exam 1 practice questions

A manager demonstrating an understanding of the principles of Human Capital theory will schedule which staff in-service? Select all that apply. A) Effective communication skills B) Financial planning for retirement C) Advanced cardiopulmonary resuscitation D) Meeting the needs of the patients family

A C D Human capital can refer to a groups collective knowledge, skills, and abilities. Human capital theory suggests that individuals and/or organizations will invest in education and professional development if they believe that such an investment will have a future payoff. Communication, meeting family needs, and cardiopulmonary resuscitation are all skills and abilities that will enhance the individuals professional development and ultimately the services of the facility. The other options are related to the personal interests of the staff.

Which characteristics are associated with Collins Highly Capable Individual level of leadership? Select all that apply. A) Possesses useful knowledge B) Builds effective interdisciplinary teams C) Galvanizes members to achieve goals D) Demonstrates effective organization skills

A, D Highly capable individual makes high quality contributions with their work; possesses useful levels of knowledge; and has the talent and skills needed to do a good job. Team building is a Level 2 characteristic. Organizational skills are associated with Level 3 while galvanizing members to achieve goals is demonstrated by Level 4 leaders.

What statement describes the concept of quantum leadership? A) Ability to use emotions effectively that is required by leader-managers in order to enhance their success B) In order to lead, leaders must be true to themselves and their values and act accordingly C) One individual convinces another to consider a new idea, product, or way of looking at things D) The environment and context in which people work is complex and dynamic and that this has a direct impact on organizational productivity

D

What is the conclusion of interactional theories regarding successful leadership? A) Leaders, followers, and the situation were all variables that interacted B) The situation had the most profound effect on success in leadership C) The situation has a greater effect on outcomes than followers do D) Good results would occur if leaders led well

A The successful leader will diagnose the situation before applying strategies from a large repertoire of skills that involve assessing the various variables presented by the leader, the followers and the situation. The remaining options are not related to interactional leadership theory

What type of manager is concerned with the day-to-day operations? A) Transactional B) Transformational C) Interactional D) Bureaucratic

A The traditional manager, concerned with the day-to-day operations, is termed a transactional leader. This is not a characteristic of the other options.

Avolio states that there are four factors that cover the components of authentic leadership. What is occurring when analyzing data rationally before making decisions? A) Balanced processing B) Internalized moral perspective C) Relational transparency D) Self-awareness

A Balanced processing refers to analyzing data rationally before making decisions. Internalized moral perspective suggests that the authentic leader is guided by internal moral standards, which then guide his/her behavior. Relational transparency refers to openly sharing feelings and information appropriate to a situation, and self-awareness alludes to a knowing of self so as to make sense of the world.

What is the basic premise of interactional theory A) Leadership behavior is generally determined by the relationship between the leaders personality and the specific situation B) Manager behaviors are generally determined by the relationship between the managers personality and the specific situation C) Both managers and followers have the ability to raise each other to higher levels of motivation and morality D) Both leaders and followers have the ability to raise each other to higher levels of motivation and morality

A The basic premise of interactional theory is that leadership behavior is generally determined by the relationship between the leaders personality and the specific situation. Transformational leadership is where both leaders and followers have the ability to raise each other to higher levels of motivation and morality.

Goleman in his best seller Emotional Intelligence identifies self-awareness as one of the five components of emotional intelligence. What is self-awareness? A) The ability to recognize and understand one's moods, emotions, and drives as well as their effects on others B) The ability to control or redirect disruptive impulses or moods as well as the propensity to suspend judgment C) A passion to work for reasons that go beyond money or status; a propensity to pursue goals with energy and commitment D) The ability to understand and accept the emotional makeup of other people

A

What determines the functions and priorities of an organization? A) The organizations mission statement B) The organizations budget C) Consumer satisfaction surveys D) The organizations policy and procedure statements

A

Which leadership style maintains strong control over the work group and uses coercion to motivate others? A) Authoritarian B) Democratic C) Laissez-faire D) A contingency approach

A Lewin identified three common leadership styles: authoritarian, democratic, and laissez- faire. Authoritarian leadership results in well-defined group actions that are usually predictable, reducing frustration in the work group and giving members a feeling of security. Productivity is usually high, but creativity, self-motivation, and autonomy are reduced. Authoritarian leadership is frequently found in very large bureaucracies such as the armed forces. Coercion to motivate is not associated with the other options

What type of management was emphasized in the human relations era of management? A) Participatory B) Authoritarian C) Democratic D) Laissez-faire

A The human relations era of management science emphasized concepts of participatory and humanistic management. Three primary leadership styles have been identified: authoritarian, democratic, and laissez-faire

The failure to engage in which activity is considered a fatal flaw of leadership? Select all that apply A) collaboration B) communication C) self-improvement D) staff development

A, B, C, D

8. Which term is used for strategies that are neither written nor stated verbally and that have developed over time called? A) Implied policies B) Expressed policies C) Understood precedents D) The organizational culture

Ans: A Feedback: Implied policies are neither written nor stated verbally and have developed over time. The other options fail to meet this description.

Which intervention is associated with the nursing leadership role? 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 changes D) Identifying outcomes that support quality nursing care

Ans: A Feedback: Inspiring subordinates to establish and achieve high standards of care is a leadership skill. The remaining options are management roles.

21. Which factor contributes to the difficulty health-care organizations are having in planning for identified long-term needs? Select all that apply. A) Government regulations B) Rapidly changing technologies C) Decreased provider autonomy D) Changing population demographics

Ans: A, B, C, D Feedback: Because of the rapidly changing technology, increasing government regulatory involvement in health care, changing population demographics, and reduced provider autonomy, health-care organizations are finding it increasingly difficult to appropriately identify long-term needs and plan accordingly. Consumer distrust is not a current factor contributing to the difficulty health-care organizations are experiencing with long-term planning.

Who is involved in quality control measurement functions? Select all that apply. A) Facility staff B) Consumers C) All levels management D) Health-care professionals

Ans: A, B, C, D Feedback: Consumers, health professionals, staff, and all levels of management should be involved in quality control measurement. Community members become involved when they become health-care consumers.

20. One of the most commonly used tools in health-care organizations is SWOT analysis. What is the definition for opportunities? 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

Ans: C Feedback: Opportunities are external conditions that promote achievement of organizational objectives. Strengths are internal attributes that help an organization achieve its objectives. Weaknesses are internal attributes that challenge an organization in achieving its objectives. Threats are external conditions that challenge or threaten the achievement of organizational objectives.

What is the best definition for the process of planning? A) Problem oriented B) Short-term goal setting C) Continuous with cyclic evaluation checkpoints D) A long-range needs assessment

Ans: C Feedback: Planning can be short term or long term, but should always include built-in evaluation checkpoints so there can be a midcourse correction if unexpected events occur.

10. What is represented in a document entitled Fourteen Specific Steps to Successful Intravenous Catheterization at Hospital XYZ? A) Philosophy B) Mission statement C) Policy D) Procedure

Ans: D Feedback: Procedures delineate a series of specific steps of required action. None of the other options is the focus of this document.

What is the guiding principle when attempting to address errors made in the delivery of health care? A) Reporting of errors must be both mandatory and voluntary B) Errors are a result of faulty organizational processes C) People are the root cause of health delivery errors D) Errors are either unavoidable or result from reckless behavior

Ans: D Feedback: A just organizational culture emphasizes the finding of the middle ground between the two extremes of error cause (people or system). It seeks to separate unavoidable error from reckless behavior and unjustifiable risk. Reporting of errors can be both mandatory and voluntary but this factor has less importance than the organization attitude regarding the cause of errors.

Which is a characteristic of Theory Z? A) Non-consensus decision making B) Fitting employees to their jobs C) Rapid career promotions D) Authoritative problem solving

B Characteristics of Theory Z include fitting employees to their jobs, consensus decision making, job security, slower promotions, examining the long-term consequences of management decision making, quality circles, guarantee of lifetime employment, establishment of strong bonds of responsibility between superiors and subordinates, and a holistic concern for the workers

Max Weber, a well-known German sociologist, began to study large-scale organizations to determine what made some more efficient than others. What was his conclusion? A) Workers had to have a say in management to work most effectively B) Consistent rules and regulations for workers increased efficiency C) Employees should feel appreciated and valued D) Workers need frequent rest periods to increase overall production

B Weber saw the need for legalized, formal authority and consistent rules and regulations for personnel in different positions. He thus proposed bureaucracy as an organizational design. None of the other options reflect his conclusions

What is a distinguishing trait of integrated leader-managers? Select all that apply. A) Inward thinkers B) Long-term thinkers C) Concerned with employee motivation D) Possess influence beyond their own group

B, C, D Gardner asserted that integrated leader-managers possess six distinguishing traits: They influence others beyond their own group; they emphasize vision, values, and motivation; they think longer term; they look outward, toward the larger organization they are politically astute; they think in terms of change and renewal.

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. What is this an example of?

C Principal agent theory suggests that followers may have an informational (expertise or knowledge) advantage over the leader as well as their own preferences, which may deviate from that of the principal. This may lead to a misalignment of goals. To influence the agent, the principal offers an incentive that corrects excessive overtime. The remaining options do not represent the example offered.

There are current and future paradigm shifts in health care that affect the leadership skills needed by nurses in the twenty-first 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) Shortage of qualified first-level nursing managers D) High turnover rates by staff nurses

D

Which statement concerning nursing leadership functioning at its potential is true? A) The leadership role is most important in nursing today B) Leadership is most important in managing health-care costs C) The most important nursing leadership role is being charismatic D) There is a need to integrate nursing management and nursing leadership

D For managers and leaders to function at their greatest potential, the two roles must be integrated. The other statements are not true

Which statement about situational or contingency leadership theory is correct? A) High relationship behavior is much more essential to a good manager than high task behavior B) This leadership model is effective in bureaucratic organizations because it is task focused C) Management should be consistent in different situations so workers understand what is expected of them D) The leadership style chosen by a manager should reflect the task/relationship behavior of those being managed

D The idea that leadership style should vary according to the situation or the individuals involved was first suggested almost 100 years ago by Mary Parker Follett, one of the earliest management consultants and among the first to view an organization as a social system of contingencies. The other options present statements that are incorrect.

What is the idea that workers should be hired, trained, and promoted based on their competence and abilities related to? A) Part of the management functions identified by Fayol B) The result of the human relations studies C) The outcome of studies done by Mayo at the Hawthorne Works D) One of the four overriding principles of scientific management

D Frederick Taylor, the father of scientific management, had the idea that workers should be hired, trained, and promoted based on their competence and abilities. This concept is not associated with any of the other options.

What is a focus of thought leadership A) Challenging the status quo B) Learning new technology C) Keeping up with current nursing knowledge D) Being a transformational leader

A

A transition has occurred in the twenty-first-century industrial age leadership to what type of leadership? A) Relationship age B) Quantum C) Authentic D) Thought

A A transition has occurred in the twenty-first-century industrial age leadership to relationship age leadership. Quantum leadership suggests that the environment and context in which people work is complex and dynamic and that this has a direct impact on organizational productivity required by leader-managers in order to enhance their success. Authentic leadership suggests that in order to lead, leaders must be true to themselves and their values and act accordingly. Thought leadership refers to any situation whereby one individual convinces another to consider a new idea, product, or way of looking at things.

Which principle will help increase the likelihood that followers do not mislead their leader? A) Support the followers right to disagree B) Rely only on facts and discount intuition C) Discourage acceptance until the facts are proved D) Identify who to rely upon and who not to listen to

A There is no guarantee that followers will not mislead leaders, but adhering to certain principles, such as making sure that followers are allowed to disagree, will guard against this happening. The remaining options are flawed in the principles they support

What concept is servant leadership based upon? A) Trusting and valuing employees B) Genuinely liking your colleagues C) A laissez-faire style of leadership D) A dynamic leadership charisma

A These managers, termed servant leaders, put serving others, including employees, customers, and the community, as the number-one priority. In addition, servant leaders foster a service inclination in others that promotes collaboration, teamwork, and collective activism. The servant leader is not necessarily associated with the concepts identified in the other options

What does the Hawthorne effect implied about people? A) Human beings under investigation will respond to the fact that they are being studied B) Production will increase or decrease as light in a factory is increased or decreased C) Membership in small groups forms social control D) People are inherently good and will seek out work

A Hawthorne effect indicated that people respond to the fact that they are being studied, attempting to increase whatever behavior they feel will continue to warrant the attention. The other statements do not reflect implied beliefs about people.

Which action is associated with relationship age leadership? Select all that apply. A) Communicates regularly with subordinates B) Encourages teamwork to achieve problem solving C) Includes committee representatives from all areas that will be affected by the change D) Recognizes staff members who have contributed plausible problem-solving solutions

A, B, C, D Ans: A, B, C, D

Which activity is associated with a leadership role? Select all that apply. A) Mentoring two new managers B) Establishing goals for the coming year C) Advocating for employee regarding personal policies D) Providing a motivational speech at the new employee orientation

A, B, C, D Leadership roles include mentoring, decision making, advocating, and energizing. Risk taking is also considered a leadership role

11. Which statement is true regarding individual values? A) They are often modified by parents, peers, and role models throughout life B) They seldom change as a result of lifes experiences C) They have little influence on decision making once employed because organizational values eliminate personal values D) They show little variation between nursing managers once they have achieved some level of authority

Ans: A Feedback: Personal values are shaped by the socialization processes experienced by that person, and values change with time. The remaining statements are not true regarding individual values.

19. One of the most commonly used tools in health-care organizations is SWOT analysis. What is the definition for S? 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

Ans: A Feedback: Strengths are internal attributes that help an organization achieve its objectives. Weaknesses are internal attributes that challenge an organization in achieving its objectives. Opportunities are external conditions that promote achievement of organizational objectives. Threats are external conditions that challenge or threaten the achievement of organizational objectives.

7. What is required in a health-care organization philosophy statement? A) Should be evident in a nursing departments decisions, priorities, and behavior B) Has value, even if not implemented, because it provides a picture of what the organization would like to accomplish C) Should reflect the values and priorities of each specific unit manager D) Should be consistent with that of other health care agencies in the area to avoid competition

Ans: A Feedback: The unit philosophy will be congruent with the organizational philosophy. A philosophy delineates the set of values and beliefs that guide all actions. The other options do not accurately describe requirements of a health-care organization philosophy statement

5. Which statement identifies a characteristic of a planning objective? A) It has a specific time frame for completion B) It is subjectively evaluated on a periodic basis C) It has a100% compliance as a minimum criterion D) It is broad and inclusive in its nature

Ans: A Feedback: Multiple planning objectives, each with a target completion date, make up a goal. The remaining options are not characteristics of this objective.

16. Benefits of effective planning include timely accomplishment of higher quality work and the best possible use of capital and human resources. Because planning is essential, managers must be able to overcome barriers that impede planning. What is an important point for successful organizational planning? A) The organization can be more effective if movement within it is directed at specified goals and objectives B) Plans to reach a goal must be rigid and not be distracted by current events C) The manager should include in the planning process the leadership people of units that could be affected by the plan D) A global plan and outline is sufficient to encourage and motivate employees

Ans: A Feedback: The organization can be more effective if movement within it is directed at specified goals and objectives. Because a plan is a guide to reach a goal, it must be flexible and allow for readjustment as unexpected events occur. The manager should include in the planning process all people and units that could be affected by a plan. A plan that is too global or unrealistic discourages rather than motivates employees.

What is the definition of a standard? A) A predetermined baseline condition or level of excellence that constitutes a model to be followed and practiced B) Diagnosis-based, step-by-step interventions for nurses to follow in an effort to promote evidence-based, high-quality care C) Process of measuring products, practices, and services against those of best- performing organizations D) Identify not only what and how an event happens but why it happens, with the end goal being to ensure that a preventable negative outcome does not recur

Ans: A Feedback: A standard is a predetermined baseline condition or level of excellence that constitutes a model to be followed and practiced. The remaining options all fail to accurately define a standard.

What are the four evidence-based standards identified by the Leapfrog Group to reduce medical errors? A) Computerized physician provider order entry, evidence-based hospital referral, ICU physician staffing, and the use of Leapfrog Safe Practices scores B) Computerized physician provider order entry, evidence-based visiting nurse referral, ED physician staffing, and the use of Leapfrog Safe Practices scores C) Computerized primary care provider order entry, evidence-based hospital referral, ICU physician staffing, and the use of Leapfrog Safe Medication scores D) Computerized nurse practitioner provider order entry, evidence-based outpatient referral, ED physician staffing, and the use of Leapfrog Safe Medication scores

Ans: A Feedback: The Leapfrog Group identified four evidence-based standards that they believe will provide the greatest impact on reducing medical errors: computerized physicianñprovider order entry, evidence-based hospital referral, ICU physician staffing, and the use of Leapfrog Safe Practices scores.

Which practice has the U.S. Food and Drug Administration 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 patients at predetermined times C) Use of medication nurses to administer all ordered medications D) Have patients' medications kept at the bedside for self-administration

Ans: A Feedback: The U.S. Food and Drug Administration has suggested that a drug bar code system coupled with a computerized order entry system would greatly decrease the risk of medication errors.

Which task is a management function associated with quality control? A) Periodic evaluation of unit mission and philosophy B) Making out the daily patient care assignments C) Creating a yearly budget D) Distributing holiday staffing policies

Ans: A Feedback: Unit mission, philosophy, goals, and objectives are the blocks on which policies and standards rest. All these must be in place to measure whether quality is being achieved on the unit. The other options are not related to quality control.

25. Which statement concerning the role of the leader-manager in organizational planning is true? Select all that apply. A) They need to be future oriented B) They must be willing to take risks C) They must possess human resource management skills D) They need to be prepared to appraise the social climate that affects the organization

Ans: A, B, C, D Feedback: Planning requires managerial expertise in health-care economics, human resource management, political and legislative issues affecting health care, and planning theory. Planning also requires the leadership skills of being sensitive to the environment, being able to appraise accurately the social and political climate, and being willing to take risks. Managers then must draw on the philosophy and goals established at the organizational and nursing service levels in implementing planning at the unit level. The manager then draws on his or her leadership skills in creativity, innovation, and futuristic thinking to problem solve.

12. What is a characteristic of strategic planning? Select all that apply. A) Requires managerial expertise in health-care economics B) Should reflect political issues related to health care C) Human resource expertise is required D) Should be based on a planning theory

Ans: A, B, C, D Feedback: Strategic planning generally forecasts 3 to 10 years into the future and requires managerial expertise in health-care economics, human resource management, and political and legislative issues affecting health care, as well as planning theory.

4. During the process of acquiring values, criteria should be used to assist in clarifying the chosen value. Which is a criterion for a true value? Select all that apply. A) It is freely chosen from among alternatives B) It is prized and cherished C) It is positively affirmed D) It is acted upon

Ans: A, B, C, D Feedback: A value is prized and cherished, positively affirmed and acted upon, and chosen freely from among alternative. Because our values change with time, periodic clarification is necessary to determine how our values may have changed.

What is the typical focus of managers? Select all that apply A) Establishing a legitimate source of power B) Delegating responsibilities to staff members C) Formulate the budget to achieve the stated goals D) Direct attention to the management of unwilling subordinates

Ans: A, B, C,D The manager is typically involved in the delegation of responsibilities through the power of the legitimate power associated with the position. To manipulate people, the environment, money, time, and other resources to achieve organizational goals is also a managers focus. Attention to both willing and unwilling subordinates as well as established responsibilities is associated with the role of the manager

17. A good plan incorporates which characteristic? A) A midterm evaluation B) Built-in evaluation checkpoints C) The rejection of plans that originally failed D) Over-planning to arrange required details

Ans: B Feedback: Good plans have built-in evaluation checkpoints so that there can be a midcourse correction if unexpected events occur. A final evaluation should always occur at the end of the plan. If goals were not met, the plan should be examined to determine why it failed. This evaluation process assists the manager in future planning. One who over plans may devote excessive time to arranging details that might be better left to those who will carry out the plan.

22. What makes an organizational philosophy useless? A) Being expensive to implement B) Viewed as being impossible to implement C) Not having the support of all the involved parties D) Involving a change in the organizational point of view

Ans: B Feedback: An organizational philosophy that is not or cannot be implemented is useless. While challenging, the other options are surmountable.

15. How are preactive planners described? A) They consider and value the past, the present, and future B) They use evolving technologies to accelerate change C) They consider the status quo as a stable environment D) They direct planning in response to a crisis

Ans: B Feedback: Dissatisfied with the past and present, preactive planners do not value experience and believe the future is always preferable. Their focus is not necessarily crisis response.

23. Which statement regarding nursing policies and procedures is most important to their successful role 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) Policy or procedure adoption is dependent upon effective utilization of resources D) 100% of the staff adheres to established policies and procedures 100% of the time

Ans: B Feedback: Policies and procedures should be evidence based. While the other options are influential to success, they are the most important aspect of policies and procedures.

Nursing students who scored in the top 5% on the examination 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 this type of data? A) Structure B) Process C) Outcome D) Concurrent

Ans: B Feedback: A process audit assumes that a relationship exists between the process used and the quality of the result. This is the only option that fulfills that function.

Which statement is true regarding adverse drug events (ADEs)? A) They occur infrequently in accredited hospitals B) They are responsible for about 20% of hospitalized disabilities C) They usually involve either prescribing or pharmacy errors D) They occur because of individual recklessness

Ans: B Feedback: ADEs occur in all hospitals, are to blame for 20% of injury disabilities, and involve more than prescribing or pharmacy errors, but are rarely due to individual recklessness. They occur in both accredited and unaccredited facilities.

What results from the development of plan of correction associated with health-care delivery errors? A) Sentinel event B) Root cause analysis C) Quality assessment (QA) program D) Failure mode and effects analysis (FMEA)

Ans: B Feedback: Another Joint Commission priority is the development of root cause analysis with a plan of correction for the errors that do occur. A sentinel event is likely the trigger of the root cause analysis. FMEA examines all possible failures in a designóincluding sequencing of events, actual and potential risk, points of vulnerability, and areas for improvement. QA is an ongoing process that focuses on continued delivery improvement.

What do clinical practice guidelines provide? A) A predetermined baseline condition or level of excellence that constitutes a model to be followed and practiced B) Diagnosis-based, step-by-step interventions for nurses to follow in an effort to promote evidence-based, high-quality care C) Process of measuring products, practices, and services against those of best- performing organizations D) Identify not only what and how an event happens but why it happens, with the end goal being to ensure that a preventable negative outcome does not recur

Ans: B Feedback: Clinical practice guidelines provide diagnosis-based, step-by-step interventions for nurses to follow in an effort to promote evidence-based, high-quality care and yet control resource utilization and costs. The remaining options all fail to accurately identify what a clinical practice guideline provides.

When working on clinical practice guidelines for a mental health unit, the nursing committee will implement which intervention initially? A) Assessing the medical psychiatric staff for practice suggestions B) Implementing a search of the literature for current related research results C) Reviewing patient satisfaction data to identify the unit's strengths and weaknesses D) In-servicing all unit nursing staff on the need to adhere to established guidelines

Ans: B Feedback: Clinical practice guidelines reflect evidence-based practice; that is, they should be based on cutting edge research and best practices. The other options may be helpful but should occur after the review of the research literature.

What is the greatest limitation of the Health Plan Employer Data Information Set (HEDIS)? A) Findings are not released to the public B) Only about half of managed care organizations have chosen to participate C) Performance indicators are process focused rather than outcome focused D) There are only 15 performance measures

Ans: B Feedback: The NCQA, a private nonprofit organization that accredits managed care organizations, has developed HEDIS. One of the most significant weaknesses of NCQA accreditation is that such accreditation is voluntary and only about half of managed care organizations currently undergo such review. The remaining options do not relate to the HEDIS

24. Which statement regarding rules is true? Select all that apply. A) Rules should be flexible B) There should be as few rules as possible C) Rules should be changed on a regular basis D) Enforcement of the rules supports staff morale

Ans: B, D Feedback: Rules are fairly inflexible, so the fewer rules, the better. Existing rules, however, should be enforced to keep morale from breaking down and to allow organizational structure. It is neither reasonable nor necessary for all involved parties to agree with the rules but all must follow them. Rules require regular evaluation but change may not be warranted.

14. Which element influences the nurse executive most heavily when assessing the organizations philosophy for nursing services for possible revision? A) Consumer surveys B) Financial resources C) Mission statement D) Policy statements

Ans: C Feedback: The philosophy flows from the mission statement, the highest priority in the planning hierarchy. The other options are not as influential.

hirty-eight percent of the people who attended a smoking cessation clinic were not smoking 1 year after the clinic closed. What type of audit provided this type of data? A) Structure B) Process C) Outcome D) Concurrent

Ans: C Feedback: An outcome audit determines what outcomes resulted from specific nursing interventions for clients. That is the function of the remaining options.

Which statement is true regarding criteria for assuring that a quality control program will be effective? A) The primary purpose of the program is to satisfy various federal and state standards B) Developed standards should reflect minimally acceptable levels so the organization will score well on self-assessment audits C) A belief in the importance of quality control must be integrated through all levels of the organizational hierarchy D) The process should be reactive; in other words, quality improvement efforts should be initiated after problems are identified

Ans: C Feedback: For any quality control program to be effective, a belief in the importance of quality control must be integrated through all levels of the organizational hierarchy. The remaining statements are false.

What results from effective benchmarking? A) Two organizations become financially integrated under a capitated model B) Organizations compete for a ìbest practicesî label from the National Committee for Quality Assurance (NCQA) C) An organization compares its performance with that of ìbest-performing institutionsî D) Minimum practice guidelines are established for each health-care organization

Ans: C Feedback: In benchmarking, an organization compares its performance with that of ìbest- performing institutions.î Benchmarking is not associated with the other options.

What is the best course of action to stimulate staff nurses' involvement in quality control research on a nursing unit? A) Hire a well-qualified researcher to help staff design studies B) Create a joint medical/nursing staff research committee C) Provide staff with paid release time for research activities D) Ensure that research designs are well grounded and scientific

Ans: C Feedback: Staff should be involved in determining criteria or standards, reviewing standards, and collecting data. To stimulate staff nurses' involvement in quality control research, the best course of action would be to provide staff with paid release time for research activities. The other options fail to actually stimulate the nurse's involvement in the process.

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 is based on the premise 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

Ans: C Feedback: TQM is based on the premise that the customer is the focal element on which production and service depend. The other options are false statements.

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 hospitals that fail to meet standards

Ans: C Feedback: The Joint Commission ensures quality at the organizational level by requiring participating organizations to choose from among 60 acceptable performance measurement systems. The Joint Commission is not actively involved in any of the other options.

What is the first step in quality control? A) To take corrective action when standards have not been met B) To collect data to determine whether standards have been met C) To determine criteria and standards D) To determine who will measure the standard

Ans: C Feedback: The first step in quality control is to determine criteria and standards. Measuring performance or making corrections is impossible if standards have not been clearly established.

What is the function of a nursing minimum data set? A) Compares the quality of nursing care and medical care B) Identifies minimal levels of quality necessary for nurses to maintain licensure C) Standardizes the collection of nursing data for use by multiple data users D) Identifies only ìnursing-sensitiveî patient outcome measures

Ans: C Feedback: The nursing minimum data set standardizes the collection of nursing data for use by multiple data users. None of the remaining options accurately describes the function of such a data set.

18. At the unit level, what time frame may be considered long-range planning? A) 3 months B) 4 months C) 5 months D) 6 months

Ans: D Feedback: At the unit level, any planning that is at least 6 months in the future may be considered long-range planning.

3. Which is a true statement about planning? A) All plans should be defined well so that changes arent 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 include reasonable time limits

Ans: D Feedback: Every plan should have a reasonable time span for completion. The other statements are not true regarding the process of planning.

6. How is the leadership role and management function associated with operational and strategic planning? A) Articulating the unit philosophy in writing B) Assessing unit resources available for planning C) Developing unit policies and procedures that operationalized unit objectives D) Encouraging subordinates to be involved in policy formation

Ans: D Feedback: Encouraging subordinates is a leadership function; the others are management functions. The other options do not achieve this goal.

13. Which statement describes an emerging paradigm that is likely to influence strategic planning for health care in the twenty-first 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) A movement from client-as-customer to population-as-customer

Ans: D Feedback: Health services are increasingly being provided to large groups of people, usually defined by employers, through managed care or capitated contracts. The other options do not describe an influential twenty-first-century paradigm.

What do the critics of prospective payment system argue? A) Diagnosis-related groups have not helped to contain rising health care costs B) The system has increased the length of hospital stay C) Services provided under this system have only slightly increased D) On the whole quality of care has declines since its implementation

Ans: D Feedback: Critics of the prospective payment system argue that although DRGs may have helped to contain rising health-care costs, the associated rapid declines in length of hospital stay and services provided have resulted in declines in the quality of care.

An RN is a supervisor in an organization that has total quality management (TQM) as the backbone of its organizational goals and objectives for quality control. How does the RN practice TQM on the unit? A) Encouraging employees to think of a unit slogan B) Developing a quota system for number of patients cared for C) Explaining to the staff that ìif it's not broke, don't fix itî D) Promoting teamwork rather than individual accomplishments

Ans: D Feedback: In TQM, team efforts are favored over individual accomplishments. Slogans, quota systems, and maintaining the status quo work against quality in this philosophy.

What is the best qualitative measurement in determining quality control for marketing? A) Morbidity and mortality rates B) Nursing care hours per patient day C) Average length of stay D) Patient surveys of general satisfaction

Ans: D Feedback: In determining quality control for marketing, the best qualitative measurement would be patient surveys. The other options are not necessarily qualitative measurements.

Which statement is true regarding the factors that impact patient satisfaction with a hospitalization? A) The quality of care delivered is the primary factor related to B) The patient's understanding of his/her condition influences satisfaction C) The length of the hospital stay is the deciding influence on satisfaction D) The patient's satisfaction has little to do with actual health improvement

Ans: D Feedback: Patient satisfaction often has little to do with whether a patient's health improved during a hospital stay. It is important to remember that quality care, length of stay, and patient perception do not always equate with patient satisfaction.

What is an example of a positive outcome of a leader's emotional intelligence? A) Emotions are held in check B) Emotions are used effectively C) Expression of ones emotions is expected D) Expression of ones emotions is encouraged

B

Which response is 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. C) Do whatever it takes to get it done fast D) iIl personal handle this situation.

B A servant leader always thinks before reacting. This leader also chooses words carefully so as to not damage those being led, provides directions toward goal achievement, and finds asking for input more important than personally providing solutions.

Shirey suggests there are five distinguishing characteristics of authentic leaders. Which characteristic is occurring when authentic leaders link between purpose and passion by having congruence in beliefs and actions? A) Purpose B) Values C) Heart D) Relationships

B Authentic leaders link between purpose and passion by having congruence in beliefs and actions. Purpose: Authentic leaders understand their own purposes and passions as a result of ongoing self-reflection and self-awareness. Heart: Authentic leaders care for themselves and the people they lead, and their compassion is genuine. Relationships: Authentic leaders value building relationships and establishing connections with others, not to receive rewards but rather to strengthen the human connection

Which statement regarding the characteristics of a good leader is true? A) They are totally trustworthy B) They may have character flaws C) They are by nature good intentioned D) Charisma is their strongest attribute

B Leaders may be deceitful and trustworthy, greedy and generous, and cowardly and brave. To assume that all good leaders are good people is foolhardy and makes us blind to the human condition. It is only when we recognize and manage our failings that leaders achieve greatness.

Which statement by a subordinate demonstrates the greatest problem for the leader? A) Your plans for the changes will be difficult to implement 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 The statement is a clear indication that the subordinate feels the leader is not listening and collaborating; this is a fatal flaw. The other statements are more open to explanation by and with the subordinate and leader

What type of leader is the person who is committed, has a vision, and is able to empower others with this vision? A) Transactional B) Transformational C) Interactional D) Bureaucratic

B Transformational leadership positively impacts the leader and the follower, who have a collective purpose. The traditional manager, concerned with the day-to-day operations, was termed a transactional leader. The remaining options are not associated with these characteristics.

What assumption about workers does Theory X hold? A) Workers will naturally put forth effort B) Workers need threats to be motivated C) Workers are diligent and responsible D) Workers are in tune with organizational needs

B Theory X managers believe that their employees are basically lazy, need constant supervision and direction, and are indifferent to organizational needs. Oppositely, the other options describe a Theory Y worker

Classical, or traditional, management science focuses on A) Meeting worker satisfaction B) Delineating barriers to productivity C) Using a laissez-faire approach D) Encouraging employee participation

B focuses on production in the workplace and on delineating organizational barriers to productivity. Little attention was given to worker job satisfaction, and workers were assumed to be motivated solely by economic rewards.

Which represents the management functions that are incorporated into the management process? A) Planning, directing, organizing, staffing, and evaluating B) Planning, organizing, staffing, directing, and controlling C) Organizing, planning, staffing, directing, and evaluating D) Organizing, staffing, planning, implementing, and controlling

B. Planning, Organizing, Staffing, Directing, Controlling

Avolio states that there are four factors that cover the components of authentic leadership. What is occurring when one openly shares feelings and information appropriate to a situation? A) Balanced processing B) Internalized moral perspective C) Relational transparency D) self-awareness

C

Which statement depicts leadership? A) A leadership position is assigned B) A leadership position carries a legitimate source of power C) Members of a group will follow a person in a leadership position only by choice D) Leadership requires meeting organizational goals

C A leader is the person who guides direction, opinion, and course of action without having an assigned position within the formal organization and so people choose to follow them. The other options are not accurate descriptions of leadership

Managing conflict among staff members would occur in which part of the management process? A) Planning B) Organizing C) Directing D) Evaluating

C Directing sometimes includes several staffing functions. However, this phases functions usually entail human resource management responsibilities, such as motivating, managing conflict, delegating, communicating, and facilitating collaboration. Planning encompasses determining philosophy, goals, objectives, policies, procedures, and rules; carrying out long- and short-range projections; determining a fiscal course of action; and managing planned change. Organizing includes establishing the structure to carry out plans, determining the most appropriate type of patient care delivery, and grouping activities to meet unit goals.

It is the idea that context is an important mediator of transformational leadership, that led to the creation of full range leadership theory early in the 21st century. This theory originally developed by Antonakis, Avolio, and Sivasubramaniam suggests how many transformational factors impacting leadership style and its impact on followers? A) One B) Three C) Five D) Nine

C There are nine factors impacting leadership style and its impact on followers; five are transformational, three are transactional, and one is a nonleadership or laissez-faire leadership factor.

Gardner states that integrated leaders-managers distinguish themselves from more traditional managers in six ways. Which is a distinguishing trait of a traditional manager rather than an integrated leader-manager? A) They are politically astute B) They look outward, toward the larger organization C) They extend influence only to their own group D) They emphasize vision, values, and motivation

C Traditional managers influence those in their own groups while integrated leaders influence others beyond their own group. The remaining options represent traits that may be shared by both types.

How many primary leadership styles have been identified? A) One B) Two C) Three D) Four

C authoritarian, democratic, and laissez- faire

A manager has proposed to the hospital board that it hires 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

C by providing classes in leadership, the manager is investing in the potential of the head nurse staff to become better leaders and managers. Human capital refers to the attributes of a person that are productive in some economic context, although it is normally measured and conceived of as a private return to the individual as well as a social return. None of the remaining options relate to the example provided.

What concept does early leadership-theory development suggest? A) Leadership is a process of influencing others within an organizational culture B) The interactive relationship between the leader and the follower is significant C) Some are born to lead, whereas others are born to be led D) Vision and empowerment are two of the most critical leadership skills

C Early leadership theorists focused on broad conceptualizations of leadership that assumed that people have certain characteristics or personality traits that make them better leaders than others. The remaining options do not describe a concept suggested by early leadership- theory development.

An organization has hired six RNs who have recently immigrated to the United States. 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) Begin a short sharing session before client report, so all RNs can share information about their cultures and differences in client care.

D Providing an opportunity for both groups of nurses to share their cultural heritage and differences in nursing care is an opportunity to promote acceptance among all members of the staff. It has been established that speaking the language is not a problem since they do so while on duty. Including them in after-work activities may demonstrate willingness on the staffs part but will not address work-related isolation. Merely presenting the problem to the new nurses does not show managing initiative.

Which function of the management process involves the performance evaluation of staff? A) Planning B) Organizing C) Staffing D) Controlling

D Controlling is the function that includes performance appraisals, fiscal accountability, quality control, legal and ethical control, and professional and collegial control.

9. Place the planning hierarchy in its proper order from top (being 1) to bottom (being 7) represent. A) Philosophy B) Goals C) Mission statement D) Objectives E) Policies F) Procedures G) Rules

The planning hierarchy follows this order: begins with organizations mission statement, philosophy, goals, objectives, policies, procedures, and ends with rules.

Which activity supports the principles of strengths-based leadership? A) Tuition reimbursement for LPN to RN transition programs B) Rehab services to staff diagnosed with abuse problems C) Mental health counseling for depression and anxiety D) Smoking cessation support classes

a Strengths-based leadership, which grew out of the positive psychology movement (began in the late 1990s), focuses on the development or empowerment of workers strengths as opposed to identifying problems, improving underperformance, and addressing weaknesses and obstacles.

How many characteristics such as servant leadership does Tabaka suggest is required of an agile organization today? A) 1 B) 5 C) 10 D) 15

c Tabaka suggests that servant leadership is one of the top 10 characteristics of an agile organization today.

What is the critical leadership skill when attempting to build a cooperative and effective team? A) Showing their true feelings B) Empathizing with followers C) Identifying existing emotions in themselves and others D) Manipulating the emotions of all involved to achieve stated goals

c Theorists studying emotional intelligence posit that the ability to identify emotions in themselves and in others is a critical ingredient of leaders, enabling them to build a cooperative and effective team. While the other options may have value, they do not represent the critical skill related to team building.