Exam 1 Practice Questions

a. Presenting the research evidence that supports the change

A change in the skills mix has been proposed at a care facility. What action by the nurse-manager would best support a rational-empirical change strategy? a. Presenting the research evidence that supports the change b. Publicizing the change to generate enthusiasm c. Appointing "champions" to ensure communication throughout the change process d. Ensuring that employees know the consequences of resisting

a. the effect of diagnosis-related groups.

A client was treated in the hospital for a stroke and was the client's family members assert that the client was discharged too early and did not receive sufficient rehabilitation. The client's early discharge may have been attributable to: a. the effect of diagnosis-related groups. b. a sentinel event. c. the application of total quality management. d. deliberate malpractice.

d. The CNS does not have formal authority over other staff members.

A clinical nurse specialist (CNS) is included on a hospital department's organizational chart. However, there are no solid lines leading to or from the nurse's position on the chart. What does this imply? a. The CNS lacks productive relationships with colleagues. b. Any member of staff may exercise authority over the CNS. c. The CNS is not accountable for his or her practice. d. The CNS does not have formal authority over other staff members.

c. The philosophy is reflected in the care that clients and families receive.

A health-care organization has adopted a new philosophy statement. What observation best shows that the philosophy is being implemented? a. The philosophy is displayed prominently in client care areas and staff areas. b. The philosophy aligns with the organization's vision and mission. c. The philosophy is reflected in the care that clients and families receive. d. The philosophy was created by an interdisciplinary group that included nurses.

a. Expanding the use of computerized physician-provider order entry c. Ensuring that hospital referrals are evidence-based d. Utilizing the National Quality Forum-endorsed Safe Practices scores e. Ensuring that adequately trained intensive care physicians are easily accessible

A health-care organization has experienced a rise in medical errors and has committed to implementing Leapfrog initiatives. What aspects of health care should the organization address? Select all that apply. a. Expanding the use of computerized physician-provider order entry b. Increasing the budget for continuing education for nurses c. Ensuring that hospital referrals are evidence-based d. Utilizing the National Quality Forum-endorsed Safe Practices scores e. Ensuring that adequately trained intensive care physicians are easily accessible

c. Increased effectiveness of client care

A health-care organization has undergone an organizational restructure that increases nurses' autonomy and empowerment. What effect is most likely?a. Increased interdisciplinary collaboration b. Increased communication c. Increased effectiveness of client care d. Increased client autonomy

a. A decision can be made at the lowest practical managerial level.

A health-care organization utilizes decentralized decision making. What will most likely happen when there is need for decisions to be made in the organization? a. A decision can be made at the lowest practical managerial level. b. The decision will be made by top-level managers. c. There is a potential that the decision will be made too quickly. d. It will be unclear who is ultimately accountable for the decision.

c. Purchasing a computerized physician-provider order entry system

A hospital is using the guidelines of the Leapfrog Group to inform safety improvements in the organization. What action will best incorporate these guidelines? a. Replacing practical nurses with registered nurses whenever possible b. Eliminating the use of high-risk medications and increasing the role of pharmacists c. Purchasing a computerized physician-provider order entry system d. Converting shared rooms to single-occupant rooms

a. Systemic flaws in health-care delivery

A hospital system is trying to address some of the deficits in care that were described in To Err Is Human. When addressing the errors that this report identified, the hospital's leaders should focus on what factor? a. Systemic flaws in health-care delivery b. Malice on the part of some health-care providers c. Lack of education for health-care workers d. Increased use of nursing assistive personnel

d. Include subordinates early in the process and include them in all aspects of policy formation.

A leader has launched an organizational planning process that requires the development of new policies. How should the leader utilize subordinates during this process? a. Delegate the evaluation phase of organizational planning to subordinates. b. Ask subordinates to brainstorm alternatives and then have industry experts evaluate each alternative. c. Limit the involvement of subordinates to developing unit-level policies and procedures. d. Include subordinates early in the process and include them in all aspects of policy formation.

b. Emotions are used effectively.

A leader is applying the principles of emotional intelligence? What outcome indicates successful application of these principles? a. Emotions are held in check. b. Emotions are used effectively. c. Emotions dominate decision making. d. Expression of emotion indicates success.

c. Prioritizing tasks accurately

A leader-manager has recognized the need to be more consistent with time management? What skill should the nurse develop in order to facilitate time management? a. Enlisting the help of an administrative assistant b. Recognizing the need for goal setting c. Prioritizing tasks accurately d. Handling emergency situations quickly

b. Communicating the fact that the majority of nurses are enthusiastic supporters of the change

A leader-manager plans to implement normative-reeducative strategies to facilitate change in a community health clinic. What action will the leader-manager most likely choose? a. Addressing likely points of resistance before they can be stated by nurses who are reluctant to change b. Communicating the fact that the majority of nurses are enthusiastic supporters of the change c. Publicizing the benefits of the proposed change and the research that supports it d. Providing incentives to nurses who are willing to adopt the change early

d. hires and promotes employees on the basis of their competence and skills.

A manager demonstrates one of the four principles of scientific management when he or she: a. shows an interest in employees' personal lives and emotional health. b. engages in lifelong learning and expects employees to do the same. c. allows employees to do their jobs independently, with minimal oversight. d. hires and promotes employees on the basis of their competence and skills.

b. The manager has a large span of control.

A manager has accepted a new position and there are more than 20 people who directly report to the manager. What description of this manager's role is most accurate? a. The manager's workload is unrealistic. b. The manager has a large span of control. c. The manager has a top-level management position. d. The manager is working in a poorly designed organization.

a. Reevaluate whether the goals and objectives are appropriate and achievable.

A manager has been experiencing challenges during a planning process and must implement strategies to overcome barriers that impede planning. What is the manager's best action? a. Reevaluate whether the goals and objectives are appropriate and achievable. b. Establish a fixed goal that is unaffected by changes in the organization. c. Limit membership in the planning team to administrators, leaders, and executives. d. Make the goals of the plan more general so that they can be more easily achieved.

b. At the beginning of each day

A manager has identified the need to spend more time planning in order to accomplished each day's tasks. When should the manager do this planning? a. Whenever a block of time is available b. At the beginning of each day c. In the middle of the day, after high-priority tasks have been completed d. At the end of the day, in preparation for the next day

c. Building human capital

A manager has proposed to the hospital board that it hire someone to teach management and leadership classes and that head nurses are paid to attend the classes. What is this an example of? a. Using emotional intelligence b. Transformational leadership c. Building human capital d. Using quantum leadership

b. Form joint practice committees.

A manager is participating in introducing a shared governance model to a health-care organization. What is the manager's best action? a. Remove lines of authority. b. Form joint practice committees. c. Eliminate performance appraisals. d. Increase the number of first-level managers.

b. include flexibility in the implementation of the list.

A manager is trying to get in the habit of creating a daily list of tasks. The manager should: a. avoid changing the list once initial planning is completed. b. include flexibility in the implementation of the list. c. include all relevant short-term, intermediate, and long-term goals. d. keep the list highly structured, thus decreasing the possibility of procrastination.

c. The manager receives much communication from varied directions.

A middle-manager who oversees the operations of several nursing units has a high degree of organizational centrality. What is most likely true about this manager? a. The manager is isolated from top-level managers. b. The manager interacts with a comparatively small number of coworkers. c. The manager receives much communication from varied directions. d. There are more middle-level managers than first-level managers in the organization.

b. Employees will not sabotage the change process.

A multidisciplinary team has been assigned responsibility for managing the change process in a large health-care organization. What goal should this team set for their activities? a. Resistors will face workplace discipline. b. Employees will not sabotage the change process. c. Change will happen as quickly as possible. d. Change will become a constant state in the organization.

a. Implied policies

A new nurse on the unit has been criticized for deviated from the accepted model of end-of-shift report, even though there is no written policy about the content or format for report. Which term is used for this type of policy? a. Implied policies b. Expressed policies c. Understood precedents d. The organizational culture

a. Identify and reflect on her own principles.

A new nurse-manager has set a goal of implementing authentic leadership. What is the manager's best initial action? a. Identify and reflect on her own principles. b. Examine the source of her power in the organization. c. Differentiate colleagues who are allies from those who are potential threats. d. Delegate management activities so she can focus on leadership.

a. Ensure that specific goals are identified during the planning process.

A novice nurse has been trying to apply the nursing process to each client interaction. What should the nurse do to enhance the effectiveness of this process for making decisions and solving problems? a. Ensure that specific goals are identified during the planning process. b. Conduct assessment and diagnosis simultaneously whenever possible. c. Prioritize ethics during each phase of the nursing process. d. Avoid evaluating the process until every outcome has been met.

c. Determine the specific criteria and standards by which quality will be measured.

A novice nurse-manager is a member of a team that will oversee quality control in a health-care organization. What action should the nurse and the other members off the team perform first? a. Take corrective action to address standards that are known to be challenging. b. Collect the essential data that will give a general overview of performance data. c. Determine the specific criteria and standards by which quality will be measured. d. Assign tasks between the team members to address identified standards.

c. The manager does not value other people's time.

A novice nurse-manager is frequently late for appointments. This manager's colleagues are likely to have what perception of the manager? a. The manager is overworked with too many responsibilities. b. The manager needs additional management training. c. The manager does not value other people's time. d. The manager lacks the skill necessary for the job.

c. Clarify and reflect on his or her own values.

A nurse has accepted a management position in a busy ambulatory clinic and recognizes that the day-to-day operations of the clinic will require many decisions. What is the nurse's best initial action when preparing for this new role? a. Identify staff who are likely to be allies. b. Determine where organizational power exists in the clinic. c. Clarify and reflect on his or her own values. d. Collaborate with the previous manager of the clinic.

a. Enlist members with expertise in health-care economics. b. Carefully consider political issues related to health care. d. Identify and implement a planning theory. e. Include as many stakeholders as possible in the planning process.

A nurse has been asked to join the health-care organization's strategic planning committee. What actions should the committee perform in order to create an efficient and evidence-based planning process? Select all that apply. a. Enlist members with expertise in health-care economics. b. Carefully consider political issues related to health care. c. Prioritize the role of intuition in the planning process. d. Identify and implement a planning theory. e. Include as many stakeholders as possible in the planning process.

d. Integrate nursing management and nursing leadership roles and practices.

A nurse has been hired to oversee a day surgery clinic. What action will best ensure good outcomes for this nurse, the clients, and the employees of the clinic? a. Implement the principles of authoritative leadership. b. Teach all employees about the financial considerations at the clinic. c. Consciously develop the ability to be charismatic. d. Integrate nursing management and nursing leadership roles and practices.

b. integrating leadership skills and management skills.

A nurse has been hired to oversee the operations of a series of ambulatory clinics. The nurse can best promote the success of the organization by: a. promoting management skills among all employees. b. integrating leadership skills and management skills. c. clearly communicating to employees that they will be required to follow. d. advocating for the organization to hire a leader for each site.

d. try to perceive the dominant values, traditions, and beliefs in the organization.

A nurse has begun working in a new health-care facility and is beginning to understand the organizational culture. When seeking to understand the organizational culture, the nurse should: a. carefully examine the demographic characteristics of the workforce. b. ask the middle- and upper level managers about the potential for advancement. c. ask coworkers at various levels to interpret the organizational chart. d. try to perceive the dominant values, traditions, and beliefs in the organization.

b. promoting best outcomes for clients while reducing costs.

A nurse has recently begun a leadership-management role and is most likely to face challenges in: a. resolving tensions between baccalaureate-educated nurses and nurses without a degree. b. promoting best outcomes for clients while reducing costs. c. educating nurses about their legal scope of practice. d. marketing the organization to members of the community.

b. "That's a good idea for you, but I'm just thankful that I'm done with school."

A nurse intends to enroll in graduate school and has informed a colleague of this intention. What response suggests that the colleague is in the precontemplation stage of change? a. "I haven't decided, but I might start looking into doing that as well." b. "That's a good idea for you, but I'm just thankful that I'm done with school." c. "I suppose that will open up some new opportunities for you." d. "That's my plan as well. When will you start?"

a. "How comfortable am I with taking risks?"

A nurse is considering applying for a management job that will require the nurse to make many difficult decisions. What question should the nurse ask when considering his or her ability to make difficult decisions? a. "How comfortable am I with taking risks?" b. "Am I able to apply the nursing processes in varied circumstances?" c. "Am I usually able to please my coworkers?" d. "How quickly do I think?"

a. Review the organization's mission statement.

A nurse is considering applying for employment at a new health-care facility. How should the nurse best identify the aims and priorities of the organization? a. Review the organization's mission statement. b. Speak with as many front-line workers as possible. c. Ask interviewers about recent responses to consumer satisfaction surveys. d. Review the organization's policy and procedures documents.

b. Normative-reeducative

A nurse is ostracizing a staff member who dresses "unprofessionally" and is encouraging other nurses to treat the staff member in the same way. This most closely represents which change strategy? a. Power-coercive b. Normative-reeducative c. Rational-empirical d. Resistance-withdrawal

a. It is freely chosen from among alternatives. c. It is prized and cherished. d. It is positively affirmed. e. It is acted upon.

A nurse is participating in the process of values clarification. What are the characteristics of a true value? Select all that apply. a. It is freely chosen from among alternatives. b. It aligns with the dominant values of society. c. It is prized and cherished. d. It is positively affirmed. e. It is acted upon.

b. "Our workplace is in a constant state of change. Each part of our work is unpredictable and always shifting."

A nurse manager-leader is experiencing many challenges overseeing the care in a health-care organization. What statement most clearly indicates a need to apply quantum leadership principles? a. "There's a lot of conflict, not just between nurses but also between members of other disciplines." b. "Our workplace is in a constant state of change. Each part of our work is unpredictable and always shifting." c. "Historically, many decisions seem to have been made on the basis of emotion, and I'd really like to change that." d. "There's a rift between management and employees and it affects communication."

b. The nurse's thinking includes long-term issues. c. The nurse consciously attempts to motivate the employees. d. The nurse has influence that goes beyond her own group. e. The nurse is always conscious of political realities.

A nurse oversees the care on a hospital unit in the role of an integrated leader-manager. What characteristics should this nurse exhibit? Select all that apply. a. The nurse describes herself has an "inward thinker." b. The nurse's thinking includes long-term issues. c. The nurse consciously attempts to motivate the employees. d. The nurse has influence that goes beyond her own group. e. The nurse is always conscious of political realities.

c. Allow the two nurses to dialogue about this event and observe for evidence of a satisfactory resolution.

A nurse was 20 minutes late returning from a scheduled lunch break and a colleague's break was consequently cut short. What response by the manager best demonstrates a laissez-faire leadership approach? a. Ask each of the nurses to speak with the manager separately to discuss the implications of this event. b. Ask the nurses to attend a short meeting together in the manager's office. c. Allow the two nurses to dialogue about this event and observe for evidence of a satisfactory resolution. d. Impose a meaningful consequence on the first nurse and have the nurse apologize to the colleague.

c. The nurse empowers others to reach their full potential

A nurse-leader has set a goal of becoming a more transformational leader. What outcome will best indicate progress toward achieving this goal? a. The nurse maximizes efficiency when allocating scarce resources. b. The nurse's subordinates demonstrate respect and loyalty. c. The nurse empowers others to reach their full potential d. The nurse provides praise for good work performances.

b. Complete a time inventory to identify how time is used.

A nurse-manager admits to feeling frustrated and confused by the fact that each day "just slips away," leaving many important tasks undone. How should this manager begin develop better time management skills? a. Identify a mentor who can plan the manager's schedule. b. Complete a time inventory to identify how time is used. c. Experiment with adjustments to the daily schedule. d. Request a temporary reduction in workload.

b. Clients' perspectives on the care they received

A nurse-manager and several colleagues are reviewing the results of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. These results will allow the team to make what assessment? a. The root causes of adverse incidents b. Clients' perspectives on the care they received c. Consumers' health outcomes at 3 and 6 months after discharge d. Clients' health status at admission versus at discharge

b. using new technologies to accelerate change.

A nurse-manager can implement the principles of preactive planning by: a. responding quickly to emergent problems. b. using new technologies to accelerate change. c. preferring the status quo as a stable environment. d. directing planning in response to a crisis.

c. Taking responsibility for errors that he or she makes

A nurse-manager demonstrates Level 5 leadership by performing what action? a. Keeping emotions in check b. Accepting nothing less than perfection from subordinates c. Taking responsibility for errors that he or she makes d. Avoiding conflict unless absolutely necessary

a. The manager applied heuristics to a problem that required a quick solution.

A nurse-manager had to intervene in a conflict between a client and a staff member. The manager chose to make a decision "in the moment" rather than applying a methodical or deliberate decision-making tool. How should this manager's actions be best interpreted? a. The manager applied heuristics to a problem that required a quick solution. b. The manager should have used a decision-making tool before responding. c. The manager's decision was likely made on the basis of emotion. d. The manager demonstrated an autocratic leadership style.

c. Identify and examine his or her own planning style.

A nurse-manager has been asked for the first time to join the health-care facility's strategic planning committee. What action should the manager take first? a. Approach potential mentors on the committee. b. Perform a SWOT analysis of the issues facing the committee. c. Identify and examine his or her own planning style. d. Review the committee's most recent Balanced Scorecard.

d. The manager is applying the social skills necessary for emotional intelligence.

A nurse-manager has been attending several conferences and workshops in order to network with colleagues and build relationships with people outside the organization. How should a nurse best interpret this manager's actions? a. The manager is building on his or her strengths. b. The manager's self-regulation is likely to grow because of this activity. c. The manager is demonstrating servant leadership, which will ultimately benefit the whole organization d. The manager is applying the social skills necessary for emotional intelligence.

b. aim for diversity of genders and cultures among the membership.

A nurse-manager has been commissioned to create a new workplace committee that will focus on client safety issues. When forming this committee, the manager should: a. meet at least twice per week for the first month to create momentum. b. aim for diversity of genders and cultures among the membership. c. ensure that half of the members are the manager's subordinates and half are the manager's superiors. d. give members permission to attend meetings as often or as rarely as they wish in order to accommodate their schedules.

d. Implementing shared decision making

A nurse-manager has established a new committee and will be chairing the committee. The committee consists of six representatives from various departments, at various levels within the organization. What goal should the committee members set? a. Creating a new organizational chart b. Adding four to six new members c. Emphasizing formal communication d. Implementing shared decision making

d. Include a time frame in the statement.

A nurse-manager has identified the following objective for the care on the unit: "At least 95% of new clients' health records will contain a completed assessment for intimate partner violence." How should the manager improve this objective? a. Increase the objective to 100% of health records. b. Include the rationale for the objective. c. Focus on client actions rather than documentation. d. Include a time frame in the statement.

a. Resistance is an expected component of a proposed change.

A nurse-manager has introduced a proposed change to the operations of an ambulatory clinic and has been met with resistance. How should the manager best interpret this resistance? a. Resistance is an expected component of a proposed change. b. Resistance confirms that the proposed change is necessary. c. The presence of resistance suggests that the change may be unsuccessful. d. The presence of resistance indicates a need to implement power-coercive strategies.

d. Did the outcomes align with the original objectives?

A nurse-manager has made a decision and is now preparing to evaluate the decision. What question should best guide the nurse's evaluation process a. Is evaluation necessary when using a good decision-making model? b. Can evaluation be eliminated if the problem is resolved? c. Is every party happy with the outcomes of the decision? d. Did the outcomes align with the original objectives?

a. Skeptics of the plan have begun to see it as innovative and beneficial.

A nurse-manager has proposed a change in the skills mix on a hospital unit, with fewer registered nurses and more nursing assistants. What outcome best demonstrates that the nurse is applying the principles of thought leadership? a. Skeptics of the plan have begun to see it as innovative and beneficial. b. Individuals who oppose the plan have become isolated by their peers. c. Nurses and nursing assistants will both participate in the operations planning. d. The ultimate decision on the matter will be based on rational ideas rather than emotions.

b. Make sure not to prioritize information that supports the manager's beliefs.

A nurse-manager has realized that the data gathering process before a recent decision may have been influenced by confirmation bias. How can the manager best prevent this in the future? a. Delegate data gathering to a trusted colleague who has different values. b. Make sure not to prioritize information that supports the manager's beliefs. c. Consider all of the implications of an alternative before making a decision. d. Collect only the minimum quantity of data before making a decision.

b. Gathering input from employees in order to reach a consensus

A nurse-manager has recently been accused of assigning work unequally. The manager has recognized the need to revise the process for assigning work to nurses. How can the manager best apply the principles of Theory Z? a. Making a decision independently and imposing it on the nurses b. Gathering input from employees in order to reach a consensus c. Making a decision based on the pros and cons of each option d. Identifying as many different alternatives as possible

b. Schedule appointments so that interactions can be predicted and controlled.

A nurse-manager has recognized that unproductive socialization is making it difficult to complete each day's tasks. What action should the manager take to prevent this cause of inefficiency? a. Maintain an open-door policy so employees can have more rapid interactions with the manager. b. Schedule appointments so that interactions can be predicted and controlled. c. Request a transfer to a site where the manager knows fewer coworkers and employees. d. Ban socialization on the unit during working hours.

b. It will describe interventions for nurses to follow in an effort to provide evidence-based care.

A nurse-manager has referred staff members to a clinical practice guideline (CPG) that addresses the prevention of pressure ulcers. What is a characteristic of this CPG? a. The CPG will lay out the criteria that the health-care organization must meet in order to be reimbursed for treating a client's pressure ulcer. b. It will describe interventions for nurses to follow in an effort to provide evidence-based care. c. It will describe the treatment for pressure ulcers that is provided at the best performing organizations. d. The CPG will summarize the etiology and diagnosis of pressure ulcers.

d. The large quantity of paperwork that the manager must complete

A nurse-manager has set a goal of addressing external time wasters. What phenomenon should the manager address? a. Difficulty in setting clear, achievable objectives b. The manager's inability to say no to coworkers' and subordinates' requests c. The fact that the manager has a tendency to procrastinate d. The large quantity of paperwork that the manager must complete

d. Clearly identify each of the desired objectives in the situation.

A nurse-manager has to make some difficult decisions around the allocation of vacation time during the holiday season. When making a decision, what should the manager do first? a. Elicit ideas from as many staff members as possible. b. Consider how the issues has been addressed in the past. c. Think of as many alternatives as possible. d. Clearly identify each of the desired objectives in the situation.

d. Finding underlying order in seemingly random data

A nurse-manager is applying chaos theory to a proposed change in the structure of care at a clinic. What skills will best facilitate the manager's application of this theory? a. Creating "buy-in" from the stakeholders b. Finding solutions to resistance to change c. Changing attitudes more than increasing knowledge d. Finding underlying order in seemingly random data

b. Complete the high-priority task as early in the day as possible.

A nurse-manager is beginning a day and is responsible for completing numerous tasks, including one high-priority task, three medium-priority tasks, and several lower priority tasks. How should the manager plan the day? a. Complete some low-priority tasks first to make room for focusing on the high-priority task. b. Complete the high-priority task as early in the day as possible. c. Arrange the tasks according to the amount of time that they will require. d. Complete the low-priority tasks first, then a medium-priority task, and then focus exclusively on the high-priority task.

a. Keeping members on task and promoting productivity

A nurse-manager is chairing a workplace committee. What should the manager prioritize in this role? a. Keeping members on task and promoting productivity b. Promoting members' career development c. Resolving interpersonal conflicts and preventing groupthink d. Providing information on each agenda item

b. Several predefined evaluation checkpoints

A nurse-manager is creating an organizational plan. What characteristic of the plan is more likely to promote success? a. A midterm evaluation of the planning process b. Several predefined evaluation checkpoints c. The rejection of any earlier plans that did not succeed d. Overplanning to accommodate predicted lapses in the planning process

a. Periodically evaluating the unit mission and philosophy

A nurse-manager is focusing on management controlling functions that are associated with quality control. What task best addresses this goal? a. Periodically evaluating the unit mission and philosophy b. Creating the daily client care assignments to distribute workload evenly c. Contributing to the development of the annual budget d. Distributing staffing policies related to the choice of vacation time

d. "Let's take a quick break and get something to eat, even if we have to come back a bit early."

A nurse-manager is having an exceptionally busy day and tells a colleague, "There's no way I can take a lunch break today. I've got too much to do." What is the colleague's best response? a. "It's important to take breaks, so there's never any valid reason for skipping lunch." b. "I know that happens sometimes. Let me know if you need help with organizing your day." c. "You probably just need to reorganize your day. Do you need help with that?" d. "Let's take a quick break and get something to eat, even if we have to come back a bit early."

b. Allow enough time for sufficient daily planning.

A nurse-manager is having difficulty finishing the necessary tasks for each day. When implementing the time management process, what should the manager do first? a. Complete the highest priority task. b. Allow enough time for sufficient daily planning. c. Reprioritize based on new information received. d. Delegate work that cannot be accomplished in a day.

b. The health-care organization's budget d. The existing processes that are in place e. Opportunities for learning and growth f. Feedback that clients and families have provided

A nurse-manager is on a strategic planning team that is applying the balanced scorecard while strategic planning. The team should specifically consider what variables when creating the scorecard? Select all that apply. a. Legislation that governs the organization's operations b. The health-care organization's budget c. Goals identified by similar organizations d. The existing processes that are in place e. Opportunities for learning and growth f. Feedback that clients and families have provided

d. The PPS has been linked to a decline in the quality of care.

A nurse-manager is opposing the expansion of the prospective payment system (PPS). What argument against the PPS should the manager cite? a. Diagnosis-related groups have caused an increase in health-care costs. b. The PPS has unnecessarily increased the length of hospital stays. c. The PPS is linked to increased prices for pharmaceuticals. d. The PPS has been linked to a decline in the quality of care.

c. Standardizing the collection of nursing data for use by multiple users

A nurse-manager is overseeing an organization that uses the Nursing Minimum Data Set (NMDS). What will the use of the NMDS achieve? a. Comparing the quality of nursing care and medical care with reference to standardized data Identifying minimal levels of quality necessary for nurses to maintain licensure c. Standardizing the collection of nursing data for use by multiple users d. Identify only "nursing-sensitive" client outcome measures

c. Results of interviews with discharged clients

A nurse-manager is participating in a hospital's quality control efforts and is collating data sources. What data source should the manager identify as a qualitative source? a. The hospital's rate of nosocomial infections b. The hospital's readmission rate c. Results of interviews with discharged clients d. The previous year's budget for continuing education initiatives

a. Be aware that the tool cannot eliminate the risk of human error.

A nurse-manager is planning to apply a decision-making model to a clinical challenge. When using a decision-making tool, what should the manager do? a. Be aware that the tool cannot eliminate the risk of human error. b. Have an impartial colleague apply the tool, if possible. c. Apply the tool as quickly as possible. d. Recognize that the tool will negate the effect of the manager's values.

b. Covering sick calls for the upcoming shift to ensure there are enough nurses

A nurse-manager is prioritizing tasks. Which tasks should the manager put into the "do now" category? a. Adding follow-up comments to an incident report from the previous day b. Covering sick calls for the upcoming shift to ensure there are enough nurses c. Conducting a new employee's initial performance review d. Meeting with the chairperson of the hospital's strategic planning committee

c. Break the task into smaller, less intimidating units.

A nurse-manager is responsible for implementing a large and complex plan that will require much time and effort. How should the manager address this large task? a. Work on the task with few breaks in order to finish as quickly as possible. b. Delegate as much of the task as possible to employees and focus on evaluation. c. Break the task into smaller, less intimidating units. d. Delay beginning the task until it has the manager's undivided attention.

b. Don't do

A nurse-manager is reviewing a backlog of correspondence and reads an e-mail asking for feedback from a manufacturer about a piece of equipment that is used at the facility. The manager reads that the sender asked for all feedback to be submitted by the end of last week. In what category of prioritizing should this task be placed? a. Squeaky wheel b. Don't do c. Do later d. Do now

a. be aware that the informal structure of the organization cannot be discerned from the chart.

A nurse-manager is reviewing the organizational chart of a health-care facility before accepting a job offer. When reviewing the organizational chart, the nurse should: a. be aware that the informal structure of the organization cannot be discerned from the chart. b. confirm the accuracy of the chart with the human resource department. c. try to meet with the people at the top of the chart, if possible. d. review the qualifications of each person on the chart.

a. Members of the committee are unwilling to take risks with new ideas.

A nurse-manager is working with a committee that is showing evidence of groupthink. What characteristic of the committee would show evidence of this phenomenon? a. Members of the committee are unwilling to take risks with new ideas. b. The committee prefers to make decisions by consensus. c. The committee members want to take turns chairing the meetings. d. Membership in the committee is frequently changing.

a. Reevaluate the lists on a regular basis and adjust them as needed.

A nurse-manager makes lists of tasks for each day. What should the manager do in order to ensure that lists accurately reflect changes in priorities? a. Reevaluate the lists on a regular basis and adjust them as needed. b. Ensure that each day's list is significantly different from the previous day's list. c. Make lists as detailed as possible in terms of the time allocated and the specifics of each task. d. Have the lists reviewed by a trusted colleague on a regular basis.

a. The manager should carefully reflect on his or her most important values.

A nurse-manager recognizes the role that individual values play on decision making. How should the manager best address this fact during a period of organizational planning? a. The manager should carefully reflect on his or her most important values. b. The manager should make every attempt to set values when making decisions. c. The manager should seek individuals who have similar values when creating a decision-making team. d. The manager should seek individuals who claim to have flexible values when creating a decision-making team.

d. Enhanced productivity e. Decreased stress

A nurse-manager set a goal early in the year take better control of time management. Upon achieving this goal, the manager is likely to experience what benefits? Select all that apply. a. Increased learning b. Increased influence on coworkers c. Increased knowledge d. Enhanced productivity e. Decreased stress

a. Convincing employees that the change will be beneficial and innovative

A nurse-manager will soon be introducing a significant change in the way that overtime shifts are allocated on a hospital floor. What action by the manager will best demonstrate the principles of thought leadership? a. Convincing employees that the change will be beneficial and innovative b. Relating the change to the fact that the floor has been required to cut costs c. Delegating the implementation of the change to the nurses themselves d. Describing clear expectations for nurses' adherence to the new policy

a. The desired outcome will not be achieved.

A nursing supervisor has been given the responsibility for increasing the frequency and thoroughness of nursing assessments on a hospital unit. However, the supervisor does not have the authority to enforce new guidelines for assessment or assign consequences for noncompliance. What is the most likely outcome of this scenario? a. The desired outcome will not be achieved. b. The assessments will improve, but the nurses will be resentful. c. The supervisor will need to use unauthorized enforcement. d. The assessments will improve as a result of collaboration.

b. Demonstrating a positive attitude toward the prospect of change

A planned change has been imposed by upper management at a large hospital and will greatly affect the delivery of care on inpatient units. What is an appropriate role for the leader-manager in this time of change? a. Mobilizing resistance in a respectful but assertive way b. Demonstrating a positive attitude toward the prospect of change c. Implementing the change as rapidly as possible d. Dialoguing with staff about the benefits of maintaining the status quo

d. procedure manual.

A recent nursing graduate has not performed a dressing change on a central catheter for several months and is unsure of how to correctly perform this. The nurse should refer to the: a. documentation. b. practice rules. c. organization policy. d. procedure manual.

d. consult with local stakeholders.

A rural hospital is considering a sharp reduction in the range and availability of the services it provides. Before making this change, the hospital's leadership should: a. decentralize its decision-making model. b. implement shared governance. c. review its organizational chart. d. consult with local stakeholders.

d. The representative is affirming the consequences.

A sales representative is describing the benefits of a new brand of incontinence brief to a manager. The representative states, "These are a superior product. With what you're currently using, you're actually causing harm to your clients." How should the manager best interpret this statement? a. The representative is analogy. b. The representative is overgeneralizing about the new briefs. c. The representative is overgeneralizing about the briefs the unit currently uses. d. The representative is affirming the consequences.

b. entitles all citizens to similar levels of health-care services.

A society that highly values social equity and equality is likely to support a health-care system which: a. prioritizes the role of the free market in providing health-care services. b. entitles all citizens to similar levels of health-care services. c. relies on the private sector to organize and provide health care. d. is cost-effective and efficient.

a. Identify and reflect on the feelings that she experiences after being accused.

A subordinate has accused a manager of favoritism after the manager created the work assignment for the day. How should the manager best apply the principles of emotional intelligence? a. Identify and reflect on the feelings that she experiences after being accused. b. Recognize that the subordinate's statement was likely based on emotion rather than evidence. c. Involve a colleague in the situation who has no emotional investment in the situation. d. Choose a response that will diffuse the subordinate's emotions.

b. When planning, involve as many people who will be affected by the change as possible.

A team has been formed to consider a change in medication delivery. How can the team leaders best promote a successful change? a. Implement the change as rapidly as possible in order to diffuse resistance. b. When planning, involve as many people who will be affected by the change as possible. c. Bring in outside experts to implement the change. d. Enforce compliance with the change fairly and consistently.

a. The cost for each new mattress d. The cost of treating pressure ulcers

A team of nurse-managers is considering the purchase of pressure-reducing mattresses to reduce the incidence of pressure ulcers among long-term care residents. In order to use a payoff table to assist with the decision making, what must the managers know? Select all that apply. a. The cost for each new mattress b. Clients' expectations for how a mattress should feel c. The prognosis for recovery from a pressure ulcer d. The cost of treating pressure ulcers e. The amount of time between ordering the mattresses and their delivery

c. divide the project into smaller components that can be more easily completed.

A unit manager has been instructed to complete a comprehensive audit of the unit's use of resources. The manager is daunted by the size of the task, which will likely take several weeks to complete. The manager should: a. set aside low- and medium-priority tasks until the project is complete. b. delegate the project to subordinates and ask for weekly updates. c. divide the project into smaller components that can be more easily completed. d. request clerical or secretarial assistance.

b. Contemplation

A workplace health initiative has been launched in which subsidies are being offered for gym memberships and exercise equipment. This initiative is most likely to affect individuals who are in which phase of the stages of change model? a. Precontemplation b. Contemplation c. Action d. Maintenance

a. The nurses consciously improve their performance because they know it is being scrutinized.

Accreditors are scheduled to visit a hospital site, and staff members have been made aware of what they will be assessing. What staff behavior would most clearly suggest the presence of the Hawthorne effect? a. The nurses consciously improve their performance because they know it is being scrutinized. b. The nurses avoid contact with the accreditors because they fear criticism. c. The manager blames individual nurses for deficits identified in the accreditation report. d. The manager temporarily adopts a leadership role.

a. It is difficult to control or stop.

After starting a new job, a nurse-manager has been surprised at the amount of grapevine communication that happens. The manager should recognize what characteristic of this type of communication? a. It is difficult to control or stop. b. It always involves verbal, face-to-face communication. c. It consists of negative and subversive messages. d. Strong organizations have policies that prohibit it.

d. Promote teamwork rather than individual accomplishments.

An RN is a supervisor in an organization that has total quality management (TQM) as the basis for its organizational goals and objectives for quality control. How should the RN practice TQM on the unit? a. Encourage colleagues to create vision and mission statements. b. Develop a quota system for number of clients cared for. c. Explain to the staff that "if it's not broke, don't fix it." d. Promote teamwork rather than individual accomplishments.

b. Intuition

An experienced nurse-manager has been described as being a "right-brain thinker." This manager's decision-making process likely prioritizes what characteristic? a. Linear analysis b. Intuition c. Transparency d. Efficiency

d. Hold a sharing session so all RNs can share information about their cultures and differences in client care.

An organization has hired six RNs who are recent immigrants. The manager has noticed they interact very little with other staff, often speaking in their own language during their breaks, although they speak English while on duty. Which intervention would be the most helpful action for the manager to help these new RNs better assimilate? a. Explain to the new nurses the problem that their isolating is causing. b. Arrange to send them to an English language course at the local adult school. c. Ask the established RNs to make an effort to include the new nurses in after-work activities. d. Hold a sharing session so all RNs can share information about their cultures and differences in client care.

c. Efficiency will decrease in the organization.

An organization has proposed a policy stating that no more than five people should report to any single manager in the organization. What is the most likely outcome of this change in organizational structure? a. Decision making will become unpredictable. b. Workplace satisfaction will increase. c. Efficiency will decrease in the organization. d. Worker autonomy and empowerment will increase.

b. Staff claim the stated unit philosophy is in contrast to the care that is being given.

An organization is considering a revision to its philosophy. What characteristic of the current philosophy would most clearly indicate a need for revision? a. The philosophy is more than 5 years old. b. Staff claim the stated unit philosophy is in contrast to the care that is being given. c. The philosophy was appropriated from a different health-care facility. d. The philosophy was created after the organization's vision and mission were determined.

c. Relational transparency

An organization is facing budget cuts and the manager has openly shared the details, rationale, and implications of the cuts with staff. The manager has also expressed feelings of disappointment about the cuts. What component of authentic leadership has the manager demonstrated? a. Balanced processing b. Internalized moral perspective c. Relational transparency d. Self-awareness

c. separate out the unique contributions that nurses make to client outcomes.

As part of a quality improvement initiative, administrators are conducting outcomes analysis and have included nursing-sensitive outcome measures. These outcome measures will: a. highlight the aspects of nursing that are contentious or controversial. b. cause the quality improvement process to prioritize nurses over other providers. c. separate out the unique contributions that nurses make to client outcomes. d. require other members of the health-care team to rate nurses' contributions.

d. Perform interventions that will correct the deficiencies.

As part of the quality control, managers have set standards for performance and assessed whether these standards are being met. It has been determined that several standards are not being met. What is the priority response to this finding? a. Release the findings to the public to ensure transparency. b. Compare the organization's results to benchmarks. c. Determine whether similar organizations in the region are experiencing similar results. d. Perform interventions that will correct the deficiencies.

b. 6 months c. 12 months d. 18 months

At the unit level, what time frame may be considered long-range planning? SATA a. 3 months b. 6 months c. 12 months d. 18 months

b. The manager insists on accompanying nurses to community events and observes them closely.

Caregivers at a public health center believe that their manager adheres to Theory X. What action by the manager best confirms this suspicion? a. The manager collaborates with senior staff to set quarterly goals for the center. b. The manager insists on accompanying nurses to community events and observes them closely. c. The manager is difficult to access when there is a problem or crisis in the center. d. The manager allocates rewards based on the outcomes of nurses' work.

b. Identifying and preventing waste

During a quality improvement initiative, the leadership of a health-care organization has worked with senior managers to implement the principles of Lean Manufacturing. This initiative will focus on what factor? a. Identifying sentinel events b. Identifying and preventing waste c. Engaging all staff members d. Performing root cause analysis of errors

c. Request that committee members return to discussing items on the agenda.

During a strategic planning committee meeting to develop technology goals, several unit managers spend a considerable amount of time discussing current staffing problems. What is the primary action of the chairperson of this committee? a. Take the remainder of the meeting time to discuss staffing with all members. b. Adjourn the meeting and reschedule at a time when there are no staffing problems. c. Request that committee members return to discussing items on the agenda. d. Excuse those discussing staffing from the remainder of the meeting.

b. Changes occur accidentally. c. Changes take place even though they are unplanned.

Frequent turnover in leadership at a health-care organization has meant that change has often occurred by drift. What are characteristics of this mode of change? Select all that apply. a. Changes are planned by teams. b. Changes occur accidentally. c. Changes take place even though they are unplanned. d. Changes take place only as the result of threats. e. Change takes place democratically.

b. Process

High-achieving nursing students were found to have studied in small groups, attended class 100% of the time, took frequent rest breaks during study sessions, and ate a balanced diet for 1 week before the examination. What type of audit provided data about the students' preparation? a. Structure b. Process c. Outcome d. Concurrent

d. By adapting his or her leadership style to a particular circumstance

How can a manager best implement the principles of situational or contingency leadership theory? a. By establishing rules and norms that can be applied in all conditions in the organization b. By avoiding punitive consequences when addressing workers' lack of performance c. By deferring to employees for day-to-day management decisions d. By adapting his or her leadership style to a particular circumstance

c. Having limited office seating available d. Refocusing conversations as needed

How can subordinates be discouraged from taking up a nursing manager's time unproductively? Select all that apply. a. Having the manager be accessible in the nursing station b. Instituting an open-door policy c. Having limited office seating available d. Refocusing conversations as needed e. Work in a public area

c. Frequently reassessing personally established priorities

How should the nurse-manager most effectively deal with the ever-changing nature of the nursing work environment? a. Evaluating the management skills of the nursing team leaders b. Providing time management classes for staff members c. Frequently reassessing personally established priorities d. Encouraging staff to engage in daily planning

d. foster a climate where analysis of errors is not solely focused on blame.

In order to improve the likelihood that errors in the health-care system will be reported, nurse-managers should: a. give professionals the choice of whether or not to report errors. b. establish firm and meaningful punishments for staff who commit an error. c. assign "safety officers" whose exclusive role is to monitor for, identify, and follow up errors. d. foster a climate where analysis of errors is not solely focused on blame.

a. Developing a program for recruitment of young talent

In planning strategies to prevent stagnation and promote renewal, which action would most likely result in the desired outcome? a. Developing a program for recruitment of young talent b. Rewarding employees by promoting from within c. Having set pay increases mandated annually d. Using length-of-service to determine committee selection

a. The nurses may be in the unfreezing phase of change.

Many nurses at an ambulatory clinic have expressed frustration about the low quality of care that clients have been receiving. How should a manager best interpret this situation? a. The nurses may be in the unfreezing phase of change. b. The clinic is likely an aged organization. c. The movement phase of change will be difficult to initiate. d. There is a need for the manager to demonstrate power-coercive strategies.

a. Bureaucracy could provide a rational basis for administrative decisions. c. Organization charts could depict the hierarchy of authority. d. Impersonality of relationships should exist in organizations.

Max Weber, as part of the scientific management era, contributed immensely to the development of organizational theory. Which statements are representative of his beliefs? Select all that apply. a. Bureaucracy could provide a rational basis for administrative decisions. b. Worker satisfaction was integral to productivity. c. Organization charts could depict the hierarchy of authority. d. Impersonality of relationships should exist in organizations. e. Advancement and placement should be based on relationships.

d. The nurses find the current documentation system unwieldy and inefficient.

Nurses on a hospital unit have been informed that a change to the documentation system is being proposed. What factor surrounding this change is most likely to cause unfreezing? a. The proposed documentation system has been introduced in many hospitals in the region. b. The leader-manager supports a change in the documentation system. c. An influential nurse has extensive experience with different documentation systems. d. The nurses find the current documentation system unwieldy and inefficient.

c. External conditions that promote achievement of organizational objectives

One of the most commonly used tools in health-care organizations is SWOT analysis. What is the definition of the "O" component of this model? a. Internal attributes that help an organization achieve its objectives b. Internal attributes that challenge an organization in achieving its objectives c. External conditions that promote achievement of organizational objectives d. External conditions that challenge or threaten the achievement of organizational objectives

d. Overgeneralizing

One of the nurses on the unit said, "My Vietnamese patient won't look me in the eye, but I know that Asian patients avoid making eye contact as a way of showing respect." This nurse is demonstrating what type of illogical thinking? a. Affirming the consequences b. Arguing from analogy c. Deductive reasoning d. Overgeneralizing

c. Strengths-based leadership

The chief nursing officer is assembling a leadership team. The nurse is ensuring that the team is made up of people who have a diverse range of natural talents and skills. This leader is most clearly exemplifying what theory of leadership? a.Level 5 Leadership b. Emotional intelligence c. Strengths-based leadership d. Authentic leadership

a. Authoritarian

The clinic leader tends to make decisions independently and closely supervises and controls the practice of the nurses at the clinic. What type of leadership is being exemplified? a. Authoritarian b. Democratic c. Laissez-faired. d. A contingency approach

a. Collaboration with colleagues b. Communication with employees c. Self-improvement d. Staff development

The failure to engage in which activities are considered a fatal flaw of leadership? Select all that apply. a. Collaboration with colleagues b. Communication with employees c. Self-improvement d. Staff development e. Determining salary scales for employees

a. restoring stability to the workplace.

The leader-manager has successfully implemented a change and is now entering the refreezing stage of the change process. During this stage, the leader-manager should prioritize: a. restoring stability to the workplace. b. rewarding the employees who embraced the change early. c. communicating the specific benefits of the change. d. addressing the concerns of resistors.

a. Support employees' right to disagree with proposed changes.

The leader-manager provides oversight on a busy medical-surgical unit. There has recently been an incident where two nurses were not honest about neglecting a controversial new protocol and misled the leader. How can the leader-manager best prevent similar episodes? a. Support employees' right to disagree with proposed changes. b. Ensure that employees know the consequences of misleading the manager. c. Avoid making decisions that displease large numbers of employees. d. Identify allies who can be trusted to report employees who may mislead the manager.

d. Reimbursement of tuition to nurses who are upgrading their education

The leaders of a health-care organization ascribe to human capital theory and are planning the budget for the next year. What activity should the team prioritize in the budget to promote the goals of this theory? a. Signing bonuses for nurses who are hired from outside the region b. Incentives for staff members who provide exemplary care and who make no errors c. Community outreach activities that will increase engagement between staff and residents d. Reimbursement of tuition to nurses who are upgrading their education

a. A community group that advocates for the rights of people addicted to drugs b. Representatives from the labor union that represents many staff members, an external organization, or individual c. A community group that promotes client safety in health care e. The surgeons and anesthetists who work in the operating room

The leadership of a large health-care organization has arranged a series of meetings with stakeholders. What individuals or groups would be included in this category? Select all that apply. a. A community group that advocates for the rights of people addicted to drugs b. Representatives from the labor union that represents many staff members, an external organization, or individual c. A community group that promotes client safety in health care d. Members of the local media e. The surgeons and anesthetists who work in the operating room

c. Directing

The manager at a long-term care facility has intervened in a conflict between two staff members about the timing and length of lunch and coffee breaks. What management function is this manager demonstrating? a. Planning b. Organizing c. Directing d. Evaluating

a. The unit philosophy should align with the larger organization's philosophy.

The manager is leading a team to develop a unit-level philosophy statement. What guideline should the team use during this process? a. The unit philosophy should align with the larger organization's philosophy. b. The unit's philosophy should include a mission statement and vision statement. c. The statement should reflect the values and priorities of the specific unit manager. d. The statement should be consistent with that of other similar health-care agencies.

a. Transactional

The manager of a busy emergency department is primarily concerned with the practical, day-to-day operations of the department. This manager is most clearly demonstrating what type of leadership? a. Transactional b. Transformational c. Interactional d. Bureaucratic

b. Identifying and addressing barriers to efficiency

The manager of a care facility advocates traditional management science. What is this manager most likely to prioritize? a. Ensuring that workers are satisfied in their roles b. Identifying and addressing barriers to efficiency c. Empowering workers to make decisions independently d. Providing rewards for exceptional caring

b. W

The manager of a clinic is considering a change in the scheduling of vacation time in which nurses would self-schedule their vacation rather than having the manager respond to their submitted requests. A nurse has pointed out that it is possible that newer nurses may feel intimidated by more experienced nurses on the unit when scheduling their vacation. This observation constitutes what component of a SWOT analysis? a. S b. W c. O d. T

a. Unfreezing

The manager on a hospital unit has highlighted some of the large gaps between desired client outcomes and actual client outcomes. What component of Lewin's change theory is the manager demonstrating? a. Unfreezing b. Movement c. Refreezing d. Resistance

d. The nurse may have to accept decisions contrary to his or her own values.

The nurse has accepted a job in a workplace where organizational power has a pronounced effect. This characteristic may have what effect on the nurse and the workplace? a. Many decisions will be delegated to the nurse by supervisors. b. There will be high levels of mistrust and suspicion at the workplace. c. Communication will be compromised in the workplace. d. The nurse may have to accept decisions contrary to his or her own values.

a. The medications that the client was taking prior to admission e. The list of medications the client has been prescribed by the admitting physician

The nurse is admitting a new client and is reviewing the results of the medication reconciliation. What data will be included in the client's medication reconciliation? Select all that apply. a. The medications that the client was taking prior to admission b. The client's expectations for treatment with medications during admission c. The client's medication administration record from any previous admissions d. The results of the nurse-manager's review of the client's treatment plane. e. The list of medications the client has been prescribed by the admitting physician

c. choose between different courses of action.

The nurse is applying a decision-making process to a clinical challenge. When applying this process, the nurse must: a. analyze the root causes of a situation. b. begin by solving the underlying problem. c. choose between different courses of action. d. prioritize the maximum good for the maximum number of people.

a. Identifying the root cause of the conflict

The nurse is applying the traditional problem-solving model when mediating in a conflict between two colleagues. When applying this model, the nurse should prioritize what task? a. Identifying the root cause of the conflict b. Implementing a solution as quickly as possible c. Eliciting input from other nurses d. Encouraging each nurse to reflect on his or her actions

c. ensure that evaluation occurs at several points during the process.

The nurse is participating in a planning process in a large health-care organization. The nurse and the other members of the team should: a. avoid specifics so that the plan can be applied in any health-care setting. b. ensure that long-term priorities are always prioritized over short-term priorities. c. ensure that evaluation occurs at several points during the process. d. begin to engage employees in the process after the plan has been implemented.

a. New leadership

The nurse is working on a unit whose culture has become firmly entrenched. What solution should the nurses on the unit best propose? a. New leadership b. A decrease in workload c. Collaboration with a unit that is not entrenched d. Increased administration support

b. Use simulation for the students to learn and practice the skill.

The nurse is working with a group of students who are learning a high-risk procedure. How should the nurse best ensure learning while protecting the safety of clients? a. Create an unfolding case study featuring the procedure. b. Use simulation for the students to learn and practice the skill. c. Help the students use a decision-making model to choose the safest technique. d. Teach the students about the traditional problem-solving process before they practice the procedure.

b. Transformational

The nurse who manages an ambulatory clinic is well known as being a visionary leader who is skilled at empowering others with this vision. What type of leader is this nurse? a. Transactional b. Transformational c. Interactional d. Bureaucratic

d. communicating a vision that change is an opportunity to be embraced.

The nurse who provides oversight to a large health-care organization can best demonstrate leadership during a time of change by: a. clearly and assertively reminding nurses of their responsibilities to accept change. b. asking permission of nurses before proposing a change process. c. acknowledging that there is going to be resistance during the change process. d. communicating a vision that change is an opportunity to be embraced.

a. The manager is giving an example of democratic leadership.

The nurse-manager has been approached by three different families in recent weeks, all of whom have described a particular nurse as giving exceptional care. The manager has relayed this feedback to the nurse and nominated the nurse for an organization-wide award. How should the manager's actions be best interpreted? a. The manager is giving an example of democratic leadership. b. The manager's actions are likely to cause accusations of favoritism. c. The manager is following the Great Man theory of leadership. d. The manager's actions may inadvertently discourage the other nurses.

d. Collaborate with stakeholders to develop a plan.

The nurse-manager has begun the movement stage of a proposed change. What is the manager's most appropriate activity?a. Gather data about the need for change. b. Accurately diagnose the problem. c. Decide whether change is needed. d. Collaborate with stakeholders to develop a plan.

d. Controlling

The nurse-manager is addressing a nurse's suspected breach of client confidentiality in a social media posting. What function of the management process is this nurse-manager demonstrating? a. Organizing b. Staffing c. Directing d. Controlling

c. The clients for whom the intervention would be relevant

The nurse-manager is applying an evidence-based approach to a clinical question around client mobilization. When using a PICO format to search for evidence, the nurse should identify what? a. The role of intuition in the decision-making process b. The preferences of clients and their families c. The clients for whom the intervention would be relevant d. Costs associated with a potential change in practice

b. a chosen course of action.

The nurse-manager is applying the decision-making process when addressing a nurse's high rate of absenteeism. This process should result in: a. an outcome that is desired by all. b. a chosen course of action. c. an action that guarantees success. d. a new understanding of the problem.

b. avoid overt demonstrations of power or authority.

The nurse-manager is chairing a committee, most of whose members are subordinates. When communicating with the members during meetings, the manager should: a. ensure their contributions are recorded for performance appraisal purposes. b. avoid overt demonstrations of power or authority. c. reserve the right to impose decisions on the committee. d. avoid informality in speech or writing.

c. Begin by ranking the priority of tasks that need to be accomplished.

The nurse-manager is creating a list in order to promote efficiency and productivity. What is the manager's best action? a. Use long-term goals as the framework for creating the list. b. Include slightly more activities than can be completed in a day, in order to motivate. c. Begin by ranking the priority of tasks that need to be accomplished. d. Keep each day's list as similar as possible to each other day's lists.

a. Increased cost of health-care services b. Shortages of health-care professionals and providers c. Decreased third-party reimbursement for health-care services e. Increased need to update health-care-related technologies

The nurse-manager is describing the forces that are driving change in today's health-care environment. What phenomena should the nurse describe? Select all that apply. a. Increased cost of health-care services b. Shortages of health-care professionals and providers c. Decreased third-party reimbursement for health-care services d. Decreased use of technology due to high cost of implementation e. Increased need to update health-care-related technologies

d. Identify and reflect on his or her own values.

The nurse-manager is faced with a difficult decision in a situation that involves the manager's values. What is the manager's best action? a. Try to base a decision on intuition rather than values. b. Set aside his or her values and make a rationale decision. c. Defer the decision to a colleague with different values. d. Identify and reflect on his or her own values.

c. Deal with paper correspondence as soon as possible after it arrives.

The nurse-manager is frustrated by the quantity of paper clutter? How should the manager best deal with this time waster? a. Require face-to-face communication between staff members rather than written documentation. b. Set aside a block of time once per week to process documents. c. Deal with paper correspondence as soon as possible after it arrives. d. Place additional recycling and trash receptacles throughout the unit.

c. Identify any characteristics of the staffing system that currently help the clinic meet its goals.

The nurse-manager is on a team that is performing a SWOT analysis of the staffing system at a community clinic. What should the manager do when addressing the "S" component of the SWOT analysis? a. Identify stakeholders in the current staffing system. b. Examine the factors indicating that a change in the staffing system is necessary. c. Identify any characteristics of the staffing system that currently help the clinic meet its goals. d. Strategize about ways that the staffing system could possibly be improved.

a. Government regulations b. Rapidly changing technologies d. Changing population demographics

The nurse-manager is participating in organizational planning. Which factors should the team consider when identifying variables that may complicate the planning process? Select all that apply. a. Government regulations b. Rapidly changing technologies c. Decreased acknowledgement of the importance of planning d. Changing population demographics e. Public mistrust of the nursing profession

c. Timing

The nurse-manager is preparing to use the PERT tool when making a staffing decision. This tool will primarily address what component of the decision-making process? a. Values b. Consequences c. Timing d. Ethics

a. Rules should be flexible. b. The number of rules should be kept to a minimum. d. Enforcement of the rules supports staff morale. e. Consistent rule enforcement supports organizational structure.

The nurse-manager is reviewing the rules that the previous manager had put into place. When reviewing these rules, what principles should guide the manager's actions? Select all that apply. a. Rules should be flexible. b. The number of rules should be kept to a minimum. c. Rules should be changed on a regular basis. d. Enforcement of the rules supports staff morale. e. Consistent rule enforcement supports organizational structure.

a. The characteristics of the nurse's personality e. The specifics of the clinical challenge that the nurse is addressing

The nurse-manager of a community clinic is applying the principles of interactional leadership when addressing a challenging situation. What variables should the nurse prioritize when applying this model of leadership? Select all that apply. a. The characteristics of the nurse's personality b. The financial resources available to the nurse c. The consequences of failure d. The factors that motivate the employees of the clinic e. The specifics of the clinical challenge that the nurse is addressing

a. the unit's day-to-day operational needs.

The nurse-manager of a hospital unit has categorized some tasks in the "do now" category. The tasks most likely reflect: a. the unit's day-to-day operational needs. b. issues related to long-term goals. c. large, time-consuming tasks. d. problems that cannot be safely delegated.

c. generate as many different alternatives as possible.

The nurse-manager of a short-staffed unit needs to make a decision about a nurse's request for an unpaid leave of absence. In order to increase the chance of making a good decision, the manager should: a. involve as many people in the decision-making process as possible. b. begin the decision-making process by presuming the status quo to be the best option. c. generate as many different alternatives as possible. d. prioritize the option that is most innovative.

a. Laissez-faire d. Transactional e. Transformational

The nurse-manager of the perioperative department is attempting to apply the full-range leadership model (FRLM) when overseeing the department. The nurse should attempt to integrate what types of leadership? Select all that apply. a. Laissez-faire b. Scientific c. Autocratic d. Transactional e. Transformational

c. regulate his or her own emotions and those of others.

The nurse-manager who seeks to exemplify emotional intelligence should: a. attempt to remove emotion from decision making. b. prioritize emotion over reason when making decisions. c. regulate his or her own emotions and those of others. d. effectively manipulate the emotions of others to achieve goals.

b. Open, participatory management c. Improved patient outcomes d. High staff nurse satisfaction

The nurse-manager works in a health-care facility that has applied for Magnet status. What characteristics of the organization will support the application? Select all that apply. a. Centralized decision-making environment b. Open, participatory management c. Improved patient outcomes d. High staff nurse satisfaction e. Large number of registered nurses and an absence of practical nurses

a. To solve an existing problem c. To increase staff efficiency d. To reduce unnecessary workload e. To improve staff productivity

The nurse-manager would be justified in making a change for which reasons? Select all that apply. a. To solve an existing problem b. To test workers' abilities to adapt c. To increase staff efficiency d. To reduce unnecessary workload e. To improve staff productivity

b. Formulate a specific, searchable clinical question about wound care.

The nurses on a medical unit are using several different techniques for performing wound care and the manager recognizes a need to implement evidence-based practice (EBP). What should the manager do first when applying the principles of EBP? a. Identify the main peer-reviewed journals in field of wound care. b. Formulate a specific, searchable clinical question about wound care. c. Perform a review of the literature about wound care. d. Identify how expert nurses typically perform wound care.

d. A clear division of labor among employees

The organization of work in a large health-care facility reflects Weber's theories around bureaucracies. What characteristic is most likely to exist in this facility? a. High flexibility in the way that work is structured b. Promotion and advancement on the basis of relationships c. Absolute autonomy of each employee d. A clear division of labor among employees

b. The findings from an onsite visit by assessors

The top-level managers of a hospital have chosen to apply for magnet designation. The decision to grant this designation will be largely based on what factor? a. Input from local nursing educators and academics b. The findings from an onsite visit by assessors c. The results of a local public opinion survey d. Review of the organizational chart

a. examine alternatives visually and compare each against the same criteria.

The unit manager has created a decision grid in order to assist with a difficult staffing decision that will affect many nurses. The decision grid will allow the manager to: a. examine alternatives visually and compare each against the same criteria. b. ensure that the decision is made objectively rather than subjectively. c. plot the outcomes of a decision over time and evaluate the decision-making process. d. predict when events must take place to complete a project on time.

d. High turnover rates by staff nurses

There are current and future paradigm shifts in health care that affect the leadership skills needed by nurses in the 21st century. What issue at the organizational and unit levels are nurse-leaders being directed to address? a. Active involvement in greatly needed health-care reform b. Persistent and growing international nursing shortage c. Increasing disparities between health outcomes for wealthy clients and poorer clients d. High turnover rates by staff nurses

c. The middle manager has only one boss.

There is one vertical, solid line connecting a middle manager and a top-level manager on a clinic's organizational chart. What should a nurse conclude from this aspect of the organizational chart? a. The middle- and top-level manager share equal authority. b. The middle manager is in a permanent position. c. The middle manager has only one boss. d. The top-level manager was originally promoted from being a middle-manager.

c. Outcome

Thirty-eight percent of the people who attended a smoking cessation clinic were not smoking 1 year after completing treatment. What type of audit provided this type of data? a. Structure b. Process c. Outcome d. Concurrent

a. Allow time for planning and establish priorities. c. Complete the highest priority task, and whenever possible, finish one task before beginning another. d. Reprioritize based on remaining tasks and new information that may have been received.

Time management can be reduced to cyclic steps that include which of the following? Select all that apply. a. Allow time for planning and establish priorities. b. Complete tasks according to their difficulty, from easiest to most difficult. c. Complete the highest priority task, and whenever possible, finish one task before beginning another. d. Reprioritize based on remaining tasks and new information that may have been received. e. Divide each day into 1-hour blocks.

c. Principal agent theory

To decrease overtime, the manager of a surgical unit offers nurses who get their work finished on time for an entire 2-month period an extra day off with pay at regular time. The nurse is enacting what model of leadership? a. Favoritism b. Quantum leadership c. Principal agent theory d. Servant leadership

a. relationships.

Twenty-first-century leadership models generally emphasize the importance of: a. relationships. b. incentives. c. motivation. d. consequences.

b. Analyze the facts of the situation before making a decision.

Two nurses have approached the manager and have asked the manager to speak to a nurse on the unit who has a reputation for being difficult to get along with. How can the manager best implement authentic leadership? a. Meet with the "difficult" nurse to assess emotions. b. Analyze the facts of the situation before making a decision. c. Encourage all three nurse to meet without the manager present. d. Encourage all three nurses to disregard their emotions.

a. Prioritizing the interests of others over the manager's own interests

What action by a nurse-manager best demonstrates servant leadership? a. Prioritizing the interests of others over the manager's own interests b. Cultivating a personal relationship with each subordinate c. Making decisions on the basis of customer serviced. d. Communicating a clear vision for the future and asking subordinates to share it

d. The manager holds a workshop to outline a new vision for patient-centered care.

What action by the nurse-manager in a health organization best demonstrates transformational leadership? a. The manager readily takes responsibility after making a scheduling error. b. The manager's employees are reminded that they must submit evidence of renewing their license. c. The manager informs each employee about the new criteria that will be the basis of the performance reviews. d. The manager holds a workshop to outline a new vision for patient-centered care.

c. Integrate quality control through all levels of the organizational hierarchy.

What action should the nurse-manager and other leaders in the health-care organization perform in order to ensure that a quality control program will be effective? a. Set a goal of meeting federal and state standards. b. Set quality control standards at minimum acceptable levels so the organization will score well on self-assessment audits. c. Integrate quality control through all levels of the organizational hierarchy. d. Focus quality improvement efforts on reacting to problems that have been identified.

a. Communicating regularly and openly with employees b. Encouraging teamwork to solve problems and address issues c. Including committee representatives from all areas that will be affected by a changed d. Recognizing staff members who have contributed to the organization's goals

What actions by the nurse-manager are consistent with relationship age leadership? Select all that apply. a. Communicating regularly and openly with employees b. Encouraging teamwork to solve problems and address issues c. Including committee representatives from all areas that will be affected by a changed d. Recognizing staff members who have contributed to the organization's goals e. Encouraging competition between staff members to increase overall efficiency

b. The hierarchy of authority and the policies and procedures on the unit are clearly posted.

What aspect of the way that work is organized on a nursing unit best reflects the management theories of Max Weber? a. A committee that includes employees and managers has been established to plan the work on the unit. b. The hierarchy of authority and the policies and procedures on the unit are clearly posted. c. Quarterly awards are granted to employees who have demonstrated exceptional service. d. Employees are allowed to self-schedule their vacation time and must work out any conflicts on their own.

c. The organization has a history of stifling innovation.

What characteristic of a health-care organization most clearly suggests that is an aged organization? a. The organization was established more than 75 years ago. b. The organization used to be the largest in the region but is now smaller than several similar organizations. c. The organization has a history of stifling innovation. d. The organization is having difficulty attracting new graduates.

c. The manager applies a linear, analytical model when making a decision.

What characteristic of a nurse-manager best demonstrates left-brained thinking? a. The manager highly values innovation and intuition when making decisions. b. The manager's relationships with peers are prioritized when evaluating decisions. c. The manager applies a linear, analytical model when making a decision. d. The manager is open to feedback from staff when making a decision.

c. The manager's influence is limited to his or her group.

What characteristic of a nurse-manager suggests that he or she is acting in the role of a traditional manager rather than an integrated leader-manager? a. The manager is conscious of the important role of politics and is politically astute. b. The manager has an outward view, extending to the larger organization. c. The manager's influence is limited to his or her group. d. The manager emphasizes the importance of vision and values.

c. Engage closely with the frontline staff who provide client care.

What is the best course of action to stimulate broad participation of employees in quality control efforts? a. Encourage regular meetings between middle management and upper management. b. Educate staff about the relationship between the organization's accreditation and their own licensure. c. Engage closely with the frontline staff who provide client care. d. Educate staff about the correct way to document and report sentinel events.

b. "I can't speak with you now, but I'm going to have free time at 11 AM."

What is the best response for a nurse-manager to handle someone who has a pattern of lengthy chatter? a. "We'll need to make it brief since my schedule is tight today." b. "I can't speak with you now, but I'm going to have free time at 11 AM." c. "Stop by and we can talk during your lunch break." d. "I am sorry but I do not have anytime today to talk with you."

b. Managed care organizations are not required to collect HEDIS data.

What is the greatest limitation of the Health Plan Employer Data Information Set (HEDIS)? a. The Joint Commission has not updated the HEDIS since 2009. b. Managed care organizations are not required to collect HEDIS data. c. Performance indicators are exclusively process focused rather than outcome focused. d. HEDIS performance measures focus on medical interventions and do not address nursing actions.

a. Decreasing the risk of inaccurate documentation

What is the primary reason for documenting nursing interventions as soon as possible after an activity is completed? a. Decreasing the risk of inaccurate documentation b. Implementing effective time management skills c. Demonstrating professional nursing behavior d. Observing an established nursing principle

a. They generally interact directly with a greater number of individuals in daily planning.

What is the reason that first- and middle-level managers experience more interruptions than higher level managers? a. They generally interact directly with a greater number of individuals in daily planning. b. They seldom have the clerical and secretarial help assigned to higher level managers. c. They often lack the time management skills that more experienced managers possess. d. They generally have heavier workloads than higher level managers.

b. Supports the acquisition of clinical reasoning

What is the value of using a structured approach to problem solving for the novice nurse? a. Facilitates effective time management b. Supports the acquisition of clinical reasoning c. Supplements the orientation process d. Encourages professional autonomy

a. Collaborative decision making

What management activity characterizes the priorities that existed during the human relations era of management? a. Collaborative decision making b. Punishing workers who were unproductive c. Granting equal rights to men and women d. Application of laissez-faire leadership

d. At discharge, a client was able to ambulate 40 feet unassisted.

What piece of data should the nurse-manager include in an outcome audit? a. Nursing handoffs occur at the client's bedside and include family input. b. Client-nurse ratios are capped at 3:1 in the day and 4:1 at night. c. Technology is acquired so documentation can be completed at the bedside. d. At discharge, a client was able to ambulate 40 feet unassisted.

c. Standardizing clinical outcome data collection

What role has The Joint Commission assumed in ensuring quality at the organizational level? a. Establishing clinical practice guidelines b. Reducing diagnosis-related group reimbursement levels c. Standardizing clinical outcome data collection d. Assessing monetary fines for organizations that fail to meet standards

d. There should be sufficient expertise among committee members to accomplish the assigned task.

What should the leader remember when forming committees? a. Committees work best when there is an adequate supply of workers, with 10 members being the minimum. b. Willingness to work hard is the most important criterion for appointment. c. Written agendas provide excessive structure and stifle committee creativity. d. There should be sufficient expertise among committee members to accomplish the assigned task.

c. "Some people are born to lead, and some are born to be led."

What statement by a leader most clearly demonstrates the Great Man theory of leadership? a. "Leadership is grounded in close, supportive relationships." b. "Leadership and management are two different manifestations of one skill set." c. "Some people are born to lead, and some are born to be led." d. "Leadership can't exist without earning people's respect."

a. "People's motives are important, and motives change over time."

What statement by a manager best reflects the principles of interactional leadership? a. "People's motives are important, and motives change over time." b. "People perform to their fullest potential and then they're under pressure." c. "A person can't simultaneously act as a manager and a leader." d. "Organizations run best when there is no formal, centralized authority."

c. Comparing the organization's performance with that of best performing institutions

What task will best allow a health-care organization to benchmark its performance? a. Comparing its performance on key indicators to its performance the previous year b. Setting ambitious but realistic goals for the coming year c. Comparing the organization's performance with that of best performing institutions d. Seeking input from clients and families about the organization's performance

d. Small variations in the change process can have major effects.

When applying the principles of complex adaptive systems (CAS) theory, the nurse-manager should consider what principle? a. Change must occur by organized, linear steps. b. Change should be guided by intuition instead of being constrained by planning. c. Change is easier in small organizations than large organizations. d. Small variations in the change process can have major effects.

d. the fact that workplaces are complex and dynamic.

When applying the principles of quantum leadership, the nurse-manager should prioritize: a. careful management of emotions. b. his or her own values, beliefs, and moral character. c. the difference between personal goals and organizational goals. d. the fact that workplaces are complex and dynamic.

b. Conducting a search of the literature for research results

When creating a clinical practice guideline for the management of aggressive behavior on a mental health unit, the nursing committee should perform what action first? a. Interviewing senior staff for practice suggestions b. Conducting a search of the literature for research results c. Reviewing client satisfaction data to identify the unit's strengths and weaknesses d. Educating all unit nursing staff on the need to adhere to established guidelines

a. Inspiring staff to establish and maintain high standards regarding patient care

Which action is associated with the nursing leadership role in quality improvement? a. Inspiring staff to establish and maintain high standards regarding patient care b. Being aware of the changes in quality control regulations c. Reviewing research results upon which to base change d. Identifying outcomes that support quality nursing care

d. Identifying the options and resources available to implement change

Which action represents a management function in planned change? a. Inspiring group members to be involved in planned change b. Visionary forecasting c. Role modeling high-level interpersonal communication skills in providing support for individuals undergoing rapid or difficult change d. Identifying the options and resources available to implement change

a. Mentoring two new managers b. Establishing goals for the coming year c. Advocating for nurses to receive more professional development opportunities d. Providing a motivational speech at the new employee orientation

Which activities are associated with a leadership role? Select all that apply. a. Mentoring two new managers b. Establishing goals for the coming year c. Advocating for nurses to receive more professional development opportunities d. Providing a motivational speech at the new employee orientation e. Finding a nurse to cover another nurse's shift

d. The need for change is perceived by those affected by the problem

Which activity associated with the unfreezing state of change will have the greatest impact on the success of the movement stage of the change process?a. Accurate identification of the problem requiring change b. Effective information gathering concerning the problem c. Key personnel voicing their opinions regarding the need for change d. The need for change is perceived by those affected by the problem

a. Funding for staff to become educated in areas where they are naturally talented

Which activity best supports the principles of strengths-based leadership in a health-care organization? a. Funding for staff to become educated in areas where they are naturally talented b. Providing remedial services to staff who have committed a medication error c. Mental health counseling for staff who have depression or anxiety d. Smoking cessation support classes

a. Assisting followers in working cooperatively to maximize time use

Which activity is associated with a leadership role in time management? a. Assisting followers in working cooperatively to maximize time use b. Prioritizing day-to-day planning to meet short-term and long-term unit goals c. Building time for time management planning into the work schedule d. Utilizing technology to facilitate timely communication and documentation

d. Being available to support those affected by a change until the change is complete

Which activity should a change agent perform in order to best assure a successful implementation of a change? a. Helping followers arrive at total consensus regarding the change b. Encouraging subgroup opposition to change so many viewpoints can be heard c. Using change by drift if the resistance to change is too strong d. Being available to support those affected by a change until the change is complete

a. The suggested change is introduced to staff after the plan has been formalized.

Which characteristic of a planned change is most likely to threaten its success? a. The suggested change is introduced to staff after the plan has been formalized. b. Individuals affected by the change are involved in planning for the change. c. The change agent is aware of the organization's internal and external environment. d. An assessment of resources to carry out the plan is completed before unfreezing.

b. There is reduction in the administration levels.

Which characteristic of an organization would suggest that flattening is occurring? a. There is a collective spirit. b. There is reduction in the administration levels. c. There are shared work goals across units. d. There are formal and informal systems are in place to address conflicts.

a. Possesses useful knowledge d. Has the talent and skills needed to do a good job

Which characteristics are associated with a Highly Capable Individual in Collin's Level 5 Leadership model? Select all that apply. a. Possesses useful knowledge b. Builds effective interdisciplinary teams c. Galvanizes members to achieve goals d. Has the talent and skills needed to do a good job e. Works effectively to help a team succeed

a. The individuals included in the group b. Lines of communication c. Decision-making process d. Channels of legitimate authority

Which components are considered a part of an organizational structure? Select all that apply. a. The individuals included in the group b. Lines of communication c. Decision-making process d. Channels of legitimate authority e. Organizational culture

c. The organization's mission statement

Which element should influence the nurse executive most heavily when assessing the organization's philosophy of nursing services for possible revision? a. Consumer surveys b. Input from other health disciplines c. The organization's mission statement d. Policy statements

d. The hospital's nursing supervisor

Which employee of a health-care organization would likely be considered a middle-level manager? a. An experienced primary care nurse who mentors other nurses b. The team leader of the hospital's wound care specialists c. The charge nurse who oversees day shifts on a medical unit d. The hospital's nursing supervisor

b. Presence of employee mistrust

Which factor is the greatest contributor to the resistance encountered with organizational change? a. Poor organizational leadership b. Presence of employee mistrust c. Ineffective organizational management d. Insufficient staff involvement in the process

d. Controlling

Which function of the management process involves the performance evaluation of employees? a. Planning b. Organizing c. Staffing d. Controlling

d. All plans should be flexible to accommodate changing circumstances.

Which is a true statement about planning? a. All plans should be defined at the outset so that changes are not necessary. b. Long- and short-range plans should be kept separate so priorities do not become confused. c. Objectives and goals must be established before the philosophy is written. d. All plans should be flexible to accommodate changing circumstances.

c. It recognizes that the customer is the focal element on which production and service depend.

Which is a true statement regarding TQM? a. It is based on the premise that the organization knows what is best for the consumer. b. Its guiding purpose is to save the organization money. c. It recognizes that the customer is the focal element on which production and service depend. d. It assumes that inspection and removal of errors lead to the delivery of quality services.

b. A client with dementia falls and suffers a hip fracture while trying to walk to the bathroom. d. A client experiences nephrotoxicity and requires dialysis because of a medication error. e. A client experiences a transfusion reaction after receiving the wrong type of packed red blood cells.

Which of the following would be considered sentinel events that should be reported to The Joint Commission? Select all that apply. a. A client with ischemic heart disease dies of a myocardial infarction. b. A client with dementia falls and suffers a hip fracture while trying to walk to the bathroom. c. A client files a formal complaint about the inattention of staff while he was in the hospital. d. A client experiences nephrotoxicity and requires dialysis because of a medication error. e. A client experiences a transfusion reaction after receiving the wrong type of packed red blood cells.

a. Computerized order entry with a drug bar code system

Which practice has the U.S. Food and Drug Administration (FDA) suggested in order to decrease the risk of medication errors? a. Computerized order entry with a drug bar code system b. Medications automatically dispensed to clients at predetermined times c. Use of medication nurses to administer all ordered medications d. Have clients' medications secured at the bedside for self-administration

b. Planning, organizing, staffing, directing, and controlling

Which represents the management functions that are incorporated into the management process? a. Planning, directing, organizing, staffing, and transforming b. Planning, organizing, staffing, directing, and controlling c. Inspiring, planning, staffing, directing, and evaluating d. Organizing, staffing, planning, empowering, and controlling

b. "Let me think about that request for 24 hours and get back to you."

Which response is most characteristic of a servant leader? a. "I don't think you have the skills necessary to be effective." b. "Let me think about that request for 24 hours and get back to you." c. "Do whatever it takes to get it done fast." d. "I'll personally handle this situation."

b. Nurses with clearly identified personal goals and priorities have greater control over how they spend their time.

Which statement about time management is true?a. Most people have an accurate perception of the time they spend on a particular task or the total amount of time they are productive during the day. b. Nurses with clearly identified personal goals and priorities have greater control over how they spend their time. c. Writing goals down is not usually necessary if the goals are limited to fewer than five in number. d. Keeping a time inventory for a day will allow the manager to identify a time management pattern.

c. People will follow a person in a leadership position only by choice.

Which statement best depicts leadership? a. Strong leaders can coerce people into following them. b. A leadership position has a narrower scope than a management position. c. People will follow a person in a leadership position only by choice. d. Leadership requires meeting organizational goals.

d. Continued increases in the cost of pharmaceuticals

Which statement best describes an emerging paradigm that is likely to influence strategic planning for health care in the 21st century? a. Reduced emphasis on cost containment b. Reduced regulatory oversight of health-care organizations c. A shift from interdependence of health-care professionals to greater autonomy d. Continued increases in the cost of pharmaceuticals

d. Change is necessary because organizational stability is brief.

Which statement best describes the philosophy of nonlinear change theories? a. Change occurs in sequential steps of varying speed. b. Change is predictable with proper analysis. c. Change success relies on clear policies and hierarchies. d. Change is necessary because organizational stability is brief.

a. "Your plans for the change can't realistically be implemented."

Which statement by a subordinate demonstrates the greatest challenge for the leader? a. "Your plans for the change can't realistically be implemented." b. "I don't think you heard what the rest of us had to say." c. "Do you have an idea what direction we need to go?" d. "Can you tell me why my suggestion will not work?"

b. They often make decisions that are in congruence with their own values.

Which statement concerning the role of the most powerful individuals in organizational decision making is true? a. They exert less influence on decisions than was previously thought. b. They often make decisions that are in congruence with their own values. c. They tend to delegate decision making rather than making decisions themselves. d. They usually make the important decisions with consideration of effect on others.

b. "I always handle each client's needs as they arise."

Which statement identifies a common mistake made related to daily planning? a. "Crises always come up so my plan is always changing." b. "I always handle each client's needs as they arise." c. "Sometimes it's difficult to reserve time for daily planning." d. "Client care requires a lot of reassessment by nursing."

a. "Every nurse will screen newly admitted clients for alcohol abuse."

Which statement is an example of a process objective? a. "Every nurse will screen newly admitted clients for alcohol abuse." b. "The falls rate on the unit will decrease by 50% compared with 2016 rates." c. "The health-care facility will achieve accreditation within the next 24 months." d. "The new bowel care protocol will be fully implemented by the end of the calendar year."

c. It requires reasoning and creative analysis.

Which statement is true concerning critical thinking? a. It is a simple approach to decision making. b. It is narrower in scope than decision making. c. It requires reasoning and creative analysis. d. It is a synonym for the problem-solving process.

a. The focus of this phase is to integrate the change into the status quo. c. If refreezing is incomplete, prechange behavior will be resumed. d. The change agent must remain involved until the refreeze stage is complete.

Which statement is true concerning the refreezing phase of the change process? Select all that apply. a. The focus of this phase is to integrate the change into the status quo. b. Stabilization of change requires a 6- to 9-month period of time. c. If refreezing is incomplete, prechange behavior will be resumed. d. The change agent must remain involved until the refreeze stage is complete. e. The priority in this phase is to identify resistance.

d. The manager gathers as much information as possible and produces many alternatives.

Which statement is true regarding an economic man style manager? a. The manager may lack complete knowledge and generate few alternatives. b. The manager makes decisions that may not be ideal but result in solutions that have an adequate outcome. c. The manager is primarily motivated by his or her own financial gain. d. The manager gathers as much information as possible and produces many alternatives.

b. Decisions are greatly influenced by each person's value system.

Which statement is true regarding decision making? a. Scientific methods provide identical decisions by different individuals for the same problems. b. Decisions are greatly influenced by each person's value system. c. Personal beliefs can be adjusted for when the scientific approach to problem solving is used. d. Past experience has little to do with the quality of the decision.

b. All policies and practices are based on current evidence related to practice.

Which statement regarding nursing policies and procedures is most important to their successful application in achieving goals? a. The policies and procedures are created by staff representatives. b. All policies and practices are based on current evidence related to practice. c. Policies and procedures are reviewed at fixed times, every 5 years. d. One hundred percent of the staff adheres to established policies and procedures 100% of the time.

b. They may have character flaws.

Which statement regarding the characteristics of a good leader is true? a. They are brave in all situations. b. They may have character flaws. c. They are by nature good-intentioned. d. Charisma is their strongest attribute.

a. It is commonly referred to as a line organization. b. It is typically found in large health-care organizations. d. They resemble Weber's original design of organization. e. Its authority is represented by its staff organizational chart.

Which statements are true concerning a bureaucratic organization? Select all that apply. a. It is commonly referred to as a line organization. b. It is typically found in large health-care organizations. c. It is rooted in individual personalities. d. They resemble Weber's original design of organization. e. Its authority is represented by its staff organizational chart.

a. Resistance to change should be expected as a natural part of the change process. b. Change should be viewed as a chance to do something innovative. d. Change affects the homeostasis of a group.

Which statements are true regarding planned change? Select all that apply. a. Resistance to change should be expected as a natural part of the change process. b. Change should be viewed as a chance to do something innovative. c. Technical changes are more resisted by staff than social changes are. d. Change affects the homeostasis of a group. e. Careful planning can guarantee the success of a change initiative.

a. The leader-manager must be future-oriented. b. The leader-manager has to be willing to take risks. c. The leader-manager should possess human resource management skills. d. The leader-manager must evaluate the social climate that affects the organization.

Which statements concerning the role of the leader-manager in organizational planning are true? Select all that apply. a. The leader-manager must be future-oriented. b. The leader-manager has to be willing to take risks. c. The leader-manager should possess human resource management skills. d. The leader-manager must evaluate the social climate that affects the organization. e. The leader-manager must be the most experienced clinician in the organization.

a. "Since that didn't work effectively, let's try something different" b. "The solution has to be something the client is willing to do." c. "I'll talk to the client's primary care giver about the problem." e. "It's important that we not give up; our clients deserve it."

Which statements demonstrate a characteristic of a critical thinker? Select all that apply. a. "Since that didn't work effectively, let's try something different" b. "The solution has to be something the client is willing to do." c. "I'll talk to the client's primary care giver about the problem." d. "Maybe there is no new solution to this particular problem." e. "It's important that we not give up; our clients deserve it."

b. "I'm learning to trust the members of my team." c. "I've learned that I'm most energetic in the morning." d. "I'll adjust my sleep schedule now that I'm on night shift."

Which statements demonstrate adherence to habits that supports good personal time management skills? Select all that apply. a. "It's important to me to be professional." b. "I'm learning to trust the members of my team." c. "I've learned that I'm most energetic in the morning." d. "I'll adjust my sleep schedule now that I'm on night shift." e. "I never quit a task that I've decided to do."

b. Prioritize the amount and type of nursing care each client requires.

Which task should the team leader perform first when planning care for a group of clients? a. Plan so that each client on the team receives equal amounts of nursing care. b. Prioritize the amount and type of nursing care each client requires. c. Identify the staff who will comprise the individual care teams. d. Assign clients to the specific nursing teams.

a. Giving subsidies to nurses who want to advance their education c. Providing in-services and workshops for nurses and other care providers

he leadership of a health-care organization has chosen to implement human capital theory. What actions should the organization promote in order to meet this goal? Select all that apply. a. Giving subsidies to nurses who want to advance their education b. Increasing the frequency of performance appraisals for managers c. Providing in-services and workshops for nurses and other care providers d. Increasing opportunities for families to participate in care planning e. Providing salary increases of 2% for all nonmanagement staff