~~~ Final leadership

3. Although some subjectivity is inescapable in performance appraisals, what action can the manager take to arrive at a more fair and accurate assessment? A) Written anecdotal notes regarding the employee's performance should be maintained throughout the evaluation period B) Evaluation criteria that reflect on the employee as a person rather than just on work performance should be used C) Data gathered by the manager in preparation for the performance appraisal should be limited to not more than two sources, so no conflicting information is received D) The manager should rate all employees using central tendency whenever possible

Ans: A Feedback: Because a manager will tend to remember an employee's performance better in the weeks or months directly preceding the appraisal, a manager should take notes on an employee's performance throughout the year. The other options are less effective in proving a balanced appraisal.

22. What is the purpose of competency assessment regarding a nurse's career? A) Identifying ways to exceed minimal licensing requirements B) Fulfilling state requirements for minimal nursing practice C) Facilitating advancement up the facility's career ladder D) Satisfying institutional employment qualification

Ans: A Feedback: Competency assessment and goal setting in career planning should help the employee identify how to exceed the minimum levels of competency required by federal, state, or organizational standards. The remaining options do not describe the purpose of competency assessments.

11. Where did critical pathways originate from? A) Case management B) Functional nursing C) Team nursing D) Primary care nursing

Ans: A Feedback: Critical pathways were developed as a result of the case management system. None of the other options identify that original connection.

Which would be a normal and expected behavioral response during the unfreezing phase of change? A) Anger B) Withdrawal and acceptance C) Open acceptance D) Active collaboration

Ans: A Feedback: During the unfreezing stage, people become discontented, and even angry, with the status quo. Ironically, they may also become angry that change is needed, because of the resistance that is a normal and expected part of the change process. The other options are not usually associated with the unfreezing phase of change.

Which behavior/attitude makes it likely that a planned change will be unsuccessful? A) The suggested change is brought forward 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

Ans: A Feedback: Employees should be involved in the change process. When information and decision making are shared, subordinates will be more accepting of the change. The other options support the change.

8. What is the largest budget expenditure for health-care organizations? A) The personnel budget B) Short-term capital acquisitions C) The operating budget D) Supplies and equipment

Ans: A Feedback: Health care is labor intensive; therefore, the personnel budget makes up the largest expense. The other options represent less expensive expenditures.

13. When do nursing shortages historically occur? A) When the economy is beginning an upswing B) When the economy is receding C) When nursing salaries decline D) When patient acuity increases

Ans: A Feedback: Historically, nursing shortages occur when the economy is on the upswing and decline when the economy recedes. Historically, salaries were not a factor in existing nursing shortages. Currently, as the nursing pool ages, there is a nursing shortage projected.

8. Which statement best describes case management? A) Clinical outcomes should occur within a prescribed time frame B) Case managers do not provide direct patient care C) Managed care practice is a unit-based model of care D) The goal is outcome management for every patient

Ans: A Feedback: In case management, clinical outcomes need to occur within prescribed time frames. Case managers do not provide care; neither is managed care unit based. The goal is outcome management for specific patients, but not every patient needs case management.

6. Which is an appropriate strategy for planning, conducting, and controlling the interview? A) When an applicant clearly does not have the proper qualifications for a position, the interviewer should be tactful, but advise the applicant as soon as possible that there is a lack of appropriate qualifications for the job B) Personal questions should be asked early during the interview process so a rapport can be established between the interviewer and the applicant C) The interviewer should develop questions that can be answered with a yes or no answer D) The interviewer should assess an applicant's perceptive skills by sending nonverbal cues to the applicant during his or her responses

Ans: A Feedback: In situations in which the interviewee is not qualified for the position, the interviewer must inform the interviewee of this early and tactfully. After the interview is completed, the interviewer should take notes for the file of the exact reason for rejection in case of later discrimination charges. None of the other options identify an appropriate strategy.

4. Which statement most accurately defines intrinsic motivation? A) Motivation that is directly related to a person's internal level of aspiration B) Motivation that is enhanced by the job's environmental conditions C) Motivation that is not shaped by personal values D) Motivation that is not related to achievement

Ans: A Feedback: Intrinsic motivation comes from within the individual. To be intrinsically motivated at work, the worker must value job performance and productivity. The other options are not as relevant to this factor.

18. What type of interview questions are difficult to respond to without some advance thought? 1. Personal philosophy of nursing 2. Professional organizations membership 3. Individual strengths and weaknesses 4. Career goals A) 1, 3, 4 B) 1, 2, 3 C) 1, 2, 4 D) 2, 3, 4

Ans: A Feedback: It is difficult to spontaneously answer interview questions about your personal philosophy of nursing, your individual strengths and weaknesses, and your career goals if you have not given them advance thought.

21. How does a leader effectively use a performance appraisal? A) To motive staff B) To identify staff educational needs C) To follow up on identified deficiencies D) To provide feedback on work performance

Ans: A Feedback: Leaders use the appraisal process to motivate employees and promote growth. The remaining options are manager responsibilities.

Collecting data about the ethical problem and identifying who should be involved in the decision-making process is accomplished in which phase of the MORAL decisionmaking model? A) Massage the dilemma B) Outline options C) Review criteria and resolve D) Affirm position and act

Ans: A Feedback: Massage the dilemma: Collect data about the ethical problem and who should be involved in the decision-making process. Outline options: Identify alternatives, and analyze the causes and consequences of each. Review criteria and resolve: Weigh the options against the values of those involved in the decision. This may be done through a weighting or grid. Affirm position and act: Develop the implementation strategy.

21. Which statement concerning a budget is true? A) A budget's reliability is related to how far in advance it was created B) Budgets should be created as far in advance is possible C) A budget is revised every 3 months during a fiscal year D) Budgets are reliable only when expenses are fixed

Ans: A Feedback: A budget that is predicted too far in advance has greater probability for error. The other options are incorrect statements regarding a budget.

Which leadership role is associated with advocacy? A) Create a climate where advocacy and its associated risk-taking are valued B) Give subordinates and patients adequate information to make informed decisions C) Ensure that rights and values of patients supersede those of the health-care providers D) Seek appropriate consultation when advocacy results in intrapersonal or interpersonal conflict

Ans: A Feedback: A leadership role associated with advocacy is to create a climate where advocacy and its associated risk-taking are valued. Management functions include the following: give subordinates and patients adequate information to make informed decisions; ensure that rights and values of patients supersede those of the health-care providers; and seek appropriate consultation when advocacy results in intrapersonal or interpersonal conflict.

Which management function is associated with advocacy? A) Awareness of current legislative efforts affecting nursing practice and organizational and unit management B) Role modeling proactive involvement in health-care policy through both formal and informal interactions with the media and legislative representatives C) Participation in professional nursing organizations and other groups that seek to advance the profession of nursing D) Assertively advocating on behalf of patients and subordinates when an intermediary is necessary

Ans: A Feedback: A management function associated with advocacy is awareness of current legislative efforts affecting nursing practice and organizational and unit management. Leadership roles include the following: role models' proactive involvement in health-care policy through both formal and informal interactions with the media and legislative representatives; participates in professional nursing organizations and other groups that seek to advance the profession of nursing; assertively advocate on behalf of patients and subordinates when an intermediary is necessary.

23. What is the primary goal of a performance appraisal? A) Promotion of employee growth B) Compliance with stated regulations C) Identification of ineffective staff D) Providing a basis for staff wage increases

Ans: A Feedback: A performance appraisal wastes time if it is merely an excuse to satisfy regulations and the goal is not employee growth. None of the remaining options express the goal of a performance appraisal.

9. Determine the nursing care hours per patient day (NCH/PPD) if the following staffing existed for a 24-hour period (unit census = 10): 12 midnight to 12 noon, 1 registered nurse, 1 licensed vocational nurse 12 noon to 12 midnight, 1 registered nurse, 1 licensed vocational nurse, 1 unit clerk (8 hours only) A) 5.6 NCH/PPD B) 4.8 NCH/PPD C) 5.0 NCH/PPD D) 6.2 NCH/PPD

Ans: A Feedback: A total of 56 hours of nursing was worked in 24 hours (unit clerks are counted in NCH/PPD) and the census was 10 patients. Dividing the total number of nursing care hours by the census (56 divided by 10) yields an NCH/PPD calculation of 5.6 NCH/PPD.

7. Which area of questioning is considered an illegal interview inquiry? A) Questions about the applicant's marital status B) The languages the applicant speaks or writes C) Inquiries about educational experiences D) Place of residence

Ans: A Feedback: Asking applicants about their marital status or whether they have children is unlawful. None of the other options are considered illegal areas of questioning.

What does the morale principle of autonomy govern? A) A person's right to make his or her own decision B) The obligation to do good and prevent harm C) Doing what is right and fair D) Truth telling

Ans: A Feedback: Autonomy, or self-determination, is also referred to as freedom of choice and accepting the responsibility for one's choice. None of the other options addresses this concept.

There are many terms used to describe moral issues faced by nurses, including moral uncertainty, moral conflict, moral distress, moral outrage, and ethical dilemmas. Which statement describes how moral uncertainty occurs? A) Occurs when an individual is unsure which moral principles or values apply and may even include uncertainty as to what the moral problem is B) Occurs when the individual knows the right thing to do but organizational constraints make it difficult to take the right course of action C) Occurs when an individual witnesses the immoral act of another but feels powerless to stop it D) Occurs when being forced to choose between two or more undesirable alternatives

Ans: A Feedback: Moral uncertainty occurs when an individual is unsure which moral principles or values apply and may even include uncertainty as to what the moral problem is. Moral distress occurs when the individual knows the right thing to do but organizational constraints make it difficult to take the right course of action. Moral outrage occurs when an individual witnesses the immoral act of another but feels powerless to stop it. Ethical dilemma is being forced to choose between two or more undesirable alternatives.

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.

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

Ans: A Feedback: Self-awareness: The ability to recognize and understand one's moods, emotions, and drives as well as their effects on others. Self-regulation: The ability to control or redirect disruptive impulses or moods as well as the propensity to suspend judgment. Motivation: A passion to work for reasons that go beyond money or status; a propensity to pursue goals with energy and commitment. Empathy: The ability to understand and accept the emotional makeup of other people.

17. What are the least common sources of organizational conflict? A) Communication problems B) Organizational structure C) Individual behavior within the organization D) Self-scheduling

Ans: A Feedback: Self-scheduling is not generally associated with common causes of organizational conflict. The most common sources of organizational conflict are communication problems, organizational structure, and individual behavior within the organization.

3. Which statement accurately reflects self-scheduling? A) Self-scheduling requires greater worker accountability B) The manager has little responsibility in self-scheduling C) Self-scheduling has few or no shortcomings D) Self-scheduling works in most organizations

Ans: A Feedback: Self-scheduling requires greater worker participation in decision making and shared responsibility for adequate staffing. None of the remaining options is accurate.

5. Which statement reflects the contemporary thinking about conflict? A) It can lead to new ideas B) It leads to decreased motivation C) It should be avoided whenever possible D) It is neither qualitative nor quantitative

Ans: A Feedback: Some level of conflict in an organization appears to be desirable since it appears to prevent organizational stagnation. None of the other options reflect contemporary thinking about conflict.

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.

6. What is the goal of case management? A) Containing health-care costs B) Providing challenging work C) Enhancing professionalism D) Decreasing length of hospital stays

Ans: A Feedback: The ANA maintains that case management is designed to contain health-care costs. None of the other options identify a goal of casement.

How is the action of advocacy described? A) Informing others of their rights and making certain they have sufficient information to make decisions B) Learning about the need for a decision and then making a good decision for other people C) Supporting an individual's right to make a decision even when they do not have accurate information D) Protecting the rights of patients in accordance with the law

Ans: A Feedback: The advocate informs others of their rights and makes certain they have sufficient information to make decisions. The remaining options are incorrect when describing the action associated with advocacy.

12. A nursing aide has been given a formal written warning regarding arguing repeatedly with the team leader about the given assignment. Today the nursing aide has taken four lengthy personal phone calls during work time. This is the first offense of this nature. How will the manager deal with this disciplinary situation? A) Provide a verbal warning that includes the rules related to personal telephone calls B) Determining whether there is a legitimate personal problem that justifies the telephone calls C) Presenting the nursing aide with a formal written reprimand D) Suspending the nursing aide for a week

Ans: A Feedback: The best choice of action in this case would be to provide an explanation for the rule and proceed to give a verbal admonishment. Since this is a new infraction, the progressive discipline starts with a verbal warning again and none of the other options.

What is the basic argument for the use of rationalñempirical change strategies? A) Information supports change B) Peer influence brings about change C) Reward-based incentives influence change D) Punishment supports the acceptance of change

Ans: A Feedback: The change agent using this set of strategies assumes that resistance to change comes from a lack of knowledge and that humans are rational beings who will change when given factual information documenting the need for change. Normativeñreeducative strategies use group norms and peer pressure to socialize and influence people so that change will occur. Powerñcoercive strategies, features the application of power by legitimate authority, economic sanctions or rewards, or political clout of the change agent.

19. What is the most significant barrier to effective interpersonal communication? A) Incongruence between verbal and nonverbal messages B) Incongruence between telephone and written messages C) Incongruence between verbal and written messages D) Incongruence between telephone and nonverbal messages

Ans: A Feedback: The incongruence between verbal and nonverbal messages is the most significant barrier to effective interpersonal communication.

Whose rights do the legislative controls of nursing practice primarily protect? A) Patients B) Subordinates C) Managers D) Administrators

Ans: A Feedback: The legislative controls of nursing practice primarily protect the rights of patients. Protection of those identified by the other options while important is the primary focus of the nursing practice legislative bodies.

Refusing to work with a staff member who dresses unprofessionally most closely represents which change strategy? A) Powerñcoercive B) Normativeñreeducative C) Rationalñempirical D) Resistanceñwithdrawal

Ans: A Feedback: The powerñcoercive strategy assumes that people are often set in their ways and will change only when faced by negative sanctions or some other method that demonstrates power and/or coercion. This is not the principle guiding any of the other options.

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

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

What is a weakness of the traditional problem-solving model? A) Its need for implementation time B) Its lack of a step requiring evaluation of results C) Its failure to gather sufficient data D) Its failure to evaluate alternatives

Ans: A Feedback: The traditional problem-solving model is less effective when time constraints are a consideration. Decision making can occur without the full analysis required in problem solving. Because problem solving attempts to identify the root problem in situations, much time and energy are spent on identifying the real problem.

Which situation is characteristic of the weakness of the nursing process? A) The frequent absence of well-written patience-focused objectives B) The confusion created by the existence of numerous nursing diagnoses C) The ever-increasing need for effective assessment skills required of the nurse D) The amount of nursing staff required to implement the patients' plans of care

Ans: A Feedback: The weakness of the nursing process, like the traditional problem-solving model, is in not requiring clearly stated objectives. Goals should be clearly stated in the planning phase of the process, but this step is frequently omitted or obscured. While the remaining options relate to the nursing process, they are not directly a result of the process itself.

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

Ans: A Feedback: 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.

18. What occurs when there is very little conflict in an organization? A) Stasis B) Increased productivity C) Decreased effectiveness D) Employee immobilization

Ans: A Feedback: Too little conflict results in organizational stasis and decreased productivity, whereas too much conflict reduces the organization's effectiveness and eventually immobilizes its employees.

14. What is the oldest form of organizing patient care that is still widely used today? A) Total patient care B) Functional nursing C) Team or modular nursing D) Primary care nursing

Ans: A Feedback: Total patient care, utilizing the case method of assignment, is the oldest form of patient care organization and is still widely used today.

18. What occurs when a manager has the false assumption that delegation may be interpreted as a lack of ability on the subordinate's part to do the job correctly or completely? A) Underdelegating B) Overdelegating C) Improper delegating D) Inappropriate delegating

Ans: A Feedback: Underdelegating occurs when a manager has a false assumption that delegation may be interpreted as a lack of ability on his or her part to do the job correctly or completely.

Distributing flyers that charge arbitrary action on the part of an employer in an effort to garner interest in employee unionization would be a part of what phase of planned change? A) Unfreezing B) Movement C) Refreezing D) Resistance

Ans: A Feedback: Unfreezing occurs when the change agent coerces members of the group to change, or when guilt, anxiety, or concern can be elicited. This is not observed in the other options.

3. 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.

17. What was the focus historically for case management? A) Individual patient B) Care for populations C) Group of patients with same chronic illness D) Group of patients with same acute need for surgery

Ans: A Feedback: While the focus historically for case management has been the individual patient, the case manager employed in a disease management program plans the care for populations or groups of patients with the same chronic illness.

5. It is 2 PM. You are calculating the nursing care hours for the 3 to 11 PM shift and must decide whether you need to call in additional help. You have three RNs, three nursing assistants, and one ward clerk scheduled. You have 22 patients with the following acuity and nursing care hours allotted for the evening shift: Category I, 4 patients @ 2.0 hours Category II, 2 patients @ 2.3 hours Category III, 10 patients @ 2.8 hours Category IV, 6 patients @ 3.4 hours What are the needed hours of nursing care? A) 61 hours B) 52.6 hours C) 68.4 hours D) 48.4 hours

Ans: A Feedback: Four category I patients require 8 hours of care; two category II patients require 4.6 hours of care; 10 category III patients require 28 hours; six category IV patients require 20.4 hours; total nursing care hours equal 61.

16. Primary care nursing is organized so that the patient is at the center of the structure. How many nurses have 24-hour responsibility for care planning and coordination? A) One B) Two C) Three D) Four

Ans: A Feedback: Primary care nursing is organized so that the patient is at the center of the structure. One nurse has 24-hour responsibility for care planning and coordination.

22. What is the foundation of reference power? A) Association with others B) Ability to grant favors C) Personality D) Fear

Ans: A Feedback: Referent power is power that a person has as others identify with that leader or with what that leader symbolizes. Referent power also occurs when one gives another person, feelings of personal acceptance or approval. It may be obtained through association with the powerful. Reward power, charismatic, and coercive are the powers associated with the other options.

13. What is the focus of the entry job stage? A) Skill development B) Job esteem C) Sense of purpose D) Indifference

Ans: A Feedback: During the entry phase of learning a job, an individual concentrates on skill development. None of the other options is the focus of this stage.

Which factor should be considered when assessing the quality of ethical problem solving? Select all that apply. A) Outcomes B) Decision-making process C) Multiple alternatives D) Data gathering

Ans: A, B Feedback: Outcomes should never be used as the sole criterion for assessing the quality of ethical problem solving, because many variables affect outcomes that have no reflection on whether the problem solving was appropriate. Quality, instead, should be evaluated both by the outcome and the process used to make the decision. If a structured approach to problem solving is used, multiple alternatives are analyzed, and data gathering is adequate, then, regardless of the outcome, the manager should feel comfortable that the best possible decision was made at that time with the information and resources available. The satisfaction of the involved parties is not a reliable factor.

Which statement demonstrates a characteristic of a critical thinker? Select all that apply. A) ìSince that didn't work effectively, let's try something different.î B) ìThe solution has to be something the patient is willing to do.î C) ìI'll talk to the patient's primary care giver about the problem.î D) ìMaybe there is no new solution to this particular problem.î

Ans: A, B, C Feedback: A critical thinker displays persistence, empathy, and assertiveness. The remaining options reflect limited thinking and an inability to think outside the box.

A lawsuit pertaining to professional negligence must include duty, breach of duty, injury, and a causal relationship between breach of duty and injury. What else must be included? Which element is necessary to prove professional negligence? Select all that apply. A) Breach of duty B) Presence of injury C) Ability to foresee harm D) Causal relationship

Ans: A, B, C, D Feedback: A lawsuit pertaining to professional negligence must include duty, breach of duty, injury, a causal relationship between breach of duty and injury, and the ability to foresee harm. Intent to cause injury is not a requirement.

24. An effective transition program for new nursing graduates will address which issue? Select all that apply. A) Supporting practice autonomy B) Strengthening new clinical skills C) Introducing time management skills D) integrating into the nursing unit environment

Ans: A, B, C, D Feedback: A well-designed transition-to-practice program strengthens new graduates skills and competencies and prepares the new nurse for the demands of caring for patients. Fu11hermore, a systematic app roach to transition not only facilitates ion-boarding (integration into staffing on the nursing unit to prov ide direct patient care), it reduces turnover by decreasing the toll associated with insufficient preparation for the work environment. Satisfying nursing position needs is not a focus of a transition program for new graduates.

Which intervention demonstrates that the nurse-manager is to advocate for patients in common areas of concern? Select all that apply. A) Staffing a unit with sufficient care providers B) Orienting staff to safely use a new patient lift C) Providing an in-service on culturally meeting end-of-life needs D) Arranging for patient consultations with members of the financial office

Ans: A, B, C, D Feedback: Common areas for managers to advocate for patients include distribution of resources; use of technology; end-of-life decisions; and health-care reimbursement. While aesthetics is an important consideration, it is not a common area for managers to act as advocators

Which are common areas requiring nurseñpatient advocacy? Select all that apply. A) Securing patient consents B) Preventing medication errors C) Facilitating access to health-care services D) Respect for patient dignity and cultural values

Ans: A, B, C, D Feedback: Common areas requiring nurseñpatient advocacy include inadequate patient consents; medical errors; access to health care; and respect for patient dignity and cultural values. While hospitalization is expensive, education on this subject is not considered a nursing advocacy role.

9. 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.

25. Which activity is directed toward a new graduate's responsibility to their nursing career? Select all that apply. A) Earning a professional nursing certification B) Gaining expertise in a specific field of nursing C) Being a member of a professional nursing association D) Earning an advanced nursing degree within 5 years of initial licensure

Ans: A, B, C, D Feedback: New graduates also have responsibility during the crucial first few years of employment to gain the expertise they need to have more opportunities for career divergence in the future. This includes becoming an expert in one or more areas of practice, gaining professional certifications, and being well informed about professional nursing and health-care issues. This is also a time where participation in professional associations has great value as a result of the opportunities for mentoring and networking. Finally, all new graduates should consider at what point, continued formal education will be a part of their career ladder and professional journey.

Which characteristic associated with being a patient increases the need for advocacy? Select all that apply. A) Loss of physical freedom as a result of extended hospitalizations B) Decreased independence due to physical or psychosocial limitations C) Physical or psychosocial limitations negatively impacted autonomy D) Illness tends to make an individual more vulnerable to unethical activities

Ans: A, B, C, D Feedback: Patient advocacy is necessary because disease almost always results in decreased independence, loss of freedom, and interference with the ability to make choices autonomously. In addition, aging, as well as physical, mental, or social disability may make individuals more vulnerable and in need of advocacy. It is not true that cognitive function is impaired as a result of chronic and/or acute illness.

Which statement is 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

Ans: A, B, D Feedback: Change should not be viewed as a threat but as a challenge and a chance to do something new and innovative. Change should be implemented only for good reason. Because change disrupts the homeostasis or balance of the group, resistance should be expected as a natural part of the change process. The level of resistance to change generally depends on the type of change proposed not the age of the staff affected by the change. Technological changes encounter less resistance than changes that are perceived as social or that are contrary to established customs or norms.

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

Ans: A, C, D Feedback: During the refreezing phase, the change agent assists in stabilizing the system change so that it becomes integrated into the status quo. If refreezing is incomplete, the change will be ineffective and the prechange behaviors will be resumed. For refreezing to occur, the change agent must be supportive and reinforce the individual adaptive efforts of those affected by the change. Because change needs at least 3 to 6 months before it will be accepted as part of the system, the change agent must be sure that he or she will remain involved until the change is completed. The successfulness of the refreezing stage is dependent about the acceptance of change by all staff.

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 patient's family

Ans: A, C, D Feedback: Human capital can refer to a group's 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 individual's professional development and ultimately the services of the facility. The other options are related to the personal interests of the staff.

How can nurses act as advocates? Select all that apply. A) Helping others make informed decisions B) Directly intervening on behalf of others C) Providing consent to treat for the cognitively impaired patients D) Making health-care decisions for those who are not able to do so

Ans: A, C, D Feedback: Nurses may act as advocates by either helping others make informed decisions, by acting as intermediary in the environment, or by directly intervening on behalf of others. Advocates do not make decisions or provide consent but rather educate patients so they can be informed.

Which statement correctly identifies the composition of a letter to a legislator? Select all that apply. A) Identify yourself as a constituent in the first paragraph B) State your reason for writing in the second paragraph C) Sign the letter and include your contact information D) Address the legislator by title

Ans: A, C, D Feedback: Personal letters are more influential than formal letters, and the tone should be formal but polite. The letter should also be concise (not more than one page). Be sure to address the legislator properly by title. Establish your credibility early in the letter as both a constituent and a health-care expert. State your reason for writing the letter in the first paragraph, and refer to the specific bill that you are writing about. Then, state your position on the issue and give personal examples as necessary to support your position. Offer your assistance as a resource person for additional information. Sign the letter, including your name and contact information. Remember to be persistent, and write legislators repeatedly who are undecided on an issue. Display 6.5 displays a format common to letters written to legislators.

19. What is coercive power based on? A) The ability to grant rewards to others B) The power of fear and of punishment C) The power inherent in one's position D) The gaining of knowledge and skills

Ans: B Coercive power is based on fear and punishment. Reward power is obtained by the ability to grant reward s to others. Legitimate power is the power inherent in one's position . Expert power is gained through knowledge or skill.

1. What type of power does a professional nursing certification provide? A) Legitimate B) Expert C) Charismatic D) Organizational

Ans: B Feedback: A nursing certification n provides the proof of earned expert power such as having knowledge or skill not possessed by all nurses .

Which response is characteristic of a servant leader? A) ìI don't think you have the skills necessary to be effective.î B) ìLet me think about that request for 24 hours.î C) ìDo whatever it takes to get it done fast.î D) ìI'll personal handle this situation.î

Ans: B Feedback: 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.

24. 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 design including 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.

3. Which statement concerning nonverbal communication is true? A) It is consistent across cultures B) It is given more credence than verbal communication when the two are incongruent C) It should be minimized because it confuses the receiver regarding the true intent of the message D) It is a significant part of the communication exchange only when it is not congruent with the verbal exchange

Ans: B Feedback: Because nonverbal communication indicates the emotional component of the message, it is generally considered more reliable than verbal communication. None of the remaining options present true statements regarding nonverbal communication.

What does traditional management science focuses upon? A) Meeting worker satisfaction B) Delineating barriers to productivity C) Using a laissez-faire approach D) Encouraging employee participation

Ans: B Feedback: Classical, or traditional, management science 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.

23. What is the principle that guides constructive discipline? A) Constructive discipline is punitive in its nature B) The focus of constructive discipline is employee growth C) Constructive discipline employs the manager as a resource not a helper D) Behavior modification is the desired outcome of constructive discipline

Ans: B Feedback: Constructive discipline uses discipline as a means of helping the employee grow, not as a punitive measure.

7. What is inferred if an item is ìcost-effectiveî? A) It is the least expensive product available B) It is worth the cost C) It is reimbursable D) Its cost was anticipated

Ans: B Feedback: Cost-effective does not necessarily imply the cheapest, but it requires that the expenditure be worth the cost. The other options are not characteristic of the term cost effective.

8. What is the term used to identify the effect that results when some negative aspect of an employee's performance unduly influence all other aspects of performance? A) A halo effect B) A horns effect C) Central tendency D) A job dimension scale

Ans: B Feedback: Data should be gathered from many different sources and must reflect the entire time period of the appraisal to avoid the horns effect, which is when some negative aspect of an employee's performance unduly influences all other aspects of his or her performance. None of the other options accurately identifies this outcome.

22. Which statement demonstrates an intervention focused on the primary disadvantage of team nursing? A) We are working with 1 fewer team members today. B) The team will be meeting for a care report update in 5 minutes. C) Our patient assignment is comprised of both males and females D) We will be having a member of the float pool on our team today.

Ans: B Feedback: Disadvantages to team nursing are associated primarily with improper implementation rather than with the philosophy itself. Frequently, insufficient time is allowed for team care planning and communication. This can lead to blurred lines of responsibility, errors, and fragmented patient care. None of the other options address a known disadvantage of team nursing.

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.

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 one's emotions is expected D) Expression of one's emotions is encouraged

Ans: B Feedback: Emotional intelligence refers to the ability to use emotions effectively and is required by leader-managers in order to enhance their success. Holding one's emotions in check can be unhealthy. The remaining options do not address the usefulness of emotions.

1. What should the manager do in completing an annual performance appraisal? A) Consider good intentions as well as actual performance B) Base the appraisal on a standard to which all are held accountable C) Always make an effort to include subjective data D) Closely observe the employee for the 2 weeks preceding the appraisal conference

Ans: B Feedback: For an objective appraisal, the manager must have a fair performance appraisal tool that is used for all employees in the same classification.

7. What is the implication in a hierarchy of needs? A) All needs have equal power in motivation B) Unsatisfied needs trigger behavior C) Lower level needs are less valued D) Some individuals have hereditary needs

Ans: B Feedback: Hierarchy of need implies that people are motivated to satisfy certain needs, ranging from basic survival to complex psychological needs, and people seek a higher need only when the lower needs have been predominantly met.

15. What is the first step to developing an educational program for an organization? A) Identifying the resources available to meet the needs B) Identifying the desired skills or knowledge the staff should have C) Explaining to the team that human resources should be doing this work D) Assessing the staff's willing to learn new skills

Ans: B Feedback: Identifying the desired skills or knowledge the staff should have is the first step in developing an educational program. While the other options are relevant, they lack the organizational priority of the correct option.

22. What factor contributes most to a performance appraisal being viewed as relevant by the employees? A) Its influence on whether a raise will be awarded B) Belief that it is based on the performance of job descriptionñrelated tasks C) The perception that the manager truly likes and approves of them personally D) The formality with which the appraisal is conducted and presented

Ans: B Feedback: If employees believe that the appraisal is based on their job description rather than on whether the manager approves of them, they are more likely to view the appraisal as relevant. The remaining options are not viewed as being factors in the view that the appraisal is relevant.

17. What is the leadership role when a unit is attempting to overcome the decentralization of patient care? A) Determining what changes will be made to the plan of care B) Facilitating the group's work C) Identifying the patient care problems D) Selecting solutions to problems

Ans: B Feedback: In a patient-centered focused activity, the team leader should facilitate the work of the group and should not be the sole decision maker.

2. A charge nurse assists a group of personnel to resolve their conflict, with the outcome being that the two opposing goals were discarded and new goals were adopted. What is this an example of? A) Smoothing of conflict by the leader B) Facilitating collaboration among personnel C) A majority rule approach D) A good lesson in compromising

Ans: B Feedback: In collaboration, all parties set aside their original goals and work together to establish a common goal. None of the other options are examples of the described outcome.

3. A nurse has accepted a position as a staff nurse and will practice primary care nursing. The nurse will be the only RN on the team. What is an appropriate role expectation for role fulfillment? A) Planning nursing care independently of others B) Assigning work according to the expertise of group members C) Being responsible for care planning 24 hours a day D) Carrying out the majority of personal care for your patients

Ans: B Feedback: In primary nursing, the sole RN would not plan the care without others' input or be responsible for care planning for 24 hours. Neither would the RN carry out the majority of personal care.

15. What occurs during implementation of a shared governance model? A) Lines of authority are altered B) Joint practice committees are formed C) Participatory management is initiated D) The roles of first-level managers are stabilized

Ans: B Feedback: In shared governance, the organization's governance is shared among board members, nurses, physicians, and management. Joint practice committees are developed to assume the power and accountability for decision making, and professional communication is egalitarian rather than hierarchical. Shared governance is not associated with the other options.

20. What does indoctrination include for an employee? 1. Induction 2. Orientation 3. Socialization 4. Continuing education A) 1, 3, 4 B) 1, 2, 3 C) 1, 2, 4 D) 2, 3, 4

Ans: B Feedback: Indoctrination consists of induction, orientation, and socialization of employees.

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

Ans: B Feedback: Management functions include planning, organizing, staffing, directing, and controlling. These are incorporated into what is known as the management process.

18. Which organizational characteristic makes employees view a union as an appealing option? A) Organizational mission is too board to be achieved B) Organizational philosophy is insensitive to the worker C) Organizational philosophy is sensitive to management D) Organizational mission is insensitive to the population it serves

Ans: B Feedback: Management that is perceived to be deaf to the workers' needs provides a fertile ground for union organizers, because unions thrive in a climate that perceives the organizational philosophy to be insensitive to the worker. The other options are not believed to have the influence that insensitivity to employees has.

3. What is the most important consideration for the manager when identifying the appropriate person to whom to delegate a specific task? A) Whose turn it is to delegate a task B) The qualifications of the person regarding the task C) The fiscal cost of delegating the task D) Whether the person has experience with similar tasks

Ans: B Feedback: Managers should ask the individuals to whom they are delegating if they are capable of completing the delegated task.

How do administrative man managers make the majority of their decisions? A) After gathering all the facts B) In a manner good enough to solve the problem C) In a rational, logical manner D) After generating all the alternatives possible

Ans: B Feedback: Many managers make decisions that are just ìgood enoughî because of lack of time, energy, or creativity to generate a number of alternatives. This is also called ìsatisficing.î Most people make decisions too quickly and fail to systematically examine a problem or its alternatives for solution.

Which term is used to identify a person's feelings of powerlessness to stop unethical behavior in another person or institution? A) Moral conflict B) Moral outrage C) Ethical relativism D) Ethical universalism

Ans: B Feedback: Moral outrage occurs when an individual witnesses the immoral act of another but feels powerless to stop it. Moral uncertainty or moral conflict occurs when an individual is unsure which moral principles or values apply and may even include uncertainty as to what the moral problem is. Ethical relativism suggests that individuals make decisions based only on what seems right or reasonable according to their value system or culture. Ethical universalism holds that ethical principles are universal and constant and that ethical decision making should not vary as a result of individual circumstances or cultural differences.

Which behavior will best minimize a nurse's risk for a malpractice claim? A) Always carry a personal liability insurance policy B) Always function with the state's nursing practice act C) Ask for assistance when engaged in complicated procedures D) Devote time to establishing an effective nurseñpatient relationship

Ans: B Feedback: Nurses can reduce the risk of malpractice claims by practicing within the scope of the Nurse Practice Act. Nurses should purchase their own liability insurance and understand the limits of their policies. Although this will not prevent a malpractice suit, it should help to protect a nurse from financial ruin should there be a malpractice claim. While the other options present reasonable advice, they will not necessarily help in the avoidance of a malpractice claim.

3. What is the relationship between the national and local economy and an organization's ability to maintain an adequate workforce? A) When the economy is on an upswing, many unemployed nurses return to work and recruitment becomes easier B) When a recession occurs it causes many part-time nurses to return to full-time employment and others to delay their retirement C) Although the economy tends to affect the size of the blue-collar workforce, professions such as nursing remain fairly stable regardless of economic changes D) When there is an economic downturn, many nurses reduce their work hours from full time to part time

Ans: B Feedback: Nursing shortages occur when the economy is on the upswing and decline when the economy recedes, because many unemployed nurses return to the workforce and part- time employees return to full-time employment. None of the other options identify that relationship.

3. What event tends to be the primary reason for an increase in the numbers of unions being formed? A) Salaries are not keeping pace with the economy B) Organizations are insensitive to the needs of the worker C) There is an economic downturn D) Jobs are scarce

Ans: B Feedback: One reason that unions are started is to protect workers' rights against management that is insensitive to their needs. While economic issues do play a role, the primary reason for increased union formation is a more general dissatisfaction among employees.

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

Ans: B Feedback: Perhaps the greatest factor contributing to the resistance encountered with change is a lack of trust between the employee and the manager or the employee and the organization. While the other options may increase resistance, employee distrust is the primary barrier to change.

15. How can a nursing professional demonstrate advanced achievement of competencies? A) Lateral transfer B) Professional specialty certification C) Transfer to a new department D) Professional registered nursing licensure

Ans: B Feedback: Professional specialty certification is one way that an employee can demonstrate advanced achievement of competencies. The transfer, when used appropriately, may be an effective way to provide career development but a lateral transfer does not demonstrate advancement. A transfer to a new department often requires the acquisition of new skills before advance can occur. A nursing license signifies entry-level skills.

4. What has research shown regarding interviewing reliability? A) Interviewer reliability is high if the interview is unstructured B) Interviewer reliability improves if the interview is structured uniformly C) Reliability increases when there is a team approach to the interview D) Positive information is weighed more heavily than negative information

Ans: B Feedback: Reliability means that something is measured consistently time after time. Therefore, if more than one interviewer uses the same format to interview a candidate, the reliability of the interviews improves. None of the other options identify the research findings.

20. Which method best provides a structured orderly approach to communicating accurate, relevant information, in emergent patient situations as well as routine handoffs? A) GRRRR listening model B) SBAR tool C) Hospital information system D) Wireless, local area networking

Ans: B Feedback: SBAR provides a structured, orderly approach to provide accurate, relevant information, in emergent patient situations as well as routine handoffs. The other options are not as focused on providing information in all the described situations.

14. The nurse-manager is preparing for the unit ward clerk's annual evaluation and sends out a short questionnaire requesting feedback on the ward clerk's effectiveness in her job. The nurse-manager sent the request to one doctor who uses the unit frequently, to a staff nurse on each shift, to the housekeeping department head, and to the head of the volunteer program. In addition, the nurse-manager interviews three patients to determine how courteous the ward clerk is when answering call lights from the unit desk. What is this an example of? A) Peer review B) A 360-degree evaluation C) An overreaching performance review D) An anecdotal performance review

Ans: B Feedback: Seeking feedback from patients, staff, and other departments who interact with an employee to determine his or her effectiveness in his or her job is called a 360-degree evaluation. None of the other options are associated with the scenario described.

What defines the legal boundaries of nursing at the state level? A) The state's Attorney General B) The Nurse Practice Act C) The ANA standards of practice D) The ANA Code for Nurses

Ans: B Feedback: The 51 Nurse Practice Acts representing the 50 states and the District of Columbia are examples of statutes. These Nurse Practice Acts define and limit the practice of nursing, stating what constitutes authorized practice as well as what exceeds the scope of authority. Although Nurse Practice Acts may vary among states, all must be consistent with provisions or statutes established at the federal level. The other options lack the comprehensiveness and focus of a state's Nurse Practice Act.

5. Which statement is true regarding the Behaviorally Anchored Rating Scale (BARS)? A) Has long been used as a performance appraisal tool in the health-care industry B) Requires that a separate rating form be developed for each job classification C) Is often referred to as a free-form review D) Is a rapidly scored and administered performance appraisal tool

Ans: B Feedback: The BARS key areas of responsibility are delineated and ranked by importance. This system reduces subjectivity, but has the drawback of being time-consuming.

12. What does the Joint Commission advocate about employee performance appraisals? A) They be conducted at least every 6 months B) They be based on employee job descriptions C) They be documented by anecdotal notes D) They be reflective of employees' personal goals

Ans: B Feedback: The Joint Commission advocates that employee performance appraisals be based on employee job descriptions. None of the other options are identified for this purpose.

10. The measurement of NCH/PPD will provide what information? A) The acuity level of the patients on a particular unit in a 24-hour time span B) The total number of hours worked by nursing personnel on a particular unit in a 24-hour time span divided by the patient census C) The specific amount of money spent on staffing during a 24-hour period D) The quality of nursing care that was provided on a particular unit in a 24-hour time span

Ans: B Feedback: The Personnel Budget NCH/PPD refers to number of nursing care hours worked in 24 hours divided by the patient census.

4. What did the interactionist theorists of the 1970s believe about organizational conflict? A) It should be dealt with immediately B) It should be encouraged C) It was an indication of poor management D) It should be avoided

Ans: B Feedback: The interactionist movement encouraged organizations to promote conflict as a means of producing growth. The remaining options were not necessarily supported by the interactionist theorists.

6. What is the priority goal for a manager with regard to staffing and scheduling? A) Schedule staff so there is no overtime B) Ensure that there is adequate staff to meet the needs of each patient C) Develop trust in staff by seeing that staffing is carried out in a fair manner D) Ensure that staff members usually have days off and special requests granted

Ans: B Feedback: The manager is tasked with seeing that patient care needs are met first and foremost. While the other options are relevant, they are not the priority goal of the manager.

11. What does the term optimum span of control mean? A) It defines the manager's decision-making authority B) It identifies the manager's abilities and responsibilities C) It refers to a line-and-staff organizational structure model D) It is the number of subordinates and manager is responsible for

Ans: B Feedback: The number of people directly reporting to any one manager represents that manager's span of control and determines the number of interactions expected of him or her. None of the remaining options correctly describes this term.

2. Anew graduate who began their nursing career 6 months ago and who completed orientation 3 months ago is in what stage of professional development? A) Experimentation B) Entry C) Mastery D) Disengagement

Ans: B Feedback: The nurse is still in the entry stage and will be until necessary skills are learned. It generally takes an extended period of time to obtain the skills necessary for mastery. The remaining options are not relevant to this questions.

12. What nursing model provides the foundation for matching patient needs with nursing competencies? A) Primary nursing practice B) Differentiated nursing practice C) Modular nursing D) Case management

Ans: B Feedback: To facilitate the effective use of nursing resources, patient needs and nursing competencies should be matched. None of the other options identify that connection.

7. Which is the most accurate statement regarding staffing and scheduling policies? A) It is more important to communicate policies verbally than in writing B) It is necessary that policies are written in a manner that allows some flexibility C) Policies should focus on the process D) Managers should have autocratic control over scheduling and staffing policies

Ans: B Feedback: To retain employees, the staffing policies must allow some flexibility, which could include job sharing, flextime, a part-time staffing pool for weekends, or allowing employees to exchange hours of work among themselves.

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

Ans: B Feedback: 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 is the best reason that nurse-managers have an ongoing responsibility to be aware of legislation affecting nursing practice? A) This will prevent them from getting sued B) Laws are fluid and subject to change C) It will protect the agency from a lawsuit D) It will ensure that correct procedure is carried out

Ans: B Feedback: When using doctrines as a guide for nursing practice, the nurse must remember that all laws are fluid and subject to change. Laws are not static. It is the responsibility of each manager to keep abreast of legislation and laws affecting both nursing practice and management practice. While the other options are correct, they do not describe the most encompassing reason that nurse-managers need to keep aware of current legislature affecting nursing practice.

2. What is a common cause of a manager to underdelegation? A) A high degree of trust in subordinates B) A democratic leadership style C) A need for perfectionism D) Sufficient time to accomplish unit goals alone

Ans: C Feedback: A manager with a need for perfectionism and control may believe that another person will not complete a task. Trust in subordinates and a democratic leadership style would support effective delegation. Delegating should not be based on the issue of time exclusively.

Which statement regarding the responsibility of a manager in advocacy is accurate? A) Advocacy is a management function and not a leadership role B) Managers advocate only as needed to meet organizational goals C) Managers should advocate for patients as well as subordinates D) Professional advocacy is not a primary concern for most managers

Ans: C Feedback: Advocacy is helping others to grow and self-actualize. The manager must be an advocate for patients, subordinates, and the nursing profession. The remaining statements are not accurate descriptions of the manager's role as advocate.

13. What is one of the most important differences between case management and disease management? A) Disease management referrals begin in the hospital inpatient setting B) Disease management is a collaborative process to meet patient needs C) High-cost population groups are targeted in disease management D) Disease management treatment is episodic

Ans: C Feedback: Although there are many similarities between disease management and case management, the primary goal of disease management is to target high-cost disease populations.

15. What location of the SBAR charting tool states the patient's problem? A) Situation B) Background C) Assessment D) Recommendation

Ans: C Feedback: Assessment is where the nurse states the patient's problem. The problem is not documented in any of the other SBAR locations.

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

Ans: C Feedback: 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.

11. Which statement best defines conflict? A) It involves an internal struggle resulting from value-related discord B) Its basis is the violation of personal rights or values C) It centers on either internal or external discord between individuals D) It is the outcome of a visible struggle between individuals

Ans: C Feedback: Conflict is generally defined as the internal or external discord that results from differences in ideas, values, or feelings between two or more people. The remaining options describe only limited aspects of conflict.

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

Ans: C Feedback: Critical thinking has a broader scope than decision making and problem solving. It is sometimes referred to as reflective thinking. Critical thinking also involves reflecting upon the meaning of statements, examining the offered evidence and reasoning, and forming judgments about facts.

What is the best definition of decision making? A) The planning process of management B) The evaluation phase of the executive role C) One step in the problem-solving process D) Required to justify the need for scarce items

Ans: C Feedback: Decision making is a complex, cognitive process often defined as choosing a particular course of action. Decision making, one step in the problem-solving process, is an important task that relies heavily on critical thinking and clinical reasoning skills.

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

Ans: C Feedback: Directing sometimes includes several staffing functions. However, this phase's 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.

Malpractice or professional negligence is the failure of a person with professional training to act in a reasonable and prudent manner. How many components must be present for an individual to be found guilty of malpractice? A) Three B) Four C) Five D) Six

Ans: C Feedback: Five components must be present for a professional to be held liable for malpractice: duty to use care, failure to meet standard of care, foreseeability of harm, direct relationship between failure to meet the standard of care and injury can be proved, and injury.

5. What would be the most appropriate level of employee discipline for a first infraction of gross mistreatment of a patient? A) Suspension with pay B) Suspension without pay C) Termination D) Written admonishment

Ans: C Feedback: For a first infraction of gross mistreatment of a patient, the most appropriate level of employee discipline would probably be termination. The organization's first responsibility is in the protection of patients.

11. 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.

16. Which statement concerning the recognition of chemical impairment in an employee is correct? A) It is relatively easy to identify employees who are chemically impaired B) It is easier to recognize if the employee is impaired by alcohol than by drugs C) Impairment should result in an immediate intervention by the manager D) Impairment must be supported by data gathering before intervention occurs

Ans: C Feedback: For safety reasons and to protect clients, employees should be confronted as soon as possible after chemical impairment is recognized. None of the remaining options are true statements regarding the recognition of a chemically impaired employee.

1. Which statement best describes functional nursing care delivery? A) Nursing care is holistic and patient centered B) The nurse must be a licensed person C) Emphasis is on getting work done through tasks D) It is also known as total patient care

Ans: C Feedback: Functional nursing is task focused. None of the other options identify that connection.

4. Which situation presents an example of inappropriate delegation? A) Temporary authority is given to support completion of a delegated task B) The person to whom a task is delegated considers it a challenge C) The employee is given exact instructions on completing the task D) Regular updates on the task are exchanged with the manager and the employee

Ans: C Feedback: If an employee has the skills necessary to complete a task, that employee should be able to carry out the task with autonomy and be provided with the authority and resources necessary. Depending on the complexity of the project, the manager should meet with the employee for updates. One of the goals of delegation is to challenge employees into learning new skills.

2. What increases the likelihood that the performance appraisal will have a positive outcome? A) The manager refrains from making any comments about the worker's performance B) The employee is encouraged to identify three areas of satisfactory performance C) The employee provides input into developing the performance standards D) The manager identifies not more than three areas of deficient performance

Ans: C Feedback: If the employee has some input into developing the standards or goals on which his or her performance is judged, there is more of a chance that the appraisal will have a positive outcome. The remaining options fail to contribute to an effective performance appraisal.

4. Which is an outcome of decentralized staffing? A) Increased fairness to employees through consistent, objective, and impartial application B) Cost-effectiveness through better use of resources C) Greater manager autonomy to control the staffing on the units, resulting in an increase in self-esteem and teamwork D) Increased availability of data for monitoring the effect of staffing size and composition, quality of care, and costs

Ans: C Feedback: In an institution that has no human resources department and no nurse recruiters, the unit manager does the hiring and has greater autonomy in personnel matters. The other options are not associated with decentralized staffing.

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

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

15. What is intrinsic motivation directly related to? A) Work environment B) External rewards C) Personal aspiration D) Completion of work

Ans: C Feedback: Intrinsic motivation comes from within the person, driving him or her to be productive such as personal goals and aspirations. Rewards resulting from extrinsic motivation (which is motivation that is enhanced by the work environment) occur after the work has been completed.

14. What do labor standards deal with? 1. Conditions of the employees' work 2. Pay for continuing education 3. Financial aspects 4. Number of hours worked A) 1, 2, 3 B) 1, 2, 4 C) 1, 3, 4 D) 2, 3, 4

Ans: C Feedback: Labor standards are regulations dealing with the conditions of the employee's work, including physical conditions, financial aspects, and the number of hours worked.

Which factor has the greatest influence on a legislator? A) Form letters from group members B) Individual phone calls from constituents C) Meeting with a strong collective political group D) A personal visit by an individual constituent

Ans: C Feedback: Legislators and policy makers generally are more willing to deal with a group rather than individuals; thus, joining and supporting professional organizations allow nurses to become active in lobbying for a stronger nurse practice act or for the creation or expansion of advanced nursing roles.

17. McClelland's studies state that all people are motivated by three basic needs. What are these needs? A) Physiological, security, esteem B) Safety, social, self-actualization C) Achievement, affiliation, power D) Responsibility, supervision, job security

Ans: C Feedback: McClelland's studies state that all people are motivated by three basic needs: achievement, affiliation, and power. McClelland does not include the other options as needs associated with motivation.

15. What type of nursing uses mini teams, typically an RN and unlicensed health-care workers, to provide care to a small group of patients who are centralized geographically? A) Total patient care B) Functional nursing C) Modular nursing D) Primary care nursing

Ans: C Feedback: Modular nursing and model RN line use mini teams, typically an RN and unlicensed health-care worker(s), to provide care to a small group of patients, centralized geographically. None of the other options provide that staffing format.

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.

Which ethical principle associated with an adult child is legally given the right to make medical decisions for a cognitively impaired parent? A) Justice B) Fidelity C) Paternalism D) Beneficence

Ans: C Feedback: Paternalism is when one individual assumes the right to make decisions for another. Justice requires that a person seek fairness, treat ìequalsî equally, and treat ìunequalsî according to their differences. Fidelity involves the need to keep promises. Beneficence involves actions that are taken in an effort to promote good.

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.

19. What must be completed before a position is offered? A) Physical examination B) Preemployment testing C) Reference check D) Personal interview

Ans: C Feedback: Positions should never be offered until information on the application has been verified and references have been checked.

5. Which statement is correct concerning primary nursing care? A) Requires minimal RN staffing B) Is easy to implement C) Provides challenging work D) Has proved to be a failure

Ans: C Feedback: Primary care provides challenging work for nurses; however, it is not easy to implement and requires an all-RN staff. None of the other options accurately describes the concept of primary nursing care.

8. Which statement is true regarding the general delegation liability of the registered nurse (RN)? A) It is minimal because subordinates alone are held accountable for practicing within the accepted scope of practice for their job classification B) It is great because the RN is automatically held liable for the tasks delegated to all recognized subordinates C) It is reduced when the RN appropriately assesses what and to whom delegation is appropriate and supervises the completion of the tasks D) It is avoided entirely by delegating tasks to only other licensed personnel

Ans: C Feedback: Proper delegation practices that include assessment and evaluation help protect the RN from liability. The other statements are not true.

22. What negative outcome can result from the decentralization of the responsibilities of staff development? A) Poor staff retention B) Deficient nursing care C) Increased role ambiguity D) Decreased nursing autonomy

Ans: C Feedback: Some difficulties associated with decentralized staff development include the conflict created by role ambiguity whenever two people share responsibility. Role ambiguity is sometimes reduced when staff development personnel and managers delineate the difference between training and education. None of the other options are recognized as a result of decentralization of staff development.

14. 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.

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

Ans: C Feedback: Tabaka suggests that servant leadership is one of the top 10 characteristics of an agile organization today.

10. Which is a true statement about the patterns of patient care management? A) Functional nursing is organized according to the desires of the worker B) Primary nursing and total patient care are synonymous C) Team leading includes the concept of patient care conferences D) Case load nursing provides little autonomy for nurses

Ans: C Feedback: Team leading includes the need for patient care conferences. None of the other options identify that need.

1. What is an inappropriate reason for delegation? A) To empower subordinates by stretching them in their work assignment B) To free the manager to address more complex, higher-level unit needs C) When the task is not a challenge for the manager D) Because someone else is better qualified to do the task that needs to be done

Ans: C Feedback: That the manager is not challenged by a task is not a valid reason for delegating that task to another. The other options are all appropriate reasons to delegate tasks to qualified staff.

4. How did the Civil Rights Act of 1964 affect employees? A) It eliminated sexual harassment in the workplace B) It allowed veterans to return to jobs they held before their military service C) It prohibited job discrimination based on factors unrelated to job qualifications D) It eliminated racial discrimination in this country

Ans: C Feedback: The Civil Rights Act of 1964 prohibited job discrimination based on factors unrelated to job qualifications. This legislation is not associated with any of the other options.

1. 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 component of professional negligence is represented when a nurse fails to look up an unfamiliar medication before administering it? A) Duty to use due care B) Failure to meet standard of care C) Foreseeability of harm D) A direct relationship between failure to meet the standard of care (breach) and injury can be proved

Ans: C Feedback: The nurse must have reasonable access to information about whether the possibility of harm exists not fulfilling this responsibility may result in a foreseeable harm to the client. None of the remaining options are relevant to this criterion.

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

Ans: C Feedback: The planning hierarchy follows this order: begins with organization's mission statement, philosophy, goals, objectives, policies, procedures, and ends with rules.

11. What action will the manager take when implementing the second step in the progressive disciplinary process? A) Suspend the employee from work for a specified period of time B) Explain in detail the nature of the inappropriate behavior C) Complete a formal written reprimand D) Verbally instruct the employee not to repeat the infraction

Ans: C Feedback: The second step in the progressive disciplinary process is for the manager to complete a formal written reprimand signed by the employee and the manager. The second step in the progressive disciplinary process does not involve any of the other options.

25. What is considered the primary reason a nurse will join a union? A) To eliminate discrimination B) To fill the social need to be accepted C) To increase their personal power D) To improve the quality of patient care

Ans: C Feedback: The six primary motivators in order of importance are as follows: to increase the power of the individual, to increase their input into organizational decision making, to eliminate discrimination and favoritism, because of a social need to be accepted, because they are required to do so as part of employment (closed shop), and because they believe it will improve patient outcomes and quality of care.

4. With modular nursing, who checks the completion of tasks assigned to a team member? A) The charge nurse B) The area manager C) The team leader D) Another team member

Ans: C Feedback: The team leader should check the work of team members. None of the other options identify the role correctly.

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

Ans: C Feedback: 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.

15. Several RNs on the unit want to address the possibility of initiating flextime on the unit. What is the manager's initial response? A) Assuring the RNs that their suggestion will be taking under consideration B) Asking the RNs to circulate a partition to be signed by employees who support the change C) Arranging for the RNs to air their views at the next staff meeting. D) Sharing with the RNs that they need to address the issue with upper management

Ans: C Feedback: This manager should plan to let employees air their views at the next staff meeting. Nursing managers can no longer afford to respond to conflict traditionally (to avoid or suppress conflict), because this is nonproductive. In an era of shrinking health-care dollars, it has become increasingly important for managers to confront and manage conflict appropriately. The ability to understand and deal with conflict appropriately is a critical leadership skill.

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

Ans: C Feedback: Three primary leadership styles have been identified: authoritarian, democratic, and laissez-faire.

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

Ans: C Feedback: 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.

5. What determines the size of the authority gap between a manager and an employee? A) The organizational philosophy B) The degree of rigidity in the corporate chart C) How credible the manager is perceived to be D) How much informal power the manager possesses

Ans: C Feedback: When a manager loses credibility, the authority power gap widens. None of the other options are relevant.

7. What should an employee expect when a manager terminates his/her employment for continuous rule breaking? A) The employee will be escorted from the building by security staff B) The employee will be allowed to work out a 2-week termination period C) The manager will describe what, if any, references will be supplied to future employers D) The manager will arrange for a meeting between the employee and senior administration

Ans: C Feedback: When a manager terminates an employee for continuous rule breaking, the manager should tell the employee what, if any, references will be supplied to future employers. The remaining options are not generally associated with such a termination.

17. What type of interview is a predictor of job performance and overall effectiveness? A) Unstructured B) Semistructured C) Structured D) Informal

Ans: C Feedback: As a predictor of job performance and overall effectiveness, the structured interview is much more reliable than the unstructured, semistructured, or informal interviews.

16. What arc restraining forces for specialty certification in professional nursing? 1 . Decreased collaboration with other health-care providers 2. Cost 3. Lack of recognition 4. Increased retention A) 1, 2 B) 1, 4 C) 2,3 D) 3, 4

Ans: C Feedback: Cost coupled with lack of institutional reward and support kept some nurses from pursuing certification. The impact of certification on absenteeism and retention was unclear.

18. What communication mode is considered most reliable in conveying the emotional component of the message? A) Written B) Verbal C) Nonverbal D) Telephone

Ans: C Feedback: Nonverbal communication is considered more reliable because it conveys the emotional part of the message. The other modes are not as effective with conveying emotion.

Which statement is true regarding the implications of a Good Samaritan law for a registered nurse? Select all that apply. A) A nurse has a legal responsibility to provide emergency services B) Such laws are universally worded so as to minimize state-to-state differences C) In order for protection to apply, the nursing care cannot be considered negligent D) A nurse who provided out-of-scope care is not protected by the Good Samaritan law

Ans: C, D Feedback: Nurses are not required to stop and provide emergency services as a matter of law, although most health-care workers feel ethically compelled to stop if they believe they can help. Good Samaritan laws suggest that health-care providers are typically protected from potential liability if they volunteer their nursing skills away from the workplace (generally limited to emergencies), provided that actions taken are not grossly negligent and if the health-care worker does not exceed his or her training or scope of practice in performing the emergency services. However, not being paid for your services alone will not provide Good Samaritan law protection. Good Samaritan laws apply only if the health-care worker does not exceed his or her training or scope of practice in performing the emergency services. Protection under Good Samaritan laws varies tremendously from state to state. In some states, the law grants immunity to RNs but does not protect LVNs or LPNs. Other states offer protection to anyone who offers assistance, even if they do not have a health-care background. Nurses should be familiar with the Good Samaritan laws in their state.

3. Which reasons do NOT qualify as organizational justification for a career development program? Select all that apply: A) Employee attrition can be reduced B) Personnel can be used more effectively C) Employees can increase earning power D) Employment benefits are increased

Ans: C, D Feedback: Organizational justification for career development programs includes attrition reduction, improved productivity, and general improved quality of life. Although employees may earn more money and additional benefits as a result of career development they are not the reason that organizations undertake career development programs.

What component of professional negligence is represented when a patient experiences a seizure resulting from a medication error? A) Duty to use due care B) Failure to meet standard of care C) Foreseeability of harm D) A causal relationship

Ans: D Feedback: A direct causal relationship between failure to meet the standard of care (breach) and injury can be proved when a patient is harmed because proper care is not given. None of the remaining options are relevant to this criterion.

15. What occurs when RN hours decrease in a unit's calculation of nursing care hours per patient day (NCH)/(PPD)? A) Adverse patient outcomes generally increase B) Decreased errors C) Decreased patient falls D) Decreased patient satisfaction

Ans: D Feedback: A review of current literature suggests that as RN hours decrease in NCH/PPD, adverse patient outcomes generally increase, including increased errors and patient falls as well as decreased patient satisfaction.

12. What is a critical goal in negotiation? A) That gains for each party are different but equal B) That the hidden agendas of all parties be exposed C) That each party willingly reveals their negotiated limits D) That both parties perceive that they have won something they value

Ans: D Feedback: A successful negotiation leaves both parties feeling like they have gained something they want and/or value. None of the other options are considered a goal of negotiation.

10. What does the filing of a grievance by an employee do? A) It serves as evidence that a manager's actions have been unfair or arbitrary B) It means that the conflict will have to be resolved in arbitration C) It negates the need for the manager to attempt to solve the conflict through communication, negotiation, compromise, or collaboration D) It requires a great deal of time and energy from both the employee and the manager

Ans: D Feedback: Although grievance procedures extract a great deal of time and energy from both employees and managers, they serve several valuable purposes. However, most grievances or conflicts between employees and management can be resolved informally through communication, negotiation, compromise, and collaboration before grievance procedures need to be undertaken. The remaining options are not the result of a grievance filing.

What statement is true concerning nurses as a political body? A) They are very committed to both their profession and the political process B) Many are active members of the American Nurses Association (ANA) C) Their primary focus is to speak out on consumer health-related issues D) They have not yet recognized the full potential of political activity

Ans: D Feedback: As a whole, the nursing profession has not yet recognized the full potential of collective political activity. Nurses must exert their collective influence and make their concerns known to policy makers before they can have a major impact on political and legislative outcomes. The remaining options are not true of nurses in general.

Even after a lengthy discussion concerning the ramifications, a patient wants to leave the hospital against medical advice (AMA). What would the nurse do in the role of patient advocate? A) Encourage the patient to wait until morning to leave the hospital B) Ask family members to help talk the patient out of the decision C) Call the security guard to escort the patient off hospital property D) Make sure the patient has appropriate follow-up appointments

Ans: D Feedback: As advocate for this patient, you have made sure he is informed of the ramifications of leaving AMA; however, it is a patient's right to refuse treatment. The other options fail to recognize the patient's right to make autonomous choices.

2. The nurse is assigned to administer medications to all patients throughout the shift. What is this an example of? A) Team nursing B) Case method nursing C) Primary care delivery D) Functional nursing care

Ans: D Feedback: Being assigned a specific task to do is part of functional nursing. None of the other options identify that connection.

12. How is competency of an employee best determined? A) An examination of patient records by a review team B) Self-reporting on an administered skills checklist C) Evidence of attendance in continuing education classes D) Documentation of effectively meeting role demands

Ans: D Feedback: Competency relates to role and is determined by each role demand. None of the other options are able to determine competency as effectively as documentation of performance.

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

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

Which statement is true regarding an economic man style manager? A) Lacks complete knowledge and generates few alternatives B) Makes decisions that may not be ideal but result in solutions that have an adequate outcome C) Makes most management decisions using the administrative man model of decision making D) These managers gather as much information as possible and generate many alternatives

Ans: D Feedback: Economic managers gather as much information as possible and generate many alternatives. Most management decisions are made by using the administrative man model of decision making. The administrative man never has complete knowledge and generates fewer alternatives.

Which statement best describes ethics? A) How our lives and relationships are led in our reality B) How people make decisions they see as legally and morally appropriate C) The conflict, power, and interdependency associated with the way we live D) What our conduct and actions should be regarding what is right and good

Ans: D Feedback: Ethics is the systematic study of what a person's conduct and actions should be with regard to self, other human beings, and the environment; it is the justification of what is right or good and the study of what a person's life and relationships should be, not necessarily what they are.

Which is a true statement about planning? A) All plans should be defined well so that changes aren't 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.

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

Ans: D Feedback: Frederick Taylor, the ìfather of scientific management,î 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.

2. 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 if it's not broke, don't fix it 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.

13. 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.

16. What is the best method for determining the effectiveness of a staff development program for managing IV puncture sites? A) Having class participants evaluate the instructor and the class B) Giving participants an examination or test at the conclusion of the course C) Having a documented decrease in the unit's IV site infections D) Observing staff implement and document the changes recommended

Ans: D Feedback: Instructor evaluation supports effective teaching but not learning of the new skills. Testing someone at the end of educational training does not confirm that the learning changed behavior, which is the primary goal of staff development. There needs to be some method of follow-up to observe whether a behavior change occurred, showing that the education was effective. Observation of the staff will fulfill this need. Having a decrease in IV site infections may or may not be the result of the staff implementing the educational program.

6. What term is used when two or more people have conflict about values or goals? A) Intergroup conflict B) Common control C) Intrapersonal conflict D) Interpersonal conflict

Ans: D Feedback: Interpersonal conflict happens between two or more people with differing values, goals, and beliefs. No other option is used to describe this situation.

11. Which question asked during an interview is acceptable? A) Are you married? B) Have you ever been arrested? C) What is your religious preference? D) What professional organizations do you belong to?

Ans: D Feedback: It is lawful for an interviewer to ask about professional organizations, but the interviewer cannot ask the interviewee to produce a list of all memberships. None of the other options identify an acceptable question.

The practice of allocating organs for transplantation based on a person's ìworth to societyî is an example of what ethical principle for decision making? A) Autonomy B) Beneficence C) Utility D) Justice

Ans: D Feedback: Justice: Seek fairness, treat ìequalsî equally, and treat ìunequalsî according to their differences. Autonomy: Promotes self-determination and freedom of choice. Beneficence: Actions are taken in an effort to promote good. Utility: The good of the many outweighs the wants or needs of the individual.

7. Which statement is true regarding long-term-coaching for career development? A) It occurs annually at performance appraisal reviews B) It focuses on employee performance deficits C) It requires the same intensity as a mentoring relationship D) It occurs over the entire employment tenure of an employee

Ans: D Feedback: Long-term coaching should occur over the entire employment of the employee

18. What is a management function associated with career development? A) ls self-aware of personal values influencing career r development B) Encourages employees to lake responsibility for their own career planning C) Identifies, encourages, and develops future leaders D) Works cooperatively to arrange intra-organizational transfers

Ans: D Feedback: Management function is to work cooperatively with other departments in arranging for the release of employees to take other positions within the organization. Leadership functions associated with career development are self-aware of personal values influencing career development; encourage employees to take responsibility for their own career planning, and identifies, encourages, and develops future leaders.

16. Using a decision package to aid in fiscal priority setting is a key feature of what type of budgeting? A) Personnel workforce B) Operating C) Capital D) Zero based

Ans: D Feedback: Managers must rejustify their program or needs every budgeting cycle in zero-based budgeting. Among the options available using a decision package to set funding priorities is a key feature of only zero-based budgeting.

10. A registered nurse reports to the nurse-manager that the team's nursing assistant regularly fails to complete assigned tasks. The nurse-manager responds that it is the nurse's responsibility to talk with the nursing assistant about this problem. The manager is engaged in what aspect of conflict? A) Conflict avoidance B) Conflict smoothing C) Encouraging competitive conflict D) Facilitating conflict resolution

Ans: D Feedback: Managers should not intervene in every conflict, but should urge subordinates to handle their own problems. This is an example of supporting conflict resolution. The action of the manager is not reflective of any of the other options.

13. How do managers view their responsibility to discipline staff? A) It is a necessary means for controlling an unmotivated and self-centered workforce B) It is a ìBig stickî that management can use to eliminate behavior that conflicts with organizational goals C) It is a means to assist in the development of self-discipline in an employee D) It is necessary to the organization if established rules are to be enforced

Ans: D Feedback: Managers use discipline to enforce established rules, policies, and procedures. The other options are very limited views regarding discipline.

5. According to McClelland, what does achievement motivation focus on? A) The extrinsic rewards to be acquired B) A need to nurture others C) A need to have legitimate power over others D) The intrinsic need to be successful

Ans: D Feedback: McClelland stated that achievement-oriented people will focus on improving (succeeding) through action. None of the other options have that impact on motivation.

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

Ans: D Feedback: 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.

Goleman in his best seller Emotional Intelligence built upon work in his identification of five components of emotional intelligence. Which component of emotional intelligence is occurring when a person is proficiently handling relationships and building networks? A) Self-regulation B) Motivation C) Empathy D) Social skills

Ans: D Feedback: Social skills: Proficiency in handling relationships and building networks; an ability to find common ground. Self-regulation: The ability to control or redirect disruptive impulses or moods as well as the propensity to suspend judgment. Motivation: A passion to work for reasons that go beyond money or status; a propensity to pursue goals with energy and commitment. Empathy: The ability to understand and accept the emotional makeup of other people.

18. What are often neglected areas of the indoctrination process? 1. Induction 2. Orientation 3. State or national laws 4. Union contracts A) 1, 2, 3 B) 1, 2, 4 C) 1, 3, 4 D) 2, 3, 4

Ans: D Feedback: Socialization and re-socialization are often neglected areas of the indoctrination process.

14. Which organization is actively engaged in clarifying the delegation parameters for RNs? A) American Hospital Association (AMA) B) The federal government C) National League for Nursing (NLN) D) State Boards of Nursing Licensure

Ans: D Feedback: State Boards of Nursing Licensure is responsible for clarifying the delegation parameters for RNs. None of the other options are involved in this process.

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 all those affected by the problem

Ans: D Feedback: The change agent should not proceed to the movement stage until the status quo has been disrupted and the need for change is perceived by the others. While the other options will affect the process, perception of the need to change by all affected by the change is the most impactful of the options provided.

4. What is the process involved in progressive discipline? A) A written warning precedes verbal warnings B) Formal warnings are followed up with informal warnings C) Written warnings are advocated only in the most serious of offenses D) The initial step is the delivery of a verbal warning by the manager

Ans: D Feedback: The first step of the progressive disciplinary process is an informal reprimand or verbal warning. This reprimand is followed by a formal reprimand or written warning when the behavior has not been changed.

16. What is the name of the gap that sometimes exists between a position of authority and subordinate response? A) Leadership subordinate B) Manager subordinate C) Administrator power D) Authority power

Ans: D Feedback: The gap that sometimes exists between a position of authority and subordinate response is called the authority power gap.

17. The manager should have a well-developed, planned system for career development for all employees . What should be included in this program ? I . Policies communicated to administrators 2. Appropriate use of transfers 3. How promotions are handled 4. Long-term coaching A) 1,2,3 B) 1, 2, 4 C) 1, 3, 4 D) 2, 3, 4

Ans: D Feedback: The manager should have a well-developed , planned system for a career development for all employees; this system should include the appropriate use of transfers, how promotions are to be handled, and long-term coaching. These policies should be fair and communicated effectively to all employees.

What is an ethical dilemma? A) A problem that can be solved using empirical data B) A situation that has clearly delineated facts for decision making C) A problem that when handled effectively has a mutually agreed-upon solution D) A situation that requires choosing between two or more undesirable alternatives

Ans: D Feedback: The most difficult of all moral issues is termed a moral or ethical dilemma, which may be described as being forced to choose between two or more undesirable alternatives. The problem is not generally solved with a solution that is mutually satisfying nor does it lend itself to empirical or delineated facts.

2. Which statement about power is correct? A) It is a finite quality and, once gained, is very difficult to lose B) It is destructively manipulative but is necessary for effective management C) Women generally view power more positively than do men D) Having power generally results in the gain of additional power

Ans: D Feedback: The only true statement here is that power is likely 10 bring more power in an ascending cycle, whereas powerlessness often generates more powerlessness.

The only treatment alternative left for a patient diagnosed with advanced cancer is a rare, highly experimental bone marrow transfusion with a 10% success rate. The insurance company refuses to authorize payment for the $200,000 procedure, arguing that the money could be better spent providing well-baby screening for 2,000 residents in the service area. What does this decision by the insurance company reflect? A) Unethical conduct B) Maleficence C) Paternalism D) Utility

Ans: D Feedback: The principle of utility states that what is best for the common good outweighs what is best for the individual. There is no indication of unethical or maleficence behavior on the part of the insurance company. Paternalism would be characterized by the insurance company making treatment decision without the patient having input.

14. What is the manager's role when dealing with employees who break the rules? A) To terminate their employment B) To be a good listener C) To act as counselor D) To ensure organizational goals are met

Ans: D Feedback: To act as coach and supporter, counselor, or good listener could be enabling to the employee who breaks the rules. The manager should be humanistic, however, and not scold or blame. Not all situations would result in employment termination.

9. Which statement most accurately describes how discipline in a unionized organization may vary from one that is nonunionized? A) Nonunionized organizations require a demonstration of just cause, whereas unionized organizations do not B) Discipline in nonunionized organizations tends to entail more procedural, legalistic safeguards than unionized organizations C) Only unionized organizations have grievance procedures D) Unionized employees must generally be disciplined according to specific steps and penalties within an established time frame

Ans: D Feedback: Unionized employees must generally be disciplined according to specific, pre- established steps and penalties within an established time frame. The remaining options do not accurately describe unionized organizational discipline procedures.

12. How can the RN best teach a patient how to self-administer insulin? A) Schedule a long, uninterrupted session B) Explain the most complicated part first C) Use a dynamic lecture technique D) Teach in short, frequent sessions

Ans: D Feedback: When learning motor skills, spaced practice is more effective than massed practice. The other options would be less effective.

19. The promise phase of career development typically reflects how many years of initial nursing employment'? A) 1 B) 2 C) 5 D) 10

Ans: D Feedback: Promise is the earliest of the career phases and typically reflects the first 10 years of nursing employment.

1. Which is the FIRST step in the time management process? A). Completing the highest priority task. B) Allowing enough time for sufficient daily planning C). Reprioritizing based on new information received D). Delegating work that cannot be accomplished in a day

B). Daily planning is essential if the manager is to manage by efficiency rather than by crisis. The remaining options are steps that occur after planning.

20. In prioritizing all the "do now" items, the manager may find preparing a written list helpful. What is important to remember about the written list? 1. It is a plan. 2. It is a product 3. It is a planning tool 4. It is the final goal to be accomplished. A). 1, 2 B). 1, 3 C). 2, 3 D). 3, 4

B). In prioritizing all the "do now" item, the manager may find preparing a written list helpful. The list is a planning tool. Remember, however, that a list is a plan, not a product, and that the creation of the list is not he final goals.

7. Which statement about time management is true? A). Mos 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 who are self-aware and have clearly identified personal goals and priorities have greater control over how they spend their time. C). Writing goals down is not necessary if the goals are limited to fewer than five in number. D). A time inventory for 2 or 3 days is sufficient to identify a time management pattern

B). Nurses, who are self-aware and have clearly identified personal goals and priorities have greater control over how they spend their time. The other options are not true statements regarding time management.

18. What category of prioritizing will an item that will take care of itself be placed? A). Squeaky wheel B). Don't do C). Do later D). Do now

B). One simple means of prioritizing what needs to be accomplished is to divide all requests into three categories: "don't do; do later; & do now" items probably reflect problems that will take care of themselves, are already outdated, or better accomplished by someone else.

8. Which task should the team leader INITIALLY engage in when planning care for a group of patients? A). Plan so that each patient on the team receives equal amounts of nursing care B). Prioritize the amount and type of nursing care each patient requires C). Identify the staff who will compromise the individual care teams. D). Assign patients to the specific nursing teams.

B). Prioritizing the care each patient will require is the initial step in care planning. The other options are considered but implementation will happen after prioritizing.

16. When is the best time of day for the manager to spend appropriate time on planning? A). Whenever a block of time is available B). Beginning of the day C). Middle of the day D). End of the day

B). Setting aside time at the beginning of each day to plan the day allows the manager to spend appropriate tie on high-priority tasks.

10. Which technique will help the manager prioritize? A). Doing trivial I items first to get them out of the way. B). Putting some items in the "don't do" category C). "Breaking of" overwhelming tasks D). "Delegating" the most important things to someone else

B). The "don't do" list contains items that will take care of themselves, are already outdated, or are best accomplished by someone else. In the case of items that are best done by someone else, the manager should pass these along in a timely fashion, none of the remaining options address prioritization.

4. What does the good manager have to remember about creating a daily list? A). It should remain changed once initial planning is completed B). It is a planning tool, and thus must have flexibility in its implementation C). It should include all the planner's short-term, intermediate, and long-term goals D). It should be highly structured, thus decreasing the possibility of procrastination

B). The daily list should be flexible, changeable, leave some time for the unexpected, and include appropriate short-term goals.

17. What is the most critical skill in good time management? A). Allow adequate time for planning B). Recognizing the need for daily planning C). Priority setting D) Handling situations as they arise

C). Priority setting is perhaps the most critical skill in time management because all actions taken are some type of relative importance.

15. Time management can be reduced to cyclic steps. What are the steps? 1. Allow time for planning and establish priorities 2. Complete the quickest priority task first- 3. Complete the highest priority task, and whenever possible, finish one task before beginning another. 4. Reprioritize based on remaining tasks and new information that may have been received. A) 1, 2, 3 B). 1, 2, 4 C). 1, 3, 4 D). 2, 3, 4

C). Time management can be rescued to three cyclic steps (a) allow time for planning and establish priorities; (b) complete the highest priority task, and whenever possible, finish one task before beginning another, and (c) reprioiritize based on remaining tasks and new information that may have been received.

19. What do the "do now" requests reflect? A). A units day-to-day operational needs B) Issues R/T short-term goals C). Large, time-consuming tasks D). Problems that cannot be delegated

A). The "do now" requests most commonly reflect a unit's day-to-day operational needs. These "do now? Requests are not necessarily R/T short-term goals or time-consuming. Nor are they also non-delegatable.

5. What should the interviewer do to increase the reliability and validity of an interview? A) Conduct single, rather than multiple, interviews B) Trust his or her first impressions of an applicant C) Avoid taking notes during the interview D) Develop a structured interview format

Ans: D Feedback: The same structured interview should be used for all employees applying for the same job classification. None of the other options identify an appropriate technique.

15. What type of evaluation has been proved to increase productivity and commitment in employees? A) Rating scale B) Checklist C) Essay D) MBO

Ans: D Feedback: MBO has been proved to increase productivity and commitment in employees. Research does not support that claim related to the other options.