Leadership Exam 2

One of the most commonly used tools in health-care organizations is SWOT analysis. What is the definition for S? A) Internal attributes that help an organization achieve its objectives B) Internal attributes that challenge an organization in achieving its objectives C) External conditions that promote achievement of organizational objectives D) External conditions that challenge or threaten the achievement of organizational objectives

Ans: A Feedback: Strengths are internal attributes that help an organization achieve its objectives. Weaknesses are internal attributes that challenge an organization in achieving its objectives. Opportunities are external conditions that promote achievement of organizational objectives. Threats are external conditions that challenge or threaten the achievement of organizational objectives.

What is the focus of the entry job stage? a. skill development B. job esteem C. sense of purpose d. Indifference

Ans: A Feedback: During the entry phase of learning a job, an individual concentrates on skill development. None of the other options is the focus of this stage.

Why would an experienced nurse voluntarily opt for a self selected downward transfer? a. doing so increases the chances of long term career success. b. it allows for keeping a similar salary. c in times of downsizing, it allows a nurse to stay employed d. it occurs when a nurse if psychically impaired and productivity is affected.

Ans: A Feedback: For individuals to gain experience in a new area and to enhance long-term career goals, a self-selected downward transfer may be used. None of the other options accurately describe the reason for a self-selected downward transfer.

Which statement is true regarding individual values? A) They are often modified by parents, peers, and role models throughout life B) They seldom change as a result of life's experiences C) They have little influence on decision making once employed because organizational values eliminate personal values D) They show little variation between nursing managers once they have achieved some level of authority

Ans: A Feedback: Personal values are shaped by the socialization processes experienced by that person, and values change with time. The remaining statements are not true regarding individual values.

Benefits of effective planning include timely accomplishment of higher quality work and the best possible use of capital and human resources. Because planning is essential, managers must be able to overcome barriers that impede planning. What is an important point for successful organizational planning? A) The organization can be more effective if movement within it is directed at specified goals and objectives B) Plans to reach a goal must be rigid and not be distracted by current events C) The manager should include in the planning process the leadership people of units that could be affected by the plan D) A global plan and outline is sufficient to encourage and motivate employees

Ans: A Feedback: The organization can be more effective if movement within it is directed at specified goals and objectives. Because a plan is a guide to reach a goal, it must be flexible and allow for readjustment as unexpected events occur. The manager should include in the planning process all people and units that could be affected by a plan. A plan that is too global or unrealistic discourages rather than motivates employees.

What is required in a health-care organization philosophy statement? A) Should be evident in a nursing department's decisions, priorities, and behavior B) Has value, even if not implemented, because it provides a picture of what the organization would like to accomplish C) Should reflect the values and priorities of each specific unit manager D) Should be consistent with that of other health care agencies in the area to avoid competition

Ans: A Feedback: The unit philosophy will be congruent with the organizational philosophy. A philosophy delineates the set of values and beliefs that guide all actions. The other options do not accurately describe requirements of a health-care organization philosophy statement.

Which statement concerning a budget is true? A) A budget's reliability is related to how far in advance it was created B) Budgets should be created as far in advance is possible C) A budget is revised every 3 months during a fiscal year D) Budgets are reliable only when expenses are fixed

Ans: A Feedback: A budget that is predicted too far in advance has greater probability for error. The other options are incorrect statements regarding a budget.

Determine the nursing care hours per patient day (NCH/PPD) if the following staffing existed for a 24-hour period (unit census = 10): 12 midnight to 12 noon, 1 registered nurse, 1 licensed vocational nurse 12 noon to 12 midnight, 1 registered nurse, 1 licensed vocational nurse, 1 unit clerk (8 hours only) A) 5.6 NCH/PPD B) 4.8 NCH/PPD C) 5.0 NCH/PPD D) 6.2 NCH/PPD

Ans: A Feedback: A total of 56 hours of nursing was worked in 24 hours (unit clerks are counted in NCH/PPD) and the census was 10 patients. Dividing the total number of nursing care hours by the census (56 divided by 10) yields an NCH/PPD calculation of 5.6 NCH/PPD.

Which use of limited resources would result in increased reimbursement revenues? A) Education on appropriate documentation on patient care records B) Number of clinical nurse specialists C) Educational paid days for licensed staff D) Mix and number of clinical staff

Ans: A Feedback: Although options B, C, and D have the potential to improve patient care, education on documentation would most likely increase revenues.

What is the purpose of competency assessment regarding a nurses career? a. identifying ways to exceed minimal licensing requirements b. fulfilling state requirements for minimal nursing practice. C. facilitating advancement up the facilities career ladder d. satisfying institutional employment qualification A

Ans: A Feedback: Competency assessment and goal setting in career planning should help the employee identify how to exceed the minimum levels of competency required by federal, state, or organizational standards. The remaining options do not describe the purpose of competency assessments.

How does decentralized organizational structure promote decision making? A) Allows problems to be solved at the level at which they occur B) Encourages decisions to be made by top-level hierarchy C) Limits communication to managers at various levels D) Assigns responsibility at the highest practical level

Ans: A Feedback: Decentralized organizational structure allows decision making to be made at the level at which problems occur. None of the other options describes how decentralized organizational structure promotes decision making.

What is fiscal planning? A) A learned skill that improves with practice B) A job role of the facility business manager C) Part of the organizing phase of the management process D) Reactive based on political, social, and economic forces

Ans: A Feedback: Fiscal planning is a learned skill and must include nursing management input. It should never be reactive, and it is part of the planning process of management.

What is the largest budget expenditure for health-care organizations? A) The personnel budget B) Short-term capital acquisitions C) The operating budget D) Supplies and equipment

Ans: A Feedback: Health care is labor intensive; therefore, the personnel budget makes up the largest expense. The other options represent less expensive expenditures.

Which term is used for strategies that are neither written nor stated verbally and that have developed over time called? A) Implied policies B) Expressed policies C) Understood precedents D) The organizational culture

Ans: A Feedback: Implied policies are neither written nor stated verbally and have developed over time. The other options fail to meet this description.

Which statement identifies a characteristic of a planning objective? A) It has a specific time frame for completion B) It is subjectively evaluated on a periodic basis C) It has a100% compliance as a minimum criterion D) It is broad and inclusive in its nature

Ans: A Feedback: Multiple planning objectives, each with a target completion date, make up a goal. The remaining options are not characteristics of this objective.

What was the primary reason for the development of the prospective payment system? A) Skyrocketing health-care costs following the advent of Medicare and Medicaid B) The passage of the Health Maintenance Act of 1973 C) The introduction of the Health Security Act to Congress D) A coalition held by the three largest private insurers in 1975

Ans: A Feedback: Prospective payment systems were the result of skyrocketing medical costs in the United States. That is not true of the other options.

What is the basic principle of responsibility accounting? A) An organizations revenues, expenses, assets, and liabilities are someones concern. B) Managers have a responsibility to submit their budgets on time. C) The organizations financial officer works with department heads regarding budget approval. D) Fiscal accounting should be honest and accurate.

Ans: A Feedback: Responsibility accounting requires that someone must be responsible for all revenue, expenses, assets, and liabilities. While true, the other options are not the basic principle of responsibility accounting

Which information is too much in flux to identify on an organizational chart? A) Grapevine lines of communication B) Line and staff authority C) Span of control D) Scalar chains

Ans: A Feedback: The grapevine lines of communication cannot be placed on an organizational chart because they are constantly in flux. The remaining information is stable and so identified on the chart.

What determines the functions and priorities of an organization A) The organizations mission statement B) The organizations budget C) Consumer satisfaction surveys D) The organizations policy and procedure statements.

Ans: A Feedback: The mission statement is a brief statement identifying the reason the organization exists and its future aim or function. This is not the function of the other options.

Which reason qualifies as organization justification for a career development program? A. employee attrition can be reduced B. personnel can be used more effectively C. employees can increase earning power. D. employment benefits are increased

Ans: A Feedback: Organizational justification for career development programs includes attrition reduction, improved productivity, and general improved quality of life. Although employees may earn more money and additional benefits as a result of career development they are not the reasons organizations undertake career development programs.

What is the primary responsibility of the committee chairperson during a committee meeting? A) Keeping members on task B) Asking questions C) Resolving conflicts D) Providing information on each agenda item

Ans: A Feedback: Although all the items may be something the chairperson does, the primary responsibility is to keep members on task so committee work gets completed.

Which factor contributes to the difficulty health-care organizations are having in planning for identified long-term needs? Select all that apply. A) Government regulations B) Rapidly changing technologies C) Decreased provider autonomy D) Changing population demographics

Ans: A, B, C, D Feedback: Because of the rapidly changing technology, increasing government regulatory involvement in health care, changing population demographics, and reduced provider autonomy, health-care organizations are finding it increasingly difficult to appropriately identify long-term needs and plan accordingly. Consumer distrust is not a current factor contributing to the difficulty health-care organizations are experiencing with long-term planning.

Which statement concerning the role of the leader-manager in organizational planning is true? Select all that apply. A) They need to be future oriented B) They must be willing to take risks C) They must possess human resource management skills D) They need to be prepared to appraise the social climate that affects the organization

Ans: A, B, C, D Feedback: Planning requires managerial expertise in health-care economics, human resource management, political and legislative issues affecting health care, and planning theory. Planning also requires the leadership skills of being sensitive to the environment, being able to appraise accurately the social and political climate, and being willing to take risks. Managers then must draw on the philosophy and goals established at the organizational and nursing service levels in implementing planning at the unit level. The manager then draws on his or her leadership skills in creativity, innovation, and futuristic thinking to problem solve.

What is a characteristic of strategic planning? Select all that apply. A) Requires managerial expertise in health-care economics B) Should reflect political issues related to health care C) Human resource expertise is required D) Should be based on a planning theory

Ans: A, B, C, D Feedback: Strategic planning generally forecasts 3 to 10 years into the future and requires managerial expertise in health-care economics, human resource management, and political and legislative issues affecting health care, as well as planning theory.

Which statement regarding a budget is true? Select all that apply. A) A budget contains an estimate of both expenses and income for a year. B) It allows for an institution to plan for the effective use of its resources C) The cost of supplies is an example of a variable expense D) A mortgage is an example of a fixed expense

Ans: A, B, C, D Feedback: A budget is a financial plan that includes estimated expenses as well as income for a period of time. Accuracy dictates the worth of a budget; the more accurate the budget blueprint, the better the institution can plan the most efficient use of its resources. Because a budget is at best a prediction, a plan, and not a rule, fiscal planning requires flexibility, ongoing evaluation, and revision. In the budget, expenses are classified as fixed or variable and either controllable or non-controllable. Fixed expenses do not vary with volume, whereas variable expenses do. Examples of fixed expenses might be a building's mortgage payment or a manager's salary; variable expenses might include the payroll of hourly wage employees and the cost of supplies.

An effective transition program for new nursing grads will address which issue? select all that apply a. supporting practice autonomy b. strengthening new clinical skills c. introducing time management skills d. integrating into the nursing unit environment

Ans: A, B, C, D Feedback: A well-designed transition-to-practice program strengthens new graduates skills and competencies and prepares the new nurse for the demands of caring for patients. Furthermore, a systematic approach to transition not only facilitates on-boarding (integration into staffing on the nursing unit to provide direct patient care), it reduces turnover by decreasing the toll associated with insufficient preparation for the work environment. Satisfying nursing position needs is not a focus of a transition program for new graduates.

Which statements is true concerning a bureaucratic organization? A) It is commonly referred to as a line organization B) It is typically found in large health-care organizations C) They resemble Weber's original design of organization D) Its authority is represented by its staff organizational chart

Ans: A, B, C, D Feedback: Bureaucratic organizational designs are commonly called line structures or line organizations. Those with staff authority may be referred to as staff organizations. Both of these types of organizational structures are found frequently in large health-care facilities and usually resemble Weber's original design for effective organizations. Because of most people's familiarity with these structures, there is little stress associated with orienting people to these organizations.

Which activity represents a commitment to career planning? select all that apply a. introduces EBP changes regarding wound dressings b. discussing the health needs of the homeless with local politicians c. earning a BSN in nursing d. Working with a seasoned mentor

Ans: A, B, C, D Feedback: Career planning should include, at minimum, a commitment to the use of evidence based practice, learning new skills or bettering practice through the use of role models and mentors, staying aware of and being involved in professional issues, and furthering one's education. Full-time employment is not a necessary commitment.

Which statement regarding fiscal planning is true? Select all that apply. A) Social influences affect fiscal planning B) The successful fiscal planner is creative C) An understanding of economic forces is necessary D) Practical experience is a key to being a good fiscal planner

Ans: A, B, C, D Feedback: Fiscal planning is not intuitive; it is a learned skill that improves with practice. Fiscal planning also requires vision, creativity, and a thorough knowledge of the political, social, and economic forces that shape health care.

Which activity is directed toward a new graduate's responsibility to their nursing career? select all that apply a. earning a professional nursing certification b. gaining expertise in a specific field of nursing c. being a member of a professional nursing association d. earning an advance nursing degree within 5 years of initial licensure

Ans: A, B, C, D Feedback: New graduates also have responsibility during the first few years of employment to gain the expertise they need to have more opportunities for career divergence in the future. This includes becoming an expert in one or more areas of practice, gaining professional certifications, and being well informed about professional nursing and health-care issues. This is also a time where participation in professional associations has great value as a result of the opportunities for mentor ing and networking. Finally, all new graduates should consider at what point, continued formal education will be a part of their career ladder and professional journey.

Which component is considered a part of an organizational structure? Select all that apply. A) Group formation B) Lines of communication C) Decision-making process D) Channels of legitimate authority

Ans: A, B, C, D Feedback: Organizational structure refers to the way in which a group is formed, its lines of communication, and its means for channeling authority and making decisions.

During the process of acquiring values, criteria should be used to assist in clarifying the chosen value. Which is a criterion for a true value? Select all that apply. A) It is freely chosen from among alternatives B) It is prized and cherished C) It is positively affirmed D) It is acted upon

Ans: A, B, C, D Feedback: A value is prized and cherished, positively affirmed and acted upon, and chosen freely from among alternative. Because our values change with time, periodic clarification is necessary to determine how our values may have changed.

Which statement regarding rules is true? Select all that apply. A) Rules should be flexible B) There should be as few rules as possible C) Rules should be changed on a regular basis D) Enforcement of the rules supports staff morale

Ans: A, B, D Feedback: Rules are fairly inflexible, so the fewer rules, the better. Existing rules, however, should be enforced to keep morale from breaking down and to allow organizational structure. It is neither reasonable nor necessary for all involved parties to agree with the rules but all must follow them. Rules require regular evaluation but change may not be warranted.

When considering the interprofessional approach to healthcare, to whom does the nurse owe accountability? Select all that apply. A) The physician B) Their patients C) Their unit manager D) Their director of nursing

Ans: A,B,C,D. Feedback: Nurses frequently feel as though they have many individuals to account to because health care often involves an interprofessional approach. Additional individuals the nurse may need to be accountable to may include the immediate supervisor, the patient, the patient's family, central administration, and the physician. The nurse has no accountability to other nurses in this situation.

Which characteristics are associated with a constructive culture? A Affiliative norms B. Self-actualization C. Encouragement of humanism D. Perfectionist norm

Ans: A,B,C. Feedback: Affiliation, self-actualization, and encouragement are all characteristics of a constructive culture, whereas perfectionist norms are a characteristic of destructive organizational cultures.

What is needed to change a unit culture that has become firmly entrenched? A) New leadership B) A change agent with management skills C) Identification with a unit that is not entrenched D) Administration support

Ans: A. Feedback: It is extremely difficult to change a unit culture without new leadership. The remaining options are directly involved in the change out of entrenchment.

The measurement of NCH/PPD will provide what information? A) The acuity level of the patients on a particular unit in a 24-hour time span B) The total number of hours worked by nursing personnel on a particular unit in a 24-hour time span divided by the patient census C) The specific amount of money spent on staffing during a 24-hour period D) The quality of nursing care that was provided on a particular unit in a 24-hour time span

Ans: B Feedback: The Personnel Budget NCH/PPD refers to number of nursing care hours worked in 24 hours divided by the patient census.

Which activity is a responsibility of the unit manager regarding fiscal planning? A) To assume responsibility for achieving budgetary planning goals B) To monitor and evaluate all aspects of the units budget control C) To streamline the number of subordinates involved in the budgetary process D) To control unpredictable census variations that may undermine the personnel budget

Ans: B Feedback: The managers responsibility is to monitor all aspects of the units budget. The other options fail to identify a managers responsibility.

How are preactive planners described? A) They consider and value the past, the present, and future B) They use evolving technologies to accelerate change C) They consider the status quo as a stable environment D) They direct planning in response to a crisis

Ans: B Feedback: Dissatisfied with the past and present, preactive planners do not value experience and believe the future is always preferable. Their focus is not necessarily crisis response.

A good plan incorporates which characteristic? A) A midterm evaluation B) Built-in evaluation checkpoints C) The rejection of plans that originally failed D) Over-planning to arrange required details

Ans: B Feedback: Good plans have built-in evaluation checkpoints so that there can be a midcourse correction if unexpected events occur. A final evaluation should always occur at the end of the plan. If goals were not met, the plan should be examined to determine why it failed. This evaluation process assists the manager in future planning. One who overplans may devote excessive time to arranging details that might be better left to those who will carry out the plan.

What is the leadership role when a unit is attempting to overcome the decentralization of patient care? A) Determining what changes will be made to the plan of care B) Facilitating the group's work C) Identifying the patient care problems D) Selecting solutions to problems

Ans: B Feedback: In a patient-centered focused activity, the team leader should facilitate the work of the group and should not be the sole decision maker.

Max Weber, as part of the scientific management era, contributed immensely to the development of organizational theory. Which statement is not representative of his beliefs? A) Bureaucracy could provide a rational basis for administrative decisions B) Worker satisfaction was integral to productivity C) Organization charts could depict the hierarchy of authority D) Impersonality of interpersonal relationships should exist in organizations

Ans: B Feedback: Max Weber's theories did not address worker satisfaction. The other options do represent the Weber organizational theory.

How can a nursing professional demonstrate advanced achievement of competencies? A. lateral transfer B. prof. specialty certification c. transfer to a new dept. D. professional registered nursing licensure

Ans: B Feedback: Professional specialty certification is one way that an employee can demonstrate advanced achievement of competencies. The transfer, when used appropriately, may be an effective way to provide career development but a lateral transfer does not demonstrate advancement. A transfer to a new department often requires the acquisition of new skills before advance can occur. A nursing license signifies entry-level skills.

Research supports that which factor may lead nurses to become disengaged in their careers? A. they do not feel that nursing is valued as a career B. Boredom increases with time on the same job C. Many nurses interrupt their careers for childrearing D. nursing is low paying compared to other careers B

Ans: B Feedback: Research has shown that boredom and job indifference leading to disengagement increase with time on the same job. While the o the r options may be factors, they are not research supported.

A new grad who began their nursing career 6 months ago and who completed orientation 3 months ago is in what stage of professional development? A. Experimentation B. Entry C. Mastery D. Disengagement

Ans: B Feedback: The nurse is still in the entry stage and will be until necessary skills are learned. It generally takes an extended period of time to obtain the skills necessary for mastery. The remaining options are not relevant to this question.

What makes an organizational philosophy useless? A) Being expensive to implement B) Viewed as being impossible to implement C) Not having the support of all the involved parties D) Involving a change in the organizational point of view

Ans: B Feedback: An organizational philosophy that is not or cannot be implemented is useless. While challenging, the other options are surmountable.

Which term is used to identify having official power to act? A) Responsibility B) Authority C) Accountability D) Leadership

Ans: B Feedback: Authority means having the official power to act. None of the other terms is used to identify having official power to act.

What is inferred if an item is cost-effective? A) It is the least expensive product available B) It is worth the cost C) It is reimbursable D) Its cost was anticipated

Ans: B Feedback: Cost-effective does not necessarily imply the cheapest, but it requires that the expenditure be worth the cost. The other options are not characteristic of the term cost effective.

What are the results of managed care backlash? 1. Delay of payment for services provided 2. Denial of requests for additional treatment 3. Increased premiums to consumers 4. Lower co-pays and deductibles A) 1, 2 B) 1, 3 C) 2, 4 D) 3, 4

Ans: B Feedback: Providers have grown increasingly frustrated with limited and delayed reimbursement for services provided as well as the need to justify need for services ordered. This phenomenon, referred to as managed care backlash, resulted in some managed care programs beginning to say ìyesî to more treatments although they have passed the cost along with customers in the form of higher premiums, co-pays, and deductibles.

Which would suggest that flattening of the organization is occurring? A) There is a collective spirit B) There is reduction in the administration levels C) There are shared work goals across units D) There are formal and informal systems are in place to address conflicts

Ans: B Feedback: Reducing the numbers of administration levels is called flattening the organization. The remaining options are not related to organizational flattening.

Which factor is primarily important when budgeting for a healthcare facility? A) Services provided B) Budget time frame C) Size of organization D) Acuity of patients being served

Ans: B Feedback: Selecting the optimal time frame for budgeting is important. Errors are more likely if the budget is projected too far in advance. The other options are considered but not of primary importance.

What changed the structure of Medicare payments from a retrospectively adjusted cost reimbursement system to a prospective, risk-based one? A) Zero-based budgets B) Diagnostic-related groupings C) Prospective payment system D) Incremental budgets

Ans: B Feedback: The impetus of diagnosis-related groupings changed the structure of Medicare payments from a retrospectively adjusted cost reimbursement system to a prospective, risk-based one. None of the other options were involved in the change.

What is is an institutional grapevine? A) Organizational gossip B) An informal channel of communications C) An institution's informal authority chain D) The connecting format used on an organizational chart

Ans: B Feedback: The informal structure also has its own communication channels, often referred to as the grapevine. None of the remaining options accurately describes an organizational grapevine.

A nurse has been transferred to another unit in the hospital to perform the same type of duties. What type of transfer is this called? A. accommodating b. Lateral C. Diagonal D. Downward

Ans: B Feedback: Doing the same type of duties in another location is called a lateral transfer. The remaining terms do not infer this type of transfer.

What is the name of the stage of a career where nurses are experienced clinicians with expert knowledge, skills, abilities, credentials, and education base? A) Promise B) Momentum C) Harvest D) Legacy

Ans: B Feedback: Momentum is the middle career phase and typically reflects the nurse with 11 to 29 years of experience. Nurses in this phase are experienced clinicians with expert knowledge, skills, abilities , credentials, and education base.

Which statement regarding nursing policies and procedures is most important to their successful role in achieving goals? A) The policies and procedures are created by staff representatives B) All policies and practices are based on current evidence related to practice C) Policy or procedure adoption is dependent upon effective utilization of resources D) 100% of the staff adheres to established policies and procedures 100% of the time

Ans: B Feedback: Policies and procedures should be evidence based. While the other options are influential to success, they are the most important aspect of policies and procedures.

Which characteristics are associated with Magnet hospital status? Select all that apply. A. Centralized environment B. Open, participatory management C. Improved patient outcomes D. Higher staff nurse satisfaction

Ans: B, C, D Feedback: Magnet designation is conferred by the ANCC to health-care organizations exemplifying well-qualified nurse executives in a decentralized environment, with organizational structures that emphasize open, participatory management. Magnet- designated organizations demonstrate improved patient outcomes and higher staff nurse satisfaction than organizations that do not have Magnet status.

What occurs during implementation of a shared governance model? A) Lines of authority are altered B) Joint practice committees are formed C) Participatory management is initiated D) The roles of first-level managers are stabilized

Ans: B. Feedback: In shared governance, the organizations governance is shared among board members, nurses, physicians, and management. Joint practice committees are developed to assume the power and accountability for decision making, and professional communication is egalitarian rather than hierarchical. Shared governance is not associated with the other options.

What is the name for a provision of health care in an organized system to subscribing members in a geographical area with an agreed-on set of basic and preventive supplemental health maintenance and treatment services for a fixed, prepaid charge? A) Preferred provider organizations (PPOs) B) A traditional third-party payer indemnity plan C) A health maintenance organization (HMO) D) Diagnostic-related groupings (DRGs)

Ans: C Feedback: HMOs provide health care in an organized system to subscribing members in a geographical area with an agreed-on set of basic and preventive supplemental health maintenance and treatment services for a fixed, prepaid charge. That definition does not apply to the other options.

Which statement about organizational centrality is true? A) It refers to the decision-making structure in an organization B) It occurs when there is consonance of subunit cultures in the organization C) It is a position on the organizational chart where types of communication occur D) It occurs primarily in line relationships

Ans: C Feedback: Centrality is a position on an organizational chart where it is possible to have many different types of communication (upward, downward, lateral, and diagonal). The other statements do not describe organizational centrality accurately.

What is the purpose of a cover letter? Select all that apply 1. Introduce the applicant 2. briefly highlight key points of career 3. Make a positive first impression. 4. always used when submitting a resume a. 1,2,3 b. 1,2,4 c.1,3,4 d. 2,3,4

Ans: C Feedback: Cover letters (whether by mail or e- mail) should always be used when submitting a resume. Their purpose is to introduce the applicant, briefly highlight key points of the resume, and make a positive first impression.

Which statement is true regarding career planning? a. employer's responsibility b. results in the spontaneous assessment of goals c. it requires the development of a long term plan d. functions best when the planning is episodic in nature

Ans: C Feedback: Effective career planning requires long-term planning; it is the responsibility of the individual and requires constant attention to function properly.

One of the most commonly used tools in health-care organizations is SWOT analysis. What is the definition for opportunities? A) Internal attributes that help an organization achieve its objectives B) Internal attributes that challenge an organization in achieving its objectives C) External conditions that promote achievement of organizational objectives D) External conditions that challenge or threaten the achievement of organizational objectives

Ans: C Feedback: Opportunities are external conditions that promote achievement of organizational objectives. Strengths are internal attributes that help an organization achieve its objectives. Weaknesses are internal attributes that challenge an organization in achieving its objectives. Threats are external conditions that challenge or threaten the achievement of organizational objectives.

Which statement is accurate concerning management development classes? a. they are not cost effective, but increase worker satisfaction b. they are necessary for advancement to management positions C. they require the inclusion of social learning activities D. They are a responsibility of middle-level management

Ans: C Feedback: The inclusion of social learning activities in management development increases the possibility for employee retention. Management development is cost-effective for the organization but may not be necessary for all managers. Top executives in the organization have a responsibility to support the management development program.

What does the term unity of command mean? A) The number of individuals directly reporting to a manager B) Having a limited number of top-level managers C) Each employee having only one boss D) A flexible structure that encourages participative decision making

Ans: C Feedback: Unity of command means one immediate boss per employee. None of the other options correctly describes the term unity of command.

During a strategic planning committee meeting to develop futuristic technology goals, several unit managers spend a considerable amount of time discussing current staffing problems. What is the primary action of the chairperson of this committee? A) Take the remainder of the meeting time to discuss staffing with all members B) Adjourn the meeting and reschedule at a time when there are no staffing problems C) Request that committee members return to discussing items on the agenda D) Excuse those discussing staffing from the remainder of the meeting

Ans: C Feedback: Committee time is wasted when agendas are not adhered to. The remaining options do not address the issue of wasted time effectively.

What is the focus of a nursing portfolio? a. career goals b. salary expectations c. professional growth d. educational background

Ans: C Feedback: All nurses should maintain a professional portfolio (a collection of materials that document a nurse's competencies and illustrate the expertise of the nurse) to reflect their professional growth over their career. The other options are not the focus of a professional portfolio.

What is the best definition for the process of planning? A) Problem oriented B) Short-term goal setting C) Continuous with cyclic evaluation checkpoints D) A long-range needs assessment

Ans: C Feedback: Planning can be short term or long term, but should always include built-in evaluation checkpoints so there can be a midcourse correction if unexpected events occur.

Which statement accurately describes provision of service? 1. It guarantees reimbursement 2. Proof is required for need for services 3. Reimbursement is based on services provided 4. The social worker is the gatekeeper A) 1, 2 B) 1, 4 C) 2, 3 D) 3, 4

Ans: C Feedback: Provision of service no longer guarantees reimbursement. Clear and comprehensive documentation of the need for services and actual services provided is needed for reimbursement.

Which statement about American health-care budget spending is correct? A) A large health-care budget equals quality health-care outcomes B) America spends less than any other industrialized country on health care C) The outcomes related to low birth-weight infants have not been successfully met D) The scarcity of resources is the biggest factor in the failure to reach outcomes

Ans: C Feedback: Spending more does not always equate to higher-quality health outcomes. The United States spends more per capita on health care than does any other industrialized country, and yet our outcomes in terms of teenage pregnancy rates, low birth-weight infants, and access to care are worse than many countries that spend significantly less. The problem then is not a scarcity of resources. The problem is that we do not use the resources we have available, in a cost-effective manner.

What type of budget requires rejustification for yearly fiscal needs? A) Incremental budgeting B) Perpetual budgeting C) Zero-based budgeting D) Managed care

Ans: C Feedback: Zero-based budgeting begins each year with zero and requires rejustification. This is not true of the other options.

What are restraining forces for specialty certification in a professional nursing? 1. decreased collaboration with other HCPS 2. cost 3. lack of recognition 4, increased retention A. 1,2 B. 1,4 C. 2, 3 D. 3 4

Ans: C Feedback: Cost coupled with lack of institutional reward and support kept some nurses from pursuing certification. The impact of certification on absenteeism and retention was unclear.

Which element influences the nurse executive most heavily when assessing the organizations philosophy for nursing services for possible revision? A) Consumer surveys B) Financial resources C) Mission statement D) Policy statements

Ans: C Feedback: The philosophy flows from the mission statement, the highest priority in the planning hierarchy. The other options are not as influential.

Research supports that organizational restructure affects nursing in what manner? A) It decreases nursing autonomy B) It decreases nursings formal authority C) It increases the effectiveness of patient care D) It increases patient autonomy

Ans: C. Feedback: Current research suggests that changing an organizations structure in a manner that increases autonomy and work empowerment for nurses will lead to effective patient care. The remaining options failed to describe the research supported effect of organizational restructure on nursing.

Which statement is true regarding long-term coaching for career development? A. it occurs annually at performance appraisal reviews B. it focuses on employee performance deficits C. it requires the same intensity as a mentoring relationship D. it occurs over the entire employment tenure of an employee

Ans: D Feedback: Long-term coaching should occur over the entire employment of the employee. The remaining options are not true statements regarding career development.

Which is a symptom of poor organizational structure? A) Communication follows the chain of command B) The smallest possible number of managers exists to keep units functioning C) The chain of command is fairly short D) There is a heavy reliance on committees to solve unit problems

Ans: D Feedback: A heavy reliance on committees to solve problems is an indication of a poorly structured organization and often results in delays in critical decision making. The other options describe examples of good organizational structure.

At the unit level, what time frame may be considered long-range planning? A) 3 months B) 4 months C) 5 months D) 6 months

Ans: D Feedback: At the unit level, any planning that is at least 6 months in the future may be considered long-range planning.

How is competency of an employee best determined? A. an exam of patients records B. self reporting on an administered skills check sheet C. Evidence of attendance in continuing edu class D. Documentation of effectively meeting role demands

Ans: D Feedback: Competency relates to role and is determined by each role demand. None of the other options are able to determine competency as effectively as documentation of performance.

Which is a leadership role in fiscal planning? A) Coordinating the monitoring aspects of budget control B) Accurately assessing personnel needs using agreed-on standards or an established patient classification system C) Assessing the internal and external environment of the organization in forecasting to identify driving forces and barriers to fiscal planning D) Being visionary in identifying short- and long-term unit fiscal needs

Ans: D Feedback: Leaders are visionary; the other roles are management related.

What is a management function associated with career development? a. is self aware of personal values influencing career development. b. encourages employees to take responsibility for their own career planning. c. identifies, encourages, and develops future leaders d. works cooperatively to arrange intra-organizational transfers

Ans: D Feedback: Management function is to work cooperatively with other departments in arranging for the release of employees to take other positions within the organization. Leadership functions associated with career development are self-aware of personal values Influencing career development; encourage employees 10 take responsibility for their own career planning; and identifies, encourages, and develops future leaders.

What activity is a personal responsibility for career management? A. developing career ladders B. establishing career paths C. providing challenging assignments D. developing a career plan

Ans: D Feedback: Only the development of a career plan is the responsibility of the individual. The first three choices are management responsibilities.

Which statement concerning organizational culture is true? A) It presents how employees "perceive" an organization B) It defines how power is used by organizations to direct the work of others C) It describes the predictable stages of group and organizational development D) It is a system of symbols, beliefs, values, history, and communication patterns

Ans: D Feedback: Organizational culture is the symbols and beliefs, values, history, and communication patterns of the organization. It differs from organizational climate, which is how the employees perceive the organization. The other options are not relevant to the term organizational culture.

What principle is key in resumes' construction? a. emphasize strong and weak points equally b. be at least four to five pages in length c. reflect complex, scholarly language d. be concise and easy to read.

Ans: D Feedback: The content of a resume should be able to be grasped quickly by the individual doing the hiring, so conciseness and readability are of key importance. The remaining options do not express correct information concerning resume construction.

The manager should have a well developed planned system for career development for all employees. What should be included? 1. policies communicated to administrators 2. appropriate use of transfers 3. How promotions are handled 4. long term coaching a. 1,2,3 b. 1,2,4 c. 1,3,4 d. 2,3,4

Ans: D Feedback: The manager should have a well-developed, planned system for career development for all employees; this system should include the appropriate use of transfers, how promotions are to be handled, and long -term coaching. These policies should be fair and communicated effectively to all employees.

What is capitation? A) A reimbursement schema whereby health-care organizations receive a predetermined amount (based on a patient's diagnosis for services provided) B) The limited availability of services to patients in managed care organizations C) The use of a ìgatekeeperî to ensure appropriate utilization of services D) A predetermined, negotiated payment to providers, per patient, regardless of whether services are used

Ans: D Feedback: Capitation is a predetermined, negotiated payment to providers, per patient, regardless of whether services are used. None of the other options correctly describe capitation.

Which statement best describes critical pathways? A) They determine justifiable differences among clients B) They decrease the amount of paperwork required for reimbursement C) They reduce administrative costs D) They provide a means of standardizing care for clients with similar diagnoses

Ans: D Feedback: Critical pathways are one means of standardizing care for clients with similar diagnoses. The other options are not true statements regarding critical pathways.

Which statement is true regarding depiction of staff positions on an organizational chart? A) They are depicted as unbroken lines B) They are represented by double dotted lines C) They are shown as a solid, vertical line D) They are identified with a dotted line.

Ans: D Feedback: Dotted or broken lines on the organization chart represent staff positions. Formal relationships, lines of communication, and authority are depicted on a chart by unbroken (solid) lines. Double dotted lines are not generally used on an organizational chart.

Which is a true statement about planning? A) All plans should be defined well so that changes aren't necessary B) Long- and short-range plans should be kept separate so priorities do not become confused C) Objectives and goals must be established before the philosophy is written D) All plans should include reasonable time limits

Ans: D Feedback: Every plan should have a reasonable time span for completion. The other statements are not true regarding the process of planning.

Key principles of managed care include: 1. Nurses as gatekeepers 2. Focus on prevention 3. Decreased emphasis on inpatient hospital care 4. Capitation A) 1, 2, 3 B) 1, 2, 4 C) 1, 3, 4 D) 2, 3, 4

Ans: D Feedback: Key principles of managed care include the use of primary care providers as gatekeepers, a focus on prevention, a decreased emphasis on inpatient hospital care, the use of clinical practice guidelines for providers, selective contracting, capitation, utilization review, the use of formularies to manage pharmacy care, and continuous quality monitoring and improvement.

Using a decision package to aid in fiscal priority setting is a key feature of what type of budgeting? A) Personnel workforce B) Operating C) Capital D) Zero based

Ans: D Feedback: Managers must rejustify their program or needs every budgeting cycle in zero-based budgeting. Among the options available using a decision package to set funding priorities is a key feature of only zero-based budgeting

Which position is characteristic of a middle-level manager? A) Primary care nurse B) Team leader C) Charge nurse D) Nursing supervisor

Ans: D Feedback: Nursing supervisors are middle-level managers. All the others are first-level managers.

What is represented in a document entitled Fourteen Specific Steps to Successful Intravenous Catheterization at Hospital XYZ? A) Philosophy B) Mission statement C) Policy D) Procedure

Ans: D Feedback: Procedures delineate a series of specific steps of required action. None of the other options is the focus of this document.

Equipment depreciation, the number and type of supplies needed by patients, and overtime that occurs in response to an emergency are all examples of what type of expenses? A) Controllable B) Fixed C) Capital budget D) Noncontrollable

Ans: D Feedback: The items mentioned are noncontrollable as these cannot be controlled or fixed and are not parts of capital costs.

What does the term "optimum span of control" mean? A) It defines the manager's decision-making authority B) It identifies the manager's abilities and responsibilities C) It refers to a line-and-staff organizational structure model D) It is the number of subordinates and manager is responsible for

Ans: D Feedback: The number of people directly reporting to any one manager represents that manager's span of control and determines the number of interactions expected of him or her. None of the remaining options correctly describes this term.

How is the leadership role associated with operational and strategic planning? A) Articulating the unit philosophy in writing B) Assessing unit resources available for planning C) Developing unit policies and procedures that operationalized unit objectives D) Encouraging subordinates to be involved in policy formation

Ans: D Feedback: Encouraging subordinates is a leadership function; the others are management functions. The other options do not achieve this goal.

Which statement describes an emerging paradigm that is likely to influence strategic planning for health care in the twenty-first century? A) Reduced emphasis on cost containment B) Reduced regulatory oversight of health-care organizations C) A shift from interdependence of health-care professionals to greater autonomy D) A movement from client-as-customer to population-as-customer

Ans: D Feedback: Health services are increasingly being provided to large groups of people, usually defined by employers, through managed care or capitated contracts. The other options do not describe an influential twenty-first-century paradigm.

The promise phase of career development reflects how many years of initial nursing employment? a. 1 b.2 c. 5 d. 10

Ans: D Feedback: Promise is the earliest of the career phases and typically reflects the first 10 years of nursing employment.

What should the leader remember when forming committees? A) Committees work best when there is an adequate supply of workers, with 10 members being the minimum B) Willingness to work hard is the most important criterion for appointment C) Written agendas provide excessive structure and stifle committee creativity D) There should be sufficient expertise among committee members to accomplish the assigned task

Ans: D. Feedback: The most important criterion for committee selection is overall adequate expertise to accomplish the agenda. The remaining options are not as relevant as the correct option.

What is the advantage of recruiting from outside the organization? A. promotes long term retention of employees B. tends to increase the number of candidates C. provides well motivated candidates. D. attracts well qualified candidates

Ans:B Feedback: Recruiting from outside the organization provides an opportunity to increase the pool of candidates (or positions but is no guarantee that these candidates will be more qualified or motivated than those who come from within the organization.

Place the planning hierarchy in its proper order from top (being 1) to bottom (being 7) represent. A) Philosophy B) Goals C) Mission statement D) Objectives E) Policies F) Procedures G) Rules

Feedback: The planning hierarchy follows this order: begins with organizations mission statement, philosophy, goals, objectives, policies, procedures, and ends with rules.