Leadership & Management Final Exam

The Social Security Act of 1935 impacted public health nursing because it contained provisions for care for which of the following vulnerable populations? A. Disabled children B. Mentally disabled C. Older adults D. Opioid addicts

A. Disabled children This is correct. The Social Security Act of 1935 strengthened public health services, particularly for dependent mothers and children, the blind, and disabled children.

Professionalism has been historically difficult to define. Early definitions of professionalism included which of the following characteristics? A. Expertise B. Empathy C. Ethical and moral values D. Honesty

A. Expertise This is correct. Older definitions of professionalism only look at knowledge and expertise.

An RN is explaining to a student nurse what professionalism in nursing means. Which of the following statements, if made by the student nurse, demonstrates teaching has been successful? A. "Commitment to others means I should be honest and accountable for my actions." B. "I should encourage my fellow nurses to talk when they are having a bad day." C. "I should be flexible with myself and my fellow nurses when it comes to the dress code." D. "If I need a day off, I should promptly call in sick to give my manager plenty of time to find a replacement."

A. "Commitment to others means I should be honest and accountable for my actions." This is correct. Commitment to others involves accountability for one's actions, lifelong learning, and commitment to colleagues.

Which of the following is a reason for increasing the use of advanced practice nurses? A. A 2010 Institute of Medicine report encouraged nurses to practice to the full extent of their education. B. Advanced practice nurses serve as an extension of physicians. C. The National League for Nursing promotes the master of science in nursing (MSN) as the terminal degree for nurse practitioners. D. Advanced practice nurses do not have the skills to diagnose.

A. A 2010 Institute of Medicine report encouraged nurses to practice to the full extent of their education. This is correct. A 2010 Institute of Medicine report stated nurses should be allowed to practice to the full extent of their education.

A nurse recently started working in a busy hospital in a high-crime neighborhood. Which of the following recommendations will best help the nurse to prevent violent behavior? A. Acknowledge the feelings of others. B. Monitor patients for increased alcohol consumption. C. Ensure all individuals enter the building through a metal detector. D. Report outages in the parking lot lights.

A. Acknowledge the feelings of others. This is correct. Acknowledging the feelings of others is a behavior that helps to defuse anger.

An RN identifies safety concerns on an inpatient unit. The RN implements changes in order to improve patient outcomes. Which of the following best describes this scenario? A. Apply quality improvement. B. Utilize informatics. C. Employ evidence-based practice. D. Provide patient-centered care.

A. Apply quality improvement. This is correct. Quality improvement involves identification of errors and safety hazards, as well as designing and implementing interventions to change processes and improve safety.

A new registered nurse (RN) with an organization is learning the layout of patient rooms. Which of the following organizational levels does this best describe? A. Artifact level B. Espoused beliefs C. Underlying assumptions D. Organizational culture

A. Artifact level This is correct. The artifact level of organizational culture includes visible characteristics, such as the layout of patient rooms.

Which of the following should be included in training for the prevention of needlestick injuries and other exposures to health risks? A. Clean all contaminated work surfaces according to established guidelines. B. Recap needles before disposal to avoid accidental pricks when emptying containers. C. Staff should be treated within 3 hours of a needlestick injury. D. Although sharps injuries have significantly declined in most areas, emergency departments are still the most at risk when it comes to needlestick injuries.

A. Clean all contaminated work surfaces according to established guidelines. This is correct. Guidelines have been established regarding cleaning of contaminated surfaces with an intent to prevent needlestick injuries and exposure to health risks.

An RN is considering returning to school for a bachelor of science in nursing (BSN) degree. The RN realizes the knowledge gained will improve his practice and could impact patient outcomes. However, the RN is not sure about when to start the process. The RN's manager shares her own story with the RN, explaining why the manager decided to return to school and how this has impacted her professional life and personal life. Which of the following stages of change is the RN most likely in? A. Contemplation B. Preparation C. Precontemplation D. Action

A. Contemplation This is correct. During the contemplation stage, the individual intends to make a change. It is during this stage that a compelling leader can use emotional persuasion to encourage a change.

An organization focuses on improving interdisciplinary collaboration. Which of the following most likely is the focus of the organization? A. Culture of safety B. Care environment C. Excellence D. Meaningfulness

A. Culture of safety This is correct. A culture of safety involves a commitment to consistent and safe operations, including an emphasis on interdisciplinary collaboration.

Which of the following is true regarding horizontal violence? A. Horizontal violence is a sentinel event. B. Horizontal violence is rare on nursing units. C. Bullying only occurs as horizontal violence. D. New graduates often experience incivility from their superiors.

A. Horizontal violence is a sentinel event. This is correct. Horizontal violence is considered to be a sentinel event because it is a threat to patient safety.

Shift work disorder results in a greater risk for accidents, ulcers, heart disease, and chronic fatigue. Which of the following recommendations can prevent or lessen the risk of shift work disorder for those on night shift? A. If driving home during the morning sunlight, wear sunglasses. B. Schedule some day shifts and some night shifts during the scheduling period to allow for more nighttime sleep periods. C. Change days scheduled off to allow for more days off at one time. D. Take naps whenever possible during time off.

A. If driving home during the morning sunlight, wear sunglasses. This is correct. Wear sunglasses if driving home during the bright morning sunlight.

A nurse manager is planning for implementation of a change in practice based on current evidence. When planning for implementation, which of the following is the priority consideration? A. Is this the only change taking place? B. Will the change work on this unit? C. Is the change necessary? D. Where have past changes failed?

A. Is this the only change taking place? This is correct. Considering whether other changes are also occurring can assist the manager in gauging stress, a factor to consider when implementing change.

The Occupational Safety and Health Administration requires employers to inform workers of potential risks and health hazards. Which of the following organizations should a nurse leader monitor to best learn of new and emerging health hazards? A. National Institute of Occupational Safety and Health B. Institutes of Medicine C. American Nurses Association D. Occupational Safety and Health Administration

A. National Institute of Occupational Safety and Health This is correct. Initial warnings usually come from the CDC, NIOSH, or federal, state, and local agencies, who are charged with monitoring potential threats.

Which of the following best describes the characteristic of efficient quality in health care? A. Opening only the supplies that are necessary B. Utilizing the CAUTI bundle to prevent urinary tract infections when placing indwelling urinary catheters C. Using an interpreter for patients who do not speak the health-care provider's language D. Working to reduce wait times in the emergency department

A. Opening only the supplies that are necessary This is correct. Efficiency in health care includes avoiding waste.

In which of the following types of networks is the main focus of supervisors on planning and providing resources? A. Organic B. Bureaucratic C. Traditional D. Innovative

A. Organic This is correct. Organic networks shift decision making to the individuals who implement the decisions, rather than the supervisors. This leaves the supervisors free to focus on planning and providing resources.

1. Which of the following is an example of a macro-level change? A. Policy changes B. Adjustments to shift change report C. Implementing a new evidence-based practice (EBP) D. Quality improvement changes

A. Policy changes This is correct. Policy changes occur at the state or federal level and impact every health-care facility.

Which of the following is true regarding nursing practice councils? A. Practice councils are a form of shared governance, giving nurses the ability to participate in levels of decision making for the unit. B. Practice councils give nurses the authority to control all aspects of their practice. C. Genuine sharing of decision making occurs when managers retain control. D. A nursing practice council works best for an organization when it is the only practice council in place.

A. Practice councils are a form of shared governance, giving nurses the ability to participate in levels of decision making for the unit. This is correct. Shared governance is a nursing practice structure that gives nurses the authority to participate in decision making for the unit through practice councils.

Which of the following will provide psychological safety when making a major change? A. Provide opportunities for individuals to ask questions. B. Allow individuals to agree to the change without consequences when they do not implement the change right away. C. Provide details about why the change is necessary. D. Recognize resistance and work to eliminate it.

A. Provide opportunities for individuals to ask questions. This is correct. Providing an opportunity for individuals to ask questions and express themselves will increase psychological safety.

A nurse is completing the morning assessment on a new patient. As the nurse approaches the IV pole, the nurse's foot gets stuck to the floor and the nurse falls to the ground, injuring his knee. It was discovered that an IV bag containing dextrose had leaked onto the floor and was not properly cleaned up. The nurse suffered a sprain and returned to work 1 week later. Which of the following does this best describe? A. Serious incident B. Service occurrence C. Minor injury D. Sentinel event

A. Serious incident This is correct. A serious incident occurs when a patient or employee suffers injury without the threat of death.

A new nurse on a busy intensive care unit thinks constantly about potential mistakes and has started dreading going to work. This nurse uses alcohol to relax. Which of the following is most likely true? A. The nurse's stress level is too high. B. The nurse is a victim of bullying. C. The nurse is a victim of sexual harassment. D. The nurse is unprepared to be on a high acuity unit.

A. The nurse's stress level is too high. This is correct. Another sign of a high stress level is avoiding coworkers, patients, or assignments.

A chief nursing officer is working to develop a culture of safety. Which of the following recommendations should be implemented? A. When sentinel events occur, study what happened in order to learn from the consequences. B. Determine who was most responsible for an error that occurred. C. Identify what errors occur for mandatory reports. D. Eliminate the cause of errors.

A. When sentinel events occur, study what happened in order to learn from the consequences. This is correct. A root cause analysis should be completed for sentinel events.

Nurses are advocates for their patients and have a duty to report any behaviors that may negatively impact patient outcomes. Which of the following is true regarding reporting quality and safety issues? A. Whistleblower laws protect nurses from reprisals by employers. B. An organization may terminate employment of a nurse who reports quality and safety issues. C. The state nurses practice act will have information if there are whistleblower laws in the state to protect nurses. D. As long as nurses do the right thing for their patients, they will be protected.

B. An organization may terminate employment of a nurse who reports quality and safety issues. This is correct. Doing the right thing does not ensure protection.

Which of the following best describes safety in health care? A. A registered nurse (RN) who made a major medication error was terminated. B. After a medication error, a team works to prevent similar errors in the future. C. An organization focuses on efficiency on the nursing units. D. Safety indicators are reported regularly.

B. After a medication error, a team works to prevent similar errors in the future. This is correct. Determining why an error was made and how to prevent it in the future promotes a culture of safety.

A nurse manager is developing a safety program for the unit. Which of the following steps should be included during the third step of creating the plan? A. Recognize potential safety hazards. B. Calculate the costs of the plan. C. Assess the amount of risk involved. D. Provide the necessary safety supplies and equipment.

B. Calculate the costs of the plan. This is correct. During creation of the plan, the costs of the plan should be calculated.

Which of the following scenarios most likely is sexual harassment? A. Asking a coworker out on a date B. Commenting on a coworker's gender C. Telling jokes D. Asking about a coworker's family

B. Commenting on a coworker's gender This is correct. Commenting on an individual's gender or body most likely is sexual harassment.

Which of the following best describes why health care is stressful? A. Outside demands can be a major source of stress. B. Continued intensive contact occurs with noncompliant patients. C. Most nurses learn how to manage stress. D. Small stressors may accumulate quickly.

B. Continued intensive contact occurs with noncompliant patients. This is correct. Noncompliance in patients is a major source of stress. Additionally, nurses are in continual, intensive, and intimate contact with individuals who are seriously ill.

The decades between the 1960s and 1980s brought about many changes in nursing. Which of the following is a reason for advances in nursing? A. Decreased demand for health care B. Development of specialty care disciplines C. Gender discrimination D. Advances in technology leading to more generalized care

B. Development of specialty care disciplines This is correct. Specialty care disciplines developed because of advances in intensive care, neurosurgical techniques, and cardiothoracic surgery.

Improvement of patient care outcomes is a focus of all health-care providers. Which of the following is a method for nurses to improve patient care outcomes? A. Focus on improving patient teaching. B. Encourage nurses to further their education. C. Evaluate only when patient teaching fails. D. Nurse leaders should control decision making.

B. Encourage nurses to further their education. This is correct. Increasing education of nurses improves patient outcomes.

Which of the following is true regarding a root cause analysis? A. The goal of a root cause analysis is to find the one root cause of an error. B. Finding the root cause may not always be possible. C. Determine the necessary and sufficient influences at the beginning of the root cause analysis. D. Focus on the direct cause of the error.

B. Finding the root cause may not always be possible. This is correct. Whenever feasible, the root cause should be found.

In a health-care organization, all employees are ranked according to their level of authority. Which characteristic of a bureaucracy does this best describe? A. Division of labor B. Hierarchy C. Rules and regulations D. Technical competence

B. Hierarchy This is correct. Hierarchy is the ranking of each employee according to his or her level of authority.

A new RN asks a peer how the peer always seems to get timely responses from the laboratory department. The experienced RN explains the process she uses. This is most likely an example of which of the following? A. Formal processes B. Informal processes C. Authority D. Reward

B. Informal processes This is correct. Informal processes are not written processes and may not even be discussed, but are often much simpler and easier to navigate than the formal processes.

The first step in change is to plan carefully. Which of the following questions should be asked during the design stage of change? A. Does everyone agree on the change? B. Is the change really needed? C. How difficult is the change to make? D. How quickly should the change be made?

B. Is the change really needed? This is correct. It is important to ascertain if there is a better way of doing things and if the change is really necessary.

A patient suffered a hemolytic transfusion reaction after being given packed red blood cells with an incompatible blood type. The patient recovered. Which of the following types of safety events does this scenario best describe? A. Serious incident B. Never event C. Minor injury D. Sentinel event

B. Never event This is correct. A hemolytic transfusion reaction resulting from being given incompatible blood components is a shocking event that should never occur, regardless of the patient outcome.

Which of the following organizations is primarily responsible for developing and enforcing workplace safety policies? A. National Safety Council (NSC) B. Occupational Safety and Health Administration (OSHA) C. National Institute of Occupational Safety and Health (NIOSH) D. U.S. Department of Health and Human Services

B. Occupational Safety and Health Administration (OSHA) This is correct. OSHA, part of the U.S. Department of Labor, develops and enforces workplace safety policies and health regulations.

A nursing unit updated their barcode scanners because the batteries of the old ones were not replaceable and stopped holding charge. The proposed new scanners are wired so that batteries are not required. However, the registered nurses (RNs) resist this change because the placement of the scanners could make it difficult to reach the patients if they were not in bed. Which of the following most likely describes the source of the resistance? A. Design flaws B. Practical reasons C. Personal needs D. Position and power

B. Practical reasons This is correct. Practical reasons for resistance result from a question of whether the change can realistically be implemented without needing to have workarounds created.

To increase the number of baccalaureate-prepared RNs on the unit, the manager has proposed starting a cohort of RNs in a BSN program at one time. The manager has scheduled an information session for all who are interested. During the session, six RNs sign up for assistance with the application process. Which stage of change are these RNs most likely in? A. Precontemplation B. Preparation C. Contemplation D. Action

B. Preparation This is correct. The RNs are planning to make a change and have set a goal time for starting the change.

Which of the following is a way to assist the health-care team to manage stress effectively? A. Create a peaceful breakroom far from the unit. B. Provide a private room away from the hearing of patients and families, but nearby for nurses to collaborate with one another. C. Encourage new nurses to quickly move into the mentor role. D. Remind the team they are in control.

B. Provide a private room away from the hearing of patients and families, but nearby for nurses to collaborate with one another. This is correct. Providing a space for nurses to get some downtime and speak with coworkers out of the hearing of patients and families will foster peer support and reduce stress.

Which of the following is the best way for a nurse to become a culturally competent practitioner? A. Immerse himself or herself in other cultures. B. Reflect on one's own culture, values, and biases. C. When assigned a patient with a different culture, take some time to read about the culture. D. Promote minority representation at all levels of the organization.

B. Reflect on one's own culture, values, and biases. This is correct. Taking the time to reflect on one's own values and biases will increase sensitivity to culture and enable one to become a more culturally competent practitioner.

Which of the following is a way to appeal to feelings in order to increase receptivity for a change? A. Present statistics on the number of patients with catheter-associated urinary tract infections during the next staff meeting. B. Share a patient's story of how a catheter-associated urinary tract impacted him personally. C. Provide staff with a report of infection control measures and their effectiveness. D. Inform staff about the cost of individual supplies.

B. Share a patient's story of how a catheter-associated urinary tract impacted him personally. This is correct. Sharing a patient story or visual presentation impacts feelings.

A registered nurse (RN) who usually uses public transportation has not renewed her driver's license. During a recent car trip with a friend, she took over driving when her friend became tired. Which of the following is true? A. She has acted in a professional manner. B. She may lose her RN license for driving without a license. C. She should renew her driver's license as soon as possible. D. Under the circumstances, she will not be faulted for driving without a license.

B. She may lose her RN license for driving without a license. This is correct. Driving without a license is deemed an unprofessional and illegal behavior for which a nurse may lose his or her license.

For nurses to participate in decision making, they need to have the authority to make decisions without asking permission. Which source of power does this best describe? A. Resources B. Support C. Information D. Opportunity

B. Support This is correct. Support is the authority to take action without asking permission.

Which of the following best describes a reason why radical changes are often easier to maintain than relatively smaller changes? A. Information is more abundant with radical changes. B. Support groups for radical changes deal with emotional aspects of change. C. It takes much longer to feel a difference. D. Fear is often the motivation for making radical changes.

B. Support groups for radical changes deal with emotional aspects of change. This is correct. Knowledge alone is often not enough. Support groups, meditation, yoga, relaxation, and aerobic exercise can deal with the emotional aspects of change.

Which of the following is true regarding needlestick injuries? A. The Needlestick Safety and Prevention Act has been so effective that needlestick injuries are no longer a concern. B. The ANA has recently promoted the inclusion of nurses in the selection of safety devices. C. OSHA standards require the use of longer needles with caps to prevent needlesticks. D. The Joint Commission surveyors routinely ask about treatment of nurses who have suffered needlestick injuries.

B. The ANA has recently promoted the inclusion of nurses in the selection of safety devices. This is correct. A recent consensus statement from the ANA recommends including nurses in determining which safety devices will be used to prevent needlestick injuries.

Which of the following is true regarding ergonomic injuries? A. Ergonomic injuries do not occur when safe patient handling technology is used. B. Unexpected patient movements during transfers can cause back injuries to nurses. C. Health-care facilities are required to attempt to keep workplaces free from ergonomic hazards. D. Nurses are not at risk for repetitive stress injuries.

B. Unexpected patient movements during transfers can cause back injuries to nurses. This is correct. Unexpected movements or resistance from patients during transfers can throw a nurse off balance and result in a back injury.

As the definition of nursing evolved, which of the following nurse theorists focused on the uniqueness of nursing? A. Florence Nightingale B. Virginia Henderson C. Martha Rogers D. Abraham Maslow

B. Virginia Henderson This is correct. Virginia Henderson's definition of nursing focused on its uniqueness.

Which of the following is a challenge the profession of nursing faced? A. Because of fear, nursing contributed to the stigma of AIDS in the 1980s. B. During the Korean War, nursing practice grew in field hospitals where supplies and equipment were abundant. C. After the Vietnam War, many nurses were frustrated with the lack of independent functioning of nurses when they returned home. D. Ethical dilemmas led to a decline in the number of hospice nurses.

C. After the Vietnam War, many nurses were frustrated with the lack of independent functioning of nurses when they returned home. This is correct. During the Vietnam War, many nurses functioned independently in mobile hospital units performing lifesaving procedures for wounded soldiers. Many felt restricted by the lack of independent practice when they returned home.

Which of the following recommendations promotes safe, quality, patient-centered care? A. Focus on tasks. B. Establish patient goals with the care team. C. Communicate the care plan with the care team. D. Evaluate outcomes at the end of the shift.

C. Communicate the care plan with the care team. This is correct. The full care plan, objectives, and each team member's role should be discussed with the care team.

The ability of an RN to conduct research, collect data, interpret it, and utilize it best describes which source of power? A. Authority B. Reward C. Control of information D. Coercion

C. Control of information This is correct. Control of information is power that stems from the special knowledge an individual is believed to possess.

A recent nursing school graduate is preparing to take the NCLEX. The graduate knows which of the following is true? A. Upon graduation from nursing school, she can use the title RN. B. Because the NCLEX is a national examination, her RN license will allow her to practice in all states and territories of the United States. C. If her home state participates in the compact agreement, she may practice in other states participating in the agreement, but should renew her license in her home state. D. The RN license is a permissive license.

C. If her home state participates in the compact agreement, she may practice in other states participating in the agreement, but should renew her license in her home state. This is correct. The state in which the nurse lives is considered her home state. Although the nurse may practice nursing in other states participating in the compact, she should renew her RN license in her home state.

Which of the following is true about behavior changes? A. Crisis is a powerful motivation for change. B. Change is motivated by fear. C. Individuals who are active and engaged can learn to make a change. D. Small changes are easier to make and sustain.

C. Individuals who are active and engaged can learn to make a change. This is correct. People can continue learning and implementing changes throughout their lives, as long as they remain active and engaged.

A nurse leader is involved with establishing the organization's quality improvement plan. Which of the following should be included in the plan? A. Educate the managers in the organization about quality improvement. B. Establish a quality council to set goals according to organizational values. C. Link quality improvement goals to the organization's strategic plan. D. Encourage individuals to think about quality improvement.

C. Link quality improvement goals to the organization's strategic plan. This is correct. The organization's strategic plan should be taken into consideration when setting quality improvement goals.

An RN receives a patient with a diagnosis of thrombotic stroke from the emergency department. The pharmacy alerts the RN that the dose of tPA must be administered within the next 15 minutes and sends the medication to the RN. The usual practice is for tPA to be administered in the emergency department before admission to the unit. The RN checks the medication administration record, noting there is no indication that the tPA was administered in the emergency department. The RN calls down to the emergency department to speak with the nurse who cared for the patient. The previous nurse failed to document administration of the medication and corrects the documentation with a late entry note. This scenario best describes which of the following? A. Medication error B. Adverse event C. Near miss D. Risk management

C. Near miss This is correct. An example of a near miss is catching a medication error before the medication is administered.

An RN visits a middle school class to discuss the profession of nursing. Which of the following statements is true of nursing? A. Nurses must graduate from nursing school in order to obtain a license to practice. B. Nursing is a vocation that requires continuous education. C. Nurses function autonomously within their scope of practice. D. Nurses must adhere to expected professional behaviors in their lives.

C. Nurses function autonomously within their scope of practice. This is correct. Rather than being assistants to doctors, nurses are able to function autonomously within their scope of practice. Nurses formulate and deliver a plan of care for clients, utilizing nursing judgment and critical thinking skills to make decisions in client care.

Recent polls have placed nursing as one of the most trusted professions because of which of the following? A. Nurses engage in lifelong learning. B. Nurses abide by a dress code. C. Nurses have the skills needed to care for diverse populations. D. Nurses must pass the NCLEX in order to obtain a license to practice.

C. Nurses have the skills needed to care for diverse populations. This is correct. Nurses are one of the most trusted professions because they have the knowledge, expertise, and ability to care for diverse populations.

A nurse manager of a busy emergency department is working to reduce the potential for violence on the unit. Which of the following will most likely reduce the potential for violence? A. Decrease the number of visible security guards to avoid antagonizing patients. B. Implement procedures to speed up the discharge process for mentally ill patients. C. Propose a plan to expand and update the waiting room. D. Ensure post-assaultive treatment and support is available to all staff.

C. Propose a plan to expand and update the waiting room. This is correct. Overcrowded and uncomfortable waiting rooms increase the risk for violence.

Which of the following components of the care environment involves understanding and valuing the work individuals do? A. Excellence B. Meaningfulness C. Regard D. Learning and growth

C. Regard This is correct. Regard requires understanding and valuing the work of individuals.

Which of the following is an example of incivility in the workplace? A. Giving one nurse, who is suffering a family crisis, a light assignment, which means the other nurses have to do more B. Discussing an error that occurred with a group of nurses on the unit C. Reprimanding a nurse who made an error in front of staff so that everyone can learn from the mistake D. Workgroup cohesion

C. Reprimanding a nurse who made an error in front of staff so that everyone can learn from the mistake This is correct. Reprimanding an employee in front of others is an example of incivility.

Which of the following is true regarding sexual harassment? A. Men are not harassed by women. B. Quid pro quo is the most common sexual harassment claim. C. Sexual harassment is prohibited by the Civil Rights Act of 1964. D. A work environment must be proven to be psychologically injurious to be considered hostile.

C. Sexual harassment is prohibited by the Civil Rights Act of 1964. This is correct. Sexual harassment is prohibited by Title VII of the Civil Rights Act of 1964.

Nurses face threats to safety in their daily work experiences. According to an American Nurses Association (ANA) study in 2011, which of the following is currently the greatest threat to safety of nurses in the workplace? A. Sharps injuries B. Patient assaults C. Stress D. Lifting injuries

C. Stress This is correct. Stress from being overworked and increased shift lengths is a major safety concern.

Which of the following is true about personal change? A. The most effective leaders focus on improving the team, rather than themselves. B. Radical changes are more important for leaders than small changes. C. The process of personal change may follow the same steps as organizational change. D. Small personal changes do not require much effort.

C. The process of personal change may follow the same steps as organizational change. This is correct. Personal changes follow a similar process as organizational changes.

Which of the following best describes the main purpose of collective bargaining? A. To provide protection to employers B. To promote cooperation C. To equalize power between employees and employers D. To promote a clinical ladder for staff

C. To equalize power between employees and employers This is correct. The purpose of collective bargaining is for an equalization of power between employees and employers. This equalization leads to improved working conditions, increased job security, and pay raises.

Management on a nursing unit has decided to upgrade to new beds in an effort to decrease occurrences of skin breakdown on the unit. The manager begins the staff in-service on the new beds by reviewing the recent incidence of skin breakdown and comparing it with statistics from similar units. Which stage of the change process is the manager addressing? A. Change B. Refreezing C. Unfreezing D. None of the above

C. Unfreezing This is correct. During the unfreezing stage, the reason for the change is discussed and it includes other actions that create a readiness for change.

Which of the following best describes the characteristic of effective quality in health care? A. Frequent assessments of patients with soft wrist restraints B. Including the patient in planning care C. Using current evidence to improve practice D. Responding to call lights quickly

C. Using current evidence to improve practice This is correct. Utilizing evidence-based practice fits with the characteristic of effectiveness in providing quality health care.

Which of the following federal laws requires employers to create affirmative action plans to hire and promote individuals with disabilities? A. Title VII B. Equal Pay Act of 1963 C. Vocation Rehabilitation Act of 1973 D. Americans with Disabilities Act of 1990

C. Vocation Rehabilitation Act of 1973 This is correct. The Vocational Rehabilitation Act of 1973 requires employers who receive federal monies to avoid discrimination against individuals with disabilities and to develop plans to hire and promote individuals with disabilities.

Which of the following is a good recommendation when planning change? A. Appoint a champion even for small changes. B. Not all effective leadership skills are needed for effecting change. C. Small changes do not require involving people who may be affected. D. Motivating people may be required even for small changes.

D. Motivating people may be required even for small changes. This is correct. Even small changes require effective leadership skills, such as motivating people.

Which of the following is a way in which nursing can impact quality and safety? A. Pay attention to detail in daily activities. B. Advocate for shift change communication to occur with the patient's medical record opened and under review. C. Encourage the patient to ask questions of the health-care team and follow the team's recommendations. D. Acknowledge the power of individuals within the profession of nursing.

D. Acknowledge the power of individuals within the profession of nursing. This is correct. It is important for professional nurses to acknowledge their power within the profession.

Which of the following organizations partners with other agencies in an effort to conduct research and implement prevention strategies to promote safe and healthy work environments? A. The Joint Commission B. American Nurses Association C. Institute of Medicine D. Centers for Disease Control and Prevention

D. Centers for Disease Control and Prevention This is correct. The Centers for Disease Control and Prevention works with other agencies to conduct research, implement prevention strategies, and promote safe and healthy work environments.

A nurse develops a relationship with a patient through respect. The nurse uses culturally appropriate touch and eye contact. Which of the following factors in understanding cultural diversity is this nurse demonstrating? A. Social organization B. Space C. Internal control D. Communication

D. Communication This is correct. Communication involves touch, eye contact, body posture, pronunciation, vocabulary, intonation, and other factors.

Which of the following is a reason for conflicts in professional nursing today? A. Some nurses who had planned to retire but find themselves forced to continue working because of the current economic situation B. Balancing state practice acts, codes of ethics, and standards of practice C. Advances in technology D. Multiple generations in the workforce

D. Multiple generations in the workforce This is correct. Multiple generations in the workforce today with multiple viewpoints can lead to conflict.

Nurses in one hospital noticed a sharp increase in violent behaviors during an economic downturn that dramatically impacted the community. There have been multiple incidences of violence during the last 3 months, including several cases involving weapons. The staff has suggested metal detectors be installed; however, the organization-stated funding was not available. Last week a health-care worker was seriously injured when a patient fired a gun, and since that time there has been a sharp increase of staff calling in sick. Which of the following is the best step to take next? A. Report the violence to the supervisor. B. Call security. C. Get involved in policy making at the state level. D. Contact the local collective bargaining unit.

D. Contact the local collective bargaining unit. This is correct. When the problem persists and there is a safety concern, the local collective bargaining unit, the state nurses association, or OSHA can push for change at the organizational level to improve workplace safety.

Nurses on a unit have prepared a presentation for their administrators on a proposal for a change in practice based on current evidence. They begin the presentation with a description of the current practice and evidence of why it is inefficient. This is an example of lowering resistance through which method? A. Sharing information B. Providing psychological safety C. Dictating change D. Disconfirming currently held beliefs

D. Disconfirming currently held beliefs This is correct. The scenario describes disconfirming currently held beliefs that the current practice is efficient. This sets the stage for the reason why a change is needed and will decrease resistance.

An organization works hard to be the best in the market and drive out competition. This describes which of the following organizational goals? A. Growth B. Profit C. Status D. Dominance

D. Dominance This is correct. An organization's goal for dominance goes beyond growth to the point of attempting to drive competition out of the market.

A new RN in the critical care unit joined the professional organization for critical care nurses. The new RN took advantage of webinars and journal articles that offered continuing education credits. The new RN attended the national conference and began studying for the certification examination. Which benefit of professional organizations does this scenario best describe? A. Collegiality B. Commitment to improved patient outcomes C. Recognition of achievement D. Enhancement of nursing competence

D. Enhancement of nursing competence This is correct. Through publications, conferences, and continuing education, professional organizations enhance an individual nurse's competence.

The main purpose of the NCLEX examination is which of the following? A. Ensure individuals have passed nursing classes. B. Provide assurance that the nursing schools are part of the service agency. C. Enable potential students to determine the best nursing schools. D. Ensure the safety of the public.

D. Ensure the safety of the public. This is correct. The purpose of the NCLEX examination is to ensure the safety of the public by establishing a minimum standard to indicate that an individual has the knowledge and skills necessary to practice nursing safely and effectively.

Which of the following is a way a nurse manager can reduce stress for the nursing team? A. Use cognitive behavioral training. B. Address the staff member's spiritual concerns. C. Provide directions for exercise routines. D. Establish peer support groups.

D. Establish peer support groups. This is correct. A nurse manager can establish peer support groups as a method for reducing stress.

Which of the following is the best way a nurse manager can work with leaders of collective bargaining units? A. Focus on staffing goals B. Focus on a clinical ladder to support staff expertise C. Focus on patient outcomes D. Focus on shared goals

D. Focus on shared goals This is correct. Through respect for differences and finding common ground, shared goals can be established that will be mutually beneficial.

An RN has joined the practice council at the hospital network. The RN is able to have some say regarding nursing practice in the network and now feels as if network administration is listening to the RN's recommendations. Which of the following components of empowerment does this scenario best describe? A. Meaning and decision making B. Self-determination and autonomy C. Impact and autonomy D. Impact and decision making

D. Impact and decision making This is correct. Impact occurs when an RN feels he or she can make a difference because others listen to his or her ideas. Decision making is control regarding nursing practice within an organization. Joining a practice council empowers the RN through impact and decision making.

A nurse in an adult step-down unit at a small community hospital has noticed increased stress in the staff's work life. The hospital has been seeing patients with increased acuity ever since an economic downturn in the community. Which of the following is the most likely reason? A. Dealing with inexperienced medical residents B. The death of young patients C. Aggression from patients D. Increased frequency of patients needing resuscitation

D. Increased frequency of patients needing resuscitation This is correct. The acuity of patients has increased; therefore, it is reasonable to believe that the frequency of patients needing resuscitation has also increased.

A nurse manager reflects on current practice and notes that a recent change has become a part of daily practice. Which stage of change does this scenario best describe? A. Implementation B. Design C. Planning D. Integration

D. Integration This is correct. Integration is the refreezing phase, when a change has become a part of practice.

Which of the following best contributes to job satisfaction? A. Efforts to achieve a peaceful end of life for patients B. Teaching patients behaviors that promote health C. Pay and advancement opportunities in the profession D. Learning to manage stress

D. Learning to manage stress This is correct. Learning to manage stress directly increases job satisfaction for nurses.

Which of the following is the best way to address bullying behaviors? A. Report bullying to the bully's nurse manager. B. Establish a minimal tolerance policy for incivility. C. Avoid confronting bullies. D. Look to managers to model appropriate behavior.

D. Look to managers to model appropriate behavior. This is correct. Administrators, supervisors, and managers should model appropriate behavior.

An RN is reviewing professional behavior expectations with a group of new nurses. Which of the following statements should be included in the teaching? A. It is OK to discuss your days at work on social media. B. When you are passionate about a topic, speak up in blogs and forums. C. Your behavior outside of the practice setting is up to you and will not impact your license. D. Nurses may lose their licenses for unprofessional actions.

D. Nurses may lose their licenses for unprofessional actions. This is correct. State boards on nursing elaborate the expected professional behaviors, and nurses can lose their licenses for unprofessional or illegal behavior.

Which of the following is true regarding patient safety and prevention of harm? A. Medication errors are adverse events. B. Errors of execution are usually intentional and occur because of time or resource constraints. C. As many as 90% of medication errors are preventable. D. Poorly coordinated care and nosocomial infections are examples of errors.

D. Poorly coordinated care and nosocomial infections are examples of errors. This is correct. Medical errors may be the result from poorly coordinated care, medication errors, health care-acquired infections, hand-off errors, falls, and diagnostic or surgical errors.

A nurse supervisor is planning an educational session for her staff regarding improving teamwork among different generations. Which of the following recommendations will reduce potential generational conflicts? A. Involve only millennials in technology decisions. B. Focus on the team as a whole, rather than individual generations. C. Involve only the baby boomers in technology decisions. D. Practice active and assertive communication techniques.

D. Practice active and assertive communication techniques. This is correct. Active and assertive communication will assist each generation to value the others' skills and perspectives.

Which of the following is an OSHA requirement regarding handling of hazardous chemicals? A. Use air filtration systems to keep the air cleaner. B. Minimize the use of toxic disinfectants. C. Avoid the use of mercury-containing products. D. Provide Material Data Safety Sheets.

D. Provide Material Data Safety Sheets. This is correct. Employers are required to clearly label and provide Material Data Safety Sheets for all hazardous chemicals.

If a nurse is the victim of sexual harassment, which of the following must be done within 180 days of the incident? A. Documentation B. Confronting the harasser C. Reporting the incident up the chain of command D. Reporting the incident to the Equal Employment Opportunity Commission

D. Reporting the incident to the Equal Employment Opportunity Commission This is correct. If the issue is not resolved it should be reported to the Equal Employment Opportunity Commission; however, this must be done within 180 days of the incident.

Which of the following best describes power? A. Power increases with each step up in hierarchy. B. Power is directly related to the amount of authority one has in an organization. C. Those at the bottom of the hierarchy have no sources of power. D. Sources of power exist at all levels of the hierarchy.

D. Sources of power exist at all levels of the hierarchy. This is correct. Sources of power exist at all levels of the hierarchy.

Which of the following can help a nurse cope with high stress at work? A. Increasing sleep time B. Work toward a higher degree C. Work hard at completing everything asked of him or her D. Teach others how to treat themselves

D. Teach others how to treat themselves This is correct. The nurse should recognize that he or she can teach others how to treat themselves.

Which of the following is true regarding an incident report? A. The incident report is completed in the affected patient's chart. B. The incident report is not available during litigation. C. The incident report should be complete, accurate, and contain the nurse's impressions of the event. D. The incident report is kept with internal hospital correspondence.

D. The incident report is kept with internal hospital correspondence. This is correct. In the event a paper incident report is completed, a single copy should be kept with hospital correspondence.