Leadership Final: Quiz Questions

Disease management is the monitoring of: A. chronic illness across the health care continuum. B. mental illness in the outpatient setting. C. surgical illness across the health care continuum. D. terminal illness in the hospice setting.

A. Chronic Illness across the health care continuum Disease management programs contain a series of clinical processes and services across the health care continuum that rely on informatics to identify and manage a medical or chronic condition in at-risk populations to improve care, promote wellness, and manage or reduce costs.

The categories of standards pertain to standards of care and standards of professional performance. Standards of care deal with: A. a competent level of care demonstrated by the nursing process B. a process of care C. behaviors/attitudes D. guidelines of care

A. A competent level of care demonstrated by the nursing process Standard of care deal with a competent level of care demonstrated by the nursing process

To establish legal liability on the grounds of malpractice, the injured party must prove which of the following (select all that apply)? A. A duty of care was owed to the injured party. B. An agreement was made to assume another party's liability. C. There was a breach of duty. D. Causation was present. E. Actual harm or damages were suffered by the plaintiff.

A. A duty of care was owed to the injured party C. There was a breach of dute. D. Causation was present E. Actual harm or damages were suffered by the plaintiff. These four elements are required to establish legal liability on the grounds of malpractice.

Definitions of stress are (select all that apply): Definitions of stress are (select all that apply): A. a negative emotional experience that is associated with biological changes that trigger the body to make adaptations. B. the accomplishment of specified activities during an available time period. C. a physical, mental, psychological, or spiritual response to an experience. D. a response that is evaluated by the individual as a threat to one's sense of well-being

A. A negative emotional experience that is associated with biological changes that trigger the body to make adaptions C. a physical, mental, psychological, or spiritual repsonse to an experience D. a response that is evaluated by the individual as a threat to one's sense of well-being Stress is a negative emotional experience associated with biological changes that trigger the body to make adaptations. It can be a physical, mental, psychological, or spiritual response to an experience that is evaluated by the individual as a threat to one's sense of well-being.

The phrase "the buck stops here" best describes which of the following terms? A. Accountability B. Authority C. Responsibility D. Trustworthiness

A. Accountability Accountability refers to the liability for task performance. Accountability means being answerable and liable. The assignment of responsibility and the granting of authority create accountability.

Cultural diversity refers to the: A. acknowledgment of variation in thoughts, communication, values, and beliefs. B. belief that one's own culture is similar to another's culture. C. realization that all people in a particular culture have the same beliefs. D. view that individuals living in a country should speak the native language.

A. Acknowledgement of variation in thoughts, communication, values, and beliefs. Cultural diversity refers to variations with respect to the thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups.

A professor at the local college of nursing is teaching at a new clinical site. She notes that the nurses greet each other and their clients with warmth and a smile. She also notes that the policies and procedures encourage nursing autonomy. Nurses and physicians seem to have a collegial relationship. These observations best describe the _____ of the unit. A. climate B. culture C. interactions D. operation

A. Climate Climate is the perception that individuals have about a particular unit or environment.

Sentinel event alerts are published by TJC to do which of the following? A. Allow facilities to learn from sentinel events that have occurred in other facilities and incorporate recommendations for prevention into their policies. B. Notify hospitals that if a sentinel event occurs during an alert, the hospital will be subject to withdrawal of Medicare and Medicaid certification and reimbursement. C. Prevent a near-miss from occurring. D. Assist hospitals to find national standardized performance measures to benchmark themselves against other similar hospitals.

A. Allow facilities to learn from sentinel events that have occurred in other facilities and incorporate recommendations for prevention into their policies. Sentinel event alerts are published by TJC to "review the lessons learned" from those facilities that had experienced these sentinel events. The hope is that other hospitals will incorporate the recommendations into their policy to avoid making similar errors.

The nurse has asked a nurse's aide to greet a postoperative patient who has just arrived on the unit and to determine whether he is in stable condition. This act of delegation is an example of a nurse inappropriately delegating: A. assessment of the patient. B. evaluation of an intervention. C. nursing judgment. D. teaching to a delegate.

A. Assessment of the patient The RN is responsible for assessment, evaluation, and nursing judgment and should not delegate these professional responsibilities.

The postoperative patient with anterior cervical laminectomy is complaining of tightness in his throat. His voice is raspy. The staff nurse asks the unit secretary to page Dr. Julio stat. This is an example of _____ leadership. A. authoritarian B. democratic C. laissez-faire D. servant

A. Authoritarian Authoritarian leadership uses directive and controlling behaviors in which the leader determines policies and makes decisions in isolation. The leader orders subordinates to carry out the tasks or work. This style is helpful in crisis situations.

A patient who is not fully informed about his or her health status is an example of a violation of which ethical principle? A. Autonomy B. Justice C. Utilitarianism D. Confidentiality

A. Autonomy Autonomy refers to the client's right of self-determination and freedom of decision making. A patient who is not fully informed is denied the freedom and access to make a decision.

An external factor that affects violence in hospitals is the: A. availability of handguns. B. growing acceptance of drug use by health professionals. C. inability of facilities to screen employees properly. D. increasing number of patients with mental illness.

A. Availability of handguns Violence in hospitals is caused by a combination of internal and external factors. External conditions include the availability of handguns.

A staff nurse is facing a dilemma between upholding personal care standards and meeting organizational goals. The nurse manager understands that the best way to assist staff members in resolving ethical dilemmas effectively is to: A. avoid applying any pressure to compromise personal values. B. change their work assignment until the dilemma is resolved. C. continually remind staff of consequences related to ignoring organizational goals. D. refer indecisive staff members for additional training.

A. Avoid applying any pressure to compromise personal values An important way in which those in health care facilities and their managers can assist nursing professionals in resolving ethical dilemmas effectively is by neither explicitly nor implicitly pressuring them to go against their own ethical values (Cooper et al., 2003).

The impending demand for a sufficient number of nurses will occur when ______ reach an age when they will consume the greatest number of health care services. A. baby boomers B. Generation Xers C. elderly adults D. children

A. Baby boomers Baby boomers are currently over 77 million strong. A sufficient number of nurses must be ready to meet the demand when they reach the age when they will consume the greatest number of health care goods and services.

The manager of a rural, thriving, nurse-managed clinic is considering purchasing equipment to furnish two additional examination rooms. The resource he must consider is the _____ budget. A. capital B. expense C. operating D. product line

A. Capital The capital budget is the plan for the purchase of major equipment or assets.

A patient is admitted with congestive heart failure, diabetes mellitus, and dementia. He has a new dark spot on the top of his toes on his right foot. The nurse contacts the primary care physician, consults with the wound care specialist nurse, writes a nursing order for a referral to the diabetic educator, and contacts the discharge planner to facilitate future discharge plans. Which of the following care delivery models best describes how the nurse is providing care? A. Case management B. Group nursing C. Functional nursing D. Private duty nursing

A. Case Management Case management is defined by the Case Management Society of America as a "collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's health needs through communication and available resources to promote quality cost-effective outcomes" (2002, p. 5).

What are the three initiatives used in the realm of coordination of care (select three that apply)? A. Case management B. Medication management C. Disease management D. Population health management E. Environmental management

A. Case Management C. Disease Management D. Population health management The three initiatives that are used in the realm of coordination of care are case management, disease management, and population health management. Case management involves an intensive focus on an individual patient in relation to one or more health conditions. Disease management generally involves an intensive focus on a disease or health condition of a population group. Population health management is a community-based population strategy.

A nursing manager recognizes that the changes that she is expected by administration to implement will be met with staff resistance. She is committed to determining the root of the resistance and communicating positively with her staff. The nurse manager's actions characterize her as a(n): A. change agent. B. implementation expert. C. restructuring motivator. D. supervisory threat.

A. Change Agent The change agent needs to anticipate resistance, determine why it is occurring, and try to determine what the person who is resisting is trying to protect.

Key examples of health care practices and interventions outcomes are (select all that apply): A. mortality. B. birth rates. C. health status. D. quality of life. E. ability to function.

A. Mortality C. Health Status D. Quality of Life E. Ability to Function

The informal performance appraisal process includes: A. coaching. B. mentoring. C. preceptoring. D. teaching.

A. Coaching The informal process includes daily supervision or coaching to moderate, modulate, or refine small parts of performance. Coaching is an approach to developing individuals in an organization that falls somewhere between preceptoring and mentoring. Coaching is a management tool that is ongoing face-to-face collaboration and influencing to improve skills and performance.

The nursing supervisor informs the staff that if they refuse to stay on the nursing unit and work an additional 8-hour shift, they will be reported to the state for patient abandonment. This type of power is known as: A. coercive. B. expert. C. legitimate. D. reward.

A. Coercive French and Raven's five sources of power (1959) include reward, coercive, expert, referent, and legitimate. When coercive power is used, an individual reacts to the fear of the negative consequences that might occur for failure to comply.

Cultural affiliation, health and care beliefs and practices, illness beliefs and customs, and spiritual practices best describe components of a: A. cultural assessment. B. data collection. C. health evaluation. D. medical history.

A. Cultural Assessment A cultural assessment consists of cultural affiliation, health and care beliefs and practices, illness beliefs and customs, interpersonal relations, spiritual practices, world view, and other social structure features.

In order to make a positive contribution to care of patients, it is critical that nurses recognize which of the following aspects of culture (select all that apply)? A. Culture of the clinician B. Culture of the patient and family C. Spiritual beliefs of the clinician D. Culture of co-workers E. Spiritual beliefs of the patient

A. Culture of the clinician B. Culture of the patient and family D. Culture of co-workers In order to make a positive contribution to the effective treatment of patients, it is critical that nurses or clinicians first recognize that they are dealing with a multiplicity of cultures. They include the clinician's own culture, the culture of the patient and patient's family, the culture of co-workers, and the health care institution's culture.

Methods to overcome procrastination include (select all that apply): A. delegating sections or portions of the task. B. determining personal benefit from completing the task. C. reassessing the purpose and goals of the task. D. waiting until motivated to begin the task.

A. Delegating Sections or portions of the task B. Determining personal benefit from completing the task

Factors that affect supply include nursing education factors, work environment factors, and _____ factors. A. demographic B. geographic C. socioeconomic D. psychological

A. Demographic Three factors that affect the supply of RNs are nursing education, work environment, and demographics.

A manager should never delegate: A. disciplining. B. hiring. C. interviewing. D. scheduling.

A. Disciplining Discipline, praise, recognition, and morale issues are aspects of the managerial role that should not be delegated.

Functional nursing: A. divided and distributed nursing tasks. B. enhanced client-oriented care. C. provided a smooth care delivery system. D. was expensive once implemented.

A. Divided and distributed Nursing Tasks Functional nursing focused on task accomplishment rather than individualized and holistic care. Nurses came to work and provided a task such as a "medication nurse" or a "temperature nurse" (Kalisch & Kalisch, 1978).

An example of indirect patient care function is: A. enabling the staff to self-schedule. B. encouraging the patient to verbalize his or her feelings. C. enlisting the patient in self-care activities. D. ensuring that the correct medication is being given.

A. Enabling staff to self-schedule The direct patient care functions in a nursing care model are facilitated by and depend on the management of indirect functions (Fox et al., 1999). Staffing issues are management functions, whether they are delegated or not.

A nursing theory used to describe the manner of communicating that acknowledges the unique characteristics of the holistic human being is the: A. Humanizing Nursing Communication Theory (HNCT). B. situation, background, assessment, and recommendation (SBAR) Communication Theory. C. Behavioral System Model. D. Human Relationship Model.

A. Humanizing Nursing Communication Theory (HNCT) The HNCT is used to describe the manner of communicating that acknowledges the unique characteristics of the holistic human being.

A successful enterprise risk management (ERM) program will (select all that apply): A. identify risks. B. improve quality. C. prevent damage. D. control occurrences. E. control legal liability.

A. Identifies Risks C. Prevent Damage D. Control Occurrences E. Control Legal Liability

There are two important elements associated with dealing with cultural diversity in the workplace. They are (select all that apply): A. increasing employee knowledge of other cultures. B. increasing employer pressure for nondiscriminating hiring practices. C. taking steps to eradicate ethnocentrism. D. taking steps to encourage egocentrism.

A. Increasing employee knowledge of other cultures C. Taking steps to eradicate ehtnocentrism There are two important elements to any workplace effectively dealing positively with the growth of cultural diversity: 1) increasing employee knowledge of other cultures and 2) taking steps to eradicate ethnocentrism in the workforce.

The critical care unit of a hospital utilizes team huddles at change of shift. This is an opportunity for the clinical supervisors to connect with team members and review the upcoming shift or any quick topics that need to be communicated. This is an example of a(n) _____ meeting. A. information-sharing B. opinion-seeking C. problem-solving D. strategy

A. Information Sharing An information-sharing meeting occurs when a group is gathered to disseminate information.

A nursing preceptor is giving feedback to a new nurse who currently is being oriented. Her preceptor suggests a better method of interacting with a family member by saying, "You might want to be cognizant of your nonverbal behaviors when talking with clients. Rather than continuing to chart when you are talking with an American family, stop charting, move closer to the family and client, look at them during the conversation, and take time to let them share their concerns." This preceptor is giving advice about: A. interpersonal communication. B. clarity. C. image. D. intention.

A. Interpersonal Communication If the verbal message is clear, but the nonverbal communication is not congruent, then listeners may misinterpret, distrust, or not even hear the intended message. In this situation, the nurse's nonverbal behavior may suggest that she is not interested in interacting with the family.

Characteristics of a Magnet hospital include: A. multidisciplinary collaboration. B. nursing leader authority. C. physician control. D. social worker retention.

A. Multidisciplinary Collaboration Characteristics of a Magnet hospital include nursing autonomy, practice control, and collaboration. Nursing support, collaborative partnerships with physicians, and nursing practice are other aspects.

The Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM) produced a report making recommendations for the future of nursing. What were the recommendations (select all that apply)? A. Nurses should practice to the full extent of their education and training. B. Nurses should maintain their current levels of education. C. Nurses should partner with physicians and other health care professionals in maintaining the status quo in health care. D. An improved education system should promote seamless academic progression. E. Effective workforce planning and policy making require better data collection and information infrastructure.

A. Nurses should practice to the full extent of their education and training D. An improved education system should promote seamless academic progression E. Effective workforce planning and policy making require better data collection and information infrastructure The IOM and the RWJF Initiative on the Future of Nursing developed key recommendations, which include the following: Nurses should practice to the full extent of their education and training; nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression; nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States; and effective workforce planning and policy making require better data collection and information infrastructure.

The _____ is a tool which is useful in assessing the readiness for organizational change. A. Organizational Change-Readiness Scale (OCRS) B. five-dimensional scale C. Rapid Cycle Change D. plan-do-study-act model

A. Organizational Change-Readiness Scale (OCRS) The OCRS is a 76-item inventory that is used to analyze the ability of an organization to manage change effectively. There are five dimensions that are a part of this assessment tool.

What are the major roles of nursing leadership in disaster planning (select all that apply)? A. Providing clearly defined roles for staff nurses in a disaster situation B. Providing policies that speak to expected hours of work in a disaster C. Encouraging staff to stay at home in the event of a disaster to decrease confusion D.Ensuring that the community is synchronizing internal department plans in the event of a disaster E. Sharing written identified roles with every department to ensure disaster preparedness

A. Providing clearly defined roles for staff nurses in a disaster situation. B. Providing policies that speak to expected hours of work in a disaster E. Sharing written identified roles with every department to ensure disaster preparedness Nursing leadership needs to lead efforts to ensure that all facility departments have an understanding of their role in a disaster situation. The role of the staff nurse in a disaster must be clearly defined and contain performance standards, including policies that speak to expected hours or refusal to work (Danna et al., 2009). Nurse leaders are the coordinators in synchronizing department plans so that everything fits together to meet the staff's, patients', hospital's, and community's essential needs. Once the comprehensive all-hazards preparedness plans are complete, every department should understand their identified written role.

Strategic management, long used in business to ensure a competitive advantage over similar enterprises, involves (select all that apply): A. setting targets. B. establishing goals. C. evaluating success. D. developing an action plan. E. defining the core purpose. F. conducting an environmental scan.

A. Setting targets B. Establishing goals C. Evaluating success D. Developing an action plan F. Conducting an environmental scan

Which of the following behaviors build trust between leaders and employees in an organization (select all that apply)? A. Sharing relevant information B. Encouraging competition via winners and losers C. Reducing controls D. Meeting expectations E. Avoiding discussion of sensitive issues

A. Sharing Relevent Information C. Reducing Controls D. Meeting Expectations

Good leaders need to be able to demonstrate an intuitive skill of empathy and expressiveness when dealing with others in the workplace. This requires sensitivity and awareness of the emotions and moods of others and is known as: A. Social Awareness B. Self-Awareness C. Self-Management D. Relationship Management

A. Social Awareness Social awareness is an intuitive skill of empathy and expressiveness in being sensitive and aware of the emotions and moods of others.

Good leaders need to be able to demonstrate an intuitive skill of empathy and expressiveness when dealing with others in the workplace. This requires sensitivity and awareness of the emotions and moods of others and is known as: A. social awareness. B. self-awareness. C. self-management. D. relationship management.

A. Social Awareness Social awareness is an intuitive skill of empathy and expressiveness in being sensitive and aware of the emotions and moods of others.

The division of work by occupation or function is a form of: A. specialization. B. interdependence. C. uncertainty. D. technology.

A. Specialization The division (or differentiation) of work by occupation or by function is a form of specialization. Specialization is the extent to which work is divided and assigned to positions and divisions.

Referring to a patient as Hispanic or Mexican can contribute to: A. stereotypes. B. cultural competency. C. spiritual competency. D. diversity.

A. Stereotypes In patient care of a Mexican versus Hispanic person, the failure to identify differences not only perpetuates stereotypes evaluations but also can cause the clinician to fail in accurately assessing potential conflicts with the cultural values of the patient or important communication barriers.

Clinicians tend to buy into the need for practice change when (select all that apply): A. there is a strong evidence base. B. the topic addresses an identified need. C. the practice change offers a relative advantage. D. the practice change is endorsed by organizational executive leadership. E. data demonstrate an opportunity for practice improvement within the clinical area.

A. There is a strong evidence base B. The topic addresses an identified need C. The practice change offers a relative Advantage E. Data demonstrate an opportunity for practice improvement within the clinical area

Which of the following statements is true about clinical pathways? A. They are a multidisciplinary, research-based plan of care. B. They are developed by current practice patterns of the institution. C. They optimize nursing and the patient's time management. D. They outline optimal care for the high-risk patient.

A. They are a multidisciplinary, research-based plan of care. A clinical pathway, also known as a critical path or CareMap, is a written plan that identifies key incidents. It must occur at set times to achieve client outcomes within an appropriate time frame, such as length of stay in the hospital. Clinical pathways are case management tools that reflect the research, experience, and consensus priorities of a multidisciplinary group of providers actively engaged in providing care to the target population.

Nurse managers are in a position of impacting the stress levels of employees through improving work environments and creating a culture of enhanced staff satisfaction. What type of leader is most effective at creating such an environment? A. Transformational B. Authoritative C. Laissez-faire D. Transitional

A. Transformational Transformational leaders are most effective at improving work environments by transcending their own self-interest. They act to inspire and create a culture of trust.

Actions designed to ensure the coordination and continuity of health care as patients transfer between different locations or different levels of care within the same location are known as: A. transition of care. B. continuum of care. C. rounds. D. disease management strategies.

A. Transition of Care The definition of transition of care is "a set of actions designed to ensure the coordination and continuity of health care as patients transfer between different locations or different levels of care within the same location" (AHRQ, 2011b, p. 1). Transitions of care have become more imperative than ever before in current health care reform.

The charge nurse is making assignments on a surgical unit. Which client should be assigned to the least experienced nurse? A. Client who had a vaginal hysterectomy and still has an indwelling catheter B. Client who had an open cholecystectomy and has gray drainage in the T-tube drainage tube and bag C. Client who had a hip replacement and stated that something popped while walking D. Client who had a Whipple procedure and is reporting being thirsty all the time

A. a client who had a vaginal hysterectomy and still has an indwelling catheter Options b, c, and d indicate the possibility of postoperative complications, but option a does not. The least experienced nurse should have the client who is not displaying the possibility of postoperative complications.

All-hazards disaster is best defined as: A. all types of natural and human terrorist events. B. an event involving floods, tornadoes, hurricanes, and earthquakes. C. an unforeseen and often unplanned event causing great damage. D. any type of biological, chemical, radiological, or nuclear event.

A. all types of natural and human terrorist events An all-hazards disaster includes all types of natural acts such as earthquakes, forest fires, floods, and hurricanes, or terrorist events such as biological, chemical, radiological, and nuclear attacks. A disaster is an unforeseen and often sudden event that causes great damage, destruction, and human suffering.

Most audience interpretations for speaker messages are determined by the speaker's: A. body language and facial expressions. B. literal words. C. pitch and volume of speech. D. vocal quality and tone.

A. body language and facial expressions Research has shown that 55% of audience interpretations for speaker messages are determined by the speaker's nonverbal communication, such as facial expression and body language; 38% by the speaker's vocal quality, including tone, pitch, volume, and variation; and 7% by the literal words.

Community health means meeting the: A. collective needs of a group by identifying problems and managing interactions. B. needs of an individual within the community by identifying problems and managing interactions. C. needs of the health care system within a population or area. D. needs of a population by identifying problems and managing interactions.

A. collective needs of a group by identifying problems and managing interactions Community health means meeting the collective needs of a group by identifying problems and managing interactions within the community and between the community and larger society.

Stakeholders who might be represented within the process of performance appraisal of a CCU nurse include (select all that apply): A. patients/patient families. B. the CCU social worker. C. the chief financial officer. D. organizational board members. E. nurses in the ED.

A. patients/patient families B. The CCU social worker E. Nurses in the ED Numerous stakeholders are represented within the process of performance appraisal of nurses. Most important is the voice of the patient. Key individuals who interact with the nurse may also be in an excellent position to provide input related to performance.

Examples of nursing care delivery models include (select all that apply): A. team nursing. B. quality nursing. C. primary nursing. D. private duty nursing. E. patient-focused care.

A. team nursing C. Primary Nursing D. Private Duty Nursing E. Patient-focused care A nursing care delivery model "is defined as a method of organizing and delivering nursing care in order to achieve desired patient outcomes" (Deutschendorf, 2010, p. 444). Examples of nursing care delivery models include patient-focused care, team nursing, private duty nursing, total patient care, functional nursing, primary nursing, and various combinations.

The network or pattern of social relationships and friendship circles within an organization is known as the: A. clique. B. formal structure. C. informal structure. D. hierarchy.

C. Informal Structure The informal structure is simply the network or pattern of social relationships and friendship circles that are outside the formal structure. It is an interconnected web of relationships that operate in and around the formally designated lines of communication.

According to the VA NPA "delegation" means the ________________ by a registered nurse to an unlicensed person to _______________ selected nursing tasks and procedures in accordance with Part VIII.

Assignment, perform

An experienced critical care nurse left a CCU staff nurse position to finish a master's degree. Periodically, he would return to work as a per diem nurse in the CCU. The staff was impressed with the nurse's performance; however, one staff member complained that he was unfamiliar with the new telemetry monitors when he first returned to work several months ago. This comment showed up in his evaluation, resulting in a poorer overall evaluation from the nurse manager compared with previous evaluations. This is an example of: A. a halo effect. B. a horn effect. C. recent behavior bias. D. similar-to-me effect.

B. A horn Effect A horn effect occurs when a manager perceives one negative aspect about an employee or that employee's performance and generalizes it into an overall poor appraisal rating.

Which of the following is an example of case management or would require the expertise of a case manager? A. A blood pressure screening clinic is started at the senior citizen center. B. A person with multiple chronic illnesses is admitted to the hospital. C. A program is started to address diabetes in the Native American population. D. An initiative is developed to promote fluoride treatments in schools.

B. A person with multiple chronic illnesses is admitted to the hospital Case management involves an intensive focus on an individual patient in relation to one or more health conditions. It is an intervention strategy used by multiple health care providers and systems to advocate for clients, coordinate health care delivery, and facilitate outcomes of both cost and quality.

Team dynamics can become dysfunctional over time. What are some factors that can contribute to team dysfunction (select all that apply)? A. Taking accountability B. Absence of trust C. Negotiating expectations D. Fear of conflict E. Lack of commitment

B. Absence of Trust C. Fear of Conflict D. Fear of Conflict Dysfunctional team behaviors can occur related to an absence of trust, fear of conflict, lack of commitment, avoiding accountability, and inattention to results. Articulating and negotiating expectations for healthy interpersonal behavior benefits team development.

A hospital administrator is involved in contract negotiations with the nursing union leaders. To resolve issues: A. nurses should be assertive to make certain that their view predominates. B. both sides should strive to meet the interests of both parties. C. the negotiator should use independent problem-solving skills. D. the budget should dictate the conditions of the negotiation.

B. Both sides should strive to meet the interests of both parties Both sides should strive to maintain the poise of the other party in a win-win situation, also known as interest-based bargaining. Each party should gain something, and the solution should be acceptable to both sides. Problem solving, consensus building, and integrative decision making are techniques used to achieve this goal.

Which of the following statements are accurate descriptors regarding change (select all that apply)? A. Organization-wide change is more sustainable when leadership imposes the change. B. Change within an organization is often externally imposed. C. Change within an organization may originate internally. D. Nurses do not need to participate actively in the organizational changes. E. Change is often complex and irrational.

B. Change within an organization is often externally imposed C. Change within an organization may originate internally E. Change is often complex and irrational Changes within an organization may be necessary due to external or internal demands. Change is seldom easy and may be complex and irrational.

The future projected demand for nurses is related to the aging population and the increase in: A. acute illnesses. B. chronic illnesses. C. medication costs. D. primary prevention.

B. Chronic Illnesses The future projected demand for nurses is related to the aging population and the increase in chronic illnesses.

Situational leadership focuses on three competencies deemed necessary for a leader's success. Which of the following are correct statements (select all that apply)? A. Communicating is a behavioral competency. B. Communicating is a process competency. C. Diagnosing is a behavioral competency. D. Diagnosing is a cognitive competency. E. Adapting is a behavioral competency.

B. Communicating is a process competency D. Diagnosing is a cognitive competency E. Adapting is a behavioral competency Situational leadership focuses on the following three competencies deemed necessary for success. Diagnosing is a cognitive—or cerebral—competency. It is the understanding of what the situation is now and knowing what it can reasonably be expected to be in the future. The discrepancy between the two is the problem to be solved. This discrepancy is what the other competencies are aimed at resolving. Adapting is a behavioral competency. It involves adapting behavior and other resources in a way that helps close the gap between the current situation and what the leader wishes to achieve. Communicating is a process competency. Leaders need to communicate effectively. If leaders cannot communicate in a way that people can understand and accept, they will be unlikely to meet their goals.

The art of being able to structure and transmit a message in a way that another can understand easily and accept is: A. articulation. B. communication. C. evaluation. D. pronunciation.

B. Communication Communication is the art of being able to structure and transmit a message in a way that another can understand easily and accept.

A patient has arrived at the critical care unit with a head injury. On admission, the patient is talking and is a little drowsy but oriented. Two hours later, the nurse discovers that the patient is talking at a rapid pace and keeps repeating his words. Which of the following examples best depicts Benner's stages and appropriate critical-thinking processes in this situation? A. Advanced beginner—thinks that the patient is trying to be funny B. Competent—thinks that the patient is experiencing effects from cerebral edema C. Novice—thinks that the patient is stressed and has had a surge of adrenaline D. Proficient—thinks that the patient is waking up from a coma

B. Competent- thinks that the patient is experiencing effects from cerebral edema The competent nurse uses the information about head injury, change in mental status from talking and drowsy but oriented to talking at a rapid pace, and the potential for the patient to deteriorate to discern that the patient is experiencing cerebral edema or increased intracranial pressure.

A long-term care facility has been busy for several months with patients who have a very high acuity. Nurses have been working double shifts. The nurses have been given the task of determining whether they would like to implement an on-call program and determine guidelines for implementation, if most nurses believe that it is the best solution. This example depicts which type of decision-making style? A. Autocratic B. Consultative C. Delegative D. Facilitative

B. Consultative

Case management is an interventional strategy used by health care providers to: A. advocate for nurses. B. coordinate health care delivery. C. facilitate cost accounting. D. investigate medical errors.

B. Coordinate Health Care Delivery Case management is an intervention strategy used by health care providers and systems to advocate for clients, coordinate health care delivery, and facilitate outcomes of cost and quality.

The major responsibility for upholding patient care standards belongs to the: A. chief executive officer of the facility. B. nurse manager. C. on-call physician. D. staff nurse providing patient care.

B. Nurse Manager Nurse managers carry the major responsibility for developing and upholding the standards of care for staff nurses.

A staff registered nurse (RN) has been struggling with the delivery system from central supply. He documents a delay of 1 to 3 hours from the time that the order is sent to central supply to the time that the requested equipment is sent to the floor. The RN asks, "Why does a central supply unit need to service the entire hospital? Why not consider a decentralized central supply established for each floor?" This is an example of what type of thinking? A. Amiable thinker B. Critical thinker C. Traditional thinker D. Unrealistic thinker

B. Critical Thinker

A staff registered nurse (RN) has been struggling with the delivery system from central supply. He documents a delay of 1 to 3 hours from the time that the order is sent to central supply to the time that the requested equipment is sent to the floor. The RN asks, "Why does a central supply unit need to service the entire hospital? Why not consider a decentralized central supply established for each floor?" This is an example of what type of thinking? A. Amiable thinker B. Critical thinker C. Traditional thinker D. Unrealistic thinker

B. Critical Thinker A critical thinker challenges and questions the norm.

Hospitals must submit specific quality performance data regarding Medicare patients or risk: A. an increase in federal tax. B. decreased payments. C. fewer physician referrals. D. sanctions by The Joint Commission (TJC).

B. Decreased Payments One of the first actions resulting from the Hospital Quality Initiative has been to require hospitals to submit their quality performance data for 10 measures to comply with the Medicare Prescription Drug Improvement and Modernization Act. Organizations that do not submit this data were to receive 0.4% smaller Medicare payments.

Transferring the authority to perform a selected nursing task in a selected situation to a competent individual is: A. authorization. B. delegation. C. empowerment. D. supervision.

B. Delegation The National Council of State Boards of Nursing (1995) defines delegation as transferring the authority to perform a selected nursing task in a selected situation to a competent individual.

Transferring the authority to perform a selected nursing task in a selected situation to a competent individual is: A. authorization. B. delegation. C. empowerment. D. supervision.

B. Delegation The National Council of State Boards of Nursing (1995) defines delegation as transferring the authority to perform a selected nursing task in a selected situation to a competent individual.

The system-wide AHPTF should conduct a gap analysis. What should be evaluated? A. Differences between standards and policies and procedures B. Differences between pieces of the program that are and are not in place C. Similarities between standards and policies and procedures D. Similarities between pieces of the program that are and are not in place

B. Differences between pieces of the program that are and are not in place

A family member of a patient files a complaint that her mother's dentures were lost when the patient was transferred from one unit to another. The risk management department interviews the patient and the staff nurses who cared for the patient. Which of the following problem-solving techniques was used? A. Delegation B. Direct intervention C. Indirect intervention D. Purposeful inaction

B. Direct Intervention Direct intervention is carrying out an activity to intervene in a situation and resolve a problem.

Some of the major disadvantages to group decision making are premature decisions, individual domination, and: A. autonomous conclusion. B. disruptive conflicts. C. group synergy. D. inaccurate data interpretation.

B. Disruptive Conflicts Group decision making can be derailed at a number of points in the process. The main disadvantages commonly noted about group decision making are the potential for premature decisions, individual domination, and disruptive conflicts (Veninga, 1982).

Shared governance is a model of organizational structure in which staff nurses are: A. employed to establish mutual goals with clients. B. empowered through autonomy and accountability. C. engaged in problem-solving strategies and techniques. D. equipped with evaluative thinking methodologies.

B. Empowered trhough autonomy and accountability Shared governance is a model of organizational structure in which staff nurses are empowered through autonomy and accountability.

A hospital with a large surgery department is concerned about surgeons starting their own surgical centers. In relation to the strategic plan evaluative process, this is an example of: A. an economic monopoly. B. an external threat. C. marketplace competition. D. political strength.

B. External Threat

Which of the following are examples of patient privacy or security breaches (select all that apply)? A. Encrypted e-mail communications B. Fax transmission sent to incorrect physician office C. Prescription given to patient with wrong label attached D. Case management coordinator obtaining information about a patient's diagnosis E. Discharge summary given to patient's spouse

B. Fax Transmission sent to incorrect physicians office C. Prescription given to patient with wrong label attached Fax transmissions sent to the incorrect physician's office or prescriptions given to a patient with the wrong label attached are examples of privacy or security breaches under HIPAA. Electronic transmissions should be end-user encrypted for data security.

An organizational chart with one line of management and one line of staff reflects which of the following types of organizational structures? A. Authoritarian structure B. Flat structure C. Power structure D. Vertical structure

B. Flat Structure A flat or horizontal structure has few administrative layers between management and employees. Employees have more decision-making power in this type of hierarchy.

A staff nurse has kept a time log to assist her in developing her time management skills. After a week, she reviews the log with her nurse manager and notices that there were several times that she was waiting for supplies and missing medications. The nurse manager suggests which of the following? A. Notifying the pharmacy and central supply that there are delays in supply delivery B. Gathering supplies and checking for the availability of medications so they can be ordered prior to starting care C. Informing the prior shift that this is a problem D. Completing an occurrence report so quality assurance will investigate the problem

B. Gathering supplies and checking for the availability of medications so they can be ordered prior to starting care Changes in patient conditions and medical orders occur frequently, which require new or different equipment and medications to be added or changed. It is always best, particularly if it is known that there are discrepancies in this area, to check to see whether all needed supplies are available before initiating care.

This generational cohort was the first generation of latchkey kids who had to be resourceful at an early age. They are skeptical of traditional practices and beliefs. They strive for a balanced life. This group is known as: A. baby boomers. B. Generation X. C. Internet Generation. D. Mature Generation.

B. Generation X Generation X members, born between 1965 and 1980, were the first generation of latchkey kids who had to be resourceful at an early age. They are skeptical of traditional practices and beliefs. They strive for a balanced life.

A group of nurses is showing resistance to changes the manager is making with regards to staffing. Which of the following ways can the manager deal with the emotionality of the situation (select all that apply)? A. Use persuasion. B. Give the nurses adequate notice of change. C. Avoid discussion. D. Explain the rationale and patient impact. E. Inform staff that senior leadership made the decision.

B. Give the nurses adequate notice of change. D. Explain the rationale and patient impact. A factor in determining how change is accepted depends upon how it is managed. The way to deal with emotionality is to avoid persuasion and to allow people to express their feelings. Staff should be given as much notice as possible when making changes in staffing or scheduling, and discussion is encouraged. Staff should be informed about the rationale for the decision as well as patient impact. Effective managers possess self-confidence to explain the change without blaming.

Any collection of interconnected individuals working together for the same purpose is known as a(n): A. club. B. group. C. meeting. D. organization.

B. Group Any collection of interconnected individuals working together for the same purpose is known as a group.

The most difficult to change is: A. attitudes. B. group behavior. C. knowledge. D. individual behavior.

B. Group Behavior Group behavior and performance changes are the most difficult to change and take the longest time.

Which of the following is an example of a nurse-sensitive indicator? A. Cardiac patient mortality B. Hospital-acquired pressure ulcers C. Pulmonary embolus after knee surgery D. Iatrogenic pneumothorax after central line placement

B. Hospital Acquired Pressure Ulcers Nurse-sensitive indicators refer to the structure, process, and outcomes of professional nursing care. These include falls and falls with injury, hospital-acquired pressure ulcers, health care-associated infections, nursing care hours per patient day, nursing care hours, nursing turnover, physical restraints, RN survey, and skill mix.

A nurse believes that she should provide optimal care to all clients, regardless of their cultural background. She is struggling with her emotions when caring for a client with a violent criminal background. What would be the best course of action for this nurse? A. Avoiding the client as much as possible but providing care B. Identifying her biases but providing care C. Requesting another patient assignment D. Taking sick days while the patient is hospitalized

B. Identifying her biases but providing care Identifying her biases but yet still providing care to the client is a step in providing culturally competent care.

Group problem solving is known to be more effective over individual problem solving because of a larger knowledge and information base, increased acceptance of solutions, more approaches to a problem, lower economic costs, and the ability for: A. group development. B. individual expression. C. hierarchical bonding. D. organizational team building.

B. Individual Expression Individual expression is one of the major advantages of group problem solving (Veninga, 1982).

The use of a new idea or method is the definition of: A. change. B. innovation. C. resistance. D. stereotyping.

B. Innovation

If a licensed practical/vocational nurse (LPN/LVN) provides discharge teaching, who is legally responsible? A. Chief executive officer B. Institution where the LPN/LVN works C. Risk manager D. UAP

B. Institution where the LPN/LVN works The institution where the LPN/LVN works is liable for negligence or malpractice of the LPN/LVN or RN. Only the RN can provide discharge instruction.

A disagreement or differences between the members of two or more groups over authority, territory, and resources is called _____ conflict. A. intragroup B. intergroup C. interpersonal D. intrapersonal

B. Intergroup Intergroup conflict refers to disagreements or differences between the members of two or more groups or their representatives over authority, territory, and resources.

Which of the following is true about negotiation? A. It commonly results in a win-lose situation. B. It is aimed at solving problems, conflicts, or disputes. C. It is used only in contract and labor union disputes. D. It is the exchanging of favors or trading activity.

B. Is aimed at solving problems, conflicts, or disputes

The hospital units most likely to employ a decentralized staffing model include (select all that apply): A. the telemetry unit. B. labor and delivery. C. the medical-surgical unit. D. the emergency department. E. the neonatal critical care unit.

B. Labor and Delivery D. The Emergency Department E. The NICU In a decentralized model, individual department managers and directors are responsible for daily staffing allocation. Units with decentralized staffing are typically units whereby volume and/or acuity may be most unpredictable, and the nursing competencies are unique to that area (e.g., emergency department, labor and delivery, critical care).

Which of the following is true of management activities? A. Inspiring a vision is a management function. B. Management is focused on task accomplishment. C. Management is more focused on human relationships. D. Management is more important than leadership.

B. Management is focused on task accomplishment

Strategic management is defined as the management of an organization based on its: A. goals. B. mission. C. plan. D. objectives.

B. Mission Strategic management is defined as the management of an organization based on its vision or mission.

"To provide the best care to every patient every day through integrated clinical practice, education, and research" is an example of a(n): A. accountability agreement. B. mission statement. C. organizational standard. D. vision and value proposal.

B. Mission Statement The mission statement of an organization is a concise statement that answers the question, "What business are we in today?" (Pelletier, 1999).

An elderly client becomes confused after surgery. He is in a room farthest away from the nurse's station. The client has been trying to get out of bed several times during the shift. The nurse documents this very well. The client falls out of bed and breaks his hip. Who can possibly be held negligent (select all that apply)? A. Client's wife B. Nurse manager C. Pharmacist D. Staff RN

B. Nurse Manager D. Staff RN It is possible that the nurse and nurse manager could be held negligent. The nurse could be held negligent for not moving the patient closer to the nurse's station, calling the physician or nurse practitioner for medications or change in medications, or obtaining an order for a vest restraint. The nurse manager may be held negligent because of 24-hour accountability for the care of patients on his or her unit and possible lack of supervision.

A new cancer center is being built in the local hospital. A patient survey has revealed that patients are not certain which caregiver is the registered nurse (RN) during their hospital stay. A group is formed to recommend methods to help patients identify which caregiver is their RN for the new cancer center. Which of the following groups best represents those who should be involved in forming recommendations? A. Chief medical officer, public relations vice-president, and human resources B. Oncology clinical nurse specialist, nurse's aides, and RNs C. Physicians, unit secretaries, and vice-president of finance D. Vice-president of nursing, decentralized pharmacist, and licensed practical/vocational (LPN/LVN) nurses

B. Oncology clinical nurse sepcialist, nurse's aides, and RNs Involving individuals at all levels of the organization will ensure a variety of perspectives and more "buy in" to the final product. Including the patient's perspective may provide additional insight about the issue. Ideally, those involved in all levels of patient care, such as the vice-president of nursing, nurse manager, oncology clinical nurse specialist, LPN/LVNs, and nurse's aides, as well as patients of the RN, may need to be included to gain additional perspective.

The Institute of Medicine (IOM) report, Crossing the Quality Chasm, was useful in describing the challenges related to moving from _____-centered to _____-centered care. A. patient; provider B. provider; patient C. patient; facility D. provider; financially

B. Provider; patient The IOM report, Crossing the Quality Chasm, describes challenges in care provision and details the shift of moving from provider-centered care to patient-centered care. The need for patient and family participation is a dominant force in treatment decisions.

The nurse on a medical unit is discussing a client with the case manager. Which of the following shows how the nurse should communicate with the case manager? A. Discussing personal information that the client shared with the nurse in confidence B. Providing the case manager with any information required for continuity of care C. Explaining that client confidentiality prevents the nurse from disclosing information D. Asking the case manager to get the client's permission before sharing information

B. Providing the case manager with any information required for continuity of care The case manager has a "need to know" to coordinate continuous care. Information that was shared in confidence is not necessary unless it has some bearing on the patient's care needs. On admission to the hospital, the patient signed a "permission to treat" form, which allows all persons providing care to have information needed to provide the care.

_____ is an expected part of change and is often related to fear and anxiety. A. Depression B. Resistance C. Acceptance D. Denial

B. Resistance Resistance to change should be expected as integral to the process of change. It may be rooted in anxiety or fear.

Evaluation of the effect of nurse staffing on quality patient, financial, and organizational outcomes is known as: A. patient acuity. B. staffing effectiveness. C. nurse-to-patient ratio. D. nursing workload.

B. Staffing Effectiveness Staffing effectiveness is the evaluation of the effect of nurse staffing on quality patient, financial, and organizational outcomes.

Group as well as individual accountability exists within a: A. work group. B. true team. C. pseudoteam. D. committee.

B. True Team A true team occurs when there is a collective entity in which leadership rotates and is shared by various members of the team. There is group as well as individual accountability.

Staff nurses' involvement in budgeting is essential because they: A. have the final authority on the annual budget. B. have the ability to contain costs at the unit level. C. have a unique perspective on the budgetary process. D. are the largest user of the budgeted funds for the unit.

B. have the ability to contain at the unit level In many organizations, staff nurses are expected to be aware of their unit's financial performance and the impact their decisions may have on it. Staff nurses' involvement is essential to the ability to contain costs at the unit level, because they make many decisions about supply and resource use.

According to the VA NPA, supervision shall include but not be limited to: 1. Monitoring the performance of the delegated task 2. Evaluating the outcome for the client 3. Ensuring appropriate documentation 4.___________________________

Being accessible for consultation and intervention

_____ has garnered considerable attention in health care because of its potential to save money, improve effectiveness, and increase quality of care. A. Disease management B. Development research groups C. Case management D. Diagnosis-related groups

C. Case Management Case management has garnered considerable attention in health care. It has been suggested that the processes associated with case management have the potential to save money, improve effectiveness, and maintain or improve the quality of care.

"To do good for others" is an example of which ethical principle? A. Nonmaleficence B. Fidelity C. Beneficence D. Confidentiality

C. Beneficence Beneficence means doing good for clients and providing benefit balanced against risk.

A nurse is caring for an elderly patient who was admitted after sustaining a fall at home. When creating a care plan for the patient, she requests that the doctor order a home health visit to assess for home safety and medication compliance. In addition, the nurse is concerned about the nutrition of the patient and requests a dietitian evaluation. The nurse is demonstrating which of the following leadership skills? A. Care provider B. Business principles C. Care coordination D. Change management

C. Care Coordination Care coordination is the delivery of nursing services that involves the organization and coordination of complex activities. The nurse uses managerial and leadership skills to facilitate delivery of quality care.

The process of identifying the specific costs related to the delivery of nursing care to each client so that nurses have data to identify the actual amount of services received is: A. personnel budget development. B. evaluating budget expenditures. C. costing out nursing services. D. strategic financial planning.

C. Costing out nursing services Costing out nursing services is defined as the determination of the costs of the services provided by nurses. By identifying the specific costs related to the delivery of nursing care to each client, nurses have data to identify the actual amount of services received.

According to the VA NPA, which task can be delegated A. circulating duties in an operating room B. determing pain relief from medications C. daily hygiene D. diabetic teaching

C. Daily Hygiene According to the Nurse Practice Act the nurse can delegate tasks which frequently occur in the routine care of patients

What is the definition of the process of making choices that will provide maximum benefit? A. Critical thinking B. Problem solving C. Decision making D. Leading

C. Decision Making

What is the definition of the process of making choices that will provide maximum benefit? A. Critical thinking B. Problem solving C. Decision Making D. Leading

C. Decision Making Decision making is the process of making choices that will provide maximum benefits.

An approach for decreasing nursing RN skill mix was implemented in a "one size fits all" approach across organizations in the 1990s. These changes in skill mix led to: A. decreases in RN workload. B. increased nursing satisfaction. C. decreased patient satisfaction. D. decreased patient safety concerns.

C. Decreased Patient Satisfaction The approach for decreasing nursing RN skill mix was implemented in a "one size fits all" approach across organizations and often lacked evaluation of the skill mix change and other changes on the quality of care and nurse job satisfaction and retention (Eck, 1999; Norrish & Rundall, 2001). This was most apparent in California where a leaner RN skill mix was tried by Kaiser Permanente Northern California in the early 1990s. Skill mix was reduced from 55% RNs to 30% RNs in 1995 (Robertson & Samuelson, 1996). The changes in skill mix led to widespread real and perceived increases in RN workload, patient safety concerns, and nurse and consumer complaints.

Utilizing the DECIDE acronym for the process of decision making, what are the first and final steps in the process (select two that apply)? A. Develop and implement an action plan for problem solution. B. Establish criteria for what you want to accomplish. C. Define the problem and determine why anything should be done about it. D. Evaluate the decision through monitoring, troubleshooting, and feedback. E. Determine the best choice or alternative.

C. Define the problem and determine why anything should be done about it D. Evaluate the decision through monitoring, troubleshooting, and feedback. The first step in the decision-making process using DECIDE is to define the problem and determine why anything should be done about it and explore what could be happening. The final step in the process is to evaluate the decision through monitoring, troubleshooting, and feedback.

An important role of the human resources department in limiting workplace violence is: A. allowing the local police force to control violence within the facility. B. delegating the control of workplace violence to individual unit managers. C. developing comprehensive violence prevention policies and procedures. D. empowering each nurse to assess each situation and react accordingly.

C. Developing comprehensive violence prevention policies and procedures Human resource management policies addressing hiring, discipline, counseling, training, threat assessment, threat management, and reporting are essential for the prevention and/or mitigation of violence from current or former workers in health care organizations.

The transferring of authority, responsibility, and freedom to act and the inspiring of self-confidence is known as: A. actualization. B. authorization. C. empowerment. D. ratification.

C. Empowerment Empowerment is the transfer of actual power and inspiring self-confidence (Kramer & Schmalenberg, 1990).

The chief operations officer of a local hospital has issued a memorandum indicating that the modular waiting room furnishings will be replaced with stationary units. This is an example of which type of strategy for preventing workplace violence? A. Administrative controls B. Behavior modification C. Environmental design D. Fixture adaptation

C. Environmental Design A worksite analysis conducted by a threat assessment team or similar taskforce or coordinator is among the recommendations of OSHA and TQM approaches. Such an effort analyzes records, trends, workplace security, physical characteristics, operating policies, and screening surveys of staff to provide an overview of the work environment.

When nurses portray an attitude that their cultural group is superior to another, it is known as practicing the concept of cultural: A. diversity. B. egocentrism. C. ethnocentrism. D. prejudice.

C. Ethnocentrisms Ethnocentrism is characterized or based on an attitude that one's own cultural group is superior to another.

What tool is used as a systematic, proactive method for evaluating a process to identify where and how care delivery might fail? A. American Nurses Association (ANA) B. UAP C. Failure Mode and Effects Analysis (FMEA) D. Institute for Healthcare Improvement (IHI)

C. Failure Mode and Effects Analysis (FMEA) Health care facilities use FMEA as recommended by the IHI. FMEA is a systematic, proactive method for evaluating a process to identify where and how care delivery might fail.

Nurses working on the intermediate care unit have had many hours of overtime in the last 6 months. Before forming a team, the nurse manager gathers data about patient condition severity, staffing ratios, educational levels of staff, and personality mixes on each shift. What level of decision making is this process? A. Establishment of solution evaluation criteria B. Evaluation of the alternative solutions C. Identification of a problem, issue, or situation D. Search for alternative solutions or actions

C. Identification of a problem, issue, or situation Data should be collected to identify properly the actual problem, issue, or situation. The five core elements to decision making are the following: (1) identification of a problem, issue, or situation; (2) establishment of the criteria to be used to evaluate potential solutions; (3) search for alternative solution or actions; (4) evaluation of the alternative; and (5) selection of a specific alternative.

Evidence-based practice includes: A. collaborative practice dynamics between health care professionals. B. documentation of patient care as evidence of nursing practice. C. integration of research with clinical expertise and patient values. D. mutual goal setting and application in the clinical setting.

C. Integration of reasearch with clinical expertise and patient values Evidence-based practice is a process of shared decision making in a partnership between patients and providers that involves the integration of research and other best evidence with clinical expertise and patient values in health care decision making (Sackett et al., 2000).

The U.S. Department of Health and Human Services (USDHHS) acted to make cultural competence a priority in health care. Federal standards were issued that included which of the following? A. Clients are expected to agree to medical services, regardless of their cultural beliefs. B. Hiring practices of hospitals should not be affected by these standards. C. Interpreters should be available to all non-English-speaking clients. D. Nursing staff that are of the same culture as the client should care for the client.

C. Interpreters should be available to all non-English -speaking clients. Interpreter services should be available at no cost to each client with limited English proficiency at all points of contact, in a timely manner, and during all hours of operation.

A continuum of care: A. deals strictly with health promotion. B. focuses on the needs of the community. C. is a linkage of health services across settings. D. provides another health care option for the homeless.

C. Is a linkage of health services across settings A continuum of care is a linkage of health services across health care delivery settings and sites of care. Nurses need to focus on managing the continuum of care as a basis of nursing practice. Collaboration and communication are essential elements of coordination and integration across a "seamless" continuum of care: Continuity of patient care involves a series of coordinating linkages across time, settings, providers, and consumers of health care.

A staff nurse has a concern about a co-worker who may be diverting medications. The staff nurse would like to report the concern to a supervisor, but she is fearful of retaliation from her colleagues. The staff nurse knows that the ethical thing to do is report the concern for the sake of patient safety. This nurse is experiencing: A. stress. B. procrastination. C. moral distress. D. burnout.

C. Moral Distress Moral distress occurs when clinicians know what is the ethical action to take, yet are prevented by either external or internal obstacles. Moral distress will contribute to stress and eventual burnout if the staff nurse does not take action.

Unspoken affective or expressive behaviors best describe which type of communication? A. Effective communication B. Ineffective communication C. Nonverbal communication D. Verbal communication

C. Nonverbal Communication Nonverbal communication is unspoken. It is composed of affective or expressive behaviors. The effectiveness of verbal communication depends on vocabulary, language, phrases, sentence structure, sentence clarity, rate of speech, diction, tone, rhythm, and volume. Nonverbal behavior includes gestures, facial expression, eye contact, body language, and positioning (Hersey et al., 2008).

The nursing chief executive officer (CEO) works in a major rehabilitation and subacute facility network. Her span of control refers to the number of: A. miles in which the network resides. B. ancillary staff accountable to her. C. nurses and non-nurses reporting to her. D. inpatients that the facilities service.

C. Nurses and non-nurses reporting to her Span of control refers to the number of nurses and non-nurses reporting to a manager.

Staffing management is one of the most critical activities for nurse leaders at every level of the health care organization today because it affects: A. delegation and supervision. B. unit leadership productivity. C. organizational outcomes. D. professional development and quality control.

C. Organizational Outcomes Staffing management is one of the most critical yet highly complex and time-consuming activities for nurse leaders at every level of the health care organization today (Abdoo, 2000; Sullivan et al., 2003). How well or poorly nursing leaders execute staff management impacts the safety and quality of patient care, financial results, and organizational outcomes, such as job satisfaction and retention of registered nurses (RNs) (Beyers, 2000).

To determine whether her patient has responded favorably to a nursing intervention, a staff nurse should observe the client for: A. improved health. B. increased complaints. C. outcome indicators. D. signs and symptoms.

C. Outcome Indicators Indicators are defined as "valid and reliable measures related to performance" (Oermann & Huber, 1999). According to the American Nurses Association, indicators measure how nursing care affects clients and therefore would provide evidence of a patient's response to treatment.

The field in health care that aims at a better understanding of the end results of health care practices and interventions is called: A. patient safety. B. risk management. C. outcomes research. D. quality management.

C. Outcomes Research Outcomes research aims at a better understanding of the end results of health care practices and interventions, such as the impacts of care that are most important to patients, families, payors, and society.

A human communication activity designed to influence another to change attitudes or alter behaviors by the use of techniques such as argument, reasoning, or pleading is known as: A. advisement. B. consultation. C. persuasion. D. suggestion.

C. Persuasion Persuasion is a human communication activity designed to influence another to change attitudes or alter behaviors by the use of techniques such as argument, reasoning, or pleading.

Performance management includes the processes of human resources management. The purpose of this system as related to the employee includes job productivity, compensation, job performance recognition, and: A. compensation administration. B. job analysis. C. planning for professional development. D. structuring educational programs for staff.

C. Planning from professional Development Performance management includes the processes of human resources management. The purpose of this system as related to the employee includes job productivity, compensation, job performance recognition, and planning for professional development. For the organization, the processes include worker requirements, job analysis, compensation administration, training needs analysis, and employee promotion or discipline evaluation.

Decentralization occurs when: A. equipment is being purchased from approved vendors. B. hiring decisions are made at the executive level. C. power is distributed to those closest to the work of caregiving. D. supplies are distributed from one central supply area in the hospital.

C. Power is distributed to those closest to the work of caregiving Decision-making authority rests at lower levels in the organizational framework, closer to the point of care, rather than being passed up through the chain of command to an executive.

The degree to which health services for individuals and populations increases the likelihood of desired health outcomes that are consistent with current professional knowledge is known as the: A. care delivery quotient. B. excellence index. C. quality of health care. D. standard of care.

C. Quality of Health Care Quality of health care is defined as the degree to which health services for individuals and populations increases the likelihood of desired health outcomes that are consistent with current professional knowledge (Lohr, 1990).

Which combination of leadership is recommended for chairing an all-hazards preparedness task force (AHPTF)? A. Chief executive officer and internal medicine physician B. Chief financial officer and emergency care nurse liaison C. Representative chief nurse officer and emergency care physician D. Representative chief information technology officer and critical care physician

C. Representative chief nurse officer and emergency care physicians

Which of the following supports successful workplace diversity? A. Being a "devil's advocate" B. Holding tight to one's cultural values C. Respect for differences D. Withholding judgment of others

C. Respect for Differences Strategies of respect for differences, exploring beyond the comfort zone, withholding judgment of others, emphasizing the positive, and practicing good communication techniques are strategies for encouraging successful workplace diversity.

Culture is best defined as (the): A. deviation from the majority. B. differences in likes and dislikes. C. shared beliefs and values. D. similar views and opinions.

C. Shared beliefs and values Culture is described as shared beliefs and values. It provides a common belief system among its members but is not expected to hold similar views and opinions of its members.

A situation in which the demand for employment of nurses (how many nurses employers would like to employ) exceeds the available supply of nurses willing to be employed at a given salary is known as a nursing: A. abundance. B. deficit. C. shortage. D. surplus.

C. Shortage The number of nurses that employers would like to employ in relation to the number of nurses willing to be employed at a given salary is known as a nursing shortage. In a nursing shortage, the demand for employment of nurses exceeds the available supply for employment at a given salary.

A nurse manager is evaluating the efficiency of a process on the nursing unit. The manager believes that the unit could be more efficient if one aspect of this process were delegated to unlicensed personnel. To establish whether the delegation of this duty would be legal, he should check with the: A. ANA. B. current federal defense attorney. C. state nurse practice act. D. policy and procedure manual of the unit.

C. State Nurse Practice Act Nurse practice acts exist for each state and govern the legal practice of nursing, including standard of care, delegation, and supervision.

SWOT is an acronym for: A. stability, wealth, opportunistic, and timeliness. B. strategies, work ethic, oppositions, and team. C. strengths, weaknesses, opportunities, and threats. D. strong, worthy, oppositional, and tactical.

C. Strengths, Weaknesses, Opportunities, Threats SWOT is an acronym for strengths, weaknesses, opportunities, and threats. SWOT analysis is used in developing strategic plans for an organization.

The five rights of delegation are right task, right circumstance, right person, right direction and communication, and right: A. interaction. B. outcome. C. supervision. D. time.

C. Supervision Right supervision is the fifth right of delegation as outlined by the National Council of State Boards of Nursing (1995).

A small number of people with complementary skills who are committed to a common purpose, performance goals, and approach for which they hold themselves mutually accountable and whose membership should be consistent is known as a: A. committee. B. group. C. team. D. unit.

C. Team A team is a small number of people with complementary skills who are committed to a common purpose, performance goals, and approach for which they hold themselves mutually accountable and whose membership should be consistent (Katzenbach & Smith, 1993; Manion et al., 1996).

_____ is defined as the accomplishment of specified activities during the time available. A. Stress B. Mismanagement of resources C. Time management D. Self-management

C. Time Management Time management is defined as the accomplishment of specified activities during the time available. It is the process of managing the things an individual does with his or her available time. At its core, time management is self-management.

What is the purpose of culture in an organization? A. To provide a perception of what it feels like to work in the organization B. To provide an organization's response to economic, social, and financial challenges C. To provide a common bond so that members know how to relate to one another and show others outside the organization what is valued D. To provide a small geographical area within the organization where nurses provide care

C. To provide a common bond so that members know how to relate to one another and show others outside the organization what is valued Culture is the set of values, beliefs, and assumptions that are shared by members of an organization. The purpose of culture is to provide a common bond so that members know how to relate to one another and to show others outside the organization what is valued.

The total number of nurses who left a unit in 1 year divided by the total number of nurses employed on that unit is the _____ rate. A. actualized B. employable C. turnover D. vacancy

C. Turnover The total number of nurses who left a unit in 1 year divided by the total number of nurses employed on that unit is the turnover rate.

The instruments that give voice to the organization's philosophy include which of the following (select all that apply)? A. Goals B. Focus C. Vision D. Mission E. Core values

C. Vision D. Mission E. Core Vlues The mission, core values, and vision are the instruments that give voice to the organization's philosophy. The mission is an aim to be accomplished. It influences the philosophy, goals, and objectives of an organization. The vision is a mental image or the power of imagination to see something that is not actually visible.

The Joint Commission's (TJC's) staffing regulation states: A. staffing ratios are recommended in perinatal and critical care areas. B. Incorrect Response nurse managers may determine the nurse-to-patient ratio as long as the patient's needs are being met. C. hospitals must also provide the right number of competent staff members to meet the patients' needs. D. hospitals may limit the number of admissions to ensure there are an adequate number of staff members to meet patient needs.

C. hospitals must also provide the right number of competent staff members to meet the patients' needs. TJC noted the following (2006): The goal of the human resources function is to ensure that the hospital determines the qualifications and competencies for staff positions based on its mission; populations; and care, treatment, and services. Hospitals must also provide the right number of competent staff members to meet the patients' needs. (p. HR-1)

Leadership is best defined as: A. an interpersonal process of participating by encouraging fellowship. B. delegation of authority and responsibility and the coordination of activities. C. inspiring people to accomplish goals through support and confidence building. D. the integration of resources through planning, organizing, and directing.

C. inspiring people to accomplish goals through support and confidence building. Leadership is the process of influencing people to accomplish goals by inspiring confidence and support among followers.

Population-based care management is the: A. assessment and planning of health initiatives within an area. B. implementation and evaluation of health programs within a community. C. integration and coordination of health services to a specific population. D. organization and regulation of health professions across the country.

C. integration and coordination of health services to a specific population. Population-based care management is the integration and coordination of health services to a specific population.

The core concept of the synergy model for patient care is based on the nurse-patient relationship and acknowledges: A. frontline charge nurses make informed patient care assignment decisions. B. organizing and delivering nursing care achieves desired patient outcomes. C. the needs or characteristics of the patients and families drive the competencies of the nurse. D. the clinical nurse leader champions innovations that improve patient outcomes, ensures quality care, and reduces health care costs.

C. the needs or characteristics of the patients and families drive the competencies of the nurse. The synergy model for patient care is presented by the American Association of Critical-Care Nurses (Hardin & Kaplow, 2005). The core concept of the model is based on the nurse-patient relationship and acknowledges that the needs or characteristics of the patients and families drive the competencies of the nurse. Synergy, or optimum outcomes, results when the needs and characteristics of the patient clinical unit, or system, are matched with a nurse's competencies (Kaplow & Reed, 2008).

The nursing shortage cycles over the past few decades have been primarily driven by factors including which of the following (select all that apply)? A. Aging of current nurses and inability of hospitals to meet nursing salary demands B. Younger nurses in the workforce and their preference for nontraditional nursing jobs C.Significant changes in the health care delivery system as the nation moves into health care reform D. Aging of the American population and struggles to expand capacity to meet demand for care E. Lower numbers of students entering nursing as a career and a shift in need for both bachelor's- and master's/doctorate-prepared nurses

C.Significant changes in the health care delivery system as the nation moves into health care reform D. Aging of the American population and struggles to expand capacity to meet demand for care E. Lower numbers of students entering nursing as a career and a shift in need for both bachelor's- and master's/doctorate-prepared nurses The nursing shortage cycles over the past few decades have been primarily driven by six factors: aging of current nurses in the workforce and their preparation for retirement, lower numbers of students entering nursing as a career and a shift in need for both bachelor's- and master's/doctorate-prepared nurses, aging of nursing faculty and inability of schools of nursing to meet education demands, aging of the American population and struggles to expand capacity to meet demand for care, and significant changes in the health care delivery system as the nation moves into health care

Authentic respect for others requiring time, presence, engagement, and intention to seek common ground is called _____.

Civility Civility is authentic respect for others requiring time, presence, engagement, and intention to seek common ground

Which organizational theory emphasized the informal aspects of organization social structure and was influenced by the Hawthorne experiments? A. Bureaucratic theory B. Scientific management school C. Classical management theory D. Human relations school

D. Human Relations School Theorists in the human relations school emphasized the informal, rather than formal, aspects of organization social structure. Hawthorne experiments were influential in this school of thought.

The purpose of a root-cause analysis (RCA) is to: A. discipline the staff involved in the patient safety event. B. disclose the medical error to the patient/patient's family. C. identify the person(s) responsible for committing the error. D. identify the systems issues that led to a sentinel event.

D. Identify the systems issues that lead to a sentinel event

An organization has encountered a serious patient safety event that was reported to the state, The Joint Commission, and the Centers for Medicare & Medicaid Services (CMS). An extensive plan of correction was received, and the organization had to make some immediate changes in practice. Additionally the organization anticipates a costly lawsuit. What is the best method of educating staff about the practice changes that were issued? A. "These changes need to be made because the state and CMS require it." B> "We understand this is a knee-jerk reaction, but please change the practice while the surveyors are in the building." C. "We need to make this change because it will help our lawsuit." D. "This change is being made so that there is no further harm to another patient."

D. "This change is being made so that there is no further harm to another patient." Rapid Cycle Changes or those that are emergent are put into place to improve patient care, with the emphasis on patient safety and quality goals. Staff should not be educated that the changes are made based upon regulatory requirements or the avoidance of litigation. Misconceptions or inaccurate information can create resistance to change.

The Scope and Standards of Practice are: A. A broad direction for the practice of nursing B. A legal document C. Authoritative statements about nursing practice D. All of the above

D. All of the Above

The Code of Ethics serves the following purposes: A. A succinct statement of the ethical obligations and duties of every individual who enters the profession B. The profession's nonnegotiable ethical standard C. An expression of nursing's own understanding of its commitment to society D. All of the above

D. All of the above The Code of Ethics is a succinct statement of ethical obligations and duties, the nonnegotiable ethical standard and nursing's understanding of its commitment to society

Ben has reported to work late four times in the last three months. His manager brings this to his attention and asks him to meet her in her office tomorrow at 10 AM to discuss the issue. At their meeting, Ben is given an opportunity to explain his tardiness. Together they come up with an action plan to reduce Ben's tardiness. This type of management of consequences is called: A. coaching. B. mentoring. C. precepting. D. counseling.

D. Couseling Counseling addresses problem performers, such as employees whose work is consistently substandard; those who regularly miss deadlines; or those who are uncooperative, insubordinate, absent, or tardy. The problem needs to be brought to the employee's attention, the employee should be given time to respond, and specific actions to improve performance should be agreed on.

The nurse manager within a small department has requested that the staff decide department coverage over the holidays. The department is not associated with patient care and serves as a supportive role to the organization. The staff is to present the manager with the coverage plan during the month of December. This is an example of which type of decision? A. Autocratic decision procedure B. Consultative decision procedure C. Joint decision making D. Delegated decision procedure

D. Delegated Decision Procedure A delegated decision procedure occurs when the leader allows participants to make the final decision. An autocratic decision procedure occurs when the leader makes all of the decisions. A consultative decision procedure occurs when decisions involve employee participation but the leader still makes the decision. Joint decision making occurs when the entire group decides by vote or consensus.

Nurse managers are able to respond better to ethical dilemmas when they have access to the organization's: A. mission and vision. B. patient safety plan. C. medical staff bylaws. D. ethics committee.

D. Ethics Committee It is critical that nurses and administrators have access to and inclusion on the health care organization's ethics committee. Nursing professionals are ideal members because of their responsibilities and experiences associated with patient care.

Which organizational theory emphasized the informal aspects of organization social structure and was influenced by the Hawthorne experiments? A. Bureaucratic theory B. Scientific management school C. Classical management theory C. Human relations school

D. Human Relations School Theorists in the human relations school emphasized the informal, rather than formal, aspects of organization social structure. Hawthorne experiments were influential in this school of thought.

A group of tenured nursing faculty at a major university votes on whether a faculty member should receive tenured status. This type of decision making is referred to as: A. autocratic decision procedure. B. consultative decision procedure. C. delegated decision procedure. D. joint decision making.

D. Joint Decision Making Joint decision making occurs when the entire group makes the decision by two-thirds vote, a simple majority, consensus, or some other process. In this process, the group members have as much power as the leader.

Which ethical principle is violated when there are insufficient community resources to meet the needs of low-income families? a. Nonmaleficence B. Autonomy C. Beneficence D. Justice

D. Justice Justice is the norm of being fair and giving all equal treatment. When low-income families do not get the same community resources as others, justice is not being served.

The workload standard commonly used in nursing when calculating staffing patterns is: A. patient days. B. patient acuity system. C. average length of stay. D. nursing care hours per patient day.

D. Nursing care hours per patient day The amount of work performed by a unit is referred to as its workload, and workload volume is measured in terms of units of service. The workload standard commonly used is nursing care hours per patient day, although the validity of this measure is disputed.

A 17-year-old male has presented to the emergency department with appendicitis. He speaks English, but his mother speaks Spanish. The mother needs to sign a consent for emergency surgery, because the patient is a minor. Which of the following is the most appropriate method of obtaining consent? A. No consent is needed because of the emergency nature of the surgery. B. Have the patient sign the consent because he understands the explanation from the surgeon. C. Have the patient's sister explain the procedure in Spanish, but ask the mother to sign the Spanish consent form. D. Obtain an interpreter to explain the procedure to the patient and mother in Spanish, and ask her to sign a Spanish consent form.

D. Obtain an interpreter to explain the procedure to the patient and mother in Spanish, and ask her to sign a Spanish consent form. According to the Office of Minority Health (2007) in the USDHHS, the National Standards on Culturally and Linguistically Appropriate Services (CLAS) state that health care organizations must offer and provide language assistance services, including bilingual staff and interpreter services, at no cost to each patient/consumer with limited English proficiency at all points of contact, in a timely manner during all hours of operation. Therefore, because the patient is a minor, the legal parent must understand the procedure in her native language.

The consequence of an intervention or treatment is known as a(n): A. achieved benefit. B. benchmark. C. expected response. D. outcome.

D. Outcomes The term outcomes has been defined as the conditions in patients and others that health care delivery aims to achieve (Peters, 1995). Donabedian (1985) described outcomes as changes in the actual or potential health status of individuals, groups, or communities.

Intravenous lines being dressed using sterile technique with a 2-´2-inch gauze and occlusive sterile tape versus a transparent dressing are being evaluated for infection rates. These data are collected and compared with current research to suggest an opportunity for improvement. This is an example of: A. best practice evaluation. B. current practice critique. C. practice difference analysis. D. performance gap assessment.

D. Performance Gap Assessment Performance gap assessment is a strategy of demonstrating an opportunity for improvement at baseline outlining current practice related to specific indicators. This is helpful in encouraging commitment for practice changes.

Time management is an essential skill for nurse managers. This can be effectively managed through the creation of to-do lists and is an example of: A. delegation. B. motivation. C. negotiation. D. prioritization.

D. Prioritization

Interpersonal communication and the ability to apply _____ are two critical skills every nurse needs to enhance professional practice. A. Vision B. Supervision C. Delegation D. Problem Solving

D. Problem Solving Every nurse needs two critical skills to enhance professional practice. One is a skill at interpersonal relationships. This is fundamental to leadership and the work of nursing. The second skill is applying the problem-solving process. This involves critical thinking, problem identification, and the development of objectivity.

A group of people who believe they are a team but fall short of the definition of a true team is known as a: A. club. B. group. C. meeting. D. pseudoteam.

D. Pseudoteam A pseudoteam is a group of people who believe they are already a team, although clearly they fall short of the definition of a true team.

Individuals join groups because of: A. monetary rewards. B. mandatory obligations. C. physical needs. D. psychological drives.

D. Psychological Drives The reasons individuals join groups vary but may include psychological drives and primary needs.

How is the refreezing stage of change similar to the nursing process? A. Refreezing is similar to the assessment phase of the nursing process. B. Refreezing is similar to the problem identification phase of the nursing process. C. Refreezing is like the planning and implementation phase of the nursing process D. Refreezing is like evaluation in the nursing process.

D. Refreezing is like evaluation in the nursing process.

Which of the following factors is used to describe the degree to which successful planned change is thought to be better than the status quo? A. Complexity B. Compatibility C. Trialability D. Relative advantage

D. Relative Advantage Relative advantage is one of the factors that helps determine successful planned change. It is the degree to which the change is thought to be better than the status quo.

Management offers a day of pampering at a spa if nurses agree to work 3 out of 4 weekends over the summer. This type of power is known as: A. coercive. B. expert. C. legitimate. D. reward.

D. Reward French and Raven's five sources of power (1959) include reward, coercive, expert, referent, and legitimate. When reward power is used, most people comply because of the positive benefits of doing so.

When determining that delegation of an element of patient care needs to occur, the nurse delegates with a clear, concise description of the task, including its objectives, limits, and expectations. The nurse allows the delegate to clarify without fear of repercussion. Which of the following five rights of delegation is being demonstrated? A. Right task B. Right circumstance C. Right person D. Right direction/communication E. Right supervision/evaluation

D. Right direction/ communication The right direction/communication of delegated elements of care will be a clear, concise description of the task, including its objective, limits, and expectations. The nurse allows for clarification without the fear of repercussions.

Responding to a code called in the psychiatric unit where she works, a staff nurse finds that a patient has committed suicide. The staff nurse correctly identifies this as a: A. benchmark incident. B. quality improvement issue. C. performance breach. D. sentinel event.

D. Sentinel Event A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof.

The provision of guidance or direction, evaluation, and follow-up by the licensed nurse for accomplishment of a nursing task delegated to unlicensed assistive personnel (UAP) is: A. authorization. B. delegation. C. observation. D. supervision.

D. Supervision Supervision is the provision of guidance or direction, evaluation, and follow-up by the licensed nurse for accomplishment of a nursing task delegated to UAP (National Council of State Boards of Nursing, 1995).

Team building is the process of _____ a group. A. forming B. identifying C. organizing D. unifying

D. Unifying Team building is the process of deliberately creating and unifying a group into a functioning work unit so that specific goals are accomplished.

On admission, the patient was found to have a blood glucose level of 218. The RN knows that except in emergency situations, it is hospital policy to obtain physician's orders before administering any medication. Because the on-call physician did not return the page, the nurse administered insulin according to the common sliding scale. Four hours later, the patient was found nonresponsive in her bed and later died. According to the autopsy, the patient died from heart failure. Her postmortem blood glucose level was 22. Because of the nurse's actions, the admitting hospital may be found to be: A. a judicial risk. B. an ostensible authority. C. indemnified. D. vicariously liable.

D. Vicariously Liable If a nurse negligently injured a client during the course of and within the scope of employment, not only would the nurse be directly liable for damages, but also the health care organization would be vicariously liable.

When staff nurses ignore a patient's verbal threats or acts of intimidation: A. a greater number of patients return to the facility for care. B. staff nurses report increased job satisfaction. C. the patient receives exposure to a positive role model. D. violence escalates.

D. Violence Escalates The toleration of hostile or threatening behavior can result in escalation that results in physical harm (Hoag-Apel, 1999).

Nurses who are successful at time management: A. display an ability to set measurable goals and objectives. B. frequently volunteer for new and creative projects. C. hesitate to delegate because of perfectionist characteristics. D. tend to accomplish specific activities within a time frame.

D. tend to accomplish specific activities within a time frame Time management is accomplishing specific activities during the time available. It is a process of managing the things an individual does with his or her available time.

Over lunch in the cafeteria, student nurses are sharing educational information about the patients for whom they are caring. This is a(n): A. breach of beneficence. B. example of maleficence. C. potential assault and battery charge. D. violation of the Health Insurance Portability and Accountability Act (HIPAA).

D. violation of Health Insurance Portability and Accountability Act (HIPAA). HIPAA provisions have heightened awareness about and encouraged strategies to protect a patient's privacy in health care transactions. This is an example of breach of confidentiality.