leadership exam 2

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

A

What is the most common initial response of an employee to a managers confrontation regarding suspected chemical impairment? A) Emphatic denial and defensiveness B) Reluctant acceptance C) Gratefulness for finally being discovered D) Silence

A

Which is a management function associated with dealing with a problem employee? A) Forewarns the employee of the consequences of breaking a rule B) Encourages employees to be self-disciplined in conforming to rules C) Serves in the role of coach in performance deficiency coaching D) Recognizes and reinforces the intrinsic self-worth of each employee

A

Which statement about rules is correct? A) If a rule or regulation is worth having, it should be enforced B) Most rule breaking is a result of the actions of a few employees C) Organizations should have as many rules and regulations as possible so employees are clear about what they are to do D) Managers should increase monitoring efforts if a particular rule is constantly broken by many staff members

A

Which statement is accurate when describing performance deficiency coaching? A) It is less spontaneous and requires more planning than ongoing coaching B) It is a one-time way of solving problems C) It requires the manager to assume the role of enforcer rather than supporter or enabler D) It occurs as a component of an employees annual performance appraisal

A

Which statement is true regarding chemical addiction among nursing professionals? A) Most chemically impaired nurses obtain drugs by stealing them from work B) Morphine is the most commonly abused drug by nurses C) Most nurses obtain their drugs on the street and avoid taking drugs from work D) Most chemically impaired nurses cannot be diverted from drug use

A

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.

D

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 iif its not broke, dont fix iti D) Promoting teamwork rather than individual accomplishments

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.

What is the result of arriving at a consensus? A) All involved parties agree to support the way a conflict has been resolved B) A conflict is resolved by meeting the goals of all involved parties C) It resolves a conflict by an initial unanimous decision D) Conflict is resolved through the mediation process

Ans: A Feedback: Consensus means that negotiating parties reach an agreement that all parties can support, even if it does not represent everyones first priorities. Consensus decision making does not provide complete satisfaction for everyone involved in the negotiation as an initially unanimous decision would, but it does indicate willingness by all parties to accept the agreed-upon conditions. Mediation is not a required factor in arriving at a consensus.

20. Considering dispute resolution, which statement is true regarding what occurs during mediation? A) It uses a neutral third party; is a confidential, legally nonbinding process designed to help bring the parties together to devise a solution to the conflict B) It asks questions to clarify the issues C) It makes a final decision for the parties in conflict D) It involves presentation of evidence including that of expert witnesses

Ans: A Feedback: Mediation uses a neutral third party; is a confidential, legally nonbinding process designed to help bring the parties together to devise a solution to the conflict. None of the other options accurately describes the process of mediation.

23. After a compromise has been made, what is the managers initial action? A) Clearly restating the compromises specific outcomes to all involved B) Thanking all involved for their cooperation on reaching the compromise C) Evaluating the compromises outcomes for fairness to all involved parties D) Assuring all involved that the compromise will not cause a change in goals

Ans: A Feedback: Once a compromise has been reached, restate it so that everyone is clear about what has been agreed upon. A compromise by its natural requires a change in original goals. The evaluation for fairness needs to have been done prior to the compromise being agreed upon. Thanking all involved is appropriate but would not be the initial action.

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.

9. What is the most important criterion for success for health-care providers collaborate on patient care? A) Having mutual respect for one anothers knowledge and expertise B) Having the skills to negotiate successfully C) Liking each other enough to want to collaborate D) Being willing to cooperate with each other

Ans: A Feedback: In collaboration, problem solving is a joint effort with no superior/subordinate relationships. Mutual respect is required for its success. While the other options identify factors that add to the collaborative process, its foundation is mutual respect.

What is the name given to the first stage in the conflict process? A) Latent B) Perceived C) Felt D) Manifest

Ans: A Feedback: The first stage in the conflict process is called latent conflict, which implies the existence of antecedent conditions. Latent conflict may proceed to perceived conflict or to felt conflict. Manifest conflict may also ensue. The last stage in the process is conflict aftermath.

16. The nurse-manager facilitates a conflict that involves the delineation of staff job descriptions. What is this an example of? A) Responsibility charting B) Smoothing conflict C) Alternate dispute resolution D) Mediation counseling

Ans: A Feedback: When a supervisor delineates job duties to persons in conflict, it is called responsibility charting. The other options are not related to job description conflict.

What does a competence assessment evaluate? 1. Knowledge and education to perform the task 2. Skills to perform the task 3. Experience to perform the task 4. How well the individual completes the task A) 1, 2, 3 B) 1, 2, 4 C) 1, 3, 4 D) 2, 3, 4

Ans: A Feedback: A competence assessment evaluates whether an individual has the knowledge, education, skills, or experience to perform the task, whereas a performance evaluation examines how well that individual actually completes that task.

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.

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 affective in proving a balanced appraisal.

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.

Which method rates a person against a set standard, which may be the job description, desired behaviors, or personal traits? A) Trait Rating Scale B) Checklist C) Essay D) MBOs

Ans: A Feedback: Trait Rating Scale is a method of rating a person against a set standard, which may be the job description, desired behaviors, or personal traits. The Trait Rating Scale has been one of the most widely used of the many available appraisal methods. None of the other options rates a person against a set standard.

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.

25. Which personal characteristics will best help meet the psychological needs of conflict negotiation? A) Perseverance and assertiveness B) Calmness and self-assuredness C) Compassion and reflectiveness D) Organization and preparedness

Ans: B Feedback: Negotiation is psychological and verbal. The effective negotiator always appears calm and self-assured. The other options are not as impactful when considering the psychological aspects of the negotiation process.

8. When is the competing approach to resolving conflict used? A) When fair play is important to all involved parties B) When one party wins at the expense of the others C) When managers need to control a volatile situation D) When an appropriate political strategy is necessary

Ans: B Feedback: The competing approach is used when one party pursues what it wants at the expense of the others. Because only one party typically wins, the competing party seeks to win regardless of the cost to others. Neither manager control nor political strategy is necessarily associated with the competing approach to resolving conflict.

What is consensus in negotiation referring to? A) One party wins at the expense of another B) The willingness by all parties to accept agreed-on conditions C) The most rapid conflict resolution strategies D) An unanimous decision has been reached

Ans: B Feedback: In a consensus, an agreement is found that all parties can support, or at least not oppose. The term is not used to describe any of the other options.

24. A nurse-manager is engaged in a negotiation with staff representatives when the discussion becomes controlled by a particularly aggressive member. Which action will the nurse-manager take to assure that the process is successful? A) Asks that the aggressive individual recognize the rights of all the other members B) States, iI need to have time to think over all that we have discussed.i C) Halts any discussion until new representatives can be appointed D) Shares with the members that aggressiveness negatively impacts the negotiations

Ans: B Feedback: Some people win in negotiation simply by rapidly and aggressively taking over and controlling the negotiation before other members realize what is happening. If managers believe that this may be happening, they should call a halt to the negotiations before decisions are made. Saying simply, iI need to have time to think this overi is a good method of stopping an aggressive takeover. The other options are much less effective and may even lead to increased aggressiveness among team members.

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.

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.

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.

In preparation for an appraisal conference, how many days of advanced notice will the manager give the employee? A) 1 B) 2 to 3 C) 4 to 5 D) 6 to 7

Ans: B Feedback: Give the employee 2- to 3-day advance notice of the scheduled appraisal conference so that he or she can be prepared mentally and emotionally for the interview.

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.

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.

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.

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.

3. Which is a true statement about negotiation tactics? A) Ridicule often takes the form of ambiguous or inappropriate questioning and is a diversionary tactic B) Most managers successfully resist the illness/wellness tactic because of their nursing preparation. C) Negotiation tactics can be manipulative; thus, managers should know how to identify and counter destructive tactics D) The tactic of paternalism allows both parties in the negotiation to reach a consensus of opinion

Ans: C Feedback: Destructive negotiation tactics are never a part of a successful collaborative conflict resolution. A good manager will be alert for such tactics. None of the other options are true statements regarding negotiation tactics.

22. What is the function of an ombudsperson? A) Providing expert testimony in conflict cases B) Mediating disputes between an organization and its employees C) Educating individuals involved in a grievance situation of their rights D) Monitoring the implementation of the terms of a conflicts compromise

Ans: C Feedback: A function of an ombudsperson is to assure that those involved in a conflict understand their rights as well as the process that should be used to report and resolve the conflict. This role is not appropriately described by any of the other options.

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.

7. Which statement is true concerning perceived conflict? A) It develops during the first stage of the conflict process B) It is sometimes referred to as antecedent conflict C) It occurs if the conflict is intellectualized D) It occurs when the conflict is emotionalized

Ans: C Feedback: Perceived or substantive conflict is intellectualized and often involves issues and roles. The person recognizes it logically and impersonally as occurring. None of the other options are true statements concerning perceived conflict.

14. The nurse-manager is negotiating for the funds necessary to purchase several new isolettes for the facilitys newborn nursery. The Chief Financial Officer (CFO) states, iIve always been curious about that piece of equipment; how does it actually work?i What negotiation action has the CFO engaged in? A) Collaborating B) Smoothing C) A diversionary tactic D) Appropriate fact finding

Ans: C Feedback: The CFO was consciously or unconsciously using a diversionary tactic. The action described is not accurately associated with any of the other options.

15. Several RNs on the unit want to address the possibility of initiating flextime on the unit. What is the managers 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.

Which statement accurately reflects self-appraisals? A) Self-appraisals are more objective than the other types of appraisals B) Self-appraisals provide an opportunity to give positive feedback to employees C) Self-appraisals usually require some introspection on the part of the employee D) Self-appraisals should be read before the supervisor does an appraisal

Ans: C Feedback: Although they require some work on the employees' part, self-appraisals can provide introspection and personal growth. The remaining options are not accurate statements.

A nurse-manager is planning a performance appraisal of an employee who has a number of performance deficiencies. What is the best approach to the performance appraisal of this employee? A) Tell the employee that he or she is not performing well and ask the employee where improvement is needed B) Prepare a list of the employee's deficiencies and give him or her time to look it over before asking for a response C) Recognize the employee's strengths, focus on one or two key deficiencies, and create a long-term coaching plan D) Tell the employee that he or she is liked as a person but is not meeting the requirements for the job and will need to brush up on skills during the next year

Ans: C Feedback: An employee who is overwhelmed with negative feedback during the performance appraisal cannot grow as a result of the appraisal. The manager should recognize the employee's strengths, focus on one or two key deficiencies, and create a long-term coaching plan.

Which statement correctly describes using self-appraisal as a performance appraisal tool? A) It should always be totally unstructured so employees can write about whatever they want to B) It is effective because most employees are self-aware and rate themselves accurately and appropriately C) It works best when used in conjunction with other appraisal tools D) It relieves the manager of the responsibility for preparing the performance appraisal

Ans: C Feedback: Because employees cannot be objective concerning their own performance, a self- appraisal is most effective when used in conjunction with other appraisal tools. The remaining options are incorrect statements regarding self-appraisal tools.

Which is the best example of coaching used to encourage and improve daily work performance? A) ìLet's discuss how to improve your charting notes.î B) ìDid you enjoy working as team leader this weekend?î C) ìWould you consider taking on the role of preceptor?î D) ìYour interpersonal skills have shown great improvement.î

Ans: C Feedback: For coaching to be effective, it must be specific, not self-serving, directed toward behavior that can be changed, well timed, and understood by the employee. This is the only option that fulfills those criteria.

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.

In performance management, appraisals are eliminated. What does the manager do in place of the appraisal? 1. Periodical coaching 2. Mutual goal setting 3. Leadership training of subordinates 4. Employee accountability for own actions A) 1, 2 B) 1, 4 C) 2, 3 D) 3, 4

Ans: C Feedback: In performance management, appraisals are eliminated. Instead, the manager places his or her efforts into ongoing coaching, mutual goal setting, and the leadership training of subordinates.

What is the outcome when a manager provides vague and ambiguous feedback to an employee during a performance appraisal? A) The employee receives the information in a positive manner B) The manager is able to avoid the appearance of being too negative C) The employee is uncertain of the value of the feedback D) The manager is viewed as being an ineffective communicator

Ans: C Feedback: Indirectness and ambiguity are more likely to inhibit communication than enhance it, and the employee is left unsure about the significance of the message. The employee is not likely to feel positive about the process. When the feedback is present appropriately, the manager will not be viewed as too negative but rather honest and helpful.

Which statement identifies an important consideration when using management by objectives (MBO) as a performance appraisal tool? A) The manager determines the objectives each employee should accomplish during the upcoming evaluation period B) Employees determine the objectives their manager should accomplish during the upcoming evaluation period C) The manager's role is supportive, assisting employees to reach goals by counseling and coaching D) Managers should encourage employees to set lofty, difficult goals in an effort to stretch the employees to their maximum

Ans: C Feedback: MBO is in use when the manager supports employees to reach goals they identify for themselves. None of the other options are associated with the use of MBO as a performance appraisal tool. Page 3

Why have health-care organizations been slow to adopt peer review? A) It tends to be an inaccurate performance appraisal tool B) Colleagues generally have little data they can contribute regarding a peer's work performance C) It requires staff be oriented to the process effectively D) It works better for professionals such as physicians than for nurses Ans: C Feedback: Peer review is effective only when adequate time is spent orienting staff to the process and the necessary support is provided to complete the process. The remaining options are not generally considered barriers to the use of peer reviews.

Ans: C Feedback: Peer review is effective only when adequate time is spent orienting staff to the process and the necessary support is provided to complete the process. The remaining options are not generally considered barriers to the use of peer reviews.

Which term is used to identify the effect that occurs when the appraisal is based on recent performance over less recent performance during the evaluation period? A) Halo B) Horns C) Recency D) Mathew

Ans: C Feedback: Taking regular notes on employee performance is a way to avoid the recency effect, which favors appraisal of recent performance over less recent performance during the evaluation period. None of the other options accurately identifies this effect.

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: D

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. A registered nurse reports to the nurse-manager that the teams nursing assistant regularly fails to complete assigned tasks. The nurse-manager responds that it is the nurses 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.

1. Which action is an accepted tactic when engaged in a negotiation? A) Being willing to win at any cost B) Communicating only when asked direct questions C) Compromising only as a last resort D) Beginning with a high but realistic expectation

Ans: D Feedback: The selected starting point in negotiations should be at the upper limits of the negotiators expectations, within reason. However, negotiators must realize they may have to come down to a lesser goal. The other options are not reflective of accepted tactics used in successful negotiations.

Which factor is the focus of an individual's performance evaluation? A) Related knowledge B) Individual skills C) Appropriate experience D) History of task completion

Ans: D Feedback: A competence assessment evaluates whether an individual has the knowledge, education, skills, or experience to perform the task, whereas a performance evaluation examines how well that individual actually completes that task.

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.

What does the employee's signature on the performance appraisal form denote? A) The employee agrees with everything written on the form B) The employee objects to what is written on the form C) The employee agrees that a merit raise is due D) The employee has read the appraisal information

Ans: D Feedback: The employee's signature on the performance appraisal form denotes that the employee has received and read the appraisal information. The signature does not mean that the employee agrees with or disagrees with the appraisal.

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

B

Which statement accurately describes a disciplinary conference? A) It is generally a highly charged emotional event, so the manager should try to soften criticisms to reduce the employees defensiveness B) It should be scheduled in advance at a time agreeable to both the employee and the manager C) When it is held in front of peers it can be used as a teaching tool D) It requires the manager to adopt nurturing and counseling roles

B

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

C

What is the managers initial progressive initial response when a staff member is caught stealing $3.00 from a patients bedside stand? A) Dismissal B) Suspension C) Written notice D) Verbal notice

C

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

C

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

C

Which statement accurately describes the initial deterrent against breaking a rule according to McGregors Hot Stove Rules? A) All discipline should be administered immediately after rules are broken B) Each time the rule is broken; there are immediate and consistent consequences C) All employees must know the rule beforehand and be aware of the punishment D) Everyone must be treated in the same manner when the rule is broken

C

Which statement concerning self-discipline is true? A) It is one of the least effective forms of discipline B) It decreases as an awareness of the rules and regulations that govern behavior increases C) It increases when employees identify with the goals of the organization D) It is internalized, and thus the leader can do little to create an environment that promotes self-discipline in employees

C

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

C

Which statement represents a correct statement regarding the identification and assisting interventions provided employees with substance abuse problems? A) It is done as an altruistic and benevolent action by the organization B) It should not be undertaken by management or the personnel department C) It should include screening that focuses on early detection D) Is best handled through disciplinary action of the personnel department

C

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 iBig sticki 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

D

What does the filing of a grievance by an employee do? A) It serves as evidence that a managers 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

D

What is the fundamental rational for conducting a disciplinary conference for a staff member who has failed to significantly modify the practice of arriving late for assigned shifts? A) This behavior disrupts the efficiency of the nursing team B) The tardiness is costing the facility money C) This behavior encourages other staff to disregard rules D) The problem will get worse if it is ignored

D

What is the managers 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

D

What is the primary difference between constructive and destructive discipline? A) The manager is friendlier to the employee in constructive discipline than in destructive discipline, so that the employee likes the manager as a person B) Constructive discipline includes verbal and written reprimands, whereas destructive discipline includes suspension without pay and termination C) The person who has received constructive discipline always appreciates and believes the feedback given, whereas it is resented and disbelieved in destructive discipline D) Constructive discipline helps the person to grow and to behave in a manner that allows him or her to be self-directive in meeting organizational goals. Destructive discipline focuses more on punishment

D

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

D

Which statement identifies a truth regarding the generally accepted plan for the reentry of the chemically impaired employee into the workplace? A) It is successful in only a small number of cases despite active treatment programs B) It is discouraged by the board of registered nursing C) It should not occur until 3 years after the employee has completed the treatment program D) It often includes an employer requirement that the employee agree to random urine screening on request by the employer

D

Which statement is true concerning the management of an employee who performs at the marginal level? A) Marginal performance is generally a result of employee burnout B) Poor motivation is the most common reason for marginal performance C) Improving skill should be the focus when assisting the marginal employee D) Some marginally performing employees will never improve their function levels

D

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

D

B

Nursing students who scored in the top 5% on the examination studied in small groups, attended class 100% of the time, took frequent rest breaks during study sessions, and ate a balanced diet for 1 week before the examination. What type of audit provided this type of data? A) Structure B) Process C) Outcome D) Concurrent

A

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

B

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

D

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

C

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

D

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

A

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

C

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

C

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

B

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

D

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

C

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

B

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)

C

What role has the Joint Commission assumed in ensuring quality at the organizational level? A) Establishing clinical practice guidelines B) Reducing diagnosis-related group reimbursement levels C) Standardizing clinical outcome data collection D) Assessing monetary fines for hospitals that fail to meet standards

B

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

A

Which intervention is associated with the nursing leadership role? A) Inspiring staff to establish and maintain high standards regarding patient care B) Being aware of the changes in quality control regulations C) Reviewing research results upon which to base changes D) Identifying outcomes that support quality nursing care

C

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

A

Which practice has the U.S. Food and Drug Administration suggested in order to decrease the risk of medication errors? A) Computerized order entry with a drug bar code system B) Medications automatically dispensed to patients at predetermined times C) Use of medication nurses to administer all ordered medications D) Have patients medications kept at the bedside for self-administration

B

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

C

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

D

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

A

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

A, B, C, D

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

C

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