Leadership Exam 2

CNO would like to design an organizational structure that limits the flow of communication and management/supervision determines decision making, what form of organization structure is this?

Centralized

Advantage of decentralized organization is?

Cost-effective

What trait would be the most important for a nursing quality improvement supervisor?

Interdisciplinary collaboration

Elements included in organizational structure are:

Level of authority Level of communication Unity of direction

Goals of root cause analysis: three questions that are asked.

What happened? Why? What can be done to prevent recurrence?

The phrase "the buck stops here" best describes which of the following terms? a) Accountability b) Authority c) Responsibility d) Trustworthiness

a) Accountability

In organizations that practice shared governance, the responsibility for unit outcomes rests with the: a) Nursing team. b) Nurse manager. c) Individual nurse. d) Chief nursing officer (CNO).

a) Nursing team.

An organizational chart with one line of management and one line of staff reflects which of the following types of organizational structures? a) Authoritarian structure b) Flat structure c) Power structure d) Vertical structure

b) Flat structure

Nursing data need to include which of the following domains? a) Fiduciary data b) Outcome data c) Client data d) Tertiary data

c) Client data

Which of the following factors influences the structure of an organization? a) Age of the building b) Brand of computer system c) Number of employees d) Square footage of the facility

c) Number of employees

It is estimated that nurses spend approximately _____ of their time documenting information in the EHR. a) 7% b) 17% c) 20% d) 35%

d) 35%

Which organizational theory emphasized the informal aspects of organization social structure and was influenced by the Hawthorne experiments? a) Bureaucratic theory b) Scientific management school c) Classical management theory d) Human relations school

d) Human relations school

Responding to a code called in the psychiatric unit where she works, a staff nurse finds that a patient has committed suicide. The staff nurse correctly identifies this as a) A benchmark incident. b) Quality improvement issue. c) Performance breach. d) Sentinel event

d) Sentinel event

The nurse manager calls a meeting of unit staff members to discuss ways to improve the timeliness of patient discharge. The nurse manager and group decide that the use of an admit/discharge nurse would help improve patient flow. This is an example of what kind of decision procedure? A. Autocratic B. Consultative C. Joint D. Delegated

C. Joint

According to the ANA, what elements are viewed as a relationship continuum as nurses apply them in decision making? (Select all that apply.) a) Data b) Technology c) Information d) Knowledge e) Wisdom

a) Data c) Information d) Knowledge e) Wisdom

In an organization that has a decentralized organizational philosophy, decision-making authority rests in levels closer to the point of service rather than in the executive levels. Benefits of a decentralized organizational philosophy include: (Select all that apply.) a) Encouraging more input. b) Supporting greater innovation. c) Facilitating faster response times. d) Permitting a narrower span of control. e) Allowing for more levels of management

a) Encouraging more input. b) Supporting greater innovation. c) Facilitating faster response times.

The division of work by occupation or function is a form of: a) Specialization. b) Interdependence. c) Uncertainty. d) Technology.

a) Specialization.

The industry-based model for quality management and measurement whose premise is that operational waste needs to be eliminated is: a) Six Sigma. b) ISO 9000. c) Lean Enterprise. d) Baldrige National Quality Award Program.

c) Lean Enterprise.

Which of the following leadership styles is best suited for implementation of a shared governance structure? a) Authoritarian b) Autocratic c) Participative d) Laissez-faire

c) Participative

The following is true regarding informal power: A. Informal power comes from relationships and alliances with people in the organization. B. Informal power is derived from work that is relevant to pressing organizational issues and that provides opportunities to perform extraordinary and highly visible activities. C. Executive leaders do not have informal power. D. Informal power is a type of empowerment

A. Informal power comes from relationships and alliances with people in the organization

The improvement process in which an organization measures its strategies, operations, or internal process performance against that of best-in-class organizations within or outside its industry determines how those organizations achieved their performance levels, and uses that information to improve its own performance is known as _____.

Benchmarking

Comparison of an organization to another organization that is determined best in class, to implement methods to improve their performance is called?

Benchmarking statement

All of the following influence the shape of the organization except: A. Formal reporting relationship B. Span of control of managers C. Informal and formal power structures D. Number of management layers

C. Informal and formal power structures

Which of the following statements is false with regard to care coordination? A. Care coordination is a part of every nursing role. B. Care coordination is a component of all case management models. C. Care coordination involves advocating for the necessary and appropriate care for patients. D. Care coordination is only a function of case managers.

D. Care coordination is only a function of case managers.

Malcolm Baldrige National Quality Award (MBNQA) Program

Establishes a set of performance standards that define a total quality organization

_____ is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.

Evidence-based practice

Select all of nurse-sensitive indicators examples:

Hospital acquired pressure ulcers CAUTI

Advantages of decentralized staffing system include:

Increased job satisfaction employee retention patient outcomes interpersonal relationship

All of the following influence the shape of the organization except:

Informal and formal power structures

The following is true regarding informal power

Informal power comes from relationships and alliances with people in the organization.

Which of the following statements about nursing informatics is false?

Nursing informatics deals exclusively with the development of electronic medical record systems.

Fractured humerus and the nurse finds the patient had completed a suicide attempt in the shower. What type of event is this?

Sentinel Event

What is an organizational structure?

Shape of an organization structure can be described relatively tall or flat

A nurse is documenting information in a computerized medical record. Which of the following nursing actions may jeopardize the confidentiality?

Share password for computer access w/ colleagues

Organization design that empowers nurses by engaging decision-making and providing accountability in nursing practice is?

Shared governance

Select all of the aspects of nurse-sensitive indicators.

Structural indicators Outcome indicators Process indicators

An organizational chart is used to depict: (Select all that apply.) a) A visual display of the organization s positions. b) The intentional relationships among positions. c) Open positions within human resources. d) Flow of authority. e) Advisory committees.

a) A visual display of the organization s positions. b) The intentional relationships among positions. d) Flow of authority.

At its start, shared governance requires the education and support of organizational executives, managers, and point-of-care staff. Organizational benefits include: (Select all that apply.) a) Accountability of the nurse. b) Reduction in liability claims. c) Reduction in workers' compensation claims. d) Improved financial outcomes. e) More expert involvement at the point of care.

a) Accountability of the nurse. d) Improved financial outcomes. e) More expert involvement at the point of care.

Sentinel Event Alerts are published by TJC to do which of the following? a) Allow facilities to learn from sentinel events that have occurred in other facilities and incorporate recommendations for prevention into their policies. b) Notify hospitals that if a sentinel event occurs during an alert, the hospital will be subject to withdrawal of Medicare and Medicaid certification and reimbursement. c) Prevent a near-miss from occurring. d) Assist hospitals to find national standardized performa

a) Allow facilities to learn from sentinel events that have occurred in other facilities and incorporate recommendations for prevention into their policies.

Mercy Hospital compares its surgical site infection rate to General Heart Hospital, which is known as a best-in-class hospital for its surgical site infection rates. Mercy Hospital studies General Heart Hospital's methods for reducing surgical site infection rates and uses that information to improve its own performance. This quality performance method is called: a) Benchmarking. b) Evidence-based practice. c) Enterprise risk management. d) Continuous quality improvement

a) Benchmarking.

Institutions organize and structure themselves by defining departmental function and authority to achieve a more coordinated effort. In institutions where the executive leader retains more decision-making authority, the operation takes on a more _____ philosophy. a) Centralized b) Decentralized c) Autocratic d) Democratic

a) Centralized

Patient surveys convey that they are uncertain about who is the registered nurse (RN). The CEO makes a decision that mandates that white nursing caps will be worn by all RNs and blue nursing caps by all licensed practical nurses to differentiate professional nurses and occupational nurses from nurses' aides and other ancillary staff. Which type of structure does this represent? a) Centralized b) Decentralized c) Nonparticipative d) Participative

a) Centralized

Nursing's data needs fall into four domains. Which of the following statements accurately describe the sources for data in each of the domains? (Select all that apply.) a) Client data is located in the client's health care record. b) Provider data refers to physicians and is located within the medical board. c) Administrative data is located in registry and regulatory performance data. d) Research data is only available with informed consent. e) Existing and newly gathered data can be a sourc

a) Client data is located in the client's health care record. c) Administrative data is located in registry and regulatory performance data. e) Existing and newly gathered data can be a source of obtaining research information.

Management information systems describe a broad scope of activities that includes but is not limited to the management of: a) Decision support systems. b) Merchandise. c) Products. d) Nursing services

a) Decision support systems. While MIS involves the management of various types of information and systems, decision support systems specifically aid decision-making processes within an organization. The other options (b, c, d) may be managed through various information systems, but they are not the primary focus of MIS.

Which of the following statements are true regarding health information technology (HIT) applications in nursing services? (Select all that apply.) a) HIT involves nursing administration, clinical informatics, and effectiveness research. b) Health information data allow nursing leaders to make informed decisions regarding patient care. c) HIT is used primarily for financial decision making. d) Clinical decision support utilizes tools for downloading, collecting, organizing, and analyzing dat

a) HIT involves nursing administration, clinical informatics, and effectiveness research. b) Health information data allow nursing leaders to make informed decisions regarding patient care. d) Clinical decision support utilizes tools for downloading, collecting, organizing, and analyzing data.

The data analysts within a health care organization pull core measure data from patient records on a quarterly basis. This data is then analyzed and collated into a report that is uploaded to TJC for analysis of adherence to core measure requirements. This is an example of: a) Health information exchange (HIE). b) Effectiveness research. c) Health information management. d) Management information systems

a) Health information exchange (HIE) Health information exchange (HIE) is defined as the electronic movement of health-related information among organizations according to nationally recognized standards that allow health care providers to access and securely share vital medical information electronically (HealthIT.gov, 2014a). The HIE is a process within either a state health information network or a regional health information organization (RHIO), often for a geographic area.

A successful enterprise risk management (ERM) program will: (Select all that apply) a) Identify risks. b) Improve quality. c) Prevent damage. d) Control occurrences. e) Control legal liability.

a) Identify risks. c) Prevent damage. d) Control occurrences. e) Control legal liability.

The goals of meaningful use include: (Select all that apply.) a) Improve quality of care and safety. b) Engage patients and their families in care. c) Improve population health. d) Reduce costs associated with health care. e) Improve care coordination.

a) Improve quality of care and safety. b) Engage patients and their families in care. c) Improve population health. e) Improve care coordination.

Organizational benefits of a culture of shared governance include: (Select all that apply.) a) Improved financial outcomes. b) Interdependence among staff nurses. c) Increased commitment of staff to the organization. d) More senior leadership involvement at the point of service. e) A more efficient model for point-of-service decision making

a) Improved financial outcomes. c) Increased commitment of staff to the organization. e) A more efficient model for point-of-service decision making

Which of the following statements describe the benefits of specialization in the health care setting? (Select all that apply.) a) Improved work performance b) Increase in expertise c) Improved efficiency and outcomes d) Increased workload e) Increased error reporting

a) Improved work performance b) Increase in expertise c) Improved efficiency and outcomes

Effectiveness research: a) Is the study of relationships among health care problems. b) Provides solutions to serious global health care issues. c) Reflects sound, reliable, and valid data that can be examined closely. d) Supplies data that are critical and worthy of gathering.

a) Is the study of relationships among health care problems. Effectiveness research applies epidemiological methods to large databases to study relationships among health care problems, interventions, outcomes, and costs, and determine alternatives and their effects with different patient characteristics and intervening variables.

The Baldrige National Quality Award (BNQA) establishes a set of performance standards that define a total quality organization. The standards in areas of excellence include: (Select all that apply.) a) Leadership. b) Strategic planning. c) Environment of care. d) Human resource focus. e) Medication management.

a) Leadership. b) Strategic planning. d) Human resource focus.

Nurse managers utilize outcomes data to make decisions about nursing care effectiveness. Which NMMDS data elements would be most effective in evaluating nursing care? (Select all that apply.) a) Nursing diagnosis b) Turnover c) Population served d) Client accessibility e) Intensity of nursing care

a) Nursing diagnosis b) Turnover e) Intensity of nursing care

According to the _____ organizational approach, organizations are logical and predictable with identifiable and scientifically measurable characteristics that can be predicted, observed, or manipulated. a) Objective b) Subjective c) Postmodern d) Realistic

a) Objective

According to organization theories, there are three perspectives regarding the nature of reality and knowledge within an organization. Which of the following are those perspectives? (Select all that apply.) a) Objectivism b) Subjectivism c) Postmodernism d) Realism e) Idealism

a) Objectivism b) Subjectivism c) Postmodernism

A rapid response team within an acute care hospital is comprised of critical care physicians, nurses, and respiratory therapists. The team assists staff throughout the hospital with detecting and managing imminent patient deterioration. This is an example of a _____ organizational form. a) Parallel b) Functional c) Modified program d) Matrix

a) Parallel

What are some of the expected outcomes in the client domain of nursing data? (Select all that apply.) a) Patient satisfaction b) Achieved care outcomes c) Continuity of care d) Level of dependency e) Intensity of nursing care

a) Patient satisfaction b) Achieved care outcomes c) Continuity of care

Successful implementation of a health information system requires a great deal of time, education, and support. The process will require which of the following expertise within the organization? (Select all that apply.) a) Quality experts b) Marketing specialists c) Clinical nurse leaders d) Nurse informaticians e) Nurse managers

a) Quality experts c) Clinical nurse leaders d) Nurse informaticians e) Nurse managers

A nurse is serving on a continuous quality improvement (CQI) committee that has been assigned to develop a program to reduce the number of medication administration errors following a sentinel event at the facility. Which of the following strategies should the committee plan to initiate first? a) Review the events leading up to each medication administration error. b) Develop a quality improvement program for nurses involved in medication administration errors. c) Require staff nurses to demo

a) Review the events leading up to each medication administration error.

A framework for understanding health care improvement has been proposed by the IOM Committee on Quality of Health Care in America. The aims for health care quality improvement propose that health care systems ensure that care is: (Select all that apply.) a) Safe. b) Timely. c) Efficient. d) Cost-controlled. e) Patient-centered

a) Safe. b) Timely. c) Efficient. e) Patient-centered

What are the primary purposes and benefits of EHRs? (Select all that apply.) a) Single source of clinical, financial, and legal record b) Electronic format supports the storage and exchange of continuity of care c) Available within the health care facility to ensure confidentiality d) Originate from a single place e) Virtual record of retrospective, concurrent, and prospective information

a) Single source of clinical, financial, and legal record b) Electronic format supports the storage and exchange of continuity of care e) Virtual record of retrospective, concurrent, and prospective information

TJC requires accredited organizations to participate in their core measure initiative. The current core measure sets include: (Select all that apply.) a) Stroke. b) Tobacco treatment. c) Pneumonia measures. d) Iatrogenic pneumothorax. e) Venous thromboembolism. f) Acute myocardial infarction

a) Stroke. b) Tobacco treatment. c) Pneumonia measures. e) Venous thromboembolism. f) Acute myocardial infarction

Principles of a fair and just culture include: (Select all that apply.) a) Zero-tolerance for reckless behavior. b) Reduction of personal accountability and discipline. c) Recognition that competent professionals make mistakes. d) Errors and unintended events being reported unless no patient harm occurs. e) Acknowledgment that even competent professionals develop unhealthy norms.

a) Zero-tolerance for reckless behavior. c) Recognition that competent professionals make mistakes. e) Acknowledgment that even competent professionals develop unhealthy norms.

Which of the following are never events? (Select all that apply.) a) A minor medication error b) A foreign object left in the body during surgery c) Surgery on the wrong body part d) A mismatched blood transfusion e) Hip fracture acquired in the hospital f) Pressure ulcer acquired in the home g) Catheter-associated urinary tract infection h) Surgical site infection

b) A foreign object left in the body during surgery c) Surgery on the wrong body part d) A mismatched blood transfusion e) Hip fracture acquired in the hospital g) Catheter-associated urinary tract infection h) Surgical site infection

The nurse manager should use which of the following behaviors when implementing a shared governance structure? a) Autocratic decision making of the manager b) Coaching the staff to be successful c) Harboring the vision within the team d) Reimbursing the staff for overtime

b) Coaching the staff to be successful

A nursing quality improvement supervisor is proposing to enhance the current quality improvement program. One of the most important themes that a nursing quality improvement supervisor should consider is: a) Budgetary considerations. b) Collaboration between health care teams. c) Regular staff training programs. d) Suggestions from patients.

b) Collaboration between health care teams.

Standardization of _____ provides a uniform structure for information delivery and flow in order to facilitate exchange among those involved in common work processes. a) Physician orders b) Communication c) Work processes d) Work outputs

b) Communication

Hospitals must submit specific quality performance data regarding Medicare patients or risk: a) An increase in federal tax. b) Decreased payments. c) Fewer physician referrals. d) Sanctions by The Joint Commission (TJC).

b) Decreased payments.

Shared governance is a model of organizational structure in which staff nurses are: a) Employed to establish mutual goals with clients. b) Empowered through autonomy and accountability. c) Engaged in problem-solving strategies and techniques. d) Equipped with evaluative thinking

b) Empowered through autonomy and accountability.

Which of the following is an example of a nurse-sensitive indicator? a) Cardiac patient mortality b) Hospital-acquired pressure ulcers c) Pulmonary embolus after knee surgery d) Iatrogenic pneumothorax after central line placement

b) Hospital-acquired pressure ulcers

Research about shared governance suggests that it is: a) Enhancing the role of the nurse's aide within the organization. b) Improving organizational and patient outcomes. c) Not a cost-effective program when examining all areas of care. d) Too much additional work for the already overwhelmed RN

b) Improving organizational and patient outcomes.

One obstacle in the implementation of a shared governance model is that nurses have: a) Empowered participation in committee meetings. b) Limited time to work on projects. c) The same basic educational foundation. d) Traditionally worked in decentralized structures

b) Limited time to work on projects.

Nurses' involvement in shared governance is an important component of: a) Practice models. b) Magnet recognition. c) Increased reimbursement d) Physician satisfaction

b) Magnet recognition.

Nursing informatics includes the: a) Coding and billing of hospital and physician services. b) Management and communication of data, information, knowledge, and wisdom in nursing practice c) Organization and selection of quality medical information. d) Support and troubleshooting of computer software issues.

b) Management and communication of data, information, knowledge, and wisdom in nursing practice

To provide the best care to every patient every day through integrated clinical practice, education, and research is an example of a(n): a) Accountability agreement. b) Mission statement. c) Organizational standard. d) Vision and value proposal

b) Mission statement.

_____ was recognized by the American Nurses Association (ANA) as a nursing specialty in 1992 and is one of the fastest growing practice areas in health care. a) Nurse anesthesia b) Nursing informatics c) Nurse-midwifery d) Clinical nurse specialist

b) Nursing informatics

The ways in which work is divided and coordinated among members and the resulting network of relationships, roles, and work groups is the: a) Organization. b) Organizational social structure. c) Structure. d) Formal relationship

b) Organizational social structure.

What are the roles of nursing informatics specialists? (Select all that apply.) a) Data analysis and reporting to governmental agencies b) Participation in education of nursing staff c) Providing direct patient care d) Providing information and evidence-based knowledge e) Supporting clinical decision making

b) Participation in education of nursing staff d) Providing information and evidence-based knowledge e) Supporting clinical decision making

The formal process of using patient data for providing evidence for the design of care protocols is termed: a) Evidence-based practice. b) Practice-based evidence. c) Data analysis. d) Effectiveness research.

b) Practice-based evidence.

The Office of National Coordinator for Health Information Technology (HIT) was created by: a) President Barack Obama. b) President George W. Bush. c) Hillary Clinton. d) President Bill Clinton

b) President George W. Bush.

Tenets embraced by health care professionals and promoted by health care leaders and organizations such as TJC and the IOM include which of the following? (Select all that apply.) a) People and systems are the problems, not processes. b) Quality measurement and monitoring is everyone's job. c) Quality cannot be enhanced by non-punitive work cultures. d) Standardization of processes is key to managing work and people. e) The impetus for quality monitoring is not primarily for accreditation o

b) Quality measurement and monitoring is everyone's job. d) Standardization of processes is key to managing work and people. e) The impetus for quality monitoring is not primarily for accreditation or regulatory compliance.

A nurse works in the critical care unit (CCU). She enjoys being on the unit charge nurse team, the recruitment and retention team, and the peer evaluation team. The recruitment and retention team is responsible for hiring new employees into the CCU. The five-member team, consisting of three registered nurses (RNs), a unit clerk, and a nurse's aide, conduct the interviewing process with key questions that were developed by the team. This is an example of: a) Centralized power. b) Shared governa

b) Shared governance.

The patient is a 69-year-old woman who has a history of diabetes mellitus, peripheral vascular disease, and myocardial infarctions. She was admitted to the hospital with a stroke and is being transferred to a subacute facility and then to a rehabilitation facility. At every transfer she must review her entire history, provide telephone numbers of family members, list all 30 of her medications, and list all home care and medical supply companies. Which of these processes could improve the fragmen

b) Standardization

A clearly recognizable process of providing care that has an evidence base demonstrating that it reduces the likelihood of harm is: a) Risk adjustment. b) A sentinel event. c) A patient safety practice. d) A performance measure.

c) A patient safety practice.

Which of the following statements are accurate when describing responsibility and accountability? (Select all that apply.) a) The assignment of responsibility assumes accountability. b) A manager is assigned responsibility by a subordinate. c) Accountability is the liability for task performance. d) The assignment of responsibility and the granting of authority create accountability. e) Accountability flows upward or outward.

c) Accountability is the liability for task performance. d) The assignment of responsibility and the granting of authority create accountability. e) Accountability flows upward or outward.

Nurse managers can create an environment that is devoted to health care safety by doing which of the following? (Select all that apply.) a) Adopting and embracing the concept of disciplining staff who commit errors b) Learning the concepts and tools related to quality improvement and quality assurance c) Becoming a role model for staff and peers in practicing health care safety concepts d) Encouraging staff to be constantly vigilant in identifying potential risks in the care environment e)

c) Becoming a role model for staff and peers in practicing health care safety concepts d) Encouraging staff to be constantly vigilant in identifying potential risks in the care environment e) Creating a sense of partnership with patients and families to promote communication about safety concerns and soliciting their suggestions to correct and prevent potential risks

Shared governance is a vehicle for engaging organizations and creating the necessary forums and intersections that assure the decisions and actions remain dynamic and as close to the point of service as possible. Shared governance promotes: a) Dependence. b) Non-punitive culture. c) Collaboration d) Executive decision making

c) Collaboration

Dividing work by occupation leads to a functional organization where services are arranged by the type of work performed. What are some benefits of the functional form within the health care organization? (Select all that apply.) a) Professional silo b) Fragmented care delivery c) Cost reduction d) Enhanced performance and quality e) Promotion of professional development

c) Cost reduction d) Enhanced performance and quality e) Promotion of professional development

In the provider domain, what are some of the variables that are used to measure variability in nursing? (Select all that apply.) a) Certification b) Hours of work c) Education level d) Years of experience e) Attitudes and beliefs

c) Education level d) Years of experience e) Attitudes and beliefs

According to the contingency theory of organizational performance, an organization must structure and adapt its nursing units to complement which two factors? (Select all that apply.) a) Skill set b) Patient population c) Environment d) Technology e) Finances

c) Environment d) Technology

The risk manager wants to illustrate the causes that have been leading to an increase in patient misidentification. The most appropriate tool to use is a: a) Pareto chart. b) Control chart. c) Fishbone diagram. d) Detailed flowchart.

c) Fishbone diagram.

The first person to analyze patient outcomes associated with nursing care delivery was: a) Clara Barton. b) Dorothea Dix. c) Florence Nightingale. d) Luther Christman

c) Florence Nightingale.

A staff nurse has been working in the neonatal critical care unit for 10 years. She believes that a professional nurse is a lifelong learner. Many staff members come to her for clinical problem solving and advice. This nurse has: a) Decisional authority. b) Formal power. c) Informal power. d) Quantum authority.

c) Informal power.

The network or pattern of social relationships and friendship circles within an organization is known as the: a) Clique. b) Formal structure. c) Informal structure. d) Hierarchy.

c) Informal structure.

Which of the following statements best describes a desirable characteristic of a good management information system? a) Data should be sorted and labeled within 2 weeks. b) For accurate interpretation, data should reflect a health bias. c) Information gathering should be comprehensive and cost-effective. d) The management information system operating system should be Windows-based.

c) Information gathering should be comprehensive and cost-effective.

The nursing chief executive officer (CEO) works in a major rehabilitation and subacute facility network. Her span of control refers to the number of: a) Miles in which the network resides. b) Ancillary staff accountable to her. c) Nurses and non-nurses reporting to her. d) Inpatients that the facilities service.

c) Nurses and non-nurses reporting to her.

The nursing staff on a critical care unit thought that professional growth could be enhanced. Which of the following interventions would support empowerment of the nursing staff? (Select all that apply.) a) Eliminating computers and reverting back to paperwork b) Increasing pay wages for ancillary and professional staff c) Providing various methods for ongoing education and continuing education units d) Working to make equipment and medications readily available

c) Providing various methods for ongoing education and continuing education units d) Working to make equipment and medications readily available

The degree to which health services for individuals and populations increases the likelihood of desired health outcomes that are consistent with current professional knowledge is known as the: a) Care delivery quotient. b) Excellence index. c) Quality of health care. d) Standard of care.

c) Quality of health care.

A nurse manager is responsible for a unit consisting of 40 nurses who report to two clinical supervisors. In addition, there are 10 support staff who report to an administrative supervisor. The subordinates reporting to this manager are known as which dimension of organizational design? a) Division of labor b) Hierarchy c) Span of control d) Decentralization

c) Span of control

Attributes of a total quality organization according to BNQA include: (Select all that apply.) a) Accreditation by TJC. b) A commitment to obtaining Magnet designation. c) Strategic planning. d) Focus on patients, other customers, and markets. e) Organizational performance results.

c) Strategic planning. d) Focus on patients, other customers, and markets. e) Organizational performance results.

The collection of data to measure performance is required by: a) The Health Insurance Portability and Accountability Act (HIPAA). b) The Centers for Medicare & Medicaid Services. c) The Joint Commission (TJC). d) Health Information Technology

c) The Joint Commission (TJC).

Which comment by the nurse manager would indicate that the hospital places a high value on patient safety? a) We have safety posters throughout the hospital that encourage people to report problems. b) We have monthly safety in-services. c) We encourage patients and families to participate in their care. d) All employees are required to update their knowledge of safety practices each year

c) We encourage patients and families to participate in their care.

The structure of authority in an organization is known as the: a) Authority. b) Centralization. c) Bureaucracy. d) Hierarchy.

d) Hierarchy.

The purpose of a root cause analysis (RCA) is to: a) Discipline the staff involved in the patient safety event. b) Disclose the medical error to the patient/patient s family. c) Identify the person(s) responsible for committing the error. d) Identify the systems issues that led to a sentinel event.

d) Identify the systems issues that led to a sentinel event.

Nursing outcome databases are critical because nurses must be able to: a) Assess the differences between an associate degree in nursing and a bachelor's of science degree in nursing. b) Compare interventional care strategies between physicians. c) Evaluate nurse's aide- and licensed practical/vocational nurse-sensitive outcomes. d) Measure how nurses influence patient outcomes.

d) Measure how nurses influence patient outcomes.

Within nursing practice, the use of advanced practice roles is an example of: a) Cross-training. b) Departmentalization. c) Fragmentation. d) Specialization

d) Specialization

The Nursing Minimum Data Set (NMDS) was designed to: a) Determine differences in care delivery between the holder of an associate degree in nursing and a bachelor's of science in nursing. b) Evaluate the nursing language of NANDA, Nursing Interventions Classification, and Nursing Outcomes Classification. c) Provide data for leaders to make decisions about staffing patterns. d) Standardize the collection of nursing data across populations.

d) Standardize the collection of nursing data across populations.

Traditionally, nurses have worked in strong, hierarchical institutions with centralized decision making and clear authority structures, rigid approval mechanisms, and extensive policies and procedures that have resulted in barriers to creating a shared governance system. One such barriers is: a) Lack of role clarity. b) Lack of time management. c) Poor time management skills. d) That development takes a long time.

d) That development takes a long time.

Which of the following responses from the nurse manager is consistent with a culture that promotes patient safety? a) We make sure that we don't have any errors on this unit. b) We identify who made the error and take corrective action. c) We provide remedial training for all staff on the unit when there is an error. d) We report any medical error or near-miss to help us find the root cause of the problem

d) We report any medical error or near-miss to help us find the root cause of the problem

Nurses utilize _____ through critical thinking and clinical reasoning skills to determine when and how to apply evidence-based knowledge. a) Orders b) Data c) Information d) Wisdom

d) Wisdom Nurses utilize wisdom through critical thinking and clinical reasoning skills to determine when and how to apply evidence-based knowledge. Wisdom involves the integration of knowledge, experience, and judgment to make sound decisions in complex and varied clinical situations.