d. Clinical autonomy, control of nursing practice, and collaborative nurse-physician relationships
a. Clinically competent peers, education support, adequate staffing, and nurse manager support d. Clinical autonomy, control of nursing practice, and collaborative nurse-physician relationships
The court has found that a registered nurse (RN) harmed a patient by violating his rights. The nurse is ordered to pay the patient a large sum of money. The court has determined that the nurse has committed a: a. a civil act b. a criminal act c. critical wrong d. quality breach
a. a civil act
To establish legal liability on the the grounds of malpractice, the injured party must prove which of the following? a. a duty of care was assumed by the injured party b. an agreement was made to assume another party's liability c. there was a breach of duty d. causation was present e. actual harm or damages were suffered by plaintiff
a. a duty of care was assumed by the injured party c. there was a breach of duty d. causation was present e. actual harm or damages were suffered by plaintiff
The statement, "We will provide high-quality care and services to our patients. We are committed to maintaining excellence, respect, and integrity in all aspects of our operations and our professional and business conduct," is an example of... a. a mission statement b. the core values of an organization c. a strategic plan d. the core purpose of an organization
a. a mission statement
The first stage of planned change involves... a. accepting the need for change b. cognitive redefinition c. integration and stabilization d. problem solving
a. accepting the need for change
Which of the following factors are central to successful nursing leadership? (select all that apply) a. access to information and resources b. respectful and collaborative teamwork c. vertical compensation d. formal and informal power
a. access to information and resources b. respectful and collaborative teamwork d. formal and informal power
At its start, shared governance requires the education and support of organizational executives, managers, and point-of-care staff. Organizational benefits include... (select all that apply) a. accountability of the nurse b. reduction in liability claims c. reduction in workers' compensation claims d. improved financial outcomes e. more expert involvement at at the point of care
a. accountability of the nurse d. improved financial outcomes e. more expert involvement at the point of care
A patient who is not fully informed about his or her health status is an example of a violation of which ethical principle? a. autonomy b. justice c. utilitarianism d. confidentiality
a. autonomy
This generational cohort currently dominates the U.S. workforce. They have grown up with little economic competition. Efficiency, teamwork, quality, and service have thrived under their leadership. This generational cohort is known as: a. baby boomers b. Generation X c. Internet Generation d. Mature Generation
a. baby boomers
Which ethical principle is violated when the RN tells the hospital accountant that the patient is HIV-positive? a. beneficence b. veracity c. confidentiality d. autonomy e. fidelity
a. beneficence c. confidentiality
The manager of a rural, thriving, nurse-managed clinic is considering purchasing equipment to furnish two additional examination rooms. The resource he must consider is the ___ budget. a. capital b. expense c. operating d. product line
a. capital
Institutions organize and structure themselves by defining departmental function and authority to achieve a more coordinated effort. In institutions where the executive leader retains more decision-making authority, the operation takes on a more _____ philosophy. a. centralized b. decentralized c. autocratic d. democratic
a. centralized
The management team of a large hospital is attempting to identify the specific cost of providing nursing services. This process is known as... a. costing out services b. fee-for-service care provision c. priority nursing management d. quality versus cost balance
a. costing out services
A 17-year-old male has presented to the emergency department with appendicitis. He speaks English, but his mother speaks Spanish. The mother needs to consent for the surgery since the patient is a minor. The doctor determines that the consent is not needed due to the emergent nature of the case. If the doctor proceeds without obtaining consent, he may face: a. cultural competence b. linguistics competence c. miscommunication concerns d. liability claims
a. cultural competence
A White nurse from the United States is assigned to care for a Vietnamese woman who speaks little English, had a baby 2 months ago, and is 1 day postoperative after fibroid removal. The nurse knows that traditional Vietnamese women will avoid drinking or eating "sour" foods such as lime Jell-O or other citrus types of liquids after surgery. She confirms her patient's values and beliefs. The nurse is exhibiting characteristics of: a. cultural competency b. ethnic sensitivity c. stereotyping d. nonjudgmental behavior
a. cultural competency
A staff nurse is facing a dilemma between meeting clinical ethical standards and meeting organizational goals. The nurse manager understands that the best way to assist staff members in resolving ethical dilemmas effectively is to focus on: a. doing the right thing and taking action b. meeting clinical standards before organizational goals c. meet organizations goals before clinical standards d. referring indecisive staff members for additional training
a. doing the right thing and taking action
An employee satisfaction survey is conducted annually and shows that nurses in a particular unit are committed to their jobs and feel that they make positive contributions. These nurses are... a. engaged b. disengaged c. unproductive d. at retirement age
a. engaged
A nurse manager at Great Lakes Hospital is meeting with the dean of a well-recognized university who is the keynote speaker today at the nursing conference. He remembers that one of the RNs is interested in attending a well-known university to obtain a doctorate. The nurse manager arranges for the RN to meet with this dean. The nurse manager is exhibiting leadership behaviors consistent with... (select all that apply) a. feminist perspective b. servant leadership c. transactional leadership d. transformational leadership
a. feminist perspective b. servant leadership d. transformational leadership
The operating budget covers a specific period, called a ___ year. a. fiscal b. budget c. calendar d. federal government
a. fiscal
Organizational benefits of a culture of shared governance include... (select all that apply) a. improved financial outcomes b. interdependence among staff nurses c. increased commitment of staff to the organization d. more senior leadership involvement at the point of service e. a more efficient model for point-of-service decision making
a. improved financial outcomes c. increased commitment of staff to the organization e. a more efficient model for point-of-service decision making
Nurse managers are able to respond better to ethical dilemmas when they have access to the organization's: a. mission and vision b. patient safety plan c. medical staff bylaws d. ethics committee
a. mission and vision
In organizations that practice shared governance, the responsibility for unit outcomes rests with the... a. nursing team b. nurse manager c. individual nurse d. chief nursing officer (CNO)
a. nursing team
The primary purpose of unit practice committees in a health care organization is to improve... (select all that apply) a. practice b. processes c. outcomes d. reimbursement e. turnover
a. practice b. processes c. outcomes
The phases of the budget process are: a. preparation, completing the forms, revision, and submission b. praying for the best c. auditing and monitoring d. purchasing and selling e. selection and evaluation
a. preparation, completing the forms, revision, and submission
To reach Magnet status the nursing service in a hospital must attain competency in which of the following areas? (select all that apply) a. professionalism b. use of critical thinking skills c. leadership d. communication and relationship management
a. professionalism c. leadership d. communication and relationship management
The process of performance appraisal includes: (select all that apply) a. setting goals b. disciplinary action c. assessing progress d. determining merit raises
a. setting goals c. assessing progress d. determining merit raises
Which of the following behaviors build trust between leaders and employees in an organization? (select all that apply) a. sharing relevant information b. reducing controls c. meeting expectations d. avoiding discussion of sensitive issues
a. sharing relevant information b. reducing controls c. meeting expectations
The culture of patient care must transition from care that is driven by providers to care that is patient-centered and family-centered in which patient and family norms, values, and preferences are respected. This direction in health care services has been sited within... (select all that apply) a. the Affordable Care Act (2009) b. The Future of Nursing: Leading Change, Advancing Health (2011) c. the Institute of Medicine's Crossing the Quality Chasm (2001) d. National Healthcare Quality Report from the Healthcare Research and Quality (2002)
a. the Affordable Care Act (2009) b. The Future of Nursing: Leading Change, Advancing Health (2011) c. the Institute of Medicine's Crossing the Quality Chasm (2001) d. National Healthcare Quality Report from the Healthcare Research and Quality (2002)
In Magnet organizations, shared governance needs to be manifested through what mechanisms for nurses' decision making? a. unit practice councils b. democratic leaders c. authoritarian leaders d. system-wide practice councils
a. unit practice councils
A measure of the severity of illness of an individual patient or the aggregate patient population on a unit is called ___.
acuity
Whether it is intentional or not, leaders and managers always communicate their...
attitude
A staff registered nurse (RN) is leading a multidisciplinary clinical pathway team in the development of care for patients with total knee replacement. Which of the following statements would exemplify leadership behaviors in a clinical pathway team meeting? a. "Nursing is responsible for pain control of the total knee replacement patient." b. "Our pharmacist has provided some excellent pain control literature." c. "Physical therapy's expertise is in rehabilitation, not pain control." d. "Total knee replacement patients require optimal pain control."
b. "Our pharmacist has provided some excellent pain control literature."
Culture is a concept that is best portrayed in nursing with which of the following statements? a. Culture provides a common bond so members know how to relate to one another and what is valued. b. A relationship-based nursing care model is used, which represents a belief in patient-centered care. c. Culture is a multifaceted phenomenon, difficult to comprehend. d. Culture is a set of values, beliefs, and assumptions that are shared by members of an organization.
b. A relationship-based nursing care model is used, which represents a belief in patient-centered care.
Nurses' involvement in shared governance is an important component of... a. practice models b. Magnet recognition c. increased reimbursement d. physician satisfaction
b. Magnet recognition
An experienced critical care nurse left a CCU staff nurse position to finish a master's degree. Periodically, he would return to work as a per diem nurse in the CCU. The staff was impressed with the nurse's performance; however, one staff member complained that he was unfamiliar with the new telemetry monitors when he first returned to work several months ago. This comment showed up in his evaluation, resulting in a poorer overall evaluation from the nurse manager compared with previous evaluations. This is an example of: a. a halo effect b. a horn effect c. a recent behavior bias d. a focused bias
b. a horn effect
A nursing executive is leading a multidisciplinary team of professionals who have worked well together on prior initiatives. Which of the following leadership styles might work best in this situation? a. authoritarian b. democratic c. transformational d. transactional
b. democratic
Shared governance is a model of organizational structure in which staff nurses are... a. employed to establish mutual goals with clients b. empowered through autonomy and accountability c. engaged in problem-solving strategies and techniques d. equipped with evaluative thinking methodologies
b. empowered through autonomy and accountability
During a staff meeting, a group of RNs has complained that medications are not arriving to the unit in a timely manner. The nurse manager suggests that the group resolve this issue through the development and work of a multidisciplinary team led by one of these RNs. This scenario demonstrates: a. adaptation b. empowerment c. flexibility d. relationship management
b. empowerment
Janice is going to give her patient a bath. She has the option of using prepackaged bathing wipes or a bath basin and washcloths. She chooses the bath basin and washcloths because she knows their performance is the same but they are less expensive. Janice's choice is an example of... a. rationing b. fiscal responsibility c. costing out services d. activity-based costing
b. fiscal responsibility
Using resources to maximize health benefits while simultaneously using resources to maximize cost-effectiveness is: a. costing out nursing services b. fiscal responsibility c. priority nursing management d. capital constraint
b. fiscal responsibility
The identification of forces that drive and restrain changes is called a(n)... a. equilibrium evaluation b. force field analysis c. status quo analysis d. refreezing system
b. force field analysis
Staff nurses involvement in budgeting is essential because they... a. have the final authority on the annual budget b. have the ability to contain costs at the unit level c. have a unique perspective on the budgetary process d. are the largest user of the budgeted funds for the unit
b. have the ability to contain costs at the unit level
The incorporation of economic evaluation into clinical practice is important to productivity because: a. rationing must occur b. health care resources are limited c. providers may not turn away clients d. uninsured clients get the same health care as insured clients
b. health care resources are limited
Research about shared governance suggests that it is... a. enhancing the role of the nurse's aide within the organization b. improving organizational and patient outcomes c. not a cost-effective program when examining all areas of care d. too much additional work for the already overwhelmed RN
b. improving organizational and patient outcomes
The key advantage of activity-based costing is: a. workload is determined based on the required hours of nursing care b. it reflects what it costs to provide services and identifies why costs were incurred c. data can be used in constructing a personnel budget because it is linked to the volume indicator of patient days d. the judgment of an expert nurse clinician must override an empirical system and be based on patient's needs in real time
b. it reflects what it costs to provide services and identifies why costs were incurred
One obstacle in the implementation of a shared governance model is that nurses have... a. empowered participation in the committee meetings b. limited time to work on projects c. the same basic educational foundation d. traditionally worked in decentralized structures
b. limited time to work on projects
Which of the following is true of management activities? a. inspiring a vision is a management function b. management is focused on task accomplishment c. management is more focused on human relationships d. management is more important than leadership
b. management is focused on task accomplishment
In organizations that practice shared governance, the nurse managers' role is to... (select all that apply) a. hire new employees b. mentor the nursing staff c. train new nurses in patient care d. support the decisions of the nursing team e. enable the staff to become effective leaders
b. mentor the nursing staff d. support the decisions of the nursing team e. enable the staff to become effective leaders
Self-appraisal is an important component in the appraisal process. Self-appraisal promotes: (select all that apply) a. peer input b. personal responsibility c. individual accountability d. a nonpunitive environment
b. personal responsibility c. individual accountability
Mary is the manager of the critical care unit. She would like to hire a wound care nurse for the unit. The type of organizational budget Mary would use to ensure she can hire the new nurse is called the ___ budget. a. capital b. personnel c. operating d. expense
b. personnel
A nurse works in the critical care unit (CCU). She enjoys being on the unit charge nurse team, the recruitment and retention team, and the peer evaluation team. The recruitment and retention team is responsible for hiring new employees into the CCU. The five-member team, consisting of three RNs, a unit clerk, and a nurse's aid, conduct the interviewing process with key questions that were developed by the team. This is an example of... a. centralized power b. shared governance c. span of control d. vertical authority
b. shared governance
The definition of veracity is: a. being loyal and faithful to commitments and accountable for responsibilities b. the norm of telling the truth and not intentionally deceiving or misleading clients c. a prohibition of disclosure of information d. a right of limited physical or informational accessibility
b. the norm of telling the truth and not intentionally deceiving or misleading clients
Evidence shows that planned change is best carried out with the input of... a. top leaders and managers only b. those affected by the change c. outside consultants d. anyone interested
b. those affected by the change
The nurse manager is evaluating Brandon, an emergency department (ED) nurse. The manager obtains input about Brandon's performance from another nurse in the ED, the ED physician, a patient-care assistant, and Brandon himself. The type of performance evaluation the nurse manager utilizes is: a. just culture b. peer review c. 360-degree evaluation d. management by objectives
c. 360-degree evaluation
One mechanism that ensures autonomy in the nursing profession is the: a. American Nurses Association b. Department of Health Professionals c. Nursing Code of Ethics d. Professional Regulatory Board
c. Nursing Code of Ethics
"To do good for others" is an example of? a. nonmaleficence b. fidelity c. beneficence d. confidentiality
c. beneficence
Strategic management is useful for nursing leaders and managers because it... (select all that apply) a. helps identify best practices on the nursing unit b. rewards those who carry out strategy successfully c. can be used to set measurable, achievable goals and plans d. can be used to analyze the environment for opportunities and threats e. can help determine the future of the nursing area, such as a department or unit
c. can be used to set measurable, achievable goals and plans d. can be used to analyze the environment for opportunities and threats e. can help determine the future of the nursing area, such as a department or unit
Shared governance is a vehicle for engaging organizations and creating the necessary forums and intersections that assure the decisions and actions remain dynamic and as close to the point of service as possible. Shared governance promotes... a. dependence b. non-punitive culture c. collaboration d. executive decision making
c. collaboration
The process of identifying the specific costs related to the delivery of nursing care to each client so that nurses have data to identify the actual amount of services received is: a. personnel budget development b. evaluating budget expenditures c. costing out nursing services d. strategic financial planning
c. costing out nursing services
A preceptor is orienting a new graduate nurse to the critical care unit (CCU). She and other nurses exhibit caring, respectful behaviors toward all families and clients and toward each other. Peers do not tolerate negative attitudes. The CCU nurses also question physician orders when necessary and provide ongoing teaching to clients and families. This scenario depicts the importance of the group's: a. attitudes b. behaviors c. culture d. feelings
c. culture
What is the definition of the process of making choices that will provide maximum benefit? a. critical thinking b. problem solving c. decision making d. leading
c. decision making
On admission, the patient was found to have a blood glucose level of 218. The RN knows that except in emergency situations, it is hospital policy to obtain physician's orders before administering any medication. Because the on-call physician did not return the page, the nurse administered insulin according to the common sliding scale. Four hours later, the patient was found nonresponsive in her bed and later died. According to the autopsy, the patient died from heart failure. Her postmortem blood glucose level was 22. Being aware of the hospital policy for medication administration, the patient's blood glucose level presented the nurse with a(n): a. assessment option b. clinical choice c. ethical dilemma d. moral decision
c. ethical dilemma
Revenues minus expenses equals: a. cash flow b. expense incurred c. income d. total reimbursement
c. income
Leadership is best defined as... a. an interpersonal process of participating by encouraging fellowship b. delegation of authority and responsibility and the coordination of activities c. inspiring people to accomplish goals through support and confidence building d. the integration of resources through planning, organizing, and directing
c. inspiring people to accomplish goals through support and confidence building
A new RN is observed breaking sterile technique by the perioperative nurse. This is an example of a violation of which ethical principle? a. autonomy b. justice c. nonmaleficence d. confidentiality
c. nonmaleficence
Which of the following leadership styles is best suited for implementation of a shared governance structure? a. authoritarian b. autocratic c. participative d. Laissez-faire
c. participative
Addressing the strategic planning process questions involves considering environmental factors. An example of an external environmental factor to be considered is... a. financial factors b. human resources c. political climate d. organizational culture
c. political climate
Decentralization occurs when... a. equipment is being purchased from approved vendors b. hiring decisions are made at the executive level c. power is distributed to those closest to the work of caregiving d. supplies are distributed from one central supply area in the hospital
c. power is distributed to those closest to the work of caregiving
A nurse manager is evaluating the efficiency of a process on the nursing unit. The manager believes that the unit could be more efficient if one aspect of this process were delegated to unlicensed personnel. To establish whether the delegation of this duty would be legal, he should check with the: a. ANA b. current federal defense attorney c. state nurse practice act d. policy and procedure manual of the unit
c. state nurse practice act
SWOT is an acronym for what? a. stability, wealth, opportunistic, and timeliness b. strategies, work ethic, oppositions, and team c. strengths, weaknesses, opportunities, and threats d. strong, worthy, oppositional, and tactical
c. strengths, weaknesses, opportunities, and threats
The most common source of legal liability for nurse managers is a(n): a. medical malpractice suit b. organizational nursing issue c. tort d. vicarious liability
c. tort
Supply budgets are a major component of the operating budget. Items such as office supplies, intravenous solutions, instruments, linen, gloves, and other personal protective equipment are examples of ___ costs. a. fixed b. flexible c. variable d. resource
c. variable
The _____ of an organization is the formulation of ideas, plans, or dreams that help shape the future and ability to persuade colleagues and associates to share those dreams. a. mission b. core values c. vision d. organizational chart
c. vision
The instruments that give voice to the organization's philosophy include which of the following? (select all that apply) a. goals b. focus c. vision d. mission e. core values
c. vision d. mission e. core values
A type of group that is stable, meets periodically, has an identified purpose, and is part of the organizational structure is called a:
committee
The art of being able to structure and transmit a message in a way that another can understand easily and accept is...
communication
Which of the following patterns of communication are utilized in HNCT? (select all that apply)
communing confronting conflicting
A staff registered nurse (RN) has been struggling with the delivery system from central supply. He documents a delay of 1 to 3 hours from the time that the order is sent to central supply to the time that the requested equipment is sent to the floor. The RN asks, "Why does a central supply unit need to service the entire hospital? Why not consider a decentralized central supply established for each floor?" This is an example of what type of thinking?
critical thinker
Climate is often confused with culture. Which statement best describes aspects of climate? a. Culture is the perceptions of the work environment, and climate is the personality of the organization. b. Climate is the shared beliefs, values, and assumptions that exist in an organization. c. Climate enhances the stability of a social system, and culture is the voice of the organization. d. Culture and climate can both be measured.
d. Culture and climate can both be measured.
Which of the following statements best describes an organizational chart? a. All job positions are displayed clearly in a two-dimensional drawing b. All outside organizations with relationships to the hospital are depicted c. Informal and formal structures within the organization are outlined d. It shows organizational positions and relationships in a visual representation
d. It shows organizational positions and relationships in a visual representation
A medical-surgical unit utilizes a group of nurses and patient care assistants to determine ways to reduce the number of falls in the unit. They conduct internet research to locate best practice interventions. They create fall risk alerts in the unit, and they implement hourly rounding to assess the need for toileting. After putting these small changes into place, they will evaluate the data to determine effectiveness. This project is an example of... a. rapid response teams b. Failure Modes and Effects Analysis c. root cause analysis d. Rapid Cycle Change
d. Rapid Cycle Change
The nurse on a medical unit is caring for a 19-year-old with complications from a congenital heart defect. The client's mother is consistently at the bedside asking questions and attempting to direct the treatment plan. Which of the following shows how the nurse should communicate with the mother? a. discuss personal information that the client shared with the nurse in confidence b. provide the mother with any information required for continuity of care c. explain that the client confidentiality prevents the nurse from disclosing information d. ask the client if he gives permission for the nurse to share information with his mother
d. ask the client if he gives permission for the nurse to share information with his mother
In organizations that practice shared governance, staff, managers, and leaders are responsible for... a. technology b. budgeting c. education d. innovation
d. innovation
Which ethical principle is violated when there are insufficient community resources to meet the needs of low-income families? a. nonmaleficence b. autonomy c. beneficence d. justice
d. justice
A budget functions as a: a. capital constraint b. employee management tool c. human resource tool d. planning instrument
d. planning instruments
The relationship between output and the goods and services used to produce them is called: a. acuity b. revenue c. variability d. productivity
d. productivity
A staff nurse's accurate recording of all services and supplies used to provide care to each client in her assignment is necessary for determining calculations used in which of the following budgets? a. expense b. gross c. inpatient d. revenue
d. revenue
The purpose of an organization's philosophy is to... a. influence the goals and objectives of an organization b. display how the parts of an organization are connected c. be an instrument that gives voice to the organization's mission d. serve as the institutional framework that shapes the direction of knowledge and skill acquisition
d. serve as the institutional framework that shapes the direction of knowledge and skill acquisition
A nursing unit is frequently short-staffed. Many agency nurses work to fill staff nurse vacancies. The manager has hired many new graduates, but most leave in less than one year. This many be the result of a lack of: a. continuity of care b. formal leadership c. ethical behaviors d. shared assumptions
d. shared assumptions
The nursing manager has assumed responsibility for ensuring that tasks within her department are delegated legally and are performed appropriately. In doing so, she has accepted which of the following nursing roles? a. ethical b. ombudsman c. paralegal d. supervisor
d. supervisor
Traditionally, nurses have worked in strong, hierarchical institutions with centralized decision making and clear authority structures, rigid approval mechanisms, and extensive policies and procedures that have resulted in barriers to creating a shared governance system. One such barrier is... a. lack of role clarity b. lack of time management c. poor time management skills d. that development takes a long time
d. that development takes a long time
Nursing management is defined as... a. delegation of authority and responsibility and the coordination of tasks b. the integration of resources through planning, organizing, and directing c. the process of influencing patients to accomplish goals d. the coordination and integration of nursing resources by applying the management process to accomplish nursing care and service goals and objectives
d. the coordination and integration by applying the management process to accomplish nursing care and service goals and objectives
Performance tools capture the critical behaviors and outcomes that result from effective nursing care and use criteria that are appropriate, meaningful, and useful in measuring what they are intending to measure. The determination of the extent that these characteristics are being measured effectively using this tool is known as: a. accuracy b. objectivity c. reliability d. validity
d. validity
A(n) ___ is the difference between the budgeted and actual amounts. a. expense b. margin c. revenue d. variance
d. variance
The RN knows that except in emergency situations, it is hospital policy to obtain physician's orders before administering any medication. Because the on-call physician did not return the page, the nurse administered insulin according to the common sliding scale. Four hours later, the patient was found nonresponsive in her bed and later died. According to the autopsy, the patient died from heart failure. Her postmortem blood glucose level was 22. Because of the nurse's actions, the admitting hospital may be found to be: a. judicial risk b. an ostensible authority c. indemnified d. vicarious liability
d. vicarious liability
A multidisciplinary team makes a decision to develop a plan for the use of thrombolytics in the emergency medical service system. Questions are asked such as "Is the client a candidate for thrombolytic therapy? Does the client has a history of gastrointestinal bleeding? Has the client ever had a stroke? Does the client have any bleeding disorders?" Which of the following decision-making strategies would work best in this situation?
decision tree
A nationwide community health care nursing organization has formed a team to assist with disaster victim relocation and to plan for psychological, physical, and emotional needs that the victims may encounter. In which stage of decision making is this group?
deliberation
_____ communication patterns exist between colleagues and serve to contribute to a hostile work environment, high turnover, burnout, and job dissatisfaction.
disruptive
The stage of group development where control issues arise and disputes or disagreements begin to emerge is the _____ stage.
emergence
In an organization that has a decentralized organizational philosophy, decision-making authority rests in levels closer to the point of service rather than in the executive levels. Benefits of a decentralized organizational philosophy include...
encouraging more input supporting greater innovation facilitating faster response times
An intravenous infusion center is considering switching intravenous pumps to another vendor. A team of nurses is gathered to examine the benefits and uses and to conduct a cost analysis of various intravenous pumps. After thoroughly reviewing the data and piloting several intravenous pumps, the team and the nurse leader vote to determine which pumps to use. This example depicts which of the following decision styles?
facilitative
The nurse's two main legal responsibilities in delegation are to assess the competency of the delegatee and to assess...
how much supervision time is needed
Interpersonal communication that recognizes an individual's human characteristics and addresses the health care issue with dignity and respect is called...
humanizing
Organizational benefits of a culture of shared governance include:
improved financial outcomes increased commitment of staff to the organization a more efficient model of point-of-service decision making
In an all-channel network of communication, the information is sent...
in any direction without restrictions
Group problem solving is known to be more effective over individual problem solving because of a larger knowledge and information base, increased acceptance of solutions, more approaches to a problem, lower economic costs, and the ability for...
individual expression
A complex combination of a hierarchical structure with project teams is the definition of which type of organization structure?
matrix
A memo sent to the unit manager reads that beginning next week, all nursing staff will be expected to conform to a new dress code selected by the hospital board of directors. The nurse manager understands that change will be more effective through which manner of communication?
open communication
A nurse manager has ordered equipment for a new unit. The company has sent two notices that the equipment is on back order. The nurse manager is debating whether to wait for the equipment on back order or to cancel the order and go with another company. She discusses this issue with another nurse manager. This is an example of...
optimizing
A client's wife is concerned about her husband's declining health. He has been admitted with an acute myocardial infarction and has had two myocardial infarctions before this admission. He is not a candidate for surgery. She and her husband have discussed "no breathing machine" for long-standing care, but she is unsure of his wishes if he were to need a "breathing machine" for a short period. The nurse discusses his current condition and care with the client and his wife. She also organizes a team meeting consisting of the client's physicians, social worker, pastoral care person, and nursing staff. During this meeting, the nurse helps the wife share her concerns and the client's concerns with the rest of the team. What type of communication technique is being utilized by the nurse? (select all that apply)
persuasion negotiation
When making a decision to delegate a nursing task, which of the following factors are assessed? (select all that apply)
potential for harm complexity of the task amount of problem solving required
Almost all changes encounter...
resistance
Patterns of communication where assertiveness and confrontation are the norm will create a relationship of...
separation
The five rights of delegation are right task, right circumstance, right person, right direction communication, and right:
supervision
A small number of people with complementary skills who are committed to a common purpose, performance goals, and approach for which they hold themselves mutually accountable and whose membership should be consistent is known as a:
team
The analysts who design, plan, change, or train individuals to do the work of an organization are known as holding the:
technostructure position
An organization has encountered a serious patient safety event that was reported to the state, The Joint Commission, and the Centers for Medicae & Medicaid Services (CMS). An extensive plan of correction was received, and the organization had to make some immediate changes in practice. Additionally the organization anticipates a costly lawsuit. What is the best method of educating staff about the practice changes that were issued?
the change is being made so that there is no further harm to another patient
When the licensed nurse makes a determination to delegate a task, which of the following occurs in the process? (select all that apply)
the nurse assesses the situation and need for delegation a plan for specific task delegation is established the nurse determines the available resources and patient safety
The charge nurse of a small nursing unit would like to gain staff acceptance of a time-intensive, budget-imposed change required by the hospital administration. She plans to emphasize several evidence-based research projects that have shown improved patient health outcomes as a result of implementing this change. This is an example of which of the following organizational change concepts?
transformation
Which of the following are examples of formal decision-making strategies? (select all that apply)
trial and error pilot project creativity technique
The hospital's regulatory department is experiencing a Joint Commission survey. The surveyors want to review hospital policies for infection control before they leave for the evening. The regulatory team leader states that she can stay past her regular hours to wait for them and acknowledges that there will be a need for a policy change before the surveyors return the following day. All of the department managers stay to assist the regulatory team leader with the required documentation. This is an example of a...
true team
A(n) ___ is the difference between the budgeted and the actual amounts.
variance
A statement that defines the purpose and reflects the values of an organization is called?
vision statement