unit 9 phaarm
15 A healthcare organization directed and financed by public funds, answering directory to a sponsoring agency or board, and indirectly to elected officials, would be classified as:
A public institution
A mission statement is:
A statement of purpose or reason for being which identifies types of services offered
The Clinical Nurse Leader graduate has many required competencies. Some of these competencies include (select all that apply):
Collaboration with healthcare professionals.Coordination of the patient care services across the continuum. Assessment of risk and quality issues to prevent patient injury and assure safety and quality.
48. The Joint Commission found that approximately 70% of sentinel events could be attributed to which of the following:
Communication
Private, nongovernmental healthcare organizations may be either for-profit or not-for profit. This designation refers to the:
Tax status of the organization and specifies how profits will be spent.
Nursing is the protection promotion and optimization of health and abilities prevention of illness and injury alleviation of suffering through diagnosis and treatment of human response and advocacy in the care of individuals families communities and populations as defined by,
The American Nurses Association
This individual defines quality in healthcare:
The customer
An operating budget it:
The financial plan for day-to-day activities of the organization
Cost-conscious nursing practices include (select all that apply):
Understanding what is required to remain financially sound Knowing costs and reimbursement practices Predicting and using nursing resources effectively
These reports compare what occurred to what was budgeted:
Variance reports
When healthcare organizations merge, they can merge with non-hospital organizations such as medical instrument manufacturers. This type of merger is known as:
Vertical merger or integration
Refers decisions being made at the top hierarchy of authority.
centralization
The degree to which policies and procedures define member function.
formalization
16 It is important for all patients with a diagnosis of diabetes to be taught how to monitor:
glucose levels using a point of care glucose monBlooditor
The SBAR system of communications is one of the most used communication systems in health care because:
it honors a familiar, structured transfer of information among health professionals.
10 This type of healthcare organization is known to have a length of stay greater than 30 days and the population served have chronic health issues that require some level of skilled care.
Long-term care
This is the number of personnel (RNs, LPNs, unit secretary, and charge nurse) required to meet the daily patient care demands for a projected number of patients expected to be on and admitted on each unit as of midnight:
Staffing matrix
A capital expenditure budget is:
A budget that reflects the purchase of major capital items with a useful life of greater than one year and exceed the cost level specified by the organization.
49. Per OSHA guidelines employers have a duty to provide employees with:
A hazard free workplace
18 Nancy is a staff nurse who works in a rehabilitation hospital. The average length of stay within this hospital is 42 days. This hospital would most likely be classified as:
A long-term care hospital
76. The American Association of Colleges of Nursing's White Paper (2007) described the competencies that a CNL will execute. These competencies included the following actions (select all that apply):
Accountable for health care outcomes within a unit and in line with the meso- and macro-systems goals Assimilates and applies research-based information to design, implement, and evaluate client plans of care Synthesize data, information, and knowledge to evaluate and achieve optimal client and care environment outcomes through measure of unit outcomes
25 The approval, recognition, or certification by an official review board that an organization has met specified standards is known as:
Accreditation
23 A healthcare organization provides women's health services on an inpatient basis (average stay of less than 30 days). This organization would be considered which of the following:
Acute care, specialized
3.Acute care hospitals exist throughout the world. These organizations have common characteristics that include (select all that apply):
Acute episodic care is delivered Length of stay is usually greater than 30 days The average length of stay is less than 30 days
The acuity or severity of a patient's conditions is influenced by several factors. These include (select all that apply):
Age Primary diagnosis and other co-morbidities Treatment stage
50. The professional nursing association which represents all Registered Nurses in the
American Nurses Association
2.Select the best response to the following description: A collection of individuals brought together in a defined environment to achieve a set of predetermined objectives is known as:
An organization
Nurse managers who are financial thinkers develop benchmarking systems using data to evaluate unit staffing and productivity. These data may include (select all that apply):
Average daily census on the unit- average number of patients cared for per day for a reporting period Percentage of occupancy on the unit - the patient census divided by the number of beds on the unit Average length of stay on the unit - the number of patient days in a specific time period divided by the number of discharges in that same period
75. Establishing clear purpose, using active listening, being compassionate, telling the truth, being flexible, and committing to resolution are included in:
Basic rules to create synergy
52. Nurse managers need the following to accurately interpret budget variances (select all that apply):
Budgeted performance, personnel costs, and supply costs, that were budgeted for the specified period of activity.
Which of the following statements best defines an accomplished effective team:
Can create a form of synergism in which the outcome is greater than the sum of the individual performances.
Characteristics of organizational structures include the following (select all that apply):
Chain of command depicted by the vertical dimensions of the organizational chart Organizational charts are graphic depiction of organizational positions and persons within those positions.
Outcomes which are relevant measures of knowledge, skills, abilities, and traits or motives are defined as:
Competencies
Two advantages of competency modeling over traditional job design and analysis methods include (select all that apply):
Competency modeling allows for more flexible and general job descriptions for employees. Competency descriptions could be more easily made universal and tied to corporate strategy.
4.Theories that are applicable to understanding healthcare organization include (select all that apply):
Complexity Theory Chaos Theory Systems Theory
26 To participate in Centers for Medicare and Medicaid (CMS) and receive payment, organizations must be certified as complying with:
Conditions of participation
14 A patient admitted to the hospital through the emergency department is experiencing ventricular tachycardia and the doctor has ordered the administration of amiodarone (Cordarone) intravenously. To provide a safe environment, the nurse ensures which specific item is implemented prior to administration of the medication?
Continuous cardiac monitoring
Four major payment methods are used for reimbursing healthcare providers and include (select all that apply):
Cost-based reimbursement Flat-rate reimbursement Capitated payments
There are several performance appraisal methods which include the following (select all that apply):
Critical incident methods Management by objectives Graphic rating scales and behaviorally anchored rating scales
Decision making where the work is done.
Decentralization
9 Healthcare costs are based on a prospective payment system devised in the late 1970s and implemented throughout the United States in the 1980s. This system is based on the determination of costs organized around:
Diagnosis Related Groups
7 Complexity theory encourages people to lead, manage, and follow in a number of ways. These include (select all that apply):
Encourage "bottoms-up" non-hierarchical interactions among workers. Focus on emergence ("creative, innovative response, "thinking outside the box") Think systematically - Think big picture, develop short- and long-term objectives using measurable data to measure effect (we see what is measured), and recognizing the dynamic interdependence in healthcare systems and life.
71. Performance appraisals should be conducted on an ongoing basis and are used to (select all that apply):
Encourage improvement in the performance of employees whose work is at the minimum acceptable level Encourage employees with outstanding performance to maintain that level.
In 2013, The Registered Nurse Safe Staffing Act was introduced in the US congress. This act requires all acute care hospitals to (select all that apply):
Establish a committee made up of 55% direct care RNs Establish upwardly adjustable minimum ratios of direct care to patient for each unit and shift
17 When educating patients on monitoring their blood glucose it is important to share that the following may result in inaccurate results (select all that apply):
Failing to cleanse the finger thoroughly after eating a glazed donut Not allowing the cleansing agent to dry before taking blood sample using water as a sample Not calibrating the monitor or conducting high and low tests as recommended.
72. This should be given to employees at the time closest to positive and negative incidents being evaluated:
Feedback
45. Research has indicated that nurse turnover (nurses leaving organizations) has been directly related to staffing concerns. Staffing concerns that have caused nurses to leave their positions include (select all that apply):
Frequent inadequate Registered Nurse staffing Mandatory overtime Frequent mandatory floating to other units to balance staffing needs
Three types of organizational structures are often noted in health care organizations and include (select all that apply):
Functional structures Service-line structures Matrix structures
8 Three of the four largest methods of financing health care include (select all that apply):
Government financing Private insurance companies Individuals
6 A collection of individuals brought together in an organized environment to provide healthcare services to people in need is known as:
Healthcare organization
5. Major changes in healthcare that have an impact on professional nursing practice include the following (select all that apply):
Inflated cost of health care supplies and equipment The Patient Protection and Affordable Care Act The changing demographics of the population
Two leading contributors to escalating health care costs include (select all that apply):
Inflation noted in health care product/supply and drug cost Administrative inefficiency
This organization provides accreditation programs for ambulatory care, behavioral health care, acute care and critical access hospitals, laboratory services, long-term care, and hospital-based surgery:
Joint Commission
Cost-conscious nursing practices include (select all that apply):
Knowing costs and reimbursement practices and understanding what is required to remain financially sound Using time efficiently and capturing all charges in a timely fashion Meeting patient needs using research and best evidence
There are numerous strategies shaping the evolving healthcare delivery system. These strategies include the following (select all that apply):
Managed care that includes both service and finance Organized delivery systems (networks or organizations made up of providers and payers Competition based on price, patient outcomes, and service quality
A major focus in nursing collective bargaining agreements (CBA) is:
Mandatory overtime
19 These institutions are required to provide healthcare services regardless of a person's ability to pay for services and are referred to as voluntary agencies controlled by voluntary boards:
Non-profit or not-for-profit healthcare institutions
13 You are the nurse manager of a nursing service organization that provides around-the-clock care to clients in their homes. To achieve maximum reimbursement for a client who is recovering from a hip replacement, the nursing staff most likely will follow the nursing care guidelines presented in:
Nursing care plan
Organizational theory focuses on the study of how organizations and their component parts act and interact.
Organizational theory development focuses on factors such as (select all that apply): Organizational culture Organizational technology Organizational structure and development
20 To prepare for the orientation of newly hired nurses, the nurse manager plans a presentation outlining the concept of healthcare networks. Healthcare networks are:
Organizations that provide a full spectrum of services within their network.
11. Improving care across the continuum requires inclusion of the following (select all that apply):
Patient and family engagement Tools for effective self-management of chronic conditions Health education for disease and medication management
The prototype evaluation and factor evaluation systems are used primarily in acute care settings to provide tools and language to describe the acuity of patients on units to determine staffing needs and are known as:
Patient classification systems
51. The metaparadigm of nursing includes these four concepts:
Person, health, environment, and nurse
Whether healthcare organizations are for-profit or not-for-profit, it is essential that both structures achieve this for sustainability:
Profitability
The National Database of Nursing Quality Indicators is a national nursing database that does the following (select all that apply):
Provides benchmarking reports comparing 18 quality indicators
The Agency for Healthcare Research and Quality (AHRQ) has shown that adequate staffing levels have been shown to (select all that apply):
Reduce medical and medication errors Decrease patient complications and mortality Reduce nurse fatigue and burnout
40. Research supports that having the appropriate number of this personnel type in healthcare impacts the outcomes of patients.
Registered Nurses
74. The RN who completes additional academic education and becomes an advanced practice registered nurse takes on a new role. This process is referred to as:
Role acquisition
This is a function of implementing the staffing plan by assigning unit personnel to work specific hours and days of the week:
Scheduling
Communication is essential in effective teams. SBAR was designed to help communication and stands for which of the following:
Situation, background, assessment, recommendation/request
12 Primary care, which is first access care, secondary care which is disease restorative care, and tertiary care which is rehabilitative care or long-term care are collectively known as:
Spectrum of care
One of the primary roles of the nurse manager is planning for hiring and deploying qualified human resources to meet the needs of a group of patients which is known as:
Staffing
