402 exam
1. Accreditors are scheduled to visit a hospital site, and staff members have been made aware of what they will be assessing. What staff behavior would most clearly suggest the presence of the Hawthorne effect? Select one: a. The nurses consciously improve their performance because they know it is being scrutinized. b. The nurses avoid contact with the accreditors because they fear criticism. c. The manager blames individual nurses for deficits identified in the accreditation report. d. The manager temporarily adopts a leadership role.
A
2. The clinic leader tends to make decisions independently and closely supervises and controls the practice of the nurses at the clinic. What type of leadership is being exemplified? Select one: a. Authoritarian b. Democratic c. Laissez-faire d. A contingency approach
A
2. Which characteristic of a planned change is most likely to threaten its success? Select one: a. The suggested change is introduced to staff after the plan has been formalized. b. Individuals affected by the change are involved in planning for the change. c. The change agent is aware of the organization's internal and external environment. d. An assessment of resources to carry out the plan is completed before unfreezing.
A
3. In planning strategies to prevent stagnation and promote renewal, which action would most likely result in the desired outcome? Select one: a. Developing a program for recruitment of young talent b. Rewarding employees by promoting from within c. Having set pay increases mandated annually d. Using length-of-service to determine committee selection
A
4. A new leader-manager is planning to implement the principles of strengths-based leadership after being hired for a new position. What action will best facilitate this plan? Select one: a. Creating a team with diverse abilities and talents b. Identifying his or her personal strengths and utilizing them c. Appraising team members on a scale that runs from "weaker" to "stronger" d. Organizing the flow of work to match his or her strengths
A
4. The unit manager has created a decision grid in order to assist with a difficult staffing decision that will affect many nurses. The decision grid will allow the manager to: Select one: a. examine alternatives visually and compare each against the same criteria. b. ensure that the decision is made objectively rather than subjectively. c. plot the outcomes of a decision over time and evaluate the decision-making process. d. predict when events must take place to complete a project on time.
A
5. The principle of autonomy would have the greatest bearing on what clinical situation? Select one: a. A client is discussing a do-not-resuscitate order with the care team. b. A client is unable to afford the treatment that carries the best chance for a cure. c. A nurse is considering whether to report a colleague's rough treatment of a client. d. The nurse is caring for two clients in pain and must choose which to treat first.
A
6. A novice nurse has been trying to apply the nursing process to each client interaction. What should the nurse do to enhance the effectiveness of this process for making decisions and solving problems? Select one: a. Ensure that specific goals are identified during the planning process b. Conduct assessment and diagnosis simultaneously whenever possible c. Prioritize ethics during each phase of the nursing process d. Avoiding evaluating the process until every outcome has been met
A
6. The manager of a busy emergency department is primarily concerned with the practical, day-to-day operations of the department. This manager is most clearly demonstrating what type of leadership? Select one: a. Transactional b. Transformational c. Interactional d. Bureaucratic
A
8. A nurse-manager has proposed a change in the skills mix on a hospital unit, with fewer registered nurses and more nursing assistants. What outcome best demonstrates that the nurse is applying the principles of thought leadership? Select one: a. Skeptics of the plan have begun to see it as innovative and beneficial. b. Individuals who oppose the plan have become isolated by their peers. c. Nurses and nursing assistants will both participate in the operations planning. d. The ultimate decision on the matter will be based on rational ideas rather than emotions.
A
8. In which situation would the nurse be justified in overriding a client's right to confidentiality? Select one: a. An older adult client discloses to the nurse that her son occasionally hits her. b. A client states that he does not want to know the results of his recent diagnostic test. c. A client does not want her husband to know that she is a client on the unit. d. A teenage client asks the nurse not to tell her parents that she is pregnant.
A
A manager has been experiencing challenges during a planning process and must implement strategies to overcome barriers that impede planning. What is the manager's best action? Select one: a. Reevaluate whether the goals and objectives are appropriate and achievable b. Establish a fixed goal that is unaffected by changes in the organization c. Limit membership in the planning team to administrators, leaders, and executives d. Make the goals of the plan more general so that they can be more easily achieved
A
A new manager is confused why nurses are not heeding her directions in the workplace. What strategy is most appropriate when attempting to resolve this problem? Select one: a. Assure the nurses that she has their best interests in mind b. Ignore the issue and reintroduce the directions in 6 to 8 weeks c. Hold a meeting to remind staff that they are under the manager's authority d. Bring in an outside consultant to have one-on-one conversations with staff
A
A nurse has asked a colleague for assistance with a complex wound dressing change. What response suggests that the colleague is at a novice level of nursing experience? Select one: a. "Sure. Can you give me directions and then I'll do what you say?" b. "I'm really busy right now. Can we do it sometime this afternoon?" c. "I can do it for you later, if that helps." d. "Definitely. I'll go and get the supplies and meet you at the bedside."
A
A nurse-manager has introduced a proposed change to the operations of an ambulatory clinic and has been met with resistance. How should the manager best interpret this resistance? Select one: a. Resistance is an expected component of a proposed change. b. Resistance confirms that the proposed change is necessary. c. The presence of resistance suggests that the change may be unsuccessful. d. The presence of resistance indicates a need to implement power-coercive strategies.
A
A nurse-manager is reviewing the organizational chart of a health-care facility before accepting a job offer. When reviewing the organizational chart, the nurse should: Select one: a. be aware that the informal structure of the organization cannot be discerned from the chart. b. confirm the accuracy of the chart with the human resources department. c. try to meet with the people at the top of the chart, if possible. d. review the qualifications of each person on the chart.
A
A nursing supervisor has been given the responsibility for increasing the frequency and thoroughness of nursing assessments on a hospital unit. However, the supervisor does not have the authority to enforce new guidelines for assessment or assign consequences for noncompliance. What is the most likely outcome of this scenario? Select one: a. The desired outcome will not be achieved. b. The assessments will improve, but the nurses will be resentful. c. The supervisor will need to use unauthorized enforcement. d. The assessments will improve as a result of collaboration.
A
Question text 3. A nurse-manager recognizes the role that individual values play on decision making. How should the manager best address this fact during a period of organizational planning? Select one: a. The manager should carefully reflect on his or her most important values. b. The manager should make every attempt to set aside his or her values when making decisions. c. The manager should seek individuals who have similar values when creating a decision-making team. d. The manager should seek individuals who claim to have flexible values when creating a decision-making team.
A
The leader-manager provides oversight on a busy medical-surgical unit. There has recently been an incident where two nurses were not honest about neglecting a controversial new protocol and misled the leader. How can the leader-manager best prevent similar episodes? Select one: a. Support employees' right to disagree with proposed changes b. Ensure that employees know the consequences of misleading the manager c. Avoid making decisions that displease large numbers of employees d. Identify allies who can be trusted to report employees who may mislead the manager
A
The nurse-manager of a community health clinic is participating in budget planning for the next year. The manager will most likely assign the most money to what expenditure category? Select one: a. The personnel budget b. Short-term capital acquisitions c. The operating budget d. Supplies and equipment
A
What action by a nurse-manager best demonstrates servant leadership? Select one: a. Prioritizing the interests of others over the manager's own interests b. Cultivating a personal relationship with each subordinate c. Making decisions on the basis of customer service d. Communicating a clear vision for the future and asking subordinates to share it
A
What is one of the most politically serious errors one can make? Select one: a. Dispensing untrue information b. Promoting the advancement of subordinates c. Withholding or refusing to divulge information d. Delaying decision making until there is additional information
A
Which client would be most likely to qualify for Medicaid? Select one: a. An adult client who earns $750.00 per month b. A veteran who sustained injuries in combat c. A Native American client who lives on a reservation d. A child who requires physical therapy to recover from traumatic injuries
A
Which statement concerning a budget is true? Select one: a. A budget's reliability decreases if it is prepared significantly in advance of the funding period. b. Budgets should be created as far in advance is possible. c. A budget is revised every 3 months during a fiscal year. d. Budgets are reliable only when expenses are fixed.
A
1. A multidisciplinary team has been assigned responsibility for managing the change process in a large health-care organization. What goal should this team set for their activities? Select one: a. Resistors will face workplace discipline. b. Employees will not sabotage the change process. c. Change will happen as quickly as possible. d. Change will become a constant state in the organization.
B
1. A nurse-manager is having difficulty finishing the necessary tasks for each day. When implementing the time management process, what should the manager do first? Select one: a. Complete the highest priority task b. Allow enough time for sufficient daily planning c. Reprioritize based on new information received d. Delegate work that cannot be accomplished in a day
B
2. A nurse-manager has recognized that unproductive socialization is making it difficult to complete each day's tasks. What action should the manager take to prevent this cause of inefficiency? Select one: a. Maintain an open-door policy so employees can have more rapid interactions with the manager b. Schedule appointments so that interactions can be predicted and controlled c. Request a transfer to a site where the manager knows fewer coworkers and employees d. Ban socialization on the unit during working hours
B
3. A charge nurse has discovered that a medication error was made on the previous shift. What is the nurse's best action? Select one: a. Share that information with the charge nurse on the previous shift b. Document the incident and follow it up as per hospital policy c. Write a memo to the nurse who made the error requesting an incident report be written d. Document in the client's chart that an incident report will be completed
B
3. A nurse-manager has realized that the data-gathering process before a recent decision may have been influenced by confirmation bias. How can the manager best reduce the risk of this in the future? Select one: a. Delegate data gathering to a trusted colleague who has different values b. Make attempts not to prioritize information that supports the manager's beliefs c. Consider all of the implications of an alternative before making a decision d. Collect only the minimum quantity of data before making a decision
B
4. A nurse is referencing the ANA code of ethics when making a decision about the best response to a challenging situation. What information will the nurse be able to obtain from this document? Select one: a. Legal guidelines to help the nurse make an ethical decision b. The principles that are most valued in nursing practice c. A model that will guide the nurse to make an ethical decision d. Guidelines that will help the nurse clarify his or her own values
B
4. A nurse-manager is reviewing a backlog of correspondence and reads an e-mail asking for feedback from a manufacturer about a piece of equipment that is used at the facility. The manager reads that the sender asked for all feedback to be submitted by the end of last week. In what category of prioritizing should this task be placed? Select one: a. Squeaky wheel b. Don't do c. Do later d. Do now
B
5. A team has been formed to consider a change in medication delivery. How can the team leaders best promote a successful change? Select one: a. Implement the change as rapidly as possible in order to diffuse resistance. b. When planning, involve as many people who will be affected by the change as possible. c. Bring in outside experts to implement the change. d. Enforce compliance with the change fairly and consistently.
B
5. Which statement identifies a common mistake made related to daily planning? Select one: a. "Crises always come up so my plan is always changing." b. "I always handle each client's needs as they arise." c. "Sometimes it's difficult to reserve time for daily planning." d. "Client care requires a lot of reassessment by nursing."
B
6. A nurse-manager admits to feeling frustrated and confused by the fact that each day "just slips away," leaving many important tasks undone. How should this manager begin developing better time management skills? Select one: a. Identify a mentor who can plan the manager's schedule b. Complete a time inventory to identify how time is used c. Experiment with adjustments to the daily schedule d. Request a temporary reduction in workload
B
6. Which action should the nurse prioritize when trying to prevent malpractice claims? Select one: a. Always carrying a personal liability insurance policy b. Always functioning with the scope of the nursing practice act c. Asking for assistance when engaged in complicated procedures d. Devoting time to establishing an effective nurse-client relationship
B
6. Which response is most characteristic of a servant leader? Select one: a. "I don't think you have the skills necessary to be effective." b. "Let me think about that request for 24 hours and get back to you." c. "Do whatever it takes to get it done fast." d. "I'll personally handle this situation."
B
7. The manager of a clinic is considering a change in the scheduling of vacation time in which nurses would self-schedule their vacation rather than having the manager respond to their submitted requests. A nurse has pointed out that it is possible that newer nurses may feel intimidated by more experienced nurses on the unit when scheduling their vacation. This observation constitutes what component of a SWOT analysis? Select one: a. S b. W c. O d. T
B
7. The nurse is admitting a client to the health-care facility who is in the late stages of pancreatic cancer. In order to comply with the terms of the Patient Self-Determination Act (PSDA), the nurse should: Select one: a. ensure the client clearly understands each treatment option. b. determine whether the client has established an advance directive. c. document that the client's family has been included in care planning. d. assess the client's expectations for recovery.
B
7. Which factor is the greatest contributor to the resistance encountered with organizational change? Select one: a. Poor organizational leadership b. Presence of employee mistrust c. Ineffective organizational management d. Insufficient staff involvement in the process
B
8. The nurse-manager oversees the care of several dozen nurses. With which nurse should the manager review the provisions of the Health Insurance Portability and Accountability Act (HIPAA)? Select one: a. A nurse who has discussed a client's status with a physician over the telephone b. A nurse who confirmed a new client's admission to the unit to a relative who telephoned c. A nurse who completed a client's documentation outside of the client's room d. A nurse who has initiated contact with the social worker to discuss a client's discharge planning
B
A new nurse-manager has set a goal of building a personal power base. What strategy should the manager choose? Select one: a. Exercise overt displays of power to subordinates whenever possible b. Seek to become highly visible in the organization c. Take every opportunity to collaborate with physicians d. Initiate dialogues with colleagues about the relationship between gender and power
B
A nurse has been hired to oversee the operations of a series of ambulatory clinics. The nurse can best promote the success of the organization by: Select one: a. promoting management skills among all employees. b. integrating leadership skills and management skills. c. clearly communicating to employees that they will be required to follow. d. advocating for the organization to hire a leader for each site.
B
A nurse-manager has been commissioned to create a new workplace committee that will focus on client safety issues. When forming this committee, the manager should: Select one: a. meet at least twice per week for the first month to create momentum. b. aim for diversity of genders and cultures among the membership. c. ensure that half of the members are the manager's subordinates and half are the manager's superiors. d. give members permission to attend meetings as often or as rarely as they wish in order to accommodate their schedules.
B
A nurse-manager is beginning a day and is responsible for completing numerous tasks, including one high-priority task, three medium-priority tasks, and several lower priority tasks. How should the manager plan the day? Select one: a. Complete some low-priority tasks first to make room for focusing on the high-priority task b. Complete the high-priority task as early in the day as possible c. Arrange the tasks according to the amount of time that they will require d. Complete the low-priority tasks first, then a medium priority task, and then focus exclusively on the high priority task
B
A nurse-manager is participating in the budgeting process. What task should the manager perform first? Select one: a. Creating a spending plan b. Determining what needs to be covered in the budget c. Identifying the organization's strengths and weaknesses d. Determining how to maximize cost effectiveness
B
A planned change has been imposed by upper management at a large hospital and will greatly affect the delivery of care on inpatient units. What is an appropriate role for the leader-manager in this time of change? Select one: a. Mobilizing resistance in a respectful but assertive way b. Demonstrating a positive attitude toward the prospect of change c. Implementing the change as rapidly as possible d. Dialoguing with staff about the benefits of maintaining the status quo
B
A recent nursing graduate has begun working full-time and is committed to career planning. What action will be most likely to advance the nurse's career? Select one: a. Changing jobs every 12 to 18 months b. Obtaining professional certification c. Adhering to standards of ethical practice d. Participating actively in performance appraisals
B
A recent switch to a new laundry provider at a long-term care facility has been described as "cost-effective." What does this imply about the change in laundry service? Select one: a. It is the least expensive service available. b. It is worth the cost. c. It is reimbursable. d. The cost was anticipated.
B
An experienced nurse-manager describes a recently hired nurse as "very promising." The manager can best promote this nurse's career development by: Select one: a. asking other nurses to model their behavior on the new nurse's behavior. b. providing the nurse with increasingly challenging work assignments. c. removing the nurse from client care responsibilities and assigning management tasks. d. providing the nurse with positive feedback.
B
During the budgetary process, a nurse-manager and the other members of the fiscal planning team are considering factors that may affect the accuracy of the budget. What factor should the team prioritize? Select one: a. Legislation regarding client safety b. Possible changes in reimbursement policies c. Depreciation of capital equipment d. Establishment of new HMOs in the region
B
How can a nursing professional best demonstrate advanced achievement of competencies? Select one: a. Participating in career planning b. Achieving a new specialty certification c. Transfer to a new department d. Maintaining ethical standards of practice
B
The manager has been experiencing challenges working with a nurse who has a history of making unsympathetic comments about clients to other nurses. The manager has tried various strategies for changing the nurse's behavior with little effect. The manager feels that an application of coercive power is now appropriate. What action will the manager most likely take? Select one: a. Change the nurse's client care assignment b. Implement disciplinary action c. Offer sensitivity training to the nurse d. Dialogue with the nurse about the effects of these comments
B
The nurse is admitting a new client who is facing a serious health problem. The nurse can best apply the skills of advocacy when working with this client by: Select one: a. seeking opportunities to demonstrate professionalism. b. engaging closely and genuinely with the client and family. c. making decisions for the client and family in order to lessen their responsibilities. d. providing evidence-based care.
B
The nurse is working with a group of students who are learning a high-risk procedure. How should the nurse best ensure learning while protecting the safety of clients? Select one: a. Create an unfolding case study featuring the procedure b. Use simulation for the students to learn and practice the skill c. Help the students use a decision-making model to choose the safest technique d. Teach the students about the traditional problem-solving process before they practice the procedure
B
The nurse-manager is chairing a committee, most of whose members are subordinates. When communicating with the members during meetings, the manager should: Select one: a. ensure their contributions are recorded for performance appraisal purposes. b. avoid overt demonstrations of power or authority. c. reserve the right to impose decisions on the committee. d. avoid informality in speech or writing.
B
The top-level managers of a hospital have chosen to apply for magnet designation. The decision to grant this designation will be largely based on what factor? Select one: a. Input from local nursing educators and academics b. The findings from an onsite visit by assessors c. The results of a local public opinion survey d. Review of the organizational chart
B
1. The nurse is participating in a planning process in a large health-care organization. The nurse and the other members of the team should: Select one: a. avoid specifics so that the plan can be applied in any health-care setting. b. ensure that long-term priorities are always prioritized over short-term priorities. c. ensure that evaluation occurs at several points during the process. d. begin to engage employees in the process after the plan has been implemented.
C
2. A client is preparing to be discharged from the health-care facility and has told the nurse that he would like to read his medical record. What is the nurse's best initial action? Select one: a. Arrange for the medical record to be provided to the client b. Inform the client that this request will be communicated to the facility's ethics committee c. Confirm the facility's policy around providing medical records to clients d. Check whether this provision is included in the jurisdiction's Nurse Practice Act
C
2. The nurse-manager who seeks to exemplify emotional intelligence should: Select one: a. attempt to remove emotion from decision making. b. prioritize emotion over reason when making decisions. c. regulate his or her own emotions and those of others. d. effectively manipulate the emotions of others to achieve goals.
C
4. A nurse is deeply concerned about a proposed piece of legislation. Which action will best influence a local legislator who will be voting on the legislation? Select one: a. Signing an online petition b. Phoning the legislator's office repeatedly c. Writing a succinct, personalized letter to the legislator d. Forwarding the legislator online articles that related to the legislation
C
4. The novice nurse can reduce the likelihood of being sued for malpractice by: Select one: a. beginning his or her career in a lower acuity setting. b. avoiding performing interventions without a witness present. c. establishing positive, therapeutic relationships with clients and families. d. engaging in lifelong learning.
C
5. A nurse leader has set a goal of becoming a more transformational leader. What outcome will best indicate progress toward achieving this goal? Select one: a. The nurse maximizes efficiency when allocating scarce resources. b. The nurse's subordinates demonstrate respect and loyalty. c. The nurse empowers others to reach their full potential. d. The nurse provides praise for good work performances.
C
5. The nurse-manager is on a team that is performing a SWOT analysis of the staffing system at a community clinic. What should the manager do when addressing the "S" component of the SWOT analysis? Select one: a. Identify stakeholders in the current staffing system b. Examine the factors indicating that a change in the staffing system is necessary c. Identify any characteristics of the staffing system that currently help the clinic meet its goals d. Strategize about ways that the staffing system could possibly be improved
C
6. One of the most commonly used tools in health-care organizations is SWOT analysis. What is the definition of the "O" component of this model? Select one: a. Internal attributes that help an organization achieve its objectives b. Internal attributes that challenge an organization in achieving its objectives c. External conditions that promote achievement of organizational objectives d. External conditions that challenge or threaten the achievement of organizational objectives
C
6. The care team is working with a client who has mental illness and who has been deemed a threat to self and others. It may be justified to take away the client's right to: Select one: a. justice. b. confidentiality. c. self-determination. d. beneficence.
C
6. What action by the manager of a community health center best demonstrates workplace advocacy? Select one: a. Phoning the home of a nurse who has called in sick to confirm that the nurse is genuinely ill b. Asking clients to provide feedback on the care that they have received in their homes c. Ensuring nurses have all the personal protective equipment they need to perform home visits d. Assigning a different nurse to a client who had personality differences with his original nurse
C
7. The interdisciplinary team is considering whether to apply the principle of paternalism in the care of a client. What question should guide the team's decision? Select one: a. Does the client have strong social or family support? b. What is the client's most likely prognosis? c. Is the client competent to make decisions? d. What interventions are in the client's best interest?
C
8. A nurse was 20 minutes late returning from a scheduled lunch break and a colleague's break was consequently cut short. What response by the manager best demonstrates a laissez-faire leadership approach? Select one: a. Ask each of the nurses to speak with the manager separately to discuss the implications of this event b. Ask the nurses to attend a short meeting together in the manager's office c. Allow the two nurses to dialogue about this event and observe for evidence of a satisfactory resolution d. Impose a meaningful consequence on the first nurse and have the nurse apologize to the colleague
C
A client has provided informed consent for surgery and is being assessed by the nurse. What statement by the client should prompt the nurse to contact the surgeon? Select one: a. 'Why am I not allowed to eat and drink before the surgery?' b. 'How long do you think I'll stay in the recovery room?' c. 'Do you think this surgery is actually safe and necessary?' d. 'What is the difference between the surgeon and the anesthesiologist?'
C
A health-care provider prescribes a medical procedure that the staff nurse has reason to believe will harm the client. Which principle should guide the nurse's choice of action? Select one: a. The staff nurse cannot be held legally liable for any harm to the client if the procedure is carried out with due care. b. The nurse may lose his or her license by refusing to carry out the procedure. c. The nurse can be held legally liable for any harm if the procedure is carried out without questioning it. d. Liability rests with the health-care provider, not the nurse.
C
A unit manager has been instructed to complete a comprehensive audit of the unit's use of resources. The manager is daunted by the size of the task, which will likely take several weeks to complete. The manager should: Select one: a. set aside low- and medium-priority tasks until the project is complete. b. delegate the project to subordinates and ask for weekly updates. c. divide the project into smaller components that can be more easily completed. d. request clerical or secretarial assistance.
C
During a strategic planning committee meeting to develop technology goals, several unit managers spend a considerable amount of time discussing current staffing problems. What is the primary action of the chairperson of this committee? Select one: a. Take the remainder of the meeting time to discuss staffing with all members b. Adjourn the meeting and reschedule at a time when there are no staffing problems c. Request that committee members return to discussing items on the agenda d. Excuse those discussing staffing from the remainder of the meeting
C
Question text 1. When applying the principles of advocacy, a nurse-manager should: Select one: a. defer to a leader whenever possible because advocacy is primarily a leadership function. b. prioritize the needs of subordinates over the needs of the organization. c. balance the need to advocate for several different individuals, groups, and organizations. d. recognize that advocacy can only be provided for individuals, not groups or organizations.
C
Question text 5. A nurse-manager demonstrates Level 5 Leadership by performing what action? Select one: a. Keeping emotions in check b. Accepting nothing less than perfection from subordinates c. Taking responsibility for errors that he or she makes d. Avoiding conflict unless absolutely necessary
C
The nurse manager of a short-staffed unit needs to make a decision about a nurse's request for an unpaid leave of absence. In order to increase the chance of making a good decision, the manager should: Select one: a. involve as many people in the decision-making process as possible. b. begin the decision-making process by presuming the status quo to be the best option. c. generate as many different alternatives as possible. d. prioritize the option that is most innovative.
C
The nurse-manager is frustrated by the quantity of paper clutter. How should the manager best deal with this time waster? Select one: a. Require face-to-face communication between staff members rather than written documentation b. Set aside a block of time once per week to process documents c. Deal with paper correspondence as soon as possible after it arrives d. Place additional recycling and trash receptacles throughout the unit
C
The nurse-manager is working in a facility where two of the organizational goals are to increase physician satisfaction and reduce costs. A unit goal is to increase professional RN staffing. Which statement best supports all the stated goals? Select one: a. Increasing the RN staff will cut down on nursing errors, prevent burn out, and decrease the cost associated with staff turnover. b. Increasing the use of unlicensed assistive personnel will result in increased patient safety and quality care, and thus improve physician satisfaction. c. Increasing the RN staff will free more nurses to be available to address doctors' concerns during their rounds and will reduce our costly use of overtime. d. Increasing the RN staff will lead to improved patient education and a reduction in costly patient stays.
C
What activity is most likely to promote a nurse's continued competence? Select one: a. Working in a variety of clinical settings b. Meeting minimal standards for relicensing c. Acquiring new knowledge and skills on a regular basis d. Submitting to regular performance reviews
C
Which statement about American health-care budget spending is correct? Select one: a. A large health-care budget equals quality health-care outcomes. b. America spends less than any other industrialized country on health care. c. Outcomes related to low-birth-weight infants are worse than many other industrialized countries. d. The scarcity of resources is the biggest factor in the failure to reach outcomes.
C
Which statement best depicts leadership? Select one: a. Strong leaders can coerce people into following them. b. A leadership position has a narrower scope than a management position. c. People will follow a person in a leadership position only by choice. d. Leadership requires meeting organizational goals.
C
2. Even after a lengthy discussion concerning the ramifications, a client wants to leave the hospital against medical advice (AMA). What should the nurse do in the role of client advocate? Select one: a. Instruct the client to wait until morning to leave the hospital b. Ask family members to help talk the client out of the decision c. Encourage the client to leave and assist with the transition d. Make sure the client has appropriate follow-up appointments
D
3. A nurse has become dismayed at repeated instances of false documentation in the health-care organization. The nurse has become aware that documentation has been altered so that acts of negligence appear to be accidents. When preparing to blow the whistle on this behavior, the nurse should: Select one: a. attempt to edit the false documentation so that it is more accurate. b. resign from the health-care facility to reduce the risk of retaliation. c. seek permission from the nurse's immediate supervisor and head of the organization. d. carefully document any prior attempts to address the issue with supervisors.
D
3. A nurse is applying the ethical principle of justice when providing care for clients. What action best exemplifies this principle? Select one: a. Meeting continuing education requirements for license renewal b. Prioritizing actions that will benefit the largest number of clients c. Respecting clients' rights to make decisions about their care d. Ensuring that time and resources are distributed equitably to clients
D
3. How can a manager best implement the principles of situational or contingency leadership theory? Select one: a. By establishing rules and norms that can be applied the same way in all conditions in the organization b. By avoiding punitive consequences when addressing workers' lack of performance c. By deferring to employees for day-to-day management decisions d. By adapting his or her leadership style to a particular circumstance
D
5. Which strategy best demonstrates an understanding of the managers role as an advocate for his or her subordinates? Select one: a. Posting a copy of the code of ethics in the staff room b. Addressing an employee's high rate of absenteeism c. Establishing friendships with as many of the nurses as possible d. Working with primary care providers to expand standing nursing orders
D
7. The leaders of a health-care organization ascribe to human capital theory and are planning the budget for the next year. What activity should the team prioritize in the budget to promote the goals of this theory? Select one: a. Signing bonuses for nurses who are hired from outside the region b. Incentives for staff members who provide exemplary care and who make no errors c. Community outreach activities that will increase engagement between staff and residents d. Reimbursement of tuition to nurses who are upgrading their education
D
8. A nurse has accepted a new position as the manager at an ambulatory clinic. The nurse can best model subordinate advocacy in this new position by: Select one: a. abolishing formal performance reviews. b. increasing the number of part-time employees and reducing the number of full-time employees. c. adopting a laissez-faire leadership style. d. encouraging employees to participate in decision making.
D
8. A nurse-manager has identified the following objective for the care on the unit: "At least 95% of new clients' health records will contain a completed assessment for intimate partner violence." How should the manager improve this objective? Select one: a. Increase the objective to 100% of health records b. Include the rationale for the objective c. Focus on client actions rather than documentation d. Include a time frame in the statement
D
8. The nurse who provides oversight to a large health-care organization can best demonstrate leadership during a time of change by: Select one: a. clearly and assertively reminding nurses of their responsibilities to accept change. b. asking permission of nurses before proposing a change process. c. acknowledging that there is going to be resistance during the change process. d. communicating a vision that change is an opportunity to be embraced.
D
A leader has launched an organizational planning process that requires the development of new policies. How should the leader utilize subordinates during this process? Select one: a. Delegate the evaluation phase of organizational planning to subordinates b. Ask subordinates to brainstorm alternatives and then have industry experts evaluate each alternative c. Limit the involvement of subordinates to developing unit-level policies and procedures d. Include subordinates early in the process and include them in all aspects of policy formation
D
A nurse is constructing a resumé before beginning to search for a new job. When creating a resumé, the nurse should: Select one: a. give equal weight to strong and weak points. b. aim for at least four to five pages in length. c. use complex, scholarly language to demonstrate competence. d. ensure that the document is concise and easy to read.
D
A nurse is facing an ethical dilemma about whether to report a colleague's offensive comment, an action which is likely to jeopardize their relationship. What is a characteristic of this nurse's ethical dilemma? Select one: a. The dilemma can be solved by applying empirical data. b. The situation involves a breach of the law. c. The dilemma has no realistic solution. d. The situation involves two or more undesirable alternatives.
D
A nurse-manager is aiming to project a powerful image of a team leader who empowers subordinates. What statement is most appropriate to this goal? Select one: a. "I'm in charge here, and so all requests need to come to me. Please let me know if you have any questions." b. "I'm too tired to deal with Dr. Jones today. When he gets here, tell him I've gone to lunch." c. "Is it okay with the rest of you if I do all the charting and you do the direct patient care?" d. "We have a great deal to accomplish today, but I am confident that we can do it by working together."
D
A rural hospital is considering a sharp reduction in the range and availability of the services it provides. Before making this change, the hospital's leadership should: Select one: a. decentralize its decision-making model. b. implement shared governance. c. review its organizational chart. d. consult with local stakeholders.
D
An older adult client has been admitted to the hospital with pneumonia and has been placed on a critical pathway. This tool will allow the care team to: Select one: a. minimize the client's out-of-pocket expenses for care. b. decrease the amount of paperwork required for reimbursement. c. minimize administrative costs. d. standardize the client's care.
D
The manager of a busy medical-surgical unit wants to establish a transition-to-practice program. The manager should cite what benefit of the proposed program to the hospital's administrators? Select one: a. More experienced nurses will be likely to apply for jobs. b. Nurses on the unit will be more motivated. c. Staffing costs will be reduced. d. Turnover of new staff will likely be reduced.
D
The nurse manager is faced with a difficult decision in a situation that involves the manager's values. What is the manager's best action? Select one: a. Try to base a decision on intuition rather than values b. Set aside his or her values and make a rational decision c. Defer the decision to a colleague with different values d. Identify and reflect on his or her own values
D
What characteristic of a nurse best indicates the attainment of an "expert" level of nursing experience? Select one: a. The nurse has more than 3 years of clinical experience. b. The nurse is learning from experience how best to react in clinical situations. c. The nurse identifies long-term goals for career advancement. d. The nurse possesses an intuitive grasp of complex clinical situations.
D
What should the leader remember when forming committees? Select one: a. Committees work best when there is an adequate supply of workers, with 10 members being the minimum. b. Willingness to work hard is the most important criterion for appointment. c. Written agendas provide excessive structure and stifle committee creativity. d. There should be sufficient expertise among committee members to accomplish the assigned task.
D
Which statement best describes ethics? Select one: a. How our lives and relationships are led in day-to-day circumstances b. How people make decisions they see as legally and morally appropriate c. The conflict, power, and interdependency associated with the way we live d. What our conduct and actions should be regarding what is right and good
D
