Leadership final

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The nurse administrator has been asked to work with other administrators to make a change in a long-standing hospital policy. What should be the nurse's first action? 1. Research the options that will work best for the nursing staff and the hospital. 2. Speak positively of the change to ensure the most "buy-in" from the nurses. 3. Encourage the other administrators to choose the option that is easiest for the nurses. 4. Ensure that each nurse is aware of the change and why it is necessary.

The nurse manager of a critical care unit creates the operating budget with the knowledge that a minimum of two professional nurses must be paid per shift regardless of the patient census. Which group determines this standard? 1. Hospital administration 2. Nursing administration of the hospital 3. The Joint Commission 4. Nursing personnel of the special care units

The nurse manager routinely experiences stress related to deadlines for projects. What should be the nurse's first action to control this stress? 1. Identify the actual stressor and the precipitating factors. 2. Plan activities to minimize time constraints to reduce stress. 3. Set aside a block of time each day for stress reduction. 4. Engage in distraction activities to minimize the stress.

Which situation requires an adaptive decision? 1. The nurse manager discovers that two clients require the use of a new piece of equipment and that the one the hospital has is the only one in the state. 2. The nurse has made a medication error on an experimental medication. 3. The nursing student makes an error when changing a client dressing. 4. The nurse manager scheduled too many nurses for the client census on the night shift, and all of the nurses scheduled have already been asked to take a low-census unpaid day off this month.

Which situation indicates the nurse needs additional training on effective delegation? 1. The charge nurse tells the unlicensed assistant to help prepare rooms for new clients. 2. The office nurse calls in orders for admission on a client following a surgical complication. 3. A rehabilitation nurse asks a physical therapy assistant to assist a client with ambulation around the facility. 4. A home health nurse calls the office and asks another nurse to make the visit on her next client.

Which situation reflects the primary service provided by home health care? 1. The physical therapy assistant performs range-of-motion exercises three times each week. 2. The nurse changes the client's abdominal dressing daily. 3. Oxygen is provided in the home and managed by a durable medical equipment company. 4. Diabetic testing supplies are delivered to the client's home each month.

The nurse manager has completed a series of team-building exercises with a command group. Which statement by a group member indicates that cohesiveness is occurring? 1. "I think I understand the work of the group now." 2. "I have gotten to know my group members better during these exercises." 3. "We have so much work to do in this group." 4. "I like the members of the group."

A client who is being discharged from the hospital will need follow-up for wound care. The client's spouse is not capable of providing bed baths for the client. The nurse case manager who is planning care for this client should contact which agency? 1. Long-term-care facility 2. Public health department 3. Temporary service agency 4. Home health agency

In order to come to a solution for an ongoing conflict among several nursing units, the nursing supervisor says, "Your managers will meet to create a voting form representing both sides of this issue. Each of you will vote, and the majority will rule." What kind of a solution is the supervisor seeking? 1. Consensus 2. Win-win 3. Forcing 4. Win-lose

The nurse manager is working on a committee whose task is to review and revise job descriptions for nursing employees. In which job description would the committee most likely include the phrase "Management responsibilities include shift-by-shift coordination and promotion of quality client care"? 1. Charge nurse 2. Staff nurse 3. Clinical nurse leader 4. Nurse executive

There is substantial unrest among the staff of an intensive care unit that has resulted in negative client outcomes. Which employee factors should the manager assess first? 1. Motivation and ability to be effective in the job 2. The age of employees and their social background 3. Gender and educational preparation of staff 4. Experience base of employees and their attitude toward the job

What is occurring as the traditional parallel structure found in hospitals is being replaced by service-line structure? 1. Adaptation and innovation are encouraged. 2. The medical staff has become autonomous from the organization. 3. Two lines of authority have been created. 4. Organizational structure is becoming much clearer.

Which is the most effective method of creating a blame-free environment? 1. Work to develop a just culture within the organization. 2. Make sure all nurses agree to report every mistake. 3. Set up a self-reporting board so that all employees will know that everyone makes mistakes. 4. Ensure nurse managers keep a list of how often each employee makes a mistake.

should be assigned. This opposition has created a "we-they" distinction on the unit. This is an example of which phenomenon? 1. Distancing 2. Suppression 3. Group withdrawal 4. Unification

In a group meeting, one of the members always arrives early and places the chairs in a circle so all members can interact. This person is responsible for confirming that the room is available for the monthly meetings. Which person does this describe? 1. Gatekeeper 2. Procedural technician 3. Coordinator 4. Initiator-contributor

Medicare reimbursement is based on what factor? 1. Physician fees 2. Client satisfaction 3. Accreditation reviews 4. State board of hospital reviews

The medical-surgical nursing manager notices the education expenditure for the month is over budget. How should the manager deal with this difference? 1. Complete an expenditure report for the month. 2. Complete a variance report for the month's budget. 3. Forward a non-revenue-producing report to the administration. 4. Forward the expense line budget to the administration.

The unit has open shifts even after staff members have signed up for overtime. The chief nurse officer (CNO) does not want to hire agency nurses to cover these shifts. The nurse manager does not understand why the CNO is offering staff an incentive versus hiring agency nurses. Which would be a reasonable conclusion? 1. It takes a significant amount of time to orient agency nurses. 2. The agency nurses are costly. 3. There is a significant amount of documentation required for agency nurses. 4. The physicians are not comfortable with agency nurses.

Using the classical organizational theory model, what would be the most appropriate method for the nurse to voice concern over unfair client workload assignments? 1. Circulate a petition to all staff seeking support for change in assignment policy and present the signed petition to the nursing supervisor. 2. Discuss the problem with the nurse's team leader and then the charge nurse if the problem remains unsolved. 3. Invite the vice president in charge of nursing to a unit meeting. 4. Organize a unit meeting to discuss the problem on all shifts.

What is the best example of a pediatric unit's organizational culture? 1. All client rooms are private. 2. Nurses wear colorful scrubs. 3. The nurse-to-client ratio is 4 to 1. 4. The primary nursing model is used for care.

What is the most important reason that excellent communication skills are essential for nurses? 1. Nurses must communicate with all disciplines. 2. All nursing activities occur in relationships. 3. Interpersonal skills get the work done. 4. Good communication ensures no problems occur.

What should a nurse manager consider when including a staff nurse in an interview of an applicant? 1. Restricting the number of questions the nurse can ask 2. Providing the nurse with an orientation program on interviewing techniques 3. Allowing the nurse to provide information but not the ability to ask the applicant questions 4. Allowing the nurse to ask and answer all questions freely

When the nurse manager orders supplies for the unit, which communication mode is best? 1. Telephone 2. E-mail 3. In person 4. Voice mail

"We want to be the hospital of choice in the Midwest" is which type of statement? 1. Value statement 2. Mission statement 3. Vision statement 4. Philosophy statement

A nurse manager has been appointed leader of a large task force charged with a complex assignment. What strategies should the manager use? 1. Limit full task force meetings to an initial meeting, a middle meeting, and a final meeting. 2. Lead one of the subgroups established at the first full task force meeting. 3. Develop a work plan with interim deadlines. 4. Set deadlines that are at least 1 week earlier than necessary to give subgroups time to be late.

A nurse manager has just posted the membership list for a newly formed quality management task force. Which statement, overheard by the manager, indicates the most potential for problems on the team? 1. "I'm glad I didn't get chosen for this task force. I'm so busy with my kids right now." 2. "I was on one of these teams at my last hospital." 3. "This is certainly an interesting choice of people to put together." 4. "She is such a good nurse; I hope she doesn't work herself too hard."

A staff nurse has been appointed to a task force. What can the nurse expect regarding this group? 1. There will be no official leader for the group. 2. The nurse will be working with people from several different departments within the hospital. 3. The assignment will be time limited. 4. The group members will compete for resources for their own units.

In a leadership training class, which statement by a student indicates learning has been successful? 1. "If I am to be successful in leadership, I should make sure no followers are friends." 2. "Most people would not be able to tell if I only pretend to be interested in them." 3. "Relationship building is essential to successful leadership." 4. "Leadership means I can delegate tasks I do not want to do."

The group leader often arrives several minutes late to meetings with excuses about workload, telephone calls, or traffic. Today's meeting was scheduled to begin 5 minutes ago, and the leader has not arrived. What should the group members do? 1. Call the leader's cell phone to see when arrival is expected. 2. Wait until the leader is 10 minutes late and then cancel the meeting. 3. One of the members should start the meeting. 4. Wait for the leader to arrive.

The hospital chief operating officer holds monthly focus groups with the purpose of gaining ideas and insights from nursing administration and staff nurses. Which type of communication does this indicate? 1. Lateral communication 2. Downward communication 3. Diagonal communication 4. Grapevine communication

The hospital has initiated a new fall risk assessment tool. The nurse manager would like to reward those staff members who use the tool regularly. Which method of reinforcement would be most successful in getting long-term compliance? 1. A coupon for free lunch for staff members each time they use the tool 2. A counseling session with the nurse manager when the assessment tool has not been used 3. A coupon for a free lunch for staff members who, according to a medical record review of nursing documentation, consistently use the tool correctly 4. A pizza party for the staff when there is 100 percent compliance

The nurse manager is writing annual evaluations for each nurse. In order to promote professional development, it is vital for the nurse manager and nurse to become involved in which activity? 1. Personal organization 2. Priority setting 3. Goal setting 4. Limit setting

The nurse manager knows that maximum power will be needed to achieve a desired change and has identified a key person on the organizational chart who will be affected by the change. What is important for the nurse manager to do? 1. Try to minimize the impact of the change when talking to this person. 2. Bypass this person and talk to the administrator who supervises him or her. 3. Pay attention to the people above and below this person on the organizational chart. 4. Try to find some information against this person to use as leverage.

The nurse manager needs to delegate specific tasks to the charge nurse of the unit. Which action is an appropriate use of delegation? 1. Instructing the charge nurse to assume a client team 2. Asking the charge nurse to discipline a nurse on the unit 3. Having the charge nurse lead a nursing quality assurance task force 4. Evaluating all unlicensed personnel assigned to the unit

The nurse's friend says, "I've been thinking about going to that health care clinic in the grocery store so someone can look at my daughter's rash. What do you think?" Which response by the nurse is appropriate? 1. "Most of those retail clinics are not very good. I'd go somewhere else." 2. "That would be okay, but you have to pay extra for the convenience." 3. "If the nurse practitioner at the clinic thinks the rash is significant, you will be referred for additional care." 4. "I would use the clinic for myself, but not for my children."

The nursing faculty would like to incorporate problem-based learning into the curriculum. Which action is essential? 1. Obtain funding for a simulation mannequin. 2. Write standardized scripts for volunteers who will portray clients. 3. Add more information to existing care plans as the study unfolds. 4. Assign client care debate topics to teams of three or four students.

When faced with the prospect of change, the nurse states, "We have always done it this way and never had any problems." A few weeks later, the same nurse remarks, "This new way seems to work better than the old way did." This statement is characteristic of which type of change response? 1. Laggards 2. Early adopters 3. Early majority 4. Innovators

Which example represents a qualifier that may interfere with the message being communicated? 1. "Please notify me when this task is complete." 2. "Are you satisfied with the care you are receiving?" 3. "I hate to bother you with this, but we have a problem." 4. "How can I help you solve your issues with this physician?"

A nursing supervisor is setting up a new unit and must make a blanket decision about whether the unit will be staffed on 12-hour shifts or 8-hour shifts. What should this supervisor keep in mind when making this decision? 1. Staffing 8-hour shifts uses slightly more full-time equivalents (FTEs). 2. Staffing 12-hour shifts uses more full-time equivalents (FTEs). 3. Staffing 12-hour shifts uses significantly fewer full-time equivalents (FTEs). 4. There is no difference in the full-time equivalents (FTEs) required.

An OB manager is interviewing a registered nurse for a labor and delivery position. The manager asks the interviewee, "Tell me about the most challenging delivery experience in your nursing career," and learns the candidate has experienced several challenges that required quick action. Which nursing skill will this exchange best assess? 1. Adaptability 2. Negotiation skills 3. Initiative 4. Decision-making skills

An accreditation visitor observes the following situations in a health care organization. Which situation would this visitor interpret and document as evidence of the shared governance type of shared leadership? 1. Nurses working in groups and managing themselves 2. Nursing leadership originating from a desire to serve and share 3. Two nurses sharing the management role 4. Nurses formally organized to make decisions regarding practice standards

Which factor best represents a driving force in the process of change? 1. An ineffective nurse manager 2. An administration composed of long-term employees 3. A staff composed of long-term employees 4. A financial deficit of millions of dollars

A nurse manager finds herself in opposition to her immediate superior. The nurse manager knows that an important strategy in a confrontation is to use: a. Absolutes. b. Negative assertion. c. "Why" questions. d. "I" language.

A nurse manager wants to call a meeting with the staff. What is the first and most important step in the meeting process? a. Determine the place and time. b. Determine which members will contribute. c. Determine the members. d. Thoroughly prepare for the meeting.

Which factor is least likely to affect successful communication? a. Cultural background b. Method of communication c. Organizational structure d. Educational achievements

) The nurse manager identified that the census was higher than anticipated and the client acuity level was also high; however, fewer nursing hours are paid. This variance is an example of which budgetary variance? 1. Efficiency 2. Nonsalary expenditure 3. Rate 4. Volume

A candidate has arrived for an interview. The interview is conducted with various personnel within the organization. This is an example of an attempt to ensure which result? 1. Interrater reliability 2. Intrarater reliability 3. Validity 4. Construct validity

A chief nurse officer (CNO) of a rural hospital is meeting with department directors and the human resources officer to discuss the hospital's recruitment strategies. A newly promoted director suggests a recruitment fair at a metropolitan city 100 miles away. The CNO rejects this proposal. Which option is likely the CNO's rationale for this decision? 1. The CNO would prefer to focus on the local area initially. 2. A metropolitan area is not a good area in which to recruit for a rural hospital. 3. Metropolitan nurses' skills are too advanced for a rural hospital. 4. The director is new to the role and the CNO does not respect the nurse's opinion.

A long-term care facility's organization reflects a functional structure. Which facility practice reflects a basic weakness in this organizational strategy? 1. The nursing department is responsible for writing the client's comprehensive care plan. 2. The dietary department is responsible for nutritional assessment. 3. All nursing tasks fall under the nursing department. 4. Physical and occupational therapy departments coordinate and evaluate activities of daily living.

A long-term-care facility is considering implementing total patient care. Prior to implementing this system, what must be available? 1. Enough RN staff to provide all the care to the residents 2. A group of licensed assistants who are good at taking direction 3. A strong nurse manager 4. RNs willing to assume 24-hour accountability for the care provided to residents

Regardless of which delivery system or combination of delivery systems is appropriate, which skill is required for effective use? 1. Flexibility 2. Strict adherence 3. Persistence 4. Resistance to change

A medical intensive care unit has a registered nurse position open. The qualifications for the position require a minimum of 1 year of acute-care nursing experience, BLS and ACLS certification, and the ability to administer intravenous cardiac drips. Which fact in an applicant's application would be sufficient reason to decline the applicant's request for an interview? 1. The candidate graduated from nursing school 9 months ago. 2. The candidate does not have ACLS certification. 3. The candidate does not have experience with cardiac drips. 4. The candidate was an LPN for 10 years prior to being an RN.

A new triage area has been built in the emergency department causing conflict between the nurse manager and the nurses who think the design is not "user friendly." After repeated complaints the nurse manager asks maintenance to change the arrangement of the room. What is the most important reason this change occurred? 1. The complaints motivated the nurse manager to make the change to increase unit effectiveness. 2. The room design was uncomfortable for the nurses, which convinced the nurse manager to change the design. 3. The nurse manager was afraid the nurses would refuse to work in the room so the room had to be changed. 4. The nurses would keep complaining so the nurse manager changed the room to stop the griping

A new triage area has been built in the emergency department, causing conflict between the nurse manager and the nurses who think the design is not "user friendly." After repeated complaints, the nurse manager asks maintenance to change the arrangement of the room. What is the most important reason this change occurred? 1. The complaints motivated the nurse manager to make the change to increase unit effectiveness. 2. The room design was uncomfortable for the nurses, which convinced the nurse manager to change the design. 3. The nurse manager was afraid the nurses would refuse to work in the room so the room had to be changed. 4. The nurses would keep complaining so the nurse manager changed the room to stop the griping.

A newly hired nurse is asked to join a group working on unit protocols. This nurse is verbal and dominates the conversation of the group. The group leader identifies the disruption this nurse causes as being from which phenomenon? 1. Status incongruence 2. Group isolates 3. Emergence 4. Deviation

A novice nurse manager is devising a schedule to meet the needs of the staff, clients, and other disciplines on the unit. Which is the most important method to counteract wasted time in nursing? 1. Delegate routine activities to concentrate on other tasks. 2. Assign a staff member to attend management meetings. 3. Redesign the position so that the nurse manager works when the unit is not busy. 4. Strictly adhere to a rule that the manager will see only staff members who make appointments

A nurse frequently has to work late and has no time to do required training while at work. She has to do it on her days off. Choose the work-related time waster that commonly puts nurses in this position. 1. Unscheduled tasks delaying those that are scheduled 2. An overwhelming amount of work to do 3. Taking longer-than-scheduled breaks 4. Volunteering for extra responsibilities

A nurse has been asked to teach newly hired nurses how to operate some client care equipment that the unit has just received. The nurse says, "I'd love to do this, but someone else will need to take my clients today." How should the manager respond? 1. "You will need to work the education into your day as you take care of clients." 2. "This will be a good break for you." 3. "You can use the classroom in the hospital basement for your instruction." 4. "I will authorize your additional salary for the next pay period."

A nurse manager is interviewing a candidate who has much experience in other industries. The candidate was recently licensed and is interviewing for a registered nurse charge position. Which consideration is most important for the manager to bear in mind when regarding this candidate? 1. Can the candidate perform the job? 2. Will the candidate perform the job? 3. Will the candidate apply past work experience? 4. How long will the candidate retain this position if hired?

A nurse manager is participating in the health care organization's strategic planning committee. Which factor is the primary driving force and controlling factor in new initiatives this committee might recommend? 1. Cost of care 2. Access to care 3. Availability of care 4. Quality of care

A nurse manager is working on several projects and is stressed most of the time. This manager prefers working at the unit desk instead of in the office to be certain nothing on the unit is missed. Which would be the most effective method to decrease this manager's stress? 1. Keep a structured schedule for "work time" on each project in the office. 2. Elicit assistance from employees to help complete the projects. 3. Allow one project to fall behind while finishing up the others. 4. Take a sick day to work on the projects uninterrupted at home.

A nurse manager states, "I cannot stand all these conflicts in my department. Nothing good can come out of it." Which indicates the best reason the manager's statement is untrue? 1. Conflict can stimulate more people to become involved in a situation, thus creating more innovative solutions to the issue. 2. When people are in conflict, they tend to work harder just to avoid the conflicting situation. 3. Groups in conflict spur competition, which is always beneficial to the units from which the groups emerged. 4. When there is conflict in an organization, people are more open to discussion, thus conflict can open the lines of communication.

A nurse manager writes the following note: "Over personnel budget by $1,250 in April due to late snowstorm. Nurses unable to get to work. Overtime wages paid." Why is this note important? 1. It will help the manager create the budget for the next year. 2. It is required by the Joint Commission. 3. All variances must be documented and forwarded to the hospital attorney. 4. It ensures that there is no question of diversion of hospital funds.

A nursing supervisor has a report due and just cannot seem to find the time to get it completed. One day before it is due, the supervisor turns it in. This situation best exemplifies which time waster? 1. The supervisor waited for the deadline pressure to increase the priority. 2. The report was one of the last tasks on the "to-do" list. 3. The supervisor has no interest in the topic of the report. 4. The report format is unfamiliar to the nursing supervisor.

The day shift nurses and night shift nurses are in clear opposition regarding the responsibilities that each shift should be assigned. This opposition has created a "we-they" distinction on the unit. This is an example of which phenomenon? 1. Distancing 2. Suppression 3. Group withdrawal 4. Unification

A staff nurse is not meeting job expectations. The manager has followed some standard strategies such as counseling to try to motivate the nurse, but they have not been successful. When discussing the situation with the supervisor, the manager says, "I think I will try shaping strategies." What can the supervisor expect of the staff nurse's performance? 1. It should gradually move toward the expected behaviors. 2. The behaviors will likely get worse before they get better. 3. The nurse will probably get frustrated and resign. 4. Performance should be at expected levels within a week.

A task force leader says, "At the beginning of our next meeting we are going to do some team-building exercises." Which comment by a group member indicates a need for further education about team building? 1. "I don't see anything wrong with the way our team works. Why do we have to go through team building?" 2. "That should help us meet the goals we have written." 3. "I did some team-building work a long time ago. I probably need a refresher." 4. "I hope the men on our task force will cooperate."

A task force leader says, "At the beginning of our next meeting, we are going to do some team-building exercises." Which comment by a group member indicates a need for further education about team building? 1. "I don't see anything wrong with the way our team works. Why do we have to go through team building?" 2. "That should help us meet the goals we have written." 3. "I did some team-building work a long time ago. I probably need a refresher." 4. "I hope the men on our task force will cooperate."

After shift change the nurse discovers that a client's IV heparin has been turned off at the IV controller. The amount of fluid left in the IV bag indicates that the client received half of the dose ordered. Which statement should be documented in the client's medical record? 1. IV heparin restarted. Physician notified. Client's vital signs unchanged. 2. IV heparin restarted at a rate to catch up dosage accidentally deleted. 3. IV heparin turned off by previous shift. Restarted. 4. IV heparin restarted and incident report completed.

An emergency department (ED) manager interviews and hires a candidate who reports having several years of ED experience. Soon after hire, the nurse makes a series of errors and harms several clients. When investigating these errors, the nurse manager discovers the nurse falsified his experience and credentials. Is the hospital liable for this nurse's actions? 1. Yes, the hospital could be liable for negligent hiring if credentials were not checked. 2. Yes, the hospital could be liable but only if it did not properly train the nurse. 3. No, the nurse is liable because information about experience was falsified in the interview. 4. Yes, the hospital is liable for all errors committed by nursing staff.

An employee is sabotaging the work of a newly oriented charge nurse, and the charge nurse has not been successful in addressing the problem. When the nurse manager addresses the issue, which is the most appropriate statement? 1. "I know it must be frustrating working with a new charge nurse, but how can we make this situation better?" 2. "This is not professional behavior, and you need to stop it or you will lose your job the next time I hear about it." 3. "I know the charge nurse is new to the role, but you should get used to it or there will be more changes." 4. "I know the new charge nurse is difficult to work with, but please help make the job easier to do."

As part of the process of promoting quality improvement, the nursing manager is comparing data between two hospitals on average length of stay for a total hip replacement. This comparison is an example of which process or step? 1. Benchmarking 2. Outcome standard 3. Indicator 4. Process standard

During a nurse's interview for a new job, the health benefits are described as being provided by a health maintenance organization (HMO). What should the nurse expect from this coverage? 1. The nurse will have to choose a provider from within the HMO. 2. The nurse can obtain services from a nonparticipating provider and the HMO will pay for a portion of the charges. 3. For an additional premium, the nurse can choose any provider. 4. By joining this HMO, the nurse is entitled to unlimited treatment and services.

During an evaluation conference, the nurse manager observes nonverbal messages, including nodding in agreement and smiling. These behaviors are examples of which aspect of communication? 1. Metacommunication 2. Intrasender conflict 3. Fogging 4. Intersender conflict

How can a nurse who is consistently falling behind at work improve to become more organized and disciplined? 1. Use the same system every day to organize client care and required activities such as paperwork. 2. Ask the nurse manager to grant permission for fewer client assignments until more experience with organization is achieved. 3. Ask the unit secretary to do required paperwork to decrease the amount of time required. 4. Practice a shorter client assessment technique to minimize the time required for this activity.

In an attempt to decrease tardiness, a hospital gives employees an extra hour's pay for each wage period that the employee has not been late for work. This incentive program is an example of which theory? 1. Expectancy 2. Shaping 3. Equity 4. Goal-setting

In the morning care conference, the nurse instructs the assistant to feed breakfast to the clients in beds 2234, 2230, and 2241. The assistant indicates understanding of the assignment and repeats the bed numbers back to the nurse. What is the nurse's next step? 1. Check with the assistant to see how the assignment is going during the time breakfast is served. 2. Check the client's breakfast trays before they are returned to dietary. 3. Check with the clients to see if they had breakfast. 4. At the end of the shift ask the assistant how the clients ate.

One of the nurse competencies of the synergy care delivery model is "moral agency." Which action is an example of that trait? 1. The nurse commits a medication error and reports it to the charge nurse. 2. The nurse collaborates well with the rest of the health care team. 3. The nurse is able to think ahead to the client's next need. 4. The nurse who does not have good baseline knowledge of a client's disease process researches it on a day off work.

The job description of the staff nurse states the nurse is responsible for attending hospital committee meetings as assigned. The nurse manager asking the staff member to attend a risk management meeting is an example of which concept? 1. Work assignment 2. Overdelegation 3. Ineffective delegation 4. Transfer of authority

The medical residents on a particular unit do not answer pages very quickly, and sometimes do not answer them at all. The nursing staff complains to the nursing supervisor. After several weeks, this conflict has spiraled into a heated disagreement. Which is the most important reason to make the necessary changes to settle this conflict? 1. Client care and satisfaction will suffer should it be allowed to continue. 2. The residents cannot be allowed to continue such unprofessional behavior. 3. Residents who do not answer pages do not get the most out of the experience. 4. Physicians do not know what is going on with clients if the residents do not tell them.

The medical residents on a particular unit do not answer pages very quickly, and sometimes the residents do not answer them at all. The nursing staff complains to the nursing supervisor. After several weeks, this conflict has spiraled into a heated disagreement. Which is the most important reason to make the necessary changes to settle this conflict? 1. Client care and satisfaction will suffer should the conflict be allowed to continue. 2. The residents cannot be allowed to continue such unprofessional behavior. 3. Residents who do not answer pages do not get the most out of the experience. 4. Physicians do not know what is going on with clients if the residents do not tell them.

The nurse executive is reviewing client satisfaction surveys. Which trend would the nurse evaluate as indicating the nursing care delivery system in use is not effective? 1. Sixty percent of respondents replied with the name of an unlicensed assistant when asked the name of the RN who cared for them. 2. Seventy percent of respondents accurately listed their discharge medication. 3. Eighty-eight percent of respondents reported that invasive interventions were performed by an RN. 4. Thirty percent of respondents reported that their nurse sometimes seemed rushed.

The nurse has attended a "how to" refresher course on successful delegation. Which statement indicates successful learning has taken place? 1. "I knew that effective delegation made my job easier, but I never thought about how it could benefit the hospital." 2. "The clients on our unit come and go so frequently that delegation is of little benefit." 3. "I just don't understand why people think delegation is difficult; all you have to do is tell other people what to do." 4. "Now I know that effective delegation means telling my nursing staff when they need to have their regular work done."

The nurse has been asked to assume a first-level management role on the nursing unit. Which statement indicates that this nurse will need further mentoring in the new role? 1. "I won't be able to increase my team's motivation. That has to come from within them." 2. "As a manager, I will be available for my team if problems with clients arise." 3. "One of my roles will be to make sure assignments are clear and understandable." 4. "I will still be responsible for the care being provided even if I am off the unit during the day to attend meetings."

The nurse is using critical thinking skills to decide which of several options is the best. Which question is most important for the nurse to take into consideration? 1. Are there different situational effects or contexts to be considered? 2. How has the problem usually been handled? 3. What is the easiest and least expensive alternative? 4. Can the problem be solved using the nursing process?

The nurse manager asks the staff nurse to work a double shift because the census is high. Although the nurse realizes the staffing for the night shift is low, the nurse has already made a family commitment for the same night. This is an example of which concept? 1. Intrapersonal conflict 2. Interpersonal conflict 3. Intragroup conflict 4. Intergroup conflict

The nurse manager assesses that two staff nurses are engaged in a conflict that is having a negative impact on client care. The manager meets with the nurses involved and identifies the conflict. An attempt is made to resolve the conflict through knowledge and reason. What strategy is this manager using? 1. Confrontation 2. Resolution 3. Negotiation 4. Forcing

The nurse manager consistently refocuses the staff on achieving outcomes and directly involves the staff in decision making to achieve those outcomes. How would this style of leadership be described? 1. Quantum 2. Transactional 3. Contingency 4. Transformational

The nurse manager has decided to work on personal time-management skills. What should this manager do first? 1. Review patterns of time use. 2. Purchase a new notebook system for time management. 3. Identify essential job activities. 4. Set a goal of prioritizing tasks every morning.

The nurse manager has determined that two staff nurses need to be hired. Which factor is most critical as the nurse manager prepares to submit the request to administration? 1. Timing of the request 2. Negative inquiry 3. Compromise 4. Persistence

The nurse manager has determined the need to hire two staff nurses. Which factor is most critical as the nurse manager prepares to submit the request to administration? 1. Timing of the request 2. Negative inquiry 3. Compromise 4. Persistence

The nurse manager has planned a meeting that all staff nurses have to attend. Which method would most efficiently notify the staff members of the meeting time? 1. E-mail 2. Voice mail 3. Memo 4. Telephone call

The nurse manager is challenged to find an innovative way to adequately staff the unit and provide quality nursing care. Which ability would be most useful to the nurse in this situation? 1. Creativity 2. Problem solving 3. Brainstorming 4. Decision making

The nurse manager is facilitating change to a new documentation system in the unit. If the manager wants to use the most common method to overcome resistance to the change, which strategy would be chosen? 1. The manager distributes a handout explaining the new system and how to use it. 2. The manager creates a "quick tip" sheet about how to use the system and schedules practice sessions for each nurse. 3. The manager identifies a key supporter of the change and has that nurse act as mentor to the remaining staff. 4. The manager threatens to transfer anyone who resists the change.

The nurse manager tells a newly hired nurse that the unit practices functional nursing. What should the new nurse expect? 1. One nurse has responsibility for all the medications on the unit. 2. One nurse has responsibility for all the needs of three clients. 3. One charge nurse and one respiratory therapist have responsibility for all clients. 4. One nurse and one nursing assistant have responsibility for ten clients.

The nurse manager's goal is to adequately staff the unit and use minimal supplementary staff. The manager has added the cost of this supplementary staff to the unit's operating budget. A colleague informs the manager it should have been added to which budget? 1. The personnel budget 2. The operating budget 3. The revenue budget 4. The fixed budget

The person who has just been promoted to nurse manager is male. If this nurse communicates in a way that is considered typical for men, what can the staff expect? 1. He will focus more on the issue than on personal experience. 2. He will strive to reach consensus within the group. 3. He will strive to avoid conflict within the group. 4. He will prefer to ask questions rather than make statements.

The quality management director of a large health care conglomerate wishes to initiate benchmarking strategies to assess care. Which directive should this manager publish? 1. We will compare outcome indicators with other health care conglomerates of similar size and organization. 2. Outcome data of hospitals within the organization will be compared to assess quality. 3. Each client care unit in the organization will establish specific unit goals for quality. 4. Each unit in the organization will create a quality monitor to assess how well unit policies are followed.

The staff nurse is unsure of the correct protocol for calling in sick to work. The nursing supervisor told the nurse to call the nursing office; however, the nurse manager told the nurse to call the unit. This issue is likely the result of which distorted communication? 1. Intersender conflict 2. Intrasender conflict 3. Metacommunication 4. Downward communication

The staff nurse job description states that the nurse is responsible for attending hospital committee meetings as assigned. The nurse manager asking the staff member to attend a risk management meeting is an example of which concept? 1. Work assignment 2. Overdelegation 3. Ineffective delegation 4. Transfer of authority

The staff nurses and nursing administration are attempting to construct a method of scheduling that meets the needs of both the clients and the nursing personnel. Because nurses and nursing administration have experienced conflict about the issue, their intent is to arrive at an agreeable solution between both parties. Which option does this process best exemplify? 1. Negotiation 2. Accommodation 3. Forcing 4. Consensus

The unpredictability of the labor and delivery area requires a set staff mix for every shift. Which type of staffing pattern should the manager use to ensure this mix? 1. Block staffing 2. Creative scheduling 3. Flexible scheduling 4. Self-staffing

What is the primary belief behind the evolution of the clinical microsystem as a nursing care delivery system? 1. Those who deliver the nursing care make the most educated decisions for a particular unit. 2. Clinical decisions are best made by the clients who are served by a particular unit. 3. Clinical decisions are best made by nursing leaders for all units within that particular hospital. 4. Nurses working in a particular service area are best suited to make decisions for the clients in that area.

Which is the most important consideration in choosing a structure for nursing care? 1. Client need 2. Efficiency 3. Cost 4. Timeliness

Which is the most important factor in whether a conflict will be perceived or felt between two nurses? 1. How well the nurses know and trust each other 2. If the nurses are on the same job level 3. The congruence of the nurse's values and beliefs 4. Whether or not the nurses perform the same roles

Which manager statement reflects concern about the most important requirement for today's nurse manager? 1. "I am taking a day off tomorrow for my annual physical." 2. "I think this class will help me learn to be innovative." 3. "I am committed to being a good manager." 4. "I feel enthusiastic about our new plans for the units."

Which organization would the hospital management team contact to pursue certification as a Magnet hospital? 1. Magnet Recognition Program 2. American National Magnet Commission 3. The Joint Commission 4. American Medical Association

Which situation best exemplifies the nurse manager as a team leader? 1. The nurse manager posts the unit's positive accomplishments from the past month in the break room. 2. The nurse manager controls the staff meetings so the staff can get back to work quickly. 3. Every year the nurse manager does staff member evaluations to determine pay raises. 4. The nurse manager encourages conjunctive task performance on the unit.

Which situation is an example of a major weakness of service-integrated structure? 1. Two different units have purchased a demonstration model that could be used by both units. 2. The pharmacy has been asked to compromise on the times medications are delivered to the units. 3. Nurse managers in several units are interviewing new graduates for staff positions. 4. The nurse manager of a unit is involved in a conflict between hospital management and the medical staff.

Which statement represents a situation is which delegation is ineffective or inappropriate? 1. The RN asks the LPN to assist with admissions by assessing the clients as they get to their rooms. 2. The RN delegates administration of oral medications for a group of clients to the LPN. 3. The LPN directs the unlicensed assistant to report vital sign changes on a post-operative client to the RN. 4. The nurse manager asks the RN to act as chairperson for today's unit council meeting since the charge nurse went home sick.

Which statement represents a situation is which delegation is ineffective or inappropriate? 1. The RN asks the LPN to assist with admissions by assessing the clients as they get to their rooms. 2. The RN delegates administration of oral medications for a group of clients to the LPN. 3. The LPN directs the unlicensed assistant to report vital sign changes on a postoperative client to the RN. 4. The nurse manager asks the RN to act as chairperson for today's unit council meeting because the charge nurse went home sick.

A client has been told that chemotherapy must be postponed until he is hydrated. The client refuses the intravenous hydration and demands to go home. How would the nurse best categorize this situation? 1. As a nonreportable incident 2. As a medical-legal incident 3. As client dissatisfaction with care 4. As a medication error

A 70-year-old client develops a catheter-induced urinary tract infection. Which statement by the nurse would indicate to the nurse manager a need for additional understanding of this situation? 1. "I wonder if there was a break of sterility when this catheter was inserted." 2. "Thankfully we can treat this with an antibiotic." 3. "This could potentially cost the hospital a lot of money." 4. "I will talk to my unlicensed assistants about proper urinary catheter care."

A change in nursing care delivery system is being considered by hospital administrators. Which information should the nurse executive add to this discussion? 1. "There has been little change in nursing care delivery over the last few years." 2. "We must look to the nursing process for guidance in nursing care." 3. "Too much time is spent deciding on a system of care." 4. "Any system is okay, as long as the nurses follow it."

A client has been told that chemotherapy must be postponed until he is hydrated. The client refuses the IV hydration and demands to go home. How would the nurse best categorize this situation? 1. Non-reportable incident 2. Medical-legal incident 3. Client dissatisfaction with care 4. Medication error

A conflict has arisen between two staff nurses who work on the same unit. Which strategy is most important for the nurse manager to consider? 1. Address the conflict in the break room. 2. Make a timely decision regarding if and when to intervene. 3. Accept full responsibility for developing a solution. 4. Redirect expressions of disagreement between the participants.

A difference in opinion has arisen regarding methods to care for clients who are on mechanical ventilators. The nurse manager asks a group of nurses to meet and review evidence-based practice related to this client care situation. Each nurse volunteers to gather data prior to the next meeting. This is an example of which type of problem solving? 1. Negotiation 2. Collaboration 3. Compromise 4. Forcing

A hospital has used capital funds to purchase a new piece of diagnostic equipment. The hospital's chief financial officer (CFO) says, "The cost of this equipment will be expensed out across all units that use it." How should the nurse manager interpret this statement? 1. The equipment is jointly owned by all units that use it. 2. If clients on the manager's unit require the use of this equipment, a portion of the cost will be charged to the unit. 3. The equipment will be rented to the units for use. 4. The nurse manager will ask physicians to refrain from using the equipment.

A newly appointed nurse manager has just completed education on time-management skills. Which statement would the instructor evaluate as indicating this nurse understands the basic concepts of time management? 1. "My job as a nurse manager is so dynamic that I probably will not be able to attain true time management." 2. "The key to using time management is to respect my time as well as the time of others." 3. "If I am going to be able to manage time, the hospital will need to invest in a computer-based time-management system." 4. "The most important aspect of time management for me is to manage paperwork flow."

A newly hired nurse manager is being mentored in this new role. How should the mentor advise this manager regarding staffing for the next shift? 1. "First you must determine the nursing care hours needed." 2. "First you must become familiar with the classification system we use." 3. "First consider how to modify the schedule to meet client needs." 4. "First consider the need to supplement the current nursing staff so that arrangements can be made."

A newly licensed nurse working on a unit committee challenges every detail of a proposal the committee is developing. How should other committee members interpret this behavior? 1. This nurse is too inexperienced to realize the behavior is inappropriate. 2. This nurse is learning to be creative. 3. This nurse believes that new nurses are more knowledgeable than those who have worked several years. 4. This nurse misunderstands the work of the committee.

A nurse asks an unlicensed assistant to help with discharging clients because so many are going home at one time. The nurse states, "Can you help get these clients ready to go home by helping them pack?" Which option best describes the statement with regard to effective delegation? 1. The delegation is ineffective because the nurse has no responsibility to pack the client's belongings. 2. Delegation would have been more effective had the nurse been more specific about which clients and when it should be completed. 3. The delegation is ineffective because the nurse has no authority to ask the unlicensed assistant to help with client discharge. 4. Delegation could have more effective had the nurse gone with the assistant to ensure the assistant did the packing as requested.

A nurse asks an unlicensed assistant to help with discharging clients since so many are going home at one time. The nurse states, "Can you help get these clients ready to go home by helping them pack?" Which option best describes the statement with regard to effective delegation? 1. The delegation is ineffective since the nurse has no responsibility to pack the client's belongings. 2. Delegation would have been more effective had the nurse been more specific about which clients and when it should be completed. 3. The delegation is ineffective because the nurse has no authority to ask the unlicensed assistant to help with client discharge. 4. Delegation could have more effective had the nurse gone with the assistant to ensure the assistant did the packing as requested.

A nurse believes that milk is part of the healthy adult's diet. The nurse frequently offers milk to adults as a between-meal beverage. This action is based on which concept? 1. Evidence 2. An underlying assumption 3. An alternative perspective 4. An inquiring attitude

A nurse leader is contemplating change on the unit. Which is the first step in the change process? 1. Defining costs/benefits 2. The problem has been clearly defined 3. Identify driving and restraining forces 4. Select and analyze data 5. Develop a plan for change

A nurse manager and a staff nurse are in conflict. The nursing supervisor has decided to use mediation to arrive at a solution. The supervisor should be most concerned about which person's level of comfort when choosing a place for the mediation meeting? 1. The manager 2. The staff nurse 3. The supervisor 4. There should be equal concern for all participants.

A nurse manager is aware that U.S. citizenship is required by a job position being filled. How should the manager handle this requirement during the job interview? 1. Ask the applicant to provide proof of citizenship before the interview is scheduled. 2. Ask the applicant if he or she is an U.S. citizen. 3. Do not ask unless the applicant mentions citizenship. 4. Ask if the applicant's family is from the United States.

A nurse manager is conducting her first interview. The manager is provided interview guidelines by the human resources (HR) director. Which advice from the HR director is most effective? 1. "Follow these guidelines and do not ask personal questions." 2. "If you are unsure of a question, ask yourself if the question applies to job performance." 3. "You may ask any question as long as it's stated in third person." 4. "You may ask only the questions that are provided."

A nurse manager must place a telephone call to a colleague who always wants to chat socially for several minutes. The manager does not have time for a social call. What is the best time for the manager to make this call? 1. At 9:00 a.m. after physician rounds are complete 2. A few minutes before the colleague usually goes to lunch 3. In the middle of the afternoon 4. First thing in the morning, just after shift report

A nurse manager wishes to use a model of job performance to help match employees and tasks to achieve the greatest effectiveness. What should the manager do first? 1. Evaluate each employee's educational and experiential background. 2. Establish, in writing, the expectations of each task. 3. Consider how much variation from standard is acceptable. 4. Review unit statistics for incidents, errors, and accidents.

A nurse manager would like to add the statement "Provide ongoing education to the client and the client's family" to the position description of RNs. Where would this statement be placed in this document? 1. In the job qualifications 2. In the job responsibilities 3. In the job overview 4. In the job benefits

A nurse plans to seek employment in an acute-care setting after graduation. Which form of communication would be most effective in applying for a position? 1. Send an email to the nurse manager, requesting a job interview. 2. Send a written letter and résumé in the mail. 3. Call the nurse manager to ask if any jobs are open. 4. Drop into the nurse manager's office to discuss employment options.

A nurse working in a rehabilitation center notices that clients frequently asking for something to drink. Which response indicates the use of creativity in finding a solution to this problem? 1. Calling local beverage distributors to inquire about service pricing 2. Asking all employees to write down their ideas about a solution 3. Determining what type of drinks most clients might want 4. Encouraging clients to bring a drink from home

A nursing assistant tells a nurse, "I am going to have to call in sick tomorrow because I don't have a babysitter." How should the nurse respond to this information? 1. The assistant's sick time is earned and should be used in any way the assistant wishes. 2. The assistant should use personal time, not sick time, for this situation. 3. The assistant's absence will not be a major problem for the unit as long as only one day is missed. 4. It will be okay for the assistant to miss a day because it will help another assistant get overtime wages.

A nursing group cannot complete a task assignment because information from another group has not been provided. Because the nursing group cannot complete its task, a group from physical therapy will not be able to complete its task. This is an example of breakdown in which task format? 1. Pooled interdependence 2. Sequential interdependence 3. Reciprocal interdependence 4. Reverse interdependence

A nursing task force has been created to determine whether a new model of differentiated practice would be more effective than the current model. The task force analyzes data as a basis to examine alternatives. Which activity does this represent? 1. Group problem solving 2. Critical thinking 3. Groupthink 4. Satisficing

A proposed change in a health care organization is controversial and will require cooperation from all parties involved. Which change strategy should the change agent use? 1. Empirical-rational 2. Normative-reeducative 3. Power-coercive 4. Empirical-reeducative

A proposed change in a healthcare organization is controversial and will require cooperation from all parties involved. Which change strategy should the change agent use? 1. Empirical-rational 2. Normative-reeducative 3. Power-coercive 4. Empirical-reeducative

A serious disagreement has arisen between two staff nurses. The unit manager elects not to make a decision regarding the disagreement until more evidence is collected. Which part of the nursing process does this manager's critical thinking reflect? 1. Assessment 2. Diagnosis 3. Planning 4. Evaluation

A staff nurse tells the manager, "I don't want to be promoted. I am a much better follower than I am a leader." How should the manager interpret this remark? 1. Leadership takes more energy than followership, so this nurse is taking the easy way out. 2. Followership is a valuable skill in nurses. 3. A nurse who is not willing to work to master the skills of leadership should not be retained on the unit. 4. Most people have difficulty developing leadership skills.

An emergency department (ED) manager has an interview scheduled for 8:00 the next morning. The manager's usual hours are 8:00 a.m. to 4:00 p.m. This manager has been working as staff due to an increased volume of clients. What action should the manager take to prepare for this interview? 1. Reschedule the interview to a later time. 2. Arrive to work early in the morning to prepare for the interview. 3. Arrive at the usual time and conduct the interview. 4. Have a human resources representative conduct the interview.

During a performance evaluation the nurse manager states, "My span of control is just too large." How should the unit supervisor interpret this statement? 1. The nurse manager is not capable of performing all the duties expected of the role. 2. The nurse manager may have too many staff members to manage. 3. The nurse manager is burned out and needs time away from the unit. 4. The nurse manager is not educationally prepared for the role.

During an interview the candidate informs the manager of a difficult experience between a client and a physician. The nurse had to negotiate between an unhappy client and a difficult physician. Which notation by the manager would describe this situation? 1. The candidate has good initiative. 2. The candidate has good conflict resolution skills. 3. The candidate is a client advocate. 4. The candidate is adaptable.

During an interview with a potential employee, the nurse manager tells the individual that an additional 10% of the hourly rate will be paid for working the 7:00 p.m. to 7:00 a.m. shift. What is another way the manager could have described this difference in pay? 1. "You will receive an additional 10% for overtime." 2. "The night shift differential is 10%." 3. "Your evening premium is 10%." 4. "You will get a 10% cost-of-living raise for working the night shift."

Every month the chief financial officer (CFO) reviews the budget with the hospital's board of directors. The CFO requests a million dollars to purchase a new MRI (magnetic response imaging) unit for the radiology department. Which category best describes this request? 1. Non-revenue expense 2. Capital expense 3. Variable cost 4. Allocation of funds

Hospital administration is considering the purchase of a robotic pharmacy system. What would be the advantage of this system to the nurses who work in the hospital? 1. The nurse will be able to leave out some of the six rights of medication administration because the robot checks the medications. 2. The nurse should get medications more quickly because the robot can work more consistently without breaks. 3. The nurse can delegate medication administration to the nursing assistant because the medications have already been checked. 4. The nurse can expect that medication administration will be easier and carry less potential for error.

Hospital administrators are considering changing from the traditional method of creating work schedules to a system in which the nurses will choose their own workdays. Choices will be made according to seniority. Which change strategy would likely be best for this endeavor? 1. A power-coercive strategy 2. A normative-reeducative strategy 3. An empirical-rational model 4. A driving force

One possible future includes which of the following wildcards? 1. Plausible occurrences 2. Unforeseen events 3. Probable future 4. Extension of the past

Procedural changes are being planned on the unit as a direct result of client satisfaction surveys. Which person is most strategically placed to handle how these changes are initiated? 1. Staff nurse 2. Nurse manager 3. Chief financial officer (CFO) 4. Chief executive officer (CEO)

The RN leader of a team overhears one of the UAPs on the team say, "I'll sure be glad when I get my RN license. All they do is sit around doing paperwork." How does the RN interpret this comment? 1. As a need to be more involved in direct client care when this UAP is on the team 2. As a common disadvantage of the team approach to nursing 3. As an indication that this UAP should be reported for unprofessional behavior 4. As confirmation that UAPs are poorly educated and do not work well on teams

The chairperson of the nursing faculty leads the monthly meetings of the curriculum committee. This permanent group, which is designed to meet organizational goals, is which type of group? 1. Competing group 2. Command group 3. Task force 4. Informal group

The daughter of a hospitalized client comes to the nurse manager's office with a complaint about the care provided on the previous shift. What is the manager's first action? 1. Call the nurse from the last shift to participate in a conference call about the complaint. 2. Ask the daughter to explain what happened. 3. Tell the daughter that the last shift was understaffed and apologize for any problems that might have occurred. 4. Ask the daughter what can be done to improve the situation.

The director of quality improvement reports that the hospital will soon be using "dashboards" as part of the quality management process. How should the staff interpret this information? 1. Surveyors are driving to clients' homes to collect data on hospital visits. 2. This electronic tool makes it easy to aggregate and display data. 3. "Dashboard" is an acronym for the topics covered in client satisfaction surveys. 4. The "dashboard" is a screen on the electronic medical record that can be accessed for quality improvement information.

The following documentation was entered in the client's medical record: "The client was found lying on the floor. Dr. X was notified. Apparently the restraints were improperly applied." Which statement best describes this documentation? 1. Appropriately written 2. Inappropriate because it places blame on an individual 3. Inappropriate because it does not include that the client's family was notified 4. Appropriately written because it only documents the facts

The following documentation was entered in the client's medical record: "The client was found lying on the floor. Dr. X was notified. Apparently, the restraints were improperly applied." Which statement best describes this documentation? 1. Appropriately written 2. Inappropriate because it places blame on an individual 3. Inappropriate because it does not include that the client's family was notified 4. Appropriately written because it only documents the facts

The health care organization's monthly newsletter has a headline reading "Nurse Promoted to Leader of Specialty Care Units." What is the error inherent in this headline? 1. One person cannot be the leader of all the specialty care units in an organization. 2. A person cannot be promoted to the role of leader. 3. Leaders have to be hired from outside the organization. 4. Nurses cannot serve as leaders over other nurses.

The hospital has an annual campaign in which the staff is divided into two teams to raise money for hospital special events. The team raising the most money gets possession of a "trophy" designed by the administrative staff. This is an example of which type of conflict? 1. A conflict that is disruptive to the work of the hospital 2. A competitive conflict that is positive to the work environment 3. An intragroup conflict that is not appropriate in health care 4. A felt conflict that will result in unresolved feelings of frustration

The hospital has an annual campaign in which the staff is divided into two teams to raise money for hospital special events. The team raising the most money gets possession of a "trophy" designed by the administrative staff. This is an example of which type of conflict? 1. A conflict that is disruptive to the work of the hospital 2. A competitive conflict that is positive to the work environment 3. An intragroup conflict that is not appropriate in healthcare 4. A felt conflict that will result in unresolved feelings of frustration

The hospital has elected to use the demand management staffing system instead of the client classification system. Because of this decision, the nurse manager who is staffing must focus on which of the following? 1. Immediate client needs 2. Historical data of expected client outcomes 3. Using hospital-wide data to staff individual units 4. Reduction of nursing care hours

The hospital is caring for more high-acuity clients due to the recent flu endemic. The chief nurse officer (CNO) reviews the census from last year's flu season and instructs the manager to schedule more RNs for the weekend. Which system has the CNO used? 1. Client classification systems management 2. Demand management system 3. The Baylor plan 4. Automated staffing

The hospital organization has developed a philosophy based on the client, organizational involvement, quantitative measurement of outcomes, and processes for improvement. In which quality management process are these characteristics typically seen? 1. Continuous quality improvement (CQI) 2. Total quality management (TQM) 3. Plan, Do, Check, Act (PDCA cycle) 4. Six Sigma

The hospital's management team wishes to institute case management to improve the quality of nursing care. As a beginning step, the team is choosing specific medical diagnoses on which to focus. What criteria should the team use when choosing these diagnoses? 1. Diagnoses given to only a few clients 2. Diagnoses that carry high risk for the client and the provider 3. Diagnoses that have low reimbursement rates 4. Diagnoses that involve as few providers as possible

The human resources (HR) director is planning on attending a career fair and has asked the director of nursing to attend as well. The nursing director replies, "I really don't have time to attend. Do you really need a nurse to go with you?" Which response by the HR director is most appropriate? 1. "Your attendance is necessary to assist me with managing the booth." 2. "Your attendance is necessary to answer specific nursing questions." 3. "I need your assistances in answering questions about our benefit package and nurses wages." 4. "I would like another person from the organization to assist in representation."

The medical-surgical unit's census has decreased since the previous shift. The manager is reviewing the staffing grid. Which factor is used to determine staffing mix? 1. Average daily census of the hospital 2. Client care needs 3. Number of staff on vacation 4. Financial productivity of the unit

The new chairperson of the nursing department has determined that the faculty's teaching is stagnant and outmoded. The chairperson would like to encourage the faculty to adopt more innovative teaching strategies. According to Lewin, what is the first step in initiating this plan? 1. Bring an expert on innovative teaching strategies to campus for a meeting with faculty. 2. Include the staff in identifying problems related to teaching strategies. 3. Ask staff to assist in the development of a plan for implementing new teaching strategies. 4. Implement interventions to improve the teaching strategies currently used.

The newly hired nurse manager is involved in the first budgetary cycle since being hired. The manager lists some capital equipment needs and is surprised when they are not available for staff use two months after the request. What is the reason for this? 1. The equipment was not approved by the manager's supervisor. 2. The budgetary cycle takes up to 1 year to occur. 3. The hospital has experienced a downturn in revenue and is not fulfilling promises. 4. The nurse manager failed to complete the correct request.

The nurse executive is reviewing statistics about the nursing staff. Which statistic shows that the staff reflects national trends? 1. The average age of the nursing staff is 40. 2. The number of nurses under age 30 has increased in the last two years. 3. There are no nurses over age 55. 4. All nurses over age 45 are managers.

The nurse has a concern regarding the quality of care being provided in the hospital. What should the nurse consider first before communicating this concern? 1. The medium of the message 2. The relationship between the nurse and the receiver of the message 3. The timing of the message 4. What to include in the message

The nurse has expressed job dissatisfaction to the unit manager. The manager assigns another staff member as a coach for this nurse. What is the most important aspect of the coach's job? 1. Get the nurse to explain the cause of the dissatisfaction. 2. Conduct the relationship in a confidential manner. 3. Encourage the nurse to stay in the organization. 4. Help the nurse increase bedside skill competency.

The nurse is acting as team leader for a client care conference. Which opening statement is best for this meeting? 1. "We are all here to discuss the issues with this client's discharge. What issues are we facing?" 2. "The issue with this client is the time limit for Medicare to pay has almost expired, and we aren't ready for discharge." 3. "I don't really have time for this meeting today; is there anything I can do to expedite this meeting?" 4. "I will let you all decide what might be best, as I am not really as familiar with this client as I should be."

The nurse manager asks a staff nurse why a procedure is done in a certain manner. The nurse replies, "I don't know why I started doing it this way. I've never read any research on it, but this technique always works for me." The manager would place this technique into which category of evidence? 1. Case study 2. Anecdotal 3. Nonexperimental design research 4. Statistical

The nurse manager asks staff members to work as a group in planning the activities for Nurses' Week. The nurse manager should report to the supervisor that which type of group has been formed? 1. Command group 2. Task group 3. Competing group 4. Informal group

The nurse manager assesses that there is conflict between two of the charge nurses. The decision is made to postpone an intervention and allow the conflict to escalate. Why might the nurse manager make this decision? 1. Allow sufficient time for the problem to spontaneously resolve. 2. Motivate the participants to seek resolution. 3. Give the nurse manager time to identify problem-solving strategies. 4. Relieve the nurse manager of the time commitment necessary to intervene.

The nurse manager determines that there is conflict between two of the charge nurses. The decision is made to postpone an intervention and allow the conflict to escalate. Why might the nurse manager make this decision? 1. Allow sufficient time for the problem to resolve spontaneously. 2. Motivate the participants to seek resolution. 3. Give the nurse manager time to identify problem-solving strategies. 4. Relieve the nurse manager of the time commitment necessary to intervene.

The nurse manager feels that changing the unit's method of assigning break times would benefit the flow of client care. What should be the manager's first action associated with this idea? 1. Tell the staff that a change is coming, but that it is positive and they should not be worried. 2. Collect and analyze information about how the current system is working. 3. Mention in a staff meeting that the current system is causing a lot of trouble. 4. Identify how the manager would know if the change is benefiting the unit.

The nurse manager gave the unit secretary complete responsibility for the unit's staffing, including finding replacements for call-ins and disciplining nurses with excessive call-ins. This is an example of which type of delegation? 1. Effective delegation 2. Overdelegation 3. Reverse delegation 4. Underdelegation

The nurse manager is counseling a male nurse about several recent incidents in which female nurses complained that he was abrupt and condescending. What advice should the manager give this nurse? 1. "Make sure that anything you say is clear and concise." 2. "Don't feel as if you are responsible for fixing every problem." 3. "Avoid using phrases such as 'sort of' when talking to females." 4. "Don't personalize everything."

The nurse manager is creating the budget for the next fiscal year. Because the client census has been higher in the past year, more supplies were used. Which type of cost does this reflect? 1. Fixed costs 2. Variable costs 3. Direct costs 4. Zero-based costs

The nurse manager is explaining her staffing budget to the hospital administration. The manager has developed a flexible staffing pattern. The administration questions the manager as to why this pattern was developed. Which answer is most correct? 1. Staff members would prefer to make out their own schedules. 2. Nursing shortages and salary constraints have affected staffing patterns. 3. Lower client acuity has contributed to the need for more flexibility. 4. Flexible pattern staffing is the easiest method available.

The nurse manager is planning to initiate new policies in the department and is reviewing several change theories. Which step of Havelock's model will the nurse find most closely resembles Lewin's moving stage? 1. Self-renewal occurs among all participants. 2. Solutions are identified to create change. 3. Resources are acquired to facilitate change. 4. Relationships are formed among all participants.

The nurse manager is reviewing the current staff to determine who should precept a newly licensed nurse. Which nurse is the most logical choice? 1. A nurse who needs the temporary pay increase that accompanies precepting 2. A nurse who is clinically competent and has the desire to assume the responsibility to train new staff 3. A nurse who has expressed the desire for additional training and unit responsibilities 4. The nurse who needs to work an 8-hour schedule for a few weeks while recovering from a work-related accident

The nurse manager makes an error that results in the unit being $20,000 short on operating budget for the fiscal year. When asked about the error, the nurse takes full responsibility This statement reflects which component of emotional intelligence? 1. Initiative 2. Transparency 3. Empathy 4. Conflict management

The nurse manager meets with the staff nurses to discuss ways to improve communication among the shifts. Which statement by the nurse manager best exemplifies the final stage of conflict management? 1. "We need to clearly define the nature of the conflict." 2. "I will evaluate the outcomes of our strategies on a monthly basis." 3. "Let's create a time line for the implementation of our strategies." 4. "Hopefully, each group can understand each other's perceptions of the issue."

The nurse manager meets with the staff nurses to discuss ways to improve communication among the shifts. Which statement by the nurse manager best exemplifies the final stage of conflict management? 1. "We need to clearly define the nature of the conflict." 2. "I will evaluate the outcomes of our strategies on a monthly basis." 3. "Let's create a timeline for the implementation of our strategies." 4. "Hopefully, each group can understand each other's perceptions of the issue."

The nurse manager overhears staff discussing the shortage of nurses. Which statement by a staff member would the manager evaluate as misinformation? 1. "There are more nurses retiring than are entering the profession." 2. "The demand for nurses is declining because of fewer hospital admissions." 3. "There are insufficient numbers of nursing faculty to teach interested students." 4. "Women still outnumber men in nursing."

The nurse manager should be most careful not to hold preconceived beliefs when listening to which person? 1. The hospital administrator discussing next year's budget 2. A staff nurse the manager has worked with for 25 years 3. A newly licensed nurse who is hesitant to address the manager 4. A physician discussing prognosis with the client and family

The nurse plans to seek employment in an acute-care setting after graduation. Which form of communication would be most effective in applying for a position? 1. Send an e-mail to the nurse manager, requesting a job interview. 2. Send a written letter and résumé in the mail. 3. Call the nurse manager to ask if any jobs are open. 4. Drop into the nurse manager's office to discuss employment options.

The nurse prepares the medication ordered for the client. The nurse asks the nurse assistant to give the medication when the client receives breakfast and to report on the task at its completion. The nurse assistant agrees. Which component of the steps of delegation was violated by this request? 1. Defining the task 2. Deciding on the delegate 3. Determining the task 4. Reaching agreement

The nurse works in a school clinic that is part of an integrated health care network. How would this nurse explain to parents and teachers the focus of care provided in the clinic? 1. Hospital focused 2. Primary care focused 3. Specialty care focused 4. Home care focused

The nursing administration has instituted a "horizontal promotion" system within the nursing department. What benefit is this program to the staff nurse? 1. The most competent nurses will rise to managerial positions. 2. It rewards the nurse's clinical excellence. 3. Over time the nurse will move steadily upward through the levels. 4. The process is practice based rather than research based.

The nursing supervisor identifies ineffective communication as a problem among the managers. According to Lippitt's phases of change, which action by the supervisor reflects the final stage of improving this issue? 1. The supervisor uses outcome data to evaluate the amount of change that has occurred. 2. The supervisor has gradually withdrawn from the role of change agent. 3. The supervisor has developed strategies to maintain the change. 4. The supervisor has determined if anyone in the group is sabotaging change efforts.

When driving towards a meeting, the nursing supervisor gets a call explaining the meeting is to be delayed for about 30 minutes. Which activity is the best use of this supervisor's waiting time? 1. Listen to music on the radio. 2. Drive to the meeting place and read the minutes from the last meeting. 3. Stop by the closest store and get doughnuts to share with everyone. 4. Use the time to make some personal phone calls.

When the nurse manager orders supplies for the unit, which communication mode is best? 1. Telephone 2. Email 3. In person 4. Voice mail

Which question is considered appropriate to ask during an interview? 1. "What is the country of your national origin?" 2. "Do you speak any language in addition to English?" 3. "Will child care be a problem if you are hired?" 4. "Are there any holidays on which you would not work?"

Which situation indicates that the nurse needs additional training on effective delegation? 1. The charge nurse tells the unlicensed assistant to help prepare rooms for new clients. 2. The office nurse calls in orders for admission on a client following a surgical complication. 3. A rehabilitation nurse asks a physical therapy assistant to assist a client with ambulation around the facility. 4. A home health nurse calls the office and asks another nurse to make the visit to her next client.

Which statement indicates understanding how a nurse could improve personal decision-making skills? 1. "We should gather a group together to make important unit decisions to ensure fairness." 2. "I should practice making decisions by developing potential solutions and then choosing one." 3. "We can make a decision and then ask for input from others to make sure it was the right choice." 4. "I know I will never be able to improve my decision-making skills because I am not a strong person."

Which statement reflects a characteristic common to all methods of quality management? 1. Each method uses all staff members in the organization. 2. None of the methods are designed to place blame on an individual. 3. All methods provide clinical information. 4. Most methods focus on cost containment.

Which statement regarding the use of electronic medical records (EMR) is accurate as associated with quality improvement? 1. EMR has strong linkage to improving quality. 2. Much more research must be done before the impact of EMR on quality can be determined. 3. EMR does not affect the quality of care provided. 4. Although no research into the impact on quality exists, EMR must continue as it is federally mandated.

Which step should be taken first when recruiting and selecting nursing staff? 1. Develop a structured interview guide. 2. Become familiar with the position description for the jobs available. 3. Develop a recruitment strategy to attract qualified applicants. 4. Identify potential applicants who would meet the job description.

Which structure is reflected by the statement "Nursing practice is best determined by nurses"? 1. Hybrid 2. Shared governance 3. Matrix 4. Functional

While providing continuing education about group dynamics and team building, the nurse manager attempts to explain the difference between a group and a team. Which statement by the manager is most effective? 1. A team is bigger than a group. 2. Teams have authority; groups may be informal. 3. A group has similar goals, whereas a team's goals are dissimilar. 4. Groups are formally designated by the organization, while teams are generally informally organized.

With the current healthcare industry focus on managed care, nurses must be more cost conscious. Which option is an example of a nurse being cost conscious? 1. The nurse reviews the client's itemized bill each day. 2. The nurse's decides to use fewer supplies when changing a dressing. 3. The nurse manager reviews client costs on a daily basis. 4. The nurse manager requests that the materials management director obtain quotes for less expensive items.

A newly promoted nurse manager would like staff to solve problems without relying on preconceived ideas. How should the manager role-model this ability? 1. When disagreements occur on the unit, the manager privately asks the dissenters to be silent about the issue at meetings. 2. Tell staff members that they must present one opinion regarding the solutions they desire. 3. Demonstrate a genuine desire to find our why there is dissention. 4. Develop "tunnel vision" when it comes to problems on the unit.

A chief nurse officer (CNO) is considering a collaborative effort with a school of nursing to offer externships to students. The chief financial officer (CFO) rejects the proposal because it will entail a cost to the organization. Which statement by the CNO would influence the CFO to reconsider this proposal? 1. "Nursing is the foundation of this hospital and we have to get nurses into the organization." 2. "We could hire students as nurse's aides, which would save costs." 3. "An externship will allow the nursing students to work with nurses, learn about the organization, and create a positive impression of our facility." 4. "Offering a nurse externship would allow the organization to create the types of nurses we would like to hire."

A community-owned hospital has been purchased by a health care conglomerate. The staff is aware that the organizational theory governing the hospital is likely to change. Which statement indicates a lack of understanding of organizational theory on the part of a staff nurse? 1. "If our new bosses want a classical organization, we can expect a strong hierarchy." 2. "If we don't want to see lots of changes, we should hope our new bosses don't like chaos theory." 3. "If this new company is based on systems theory, there will be a lot of focus on how much work we can produce." 4. "If this new company is based on contingency theory, we will see lots of focus on how our environment impacts our work."

A critical care nurse has reported off because of an illness. Which choice of replacement for this nurse would provide the best continuity of quality nursing care? 1. A nurse from an outside agency 2. A nurse from a hospital unit that has a low census today 3. A nurse from a decentralized internal float pool 4. A nurse from the centralized internal float pool

A graduating nurse student is deciding which nursing specialty would be a good place to begin a nursing career and ensure long-term stability. Which specialty is most likely to have the greatest growth in need? 1. Pediatric nursing 2. Psychiatric nursing 3. Geriatric nursing 4. Maternity nursing

A group of nurses is developing a poster presentation titled "Nursing Care Delivery Through the Ages" for the hospital's annual Nurses' Day celebration. What form of nursing care delivery should they depict as occurring prior to 1930? 1. Team nursing 2. Functional nursing 3. Total patient care 4. Primary care

A hospital has open shifts on its medical-surgical unit. The manager has listed open shifts on the hospital's intranet. This is an example of which type of scheduling? 1. External pools 2. Internal pools 3. Open shift management 4. Float pools

A hospitalized client is complaining of abdominal pain that has developed since admission. The nurse says, "I am going to call the hospitalist." How should the client interpret this statement? 1. The nurse is going to call the medical intern to assess the client. 2. The nurse is going to call the client's physician's on-call group. 3. The nurse is going to call a physician who cares for inpatients. 4. The nurse is going to call the emergency department and request that a physician see this client.

A human resources (HR) manager knows which method of recruitment is most likely to be productive and inexpensive? 1. Internet websites 2. Advertisements in professional journals 3. Employee referrals 4. Job fairs

A new nurse manager asks to see the Joint Commission manual in order to determine adequate staffing for the next shift. How should the supervisor respond to this request? 1. "The Joint Commission manual is kept with the other unit manuals." 2. "For that information you will need to refer to the human resources department's policy on employment manual." 3. "You need to look at the policy and procedure manual for the organization, not the Joint Commission manual." 4. "Before you look any further, refer to the unit's current schedule."

A new nurse manager has conducted a series of interviews, but did not use an interview guide. Why would the manager's director be dismayed that no interview guide was used? 1. Each organization has standardized interview questions that must be used. 2. The director has selected questions to ask the interviewee. 3. A list of standardized questions allows for reliability in comparing candidates. 4. The director was not included in the interview process.

A newly licensed nurse is concerned about the legal aspects of delegation. What is the most important question for the nurse to consider prior to delegating a task? 1. Do other nurses in the facility delegate similar tasks? 2. How long has the assistant worked at the facility? 3. Does this task involve nursing judgment? 4. How busy is the delegate?

A newly licensed nurse received specific knowledge of management skills while in nursing school. What does the nurse need now? 1. Nothing until the nurse has acquired enough bedside experience to become a manager 2. Time to see how these skills will be needed in the future 3. A manager who can help with skills transfer from school to work 4. A job working as a manager in a small hospital

A newly promoted nurse manager is fearful that previous coworkers will undermine her efforts to succeed in this new position. The new manager does not share information with these coworkers even though they may need the information to understand changes that are going to occur in the organization. Which emotional intelligence self-management competency is this nurse most clearly violating? 1. Adaptability 2. Initiative 3. Transparency 4. Optimism

A nurse educator is asked by the chairperson of the department to submit a list of equipment that could be used to meet the department's goals. The list includes projectors, computers, office supplies, and computer-assisted programs. How would the educator categorize the materials? 1. As an expense 2. As part of revenue 3. As part of the capital budget 4. As part of the operating budget

A nurse has a longstanding conflict with another nurse working the same shift. Over the last few days the first nurse has made an effort to smooth over the conflict. Which statement would the nurse manager evaluate as an example of a "smoothing" comment? 1. "We are never going to agree because I am from Generation X and you are a baby boomer." 2. "I'm tired of this fight and I'm not going to argue with you anymore." 3. "Even though we don't agree on much, I do think you are correct about enforcing the length of lunch breaks." 4. "I think everything is fine and that we can get along."

A nurse has a longstanding conflict with another nurse working the same shift. Over the last few days, the first nurse has made an effort to smooth over the conflict. Which statement would the nurse manager evaluate as an example of a "smoothing" comment? 1. "We are never going to agree because I am from Generation X and you are a Baby Boomer." 2. "I'm tired of this fight, and I'm not going to argue with you anymore." 3. "Even though we don't agree on much, I do think you are correct about enforcing the length of lunch breaks." 4. "I think everything is fine and that we can get along."

A nurse has been invited to discuss health care costs at a senior citizens' club. What information should the nurse plan to include in this discussion? 1. While health care costs continue to rise, the percentage of the U.S. economy spent on health care has slowly declined to less than 12%. 2. Regulations brought about by the Patient Protection and Affordable Care Act (PPACA) should bring financial relief to health care consumers. 3. The United States spends more money on health care than any other country. 4. Health care spending in the United States is slowly declining due to passage of bills such as the Patient Protection and Affordable Care Act (PPACA).

A nurse manager is trying to educate the staff regarding efficiency and how it affects the unit's costs. Strategies to increase efficiency could include which of the following? 1. Increasing the number of unlicensed assistants providing direct nursing care 2. Limiting dressing supplies on the nursing unit 3. Labeling the cost of each item in the clean supply closet 4. Eliminating staff education sessions

A nurse manager is trying to manage a conflict between a staff nurse and a medical student. Which statement by the manager would the nursing supervisor interpret as following the rules of basic mediation? 1. "Both parties need to grow up. They are so immature." 2. "The problem is partially the fault of both parties." 3. "I stopped the conversation frequently to have the parties summarize what was being said." 4. "They just went on and on. I had to stop the discussion because I was out of time."

A nursing curriculum includes integrated content on critical thinking. Which statement reflects movement toward designing the curriculum to meet Carnegie Foundation recommendations? 1. "We must find ways to increase our emphasis on critical thinking." 2. "The curriculum must focus on ways nurses can quickly and accurately acquire information." 3. "Our emphasis must change to improving students' clinical reasoning skills." 4. "Our clinical practicums must be graded separately from our theory presentations."

A nursing executive is comparing the entire hospital financials for the month and notes that the medical laboratory's revenue is higher than environmental services. What is a possible explanation? 1. The laboratory has increased charges for its services. 2. Environmental services is a non-revenue-producing cost center. 3. The laboratory is a non-revenue-producing cost center. 4. The nursing units affect the laboratory charges.

A registered nurse is dissatisfied with the wages and health benefits available in his current position and decides to seek other employment. This employee's frustration is most linked to which motivational theory? 1. Reinforcement theory 2. Process theory 3. Content theory 4. Equity theory

A staff nurse asks the nurse manager, "What assignment are you delegating to me today? I would like to begin to organize my day before shift report begins." What is the error inherent in this statement? 1. There is no way for the nurse to know how to organize until the assignment is clear. 2. The nurse manager would not make assignments. 3. The nurse manager is not delegating but rather making daily assignments. 4. Assignment occurs after shift report.

A successful nurse manager is mentoring a newly promoted nurse manager. Which comment by the mentor reflects the most important consideration of all nurse managers? 1. "You must work to develop your staff's competencies." 2. "Take your role on the strategic planning committee very seriously." 3. "Your most important role is to ensure client care accountability." 4. "Fiscal resource management is the most important aspect of your job."

A unit requires a great deal of staffing flexibility. To fill this need, the manager should use which strategy? 1. Maximizing the availability of nursing staff 2. Good communication among staff 3. A high RN-skill mix 4. Overlap between shifts

After several near-incidents during procedures, the nurse manager is increasingly concerned about how nursing staff communicates with physician staff. Which advice from the manager would be most beneficial to the nursing staff? 1. "Don't forget, you are just as good as they are." 2. "Physicians just don't listen as well as nurses." 3. "Let's review the steps of the procedures that we know are the biggest problems." 4. "I'm going to listen to the physicians, but I think most of the problem lies with them, not the nurses."

After several near-incidents during procedures, the nurse manager is increasingly concerned about how nursing staff members communicate with physician staff. Which advice from the manager would be most beneficial to the nursing staff? 1. "Don't forget, you are just as good as they are." 2. "Physicians just don't listen as well as nurses." 3. "Let's review the steps of the procedures that we know are the biggest problems." 4. "I'm going to listen to the physicians, but I think most of the problem is with the physicians, not the nurses."

After the second week of orientation the new nurse witnesses the death of a child in the ED. Which role should this nurse's preceptor focus on at this time? 1. Orientation of the nurse to protocols associated with this death 2. Socialization of the nurse to the staff 3. Counseling the new nurse 4. Serving as a role model

An emergency department manager is looking over the next month's schedule and decides to supplement the schedule due to vacations. The manager decides to use decentralized pool staffing to lower costs and provide quality care. Which group of nurses is a part of this manager's decentralized staffing? 1. PRN staff from the external pool of nurses 2. Agency nurses 3. PRN staff from the emergency department nurses 4. PRN staff from the nurses who work on medical-surgical units

As a member of the budgeting committee, the nurse manager reviews the salaries for file clerks in the accounting department. These salaries should be included in which budget item? 1. The fixed cost 2. The variable cost 3. The indirect cost 4. The direct cost

As a result of retirements, resignations, and reorganization, a nurse became nurse manager of a high-acuity unit 3 months after being licensed. The manager struggles with the responsibilities of the position and is often unable to make decisions. Which component of the AONE management competencies does this nurse probably lack? 1. Foundational thinking skills 2. Personal and professional accountability 3. Clinical practice knowledge 4. Effective communication skills

At a strategic planning meeting the nurse executive recommends instituting patient-centered care as a model of care delivery in the hospital. Which statement by the hospital CEO indicates understanding of this concept? 1. "We have always had the patient at the center of everything we do." 2. "We can't afford to hire more RNs." 3. "I'm concerned about the increased time and leadership our nurse managers will have to provide." 4. "I like the idea of centralizing all our care."

At the beginning of a brainstorming session, the manager lists the rules to be followed. Which rule should be included and enforced? 1. Do not suggest any solution that is prohibitively expensive. 2. Suggest only ideas that the group has not already tried. 3. Do not critique any ideas presented. 4. Limit the session to the first 15 ideas.

Computerized charting will be initiated on select units of the hospital. Orientation to this new system will be provided to each nurse by a team of nurses educated in nursing informatics. This is an example of which type of change strategy? 1. Normative-reeducative strategies 2. Lippitt's phases 3. Empirical-rational model 4. Power-coercive strategies

During a discussion of how to proceed on a project, a team member says, "I don't care how we do it. Just tell me what to do and I will get it done." What kind of followership is this nurse exhibiting? 1. Passive 2. Active 3. Dependent 4. Independent

During a job interview the nurse manager asks, "What are your short-term goals?" Which statement by the applicant addresses this question? 1. "I want to become a nurse anesthetist within 10 years." 2. "I will be available to come in for extra shifts if needed." 3. "My brother and I want to go to on a mission trip in the next year." 4. "I want to get this job so I can move on to the next part of my life."

During an interview, the manager has a strong impression that the applicant is a good "fit" for the position. How should the manager proceed? 1. Offer the applicant the job. 2. Cancel the remaining interviews for the position. 3. Keep this feeling in mind but do not make a hasty decision. 4. Tell the applicant that he or she is the strongest candidate for the position.

For the nurse to effectively and legally delegate, which document must be consulted and followed to reduce the likelihood of liability? 1. The American Nurses Association Bylaws 2. The National Council of State Boards of Nursing 3. The regulations of the state nurse practice acts 4. The rules of the governing specialty organization

Hospital administration has elected to use TeamSTEPPS as a method of team building. What should the nurse manager tell staff about this training? 1. "This program was developed by a nurse to use specifically in small hospitals." 2. "Teams of nurses will be sent to national training seminars." 3. "You can expect additional efforts to help us keep on track." 4. "This is a simulation-based training similar to the old disaster drills we used to do."

Hospital administration is working with a university school of nursing to establish a nursing residency program. Why is this a desired action? 1. A residency program eliminates the hospital's liability if a novice nurse makes an error. 2. A residency program is established to make nursing education more like physician education. 3. The Institute of Medicine (IOM) has proposed residency programs for nurses. 4. A residency program ensures that nurses participate in lifelong learning.

Hospital administration is working with a university school of nursing to establish a nursing residency program. Why is this a desired action? 1. A residency program eliminates the hospital's liability if a novice nurse makes an error. 2. A residency program is established to make nursing education more like physician education. 3. The Institute of Medicine has proposed residency programs for nurses. 4. A residency program ensures that nurses participate in lifelong learning.

Immediately following a barium swallow, a client noticed hives and a feeling of shortness of breath. Although there were no known allergies to food or drugs prior to this incident, the diagnosis was allergic reaction to the preservatives in the barium. Which is the correct risk category for this incident? 1. Medication error 2. Medical-legal incident 3. Procedure complication 4. This incident does not fall into a risk category.

Immediately following a barium swallow, a client noticed hives and a feeling of shortness of breath. Although there were no known allergies to food or drugs prior to this incident, the diagnosis was an allergic reaction to the preservatives in the barium. Which is the correct risk category for this incident? 1. Medication error 2. Medical-legal incident 3. Procedure complication 4. This incident does not fall into a risk category.

In order to organize services needed to achieve specific client outcomes, hospital administrators should consider what type of client care delivery system? 1. Functional nursing 2. Differentiated practice 3. Case management 4. Primary nursing

On two recent occasions, the experienced nurse manager has found it nearly impossible to discuss upcoming events with all the staff on the unit. What is a common reason for this problem? 1. The hospital is experiencing a nursing shortage, so staff members are very busy. 2. The client mix on the unit is much more varied. 3. The unit has just adopted combined staffing patterns. 4. There is a 1-hour overlap of staff between shifts.

The CEO of the hospital approaches the chief nurse with a request that the nurse act as the primary change agent in the implementation of a new hospital-wide policy. Why would the nurse be a good choice for this assignment? 1. Nurses thrive on transition and work best in such circumstances. 2. Nurses are role models for reacting positively to change. 3. Nurses routinely interact with multiple disciplines. 4. Nurses are always acting in the client's best interest.

The Institute of Medicine (IOM) report on the Future of Nursing states which of the following? 1. Society must promote rights for nurses. 2. The view of nursing should be positive and realistic. 3. Nurses need to be permitted to use their educational skills in the healthcare environment. 4. Nursing should be advanced in the interest of the public.

The RN receives reports on eight clients in the morning. Client assignments are then delegated to an LPN and two nursing assistants. The morning is busy, with physician visits and new client orders, and the RN communicates these new orders to the LPN and nursing assistants. The RN also meets with the case manager to discuss nursing home placement for a client. What type of nursing care delivery system is in place in this hospital? 1. Critical pathways 2. Total patient care 3. Team nursing 4. Functional nursing

The RN working on an orthopedic unit is caring for a postoperative client with a hip replacement who is not transferring well from bed to chair. The client is behind on the mobility training program. What action is the nurse's priority? 1. Instruct physical therapy to increase treatments to four times daily. 2. Contact the family to discuss preoperative mobility problems. 3. Inform the case manager of variance in the critical pathway. 4. Discuss the problem with the client's surgeon.

The State Board of Health requests the employee file of all agency nurses employed within the past year. At the end of the review, the organization receives a sanction associated with these nurses. What is the most likely cause of this sanction? 1. No current address on file for the nurse 2. Past employment history not documented in file 3. Evaluation of the nurse's performance missing from file 4. No documentation of past certifications in file

The chief nurse officer (CNO) receives a call that the candidate for a nurse opening has arrived, but that the unit manager who was to have interviewed the candidate had to work an unscheduled night shift and is unavailable. Which action by the CNO is appropriate? 1. Inform the candidate the interview will have to be rescheduled. 2. Have the HR department refer the candidate to a nurse on the unit. 3. The CNO should conduct an initial interview and arrange for a second interview with the manager. 4. The CNO should call the manager and conduct an interview via a conference call.

The group leader often arrives several minutes late to meetings with excuses about workload, telephone calls, or traffic. Today's meeting was scheduled to begin 5 minutes ago and the leader has not arrived. What should the group members do? 1. Call the leader's cell phone to see when arrival is expected. 2. Wait until the leader is 10 minutes late and then cancel the meeting. 3. One of the members should start the meeting. 4. Wait for the leader to arrive.

The hospital is opening its first intensive care unit. The nurse executive should plan to staff this unit according to which model of care? 1. Functional nursing 2. Team nursing 3. Total patient care 4. Modular nursing

The nurse asks the nurse manager if he can go home early because the census is low. When the request is denied, the nurse states, "I don't understand why I can't leave early. I will use vacation time and this will help minimize personnel costs for the shift." This statement is an example of which technique of influencing the supervisor? 1. Fogging 2. Negative assertion 3. Negative inquiry 4. Compromise

The nurse asks the nurse manager if he can go home early because the census is low. When the request is denied, the nurse states, "I don't understand why I can't leave early. I will use vacation time, and this will help minimize personnel costs for the shift." This statement is an example of which technique of influencing the supervisor? 1. Fogging 2. Negative assertion 3. Negative inquiry 4. Compromise

The nurse is trying to understand why it has taken so long for electronic health records (EHRs) to be used in health care. Which statement is a reason for this delay? 1. Medical-records professionals do not like these records. 2. The use of these records is more expensive than the use of paper records. 3. There have been concerns about privacy and confidentiality. 4. The transition to EHRs is time consuming and tedious.

The nurse is working on a unit with a blame-free environment and makes an error that puts a client at risk. What should the nurse do first? 1. Discuss it with the other nurses on duty. 2. Immediately report the incident to the supervisor. 3. Ensure the client's safety as fully as possible. 4. Say nothing as no one saw the incident.

The nurse manager generally uses a stepwise method to arrive at decisions that are logical and that serve to maximize the achievement of the desired objective. Which decision-making model does this manager use? 1. Political decision-making model 2. Experimentation process 3. Rational decision-making model 4. Trial-and-error method

The nurse manager has decided to use evidence-based practice (EBP) to solve an issue and has called staff nurses together for input. Which question, as posed by the manager, reflects the first step of the EBP process? 1. "What outcomes are we expecting from this work?" 2. "Is anyone prepared to evaluate the statistics we will find?" 3. "What is the exact clinical issue with which we are dealing?" 4. "Where can we look for information?"

The nurse manager has established a program that recognizes a different staff member each month for contributions to client care. As a result, overall staff productivity and the number of client compliments have increased. This is an example of which concept of organizational theory? 1. Span of control 2. Line authority 3. Hawthorne effect 4. Adhocracy

The nurse manager has instituted a policy of sending information to the staff in emails. Many misunderstandings have occurred since this policy was implemented. What technique should the manager use to reduce this miscommunication? 1. Use text messaging instead of email. 2. Require a return email from everyone reading the information. 3. Be certain that emails go only to the intended recipients. 4. Send all emails with a message line that says "Important."

The nurse manager has instituted a policy of sending information to the staff via e-mail. Many misunderstandings have occurred since this policy was implemented. What technique should the manager use to reduce this miscommunication? 1. Using text messaging instead of e-mailing 2. Requiring a return e-mail from everyone reading the information 3. Being certain that e-mails go only to the intended recipients 4. Sending all e-mails with a message line that says "Important"

The nurse manager has several tasks that need to be accomplished. Which task is the manager likely to do first? 1. A large job that holds little interest to the manager 2. A difficult task that is going to require several days to complete 3. A task that has been assigned by the supervisor instead of a task that the manager thinks will benefit the unit 4. A task that will have little impact on the unit

The nurse manager is concerned about the apparent lack of staff motivation to improve client care on a unit. How should this manager use motivational theories to help improve this situation? 1. Choose one theory that the manager thinks best suits the situation. 2. Review several theories but use no more than two. 3. Combine theories to develop a plan for this specific unit.

The nurse manager is facing resistance to change from many staff nurses. Why should the manager work hard to address this resistance? 1. Resistance will keep the change from occurring at all. 2. Resistance from the late majority can keep others from accepting the change. 3. Resistance can negatively impact future client care. 4. Resistance allows others to take power from managers.

The nurse manager tells a newly licensed nurse that having a mentor is a benefit to career development. What should the new nurse expect from a mentor-protégé relationship? 1. The protégé will select the mentor. 2. Once established, this relationship lasts forever. 3. The relationship will develop through stages. 4. Mentors are generally of the opposite gender as the protégé.

The nurse manager tells the staff that this year's budget numbers will not change, even if census drops over the rest of the year. How should the staff interpret this information? 1. The budget is a fixed one. 2. The hospital uses incremental budgets. 3. The hospital uses a variable budget. 4. The hospital starts the budgeting process with a zero-based budget.

The nursing group has been charged with the task of solving a patient care problem on the unit. Which step should this group take first in this process? 1. Investigate what has already been tried to solve the issue. 2. Brainstorm about potential solutions. 3. Gather information to define the problem. 4. Categorize information in order of reliability.

The staff development nurse has elected to use coaching as a staff development technique. Which situation is an example of this technique? 1. Pairing a newly licensed nurse with a nurse who has worked on the unit for 5 years 2. Matching a newly hired male nurse with a newly hired female nurse 3. Pairing a nurse with conflict management experience with an employee who has expressed dissatisfaction with the job 4. Matching nurses who have similar educational and cultural backgrounds when selecting participants for an educational offering

The staff nurse has been appointed to a task force. What can the nurse expect regarding this group? 1. There will be no official leader for the group. 2. The nurse will be working with people from several different departments within the hospital. 3. The assignment will be time limited. 4. The group members will compete for resources for their own units.

What action is necessary by a delegate accepting delegation? 1. Accept all aspects of the task delegated. 2. Assume the delegator will serve as a mentor. 3. Clarify the time line and expectations. 4. Realize the delegate and delegator share responsibility.

What is the most common skill shared by effective nurse leaders in leadership theories or models? 1. Critical care experience 2. Political knowledge 3. Communication 4. Informal power

Which action by the nurse manager is a demonstration of satisficing? 1. The nurse manager works with the staffing schedule until all requested days off are honored. 2. The nurse manager reposts a job opening because no applicants were a good fit for the current unit staff. 3. The nurse manager agrees with a proposed budget that does not provide badly needed new client beds. 4. The nurse manager insists on firing a nurse who is chronically late to work.

Which data would be of most interest to an organization using Lean Six Sigma as a means of quality improvement? 1. Almost 85% of call lights are answered within 4 minutes. 2. Results of pain medication administration are documented 95% of the time. 3. Nursing overtime hours increased by 25% in the last quarter. 4. In the last 6 months, overall client satisfaction scores have increased by 15%.

Which data would be of most interest to an organization using Lean Six Sigma as a means of quality improvement? 1. Eighty-five percent of call lights are answered within 4 minutes. 2. Results of pain medication administration are documented 95 percent of the time. 3. Nursing overtime hours increased by 25 percent in the last quarter. 4. In the last 6 months, overall client satisfaction scores have increased by 15 percent.

Which example represents a qualifier that may interfere with the message to be communicated? 1. "Please notify me when this task is complete." 2. "Are you satisfied with the care you are receiving?" 3. "I hate to bother you with this, but we have a problem." 4. "How can I help you solve your issues with this physician?"

Which group determines the level of nursing care and hours of care necessary to meet the needs of the hospitalized client? 1. American Nurses Association (ANA) 2. The Joint Commission 3. Nurse managers 4. Hospital administrators

Which is the most important reason that practicing and mastering effective delegation skills is essential for nurses? 1. Higher job satisfaction 2. Greater confidence in skills 3. Higher client satisfaction 4. Increased time for other tasks

Which nursing care delivery situation best reflects the concept of a clinical microsystem? 1. A rural free clinic housed in a church gymnasium that is staffed by volunteer nurses and physicians 2. A walk-in clinic in a local discount store that is staffed by a nurse practitioner 3. An inpatient burn unit 4. A general medical-surgical unit in a midsized hospital

Which part of Six Sigma is vastly different from other quality management programs? 1. Six Sigma has a client focus. 2. Data drive the program. 3. Failure is tolerated. 4. Management is proactive.

Which situation is an example of reverse delegation? 1. The nurse manager asks the staff nurse to attend an in-service on a new product. 2. The nursing supervisor asks the nurse manager to attend a meeting with the physicians. 3. The licensed practical nurse asks the nurse manager to administer insulin to a client. 4. The staff nurse asks the licensed practical nurse to record intake and output in his client's charts.

Which situation is an example of reverse delegation? 1. The nurse manager asks the staff nurse to attend an in-service on a new product. 2. The nursing supervisor asks the nurse manager to attend a meeting with the physicians. 3. The licensed practical nurse asks the nurse manager to administer insulin to her client. 4. The staff nurse asks the licensed practical nurse to record intake and output in his client's charts.

Which situation represents an obstacle to delegation? 1. Most of the nursing staff deliver highly skilled care 2. The entire organization has a team-centered culture 3. There is a budget shortfall for the current fiscal year 4. Each employee knows and executes job responsibilities

Which situation represents an obstacle to delegation? 1. Most of the nursing staff deliver highly skilled care. 2. The entire organization has a team-centered culture. 3. There is a budget shortfall for the current fiscal year. 4. Each employee knows and executes job responsibilities.

Which statement made by the nurse manager is an example of the first step of delegation? 1. "I must choose a person with good time management skills to be the delegate for this task." 2. "I plan to evaluate the outcomes of your work in 6 months." 3. "I am going to delegate the responsibility for creating the vacation schedule." 4. "I have some additional information that will help you in this task."

Which statement made by the nurse manager is an example of the first step of delegation? 1. "I must choose a person with good time management skills to be the delegate for this task." 2. "I plan to evaluate the outcomes of your work in 6 months." 3. "I am going to delegate the responsibility of creating the vacation schedule." 4. "I have some additional information that will help you in this task."

Which statement may reveal that the team member making the comment has a hidden agenda? 1. "I don't understand the second of the goals we are discussing." 2. "Are we voting on this outcome or has it already been decided?" 3. "I have to remember to add membership on the team to my resume." 4. "Are there other teams working on similar projects on other units in the hospital?"

Which statement reveals the most dangerous result of using measured standards as part of the CQI process? 1. A nurse complains, "Collecting this data takes so much time." 2. A radiology technician says, "CQI is lots of work." 3. A nurse manager says, "I'm not going to change this process, because I'd have to change the CQI monitors." 4. The laboratory technician says, "Writing these CQI reports is boring."

A client needs a high-risk surgical procedure. According to the Leapfrog Group, the client should choose which hospital for care during this procedure? 1. The hospital closest to the client's home 2. The hospital that has done the greatest number of these surgeries in the last two years 3. The hospital chosen by the client's primary care physician 4. The hospital with the highest performance ratings for this procedure

A client's spouse is concerned about the cost of hospitalization. The nurse says, "Because your spouse is on Medicare, the hospital will be paid according to the DRG." What does the nurse mean by this statement? 1. Medicare will pay the total cost for the care provided. 2. Medicare will pay an average of the total costs. 3. Medicare will pay based on the usual cost of the treatments provided. 4. Medicare will pay based on a set amount for the specific condition for which the client was hospitalized.

A community hospital has been purchased by a large health care conglomerate. Nursing administration has the task of changing the nursing practice model that has been followed for 50 years. To best achieve this change, administration should appoint a nurse executive whose leadership style follows which theory? 1. Contingency theory 2. Quantum leadership 3. Transactional leadership 4. Transformational leadership

The newly licensed nurse is delighted to have been hired at a Magnet hospital and says, "They even assigned me a mentor." What is erroneous about this statement? 1. Magnet hospitals do not hire new graduates. 2. Magnet hospitals do not use mentor programs. 3. Mentors are only assigned to experienced nurses. 4. Preceptors are assigned; mentors choose protégés.

A group of nurses has been convened to solve a problem. As the first step in this process, the group leader asks for a definition of the problem to be solved. Which statement reflects the best problem statement? 1. Emergency department nurses do not make professional client handoff reports. 2. Long-term care facility nurses lack the education to make complete assessments prior to client transfers. 3. Housekeepers are getting sloppy about cleaning rooms. 4. Unit clerks have made 10 transcription errors in the last 6 months.

A hospital is concerned about low customer satisfaction ratings and poor evaluation on quality indicators. The nurse managers are asked to implement a nursing delivery system that is cost-effective and improves both customer satisfaction and quality of care. Which nursing delivery system should the managers implement? 1. Total patient care 2. Functional nursing 3. Team nursing 4. Patient-centered nursing

A medical unit nurse manager is conducting an interview of a potential employee. Which strategy should the manager use? 1. Document first impressions of the applicant. 2. Review the résumé during the interview. 3. Use closed questions to elicit more information. 4. Use work sample questions to determine knowledge.

A new IV pump has just been purchased by the facility. Which statement by the nurse manager reflects Rogers' first step in making the change to this new equipment? 1. "The nursing staff will have the final decision on whether to change to this IV pump." 2. "Before we make the final decision, we will do a 3-month 'test run' of the equipment to make sure we like it." 3. "I have looked at the pump and I like it." 4. "I have information to share with you about the new IV pump we are considering for the unit."

A new IV pump has just been purchased by the facility. Which statement by the nurse manager reflects Rogers' first step in making the change to this new equipment? 1. "The nursing staff will have the final decision on whether to change to this IV pump." 2. "Before we make the final decision, we will do a three-month 'test run' of the equipment to make sure we like it." 3. "I have looked at the pump and I like it." 4. "I have information to share with you about the new IV pump we are considering for the unit."

A new graduate nurse is preparing for an interview by the nurse recruiter. The applicant should be ready to be asked questions about which topic? 1. General state of health 2. Availability of transportation to work 3. Previous military service 4. Willingness to work all shifts

A newly licensed RN is beginning a job search. This nurse would be best served by working in an organization that provides which nursing care delivery system? 1. Primary nursing 2. Total nursing care 3. Functional nursing 4. Practice partnerships

A nurse is working in a unit with several less-experienced nurses. Which attribute displayed by the senior nurse would make her leadership of the less-experienced nurses most effective? 1. Strong belief that the leader is accountable for actions taken by those working on the unit 2. Authority to carry out actions necessary to move the work of unit staff forward 3. Efficiency in actions and in words 4. Ability to inspire the others to commit to the team's goals

A nurse manager encourages nursing staff members to assist in developing a new creative staffing pattern that can respond quickly when staff resign or go back to school. This is an example of the use of which organizational theory? 1. Contingency theory 2. Closed-systems theory 3. Classical theory 4. Chaos theory

A nurse manager has identified that a major time waster is the amount of time spent on the telephone each day. Which strategy would help reduce this time? 1. Answer the phone, "Hello, how are you?" 2. Send all calls to voice mail. 3. Use e-mail for potentially troublesome issues. 4. Set a specific block of time to return calls.

A nurse manager has planned orientation activities for a new registered nurse. The new nurse is required to observe shift report and UAP delegation for a week. Then the new nurse is required to take shift report and delegate UAP assignments for a week. What is the rationale for making this orientation assignment? 1. Delegation is not taught at all nursing schools. 2. Shift report differs in all hospitals. 3. Shift report and UAP delegation are minimal tasks and good for novice nurses. 4. The manager should focus on those skills specific to the new nurse's role.

A nurse manager needs to supplement the staff for the next schedule. Which option would be the most significant drain on the unit's staffing budget? 1. PRN nurse 2. Internal float nurse 3. Part-time nurse 4. Agency nurse

A nurse manager tells the human resources (HR) director, "I would really like to hire someone of another race to balance out the team." The HR director tells the manager recruiting and hiring based on race is in violation of which statute? 1. The Equal Pay Act of 1963 2. Age Discrimination Act 3. Americans with Disabilities Act 4. Title VII of the Civil Rights Act

A nurse manager's week is filled with handling routine and repetitive issues. Which strategy should the manager employ to make handling these tasks most effective and efficient? 1. Ask those involved to leave voice mail messages about any routine matter. 2. Encourage those involved in routine matters to call between 10:00 a.m. and 12:00 p.m. each day. 3. Keep the office door open to be accessible to those dealing with these routine tasks. 4. Hold a meeting each week especially for dealing with routine and nonurgent matters.

A nurse practitioner and a physician have opened an office together. The nurse regularly collaborates with the physician in client care and is a general partner in the business of the office. This is an example of which diversification method? 1. Concentric diversification 2. Conglomerate diversification 3. Capitation 4. Joint venture

A nurse says, "I am always worried that I will be liable if someone I delegate a task to does something that hurts the client." What is the manager's best response to this concern? 1. "You have lots of liability in your position as an RN." 2. "The hospital will support you as long as you follow your job description." 3. "You are at greater liability if you try to do everything yourself." 4. "As long as you follow the five rights of delegation, your liability is minimal."

A staff nurse has experienced disagreements with one of the medical residents about several issues. The resident reacts to this conflict by belittling the nurse in front of colleagues. This behavior is most characteristic of which type of conflict? 1. Competitive 2. Role 3. Perceived 4. Disruptive

An experienced nurse often answers less experienced nurses' questions about client care and teaches hemodynamics during orientation to the unit. The nurse has also participated in research into hemodynamic monitoring of ICU clients. Which clinical ladder designation does this nurse best exemplify? 1. Clinical colleague 2. Clinical mentor 3. Clinical leader 4. Clinical expert

An inexperienced speaker is practicing delivering a speech. Which statement indicates a lack of understanding about how easily communication is distorted? 1. "I know I can better connect with my audience with good eye contact." 2. "If I repeat a complicated section in another way, comprehension is improved." 3. "If I know the background of the audience, it can help with tailoring the content." 4. "The topic is not complicated, so I don't have to worry about misunderstanding."

An inexperienced speaker is practicing the delivery of a speech. Which statement indicates a lack of understanding about how easily communication is distorted? 1. "I know I can better connect with my audience with good eye contact." 2. "If I repeat a complicated section in another way, comprehension is improved." 3. "If I know the background of the audience, it can help with tailoring the content." 4. "The topic is not complicated, so I don't have to worry about misunderstanding."

As a result of the Affordable Care Act, healthcare organizations are paid for the ________ of their care. 1. quality 2. time used 3. amount 4. value

During the first meeting of a newly created task force, the nurse manager notices that individuals tend to cluster with members of their specific nursing units. The nurse manager begins the meeting with an explanation of the focus of the group. These behaviors are characteristic of which stage of Homans's group process? 1. Norming 2. Storming 3. Performing 4. Forming

During the first meeting of a newly created task force, the nurse manager notices that individuals tend to cluster with members of their specific nursing units. The nurse manager begins the meeting with an explanation of the focus of this group. These behaviors are characteristic of which stage of Homans's group process? 1. Norming 2. Storming 3. Performing 4. Forming

For the last several weeks, the nurse manager has felt as if there is not enough time in the day to accomplish all the required tasks. The manager goes home exhausted and does not look forward to going to work in the morning. What strategy may help alleviate some of this stress? 1. Do tasks as quickly as possible. 2. Hurry through work, hoping someone else will catch any mistakes that are made. 3. Do not start any new tasks after lunch. 4. Pick a simple task and complete it just before going home each day.

In order to come to a solution for an ongoing conflict among several nursing units, the nursing supervisor says, "Your managers will meet to create a voting form representing both sides of this issue. Each of you will vote and the majority will rule." What kind of a solution is the supervisor seeking? 1. Consensus 2. Win-win 3. Forcing 4. Win-lose

In which situation should the nurse be most concerned that communication was distorted? 1. The nurse obtains an admission history from the parents of an adopted child. 2. The nurse gives discharge instructions to a couple in their early 80s. 3. The nurse manager hires a new nurse originally from the Philippines. 4. The emergency nurse receives a client who was transferred via ambulance for confusion.

In which situation should the nurse be most concerned that communication was distorted? 1. The nurse obtains an admission history from the parents of an adopted child. 2. The nurse gives discharge instructions to a couple in their early 80s. 3. The nurse manager hires a new nurse originally from the Philippines. 4. The emergency nurse receives a confused client who was transferred in an ambulance.

In which situation would a "meeting before the meeting" be advisable? 1. The nurse is managing a standing committee on the unit. 2. The nurse is meeting with a social group to establish a plan for weight loss by walking. 3. The nurse has written information to distribute to members before the meeting. 4. The nurse expects the disagreement that started in the last meeting to carry over into this meeting.

The OB manager is looking at staffing for the night shift. The postpartum unit is busy and the labor-delivery unit has four clients in labor. The manager collects data from the nursing staff regarding the acuity of their clients. These data assist the manager in determining the staff for the next shift. This is an example of which type of system? 1. Demand management 2. Block scheduling 3. Organizational related 4. Client classification

The health care institution has organized a committee to review and revise the strategic plan. As part of this work, committee members have been asked to submit a philosophy statement for consideration. Which statement meets the requirements of a philosophy? 1. "We will increase client satisfaction by 15 percent." 2. "We will increase productivity by 10 percent on the surgical floor." 3. "We believe in honest communication." 4. "We believe clients are most important."

The leader of the task force group announces that tentative plans for Nurses' Week activities have been approved by the hospital administration. The task force has also been given a new task of developing criteria for the nursing awards. What must the group accomplish now? 1. Forming 2. Adjourning 3. Rebuilding 4. Re-forming

The medical-surgical unit is at capacity and the clients have a high acuity, requiring care such as turning, bathing, toileting, and feeding. Which level of supplementary staff would be cost-effective? 1. Additional RNs 2. Additional unit clerks 3. Additional licensed practical nurses 4. Additional unlicensed assistive personnel

The mother of a staff nurse is critically ill and the nurse must miss several shifts of work. If the leadership style of the nursing manager is transactional, which approach to covering these shifts is most likely? 1. "I have made out a schedule of who will work to cover these shifts." 2. "I can work an extra shift tomorrow night. Who can cover tonight?" 3. "How can we work together to cover these shifts to help our coworker?" 4. "If you work overtime tonight I will authorize double your hourly pay rate."

The novice nurse manager is acting in the role of change agent for the unit. Which statement indicates that this manager needs further training in regard to change? 1. "I must not get so bogged down in details that I lose focus on the ultimate goal." 2. "As we go through this process, I think I need to be flexible but persistent." 3. "Those who are resistant will probably accept it sooner or later with my support." 4. "I think the implementation will go much better if I stay available the whole time."

The novice nurse manager is hesitant to delegate tasks to competent, experienced staff nurses. Fear of which factor is most likely to explain this hesitancy? 1. Overburdening others 2. Decreased personal satisfaction 3. Increased liability 4. Competition and criticism

The nurse and a client are discussing instructions for self-care after discharge. The client's husband says, "I can't take care of her by myself. We need home health like we had before she came to the hospital." This statement reflects which antecedent condition? 1. Task interdependence 2. Resource competition 3. Structural conflict 4. Differences in values and beliefs

The nurse has been concentrating on improving personal communication skills. Which option represents the final step in this nurse's work to improve communication? 1. Think about the goals of the communication. 2. Develop an appropriate and thoughtful response. 3. Decide how to say what you want conveyed. 4. Ensure the communication is understood.

The nurse has determined that in order to provide the highest quality care it is important to become more creative. What is the most effective way for the nurse to increase creativity? 1. Watch others implement creative solutions. 2. Work with a group to implement a creative solution. 3. Evaluate the effectiveness of creative solutions. 4. Practice the steps of the process as often as possible.

The nurse has set a goal of becoming a clinical nurse leader (CNL). What actions should this nurse plan to reach this goal? 1. Obtain experience as a nurse manager. 2. Learn as much as possible about the hospital's organization. 3. Take a class in hospital administration. 4. Return to school to obtain a master's degree.

The nurse manager has been asked to assemble several groups to work on tasks to improve the unit's performance and client satisfaction scores. This manager would put the fewest people in a group working on which type of task? 1. Additive 2. Disjunctive 3. Divisible 4. Conjunctive

The nurse manager has identified physical assessment skills lacking in a new registered nurse. Using goal-setting theory, which statement by the manager would be the most effective in enhancing the nurse's assessment skills? 1. "You need to work on your health assessment skills before your next employee evaluation." 2. "Get someone to help you with your health assessment skills by the end of the month." 3. "Read a health assessment book and practice your skills." 4. "Plan to study one body system a week and demonstrate your assessment skills to me every week."

The nurse manager has scheduled a series of meetings with employees to solve a unit problem. The manager purposefully created a two-week gap in the meetings to allow which portion of the creative process to occur? 1. Farsight 2. Verification 3. Preparation 4. Incubation

The nurse manager holds a regular Wednesday meeting with the charge nurses on the unit. There is no new information to discuss this Wednesday. What should the manager do? 1. Hold the meeting so that the charge nurses do not feel that the meetings are not important. 2. Hold the meeting, but only meet for 10 minutes instead of the usual 60 minutes. 3. Reschedule the meeting for Thursday. 4. Cancel the meeting.

The nurse manager is calculating the cost of offering two bonus incentives to nursing staff for covering call-ins for sickness. After reviewing the statistics, the manager finds that option A is more cost-effective than option B but decides to implement option B because it seems safer. Which option best describes the basis of this decision? 1. Probability 2. Probability analysis 3. Objective probability 4. Subjective probability

The nurse manager is concerned about a family member's complaint regarding the professional behavior of a nurse on the unit. Which is the most effective method to address this issue? 1. Post a memo to the nursing staff about expected professional behavior. 2. Send an e-mail to the nursing staff about expected professional behavior. 3. Address the complaint with the individual nurse in a telephone conversation. 4. Discuss the complaint with the individual nurse face-to-face.

The nurse manager is concerned about a family member's complaint regarding the professional behavior of a nurse on the unit. Which is the most effective method to address this issue? 1. Post a memo to the nursing staff about expected professional behavior. 2. Send an email to the nursing staff about expected professional behavior. 3. Address the complaint with the individual nurse in a telephone conversation. 4. Discuss the complaint with the individual nurse face-to-face.

The nurse manager is significantly behind in the required paperwork for the job. How can the manager rectify this situation? 1. Make stacks of work on the corner of the desk so the work can be seen. 2. Use paper for all communication so a record is kept. 3. Discontinue subscriptions to all journals. 4. Set a goal to work on paperwork for a portion of every day.

The nurse manager of a postsurgical unit is preparing the next month's schedule. The manager has reviewed the surgery schedule for the corresponding month and notes there are several high-acuity surgeries. Which staffing adjustment would the manager make to best provide the care needed by these postoperative clients? 1. Increase the number of unlicensed assistive personnel (UAP). 2. Increase the number of licensed practical nurses (LPN). 3. Increase the number of nonnursing support personnel. 4. Increase the number of RNs.

The nurse manager orienting newly hired nurses has explained the organization's blame-free environment. Which remark by one of the nurses indicates understanding of the policy? 1. "If I make a mistake and report it, I will not be reprimanded or punished." 2. "When I make a mistake, I should immediately fill out an incident report." 3. "It is left up to each employee to self-monitor so we do not report others' mistakes." 4. "When I make a mistake, I should report it and look for ways to prevent it from recurring."

The nurse manager presents an issue to the nursing staff for a decision. The group assesses the problem, and a decision is made meeting the needs of both the nurse manager and the nursing staff. This is an example of which conflict management strategy? 1. Integrative decision making 2. Win-lose strategy 3. Accommodation 4. Consensus

The nurse manager's expected outcome is to increase evidence-based practice on the nursing unit. To meet this outcome, the manager encourages nurses to base their practice on which technique? 1. Intuition 2. Personal clinical experience 3. Knowledge from nursing school 4. Current research

The nursing committee is planning a change in the unit's organization. Which statement reflects the priority expected outcome of these change agents' work? 1. The nurses involved will demonstrate management skills. 2. The nurses will agree with the change and present a united front for its adoption. 3. The change will guide nursing practice on the unit. 4. The change will lead to improved client care on the unit.

The nursing staff is continually upset about inability to provide clients with supplies needed because third-party payers will not reimburse for those items. This is an example of which conflict antecedent? 1. Task interdependencies 2. Distancing 3. Role 4. Incompatible goals

The nursing staff is continually upset being unable to provide clients with needed supplies because third-party payers will not reimburse for those items. This is an example of which conflict antecedent? 1. Task interdependencies 2. Distancing 3. Role 4. Incompatible goals

The nursing staff of a medical-surgical unit would like to work four 10-hour shifts each week. For which reason would the unit nurse manager probably deny this request? 1. There is no overlap of staff. 2. There are not enough nurses working during a 24-hour period. 3. This would create discord and confusion with other healthcare departments. 4. This staffing pattern would not be cost-efficient.

The nursing supervisor states, "I really don't have the time to delegate this task to a nurse manager. I can do it faster!" What is the most likely basis for this statement? 1. The nursing supervisor does not have time to delegate. 2. The nursing supervisor's job description needs to be redefined. 3. The nursing supervisor feels that he or she can do the job faster. 4. The nursing supervisor is concerned that staff is ill-prepared to assume additional responsibilities.

The nursing supervisor would like to delegate an information-gathering task. All the people listed have the ability to perform the task. In general, whom should the supervisor ask to do this work? 1. A nurse manager 2. A staff nurse 3. A licensed practical nurse 4. An unlicensed nursing assistant

The nursing task force is developing measurable goals for each client on the orthopedic unit. The statement "Each client will have a written assessment and plan of care document within eight hours of admission" is an example of which component of quality management? 1. Indicator 2. Structure standard 3. Benchmark 4. Process standard

The staff nurse would like to improve personal communication with peers, patients, and the medical staff. Which strategy would be most effective for this nurse? 1. Plan to be more assertive in all communication. 2. Work to manage fear of conflict. 3. First learn to delegate clearly to others. 4. Attend the hospital-based communication training.

This is the first meeting of a task force. What should be the leader's primary objective of this meeting? 1. Determining when the task force has to complete the assignment 2. Identifying the expected outcomes in terms of measurable objectives 3. Asking members if they have time to serve on the task force 4. Establishing a standard of total participation

To address the problem of increasing costs of staffing agencies, a hospital has developed a plan for an internal float pool of nurses to be used when scheduled staff nurses call in sick. What type of planning has the administrative staff done? 1. Strategic 2. Organizational 3. Directive 4. Contingency

Which action will have the greatest impact on the successful implementation of a planned change? 1. Disciplining individuals who continue to be resisters to the change 2. Ensuring there are no remaining pockets of disagreement when the change occurs 3. Continually rewarding those working toward the change and ignoring those who are not 4. Creating a supportive environment for those undergoing the change

Which relationship is an example of staff authority in classical theory? 1. The shift supervisor directs the staff nurse to help another nurse admit two new clients. 2. The unit manager asks the staff nurse to participate in a unit conference. 3. The team leader asks the staff nurse to assume care of an extra client after another nurse goes home ill. 4. The staff nurse's mentor calls to see how the nurse's first day on a new unit progressed.

Which situation is an example of organizational culture? 1. Every Friday the administrator allows everyone to wear crazy hats while on the units. 2. The cafeteria opens at 7:00 a.m. for breakfast, 11:00 a.m. for lunch, and 5:00 p.m. for dinner. 3. The administration has set the time clock to count staff late if clocking in 7 minutes after the shift starts. 4. ICU nurses know to take turns covering each other's clients to facilitate eating breakfast and lunch on the day shift.

Which situation is an example of the overall goal of quality management in today's health care activities? 1. The nurse manager realizes a policy was ineffective in reducing incidents. 2. The administrator walks around making a list of potential problems. 3. The human resources department fires nonproductive employees. 4. The nurse wipes up a spilled drink before clients are allowed to enter a room.

Which situation is an example of the overall goal of quality management in today's healthcare activities? 1. The nurse manager realizes a policy was ineffective in reducing incidents. 2. The administrator walks around making a list of potential problems. 3. The human resources department fires nonproductive employees. 4. The nurse wipes up a spilled drink before clients are allowed to enter a room.

Which statement by the nurse managing a unit conflict indicates that the integrative decision-making strategy is being used? 1. "I've heard all I need to hear. I'll have a decision tomorrow." 2. "Once you have signed this informed consent, the issue will go to mediation." 3. "This will all blow over if everyone just tries to get along better." 4. "Both parties should come up with as many alternative solutions as possible before our next meeting."

Which statement explains why nurses must be leaders to be successful in client care? 1. "You have to be a leader if you want physicians to respect you and the work you do." 2. "To function effectively in managed care, you have to be a good leader." 3. "Leadership skills will help you be assertive when you give orders to staff and clients." 4. "To direct client care activities and get the outcomes you desire, you need good leadership skills."

Which strategy is most likely to increase participation in the use of evidence-based practice in nursing? 1. Ensure adequate training and encourage its use by the nursing staff. 2. Elicit employee opinions of its use at least four times per year. 3. Give those nurses willing to use it extra recognition. 4. Ensure adequate training, recognition, and easy access to the Internet.

A group of physicians are in conflict with the nursing staff of a unit over when AM vital signs are recorded. To resolve the conflict, what type of technique might be used that respects the professionalism of both parties? a. Collaboration b. Avoiding c. Competing d. Accommodating

A manager decides that setting goals will assist her in better utilizing her time. Which of the following are true regarding goal setting in the manager role? a. Goals need to be measurable, realistic, and achievable to be effective. b. Goals should be vague, so they are more likely to be met. c. Setting goals is a time waster in the manager role. d. Writing goals will increase the stress level of the manager.

A manager has a budget request deadline today at 3:00. He stops his work to answer the phone, check e-mails as they arrive, and speak with staff who stop by his office. As a result, he misses the deadline. What best describes the cause of missing the deadline? a. Time wasters b. Assertiveness c. Goal setting d. Organization

A manager identifies that he is spending more time than desired on completing paperwork that is repetitive. Which of the following would not be an appropriate way to address this issue? a. Delegating staff evaluations to the staff nurse on the unit with the most experience b. Assigning the preliminary draft of the schedule to a subcommittee of staff nurses c. Combining data reports to reduce duplication d. Saying no to inappropriate paperwork assignments

A manager is prioritizing several issues. Which issue should be considered urgent and important? a. A staff nurse reports a pattern of malfunctioning IV pumps on the unit during the current shift, resulting in overdosing of medications. b. The manager of physical therapy calls and complains about inappropriate behavior of one of the staff nurses with one of the therapists. c. One of the staff nurses, who would have been an extra nurse for the next shift, calls in sick. d. A small group of staff nurses requests a meeting to discuss initiating a scheduling committee.

A nurse executive tells the nurse manager, "I have always admired your strengths in contingency planning." How should the manager interpret this remark? a. The manager is good at identifying and managing day-to-day problems. b. The manager has skills in operationalizing designed plans. c. The manager is good at seeing "the big picture." d. The manager can present a plan for the future in a persuasive manner.

A nurse is considering employment at a long-term care facility that has a functional nursing delivery system. Knowing this, the nurse could expect that: a. One RN would pass meds for all clients on a unit. b. One RN, one LPN, and one unlicensed assistive personnel would share responsibility for a group of clients. c. Each RN would deliver total care to an assigned group of clients. d. Each RN would coordinate care for a group of clients.

A nurse manager has asked a group of nurses to submit a proposal regarding a policy change. The manager already knows what change he prefers and will support the administration. This is an example of which stumbling block? a. Preconceived ideas b. Rigidity c. Personality d. Fear of risk taking

A nurse manager has two out of six staff nurses call in sick for one shift. Because of reduced availability of staff, the manager decides to manage the unit with the three remaining nurses, which keeps the unit at minimal staffing standards What type of decision-making strategy would this be? a. Satisficing b. Routine c. Adaptive d. Rationalizing

A nurse manager would like to change a policy concerning staffing on holidays. How should the manager proceed? a. Practice patience during the effort b. Confront hospital administration with the unfairness of the current policy c. Remain fixed on the desired policy change d. Coerce other managers to join the movement to change the policy

A staff nurse delegates a task to a UAP and then does half of the task herself, telling the UAP that he is too slow. This violates which principle of delegation? a. Transferring authority empowers the delegate to complete the task. b. Poor communication is a barrier to delegation. c. To delegate effectively, the individual should be matched to the task. d. In work allocation, no transfer of authority exists.

A staff nurse tells other staff nurses that the manager is ineffective in order to move into the manager position. Which of the following would describe the nurse's actions? a. Using a power play b. Using personal power c. Using information power d. Using punishment power

Advanced technology in health care, such as integrated health records, has allowed the nurse to do which of the following? a. Track clients' vital signs b. Skip the assessment step of the nursing process c. Take blood samples d. Prescribe medications

After examining her client's abdomen and noting assessment of significant findings, even though the client says it doesn't hurt, the nurse says to a colleague, "I think something is going on here; I am going to investigate further." This nurse is using: a. Intuition. b. Trial and error. c. Deductive reasoning. d. Modified scientific method.

As a staff nurse you are asked to complete a task you feel you are not qualified to do. What is the best response? a. Thank the delegator for the offer and clearly explain why you must decline. b. Ask for other tasks for which you feel prepared. c. Try to do the task anyway. d. Inform the supervisor that you are being mistreated.

In dealing with a conflict on a unit, the nurse manager decides to ask one of the staff nurses, who is not moving toward resolution, to transfer to another unit. What tactic has the manager implemented? a. Suppression b. Avoidance c. Competition d. Withdrawal

Influencing group processes on a unit toward the attainment of organizational objectives is the direct responsibility of which team member? a. The nurse manager b. All the group members c. An interested group member d. The informal group leader

Lippitt's phases of change are important factors in the change process. The phase that involves key people in data collection is known as: a. Diagnose the problem. b. Maintain the change. c. Choose a change agent. d. Assess the motivation.

Nurse managers often need to attend to the complaints of their clients. In communicating with the client who has a complaint, what principle is important to keep in mind? a. Clients and families should be treated with respect; communication should be open and honest. b. Avoid discussing complaints. c. Supervisors should always be involved. d. The client's physician is often the cause of the problem.

Selye's stress theory explains that a person stressed for long periods will: a. Face exhaustion and be more susceptible to illness. b. Ignore personal safety needs. c. Become more assertive. d. Become fatigued but also stronger.

The changes brought forth by the state boards of nursing are an example of which type of change agent? a. Power-coercive b. Resistance c. Empirical-rational d. Normative-reeducative

The changes brought forth by the state boards of nursing are an example of which type of change agent? a. power-coercive b. resistance c. empirical-rational d. normative reeducative

The nurse manager is trying to determine whether the nursing staff is functioning as a team or a group. Which characteristic would lead the manager to decide that the nurses are functioning as a team? a. They have clear goals and purpose. b. They are not very well organized. c. No one emerges as a leader. d. There is no evaluation of the work done.

The staff on a medical-surgical unit is in conflict with the occupational therapy department. What type of communication will be used to discuss the problem? a. Lateral communication b. Downward communication c. Upward communication d. Distorted communication

When trying to facilitate change in the staff, it is necessary to build trust and recognize the need for change. This type of action is known as which of the following, according to Lewin's Force-Field Model? a. Unfreeze of the system b. Moving the system to a new level c. Refreeze of the system d. Institutionalization

Which of the following clients would most likely be selected for case management? a. An elderly client awaiting a hip replacement. b. A 41-year-old client admitted for outpatient tonsillectomy. c. A young adult with a fractured pelvis. d. An adolescent with a gunshot wound who is in the ER.

Which of the following is an important emerging challenge to changes in health care? a. Bioterrorism b. Decrease in immigration c. Nursing staff shortages d. Increased surgical procedures

Which of the following theories best depicts current health care delivery systems? a. Contingency theory b. Chaos theory c. Open system theory d. Closed system theory

The staff of a medical-surgical unit is in disagreement over holiday scheduling. The nurse manager knows that this is what type of conflict? a. Interpersonal conflict b. Intragroup conflict c. Intergroup conflict d. Intrapersonal conflict

What is a positive benefit of conflict within an organization? a. Conflict always leads to a win-win resolution. b. Conflict helps people recognize differences and motivates them toward improved performance. c. Conflict leads to compromise in values and beliefs. d. Conflict leads to intergroup competition.

A committee of nurses tries to determine who should be charged with the different workloads of the committee. In what stage of group development is this committee? a. Performing b. Storming c. Forming d. Norming

A group of nurses selected by their colleagues plan an orientation program for new staff. What type of group is this? a. Command group b. Task group c. Informal group d. Formal group

A new manager is implementing an initiative with the desired outcome to have the unit run more smoothly. What quality is the manager demonstrating? a. Being democratic b. Being a change agent c. Being unrealistic d. Being authoritarian

A new nurse manager is attempting to solve a management issue by using one solution after another until she solves the problem. This would be known as what type of method? a. Experimentation b. Trial and error c. Decision making d. Analysis

A new nurse on a pediatric unit works nights and has minimal time to spend with her children. A colleague observes that the nurse speaks abruptly with parents and is easily annoyed when clients cry or are demanding. The nurse realizes she is becoming increasingly distressed. Which action should the nurse take? a. Communicate minimally with clients and parents so as not to offend them. b. Ask the nurse manager for a schedule with an equal number of day and night shifts. c. Call off sick as frequently as possible without violating policies so more time can be spent with the children. d. Express negative comments to colleagues about annoying clients and parents.

A nurse has been promoted to charge nurse. This role has changed his relationship with coworker friends, and now he feels tense and isolated. He decides to delegate more time-consuming tasks to non-friend staff, who then complain to the manager about perceived unfairness. What should the charge nurse do? a. Talk about staff who are annoying him with staff on other units b. Talk with his friends individually to let them know he will be assigning tasks to all staff in a more equitable manner c. Ignore his feelings of uncertainty, hoping they will diminish d. Not express his angry feelings

A nurse manager has left the facility, and one of the remaining managers is given that assignment in addition to his current load. He is told that the open position will not be filled. This is an example of which of the following? a. Proactive Management b. Job enlargement c. Time log d. Prioritizing

A nurse who is planning to run for the local school board will find which source of power important? a. Reward b. Connection c. Expert d. Charisma

A staff nurse describes the unit manager as "a born leader." The nurse ascribes to which theory of leadership? a. Behavioral theories b. Trait theories c. Democratic leadership theories d. Formal leadership theories

A staff nurse submits a 6-week notice of resignation. The nurse manager prepares a request to immediately post the position and begin interviews. This action is best described as which of the following? a. Delegation b. Proactive management c. A time waster d. Reactive management

Behaviors such as not calling in sick on Fridays, accommodating requests for trading shifts, and returning from breaks in a timely manner are examples of what group characteristic? a. Roles b. Norms c. Group communication d. Status

Cultural diversity presents an important challenge to nurse managers due to which of the following? a. 80% of nursing staff comes from one or more minority groups. b. The increase in cultural diversity is seen both in the client population and the nursing staff. c. Staff nurses are not trained to be culturally sensitive. d. A nursing shortage exists.

Health care systems primarily have functional structures. Which of the following would be an example of this? a. Open communication exists between Physical Therapy and Nursing. b. All nursing tasks fall under nursing service. c. Laboratory services have little authority. d. Medicine has authority over nursing.

How does decision making differ from problem solving? a. Problem solving always involves selecting one of several alternatives. b. Decision making always involves selecting from a set of alternatives. c. Problem solving never involves decision making. d. Decision making always involves solving a problem.

In determining a way to make shift change more effective for the nurse and the client, a hospital implemented a course of action. After a week of implementation, the decision was deemed appropriate. What step of Roger's diffusion of innovations is this? a. knowledge b. confirmation c. implementation d. persuasion

In determining a way to make shift change more effective for the nurse and the client, a hospital implemented a course of action. After a week of implementation, the decision was deemed inappropriate. What step of Roger's diffusion of innovations is this? a. Knowledge b. Confirmation c. Implementation d. Persuasion

Politics is a means for influencing events and the decision of others. The nurse manager who consistently reminds the staff that "there is no I in team" and periodically brings treats for the staff is using: a. Expert power. b. Political skills. c. Reward power. d. Image enhancement.

Quality management and benchmarking are two approaches used to improve the quality of care. The major difference between these two approaches is which of the following? a. Benchmarking looks only at outcomes specific to nursing. b. Benchmarking compares outcomes in a variety of settings and disciplines. c. Quality management is used only in the primary care setting. d. Quality management is not useful in the outpatient setting.

Scientific methods for problem solving are useful when time is not an issue. For problems requiring immediate action, nurses can use an organized method that involves seven specific steps. What is this method? a. Brainstorming b. Problem-solving process c. Trial-and-error d. Experimentation

The Hawthorne effect explains that the relationship between people and productivity is enhanced by which of the following? a. Creativity b. Special attention c. Organizations d. Groups

The complexities of the current health care delivery systems require a variety of leadership styles. Which of the following is one that has emerged in response to these changes? a. Emotional b. Quantum c. Servant d. Transactional

The nurse manager can use several strategies to improve communication when giving directions. Asking the subordinate to repeat the instructions would be which strategy? a. Follow-up communication b. Verifying through feedback c. Knowing the context of the instruction d. Getting positive attention

The staff nurse in a long-term-care facility wants to delegate the passing of 9 AM medications. The additional staff consists of two UAPs. What type of barrier to delegation exists? a. Approval versus affiliation b. Lack of resources c. Poor communication d. Trust versus control

The staff nurse says, "I can't take working in the emergency department anymore. I am so sick of seeing people hurt and dying." How would the nurse manager best interpret this statement? a. As posttraumatic stress disorder b. As compassion fatigue c. As prolonged anxiety d. As burnout

Which issue would be considered urgent and important? a. Preparing educational packets on self-administration of insulin for clients b. Replacing two staff who were injured while caring for a violent client c. Developing an educational program for the new heparin protocol, to be implemented in two months d. Implementing and evaluating the staff's response to a tornado drill

Which of the following conditions would be well suited to use of a nursing critical pathway? a. Foreign object in ear b. Hip replacement surgery c. Fever of unknown origin d. Bacterial infection acquired in a foreign country

Which of the following is an important principle of delegation? a. Delegation is the same as work allocation. b. When delegating, you must transfer authority. c. No transfer of authority exists in delegation. d. Responsibility is not transferred with delegation.

Which of the following is the correct definition of "chain of command"? a. The tendency for people to perform as expected. b. The hierarchy of authority and responsibility. c. Activity directed through linear authority. d. Relationship without authority.

Which of the following is the major difference between managers and leaders? a. Managers seldom are leaders. b. Leaders do not make good managers. c. Leaders usually have legitimate power. d. Managers always have legitimate power.

Which of the following leaders would be considered a transformational leader? a. A unit manager who reminds a CNA to work on time management skills b. The advanced practice nurse who encourages a staff nurse to pursue additional education for career advancement c. The supervisor of a unit who requests staff to work overtime d. The unit secretary who encourages staff to use the proper forms

Which statement by a newly promoted nurse manager would the supervisor interpret as indicating a need for further education regarding stress? a. "I have asked the staff to modulate their speaking voices while in the halls and nursing station." b. "I am working to eliminate stress from this unit." c. "I have asked maintenance to repair the noisy elevator doors at the end of the hallway." d. "I have engaged the nurses in planning a way to reorganize the nurses' station to make it more user-friendly."

A babysitter calls the staff nurse to let him know that she will not be able to take care of his children on the day the nurse is scheduled to work. The nurse is presenting important material at a committee meeting that day. What type of conflict is the staff nurse experiencing? a. Intergroup conflict b. Perceived conflict c. Role conflict d. Structural conflict

A high-volume maternity unit uses differentiated practice as its staffing model. As a new graduate employed on this unit, the nurse can expect that: a. Client teaching is the responsibility of the team leader. b. Seniority is the main determination of client assignments. c. The initial level of practice responsibility will be limited. d. Evidence-based practice guides risk management principles.

A multiple-car accident has occurred with multiple trauma clients being sent to an emergency department. The unit manager is preparing the staff for the arrival of the trauma victims. Which type of leadership would be most effective in this situation? a. Bureaucratic b. Permissive c. Authoritarian d. Participative

A nurse has been assigned to lead a steering committee for a larger project. If given a choice, the leader should pick which team for this committee? a. Fifteen people who volunteered for the committee b. Eight people assigned to the committee c. Six people who volunteered for the committee d. Twelve people assigned to the committee

A nurse manager describes a newly hired nurse executive as an "edge runner." How should the staff nurses interpret this statement? a. The executive is rigid in management style. b. The executive is unpredictable. c. The executive is very innovative. d. The executive has preconceived ideas.

A nurse manager is interested in solving a serious conflict among the nursing staff. He uses a strategy that involves allowing the group to explore a variety of options and come to a consensus on a solution. What strategy for conflict resolution has the manager used? a. Win-win b. Confrontation c. Integrative decision-making d. Competing

A nurse manager says, "One of our nurses was injured in a car accident. I know you will want to help by picking up one or more of her shifts as she recovers." This nurse is using which leadership style? a. Transactional b. Quantum c. Transformational d. Servant

A resident on night call refuses to answer pages from the staff nurse on the night shift and complains that she calls too often with minor problems. The nurse feels offended and reacts with frequent, middle-of-the-night phone calls to "get back" at him. The behavior displayed by the resident and the nurse is an example of what kind of conflict? a. Perceived conflict b. Felt conflict c. Disruptive conflict d. Competitive conflict

A staff nurse attends a continuing education class on advanced technology in health care. The nurse manager should interpret this as which of the following? a. Only important for nurse managers b. A waste of time c. Essential to nursing care d. Not important

A staff nurse develops an innovative documentation system for postoperative clients. The nurse manager grants the nurse paid leave to develop one for medical clients. What type of power is the nurse manager using? a. Legitimate power b. Information power c. Reward power d. Expert power

A staff nurse has delegated the ambulating of a new post-op client to a new staff nurse. Which of the following situations exhibits the final stage in the process of delegation? a. Having the new nurse tell the physician the task has been completed. b. Documenting that the task has been completed. c. Supervising the performance of the new nurse. d. Telling the unit manager the task has been completed.

A staff nurse is working with a client who is on a critical pathway for education in preparation for home care. Which one of the following responsibilities would the nurse address first? a. Taking vital signs b. Evaluating client teaching c. Reviewing the information with the client and family d. Answering the client's questions

A staff nurse tells a client, "I am focused on your care" but then seldom comes into the room. What is the result of communicating this way? a. Metacommunication b. Upward communication c. Intrasender conflict d. Diagonal communication

A staff nurse wants to become instrumental in changing a policy regarding scheduling. Which of the following might be helpful in this situation? a. Talking to the Director of Nursing b. Demonstrating positional power c. Compiling data that would support the policy change d. Using image power

A supervisor is restricting the flow of communication between staff. This has resulted in the staff having two very opposite directions. The supervisor's actions are known as which type of force? a. Opposing force b. Driving force c. Restraining force d. Restrictive force

After discussing alternatives to dressing change procedures to minimize discomfort the nursing staff accepted a new procedure as part of the daily routine. This is an example of which stage of Havelock's model of change? a. acquiring resources b. building a relationship c. stabilization and self-renewal d. choosing the solution

After discussing alternatives to dressing change procedures to minimize discomfort, the nursing staff accepted a new procedure as part of the daily routine. This is an example of which stage of Havelock's model of change? a. Acquiring resources b. Building a relationship c. Stabilization and self-renewal d. Choosing the solution

In a staff meeting, a nurse manager asks the staff to suggest ways to change a policy. The list is written on the whiteboard as the suggestions are made. What type of decision-making technique did the nurse manager use? a. Trial-and-error b. Democratic c. Brainstorming d. Experimentation

In dealing with conflict, the nurse manager knows that feelings or perceptions about the situation will have an effect. According to Filley, what is this effect known as? a. Resolution aftermath b. Conflict suppression c. Felt conflict d. Antecedent conditions

One of the most important driving forces behind health care policy changes is which of the following? a. Emerging role of nurse practitioners b. New technology c. Ability to pay for health care d. Outsourcing of services

Productivity is influenced by groups. Which of the following work-group dynamics would positively affect productivity? a. Resources b. Individual relationships c. Cohesiveness and collaboration d. Leadership

The nurse manager has two employees engaged in a longstanding conflict that is affecting the group's productivity and cohesiveness. She decides to meet with the employees in private, discuss the conflict openly, and attempt to resolve it using knowledge and reasoning. Which conflict management strategy is she employing? a. Suppression b. Collaboration c. Confrontation d. Intervention

The nurse manager wants to change the care delivery model from one of team nursing to that of primary nursing. The nurse manager decides to approach the change using Havelock's model. Which steps would need to be completed during Havelock's planning stage? a. Gaining acceptance b. Choosing a solution c. Acquiring resources d. Stabilizing and self-renewal

The staff nurse delegates AM care for two clients to the UAP. What principle of delegation is the nurse following? a. Delegation requires a situation with clearly defined superiors. b. Delegation is a tool used only by nurses. c. You can delegate only those tasks for which you are responsible. d. Delegation can only exist with a subordinate.

When is the time to make people think about the routines that have been previously followed and to consider what might be a better plan of action? a. Analyzing data b. Identification c. Planning d. Collection of data

When is the time to make people think about the routines that have been previously followed and to consider what might be a better plan of action? a. analyzing data b. identification c. planning d. collection of data

When would a critical pathway need to be revised? a. When a member of the team retires. b. When it becomes too long. c. When the variances show a new trend. d. When the client leaves the hospital.

Which of the following can be a negative outcome of group decision making? a. Dissent b. Decisions that do not match the manager's c. Groupthink d. Risky shift

Which of the following is true regarding health care systems today? a. They are all privately owned. b. Only HMOs are profitable. c. There are multiple types of organizations. d. They are all managed care organizations.

While interviewing for a position at City Hospital, the nurse asks about the organizational structure of the institution. She is told that hospital is organized into departments based on specialty (e.g., nursing, dietary, pharmacy, etc.). Based on what you know about organizational structure, select the structure in this example. a. Parallel b. Service-integrated c. Functional d. Matrix

Conflict is often a prerequisite to ________ in people and organizations.

change

Even though this is not easy, facilitating ___________ is a mandatory skill for all nurse managers and is crucial in the success of the manager.

change

"Organizations are made up of intertwined links and diversified choices that generate unanticipated consequences." This defines which of the following theories? a. Contingency theory b. Open system theory c. Closed system theory d. Chaos system theory

A client who is in pain refuses to be repositioned. In making a decision about what to do, what should the nurse consider first? a. When a decision is needed b. What the alternatives are c. Who actually gets to make the decision d. Why a decision is needed

A staff nurse wants to clarify his responsibilities regarding delegation. Which documents can the nurse refer to for assistance in decision making? a. The policy manual b. The job description c. The ANA standards of care d. The state nurse practice act

A team of nurses needs to move the clients and equipment to a new unit while remodeling is done. Each nurse has an assigned task within the group. This is an example of what type of group task? a. Conjunctive task b. Disjunctive task c. Informal task d. Divisible task

According to Homans's framework, there are three essential elements of group systems. Which of the following exhibits attitudes? a. An LPN enrolls in an IV certification class. b. Staff nurses perform their jobs satisfactorily. c. Two nurses share their understanding of the role of the CNA. d. An individual nurse feels that the nurse manager is ineffective.

In today's health care organization, who is most likely to fill the traditional "directing" role in management? a. The nurse manager b. The nurse executive c. The UAP d. The staff nurse

Integrated health care systems function in a variety of models. Which is a common characteristic of all systems? a. Provide care only in the primary care setting b. Deliver selective care only c. Treat clients only in the hospital d. Deliver a whole continuum of care

Magnet certification requires a significant investment in time, money, and other resources. Why would a hospital seek this recognition? a. Physician groups want to work in Magnet hospitals. b. It helps nursing and ancillary services understand each other's role in caring for clients. c. It is a popular program to undertake. d. Client safety is improved when nurse staffing meets Magnet standards.

The hospital administration plans to introduce a new system of client transport within the hospital. The nurse managers, when communicating with the staff about the change, should use which source of power to make certain the transition goes smoothly? a. Connection power b. Expert power c. Reward power d. Information power

The nurse manager has had a lot of turnover on the unit recently and decides that team building is needed. An effective technique would be to: a. Allow the team to progress through the normal group developmental process until cohesiveness occurs. b. Identify individuals who are not team players and recognize their poor attitude in a team meeting. c. Pull staff members aside individually to identify who is undermining the team. d. Clarify team goals, roles, responsibilities, and boundaries.

The nurse manager is talking with the CNA about her time management. Which of the following is an example of a nurse manager as coach? a. "You never report AM blood sugar levels on time." b. "You must get the vital signs taken on time or you will be disciplined." c. "Your appearance is seldom professional." d. "Your timely response to clients' call lights is exemplary."

The nurse manager talks with a new nurse once per week to determine how the nurse is adjusting to the new role. The manager asks if the nurse feels able to provide good care to clients and is becoming familiar with the electronic health record. This manager is demonstrating: a. An intrusive style. b. An attempt to intimidate. c. An authoritarian style. d. An effort to understand if the nurse is coping with the demands of the job.

Understanding the different modes of communication used by men and women is important for the nurse manager. Which of the following is a difference in communication in unpleasant situations? a. Women disagree more. b. Women talk longer and faster; men disclose more. c. Men tend to use tag questions. d. Men tend to talk more and women to withdraw.

Which behavior would be an early warning sign that the nurse is not handling job stress in a healthy way? a. The nurse feels it is necessary to spend more time with staff. b. The nurse has determined that the focus should be on client outcomes. c. The nurse has developed strategies to juggle work, studies, and family. d. When the nurse awakens in the morning, he does not feel rested.

Which of the following is a specific benefit to an organization when delegation is carried out effectively? a. The clients feel that more of their needs are met. b. Managers devote more time to tasks that cannot be delegated. c. Delegates gain new skills facilitating upward mobility. d. The organization benefits by achieving its goals more efficiently.

Which of the following scenarios would be an example of shared governance on a nursing unit? a. Staff nurses delegate activities to CNAs. b. Procedure manuals are written by a committee of nurse managers. c. A unit manager seeks advice from her supervisor. d. Staff nurses and CNAs make their own schedules.

The staff nurse is caring for the client with total accountability and is in continual communication with the client, the family, the physicians, and other members of the health care team. This type of nursing delivery system is known as .

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