RN 400A Final Exam

The nurse-manager is negotiating for the funds necessary to purchase several new isolettes for the facility's newborn nursery. The chief financial officer (CFO) states, "I've always been curious about that piece of equipment; how does it actually work?" What negotiation action has the CFO engaged in? A) Collaborating B) Smoothing C) A diversionary tactic D) Appropriate fact finding

C) A diversionary tactic

A performance appraisal states that the manager often under delegates. What is potential cause of this delegation error? A) A high degree of trust in subordinates B) A democratic leadership style C) A need for perfectionism D) Sufficient time to accomplish unit goals alone

C) A need for perfectionism

A nurse has successfully completed a difficult and complex task that the manager delegated. What is the manager's best action? A) Document the fact that the nurse completed the task. B) Assign a slightly more difficult task the next time. C) Acknowledge the nurse's significant accomplishment. D) Ask the nurse to act as a role model for other staff members

C) Acknowledge the nurse's significant accomplishment.

Several RNs on the unit want to address the possibility of initiating flextime on the unit because they state that the current scheduling system is unfair. What is the manager's best initial response? A) Assuring the RNs that every effort is being made to streamline the current scheduling system B) Asking the RNs to circulate a partition to be signed by employees who support the change C) Arranging for the RNs to air their views at the next staff meeting D) Sharing with the RNs that they need to address the issue with upper management

C) Arranging for the RNs to air their views at the next staff meeting

What must managers delegate to another RN in order to assure completion of a task? A) Time and space B) Leadership and creativity C) Authority and responsibility D) Personnel and knowledge

C) Authority and responsibility

What aspect of the collective bargaining and unionization process is most likely to present an ethical dilemma for a nurse? A) Navigating relationships with managers in the organization B) Identifying career goals that can be achieved by unionization C) Deciding whether participating in a strike is appropriate D) Adhering to the Occupational Safety and Health Act (OSHA)

C) Deciding whether participating in a strike is appropriate

What is the best course of action to stimulate broad participation of employees in quality control efforts? A) Encourage regular meetings between middle management and upper management. B) Educate staff about the relationship between the organization's accreditation and their own licensure. C) Engage closely with the frontline staff who provide client care. D) Educate staff about the correct way to document and report sentinel events

C) Engage closely with the frontline staff who provide client care.

A nurse executive wants to decrease the chances of unionization of the nursing service department. To accomplish this goal, where should financial and energy resources best be directed? A) Publicizing the potential cost and harm of unionization B) Increasing the quality and amount of equipment available to nurses C) Implementing a shared decision-making model in the department D) Emphasizing the identity of nursing as a "helping" profession that prioritizes others' needs

C) Implementing a shared decision-making model in the department

What action should the nurse-manager and other leaders in the health-care organization perform in order to ensure that a quality control program will be effective? A) Set a goal of meeting federal and state standards. B) Set quality control standards at minimum acceptable levels so the organization will score well on self-assessment audits. C) Integrate quality control through all levels of the organizational hierarchy. D) Focus quality improvement efforts on reacting to problems that have been identified.

C) Integrate quality control through all levels of the organizational hierarchy.

An employee who is involved in a dispute has sought the assistance of the organization's ombudsperson. What role will the ombudsperson play in resolving the employee's conflict? A) Providing expert testimony in conflict cases B) Providing psychosocial support to employees in distress C) Investigating the employee's grievance against the other party D) Monitoring the implementation of the terms of a conflict's compromise

C) Investigating the employee's grievance against the other party

An affirmative action plan has been established in the jurisdiction where a nurse works. The nurse should understand what characteristic of this program? A) The terms of the plan are laid out in United States Equal Employment Opportunity legislation. B) It aims to prevent workplace discrimination on the basis of age or sexual orientation. C) It actively seeks members of underemployed groups to fill job vacancies. D) Few affirmative action programs still exist because they encourage reverse discrimination

C) It actively seeks members of underemployed groups to fill job vacancies.

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

C) It centers on either internal discord or external discord between individuals.

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

C) It is reduced when the RN delegates appropriately and supervises the completion of the tasks.

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

C) It recognizes that the customer is the focal element on which production and service depend.

Which task would the director of a home health agency not delegate another staff RN? A) Assigning home health aides to specific client care B) Serving on a diabetic study committee of community resources C) Meeting with the agency's administration regarding budget cuts D) Reviewing the care assignment for the following shift

C) Meeting with the agency's administration regarding budget cuts

Which is a true statement about destructive negotiation tactics? A) Ridicule often takes the form of ambiguous or inappropriate questioning and is a diversionary tactic. B) Most managers successfully resist the helplessness tactic because of their nursing preparation. C) Negotiation tactics can sometimes be manipulative; thus, managers must be cognizant of the other party's motives. D) Nurses are known to be particularly vulnerable to the tactic of flattery

C) Negotiation tactics can sometimes be manipulative; thus, managers must be cognizant of the other party's motives.

What principle should guide the nurse's delegation of tasks to unlicensed nursing assistive personnel (NAP)? A) It is safe to assume that the NAP has at least a high school diploma as a minimum hiring criterion. B) Like all members of the care team, NAP stands to lose their licensure in case of negligent practice. C) No federal or community standards have been established for training the broad classification of NAP. D) The nurse is protected from liability when allowing the NAP to perform only those tasks the employer includes in their job description.

C) No federal or community standards have been established for training the broad classification of NAP.

What is the nurse-manager's initial action when it becomes obvious that the unit will not meet staffing levels? A) Ask for volunteers to work overtime. B) Close the unit to additional admissions. C) Notify upper level management of the situation. D) Begin transferring patient to units with lower censuses

C) Notify upper level management of the situation.

A hospital is using the guidelines of the Leapfrog Group to inform safety improvements in the organization. What action will best incorporate these guidelines? A) Replacing practical nurses with registered nurses whenever possible B) Eliminating the use of high-risk medications and increasing the role of pharmacists C) Purchasing a computerized physician-provider order entry system D) Converting shared rooms to single-occupant rooms

C) Purchasing a computerized physician-provider order entry system

A nurse-manager is participating in a hospital's quality control efforts and is collating data sources. What data source should the manager identify as a qualitative source? A) The hospital's rate of nosocomial infections B) The hospital's readmission rate C) Results of interviews with discharged clients D) The previous year's budget for continuing education initiatives

C) Results of interviews with discharged clients

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

C) Standardizing clinical outcome data collection

A nurse-manager is overseeing an organization that uses the Nursing Minimum Data Set (NMDS). What will the use of the NMDS achieve? A) Comparing the quality of nursing care and medical care with reference to standardized data B) Identifying minimal levels of quality necessary for nurses to maintain licensure C) Standardizing the collection of nursing data for use by multiple users D) Identify only "nursing-sensitive" client outcome measures

C) Standardizing the collection of nursing data for use by multiple users

What is an inappropriate reason for delegation? A) To empower subordinates by "stretching" them in their work assignment B) To free the manager to address more complex unit needs C) The manager does not find the task intellectually challenging. D) Someone else is better qualified to do the task.

C) The manager does not find the task intellectually challenging.

A nurse-manager delegates many tasks in the course of a day. Which practice should the manager reconsider or discontinue? A) The manager grants temporary authority to support completion of a delegated task. B) The manager confirms that the person to whom a task is delegated is adequately qualified. C) The manager provides employees with exact instructions for each step of completing the task. D) The manager asks for regular updates from the employee when tasks take a long time.

C) The manager provides employees with exact instructions for each step of completing the task.

Which of the following workplace situations would be categorized as latent conflict? A) A nurse expresses frustration to a colleague who did not perform some tasks that were clearly delegated. B) A nurse expresses anger to the manager, accusing the manager of preferential treatment toward other nurses. C) The most experienced nurses on a unit are allowed to self-schedule, but less experienced nurse are not. D) Two nurses were in conflict about inequities in their work assignment but were able to resolve the conflict

C) The most experienced nurses on a unit are allowed to self-schedule, but less experienced nurse are not.

A nurse-manager works in a nonunionized medical unit that employs numerous RNs. The manager can best prevent conditions that would promote a union drive by: A) rotating the nurses' work assignments frequently. B) offering to assist with bedside care during busy times. C) demonstrating genuine concern for the well-being of the nurses. D) ensuring that the terms of the current contract are adhered to

C) demonstrating genuine concern for the well-being of the nurses.

An experienced RN has seen a significant increase in the need for delegation skills over the past several years. This change is most likely attributable to: A) increased numbers of uninsured clients. B) increased lengths of stay. C) increases in the use of NAP. D) decreases in nurse-client ratios

C) increases in the use of NAP.

As part of a quality improvement initiative, administrators are conducting outcomes analysis and have included nursing-sensitive outcome measures. These outcome measures will: A) highlight the aspects of nursing that are contentious or controversial. B) cause the quality improvement process to prioritize nurses over other providers. C) separate out the unique contributions that nurses make to client outcomes. D) require other members of the health-care team to rate nurses' contributions.

C) separate out the unique contributions that nurses make to client outcomes.

Which nurse is experiencing intrapersonal conflict? A) A manager who has received a negative performance appraisal and who wishes to dispute the findings B) A manager who has to confront a nurse who made a medication error but did not follow up with documentation C) A manager who is in conflict with a long-standing employee who often ignores the manager's directives D) A manager who perceives a dilemma between loyalty to staff and loyalty to the organization in a particular situation

D) A manager who perceives a dilemma between loyalty to staff and loyalty to the organization in a particular situation

Which action by the manager is most likely to reduce the incidence of sexual harassment in the workplace? A) Limit one-on-one interaction between female and male employees whenever possible. B) Encourage workers to confront the "harasser" directly and resolve the conflict. C) Provide desensitivity training to minimize employee reactions. D) Actively pursue an investigation of all complaints

D) Actively pursue an investigation of all complaints

What piece of data should the nurse-manager include in an outcome audit? A) Nursing handoffs occur at the client's bedside and include family input. B) Client-nurse ratios are capped at 3:1 in the day and 4:1 at night. C) Technology is acquired so documentation can be completed at the bedside. D) At discharge, a client was able to ambulate 40 feet unassisted

D) At discharge, a client was able to ambulate 40 feet unassisted.

The nurse-manager is preparing for negotiations. When negotiating, what is the manager's most appropriate action? A) Be willing to win at any cost. B) Communicate only when asked direct questions. C) Compromise only as a last resort. D) Begin with a high but realistic expectations

D) Begin with a high but realistic expectations

A member of the team has been delegated some tasks and reports, "I've been given too much to do and I'm not going to be able to complete the work on time." What is the RN's best initial action? A) Assign the work to another team member. B) Take on the responsibility of the tasks. C) Have the team member perform only the most necessary tasks. D) Examine the workload and assist the individual in reprioritizing.

D) Examine the workload and assist the individual in reprioritizing.

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

D) Facilitating conflict resolution

Why does membership in the American Nurses Association (ANA) pose a conflict in loyalty for some nurses in management positions? A) It fails to support male nurses sufficiently. B) Minorities are not represented on its board of directors. C) Membership is based on years of nursing experience. D) It acts as a professional association and a collective bargaining agent.

D) It acts as a professional association and a collective bargaining agent.

A nurse who provides care at a county hospital is involved in a unionization drive. This nurse's right to unionize is enacted in which of the following? A) Civil Rights Act of 1964 B) Fair Labor Standards Act C) The Equal Pay Act of 1963 D) Kennedy Executive Order 10988

D) Kennedy Executive Order 10988

A nurse-manager will be participating in negotiations around the skills mix in the organization. Before these negotiations begin, the manager should perform what action first? A) Identify the ideal skills mix for the organization. B) Choose an appropriate negotiation strategy. C) Interact with the other party to identify any hidden agendas. D) Learn as much as possible about the issue

D) Learn as much as possible about the issue

Periodically during the day, the RN checks with the team members to determine whether they are having difficulty completing their assigned tasks. This describes which manager role? A) Skills evaluation B) Client safety C) Effective delegation D) Micromanagement

D) Micromanagement

What action should the nurse-manager perform when supporting the delegation of a task to a subordinate? A) Holding the subordinate's professional development as the highest priority B) Frequently reassuring the employee that if they are incapable of completing a delegated task, it will be reassigned C) Drafting a preliminary plan of how the task will be redone if the outcome does not meet stated expectations D) Occasionally providing learning or "stretching" opportunities for employees

D) Occasionally providing learning or "stretching" opportunities for employees

As part of the quality control, managers have set standards for performance and assessed whether these standards are being met. It has been determined that several standards are not being met. What is the priority response to this finding? A) Release the findings to the public to ensure transparency. B) Compare the organization's results to benchmarks. C) Determine whether similar organizations in the region are experiencing similar results. D) Perform interventions that will correct the deficiencies

D) Perform interventions that will correct the deficiencies

A nurse-manager is opposing the expansion of the prospective payment system (PPS). What argument against the PPS should the manager cite? A) Diagnosis-related groups have caused an increase in health-care costs. B) The PPS has unnecessarily increased the length of hospital stays. C) The PPS is linked to increased prices for pharmaceuticals. D) The PPS has been linked to a decline in the quality of care

D) The PPS has been linked to a decline in the quality of care

A nurse has over four decades of work experience and is weighing the benefits of retiring versus continuing to work. How will the Age Discrimination in Employment Act affect this nurse? A) The nurse may continue to work but must forfeit job security. B) The nurse will be required to retire once he or she turns 70 years. C) The nurse will be required to retire once he or she turns 65 years. D) The nurse may retire, or continue to work, as long as he or she is capable of performing the job

D) The nurse may retire, or continue to work, as long as he or she is capable of performing the job

A situation has occurred in a health-care organization where it is important to determine whether a particular nurse is categorized as a "staff nurse" or as a supervisor. What criterion should be used to make this differentiation? A) The nurse's position in the hierarchy of the unit based on years of experienced B) The nurse position on the organization's salary scale C) The nurse's level of influence on his or her peers and colleagues D) The percentage of time that the nurse spends as charge nurse versus giving direct client care

D) The percentage of time that the nurse spends as charge nurse versus giving direct client care

Which management function (in contrast to leadership role) related to collective bargaining and unionization should the nurse-manager perform? A) Examine the work environment periodically to ensure that it is supportive for all members. B) Create a work environment that is sensitive to employee needs, reducing the need for unionization. C) Actively seek a culturally and ethnically diverse workforce. D) Understand and appropriately implement union contracts

D) Understand and appropriately implement union contracts

In order to improve the likelihood that errors in the health-care system will be reported, nurse-managers should: A) give professionals the choice of whether or not to report errors. B) establish firm and meaningful punishments for staff who commit an error. C) assign "safety officers" whose exclusive role is to monitor for, identify, and follow up errors. D) foster a climate where analysis of errors is not solely focused on blame.

D) foster a climate where analysis of errors is not solely focused on blame.

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

A) Computerized order entry with a drug bar code system

A nurse delegated some tasks to a nurse several hours ago. The manager has now learned that the nurse did not complete any of the delegated tasks. What is the manager's best initial action? A) Determine exactly why the nurse did not complete the delegated tasks. B) Assertively state the expectation that delegated tasks will be completed on time. C) Document the nurse's insubordination and arrange a private meeting. D) Take action to reestablish the authority power gap

A) Determine exactly why the nurse did not complete the delegated tasks.

Which assessment should the RN prioritize when assigning tasks to nursing assistive personnel (NAP)? A) Determining the NAP's skills and knowledge level B) Assessing which tasks the NAP is motivated to perform C) Evaluating the NAP's ability to follow instructions D) Asking colleagues to appraise the NAP's strengths and weaknesses

A) Determining the NAP's skills and knowledge level

An RN is leading a care team on a busy hospital unit. What tasks is the RN justified in delegating to NAP? Select all that apply. A) Feeding a client who has unilateral weakness B) Repositioning an immobile client every 2 hours C) Assessing a client's surgical wound D) Weighing a client who has chronic heart failure E) Transporting a client to a diagnostic test

A) Feeding a client who has unilateral weakness B) Repositioning an immobile client every 2 hours D) Weighing a client who has chronic heart failure

Which statement concerning the 1967 and 1987 Age Discrimination and Employment Acts is true? A) Maximum age restrictions were lifted for almost all job categories. B) Employees can be forced to retire at age 70 years if their health is poor. C) Underage minors can be employed up to 20 hours per week. D) Individuals seeking retirement before the age of 60 years may be exempt from company pension plans.

A) Maximum age restrictions were lifted for almost all job categories.

The nurse is admitting a new client and is reviewing the results of the medication reconciliation. What data will be included in the client's medication reconciliation? Select all that apply. A) The medications that the client was taking prior to admission B) The client's expectations for treatment with medications during admission C) The client's medication administration record from any previous admissions D) The results of the nurse-manager's review of the client's treatment plan E) The list of medications the client has been prescribed by the admitting physician

A) The medications that the client was taking prior to admission E) The list of medications the client has been prescribed by the admitting physician

During orientation to a new job, a nurse is reviewing the relevance of labor standards to the new position. What aspects of the job will these standards affect? Select all that apply. A) The number of hours that the nurse will work B) The nurse's right to a safe workplace C) The way the nurse's salary is determined and paid D) The nurse's continuing education requirements E) The nurse's accountability to his or her supervisor

A) The number of hours that the nurse will work B) The nurse's right to a safe workplace C) The way the nurse's salary is determined and paid

Under which circumstance could the manager of an oncology unit deviate from the federal guidelines for handling chemotherapy agents? A) The state has instituted a policy that is more restrictive than the federal one. B) The director of nurses requested more personalized guidelines be put in place. C) The organization has been accident-free for the last 10 years. D) The state has a less restrictive policy that supersedes the federal one.

A) The state has instituted a policy that is more restrictive than the federal one.

A manager's subordinate is having difficulty carrying out a delegated task. What is the manager's best initial action? A) Release the subordinate from the task so he or she will not become demoralized. B) Be available to the employee as a role model and resource for the task. C) Assign another more experienced employee to help with the task. D) Reassign the employee a different, less complex task.

B) Be available to the employee as a role model and resource for the task.

A health-care organization has laid off several RNs and hired numerous NAPs in their place. What effect is this change most likely to have on the remaining RNs? A) There will be a risk of the RNs underdelegating. B) The RNs' level of liability will increase. C) Cultural variables will become a larger consideration. D) The RNs' scope of practice will become expanded

B) The RNs' level of liability will increase.

Which of the following behaviors should the nurse-manager identify as workplace violence, incivility, or bullying? Select all that apply. A) A group of nurses consistently refuse to help a nurse when that nurse has a heavy workload, despite having time to do so. B) Staff members assign an unwanted nickname to a colleague. C) A nurse's specific vacation request is denied by the manager for 2 years in a row. D) A nurse asks a colleague to assess a known verbally abusive client without warning to see how the colleague will respond. E) A nurse tells a nursing student to rush to room 311, knowing that the unit has no room 311

A) A group of nurses consistently refuse to help a nurse when that nurse has a heavy workload, despite having time to do so. B) Staff members assign an unwanted nickname to a colleague. D) A nurse asks a colleague to assess a known verbally abusive client without warning to see how the colleague will respond. E) A nurse tells a nursing student to rush to room 311, knowing that the unit has no room 311

Which members of a private health-care organization have their right to join a union protected by the National Labor Relations Act (NLRA)? Select all that apply. A) A registered nurse with 6 months of experience in the organization B) A licensed practical nurse C) A first-level manager D) A registered nurse with 2 years' experience in the organization E) A mid-level manager

A) A registered nurse with 6 months of experience in the organization B) A licensed practical nurse D) A registered nurse with 2 years' experience in the organization

Working conditions have deteriorated in recent months at a hospital, and there is a strong impetus for unionization. As a result, a majority of the nurses have signed interest cards. What will happen next in the steps to starting a union? A) A vote on the matter will be held among eligible staff members. B) A union will be established at the hospital. C) Management will have the opportunity to respond to the issue. D) A final decision will be made by the state board of nursing.

A) A vote on the matter will be held among eligible staff members.

A negotiating session has just concluded with a compromise agreement. What is the manager's best action? A) Clearly restate the terms of the compromise to all involved before dispersing. B) Give feedback to the members of the other negotiating team on their behavior and performance. C) Evaluate the fairness of the compromise to all involved parties. D) Restate each party's original bottom line

A) Clearly restate the terms of the compromise to all involved before dispersing.

The nurse-manager is overseeing a culturally diverse group of staff. The manager should consider what variables when planning delegation? Select all that apply. A) Communication style B) Concepts of time C) Intelligence D) Biological variations E) Social organization

A) Communication style D) Biological variations E) Social organization

An employee has come to the manager with a long list of complaints about a coworker, all of which are attributable to personality factors rather than unsafe practice. What is the manager's best initial action? A) Encourage the employee to speak directly with the coworker. B) Ask the employee to e-mail or text message the complaints to the coworker. C) Arrange for third-party mediation. D) Acknowledge and document the employee's complaints

A) Encourage the employee to speak directly with the coworker.

A health-care organization has experienced a rise in medical errors and has committed to implementing Leapfrog initiatives. What aspects of health care should the organization address? Select all that apply. A) Expanding the use of computerized physician-provider order entry B) Increasing the budget for continuing education for nurses C) Ensuring that hospital referrals are evidence-based D) Utilizing the National Quality Forum-endorsed Safe Practices scores E) Ensuring that adequately trained intensive care physicians are easily accessible

A) Expanding the use of computerized physician-provider order entry C) Ensuring that hospital referrals are evidence-based D) Utilizing the National Quality Forum-endorsed Safe Practices scores E) Ensuring that adequately trained intensive care physicians are easily accessible

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

A) Inspiring staff to establish and maintain high standards regarding patient care

By contract, employees are to receive overtime pay when their workday exceeds 8 hours. A staff member attended a mandatory, hospital-sponsored CPR certification class after working an 8-hour shift. What type of paycheck adjustment can the employee expect? A) Overtime for the time spent in the class B) Regular pay for the class because there was no charge for the class C) No pay for the class because it was identified as mandatory D) Equal compensated time back during the next pay period

A) Overtime for the time spent in the class

The nurse-manager has learned that two employees are in conflict. The manager's fact gathering reveals that the conflict exists because each employee misunderstands the job description and role of the other employee. What conflict management strategy should the manager implement first? A) Responsibility charting B) Confrontation C) Behavior change D) Third party consultation

A) Responsibility charting

A hospital system is trying to address some of the deficits in care that were described in To Err Is Human. When addressing the errors that this report identified, the hospital's leaders should focus on what factor? A) Systemic flaws in health-care delivery B) Malice on the part of some health-care providers C) Lack of education for health-care workers D) Increased use of nursing assistive personnel

A) Systemic flaws in health-care delivery

A nurse-manager has accepted a new position on a hospital unit. An experienced nurse on the unit tells the manager, "We all work really well with each other. There's never any conflict." How should the manager interpret this statement? A) The unit may be lacking in growth and new ideas. B) There is a need for the manager to introduce conflict. C) The manager needs to ensure that this characteristic continues. D) There is likely conflict that the nurse is not recognizing or acknowledging.

A) The unit may be lacking in growth and new ideas.

A nurse-manager is new to the unit and is worried about being perceived as incompetent or underqualified by subordinates. The manager should recognize that this creates a risk for what problem? A) Underdelegating B) Overdelegating C) Improper delegating D) Inappropriate delegating

A) Underdelegating

A nurse is in a conflict with a colleague, but both nurses are committed to collaboration. To promote collaboration, the nurses should: A) identify a common goal that is important to both of them. B) possess the ability to negotiate without having emotion get involved. C) have a relationship that existed before the conflict. D) ask a neutral third party to mediate in the conflict

A) identify a common goal that is important to both of them.

A client was treated in the hospital for a stroke and was the client's family members assert that the client was discharged too early and did not receive sufficient rehabilitation. The client's early discharge may have been attributable to: A) the effect of diagnosis-related groups. B) a sentinel event. C) the application of total quality management. D) deliberate malpractice

A) the effect of diagnosis-related groups.

What statement about conflict most closely reflects the interactionist theories of organizational conflict? A) "The most important response to conflict is to deal with it immediately." B) "Conflict can actually be a good thing and can help us to grow." C) "The presence of conflict in our workplace shows that there is bad management." D) "The best organizations are places where there is no conflict."

B) "Conflict can actually be a good thing and can help us to grow."

Which of the following would be considered sentinel events that should be reported to The Joint Commission? Select all that apply. A) A client with ischemic heart disease dies of a myocardial infarction. B) A client with dementia falls and suffers a hip fracture while trying to walk to the bathroom. C) A client files a formal complaint about the inattention of staff while he was in the hospital. D) A client experiences nephrotoxicity and requires dialysis because of a medication error. E) A client experiences a transfusion reaction after receiving the wrong type of packed red blood cells

B) A client with dementia falls and suffers a hip fracture while trying to walk to the bathroom. D) A client experiences nephrotoxicity and requires dialysis because of a medication error. E) A client experiences a transfusion reaction after receiving the wrong type of packed red blood cells

Two groups in the health-care organization have been unable to reach an agreement after prolonged negotiation. The groups have agreed to arbitration. What will happen during this process? A) A neutral party will facilitate new negotiations, starting from the beginning. B) A neutral party will listen to both groups and then present a binding recommendation. C) A neutral third party will act as a "go between" in the negotiations. D) Negotiations will continue in a court setting, and a lawyer will mediate between the groups

B) A neutral party will listen to both groups and then present a binding recommendation.

67. A nurse filed a grievance against the employer and the matter has proceeded to arbitration. What is true about this employee's grievance? A) Arbitration is likely the initial step in resolving the grievance. B) A neutral third party will impose a solution to the grievance. C) The grievance took place at a public health-care organization. D) The employer is likely trying to avert a strike.

B) A neutral third party will impose a solution to the grievance.

A unionization drive is taking place in a health-care organization. The National Labors Relations Board (NLRB) requires that what criterion must be met before an election for unionization can be held? A) Employees must demonstrate substandard wages or working conditions. B) At least 30% of the employees must sign an interest card. C) Management of the organization must give their written approval. D) A court order must be obtained by the organizers of the union drive.

B) At least 30% of the employees must sign an interest card.

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

B) Calmness and self-assuredness

A nurse-manager and several colleagues are reviewing the results of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. These results will allow the team to make what assessment? A) The root causes of adverse incidents B) Clients' perspectives on the care they received C) Consumers' health outcomes at 3 and 6 months after discharge D) Clients' health status at admission versus at discharge

B) Clients' perspectives on the care they received

The manager of a hospital unit has heard rumors about a unionization drive for several weeks and has just learned that the employees on the unit are planning to launch a formal drive. What is the manager's best action? A) Arrange meetings the organizers to independently address the factors that have prompted the drive. B) Collaborate with upper management and the personnel department to best address the workers' concerns. C) Apply disciplinary action to the employees who are leading the unionization drive. D) Strengthen relationships with employees who are known to be skeptical about the drive

B) Collaborate with upper management and the personnel department to best address the workers' concerns.

When creating a clinical practice guideline for the management of aggressive behavior on a mental health unit, the nursing committee should perform what action first? A) Interviewing senior staff for practice suggestions B) Conducting a search of the literature for research results C) Reviewing client satisfaction data to identify the unit's strengths and weaknesses D) Educating all unit nursing staff on the need to adhere to established guidelines

B) Conducting a search of the literature for research results

The manager has learned that some of the more experienced nurses on the unit have been playing pranks on a newly hired nurse and delegating their most challenging tasks to the nurse. What is the manager's best response after confirming that these events took place? A) Offer support and encouragement to the newly hired nurse. B) Confront the more experienced nurses directly about their behavior. C) Implement a structure change so the experienced nurses no longer work at the same time as the new nurse. D) Arrange for third-party consultation involving the more experienced nurses, the manager and the new nurse

B) Confront the more experienced nurses directly about their behavior.

A nurse-manager has begun a new role in a community health center and will need to delegate tasks often to subordinates. What actions should the manager perform when delegating tasks? Select all that apply. A) Choose the most time-consuming tasks to delegate to subordinates. B) Evaluate the skills and education of subordinates before delegating. C) Ensure that subordinates know the goal of any delegated task. D) Avoid monitoring the subordinate unless there is evidence of a problem. E) Evaluate subordinates' performance after they have completed a task

B) Evaluate the skills and education of subordinates before delegating. C) Ensure that subordinates know the goal of any delegated task. E) Evaluate subordinates' performance after they have completed a task.

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

B) Facilitating collaboration

During a quality improvement initiative, the leadership of a health-care organization has worked with senior managers to implement the principles of Lean Manufacturing. This initiative will focus on what factor? A) Identifying sentinel events B) Identifying and preventing waste C) Engaging all staff members D) Performing root cause analysis of errors

B) Identifying and preventing waste

A nurse-manager is attempting to help a group of staff members reach a consensus on a sensitive issue. What is a consequence of using a consensus-based approach? A) One group will be perceived as the "winner" and one group as the "loser." B) It is likely that neither group will achieve their desired "ideal" outcome. C) A solution that is ideal to both groups will be selected. D) There is an increased risk for similar conflict in the future.

B) It is likely that neither group will achieve their desired "ideal" outcome.

A nurse-manager has referred staff members to a clinical practice guideline (CPG) that addresses the prevention of pressure ulcers. What is a characteristic of this CPG? A) The CPG will lay out the criteria that the health-care organization must meet in order to be reimbursed for treating a client's pressure ulcer. B) It will describe interventions for nurses to follow in an effort to provide evidence-based care. C) It will describe the treatment for pressure ulcers that is provided at the best performing organizations. D) The CPG will summarize the etiology and diagnosis of pressure ulcers.

B) It will describe interventions for nurses to follow in an effort to provide evidence-based care.

What is the greatest limitation of the Health Plan Employer Data Information Set (HEDIS)? A) The Joint Commission has not updated the HEDIS since 2009. B) Managed care organizations are not required to collect HEDIS data. C) Performance indicators are exclusively process focused rather than outcome focused. D) HEDIS performance measures focus on medical interventions and do not address nursing actions

B) Managed care organizations are not required to collect HEDIS data.

High-achieving nursing students were found to have studied in small groups, attended class 100% of the time, took frequent rest breaks during study sessions, and ate a balanced diet for 1 week before the examination. What type of audit provided data about the students' preparation? A) Structure B) Process C) Outcome D) Concurrent

B) Process

An organization is attempting to prevent unionization. Which intervention demonstrates the administration's lack of understanding regarding employee motivation and satisfaction? A) Establish a well-developed formal procedure for handling employee grievances. B) Promote some of the potential union organizers to management positions. C) Have an effective performance appraisal system in place. D) Ensure that all managers are well-trained and effective

B) Promote some of the potential union organizers to management positions.

A registered nurse has been leading teams of NAP for several years and will soon be leading licensed practical nurses for the first time. In preparation for delegating to these nurses, the RN should: A) delegate the same tasks to the LPNs that the RN normally delegated to NAPs. B) review the practical nurse scope of practice in the jurisdiction where they are working. C) ask each LPN what tasks he or she is comfortable performing. D) consult a decision tree for delegation to unlicensed assistive personnel.

B) Review the practical nurse scope of practice in the jurisdiction where they are working.

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

B) State, "I need to have time to think over all that we have discussed."

A nurse-manager has delegated some administrative tasks to an experienced RN. How does this act of delegation differ from the usual practice of assigning work to subordinates? Select all that apply. A) The nurse's task will be beyond his or her scope of practice. B) The manager transfers the authority for the task to the nurse. C) The nurse is practicing on the manager's license. D) The manager is released of the need to oversee the nurse. E) The manager remains accountable for the task

B) The manager transfers the authority for the task to the nurse. E) The manager remains accountable for the task

Which organizational characteristic is most likely to make the employees view a union as an appealing option? A) This organizational mission is perceived as being too broad or ambitious to be achieved. B) The organization is perceived as being insensitive to employees' needs and well-being. C) The employees earn less than the average salary of comparable employees in the region. D) The organizational mission is insensitive to the population it serves.

B) The organization is perceived as being insensitive to employees' needs and well-being.

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

B) The qualifications of the person regarding the task

A senior manager is ensuring that organizational policies for compensation align with the Equal Pay Act of 1963. What domains of work should the manager examine? Select all that apply. A) The potential for promotion or advancement in the job B) The working conditions associated with the job C) The amount of responsibility that the job carries D) The effort that is required to perform the job E) The level of job satisfaction associated with the job F) The skill that is needed to perform the job

B) The working conditions associated with the job C) The amount of responsibility that the job carries D) The effort that is required to perform the job F) The skill that is needed to perform the job

The managers of a clinic have been accused of creating an unpleasant work schedule and increased workload for a nurse who helped lead an unsuccessful union drive. How should the managers' actions be best interpreted? A) Creating schedules and work assignment are valid management roles. B) These actions are violations of labor relations law. C) Management is within its rights but in violation of ethics standards. D) These actions are criminal offenses.

B) These actions are violations of labor relations law.

A subordinate is reluctant to accept a task that the nurse-manager wants to delegate. The manager suspects that the subordinate's reluctance is due to a lack of self-confidence. What is the manager's best initial action? A) Teach the subordinate about the value of self-confidence. B) Try to empower the subordinate. C) Offer a reward to the subordinate in order to motivate. D) Restate the importance of the task to the subordinate

B) Try to empower the subordinate.

A nurse-manager was involved in conflict where the other individual adopted a competing approach. This approach is evident in what circumstances? A) When fair play is important to all involved parties B) When one party wins at the expense of the others C) When managers need to control a volatile situation D) When an appropriate political strategy is necessary

B) When one party wins at the expense of the others

A nurse-manager is participating in negotiations around the allocation of resources in the organization. During the negotiations, the manager should: A) try to speak the same amount or slightly more than the other party. B) use open-ended questions rather than yes or no questions. C) declare his or her bottom line at the start of negotiations. D) ensure that the negotiations proceed at a rapid pace.

B) use open-ended questions rather than yes or no questions.

The nurse-manager has asked an NAP for an update on delegated tasks, and the NAP has said, "I'm swamped right now." What is the manager's best response? A) "Don't be afraid to let me know if you feel the project is overwhelming you." B) "Time management is key to keeping on schedule with your tasks." C) "I can give you a few solutions to help manage this heavy workload." D) "Do you want more time to complete your work?"

C) "I can give you a few solutions to help manage this heavy workload."

What statement by a nurse most directly reflects a common complaint about the roles of the American Nurses Association (ANA)? A) "It doesn't seem fair that every nurse contributes to the ANA but nurses in only a few states benefit from it." B) "It's incompatible for the ANA to represent staff nurses and nursing managers at the same time." C) "It doesn't seem right that the ANA simultaneously tries to advance the nursing profession while it bargains for nurses' contracts." D) "It could be unethical for the ANA to promote nurses' rights in a profession that was founded on helping others."

C) "It doesn't seem right that the ANA simultaneously tries to advance the nursing profession while it bargains for nurses' contracts."