Quality Improvement Processes, Using Quality Improvement Data, Interprofessional Collaboration and Consultation, Ethical Standards, Leadership Theories, Regulatory Standards, Role Theory, Delegation, Optimizing Employee Performance, Organizational Fr...

A nurse educator is teaching a new preceptor group about the importance of competencies and training in their new leadership role. Which statements indicate that a preceptor understands the impact of role theory on nursing leadership competencies? Select all that apply. A. "I understand that part of my competency will be developed based on feedback." B. "Part of my evaluation will be based on my new role and competencies as a preceptor." C. "I need to be checked off on my clinical skills before I can officially transition to being a preceptor." D. "I want to read the job description for my new role to gain a better understanding of what is expected." E. "I need to learn more about learning styles as part of my competency development because that was not part of staff nurse training."

A. "I understand that part of my competency will be developed based on feedback." B. "Part of my evaluation will be based on my new role and competencies as a preceptor." D. "I want to read the job description for my new role to gain a better understanding of what is expected." E. "I need to learn more about learning styles as part of my competency development because that was not part of staff nurse training."

A nurse educator is teaching a leadership course to a group of new preceptors. Which statements indicate that the preceptors understand the importance of leadership theory? Select all that apply. A. "Leadership theory helps guide leaders in problem solving." B. "Leadership theory helps provide answers to unanswered questions." C. "Leadership theory reveals a leader's power comes from being assigned to an official position." D. "Leadership theory cannot be applied universally, as there is no single correct leadership approach." E. "Leadership theory helps a nurse study the type of leader he or she wants to be and utilize that single approach."

A. "Leadership theory helps guide leaders in problem solving." B. "Leadership theory helps provide answers to unanswered questions." C. "Leadership theory reveals a leader's power comes from being assigned to an official position." D. "Leadership theory cannot be applied universally, as there is no single correct leadership approach."

A patient asks the nurse why he must be referred to another health care facility for care and wishes to refuse the referral. How should the nurse reply? A. "Of course; you can always refuse a referral." B. "You will be happier at the new facility—it's not the hospital." C. "Your insurance carrier will no longer cover your medical care here, so you will need to leave." D. "Unfortunately, you don't have a choice in the matter. We can no longer care for your medical condition here."

A. "Of course; you can always refuse a referral."

Which are true statements that a nurse can provide to a new nurse about the National Quality Forum (NQF)? Select all that apply. A. "The National Quality Forum reviews reports of hours of nursing care." B. "The National Quality Forum reviews reports of the prevalence of pressure ulcers." C. "The National Quality Forum monitors the prevalence of ventilator-associated pneumonia." D. "The National Quality Forum has developed 'Do not use' terms, symbols, and abbreviations." E. "The National Quality Forum ensures the use of proper signage in areas that contain ionizing radiation."

A. "The National Quality Forum reviews reports of hours of nursing care." B. "The National Quality Forum reviews reports of the prevalence of pressure ulcers." C. "The National Quality Forum monitors the prevalence of ventilator-associated pneumonia."

Which factors led to an increased focus on health care quality in the United States? Select all that apply. A. A rise in the cost of insurance B. Public disclosure of safety issues C. Initiation of quality improvement (QI) D. A decrease in patient numbers at hospitals E. A call to provide safe care regardless of race

A. A rise in the cost of insurance B. Public disclosure of safety issues

A nurse manager reports a medication error that a staff nurse failed to report. Which role in the ethical dilemma framework is the nurse leader portraying? A. Advocator B. Documenter C. Collaborator D. Decision-maker

A. Advocator

Which principle is common to all quality improvement (QI) models? A. An emphasis on patient needs B. The use of intuition over research C. The idea that an organization can eventually achieve all performance goals D. A hierarchical structure with leaders having primary responsibility for safety

A. An emphasis on patient needs

Which statement indicates that the nurse manager understands the connection of role strain and role stress to absenteeism? A. An employee may withdraw from coworkers as a result of role strain. B. An employee may express job dissatisfaction because of personal problems. C. An employee may express job dissatisfaction because of high learning curves. D. An employee may have irregular work attendance because of depression or substance abuse.

A. An employee may withdraw from coworkers as a result of role strain.

According to role theory, which behaviors or traits would be expected for a nurse functioning as a manager? Select all that apply. A. Applying critical thinking B. Collaborating with others C. Performing evidence-based research D. Working with interdisciplinary teams E. Teaching continuing education classes F. Employing strong reasoning or judgment skills

A. Applying critical thinking B. Collaborating with others D. Working with interdisciplinary teams F. Employing strong reasoning or judgment skills

Which actions show a new nurse manager understands the role and importance of being a leader? Select all that apply. A. Asking about patient safety initiatives B. Asking how nurses and nursing assistants report concerns C. Asking about internal policies, because public policy is not a concern D. Asking about issues regarding the retention of nurses in the institution E. Asking about available leadership, coaching, and communication training

A. Asking about patient safety initiatives B. Asking how nurses and nursing assistants report concerns D. Asking about issues regarding the retention of nurses in the institution E. Asking about available leadership, coaching, and communication training

The chief nursing officer (CNO) is discussing new staff hiring, employee development, and evaluation with the nursing directors. Which actions by the CNO indicate an understanding of role theory's connection with employee development and/or evaluation? Select all that apply. A. Asking everyone to base staff evaluations on job descriptions B. Asking everyone to think about whether they are hiring the right person for any position C. Reminding the nursing directors to use seniority as a primary qualification when hiring assistant directors D. Reminding the nursing directors to be specific regarding job descriptions for the assistant directors and their staff E. Asking the nursing directors to review job descriptions for their staff to ensure that they are specific and that mandatory requirements or certifications are included

A. Asking everyone to base staff evaluations on job descriptions B. Asking everyone to think about whether they are hiring the right person for any position D. Reminding the nursing directors to be specific regarding job descriptions for the assistant directors and their staff E. Asking the nursing directors to review job descriptions for their staff to ensure that they are specific and that mandatory requirements or certifications are included

Which suggest that a nursing director identifies with situational contingency leadership theory? Select all that apply. A. Being clear about expectations and goals B. Understanding the importance of increasing staff satisfaction C. Encouraging self-management and creativity in system redesigning D. Motivating and offering rewards to staff to gain trust and exert influence E. Being self-aware of leadership strengths and weaknesses and having a desire to improve on the ones that are not innate F. Carefully considering the work habits and complexities facing the staff before making decisions for change or identifying solutions to overcome obstacles

A. Being clear about expectations and goals B. Understanding the importance of increasing staff satisfaction D. Motivating and offering rewards to staff to gain trust and exert influence F. Carefully considering the work habits and complexities facing the staff before making decisions for change or identifying solutions to overcome obstacles

A nurse is developing a continuing education course for nurses about the importance of collaboration. Which benefits of collaboration should the nurse include in the curriculum? Select all that apply. A. Better health outcomes B. Improved patient-centered care C. Lower cost of health care expenditures D. Provision of organization-centered care E. Long-term sustainability of the health care organization

A. Better health outcomes B. Improved patient-centered care E. Long-term sustainability of the health care organization

Which actions indicate that the nurse leader understands the hypotheses in role theory related to role strain, role stress, and absenteeism? Select all that apply. A. Bringing thank-you cards to show appreciation for the team's hard work B. Asking a new nurse why he or she is withdrawing from coworkers and patients C. Asking a nurse if increased absences are due to illness, family illness, or job stress D. Not asking a nurse about increased absences out of respect for the nurse's privacy E. Not showing concern about increased absences as long as the nursing staff do a good job F. Hiring more nurses per shift after identifying that increased absences were a result of increased patient-to-nurse ratios

A. Bringing thank-you cards to show appreciation for the team's hard work B. Asking a new nurse why he or she is withdrawing from coworkers and patients C. Asking a nurse if increased absences are due to illness, family illness, or job stress F. Hiring more nurses per shift after identifying that increased absences were a result of increased patient-to-nurse ratios

How does the nurse follow the standards set by HIPAA (The Health Insurance Portability and Accountability Act) of 1996? Select all that apply. A. By only discussing patient information in private. B. By learning how to prevent and report sentinel events. C. By only discussing patient information with necessary providers. D. By knowing the correct way to report an employer's illegal action. E. By not discussing private patient information with unauthorized persons on the phone.

A. By only discussing patient information in private. C. By only discussing patient information with necessary providers. E. By not discussing private patient information with unauthorized persons on the phone.

How does the Nurse Practice Act protect patients from receiving incompetent nursing care? A. By setting the scope of practice for nurses B. By providing oversight of compact licensure C. By monitoring certification and credentialing D. By ensuring collaboration among state boards of nursing

A. By setting the scope of practice for nurses

Which are focuses of a leader? Select all that apply. A. Changing the future B. Improving a situation C. "Who can do this better?" D. The outcome of compliance E. Being a leader without being a manager

A. Changing the future B. Improving a situation E. Being a leader without being a manager

A nurse is caring for a young patient who is struggling emotionally after being diagnosed with a terminal illness. Who should the nurse consider adding to the health care team caring for this patient? A. Chaplain B. Pharmacist C. Physical Therapist D. Occupational Therapist

A. Chaplain

The benchmarking process may be used to achieve which outcomes? Select all that apply. A. Staying on budget B. Improved practices C. Enhanced productivity D. Meeting industry standards E. Identification of tools to measure patient outcomes

B. Improved practices D. Improved practices

Which statements explain how role theory influences the training of a charge nurse who is promoted to assistant director? Select all that apply. A. Competencies should be based on the desires of the new assistant director's followers. B. The nursing director should apply role theory to define the new assistant director's role and competencies. C. Competencies for the new assistant director should be vague to meet the mission and values of the organizations. D. Competencies will help the new assistant director gain the skills and knowledge to meet the needs of their position. E. The nursing director should apply role theory to develop hiring and evaluation competencies for the new assistant director. F. A nurse already functioning in the charge nurse position has the skills and knowledge to succeed in their new position regardless of competency development.

A. Competencies should be based on the desires of the new assistant director's followers. B. The nursing director should apply role theory to define the new assistant director's role and competencies. D. Competencies will help the new assistant director gain the skills and knowledge to meet the needs of their position. E. The nursing director should apply role theory to develop hiring and evaluation competencies for the new assistant director.

Which are aspects of the transformational leadership approach? Select all that apply. A. Creating enthusiasm B. Learning managing by exception C. Being creative with system redesign D. Making decisions with little input from staff E. Learning to empower employee development F. Understanding the importance of rewarding and punishing

A. Creating enthusiasm C. Being creative with system redesign E. Learning to empower employee development

Which task is important to the lean model of quality improvement (QI)? A. Customizing the workflow according to patient needs B. Ensuring that all employees have enough work to keep busy C. Using statistics to quantify improvement in health care quality D. Using a core unit of interdependent individuals to focus on patient safety

A. Customizing the workflow according to patient needs

According to the National Academy of Medicine (NAM), in which ways can health care quality be improved in the United States? Select all that apply. A. Delivering care immediately when necessary B. Ensuring that the newest treatments are used for every patient C. Keeping abreast of effective interventions and indications for use D. Considering the patient's wishes when making medical decisions E. Doubling up on staff to ensure that patients are more than adequately covered at all times

A. Delivering care immediately when necessary C. Keeping abreast of effective interventions and indications for use D. Considering the patient's wishes when making medical decisions

Which actions indicate that the nurse manager understands the use of position descriptions as a strategy to increase role clarity? Select all that apply. A. Developing preceptor training B. Updating job descriptions to make them more specific C. Sharing all job descriptions from the department with the staff D. Developing a plan for performance improvement for a new nurse E. Updating the clinical nurse educator's job description before posting the open position

A. Developing preceptor training B. Updating job descriptions to make them more specific D. Developing a plan for performance improvement for a new nurse E. Updating the clinical nurse educator's job description before posting the open position

Which activities exemplify steps in the benchmarking process? Select all that apply. A. Evaluating which processes could be performed more efficiently B. Comparing current processes against those of a successful competing organization C. Testing various new models of medication administration based on staff nurse suggestions D. Implementing a new long-term staffing model because other organizations have had positive results with the model E. Assembling a team that consists of the nurse manager, staff nurse, pharmacist, and infection control to determine the best way to improve patient satisfaction

A. Evaluating which processes could be performed more efficiently B. Comparing current processes against those of a successful competing organization E. Assembling a team that consists of the nurse manager, staff nurse, pharmacist, and infection control to determine the best way to improve patient satisfaction

Which ethical principle was violated when the nurse manager switched Nurse Behar's schedule from days to nights? Case Study: Nurse Behar accepts a day-shift position at an acute care facility. After starting, Nurse Behar receives excellent evaluations and is working independently. Nurse Behar notices that the next month's schedule is for the night shift, but no one has informed Nurse Behar about the change. After asking the director and manager about it, Nurse Behar is told, "This is just how it has to be scheduled." Nurse Behar is given the choice to accept the new schedule or resign. Since the night shift is not a possibility for Nurse Behar, and since that schedule was not previously agreed on, Nurse Behar resigns and accepts a job at another facility that can provide a day-shift schedule. A. Fidelity B. Veracity C. Paternalism D. Beneficence

A. Fidelity

A nurse is developing a set of policies to determine which medical transport company should be used when making a referral to another health care facility. The nurse knows that this is an example of which component of referrals? A. Health system B. Initiating facility C. Receiving facility D. Supervision and capacity-building

A. Health system

Which is a benefit of the principle of patient-focused care with respect to the QI model? A. Instilling confidence and trust in patients B. Making informed decisions about patient safety C. Unified implementation of actions that support the organization's goals D. The ability to immediately take advantage of opportunities to enhance health care quality

A. Instilling confidence and trust in patients

Which barriers are the most significant to nursing involvement in quality improvement? A. Insufficient time B. Insufficient training C. Lack of leadership support D. Stakeholder involvement in QI E. Prohibition of nurse involvement in QI as per the accreditation process

A. Insufficient time B. Insufficient training C. Lack of leadership support

Nurse A worked in a department for 5 years with exemplary evaluations. Nurse A is very pleasant and professional on shift; however, she is not very social outside of work. Nurse B has worked in the department for the same amount of time; however, she has been written up for being rude to a patient's family and is frequently late for work. Nurse B is very popular and spends time with the nurse manager and colleagues outside of work. Both nurses apply for a leadership position, and the nurse manager awards the promotion to Nurse B. Which ethical principle is not being displayed by the nurse manager? A. Justice B. Fidelity C. Veracity D. Paternalism

A. Justice

Which situations show that Nurse May lacks competencies in her new role as a nurse manager? Select all that apply. Case Study: Nurse May is promoted by Nursing Director Wilson to a nurse manager position. She has worked in the department for many years and she has been doing very well with patients.The staff nurses complain to Nurse Wilson that they never see Nurse May and need new equipment. They also say the shift schedules are wrong and late.Nurse May is frustrated because she is always in meetings and because the budget process is confusing. She is waiting for the budget to be approved by the administration, but it is delayed because she submitted it late. Her staff doesn't get shift requests to her on time, which makes it difficult to get the schedule made on time. She doesn't want staff to know her frustrations, because she feels like she is failing. She questions why she feels very confident as a nurse doing direct patient care, but feels so out of sorts as a manager. A. Nurse May distributes the wrong schedules. B. Nurse May yields to the administration regarding budget requests. C. Nurse May has difficulty making the schedule and getting it out on time. D. Nurse May doesn't speak with staff who are upset about not having the resources they need. E. Nurse May does not want to discuss issues with staff because she wants to remain positive.

A. Nurse May distributes the wrong schedules. C. Nurse May has difficulty making the schedule and getting it out on time. D. Nurse May doesn't speak with staff who are upset about not having the resources they need. E. Nurse May does not want to discuss issues with staff because she wants to remain positive.

Which nurse educators have an understanding of their role as a follower? Select all that apply. A. One who is self-motivated and does extra research before teaching a class B. One who asks the manager about unclear directions regarding their in-service assignment C. One who offers to help a coworker who has an exceptionally large workload for the week D. One who gives a truthful opinion after being asked to review and compare reference databases the manager is thinking about purchasing for the bedside nurses E. One who recognizes that they should not question the manager regarding two conflicting policies presented in a staff meeting because it would be considered insubordination

A. One who is self-motivated and does extra research before teaching a class B. One who asks the manager about unclear directions regarding their in-service assignment C. One who offers to help a coworker who has an exceptionally large workload for the week D. One who gives a truthful opinion after being asked to review and compare reference databases the manager is thinking about purchasing for the bedside nurses

Which type of nursing-sensitive quality indicator may Nurse Jameson be breaching? Nurse Jameson is an Adult ICU nurse. She has been assigned to care for a patient admitted to the ICU 8 days ago. During the afternoon assessment, Nurse Jameson notes the following vital signs: HR 98, RR 13, BP 132/74, temperature 101.3° F, and lung sounds clear bilaterally. Upon further assessment, Nurse Jameson finds that the patient has an indwelling urinary catheter draining a cloudy fluid with a foul smelling odor. The catheter was placed in the emergency department prior to the patient being admitted to the ICU. A. Patient-centered B. Nursing-centered C. System-centered D. Community-centered

A. Patient-centered

Which statements explain the key concepts of role theory? Select all that apply. A. Role theory predicts that a nurse in a patient advocacy role will act as a change agent. B. Role theory gives managers a structural framework for writing policies related to their role. C. Role theory indicates that a nurse will assume the role of a collaborator when the context or situation requires it. D. Role theory attempts to explain why patients trust nurses to perform certain tasks based on their position or role. E. Role theory assumes that a nurse in an educator role will teach a patient how to administer insulin because that is a role expectation.

A. Role theory predicts that a nurse in a patient advocacy role will act as a change agent. C. Role theory indicates that a nurse will assume the role of a collaborator when the context or situation requires it. D. Role theory attempts to explain why patients trust nurses to perform certain tasks based on their position or role. E. Role theory assumes that a nurse in an educator role will teach a patient how to administer insulin because that is a role expectation.

A health care provider takes steps to reduce medical errors during patient care. This is an example of which National Academy of Medicine goal to enhance the quality of health care? A. Safety B. Efficiency C. Effectiveness D. Patient-centered care

A. Safety

Which statement describes the importance of the Patient Safety and Quality Improvement Act of 2005? A. Safety violations are identified more readily due to secure reporting practices. B. The impact of nursing care on patient outcomes can be quantified and recorded. C. Data can be used to monitor outcomes of care and to test specific improvement methods. D. Nurse leaders are provided with a framework for implementing procedural changes to enhance patient safety.

A. Safety violations are identified more readily due to secure reporting practices.

A nurse manager learns that a nurse has not been providing a complete report about her patient to the oncoming shift. How can the nurse's actions be classified? A. Secretive behavior B. Excessive self-disclosure C. Selective communication D. "You and me against the world" attitude

A. Secretive behavior

Mary is meeting with the rest of the Patient Services Leadership Team for the first time. The team will include which factors to facilitate successful collaboration? Select all that apply. Case Study: Mary is the nursing director at a small community hospital. Recently, the hospital has been having difficulty with poor staff morale and low patient satisfaction scores. As a result, a Patient Services Leadership Team was established, with the first goal of increasing patient satisfaction within the organization.The members of the team were the directors of the various nursing divisions, the clinical laboratory, medical imaging, respiratory therapy, pharmacy, and perioperative services. In addition to reviewing their primary goal, the team established their purpose statement, identified their values, and developed a Code of Conduct that outlined their behavioral expectations of each other. This approach using a shared leadership responsibility for the clinical services was new to them, despite having worked together for a long time.Mary agreed to be the first formal leader of the group. The team agreed that the low patient satisfaction scores may represent poor patient care and met to discuss strategies to reverse the scores. The members of the team agreed that mentoring the staff and providing extra support on the poor performing patient care units may help the staff succeed. It was agreed that each member of the team would be responsible for mentoring the staff of a different clinical area.With the team's input, Mary listed the team's mentoring responsibilities as follows: Round on the assigned department each day Help the nursing staff troubleshoot patient and family issues Coach the staff in service recovery when there are problems After one month, the team met again to discuss their results. The leadership team was pleased to learn that not only were patient satisfaction scores higher, but employee morale rose as well. A. Stakeholders B. Common interests C. Financial guarantors D. Criteria for success E. Barriers to the solution

A. Stakeholders D. Criteria for success E. Barriers to the solution

Which features of quality improvement (QI) differ from quality assurance (QA)? Select all that apply. A. Taking risks to improve overall safety B. Goal of continuous improvement over time C. A focus on assessing the quality of health care D. A focus on identifying weaknesses and preventing problems E. Relying on the leaders of the organization to solve problems

A. Taking risks to improve overall safety B. Goal of continuous improvement over time D. A focus on identifying weaknesses and preventing problems

Which actions indicate that the nurse adapts his or her role based on the situational context? Select all that apply. A. Teaching a diabetic patient about diet and suggesting that the patient meet with a diabetic educator B. Bringing a cup of coffee to the wife of a dementia patient who expresses that she feels overwhelmed C. Alerting the rapid response team after a patient displays atypical behavior and decreased level of consciousness D. Explaining caregiver fatigue and providing support group information for a patient's mother who says she is exhausted by her child's illness and feels helpless E. Explaining that caring for a parent at home may feel overwhelming after the patient's son tells the nurse he doesn't have the equipment at home to care for his father

A. Teaching a diabetic patient about diet and suggesting that the patient meet with a diabetic educator C. Alerting the rapid response team after a patient displays atypical behavior and decreased level of consciousness D. Explaining caregiver fatigue and providing support group information for a patient's mother who says she is exhausted by her child's illness and feels helpless

Which topics describe the focus of the American Nurses Association's (ANA) quality guidelines? Select all that apply. A. The ANA develops and monitors core measures. B. The ANA monitors the number of extra hours nurses work. C. The ANA reviews links between nursing care and patient outcomes. D. The ANA develops and monitors National Patient Safety Goals (NPSGs). E. The ANA oversees the proper storage and labeling of dangerous substances.

A. The ANA develops and monitors core measures. B. The ANA monitors the number of extra hours nurses work. C. The ANA reviews links between nursing care and patient outcomes.

Which organizations maintain databases with nursing-sensitive data to be used for improving health care outcomes? Select all that apply. A. The Joint Commission B. American Nurses Association C. California Nursing Outcomes Coalition D. American Nurses Credentialing Center E. United States Department of Veterans Affairs

A. The Joint Commission B. American Nurses Association E. United States Department of Veterans Affairs

How have perspectives of managing health care quality evolved over time? A. The approach has become more proactive. B. The focus has shifted to a more traditional means of error reporting. C. The burden of monitoring quality has shifted from the group to the leader. D. The focus has shifted to comparing care against a predetermined standard.

A. The approach has become more proactive.

Which of the following are overseen by the National Council of State Boards of Nursing (NCSBN)? Select all that apply. A. The design of the NCLEX-RN B. Classroom teaching and in-service education programs C. Regulations about tasks for advanced practice nurses (APN) D. Research related to the supply of nurses in the United States E. Education about the importance of state-level nurse licensure

A. The design of the NCLEX-RN D. Research related to the supply of nurses in the United States E. Education about the importance of state-level nurse licensure

Which factors must be considered when delegating tasks to a delegatee? Select all that apply. A. The experience of the potential delegatee B. The best way to explain the delegated task C. The specific task that needs to be performed D. The person who was last delegated a similar task E. The patient's preference for who should complete the task

A. The experience of the potential delegatee B. The best way to explain the delegated task C. The specific task that needs to be performed

A nurse is developing an interprofessional collaborative team for the health care unit. It is important for the nurse to provide which information to the other team members? Select all that apply. A. The goals of the team and criteria for success B. The major financial benefactors of the health care facility C. Potential barriers to the creation of the collaborative team D. The process of the task and the most responsible person to perform it E. Information about the professional expertise of the other members of the team

A. The goals of the team and criteria for success C. Potential barriers to the creation of the collaborative team D. The process of the task and the most responsible person to perform it E. Information about the professional expertise of the other members of the team

Which are provisions of the Code of Ethics for Nursing? Select all that apply. A. The nurse advances the profession through research. B. The nurse promotes health by teaching a nutrition class. C. The nurse advocates for the patient by calling a rapid response team. D. The nurse practices with compassion when caring for a patient who is receiving comfort care. E. The nurse respects the health care provider by not bothering them late at night for pain medication orders.

A. The nurse advances the profession through research. B. The nurse promotes health by teaching a nutrition class. C. The nurse advocates for the patient by calling a rapid response team. D. The nurse practices with compassion when caring for a patient who is receiving comfort care.

A patient reports to the nurse manager being upset about the care she received: "A nurse or nursing assistant came in here without knocking or introducing herself, and just left when she was done giving me my medications." Which factors regarding the nurse's role expectations are likely the reason the patient is upset? Select all that apply. A. The nurse does not knock before entering the room or introduce herself. B. The patient is unsure of the role of the person administering his or her medications. C. The nurse does not educate the patient about which medications she is administering. D. The patient does not think the nurse is the appropriate person to administer the medication. E. The patient does not know if she was given new medications or if she should be aware of adverse reactions.

A. The nurse does not knock before entering the room or introduce herself. B. The patient is unsure of the role of the person administering his or her medications. C. The nurse does not educate the patient about which medications she is administering. E. The patient does not know if she was given new medications or if she should be aware of adverse reactions.

Which are purposes of the Code of Ethics for Nurses? Select all that apply. A. To explain the key ethical issues or concerns of the profession B. To provide ethical guidelines for the development of ethics committees C. To provide specific patient examples of ethical code breaches to the public D. To give members of the health care profession guidelines for their practice E. To explain the minimum standards of conduct by the health care profession to the public

A. To explain the key ethical issues or concerns of the profession D. To give members of the health care profession guidelines for their practice E. To explain the minimum standards of conduct by the health care profession to the public

How is a check sheet used when making organizational improvement decisions? A. To record raw data B. To evaluate performance C. To weigh multiple options D. To compare a single dataset

A. To record raw data

Which standards are included in the American Nurses Association's (ANA) Nursing: Scope and Standards of Practice? Select all that apply. A. Using job descriptions for performance appraisals B. Classroom and in-service programs for continuing education C. Certification and credentialing of nurses in specialty areas, such as critical care D. Quality improvement initiatives to help improve patient experiences and outcomes E. The explanation of compact state licensure and nursing examination requirements

A. Using job descriptions for performance appraisals B. Classroom and in-service programs for continuing education C. Certification and credentialing of nurses in specialty areas, such as critical care D. Quality improvement initiatives to help improve patient experiences and outcomes

Which set of data should be represented using a simple bar graph? A. A comparison of errors per nurse per month in 2010 B. A comparison of nursing turnover under two different nurse managers C. The identification of the most likely cause of increased falls over the last year D. The identification of the best food supplier based on cost effectiveness and patient preference

B. A comparison of nursing turnover under two different nurse managers

A nursing instructor asks a student to provide an example of a leader demonstrating modern leadership trait theory. Which leader described by the student demonstrates trait theory? A. A charge nurse who adapts well to situations. The staff has a great degree of trust and respect for the charge nurse. B. A nurse manager who has drive, integrity, and motivation and inspires staff toward a common goal of excellent patient care. C. A nurse manager who wants staff to conform to the manager's preferences. Good behavior is rewarded with incentives like a pizza party. D. A director of nursing (DON) who empowers staff, holds high morals and integrity, and encourages intellectual conversation with staff.

B. A nurse manager who has drive, integrity, and motivation and inspires staff toward a common goal of excellent patient care.

A project was initiated to decrease the number of patient falls on the geriatric unit by installing additional temporary hand rails in all patient rooms. After a 3-month trial period, the number of patient falls did not decrease. What is the next step in the quality improvement (QI) process to address patient falls? A. Do B. Act C. Plan D. Study

B. Act

Which ethical principle is displayed when a nurse respects a patient's informed decision to refuse a life-saving blood transfusion? A. Veracity B. Autonomy C. Beneficence D. Nonmaleficence

B. Autonomy

The nurse leader, using the quality improvement (QI) process, proposes modifications to health care delivery on the unit to increase efficiency. Which step should the nurse leader take first? A. List five strategies to increase efficiency on the unit. B. Determine areas of care needing improved efficiency. C. Hire more nurses to provide patient care more efficiently. D. Attend an annual conference on efficiency in health care.

B. Determine areas of care needing improved efficiency.

Which requirements does the nurse follow to be in compliance with the Occupational Safety and Health Administration (OSHA) Act of 1970? Select all that apply. A. The implementation of core measures B. Ensure the proper handling of bodily fluids C. Utilize isolation-specific precaution procedures D. Proper storage and labeling of dangerous substances E. Develop procedures related to patient privacy when conducting research

B. Ensure the proper handling of bodily fluids C. Utilize isolation-specific precaution procedures D. Proper storage and labeling of dangerous substances

Which action can organizations take to enhance patient safety? A. Handling errors internally so as not to alarm the community B. Implementing standards for health care provider performance C. Allowing more freedom to treat patients by easing regulatory policies D. Fostering a team mentality by discouraging error reporting on colleagues

B. Implementing standards for health care provider performance

A nurse manager is introducing an initiative to improve interprofessional collaboration on the patient care unit. One of the staff nurses asks how improving collaboration will improve staff satisfaction. How does the manager reply? Select all that apply. A. Reduces medical errors B. Improves communication C. Reduces burnout among staff D. Promotes the effective use of health resources E. Helps to build cohesion among the team members

B. Improves communication C. Reduces burnout among staff E. Helps to build cohesion among the team members

Hospital team members teach the staff to work more efficiently without sacrificing patient care. Which health care initiative is this hospital using? A. Quality improvement (QI) B. Performance improvement (PI) C. Total quality management (TQM) D. Continuous quality improvement (CQI)

B. Performance improvement (PI)

The nurse manager is concerned that charting is not being completed correctly by the nurses. The nurse manager should use which audit tool to evaluate this problem? A. Peer audits B. Process audits C. Concurrent audits D. Retrospective audits

B. Process audits

Which statement describes the Family Medical Leave Act (FMLA)? A. The act was created to make age discrimination by employers illegal. B. The act was created to ensure employee job security due to illness or the birth of a baby. C. The act was created to outline exceptions to employment laws regarding hiring and termination. D. The act was created to help millions of uninsured Americans obtain health insurance for themselves or their families.

B. The act was created to ensure employee job security due to illness or the birth of a baby.

A nurse in a long-term care facility is going through a rough divorce. One of her patients notices that the nurse has red eyes, is quiet, and is distracted. The patient asks the nurse if she is okay, and the nurse proceeds to tell the patient about her divorce. Why might this cause the nurse manager to be concerned?term-12 A. The nurse is at risk of a boundary violation by having a secret discussion with her patient. B. The nurse is at risk for a boundary violation by sharing personal information with a patient. C. The nurse is at risk of a boundary violation by giving this patient more attention than others. D. The nurse is at risk of a boundary violation by not protecting her patient and not asking to be removed from the case.

B. The nurse is at risk for a boundary violation by sharing personal information with a patient.

Which action provides evidence the nursing director relies on the laissez-faire leadership model? A. The nursing director does not request input from the nursing staff. B. The nursing director lets a staff nurse who has issues with the charge nurse work out the issues. C. The nursing director writes up an orienting nurse because of a medication error, but does not investigate process errors that led to the error. D. The nursing director asks the charge nurse to leave a patient's room during an emergency because no one is at the nurse's station to answer phones.

B. The nursing director lets a staff nurse who has issues with the charge nurse work out the issues.

An emergency department nurse is talking on the phone with a friend and misses the signs and symptoms of a ruptured ovarian cyst in a patient. Where would this relationship be plotted on the continuum of professional behavior? A. Overinvolvement B. Underinvolvement C. Therapeutic relationship D. Failure to protect the patient

B. Underinvolvement

Which statements are myths about leadership and management? Select all that apply. A. "Leadership is future-oriented." B. "The manager's main focus is on compliance." C. "All administrators or managers are classified as leaders." D. "If a nurse is good with patients, he or she can be a leader." E. "People with leadership traits need to be competent to lead effectively."

C. "All administrators or managers are classified as leaders." D. "If a nurse is good with patients, he or she can be a leader."

A nurse manager is disciplining a nurse for poor behavior. The nurse asks why teamwork is so important. Which response by the nurse manager is best? A. "It is a skill that is only used by nursing staff." B. "It helps to reduce health care costs to the consumer." C. "Most patients consider it as a basic prerequisite of care." D. "It indicates a shared mutual respect for other team members."

C. "Most patients consider it as a basic prerequisite of care."

How is a moral or ethical dilemma defined? A. A use of rules or legal obligations to reach a difficult decision B. A dilemma that always requires the utilization of an ethics committee C. A circumstance when a decision has to be made between two undesirable possibilities D. A situation that requires a nurse to decide who should make a choice between two available options

C. A circumstance when a decision has to be made between two undesirable possibilities

A nurse manager is looking to hire a nurse facilitator to promote the collaborative process on the stroke unit. All candidates have similar years of experience in the field. Which candidate should the nurse consider? A. A nurse who avoids conflict B. A nurse who specializes in critical care C. A nurse who has excellent communication skills D. A nurse who has primarily worked autonomously in home health care

C. A nurse who has excellent communication skills

A nurse is offered her "dream job" in another department, and her current nurse manager encourages her to take the new position. Which ethical principle did the nurse manger display? A. Veracity B. Autonomy C. Beneficence D. Nonmaleficence

C. Beneficence

The nurse draws two sets of blood cultures at least 20 minutes apart for every blood draw because this procedure has been shown to be the most accurate way to obtain blood cultures. Which feature of quality improvement does this action represent? A. Indicator B. Benchmarking C. Best practices D. Standardized tools

C. Best practices

The Quality Coordinator requests a meeting with Nurse Roulo and the unit's charge nurse. The Coordinator states, "If we cannot lower our incidence rate of urinary tract infections (UTIs), the center may lose funding." Nurse Roulo puts together a team to determine how best to decrease the number of UTI occurrences. What is the next action by Nurse Roulo? Case Study: Nurse Roulo, the nurse manager, notices an increase in urinary tract infections (UTIs) in patients with Foley catheters and asks a staff nurse to determine the cause. Nurse Roulo does a chart review of all patients with UTIs in the past 6 months and documents that 40% of the patients with Foley catheters developed a UTI. A. Determine necessary improvements B. Assess the need for additional staff training C. Collect data on best practices for Foley catheter use D. Request that staff nurses remove Foley catheters within 24 hours

C. Collect data on best practices for Foley catheter use

A nurse is preparing a patient for discharge and is looking to make community referrals to better support the patient's recovery. What should the nurse do as the first step of this process? A. Contact the social worker to take over care of this patient B. Consult the policies and procedures about making community referrals C. Determine the patient's existing home and community resources D. Check the list of patient-sensitive resources that was developed by the nurse manager

C. Determine the patient's existing home and community resources

Which statement describes a concurrent audit? A. Assesses the result of patient care B. Completed after the patient is discharged C. Implemented while the patient is receiving care D. Evaluates the implementation of nursing procedures

C. Implemented while the patient is receiving care

Mary wishes to continue the success of the patient services leadership team with other units. The team agrees to create a new position to assist other patient units in working with each other, the patient, and the family. What is the best title for this new position? Case Study: Mary is the nursing director at a small community hospital. Recently, the hospital has been having difficulty with poor staff morale and low patient satisfaction scores. As a result, a Patient Services Leadership Team was established, with the first goal of increasing patient satisfaction within the organization.The members of the team were the directors of the various nursing divisions, the clinical laboratory, medical imaging, respiratory therapy, pharmacy, and perioperative services. In addition to reviewing their primary goal, the team established their purpose statement, identified their values, and developed a Code of Conduct that outlined their behavioral expectations of each other. This approach using a shared leadership responsibility for the clinical services was new to them, despite having worked together for a long time.Mary agreed to be the first formal leader of the group. The team agreed that the low patient satisfaction scores may represent poor patient care and met to discuss strategies to reverse the scores. The members of the team agreed that mentoring the staff and providing extra support on the poor performing patient care units may help the staff succeed. It was agreed that each member of the team would be responsible for mentoring the staff of a different clinical area.With the team's input, Mary listed the team's mentoring responsibilities as follows: Round on the assigned department each day Help the nursing staff troubleshoot patient and family issues Coach the staff in service recovery when there are problems After one month, the team met again to discuss their results. The leadership team was pleased to learn that not only were patient satisfaction scores higher, but employee morale rose as well. A. Head nurse B. Nurse manager C. Nurse facilitator D. Nurse practitioner

C. Nurse facilitator

Which tool should the nurse manager use to identify the most frequent cause of incident reports over the last month? A. Run chart B. Histogram C. Pareto chart D. Decision matrix

C. Pareto chart

The health care team decides to withhold a terminal diagnosis from a patient until the consulting psychiatrist develops a treatment plan. This is an example of which ethical principle? A. Justice B. Fidelity C. Paternalism D. Respect for others

C. Paternalism

A nurse has learned that a patient has been referred to another facility. Which intervention should the nurse anticipate performing? A. Plan for rehabilitative care B. Write the back referral information C. Prepare the referral documentation D. Locate a medical transport company

C. Prepare the referral documentation

The orthopedic unit has had an increase in medication errors in the past year. As a result, the clinical nurse manager and director have been terminated, and more experienced candidates have filled their roles. Which model of health care quality does this situation exemplify? A. Lean B. Six Sigma C. Quality assurance D. Clinical microsystems

C. Quality assurance

Which is an example of a standard used in benchmarking? A. Reducing the number of patients with heart failure readmitted to the hospital by 15% B. Reducing urinary catheter-related infections by decreasing the number of urinary catheters used C. Reducing medication errors in hospitalized patients to an acceptable rate determined by Medicare D. Reducing pressure ulcers in hospitalized patients to an acceptable number determined by the hospital president

C. Reducing medication errors in hospitalized patients to an acceptable rate determined by Medicare

Which graphic tool should be used to determine if the age of a nurse influences the effectiveness of discharge teaching? A. Pie chart B. Histogram C. Scatter diagram D. Cause-and-effect diagram

C. Scatter diagram

Match the nursing role with the appropriate role expectation. Checking the crash cart as requested by the charge nurse Recognizing that a patient is allergic to an antibiotic and referring accordingly Consulting diabetic educator to ensure that the patient has a glucometer - Manager - Follower - Leader

Checking the crash cart as requested by the charge nurse - Follower Recognizing that a patient is allergic to an antibiotic and referring accordingly - Leader Consulting diabetic educator to ensure that the patient has a glucometer - Manager

How would the nurse explain the main function of the National Council of State Boards of Nursing (NCSBN) to a colleague? A. "The NCSBN provides a reference for quality improvement initiatives." B. "The NCSBN provides a reference for position descriptions and performance appraisals." C. "The NCSBN sets guidelines related to activity, duty, or tasks that nurses are able to perform." D. "The NCSBN sets guidelines to ensure that all state boards collaborate and that nursing licensure examinations are consistent."

D. "The NCSBN sets guidelines to ensure that all state boards collaborate and that nursing licensure examinations are consistent."

A nurse manager is setting goals for the unit, which includes working towards interdependency and power-sharing. The nurse knows that these are characteristics of which type of environment? A. Teamwork B. Cooperation C. Competency D. Collaboration

D. Collaboration

A nurse leader reviews the Code of Ethics for Nurses to decide if a situation is an ethical dilemma. Which role in the ethical dilemma framework is the nurse leader acting within? A. Advocate B. Collaborator C. Policymaker D. Decision-maker

D. Decision-maker

A nurse is reviewing the established referral policy. The other staff nurses are complaining about repeated phone calls from patients asking for phone numbers of their other providers. What is one action that the nurse can consider to help alleviate this concern? A. Hire a part-time assistant to answer these phone calls. B. Create a one-time list of resources that can be placed on the Web site. C. Make a new policy to stop making formal referrals to other providers. D. Develop a written provider resource list, and follow up with patients about their experiences.

D. Develop a written provider resource list, and follow up with patients about their experiences.

The local community hospital will be offering a new insurance program for residents. The hospital should seek accreditation status with which organization? A. TJC B. RWJF C. ANCC D. NCQA

D. NCQA

A nurse manager tells the nurse that he has to stop acting up and being lazy on shift, or he will be fired. The discussion occurs in front of the whole department, and the nurse manager's tone is condescending and demeaning. The nurse manager does not give any guidance or constructive feedback. Which ethical principle is the nurse manager not upholding? A. Fidelity B. Veracity C. Paternalism D. Nonmaleficence

D. Nonmaleficence

Which are benefits that come from an effective referral system? Select all that apply. A. Less expensive care B. Better living facilities C. Greater family support D. Provision of optimal care E. Appropriate use of the hospital

D. Provision of optimal care E. Appropriate use of the hospital

The nurse manager is analyzing patient outcomes after knee replacement surgeries, so the nurse manager collects data on all patients who have had knee replacement surgery five years after discharge. Which type of audit is the nurse manager conducting? A. Process audit B. Concurrent audit C. Peer review audit D. Retrospective audit

D. Retrospective audit

Which strategy for collecting data should the nurse apply when evaluating nursing outcomes? A. Evaluating the skill mix on the unit during each shift B. Assessing the departmental turnover rate in the last quarter C. Observing the number of patients who are in restraints for more than 24 hours D. Reviewing the number of patients with heart failure who have quit smoking after receiving counseling

D. Reviewing the number of patients with heart failure who have quit smoking after receiving counseling

Which describes the purpose of the American Nurses Association's (ANA) Nursing: Scope and Standards of Practice? A. To ensure the proper issuance of nursing licenses B. To ensure consistency of nursing licensure examinations in all states C. To direct collaboration among states so nurses can hold a multistate license D. To provide a reference to nurses at all levels regarding competencies within all settings and specialties

D. To provide a reference to nurses at all levels regarding competencies within all settings and specialties

Which scenario is an example of how benchmarking can improve patient care? A. To reduce the number of teenagers who smoke, nurses go to 50% of high schools and show a lung affected by cancer. B. To reduce the risk of injury from car accidents for children older than 10 years, the school nurse creates a brochure about the benefits of seatbelts. C. To reduce the readmission rate of patients with heart failure, nurses educate patients to weigh themselves daily and call their health care provider if they have a 2 lb weight gain in a 24-hour period. D. To reduce the risk of pneumonia in patients older than 50 years, nurses ensure that 90% of patients receive the pneumonia vaccine. The team monitors patient records to determine if this goal is met.

D. To reduce the risk of pneumonia in patients older than 50 years, nurses ensure that 90% of patients receive the pneumonia vaccine. The team monitors patient records to determine if this goal is met.

Which scenario describes the use of core measures for benchmarking? A. Giving all patients who have had pneumonia a prescription for home oxygen so they will breathe better and not feel short of breath B. Adding more fresh fruits and vegetables to the patient's dining choices to decrease the rate of obesity among the adult population C. Hiring additional renal specialists to treat the number of patients with kidney disease and decrease the number of patients who will need a kidney transplant D. Training more nurses to review discharge instructions for patients with congestive heart failure to decrease the readmission rate of these patients

D. Training more nurses to review discharge instructions for patients with congestive heart failure to decrease the readmission rate of these patients

Match the components of the ethical decision-making framework with the appropriate definition. Develop possible options or solutions Find the problem and decide if it represents a dilemma Review and document the process, actions, and outcomes Decide how to carry out the decision or delegate the actions - Assessment - Development - Organization - Planning

Develop possible options or solutions - Development Find the problem and decide if it represents a dilemma - Organization Review and document the process, actions, and outcomes - Planning Decide how to carry out the decision or delegate the actions - Assessment

Match the nurse role to the appropriate traits. Identifies recurring problems Works well with others and speaks with integrity Critical thinker, future oriented, and creative problem-solver - Leader - Manager - Follower

Identifies recurring problems - Manager Works well with others and speaks with integrity - Follower Critical thinker, future oriented, and creative problem-solver - Leader

Match the leadership theory with its description. Leads by example and encouragement Acclimates to determine the best action for the circumstance Hypothesizes whether reliability and poise are taught or instinctive Focuses on employee compliance through incentives and penalties - Transformational theory - Transactional theory - Situational contingency theory - Trait theory

Leads by example and encouragement - Transformational theory Acclimates to determine the best action for the circumstance - Situational contingency theory Hypothesizes whether reliability and poise are taught or instinctive - Trait theory Focuses on employee compliance through incentives and penalties - Transactional theory

Match the specific nursing role assumption to the appropriate expectation. Performing a dressing change Advising a patient's wife to join a caregiver group Showing the family how to perform a dressing change Calling in suspected abuse of an older adult patient - Patient advocate - Educator - Provider of care - Counselor

Performing a dressing change - Provider of care Advising a patient's wife to join a caregiver group - Counselor Showing the family how to perform a dressing change - Educator Calling in suspected abuse of an older adult patient - Patient advocate

Match the example with the correct central component of role theory. The position of nurse manager Communicates with staff professionally Financial management through conservation of linens - Role enactment - Assumption of social roles - Role expectations

The position of nurse manager - Assumption of social roles Communicates with staff professionally - Role expectations Financial management through conservation of linens - Role enactment