Class questions Case Management/Nurse Manager Test 3

A nurse applied for a case manager position at the local hospital because the job description of the case manager is to: 1. help clients determine the best care for the least cost 2. eliminate the competition from the other providers 3. decide what treatment will be provided 4. provide a service that costs very little to offer

1

A nurse finds out that some managers have benevolent-authoratative style of management. Which of the behaviors will most likely be exhibited? 1. have condescending trust and confidence in subordinates 2. give economic or ego awards 3. communicates downward to staff 4. allows decision making among subordinates

1

A patient with HTN resides in a homeless shelter 30 mins from the pts primary clinic. The pts HCP recommends checking BP three times per week to determine efficacy of the pts antihypertensive meds. The nurse case manager: 1. contacts the clinic more accessible to the pt for follow up care 2. have the pt puchase a BP machine to self monitor 3. inform the pt the he/she has to provide his/her own transportation 4. instructs the pt to use a BP machine at a local store

1

Henry is a unit manager on a medical unit. He is not satisfied with the way things are going in his unit. Patient satisfaction rate is 60% for 2 months and staff morale is at its lowest. He decides to plan and initiate changes that will push for a turnaround. Which of the following actions is priority for Henry? 1. call for a staff meeting and take this up in the agenda 2. seek help from the manager 3. develop a strategic action on how to deal with these concerns

1

If a necessary medical treatment or service is denied to a patient, a case managers options include all of the following EXCEPT: 1. miscontruing the clients financial status to meet benefit eligibility 2. requesting a benefit plan exception for circumstances of hard ship 3. seeking community resources to provide needed coverage 4. advocating for a longer stay to meet pt. needs pending the availability of other options

1

Mrs. Carla plans on assigning competetent people to fill the roles designed in the hierarchy. Which process refers to this? 1. staffing 2. scheduling 3. recruitment 4. induction

1

She plans on assigning competent people to fill roles designed in the hierarchy. Which process refers to this? 1. staffing 2. scheduling 3. recruitment 4. induction

1

The nurse has just been promoted to unit manager. Which advice, offered by a senior unit manager will help this nurse become inspirational and motivational in this new role? 1. If you make a mistake with your staff, admit it, apologize and correct the error if possible 2. dont be too soft on the staff. If they make a mistake be certain to reprimand them immediately 3. Give your best nurses extra attention and rewards for their help 4. Never get into a disagreement with a staff member

1 (Managers need to be honest and forthcoming with staff, which includes taking responsibility for ones own actions and errors. This also provides a positive role model for staff)

When a nurse mananger makes a decision regarding the management of the nursing unit without input from the staff, the type of leadership style that the manager is demonstrating is: 1. autocratic 2. situational 3. democratic 4. laissez-faire

1 (The leader uses his/her power and position to make decisions without input from staff)

The RN case manager knows that it is her responsibility to : (select all that apply) 1. assess the clients overall quality of care and resources 2. plan and coordinate appropriate levels of care and their settings to ensure continuity of care 3. Implement care plans in a timely and cost effective manner and ensure it is done 4. evaluate if the plan of care was realistic and beneficial to all involved 5. interact using good communication with all involved 6. plan a party when the client finally gets discharged from her care

1,2,3,4,5

The nurse is coordinating a case mngmt system of care for which of the following purposes? Select all that apply 1. avoids fragmented services 2. provides continuity of services 3. matches the intensity of services 4. encourages the client to direct the decision making of the care 5. assists the client with method of payment 6. coordinates designated components of health care

1,2,3,6 (Case management is a type of delivery of care in which the healthcare needs of the client are managed by a nurse or HCP. The purpose of case management is to ensure the continuity of care and avoid fragmented services. It also coordinates all designated components of health care and matches the intensity of the services with the clients needs over time)

A 72 year old man who had a stroke is being transferred from a medical unit to a rehab center. The nurse case manager is assisting in the process. The nurse knows that the goals of case management include which of the following? select all 1. improving the coordination of care 2. increasing referrals to local organizations 3. reducing the fragmentation of care 4. discharging the clients quickly

1,3

Regardless of the size of a workgroup enough staff must be available at all times. To accomplish which of the following? SElect all that apply 1. meet the needs of pts 2. provide a pair of hands to other units as needed 3. cover all the time periods adequately 4. allow for growth and development of nursing staff

1,3,4

A charge nurse on a pediatric unit has just been informed of a potential admit from the ED. Which of the following nurses should not be assigned to admit the pt (select all that apply) 1. a nurse caring for a child with multiple gestational bleeds 2. a nurse caring for a child with no visitors or family 3. a nurse who recently discharged 2 pts 4. a nurse caring for a pt who began recieving a blood transfusion 1 hr ago 5. a nurse preparing for a complex dressing change

1,5

Katherine tries to design an organizational structure that allows communication to flow in all directions and involve workers in decision making. What form of organizational structure is this? 1. centralized 2. decentralized 3. matrix 4. informal

2 (allows staff to make decisions on matters pertaining to their practice and communicate in downward, upward, lateral and diagonal flow)

Which is the best instructional guidance for the nurse manager to include for the staff nurses when delegating the responsibility to revise the units educational policies? 1. Let me know if you need anything 2. complete the tasks in 6 weeks 3. give your suggestions and I will decide 4. tell me what you think after looking at everything

2 (delegation must be done clearly and precisely. The nurse manager must assign responsibility, identify the task to be accomplished, explain what outcomes are needed, and identify the time frame for completing the work)

India Farrow is the new DON at your facility. Understanding what Laissez-faire management style is , you recognize this to be her style. Which of the following of her characteristics supports this? select all that apply 1. The DON recognizes a care partner at a weekly meeting for providing exceptional care to her patients 2, The DON sends text messages to staff regarding new orders for a pt. 3. The DON decides to cease all bi-weekly employee in service meetings and posts a note by the time clock in reference to a website address to visit in-service yourself 4. The DON tells the charge nurses to decide for themselves the best room for a new admit, because she is leaving to go home on time today.

2,3,4

Which of the following should be included in the perfomance evaluations of nursing staff? select all that apply 1. other nurses evaluations to give a comparison 2. areas of strength 3. goals or expectations for improvement 4 areas needing improvement 5. consequences for falling short of expectations

2,3,4

The nurse is coordinating a case management system of care for which of the following purposes? select all that apply 1. assist the client with the method of payment 2. matches the intensity of the services 3. encourages the client to direct the decisions making of the care 4. provides continuity of services 5. coordinates designated components of care

2,4,5

Typically the nruse manager of a unit uses a participatory style of leadership. Today a patient suffered a cardiac arrest; the manager took over the pts care. Issuing orders, and expecting staff to obey them immediately. Which type of leadership did this manager exhibit? select all that apply 1. bureaucratic 2. autocratic 3. permissive 4. directive 5. authoritarian

2,4,5

A nurse is completing discharge teaching for a client who is about to be discharged home from a total hip replacement. The client asks the nurse why there is a case manager involved and expresses confusion about who is in charge. the client states "I thought the Dr. manages my care". Which is the best response by the nurse? 1. No I manage your care 2. You are correct, the doctor is responsible for managing your care 3. A case manager coordinated everyone involved in your care to ensure your needs are met 4. The case manager delegates your care to the nurse

3

A nurse manager has identified a problem on the nursing unit and holds unit meetings for all shifts. The nurse manager presents an analysis of the problem, and proposals for actions to team members and invites the team to comment and provide input. Which style of leadership is this nurse manager employing? 1. situational 2, laissez-faire 3. participative 4. authoritarian

3

Susan is a nurse in a management position. She likes to tell her staff to only report to her and not ever take directives from anyone else on her floor. What kind of management style does she exhibit? 1. Laizzez-faire 2. democratic 3. authoritative 4. participative

3

The term used to identify the effective use of pt case management interventions and the impact of case management on care is: 1. implementation 2. coordination 3. outcomes 4. monitoring

3

There have been several patient complaints that the staff members of the unit are disorganized and that "no one seems to know what to do or when to do it". The staff members concur that they dont have a real sense of direction and guidance form their leader. Which type of leadership is this unit experiencing? 1. autocratic 2. bureaucratic 3. laissez faire 4. authoratarian

3

Which behavior demonstrates the nurses competency as an emotionally intelligent leader? 1. The nurse is proficient in technical skill 2. The nurse relies on policies, not options 3. The nurse supports team members 4. Productivity is not a major concern

3

You are an RN who is performing case management roles. You have been asked to present a class to newly employed nurses about your role, responsibilities, and how to collaborate with case management. Which of the following is a primary case management responsibility associated with reimbursement you should include in the class? 1. The case managers role in terms of organization wide performance improvement activities. 2. The case managers role in terms of complete, timely, accurate documentation. 3. The case managers role in terms of the clients being at the appropriate level of care 4. The case managers role in terms of contesting denied reimbursements

3

Kate comes across a theory which states that this leadership style is effective dependant on the situation. Which of the following styles best fits a situation when the followers are self-directed, experts and are motivated individuals? 1. democratic 2. authoritarian 3. Laissez-faire 4. Beurocratic

3 (Laissez-faire leadership is preferred when the followers all know what to do and are experts in the field. This leadership styple is relationship oriented rather than task centered.)

A pediatric pt who is ventilator dependant has a gastrostomy button and is scheduled to be discharged to home with visits from a home health nurse. Prior to discharge the nurse case managers most critical action is to: 1. assess the patients long term care needs 2. procure the required home equipment 3. secure funding for sources of home health care 4. verify that the patient is being discharged to a safe environment

4

Ideally nursing case management planning identifies goals that are 1. anticipated, acceptable and appropriate 2. challenging and timely 3. patient-focused and cost-effective 4. realistic, measurable, and specific

4

In synthesizing data for a disease management program, a nurse case manager is using what source of data triangulation to validate a conclusion? 1. cost, containment, and length of stay 2. method, cause, and reaction 3. reason, rationales, and resolution 4. time, space and person

4

Mr. Caputo surfs the internet for more info about leadership styles. He reads about shared leadership as a practice in some magnet hospitals. Which of the following describes this style of leadership? 1. leadership behavior is generally determined by the relationship between the leaders personality and the specific situation 2. leaders believe that people are basically good and need not be closely controlled 3. leaders rely on heavily visioning and inspire members to achieve results 4. leadership is shared at the point of care

4

Peters view of management stimulated the shift toward the realization of the importance of participatory organizations. Which option provides a scenario that is an example of a participatory organization? 1. The control of an organization is centralized and decisions are mae by upper management 2. staff nurses are expected to provide support and nurturing for managements decisions 3. the organization's approach to leadership is autocratic and bureaucratic 4. staff nurses provide input into planning and changes for their own unit

4

Which description of a clinical pathway by a nursing student would indicate the best understanding of the concept? 1. clinical pathways are tools to measure patient outcomes 2. clinical pathways are the same as nursing care plans 3. clinical pathways are developed to use in acute care settings and guide the nursing care of patients as they are admitted, treated, and discharged 4. clinical pathways guide the patient and interprofessional team in managing patient care and recovery within a designated time frame

4

In caring for a client with a terminal condition, the nurse understands that the case management role in the hospital: 1. ends when the client is discharged to home health services 2. is not appropriate because a diagnosis of a terminal condition has been made 3. begins when the order is written for chemo to begin 4. begins when the client receives the diagnosis of cancer

4 (The case manager should be involved from the time that admission of the client and the process of case mngmt are implemented. Shortly after the dx has been made. This ensures that the multiple services are provided in an efficient and cost effective manner.)

Kathleen knows that one of the staff is experiencing burn out. Which of the following is the best thing for her to do? 1. advise her staff to go on vacation 2. Ignore her observations, it will be resolved or even out without intervention 3. Remind her to show loyalty to the institution 4. let the staff ventilate her feelings and ask how she can be of help

4 (reaching out and helping the staff is the most effective strategy in dealing with burnout. Knowing that someone is ready to help makes the staff feel important, hence her self worth is enhanced)