Prof Nursing Concepts Final Review

There are three principles of person-centered care. What are they? A) Care is personalized, care is coordinated, care is enabling B) Care is individualized, care is high quality, care is enabling C) Care is personalized, care is transformative, care is culturally sensitive D) Care is individualized, care is coordinated, care is culturally competent

A) Care is personalized, care is coordinated, care is enabling

What are some of the outcomes of nursing involvement in institutional decisions? Select all that apply. A) Improved nursing retention B) Higher burnout due to the additional obligations of shared governance C) Higher facility costs related to nonproductive hours required in shared governance activities D) Improved patient outcomes E) High job satisfaction among nurses

A) Improved nursing retention D) Improved patient outcomes E) High job satisfaction among nurses

Which of the following is true regarding the ANA Principles of Staffing statement? Select all that apply. A) Staffing should be based on achieving quality of patient care indices, meeting organizational outcomes and ensuring that the quality of the nurse's work-life is appropriate. B) Staffing should be based on the nurses' education, skillset, and abilities to form good working relationships. C) Evaluation of any staffing system should include quality of work-life outcomes, as well as patient outcomes. D) The type of payor mix should determine the type of staffing. E) Nurse staffing patterns and the level of care provided should not depend on the type of payor.

A) Staffing should be based on achieving quality of patient care indices, meeting organizational outcomes and ensuring that the quality of the nurse's work-life is appropriate. C) Evaluation of any staffing system should include quality of work-life outcomes, as well as patient outcomes. E) Nurse staffing patterns and the level of care provided should not depend on the type of payor.

Which strategies will most likely assist Miguel, a student nurse at Fitzgerald University, when he transitions to being a nurse? Select all that apply. A) Strengthen internal resources. B) Negotiate the role. C) Collaborate with other nurses D) Grow with a mentor. E) Develop management knowledge and skills.

A) Strengthen internal resources. B) Negotiate the role. D) Grow with a mentor. E) Develop management knowledge and skills.

Research indicates that Interpersonal Collaboration improves patient outcomes and delivery of quality care. A) The evidence is inconclusive. B) True C) False

A) The evidence is inconclusive.

True or False: Internal sources of stress usually stem from unrealistic self-beliefs (unrealistic expectations, taking things personally, all-or-nothing thinking, exaggerating, or rigid thinking), perfectionism, or a Type A personality. A) True B) False

A) True

Which of the following is not a barrier to effectively managing time? A) Information overload B) Doing too little C) Procrastination D) Doing too much

B) Doing too little

Susan is spearheading a new process on medication administration, where nurses preparing medications wear a bright colored vest stating "Do NOT DISTURB, MED PASS in PROCESS". Most nurses on her unit pass medications with few errors, so they are not that particularly interested in the new process. What stage of Kotter's 8 stage Model of must Susan accomplish? A) She must create a vision for change B) She must create a sense of urgency C) She must demonstrate its success elsewhere first D) She must remove obstacles to change

B) She must create a sense of urgency

You are a nurse at Desert Springs Rehabilitation Hospital. You have a larger patient load today than usual, and keeping promises to your patients and making sure they all receive high quality care is challenging you. What two ethical principles are you most likely trying to balance? A) Fidelity and beneficence B) Justice and autonomy C) Autonomy and fidelity D) Fidelity and justice

D) Fidelity and justice

What is at the core of leadership, management, and followership? a) Clinical Safety b) TJC Survey Results c) Nurse Satisfaction d) Health

a) Clinical Safety

According to Murphy-Ruocco, which of the following are factors that play a role in a nurse's ability to delegate effectively? Select all that apply. a) Leadership style b) Self-confidence c) Nurse manager's educational level d) Employment area e) Nurse's educational level f) Clinical experience g) Administrative expectations h) Unit culture i) Demographic area j) UNP's role k) State practice acts

a) Leadership style b) Self-confidence d) Employment area e) Nurse's educational level f) Clinical experience i) Demographic area k) State practice acts

Which of the following is a guideline for effective termination? a) The manager must be confident that they documented everything to justify the termination. b) The manager must be certain that everything possible has been done to help the employee correct problem behaviors. c) The employee must have been given every opportunity to correct their behavior before termination. d) The legal department must review all potential terminations prior to their implementation to avoid future litigation.

b) The manager must be certain that everything possible has been done to help the employee correct problem behaviors.

Identify what core themes are reflected in patient centered care. Select all that apply. a) The overall cost of care to the patient b) The setting in which care takes place c) Patient participation and involvement d) The context in which care takes place e) The relationship between the patient and the healthcare professional f) The patient's loved ones

c) Patient participation and involvement d) The context in which care takes place e) The relationship between the patient and the healthcare professional

Match the following leadership styles with the nurse leader. 1. Autocratic 2. Democratic 3. Laissez-faire 4. Transactional 5. Transformational 6. Authentic __Susan created a checklist of tasks for each nurse to complete for every patient every day. When her nurses submit the completed checklists, she rewards them in various ways—pizza coupons, a raffle ticket for a massage, etc. Her nurses know that if the tasks are not completed, they will be "written up". __Diane set a goal for zero falls on her PACU unit in order to align with the organizational vision of providing safe and effective care. She worked with her team to develop processes in which they could achieve this goal - far more than they expected to do. __Ben goes to his office every day and rarely goes on the unit. He does not much interact with the nurses he supervises, spending time instead writing schedules and attending meetings. When crises occur on the unit, though—like a recent suicide attempt—he got involved in a Root Cause Analysis. __Kari devotes her time to making sure daily operations on her unit run well. She provides monthly performance reviews. She rewards team members who score high on performance matrices an

1 - (Autocratic) Susan created a checklist of tasks for each nurse to complete for every patient every day. When her nurses submit the completed checklists, she rewards them in various ways—pizza coupons, a raffle ticket for a massage, etc. Her nurses know that if the tasks are not completed, they will be "written up". 5 - (Transformational) Diane set a goal for zero falls on her PACU unit in order to align with the organizational vision of providing safe and effective care. She worked with her team to develop processes in which they could achieve this goal - far more than they expected to do. 3 - (Laissez-faire) Ben goes to his office every day and rarely goes on the unit. He does not much interact with the nurses he supervises, spending time instead writing schedules and attending meetings. When crises occur on the unit, though—like a recent suicide attempt—he got involved in a Root Cause Analysis. 4 - (Transactional) Kari devotes her time to making sure daily operations on her unit run well. She provides monthly performance reviews. She rewards team members who score high on performance matrices and corrects team members whose performance does not meet her expectations. She wants to advance in her career, so she knows she needs to do a good job in her current role. 2 - (Democratic) Jenna needed to implement a new process to decrease absenteeism on her unit. She set up multiple meetings to work collaboratively with her team members to come up with new processes and policies to meet the goal. 6 - (Authentic) Barbara shows up on time, follows through on her work, and honors her word. She encourages her team members to participate in the tuition reimbursement offered at their hospital so they can further their education.

Match the Leadership Theory with its descriptor. 1. Great Man / Trait Theory 2. Behavioral Leadership Theory 3. Situational and Contingency Theory 4. Charismatic and Transformational Leadership Theory 5. Complexity Leadership Theory __The oldest theory, this idealogy assumes that great leaders are born, not made. The leader emerges when the situation arises that calls for one—prior training and or preparation is not a prerequisite. Traits of an individual are considered key elements of likely success, such as a person's personality, intellect, and social attributes. __Effective leaders behave differently than ineffective leaders. They are concerned with employee morale, needs, and feels while still addressing task completion and productivity. Emotional Intelligence is considered a hallmark of this theory. __Leaders can be effective in one situation and not another. The theory takes into account the subtle and complex ways in which leaders' behaviors, followers' needs and values, and situational parameters interact. __Leaders inspire, intellectually stimulate, and recognize the contributions of their followers. They are charming and charismatic, leading their followers to meet their

1 - (Great Man/ Trait Theory) The oldest theory, this idealogy assumes that great leaders are born, not made. The leader emerges when the situation arises that calls for one—prior training and or preparation is not a prerequisite. Traits of an individual are considered key elements of likely success, such as a person's personality, intellect, and social attributes. 2 - (Behavioral Leadership Theory) Effective leaders behave differently than ineffective leaders. They are concerned with employee morale, needs, and feels while still addressing task completion and productivity. Emotional Intelligence is considered a hallmark of this theory. 3 - (Situational and Contingency Theory) Leaders can be effective in one situation and not another. The theory takes into account the subtle and complex ways in which leaders' behaviors, followers' needs and values, and situational parameters interact. 4 - (Charismatic and Transformational Leadership Theory) Leaders inspire, intellectually stimulate, and recognize the contributions of their followers. They are charming and charismatic, leading their followers to meet their high expectations. Leaders often develop strong and trusting relationships with their followers. They also instill in their followers a commitment to achieving organizational vision. 5 - (Complexity Leadership Theory) Leaders recognize the interrelationship of people and ideas, seeing that information flows to them in order to foster innovative solutions to work problems. This theory calls on the removal of organizational barriers in order to solve problems.

Maria Elena is dismayed at Sue's assertion. She is striving to make the unit inclusive of everyone there—staffs, patients, patients' loved ones, students, and vendors. She undertakes a number of different actions in order to bring this to pass. Match the Maria Elena's behavior with its descriptor. 1. Understand team member differences 2. Create social support systems 3. Empower staffs through shared governance 4. Create a respectful social environment __Maria Elena posted information about grief, grief support groups, and the Employee Assistance Program on the unit as patients began dying of COVID __Maria Elena elicited staff members to "share their stories" on a bulletin board in the break room in which each staff could talk about their childhood, their families, their education, etc. __Maria Elena posted the nondiscrimination policy on the unit, began weekly staff meetings to discuss staff concerns without reprisal, and hosted an in-service on sexual harassment __Maria Elena encouraged staff to participate in the Path to Excellence Committee as the hospital endeavors to achieve Magnet Status

2 - (Create social support systems) Maria Elena posted information about grief, grief support groups, and the Employee Assistance Program on the unit as patients began dying of COVID 1 - (Understand team member differences) Maria Elena elicited staff members to "share their stories" on a bulletin board in the break room in which each staff could talk about their childhood, their families, their education, etc. 4 - (Create a respectful social environment) Maria Elena posted the nondiscrimination policy on the unit, began weekly staff meetings to discuss staff concerns without reprisal, and hosted an in-service on sexual harassment 3 - (Empower staffs through shared governance) Maria Elena encouraged staff to participate in the Path to Excellence Committee as the hospital endeavors to achieve Magnet Status

Match the ethical principle with its descriptor. 1. Respect for persons 2. Nonmaleficense 3. Beneficence 4. Justice 5. Fidelity __Ethical principle that requires us to act in ways that are loyal, such as keeping your promises, doing what is expected of you, performing your duties, and being trustworthy. __Ethical principle that is concerned with treating people equitably, fairly, and appropriately. __Ethical principle asserting that human beings have an unconditional moral worth that requires us to treat each individual person with great value, dignity, and respect. __Ethical principle that says actions should avoid the risk of and actual harm to others. __Ethical principle that calls on people to do good.

5 - (Fidelity) Ethical principle that requires us to act in ways that are loyal, such as keeping your promises, doing what is expected of you, performing your duties, and being trustworthy. 4 - (Justice) Ethical principle that is concerned with treating people equitably, fairly, and appropriately. 1 - (Respect for Persons) Ethical principle asserting that human beings have an unconditional moral worth that requires us to treat each individual person with great value, dignity, and respect. 2 - (Nonmaleficense) Ethical principle that says actions should avoid the risk of and actual harm to others. 3 - (Beneficence) Ethical principle that calls on people to do good.

Melanie works in the Informatics Division of University Health Care System. She works to maintain the system's Electronic Health Record (EHR). When her nurse colleagues inquire about what benefits the EHR offers, what is her most likely response? A) "EHRs enhance patient engagement in their care, they are more convenient for patients than paper charts, help the team coordinate care, improve health outcomes, and make us more productive." B) "EHRs bring a lot to healthcare. Doctors love that they can access patient records from anywhere, nurses can easily see the care their patients received before they assume the patients, regulators and the Quality Improvement department can easily track errors and incident reports, and the billing department can bill so much better." C) "They're in response to consumer demand for accessibility 24/7. They really help patients see their records, pay their bills, and make their appointments." D) "EHRs help provide quality care, assist us in billing fully, make coordinating care easier, satisfy JCAHO requirements, and make us more efficient"

A) "EHRs enhance patient engagement in their care, they are more convenient for patients than paper charts, help the team coordinate care, improve health outcomes, and make us more productive."

Which of the following statements is an effective way for a leader to of address persistent absenteeism with an employee? A) "When I observe that you have been absent twice this month, I feel concerned and somewhat alarmed because absences have a negative impact on the team and quality care. Can you see how excess absences affect the unit and safety of our patients?" B) "In reviewing your attendance, I see that you were out twice this month. Our policy allows for one absence every 60 days. I'm curious what's getting in the way of your abiding by the policy." C) "I've a lot of concern about your attendance. Let's take a look at our attendance policy to see where you are missing the boat." D) "When I see that are gone a lot, I'm really taken aback because it reflects a great deal of unprofessionalism. Going forward, I really need you to be more mindful of your team and your patients."

A) "When I observe that you have been absent twice this month, I feel concerned and somewhat alarmed because absences have a negative impact on the team and quality care. Can you see how excess absences affect the unit and safety of our patients?"

Randi is now mentoring Devin, a new nurse manager on 5 West. Devin asked her what the most basic tool for developing a powerful image was. Which of the following was Randi most likely to assert? A) "You really need to communicate effectively. We need to both listen and express our thoughts really well. If you cannot communicate well, you cannot succeed as a leader." B) "Networking. Learn to not be afraid of getting to meet and know people. They are your lifeline if you want to succeed." C) "Mentoring, like I'm doing with you, is crucial. It shows the organization that you want to help others grow, and therefore help the organization get stronger." D) "Setting goals is the most fundamental step in developing power. Without goals, you've no idea where you are going."

A) "You really need to communicate effectively. We need to both listen and express our thoughts really well. If you cannot communicate well, you cannot succeed as a leader."

You are a nurse at Desert Springs Rehabilitation Hospital. You have a larger patient load today than usual, and keeping promises to your patients and making sure they all receive high quality care is challenging you. How do you best decide your course of action to make sure you are acting ethically? A) Apply a systematic approach of ethical analysis to the decision-making process B) Adhere to unit policy and procedure C) Go with your gut instinct D) Triage your patients and determine what is most pressing

A) Apply a systematic approach of ethical analysis to the decision-making process

Maria Elena is a nurse manager at Painted Desert Hospital. She has just hired Ai Zhang for a weekend days position on the unit. Ai is a first-generation Chinese immigrant who recently passed her NCLEX. Ai is scheduled to orient this week and is really excited to begin. She will be the first Chinese American to work on Maria Elena's unit. Maria Elena, naturally, would like Ai's orientation to go well educationally, clinically, and culturally. In preparing her team to welcome Ai, Maria Elena explores what it might have been like for Ai's parents when they immigrated to the United States. What would have been the most correct message for her to convey? A) As part of their acculturation, Ai's parents likely adapted their dress, language, traditions, diet, and values to the dominant culture of the United States but that differences might still exist B) Ai's parents needed to explore their own biases when they immigrated to the United States C) Ai is fully American and treating her differently than others is biased and prejudicial D) The task of assimilation is the goal and responsibility of immigrants

A) As part of their acculturation, Ai's parents likely adapted their dress, language, traditions, diet, and values to the dominant culture of the United States but that differences might still exist

What are some select functions, principles, and strategies for initiating and managing change? Select all that apply. A) Communicate regularly and consistently about the change process to sustain it. B) Create short-term targets and celebrate accomplishing them. C) Provide financial disincentive to obstructing change. D) Promote acceptance of the change by viewing the change as a positive experience. E) Allow sufficient time to pass for change to take hold before communicating abouts its effects.

A) Communicate regularly and consistently about the change process to sustain it. B) Create short-term targets and celebrate accomplishing them. D) Promote acceptance of the change by viewing the change as a positive experience.

You work in PACU (Post Anesthesia Care Unit) at River Bend Hospital. Dr. Gonzales, a surgeon, refuses to prescribe opiates for pain relief due to her concerns about addiction risk for her patients. You feel your patients' pain is not being adequately addressed. What is your best course of action? A) Consider first medical necessity, your patients' preferences and quality of life, and other contextual features (i.e, your patient's individual history with substance misuse, extent of surgery, etc.) B) Provide pain medication that is prescribed along with comfort measures like diversion and warm compresses. C) Provide alternative pain management interventions like lavender, meditation, and creative visualization techniques. D) Approach Dr. Gonzales with the latest research on opiate use post-operatively.

A) Consider first medical necessity, your patients' preferences and quality of life, and other contextual features (i.e, your patient's individual history with substance misuse, extent of surgery, etc.)

Lila is a Director of Nursing Services for ambulatory care at Riverwalk Rehab Hospital. She invited the staff nurses on her team to develop staffing and scheduling policies that provided for safe staffing ratios. The policies also addressed absences, punctuality, and overtime. They included information on the discipline process for excess absences and tardies. Which of the domains of a healthy work environment did this approach best reflect? Select all that apply. A) Decision making, because the nurses co-developed the policies B) Teammanship, because the nurses worked together in developing the policies C) Staffing, because the policies provide for sufficient number of nurses to meet patient care needs D) Collaboration, because the policy applies to everyone equally E) Recognition, because Lila recognized the skillsets of her team members to develop the policies

A) Decision making, because the nurses co-developed the policies C) Staffing, because the policies provide for sufficient number of nurses to meet patient care needs D) Collaboration, because the policy applies to everyone equally E) Recognition, because Lila recognized the skillsets of her team members to develop the policies

Sara is a new nurse on a med-surg unit at Desert Springs Hospital. She was hired to work day shift, but there has been a recent exodus of nurses from the night shift. Sara's nurse manager, Kate, let Sara know by email that she would need to move to nights effective next pay period until the night nurses were replaced with new staffs. She emphasized that this was only because of the night shift shortage and that Sara would return to days as soon as possible. Kate also informed Sara she will need to orient the traveler Kate hired to take Sara's day shifts before Sara moves to nights. Kate encouraged Sara to discuss any concerns with her before the next pay period. Sara has three small children and is a single mother. She feels she cannot accommodate Kate's directive to move to nights. She is also unhappy about having to orient the travel nurse to her day shift position. She decides to resign her post rather than accommodate Kate's demands. Which of the Gardner's Tasks of Leading did Kate NOT manifest? Select all that apply. A) Developing Trust B) Affirming Values C) Motivating D) Envisioning Goals E) Managing F) Achieving Unity

A) Developing Trust B) Affirming Values C) Motivating D) Envisioning Goals F) Achieving Unity

Maria promised her sister that she would help take care of their mother today. Her nurse manager calls her this morning, explaining that two nurses called off and she would like Maria to come in to work. Explains that she cannot come in as she already promised her sister she would help. What ethical theory is most likely guiding Maria's decision to respect her promise to her sister? A) Ethics of duty, as she already promised. Her duty to her mother and sister supersede any obligation to her nurse manager. B) Ethics of consequences as Maria knows her sister will be mad at her if she cancels. C) Ethics of relationship, because Maria is focused on minimizing harm to the most number of people D) Ethics of character, because Maria wants her mother to like her.

A) Ethics of duty, as she already promised. Her duty to her mother and sister supersede any obligation to her nurse manager.

What are the three elements that make interprofessional communication effective? A) Interprofessional communication is effective when it is open, collaborative, and respectful B) Interprofessional communication is effective when it is culturally sensitive, honest, and led by the healthcare provider C) Interprofessional communication is effective when it is led by management, attended by quality assurance team members, and focused on the behaviors of concern D) Interprofessional communication is effective when it is timely, conducted by an interdisciplinary team, and led by leadership

A) Interprofessional communication is effective when it is open, collaborative, and respectful

Monica is a Nurse Manager at Spirit Mesa Rehab Hospital. When she assumed her role 4 months ago, the staffing pattern was easily predictable because the average daily census almost never varied. She saw that the complexity of patients' conditions varied, though. Hence, she wanted to reflect these variations in a new staffing pattern. What should Monica have considered when she revised the staffing model? Select all that apply. A) Number of patients B) Range of conditions C) Observations and interventions required D) Patients' satisfaction E) Number of patients F) Range of conditions G) Payor source

A) Number of patients B) Range of conditions C) Observations and interventions required D) Patients' satisfaction E) Number of patients F) Range of conditions

Bonnie is a nurse at Mountain Shadows Medical Center. She has just attended an in-service on self-management that the hospital hosted. The educator who taught the session realizes that Bonnie is confused about the topic when Bonnie makes the following statement: A) Self-management is a new process that hospitals have implemented for the annual review process B) Emotional intelligence is a way of being that involves four skills, self-awareness, self-management, social awareness, and relationship management. C) Stress can be good or bad, depending on how the person undergoing the experience D) Self-management is a means to achieve a balance between work and personal life, as well as a way of life to achieve personal goals within self-imposed priorities and deadlines.

A) Self-management is a new process that hospitals have implemented for the annual review process

Lee is a charge nurse at Mesa Regional Medical Center. They are a mentor to a few nurses at the facility. Which of the following are some of their responsibilities Lee has in their role as a mentor? Select all that apply. A) They have a commitment to the mentee's success B) They should supervise, facilitate, and assess their mentee's learning C) They should allow their mentee to drive the relationship D) They should help front line nurses, especially those who are novice, setting attainable goals E) They should adhere to their own way, knowing their years of experience are to be trusted

A) They have a commitment to the mentee's success B) They should supervise, facilitate, and assess their mentee's learning D) They should help front line nurses, especially those who are novice, setting attainable goals

Sara is a new nurse on a med-surg unit at Desert Springs Hospital. She was hired to work day shift, but there has been a recent exodus of nurses from the night shift. Sara's nurse manager, Kate, let Sara know by email that she would need to move to nights effective next pay period until the night nurses were replaced with new staffs. She emphasized that this was only because of the night shift shortage and that Sara would return to days as soon as possible. Kate also informed Sara she will need to orient the traveler Kate hired to take Sara's day shifts before Sara moves to nights. Kate encouraged Sara to discuss any concerns with her before the next pay period. Sara has three small children and is a single mother. She feels she cannot accommodate Kate's directive to move to nights. She is also unhappy about having to orient the travel nurse to her day shift position. She decides to resign her post rather than accommodate Kate's demands. What type of leadership approach is Kate using? _____________

Autocratic

Randi is promoted to the Acute Services Director position. At the end of a recent leadership meeting, one nurse leans over and says to another "I really like Randi. She just seems so authentic to me, so approachable." Her colleague replies, "how so?" Which of the following is the nurse likely to provide as a good example of authenticity? A) "She's clear that she wants the CNO position and is going after it when David retires." B) "Randi cried when she announced that Jerusha passed away. A lot of leaders would just mention it and move on, have a stiff upper lip." C) "Nothing bothers her. She's unflappable, even when faced with really bad news." D) "She is really, really direct. Some might even say mean, but I think she just tells it like it is. I like it."

B) "Randi cried when she announced that Jerusha passed away. A lot of leaders would just mention it and move on, have a stiff upper lip."

What two factors help teams function more effectively, according to LeFasto and Larson (2001)? A) Acknowledging members and setting goals B) Building relationships and communicating effectively C) Mentoring members and building relationships D) Making commitments and being flexible

B) Building relationships and communicating effectively

What are the primary steps involved in progressive discipline? A) Reprimand the employee, suspend the employee, suspend employee again if problem persists, terminate employee B) Counsel employee, reprimand employee, suspend employee, allow employee to return with stipulations in place, terminate the employee. C) Counsel employee, reprimand employee, suspend employee, terminate employee D) Counsel the employee, reprimand the employee, terminate the employee

B) Counsel employee, reprimand employee, suspend employee, allow employee to return with stipulations in place, terminate the employee.

Rosa is an RN in the PACU at Summit Vista Hospital. She was assigned to care for Mr. Green's, an 84-year-old male patient 2 days status-post amputation of his right lower leg due to complications from uncontrolled diabetes. Mr. Green also suffers from CHF; he is also near-sighted and hard of hearing. Mr. Green hit the nursing call light and requested help getting to the bedside commode as he did not like using the bedpan. Rosa asked Mark, Mark, the Certified Nursing Assistant on duty, to assist Mr. Green to the bedside commode while she cared for another patient. Which of the following steps of delegation was crucial for Rosa to complete before delegating that task of assisting Mr. Green to Mark? A) Introducing herself and Mr. Green to Mark to establish therapeutic rapport and provide a 'warm handoff' in care B) Determining that Mark has the capacity (skills, knowledge, and ability) to complete the delegated tasks safely C) Reviewing Mark's performance review and annual skills check off D) Conferring with other nurses regarding Mark's skill set

B) Determining that Mark has the capacity (skills, knowledge, and ability) to complete the delegated tasks safely

You are caring for Sara in an outpatient reproductive health clinic. She's come to you explaining she is pregnant and understands from recent testing that her fetus has significant genetic abnormalities that indicate if brought to term, her baby will likely have a short and painful life. Sara has always been against abortion, but she does not want her child to have a life of misery. What is the best support you can provide Sara? A) Advise her to bring the pregnancy to term. Abortion is wrong. B) Encourage her to consider systematically consider her options, thinking about medical indications, her preferences, quality of life of her baby, and other contextual information (i.e., finances, other children, etc.). C) Advise her not to bring the pregnancy to term. It would be wrong to inflict suffering on her innocent baby. D) Advise her to make the best decision she can under the circumstances.

B) Encourage her to consider systematically consider her options, thinking about medical indications, her preferences, quality of life of her baby, and other contextual information (i.e., finances, other children, etc.).

Research on effective teams indicates that they create synergy, in which the team achieves results that cannot be reached individually. What basic rules must the team follow in order to be synergetic? A) Be transparent, establish clear goals, set team expectations, be compassionate, and set inflexible standards of performance B) Establish a clear purpose, use active listening, tell the truth, be compassionate, be flexible, commit to resolution, and capitalize on what individuals bring to the team. C) Establish a clear purpose, be transparent, commit to each other, rank members according to skill D) There are no rules to creating synergy; effective teams become synergetic over time

B) Establish a clear purpose, use active listening, tell the truth, be compassionate, be flexible, commit to resolution, and capitalize on what individuals bring to the team.

What did The Joint Commission (TJC) identify as the single most salient factor in sentinel events in healthcare? A) Poor role performance B) Ineffective communication C) Work stress D) Lack of safety measures

B) Ineffective communication

Rosa documented the event in the chart, including reference to the incident report she completed that indicated Mr. Green fell from his bed. Which of the following about incident reports is most true? A) Nurses do not write incident reports; this is a task left to management B) It is inadvisable to mention incident reports in charting C) Mentioning incident reports in charting is advisable because doing so provides readers the chance to obtain additional information about an event D) The individual most familiar with an event should write the incident report, even if that individual is an UAP

B) It is inadvisable to mention incident reports in charting

Rosa is an RN in the PACU at Summit Vista Hospital. She was assigned to care for Mr. Green's, an 84-year-old male patient 2 days status-post amputation of his right lower leg due to complications from uncontrolled diabetes. Mr. Green also suffers from CHF; he is also near-sighted and hard of hearing. Mr. Green hit the nursing call light and requested help getting to the bedside commode as he did not like using the bedpan. Rosa asked Mark, Mark, the Certified Nursing Assistant on duty, to assist Mr. Green to the bedside commode while she cared for another patient. Who was responsible and who was accountable for the safe transfer of Mr. Green to the commode? A) Rosa was both responsible and accountable B) Mark was responsible and Rosa was accountable C) Mark was both responsible and accountable D) Rosa was responsible and Mark was accountable

B) Mark was responsible and Rosa was accountable

What is the difference between morality and ethics? A) Morality is the difference between right and wrong and ethics are a personal code of behavior B) Morality is set of social standards that guide behavior while ethics is a process involving critical thought and action surrounding the concepts of right and wrong. C) Ethics is set of social standards that guide behavior while morality is a process involving critical thought and action surrounding the concepts of right and wrong. D) The concepts of ethics and morality are interchangeable with no discernable difference.

B) Morality is set of social standards that guide behavior while ethics is a process involving critical thought and action surrounding the concepts of right and wrong.

Is Mr. Green likely to succeed in his suit? A) Yes, because all elements of malpractice have been met B) No, because not all elements of malpractice have been met C) No, because Mark returned with the transfer belt D) Yes, because hospitals are more likely to settle cases rather than to fight

B) No, because not all elements of malpractice have been met

You have successfully obtained the position as assistant nurse manager on the evening shift that you applied for. You are encountering many situations that you have never dealt with before and are feeling a bit lost. What strategies would best help you negotiate these situations more successfully? A) Continuously monitor and assess others in similar roles to gauge their approaches B) Observe the rituals, accepted practices, and patterns of communication of the unit C) Focus on weaknesses of the culture of the unit D) Take management classes and implement what you learn on the unit

B) Observe the rituals, accepted practices, and patterns of communication of the unit

Which of the following is a source of ethics? Select all that apply. A) Media B) Profession C) Church D) Peers E) Personal experiences F) Culture G) Family

B) Profession D) Peers E) Personal experiences F) Culture G) Family

Rosa left Summit Vista Hospital soon after she admitted to pilfering Xanax from the Pyxis. She was reported to the state Board of Nursing and placed on probation and in the Diversion program given that no patient harm resulted from her impairment. Which of the following is true regarding Rosa's subsequent employment? A) Rosa's former Nurse Manager, Christine, is legally obligated to alert all future employers of Rosa's conduct B) Rosa's former Nurse Manager, Christine, can alert Rosa's potential future employer of Rosa's conduct only if Rosa listed her or Vista Summit Hospital as a reference C) Summit Vista Hospital has no duty to future employers since leadership there reported Rosa to the state Board of Nursing D) Due to the nursing shortage, Rosa will likely have little difficulty obtaining future employment despite being on probation with her state's Board of Nursing

B) Rosa's former Nurse Manager, Christine, can alert Rosa's potential future employer of Rosa's conduct only if Rosa listed her or Vista Summit Hospital as a reference

What are some points of data a Nurse Manager can consider when evaluating the effectiveness of staffing on their unit? Select all that apply. A) Frequency of restraint B) Staff vacancy rate C) Family complaints D) RN complaints E) Adverse drug events F) Nursing care hours per patient day

B) Staff vacancy rate C) Family complaints E) Adverse drug events F) Nursing care hours per patient day

How do key characteristics of selected collective action strategies apply in the workplace through shared governance, workplace advocacy, and collective bargaining? Select all that apply. A) They provide a way for nurses to fulfill their role as the only professional group that links all aspects of patient care to the organization's mission, vision, and values. B) They create conditions where it is safe to speak up, where hazards can be addressed quickly, where incivility is addressed, and where diversity is supported. C) They help to shape the moral environment of the work setting and the conditions of employment, conducive to quality health care. D) They slow the pace of change so nurses need to fac a rapidly changing environment. E) They help to improve the daily work of nurses, thus improving the quality of care nurses provide.

B) They create conditions where it is safe to speak up, where hazards can be addressed quickly, where incivility is addressed, and where diversity is supported. C) They help to shape the moral environment of the work setting and the conditions of employment, conducive to quality health care. E) They help to improve the daily work of nurses, thus improving the quality of care nurses provide.

In Mr. Green's lawsuit, he named Mark, Rosa, Christine (the nurse manager on duty), Dr. Shah, and Summit Vista Hospital as defendants. Was this overreach? A) No. All parties named were responsible for the incident and should be included in the suit B) Yes. The lawsuit has no merit as all elements of malpractice were not satisfied. C) No. The hospital should be included under the notion of respondeat superior D) Yes. Rosa and Mark had a duty; others named did not so they should not be named.

B) Yes. The lawsuit has no merit as all elements of malpractice were not satisfied.

Lou has just transitioned from days to nights in the ED at Lizard Valley Hospital. He explains to his partner soon after taking the new assignment that he is experiencing role stress. His partner replies, "I want to support you, but I don't know what that means. What is role stress?" Which of the following responses by Lou is most accurate about role stress? A) "Role stress just means I'm being taxed really hard in this job. I had no idea nights did so much!" B) "Role stress means that even though I know what I'm doing clinically, it's been hard establishing relationships with the other staffs." C) "Well, I'm unsure about my new role, there are differences between what I thought the work would be and what it is, and I'm feeling like I can't really fulfill the role very well." D) "Well, there's just too many demands on my time and I can't get all the work done in the time I have."

C) "Well, I'm unsure about my new role, there are differences between what I thought the work would be and what it is, and I'm feeling like I can't really fulfill the role very well."

What best defines a culture of safety in healthcare? A) A culture in which employees report errors in order to identify those culpable so they can be disciplined B) A milieu in which employees report errors and aim to prevent situations that threaten quality C) A blame-free environment that encourages employees to report errors and prevent situations that threaten safety so quality can be assured D) A setting in which employees are held accountable for meeting safety requirements and goals set forth by The Joint Commission

C) A blame-free environment that encourages employees to report errors and prevent situations that threaten safety so quality can be assured

Select the best explanation that reflects patient engagement according to Lieb Zalon (2021). A) A concept that includes one's own desire to participate in one's healthcare, the actual participation in such care, and the outcomes form such participation. B) When a patient fully immerses themselves in their care and directs their treatment to maximize outcomes based on their personal preferences C) A concept that includes understanding one's own role in the care process and having the capacity to fulfill that role, the interventions designed to increase patient activation, and the behavior that results from such activation. D) When a patient and their support system willingly enters the healthcare system with specific aims for improved health

C) A concept that includes understanding one's own role in the care process and having the capacity to fulfill that role, the interventions designed to increase patient activation, and the behavior that results from such activation.

Kevin is a Charge Nurse at University Medical Center. Although he has his Masters in the Science of Nursing, he just completed an 8-week course on Leadership Effectiveness. This course is part of his Master of Business Administration degree he is pursuing. He is really excited to share what he learned with his peers, believing they can help transform the hospital's leadership approach to be more effective. He is certain that achieving this will help University Medical Center achieve Magnet Status—a designation he believes the hospital can easily earn when all nurses join together to do so. Which of the following Covey's Characteristics of Effective Leaders is Kevin demonstrating? Select all that apply. A) Engage themselves in self-renewal B) Lead balanced lives and see life as an adventure C) Believe in other people D) Radiate positive energy E) Engage in lifelong learning

C) Believe in other people D) Radiate positive energy E) Engage in lifelong learning

What is the best definition of collaboration, according to Liesveld? A) Collaboration, derived from the Latin collaborare, reflects the action of nursing laboring together in making institutional decisions to best deliver high quality care. B) Collaboration is a process of interaction between people in which symbols are used to create, exchange, and interpret messages about laboring together. C) Collaboration in nursing is the development of partnerships to achieve best possible outcomes that reflect the particular needs of the patient, family, or community, requiring an understanding of what others have to offer. D) Collaboration is the distinct action of nurses co-laboring to achieve quality patient outcomes.

C) Collaboration in nursing is the development of partnerships to achieve best possible outcomes that reflect the particular needs of the patient, family, or community, requiring an understanding of what others have to offer.

3 years have gone by, and Jerusha is retiring. She recommends that Randi apply for her position as Acute Services Director. Randi is a strong contender for the position from what she's heard in "the rumor mill." What source of power does Randi most likely have that makes her a strong contender? A) Position power, because Randi is already a nurse manager B) Expert power, because Randi has her MSN C) Connection power, because of her relationship with Jerusha and those Jerusha has introduced her to D) Information power, because Randi has "the dirt" on just about everyone

C) Connection power, because of her relationship with Jerusha and those Jerusha has introduced her to

What does use of SBAR (Situation, Background, Assessment, and Recommendation) help achieve? Select the best answer. A) A zero falls environment B) An environment in which open communication is rewarded C) Fewer misunderstandings and a culture of safety D) A more democratized culture

C) Fewer misunderstandings and a culture of safety

What is the difference between first order change and second order change? A) First order change happens more quickly and seamlessly than second order change. B) First order change is planned and organized, successfully addressing the vast array of variables in play while second order change is rarely planned and fails to take into account the complexity of a system C) First order change is evolutionary, and in healthcare systems, it is often referred to as continuous improvement while second order change is revolutionary and episodic and is a large part of what healthcare systems are experiencing today. D) First order change is revolutionary and episodic and is a large part of what healthcare systems are experiencing today while second order change is evolutionary, and in healthcare systems, it is often referred to as continuous improvement.

C) First order change is evolutionary, and in healthcare systems, it is often referred to as continuous improvement while second order change is revolutionary and episodic and is a large part of what healthcare systems are experiencing today.

What are the stages of conflict? A) Frustration, Conceptualization, Interaction, Resolution B) Frustration, Conceptualization, Action, Resolution C) Frustration, Conceptualization, Action, Outcomes D) Conceptualization, Frustration, Interaction, Outcomes

C) Frustration, Conceptualization, Action, Outcomes

Monica is a Nurse Manager at Spirit Mesa Rehab Hospital. When she assumed her role 4 months ago, the staffing pattern was easily predictable because the average daily census almost never varied. She saw that the complexity of patients' conditions varied, though. Hence, she wanted to reflect these variations in a new staffing pattern. What statement best reflects what transpired? A) Monica moved from a nurse productivity staffing pattern to a patient outcomes staffing pattern B) Monica moved from an optimal staffing pattern to a safe staffing pattern C) Monica moved away from a fixed staffing pattern to a flexible staffing pattern D) Monica moved from a flexible staffing pattern to a fixed staffing pattern

C) Monica moved away from a fixed staffing pattern to a flexible staffing pattern

What is meant by value-based payment programs? A) Program developed by hospitals to purchase high value equipment and supplies that will result in higher quality outcomes for patients B) Programs used by business offices to get discounts on equipment and supplies C) Programs developed by insurers that financially incentivize or reward healthcare entities for high quality outcomes and reduce reimbursement for healthcare entities with poor quality outcomes. D) Programs developed by Centers for Medicaid and Medicare Services that provide monies for hospitals to purchase higher quality equipment and supplies

C) Programs developed by insurers that financially incentivize or reward healthcare entities for high quality outcomes and reduce reimbursement for healthcare entities with poor quality outcomes.

What is the difference between Quality Improvement and Quality Assurance? A) QA typically examines process, structure, and outcomes standards where QI focuses on clinical aspects of providers' care, often in response to an identified problem B) QI is on ongoing process completed by an established team to reach objectives identified by staffs while QA is a short-term intervention in response to errors identified to reestablish processes in order to achieve improved outcomes C) QI typically examines process, structure, and outcomes standards where QA focuses on clinical aspects of providers' care, often in response to an identified problem D) QA is comprised of an interprofessional team that works to prevent errors by reviewing nursing activities and providing for professional development while QI is comprised of departmental personnel that audits charts to discover and correct errors in order to improve quality

C) QI typically examines process, structure, and outcomes standards where QA focuses on clinical aspects of providers' care, often in response to an identified problem

Loretta is a nurse manager at River Basin Medical Center. She works diligently to make sure that her unit runs smoothly. She encourages her team members to rise to the challenges they face, thanks them for their commitment, and lets them know when their work helps achieve organizational goals. Turnover rate is low on her unit. What type of leadership style does she best represent? A) Transactional, because she is punitive and manage by exception, her followers complete their work or face negative consequences, and the organization's deadlines are often not met. B) Transformational, because she tries to inspire her team, but her followers do not feel valued, and yet the organization experiences greater commitment. C) Transformational, because she is intellectually stimulating, her followers who are committed to their work, and an organization that experiences high job satisfaction. D) Transactional, because she is inspirational, have followers who feel valued, and the organization's deadlines are met.

C) Transformational, because she is intellectually stimulating, her followers who are committed to their work, and an organization that experiences high job satisfaction.

Rosa continued to work at Summit Vista Hospital after the incident with Mr. Green. The stress of Mr. Green's lawsuit was beginning to effect Rosa and she began using benzodiazepines to help manage her related anxiety. Her use escalated to the point that she pilfered three Xanax from the Pyxis during one shift, charting that she'd administered the medication to patients when she in fact took them herself. A fellow nurse, Adam, noticed Rosa was nodding off and slurring her words. When confronted, Rosa broke down and admitted her wrongdoing. Did Rosa violate her state's nurse practice act by taking Xanax while on duty? A) Yes, because she took an illicit substance B) No, because nursing practice acts do not address the use of prescription medications C) Yes, because she was impaired while practicing D) No, because nodding off and slurring her words are not indicative of any breach of duty to her patients

C) Yes, because she was impaired while practicing

Ai has been on the unit for 6 months now. She has been welcomed and her insights and unique perspectives as a Chinese American have added much to the unit. She noticed that African American female patients tend to re-hospitalize more often and more quickly than other patients and asked at a staff meeting why this occurs. Which of the following explanations is most accurate? A) "Black women tend to be poorer than others and have jobs that get in the way of follow up care. These obstacles lead to them getting worse and coming back," explained Karen, a tech on the unit. B) "Black women just don't care as much about their health as other people," replied Sue. C) "I don't think they come back or experience anything worse than other people. I bet if we actually counted readmissions, we wouldn't see a difference," claimed Bobby, a night nurse on the unit. D) "African Americans and other minorities experience lower quality health care, poor provider-patient relationships, barriers to care, treatment that may not be evidence-based, and provider bias, among other things. It isn't something our patients are doing, but something that is pretty systemically happening to them," explained Carol, a nur

D) "African Americans and other minorities experience lower quality health care, poor provider-patient relationships, barriers to care, treatment that may not be evidence-based, and provider bias, among other things. It isn't something our patients are doing, but something that is pretty systemically happening to them," explained Carol, a nurse practitioner on the unit.

What is the core of shared governance? A) A method for nurses to be seen as knowledge professionals B) A way of nurses to bargain for better working conditions C) A process by which a hospital earns Magnet Status D) A way for shared decision making

D) A way for shared decision making

When Mark entered Mr. Green's room, Mr. Green was alert and oriented. He told Mark he didn't need any help beyond lowering the bed rail so he could use the wheelchair to get to the bedside commode. Mark empathized with Mr. Green, but explained that he really needed to assist Mr. Green and would return in just a moment with a transfer belt. Mr. Green reluctantly stated he would wait but he really did need to urinate. He implored Mark to hurry back. Mark returned soon after with the transfer belt. What ethical principle did Mark try to honor with Mr. Green? A) Veracity B) Beneficence C) Fidelity D) Autonomy E) Justice

D) Autonomy

What are the five approaches to resolving conflict? A) Collaborating, Competing, Compromising, Conspiring, Accommodating B) Achieving, Accepting, Accommodating, Competing, Compromising C) Compromising, Colluding, Competing, Conspiring, Capitulating D) Collaborating, Competing, Compromising, Accommodating, Avoiding

D) Collaborating, Competing, Compromising, Accommodating, Avoiding

Which of the following theories applicable to self-management is best summarized by the following statement-- unpredictable interactions between interdependent people and activities emphasizes the importance of innovation and rapid information sharing to improve performance? A) General Adaptation Syndrome B) Pareto Principle C) Maslow's Hierarchy of Needs D) Complex Adaptive Systems

D) Complex Adaptive Systems

You are a nurse at Mountain Shadows Dermatology Clinic. You noticed that a provider is performing services that are not medically necessary (i.e., Botox injections) but billing them as procedures that are (i.e., acne treatments). You feel you need to report these billing inconsistencies. Where is the best place for you to report them? A) Your direct manager / supervisor B) Ethics Committee at the clinic C) Human Resources D) Compliance hotline

D) Compliance hotline

Ai arrives on the unit for orientation. Over the next few days, she opens up about her experience feeling caught between two cultures—her parents' more traditional Chinese culture and the more dominant American culture Ai experienced away from home. Sue, one of Ai's preceptors, asserts "I'm not sure why you feel stuck, honey. Certainly, your parents came here for a reason—America is better. I'm not saying we're perfect, but even your parents saw that our way of life is better, or they wouldn't have come." What is the term to describe Ai's feelings of being stuck between two cultures and the term to describe Sue's assertion that the American way of life is better? A) Cultural imposition; cultural marginality B) Ethnocentrism; cultural competence C) Cultural marginality; cultural imposition D) Cultural marginality; ethnocentrism

D) Cultural marginality; ethnocentrism

What are the three main requirements of documenting personal / personnel problems? A) Account of the incident, actions taken to prevent future problems, and employee response to interventions B) Explanation of the event, actions taken to address the past behavior, and follow up plan C) Report of the problem behavior, summary of policy, indication of how behavior violates policy, disciplinary action taken D) Description of the incident, description of plan to prevent future problems, and specifics on how and when the plan will be carried out

D) Description of the incident, description of plan to prevent future problems, and specifics on how and when the plan will be carried out

Maria Elena is a nurse manager at Painted Desert Hospital. She has just hired Ai Zhang for a weekend days position on the unit. Ai is a first-generation Chinese immigrant who recently passed her NCLEX. Ai is scheduled to orient this week and is really excited to begin. She will be the first Chinese American to work on Maria Elena's unit. Maria Elena, naturally, would like Ai's orientation to go well educationally, clinically, and culturally. Maria Elena continues to help her team prepare for Ai's arrival by educating them about values, traditions, languages, and behaviors common among Chinese peoples. Which of the following best describes Maria Elena's undertaking? A) Maria Elena is embracing diversity at the cost of discounting the cultures of existing team members B) Maria Elena is manifesting ethnocentrism by pointing out the differences between the dominant American culture and Ai's Chinese culture C) Maria Elena is manifesting Leininger's theory of transcultural practice D) Maria Elena is assisting her team in developing cultural competence

D) Maria Elena is assisting her team in developing cultural competence

You are a nurse at Mountain Shadows Dermatology Clinic. You noticed that a provider is performing services that are not medically necessary (i.e., Botox injections) but billing them as procedures that are (i.e., acne treatments). You feel you need to report these billing inconsistencies, but are afraid because the provider is a powerful and well liked clinician and you think the clinic will support his practices. What are you experiencing? A) Burnout B) Low self esteem C) Ethical dilemma D) Moral distress

D) Moral distress

Susan has recently accepted a position as nurse manager at Dancing Mesa Rehabilitation Center. She is, admittedly, feeling somewhat overwhelmed. She is staying longer hours than she was told would be required, and the help promised never materialized. What stage of role transition is Susan most likely experiencing? A) Role exploration, because she is exploring what she is doing wrong B) Role confusion, because she is not quite sure what to do C) Role internalization, because she is blaming herself D) Role discrepancy, because there is a gap between performance and expectations

D) Role discrepancy, because there is a gap between performance and expectations

The SBAR communication approach is best described by the following statement: A) The communicator provides the situation, background information that contributed to the situation, asks for guidance, and then repeats back what the recipient advised. B) The communicator suggests a solution to a problem, shares the background information that contributed to the problem, makes their assessment, and then asks the recipient to repeat what was shared C) The communicator suggests a solution to a problem, provides background information that contributed to the problem, asks for guidance, and then repeats back what the recipient advised. D) The communicator provides the situation, background information that contributed to the situation, their assessment, and their thoughts on what to do to correct the problem to the intended recipient.

D) The communicator provides the situation, background information that contributed to the situation, their assessment, and their thoughts on what to do to correct the problem to the intended recipient.

Mickey is a new Nurse Manager at Mountain Vista Hospital. She routinely responds quickly to emails, has an "open door" policy that allows staff nurses to see her anytime, and holds weekly "town hall" meetings in which nurses can share their thoughts about the unit. She supports ideas the nurses bring forth and is eager to implement their suggestions. What is the most likely impact of Mickey's leadership approach on her team? A) Mickey is likely to advance quickly in her career B) Mountain Vista is likely to achieve Magnet Status more quickly C) The Chief Nursing Officer at Mountain Vista is likely to refer Mickey to leadership training to correct Mickey's Laissez-faire approach D) The nurses on Mickey's units are likely to feel cared for

D) The nurses on Mickey's units are likely to feel cared for

_________________ is a not-for-profit entity that evaluates the functioning of a hospital making unannounced site visits. This organization focuses on outcomes and nurses' roles related to the ________________ process.

The Joint Commission..., Accreditation

How does Hersey's model apply to delegation? a) Before delegating, the nurse must understand the type of support the individual needs b) During the delegation process, the nurse will provide the UNP guidance c) Before delegating, the UNP needs to understand what type of support the nurse will provide d) After delegating, the nurse and UNP will review the process and make recommendations for improvement as needed

a) Before delegating, the nurse must understand the type of support the individual needs

What drives the focus on patient centered care now? Select all that apply. a) Chronic disease is a larger burden on the healthcare system b) Patients expect person-centered care more than ever c) Utilization of healthcare has increased d) Individuals are healthier and can more readily engage in their care e) Advances in technology and its access f) Healthcare settings have become more complex and less personal g) Older and sicker patients need care that is more comprehensive

a) Chronic disease is a larger burden on the healthcare system b) Patients expect person-centered care more than ever c) Utilization of healthcare has increased e) Advances in technology and its access f) Healthcare settings have become more complex and less personal g) Older and sicker patients need care that is more comprehensive

Which of the following does Kowalski (2021) identify as personal / personnel problems? Select all that apply. a) Clinical incompetence b) Cultural incompetence c) Immature employees d) Absenteeism e) Substance use f) Emotional problems g) Social media use h) Uncooperative or unproductive behavior i) Incivility

a) Clinical incompetence c) Immature employees d) Absenteeism e) Substance use f) Emotional problems h) Uncooperative or unproductive behavior i) Incivility

Bobby is a nurse at Mesa Vista Residential Treatment Center (RTC). He is responsible for 80 adolescents taking their medications every day. Bobby knows that the state in which Mesa Vista operates allows for the observation of self-administration of medication for residents in an RTC. It also allows UAP to gather assessment information (i.e., VS, mood / affect, ADL completion, and presence of pain) to report to the licensed nurse. Bobby also knows that the RTC policies reflect the State's allowances. One particular resident, Javier, is well known to Bobby. Javier is often very angry and sometimes volatile and aggressive to peers and staffs without identifiable precipitant / cause. At times, staffs have had to physically restrain the resident because of his aggression. One morning, Bobby is attending to a resident who fell and hurt her knee. Bobby directs Jenna, a new UNP assigned to the unit that day, to help the residents take their medications and to "see how everyone is doing." Jenna asks if that includes Javier, and Bobby replies, "he's a resident here, yeah? So yeah." Jenna also asks what Bobby means by making sure the residents take their medications, and Bobby replies, "they know

a) Ensure that laws and support the delegation c) Consider the type of healthcare facility related to the delegation / task f) Determine if the institution's policies allow for this type of delegation to a UNP g) Asks question and seek clarification regarding the delegation

Which of the following are steps in the Quality Improvement process? a) Establish measurable outcomes and quality indicators b) Identify needs most important to the client served by healthcare entities c) Collect data to evaluate the plan's implementation and the outcomes reached d) Recruit nurses to drive the QI process e) Engage the public to recommend interventions to meet stated outcomes f) Identify needs most important to the healthcare entity g) Assemble an interprofessional team to review the identified needs and services h) Select and implement a plan to meet these outcomes

a) Establish measurable outcomes and quality indicators b) Identify needs most important to the client served by healthcare entities c) Collect data to evaluate the plan's implementation and the outcomes reached g) Assemble an interprofessional team to review the identified needs and services h) Select and implement a plan to meet these outcomes

Which of the following is true about conflict? Select all that apply. a) It can stimulate a stagnant team b) It is a catalyst for change c) It maintains the status quo d) It can increase productivity e) It can lead to burnout, absenteeism, and turnover if unresolved f) It has the potential to produce beneficial or detrimental effects

a) It can stimulate a stagnant team b) It is a catalyst for change d) It can increase productivity e) It can lead to burnout, absenteeism, and turnover if unresolved f) It has the potential to produce beneficial or detrimental effects

Research indicates that effective nursing leadership results in positive outcomes for nurses. What else does research indicate effective leadership results in? Select all that apply a) More opportunities for staff development b) Higher revenue per unit c) Higher staff turnover d) Better clinical outcomes e) Greater application of evidence-based practices

a) More opportunities for staff development d) Better clinical outcomes e) Greater application of evidence-based practices

Sara is a new nurse on a med-surg unit at Desert Springs Hospital. She was hired to work day shift, but there has been a recent exodus of nurses from the night shift. Sara's nurse manager, Kate, let Sara know by email that she would need to move to nights effective next pay period until the night nurses were replaced with new staffs. She emphasized that this was only because of the night shift shortage and that Sara would return to days as soon as possible. Kate also informed Sara she will need to orient the traveler Kate hired to take Sara's day shifts before Sara moves to nights. Kate encouraged Sara to discuss any concerns with her before the next pay period. Sara has three small children and is a single mother. She feels she cannot accommodate Kate's directive to move to nights. She is also unhappy about having to orient the travel nurse to her day shift position. She decides to resign her post rather than accommodate Kate's demands. What are different responses that Sara could have chosen that would have better manifested effective followership traits? Select all that apply. a) Orient the traveler nurse to her day shift care responsibilities b) Take Kate up on her invitation to dis

a) Orient the traveler nurse to her day shift care responsibilities b) Take Kate up on her invitation to discuss any concerns e) Accept the new assignment

When Mark returned, he saw that Mr. Green was on the floor. Mr. Green explained that when he tried to get out of bed, he got tangled in his IV tubing and fell on his left side. Mark lowered the bed rail, assisted him back to the bed, put the bed rail up, and informed Rosa of what happened. Rosa assessed Mr. Green and noted skin tearing to Mr. Green's left arm and pain 8/10 to his arm, ribs, and hip. She provided wound care to Mr. Green's left arm. She also informed Dr. Shah, the hospitalist, of the event. Dr. Shah completed a neuro-evaluation on Mr. Green and found no deficiencies. He ordered x-rays of Mr. Green's pelvis, abdomen / ribs, left hand, wrist, arm, and shoulder. X-rays revealed fractures to the left side of Mr. Green's pelvis, his 2 left ribs, and his left ulna. Mr. Green underwent surgery for his pelvis fracture and his left ulna was placed in an immobilizer. He was soon transferred to inpatient rehab for ongoing care. He later contacted an attorney to bring a malpractice suit forward. What elements of malpractice are satisfied? Select all that apply. a) Professional duty b) Injury c) Damages d) Foreseeability e) Breach of professional duty f) Causation

a) Professional duty

Randi is a nurse at Sisters of Mercy Hospital on the 4th Floor Surgical Unit. She has just completed her MSN and wants to apply for the Nurse Manager position on 5 West. She has discussed the opportunity with her friend, Sara, who encouraged Randi to consider what she has done to put herself into a powerful position. Which of the following are actions Randi could take to enhance her power and likelihood of securing the promotion? Select all that apply. a) Randi presented her master's thesis at a staff meeting, thanking her college faculty and the CNO for their support b) Randi picked up a shift from Jose´, and even when something arose that made it difficult to come in, she presented to the unit on time c) Randi sought feedback from her peers at time of annual review, even though this was not a required step in the performance review process d) Randi brought in donuts every Sunday morning on her way to church and attaches a little scripture on the box e) When a physician pointed out that she performed a procedure wrong in front of the patient, Randi reported the physician to HR for harassment f) Randi says she uses a lot of slang "so patients connect with me" g) Randi posts 'staff selfi

a) Randi presented her master's thesis at a staff meeting, thanking her college faculty and the CNO for their support b) Randi picked up a shift from Jose´, and even when something arose that made it difficult to come in, she presented to the unit on time c) Randi sought feedback from her peers at time of annual review, even though this was not a required step in the performance review process h) Randi reported herself when she made a medication error, even when the error did not reach the patient

Randi interviews for and is offered the Nurse Manager position on 5 West. Her mentor and friend, Jerusha, suggests it is time for Randi to start developing her political skills. Jerusha takes Randi to meetings, introduces her to other members of leadership, and guides her in developing her role. Which of the following actions is Jerusha likely to encourage Randi to undertake? Select all that apply. a) Register to vote and then vote in each election b) Work on federal holidays c) Reach out to her state senator's office and invite the senator to spend a day on the unit d) Join the state nurses' association e) Invite a state legislator to meet to discuss policy issues related to nursing f) Join the protest outside the hospital that is seeking support for higher wages and better nurse to patient ratios

a) Register to vote and then vote in each election c) Reach out to her state senator's office and invite the senator to spend a day on the unit d) Join the state nurses' association e) Invite a state legislator to meet to discuss policy issues related to nursing

There are several dimensions that constitute a professional practice model reflective of patient-centered care. Select all that apply. a) The therapeutic milieu b) Nurse practice competence and excellence c) Management of practice and influence in health systems d) Patient capacity e) Patient readiness f) Nurse professional authority g) Patient deficits

a) The therapeutic milieu b) Nurse practice competence and excellence c) Management of practice and influence in health systems f) Nurse professional authority

What is the most effective professional leadership and management strategy nurses implement in clinical practice to improve the safety and quality of person-centered care? a) Implementing evidence-based practice b) Delegating effectively c) Taking responsibility d) Getting a Bachelor of Science in Nursing (BSN)

b) Delegating effectively

According to Hoffart, how do ethics relate to effective leadership? Select all that apply. a) The Institutes of Medicine identified lack of ethics as a root cause for poor quality nursing b) Ethical integrity is a core element of all types of leadership c) Leaders rely on ethical principles to guide decisions d) Formal leaders practice and role model high ethical standards e) The Joint Commission scores organizations, in part, of ethical practices

b) Ethical integrity is a core element of all types of leadership c) Leaders rely on ethical principles to guide decisions d) Formal leaders practice and role model high ethical standards

Sara is a new nurse on a med-surg unit at Desert Springs Hospital. She was hired to work day shift, but there has been a recent exodus of nurses from the night shift. Sara's nurse manager, Kate, let Sara know by email that she would need to move to nights effective next pay period until the night nurses were replaced with new staffs. She emphasized that this was only because of the night shift shortage and that Sara would return to days as soon as possible. Kate also informed Sara she will need to orient the traveler Kate hired to take Sara's day shifts before Sara moves to nights. Kate encouraged Sara to discuss any concerns with her before the next pay period. Sara has three small children and is a single mother. She feels she cannot accommodate Kate's directive to move to nights. She is also unhappy about having to orient the travel nurse to her day shift position. She decides to resign her post rather than accommodate Kate's demands. Which of the following should be concerning to you? Select all that apply. a) Kate provided no explanation for why Sara was selected to alter her schedule b) Kate did not meet with Sara before making any changes to the schedule c) Kate is tasking Sara

b) Kate did not meet with Sara before making any changes to the schedule c) Kate is tasking Sara to orient a traveler f) Sara elected to resign without speaking to Kate about her concerns

What is the core shared component of nurse leader responsibilities, delegatee responsibilities, and the licensed nurse responsibilities? a) Best use of staff b) Public protection c) Training and education d) Efficiency and cost protections

b) Public protection

Chloe is a nurse at Mountain High Hospital. She tells her UAP, Jonathan, to help Mrs. Armijo, an 81 year-old patient admitted post right hip replacement, get ready for the day. Jonathan nodded and headed towards Mrs. Armijo's room. Which of the following communication elements related to delegation did Chloe and Jonathan not use? Select all that apply. a) Giving information b) Seeking advice c) Seeking clarity d) Giving direction

b) Seeking advice c) Seeking clarity d) Giving direction

Bobby is a nurse at Mesa Vista Residential Treatment Center (RTC). He is responsible for 80 adolescents taking their medications every day. Bobby knows that the state in which Mesa Vista operates allows for the observation of self-administration of medication for residents in an RTC. It also allows UAP to gather assessment information (i.e., VS, mood / affect, ADL completion, and presence of pain) to report to the licensed nurse. Bobby also knows that the RTC policies reflect the State's allowances. One particular resident, Javier, is well known to Bobby. Javier is often very angry and sometimes volatile and aggressive to peers and staffs without identifiable precipitant / cause. At times, staffs have had to physically restrain the resident because of his aggression. One morning, Bobby is attending to a resident who fell and hurt her knee. Bobby directs Jenna, a new UNP assigned to the unit that day, to help the residents take their medications and to "see how everyone is doing." Jenna asks if that includes Javier, and Bobby replies, "he's a resident here, yeah? So yeah." Jenna also asks what Bobby means by making sure the residents take their medications, and Bobby replies, "they know

b) provided more guidance c) agree with Jenna on what was expected and what the conditions are for her performance d) explained the specific tasks expected

Bobby is a nurse at Mesa Vista Residential Treatment Center (RTC). He is responsible for 80 adolescents taking their medications every day. Bobby knows that the state in which Mesa Vista operates allows for the observation of self-administration of medication for residents in an RTC. It also allows UAP to gather assessment information (i.e., VS, mood / affect, ADL completion, and presence of pain) to report to the licensed nurse. Bobby also knows that the RTC policies reflect the State's allowances. One particular resident, Javier, is well known to Bobby. Javier is often very angry and sometimes volatile and aggressive to peers and staffs without identifiable precipitant / cause. At times, staffs have had to physically restrain the resident because of his aggression. One morning, Bobby is attending to a resident who fell and hurt her knee. Bobby directs Jenna, a new UNP assigned to the unit that day, to help the residents take their medications and to "see how everyone is doing." Jenna asks if that includes Javier, and Bobby replies, "he's a resident here, yeah? So yeah." Jenna also asks what Bobby means by making sure the residents take their medications, and Bobby replies, "they know

c) None of the Rights of Delegation were followed

What are the principles of quality management and quality improvement? Select all that apply. a) The aims of QI / QM programs is to identify bad actors and detractors from quality who require corrective action b) Quality management operates most efficiently in a hierarchical system with clear lines of communication c) Quality improvement focuses on outcomes and relies on data-driven decisions. d) The goal of quality management is to improve systems and processes, not to assign blame e) Quality management operates most effectively within a flat, democratic organization structure. f) A shared commitment to quality improvement is essential for organizational success.

c) Quality improvement focuses on outcomes and relies on data-driven decisions. d) The goal of quality management is to improve systems and processes, not to assign blame e) Quality management operates most effectively within a flat, democratic organization structure. f) A shared commitment to quality improvement is essential for organizational success.

When Mark entered Mr. Green's room, Mr. Green was alert and oriented. He told Mark he didn't need any help beyond lowering the bed rail so he could use the wheelchair to get to the bedside commode. Mark empathized with Mr. Green, but explained that he really needed to assist Mr. Green and would return in just a moment with a transfer belt. Mr. Green reluctantly stated he would wait but he really did need to urinate. He implored Mark to hurry back. Mark returned soon after with the transfer belt. What ethical principle did Mark honor with Mr. Green? Select all that apply a) Justice b) Autonomy c) Veracity d) Fidelity e) Beneficence

d) Fidelity e) Beneficence

Bobby is a nurse at Mesa Vista Residential Treatment Center (RTC). He is responsible for 80 adolescents taking their medications every day. Bobby knows that the state in which Mesa Vista operates allows for the observation of self-administration of medication for residents in an RTC. It also allows UAP to gather assessment information (i.e., VS, mood / affect, ADL completion, and presence of pain) to report to the licensed nurse. Bobby also knows that the RTC policies reflect the State's allowances. One particular resident, Javier, is well known to Bobby. Javier is often very angry and sometimes volatile and aggressive to peers and staffs without identifiable precipitant / cause. At times, staffs have had to physically restrain the resident because of his aggression. One morning, Bobby is attending to a resident who fell and hurt her knee. Bobby directs Jenna, a new UNP assigned to the unit that day, to help the residents take their medications and to "see how everyone is doing." Jenna asks if that includes Javier, and Bobby replies, "he's a resident here, yeah? So yeah." Jenna also asks what Bobby means by making sure the residents take their medications, and Bobby replies, "they know

d) Safety, critical thinking, stability, time

Bobby is a nurse at Mesa Vista Residential Treatment Center (RTC). He is responsible for 80 adolescents taking their medications every day. Bobby knows that the state in which Mesa Vista operates allows for the observation of self-administration of medication for residents in an RTC. It also allows UAP to gather assessment information (i.e., VS, mood / affect, ADL completion, and presence of pain) to report to the licensed nurse. Bobby also knows that the RTC policies reflect the State's allowances. One particular resident, Javier, is well known to Bobby. Javier is often very angry and sometimes volatile and aggressive to peers and staffs without identifiable precipitant / cause. At times, staffs have had to physically restrain the resident because of his aggression. One morning, Bobby is attending to a resident who fell and hurt her knee. Bobby directs Jenna, a new UNP assigned to the unit that day, to help the residents take their medications and to "see how everyone is doing." Jenna asks if that includes Javier, and Bobby replies, "he's a resident here, yeah? So yeah." Jenna also asks what Bobby means by making sure the residents take their medications, and Bobby replies, "they know

e) Bobby is accountable and Jenna is responsible