LEADER FINAL 4230
A charge nurse has discovered that a medication error was made on the previous shift. What is the nurse's best action? Select one: Document the incident and follow it up as per hospital policy Document in the client's chart that an incident report will be completed Share that information with the charge nurse on the previous shift Write a memo to the nurse who made the error requesting an incident report be written
A
A client was treated in the hospital for a stroke and was the client's family members assert that the client was discharged too early and did not receive sufficient rehabilitation. The client's early discharge may have been attributable to: Select one: the effect of diagnosis-related groups. a sentinel event. deliberate malpractice. the application of total quality management.
A
A manager demonstrates one of the four principles of scientific management when he or she: Select one: a. hires and promotes employees on the basis of their competence and skills. b. allows employees to do their jobs independently, with minimal oversight. c. engages in lifelong learning and expects employees to do the same. d. shows an interest in employees' personal lives and emotional health.
A
A manager needs to delegate some tasks. What consideration should the manager prioritize when identifying the appropriate person to whom to delegate a specific task? Select one: The qualifications of the person regarding the task Whether the person has experience with similar tasks Whose turn it is to delegate a task The fiscal cost of delegating the task
A
A nurse delegated some tasks to a nurse several hours ago. The manager has now learned that the nurse did not complete any of the delegated tasks. What is the manager's best initial action? Select one: Determine exactly why the nurse did not complete the delegated tasks. Document the nurse's insubordination and arrange a private meeting. Take action to reestablish the authority power gap. Assertively state the expectation that delegated tasks will be completed on time.
A
A nurse has applied for a management position in a new organization. How can the manager best prevent intrapersonal conflict related to ethical issues in this role? Select one: Clarify his or her own values and beliefs and compare to those of the organization Identify a mentor in the organization who maintains high ethical standards Determine whether nurses in the organization are required to follow a code of ethics Become familiar with the nurse practice act in the jurisdiction where the organization is located
A
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: The situation involves two or more undesirable alternatives. The dilemma has no realistic solution. The situation involves a breach of the law. The dilemma can be solved by applying empirical data.
A
A nurse is practicing in a case management context and a patient has been following a multidisciplinary action plan (MAP). In the last 24 hours, it has become clear that the patient's health status is not improving as quickly as expected and the patient is deviating from the MAP. What is the nurse's best action? Select one: Document the presence of a variance in the MAP. Cancel the current MAP and adopt customized, rather than standardized care. Collaborate with the care team to arrange a transfer to a new setting. Cancel the patient's current MAP and call a meeting to select a new one.
A
A nurse is uncharacteristically extroverted on today's shift, with an unsteady gait. The manager suspects that the nurse may be chemically impaired. What is the manager's most appropriate action? Select one: a. Promptly confront the nurse to discuss this suspicion b. Ask the other nurses and staff members on the unit if they have noticed the same thing c. Document this finding and communicate with the personnel department d. Monitor the nurse's behavior closely for the remainder of the shift
A
A nurse-manager has made a decision and is now preparing to evaluate the decision. What question should best guide the nurse's evaluation process? Select one: Did the outcomes align with the original objectives? Is evaluation necessary when using a good decision-making model? Is every party happy with the outcomes of the decision? Can evaluation be eliminated if the problem is resolved?
A
A nurse-manager is overseeing an organization that uses the nursing minimum data set (NMDS). What will the use of the NMDS achieve? Select one: Standardizing the collection of nursing data for use by multiple users Comparing the quality of nursing care and medical care with reference to standardized data Identifying minimal levels of quality necessary for nurses to maintain licensure Identify only "nursing-sensitive" client outcome measures
A
A nurse-manager was involved in conflict where the other individual adopted a competing approach. This approach is evident in what circumstances? Select one: When one party wins at the expense of the others When managers need to control a volatile situation When an appropriate political strategy is necessary When fair play is important to all involved parties
A
A nurse-manager will soon be introducing a significant change in the way that overtime shifts are allocated on a hospital floor. What action by the manager will best demonstrate the principles of thought leadership? Select one: Convincing employees that the change will be beneficial and innovative Delegating the implementation of the change to the nurses themselves Relating the change to the fact that the floor has been required to cut costs Describing clear expectations for nurses' adherence to the new policy
A
A recent graduate has begun working at a health center and finds the behaviors of colleagues stressful and intimidating. The nurse's colleagues whisper when she is around, roll their eyes at her, and laugh when she asks for assistance or clarification. What is this recent graduate's best action initially? Select one: Report these behaviors to the nurse-manager Seek assistance from the organization's ombudsperson Organize a meeting to confront the colleagues about their behavior Avoid the offending colleagues whenever possible
A
A registered nurse (RN) was working with a nursing assistive personnel (NAP) and delegated some tasks to the NAP. The NAP exceeded his scope of practice and caused injury to a client. Ultimate responsibility for this adverse event lies with whom? Select one: The RN The NAP The unit's nursing manager The facility's director of nursing
A
A subordinate is reluctant to accept a task that the nurse-manager wants to delegate. The manager suspects that the subordinate's reluctance is due to a lack of self-confidence. What is the manager's best initial action? Select one: Try to empower the subordinate. Teach the subordinate about the value of self-confidence. Restate the importance of the task to the subordinate. Offer a reward to the subordinate in order to motivate.
A
An RN needs to confirm the specific delegation parameters for RNs. The RN should refer to guidelines from what organization? Select one: The State Board of Nursing U.S. Department of Health and Human Services The Joint Commission National League for Nursing (NLN)
A
As part of the quality control process, managers have set standards for performance and assessed whether these standards are being met. It has been determined that several standards are not being met. What is the prioritize response to this finding? Select one: Perform interventions that will correct the deficiencies Compare the organization's results to benchmarks Determine whether similar organizations in the region are experiencing similar results Release the findings to the public to ensure transparency
A
Primary care nursing is organized so that the patient is at the center of the structure. How many nurses have 24-hour responsibility for care planning and coordination for the patient? Select one: One Four Two Three
A
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: self-determination. beneficence. confidentiality. justice.
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: Support employees' right to disagree with proposed changes. Avoid making decisions that displease large numbers of employees. Ensure that employees know the consequences of misleading the manager. Identify allies who can be trusted to report employees who may mislead the manager.
A
The nurse has applied the MORAL decision-making model to a situation that involved an ethical dilemma. The nurse should complete the process by: Select one: evaluating the effectiveness of the decision-making process. reaffirming the nurse's relationships with stakeholders. leading the implementation plan. disseminating the results of the process to other nurses.
A
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: Use simulation for the students to learn and practice the skill Help the students use a decision-making model to choose the safest technique Teach the students about the traditional problem-solving process before they practice the procedure Create an unfolding case study featuring the procedure
A
The nurse manager informs the staff that in order to save money the hospital wants to do a way with using agency nurses. The individual units staff themselves so its up to the manager to address. The nurses are upset about this. The manager presents the options of mandatory overtime for everyone, or allowing the nurses to self schedule and sign up for overtime as long as its covered. Select one: Seeking consensus Competing Smoothing Mediation
A
The nurse-manager is applying the decision-making process when addressing a nurse's high rate of absenteeism. This process should result in: Select one: a chosen course of action. a new understanding of the problem. an outcome that is desired by all. an action that guarantees success.
A
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: examine alternatives visually and compare each against the same criteria. plot the outcomes of a decision over time and evaluate the decision-making process. predict when events must take place to complete a project on time. ensure that the decision is made objectively rather than subjectively.
A
What action by the nurse-manager in a health organization best demonstrates transformational leadership? Select one: a. The manager holds a workshop to outline a new vision for patient-centered care. b. The manager readily takes responsibility after making a scheduling error. c. The manager informs each employee about the new criteria that will be the basis of the performance reviews. d. The manager's employees are reminded that they must submit evidence of renewing their license.
A
What characteristic of a nurse-manager suggests that he or she is acting in the role of a traditional manager rather than an integrated leader-manager? Select one: a. The manager's influence is limited to his or her group. b. The manager emphasizes the importance of vision and values. c. The manager is conscious of the important role of politics and is politically astute. d. The manager has an outward view, extending to the larger organization.
A
What is the greatest limitation of the Health Plan Employer Data Information Set (HEDIS)? Select one: Managed care organizations are not required to collect HEDIS data. HEDIS performance measures focus on medical interventions and do not address nursing actions. Performance indicators are exclusively process focused rather than outcome focused. The Joint Commission has not updated the HEDIS since 2009.
A
What is the primary reason for documenting nursing interventions as soon as possible after an activity is completed? Select one: Decreasing the risk of inaccurate documentation Implementing effective time management skills Demonstrating professional nursing behavior Observing an established nursing principle
A
Which action should the nurse prioritize when trying to prevent malpractice claims? Select one: Always functioning with the scope of the nursing practice act Always carrying a personal liability insurance policy Asking for assistance when engaged in complicated procedures Devoting time to establishing an effective nurse-client relationship
A
Which nurse is experiencing intrapersonal conflict? Select one: A manager who perceives a dilemma between loyalty to staff and loyalty to the organization in a particular situation A manager who is in conflict with a long-standing employee who often ignores the manager's directives A manager who has to confront a nurse who made a medication error but did not follow up with documentation A manager who has received a negative performance appraisal and who wishes to dispute the findings
A
Which statement best describes ethics? Select one: a. What our conduct and actions should be regarding what is right and good b. How people make decisions they see as legally and morally appropriate c. How our lives and relationships are led in day-to-day circumstances d. The conflict, power, and interdependency associated with the way we live
A
Which statement is true concerning critical thinking? Select one: a. It requires reasoning and creative analysis. b. It is a simple approach to decision making. c. It is narrower in scope than decision making. d. It is a synonym for the problem-solving process.
A
A nurse is following a multidisciplinary action plan (MAP) when caring for a new patient. The nurse should identify what components within the MAP? Select all that apply. Select one or more: I. Critical path II. Indication of times when nursing interventions occur III. Nursing care plan IV. Identity of the nurse navigator V. Cost analysis of major interventions
A B C
An experienced registered nurse has begun a position as a clinical nurse-leader (CNL). In this role, what tasks should the nurse perform? Select all that apply. Select one or more: Collaborating with the interdisciplinary team Coaching nurses to provide evidence-based care Introducing quality improvement initiatives Guiding patients and families through the health-care system at various sites Preceptoring senior nursing students
A B C
Which of the following would be considered sentinel events that should be reported to The Joint Commission. Select all that apply. Select one or more: A client experiences nephrotoxicity and requires dialysis because of a medication error. A client experiences a transfusion reaction after receiving the wrong type of packed red blood cells. A client with dementia falls and suffers a hip fracture while trying to walk to the bathroom. A client with ischemic heart disease dies of a myocardial infarction. A client files a formal complaint about the inattention of staff while he was in the hospital.
A B C
The nurse-manager is overseeing a culturally diverse group of staff. The manager should consider what variables when planning delegation? Select all that apply. Select one or more: Communication style Concepts of time Social organization Biological variations Intelligence
A B C D
A nurse is facing a malpractice suit after an incident where a client received the wrong dose of medication. Which elements must be present to prove malpractice? Select all that apply. Select one or more: Presence of injury Breach of duty Ability to foresee harm Intent to cause harm Causal relationship between inadequate care and injury
A B C E
The failure to engage in which activities are considered a fatal flaw of leadership? Select all that apply. Select one or more: Self-improvement Collaboration with colleagues Determining salary scales for employees Staff development Communication with employees
A B D E
Which of the following behaviors should the nurse-manager identify as workplace violence, incivility, or bullying? Select all that apply. Select one or more: A nurse tells a nursing student to rush to room 311, knowing that the unit has no room 311. Staff members assign an unwanted nickname to a colleague. A nurse's specific vacation request is denied by the manager for 2 years in a row. A nurse asks a colleague to assess a known verbally abusive client without warning to see how the colleague will respond. A group of nurses consistently refuse to help a nurse when that nurse has a heavy workload, despite having time to do so.
A B D E
Which statements demonstrate an understanding of the factors that should be considered when a change in the care delivery system is being proposed? Select all that apply. Select one or more: "We have determined that our level of care would improve if we provided it differently." "It's questionable whether our current nursing staff is large enough to support the proposed change." "We're going to make our decision based on which option is newest in the literature." "We will discuss our proposed change with the multidisciplinary team members." "Administration has been supportive of the planned change in our care delivery system."
A B D E
An RN is leading a care team on a busy hospital unit. What tasks is the RN justified in delegating to NAP? Select all that apply. Select one or more: Transporting a client to a diagnostic test Assessing a client's surgical wound Weighing a client who has chronic heart failure Feeding a client who has unilateral weakness Repositioning an immobile client every 2 hours
A C D E
In which situations does the nurse-manager have a legal responsibility for reporting? Select all that apply. Select one or more: A pediatric client reports physical abuse in the home. A nurse had to work 2 hours of overtime because another nurse failed to report for a shift. There is a confirmed case of a reportable infectious disease. A nursing assistant has reported a suspected incident of elder abuse. A nurse is suspected of providing substandard medical care.
A C D E
Which statements concerning autonomy are true? Select all that apply. Select one or more: It is a form of personal liberty. It overrides paternalism but not beneficence. It is based on a person's right to make a choice. It supports the process of progressive employee discipline. Its legal equivalent is self-determination.
A C D E
Which statements demonstrate a characteristic of a critical thinker? Select all that apply. Select one or more: "Since that didn't work effectively, let's try something different." "Maybe there is no new solution to this particular problem." "It's important that we not give up; our clients deserve it." "I'll talk to the client's primary care giver about the problem." "The solution has to be something the client is willing to do."
A C D E
The nurse is admitting a new client and is reviewing the results of the medication reconciliation. What data will be included in the client's medication reconciliation? Select all that apply. Select one or more: a. The medications that the client was taking prior to admission b. The client's medication administration record from any previous admissions c. The client's expectations for treatment with medications during admission d. The list of medications the client has been prescribed by the admitting physician e. The results of the nurse-manager's review of the client's treatment plan
A D
A change in the patient care delivery system has been mandated on a hospital unit. The manager can best ensure the successful introduction of a new delivery system by: Select one: explaining the implications of the proposed change to patients and families. carefully studying the best method for implementing the planned change. assigning a senior registered nurse to lead the implementation. hiring nurses who have experience in providing the new delivery system.
B
A health-care organization has laid off several RNs and hired numerous NAPs in their place. What effect is this change most likely to have on the remaining RNs? Select one: Cultural variables will become a larger consideration. The RNs' level of liability will increase. The RNs' scope of practice will become expanded. There will be a risk of the RNs underdelegating.
B
A leader is applying the principles of emotional intelligence? What outcome indicates successful application of these principles? Select one: Emotions are held in check. Emotions are used effectively. Emotions dominate decision making. Expression of emotion indicates success.
B
A member of the team has been delegated some tasks and reports, "I've been given too much to do and I'm not going to be able to complete the work on time." What is the RN's best initial action? Select one: Have the team member perform only the most necessary tasks. Examine the workload and assist the individual in reprioritizing. Take on the responsibility of the tasks. Assign the work to another team member.
B
A novice nurse-manager admits to feeling nervous about the possibility of disciplining employees. How should the manager be encouraged by superiors to view discipline? Select one: a. As a means of narrowing the power-authority gap b. As a necessary part of fostering excellence in the organization c. As a "big stick" that management can use to eliminate behavior that conflicts with organizational goals d. As a necessary means for controlling an unmotivated and self-centered workforce
B
A nurse has accepted a position as a staff nurse and will practice primary care nursing. The nurse will be the only RN on the team. What is an appropriate role expectation for role fulfillment? Select one: Carrying out the majority of personal care for assigned patients Assigning work according to the expertise of group members Planning nursing care independently of others Being responsible for care planning only during the shift when he or she works
B
A nurse is applying the MORAL decision-making model to a dilemma involving a colleague's possible dishonesty in documentation. What is the nurse's initial action? Select one: Think of as many alternatives as possible. Gather as much information about the situation as possible. Engage the colleague in the decision-making process. Perform a critical self-reflection of the nurse's own morals and values.
B
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: The ultimate decision on the matter will be based on rational ideas rather than emotions. Skeptics of the plan have begun to see it as innovative and beneficial. Nurses and nursing assistants will both participate in the operations planning. Individuals who oppose the plan have become isolated by their peers.
B
A nurse-manager has recently been accused of assigning work unequally. The manager has recognized the need to revise the process for assigning work to nurses. How can the manager best apply the principles of Theory Z? Select one: Making a decision independently and imposing it on the nurses Gathering input from employees in order to reach a consensus Identifying as many different alternatives as possible Making a decision based on the pros and cons of each option
B
A nurse-manager is participating in a hospital's quality control efforts and is collating data sources. What data source should the manager identify as a qualitative source? Select one: The previous year's budget for continuing education initiatives Results of interviews with discharged clients The hospital's rate of nosocomial infections The hospital's readmission rate
B
A subordinate has accused a manager of favoritism after the manager created the work assignment for the day. How should the manager best apply the principles of emotional intelligence? Select one: Recognize that the subordinate's statement was likely based on emotion rather than evidence. Identify and reflect on the feelings that she experiences after being accused. Choose a response that will diffuse the subordinate's emotions. Involve a colleague in the situation who has no emotional investment in the situation.
B
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: The manager temporarily adopts a leadership role. The nurses consciously improve their performance because they know it is being scrutinized. The manager blames individual nurses for deficits identified in the accreditation report. The nurses avoid contact with the accreditors because they fear criticism
B
An employee is found to have grossly mistreated a client, which the employee has never done before. What consequence should be administered to the employee? Select one: a. Written admonishment b. Termination c. Suspension with pay d. Suspension without pay
B
Caregivers at a public health center believe that their manager adheres to Theory X. What action by the manager best confirms this suspicion? Select one: The manager is difficult to access when there is a problem or crisis in the center. The manager insists on accompanying nurses to community events and observes them closely. The manager collaborates with senior staff to set quarterly goals for the center. The manager allocates rewards based on the outcomes of nurses' work.
B
For which client are the provisions of the Patient Self-Determination Act (PSDA) most likely to be significant? Select one: A client whose reduced ability to perform activities of daily living (ADLs) has required an admission to long-term care A client who has just experienced an ischemic stroke and whose prognosis is poor A client who has recently been diagnosed with HIV A client whose neonate has just died of sudden infant death syndrome (SIDS)
B
In which situation would the nurse be justified in overriding a client's right to confidentiality? Select one: A client does not want her husband to know that she is a client on the unit. An older adult client discloses to the nurse that her son occasionally hits her. A teenage client asks the nurse not to tell her parents that she is pregnant. A client states that he does not want to know the results of his recent diagnostic test.
B
Nurses on a unit notice that a routine blood specimen collection is not being done correctly and it has become a recurrent problem. Rather than talking to the responsible individual(s), one nurse sends out a negatively worded message to all the nurses creating organizational conflict. What can the nurse manager do to best facilitate conflict resolution? Select one: Avoiding- the nurses can resolve the issue without interference of the manager Responsibility charting where the staff is educated on chain of command to resolve issues Soothing one party, assuring the nurse reporting the issue that you are just as upset at the incompetence of the staff. Structure change, transferring one of the nurses responsible to another unit
B
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: What is the client's most likely prognosis? Is the client competent to make decisions? Does the client have strong social or family support? What interventions are in the client's best interest?
B
The nurse is faced with a situation that requires ethical decision making. What statement should guide the nurse's action? Select one: Critical ethical decisions should be made quickly so the situation does not worsen. Accepting some ambiguity and uncertainty is a part of ethical decision making. Only desirable alternatives should be identified when solving ethical dilemmas. Outcomes are the main criterion for evaluating ethical decision making.
B
The nurse-manager is applying an evidence based approach to a clinical question around client mobilization. When using a PICO format to search for evidence, the nurse should identify what? Select one: The role of intuition in the decision-making process The clients for whom the intervention would be relevant The preferences of clients and their families Costs associated with a potential change in practice
B
The nurse-manager is contributing to the plan for the workplace reentry of an employee with a history of chemical abuse. What should be included in the reentry plan? Select one: The nurse should have a 50% work assignment for the first several months. The employee must agree to random urine screening. Clients and families should be made aware of the nurse's history. Reentry should not occur until the nurse has been chemical-free for at least 18 months.
B
The nurse-manager is mediating a conflict between two nurses on the unit. What goal should the manager prioritize when addressing this conflict? Select one: A solution is chosen that minimizing the effect on other employees. The nurses agree to a solution that is mutually beneficial. A solution is identified that can be easily and quickly implemented. The nurses emerge from the resolution with a close personal relationship.
B
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: begin the decision-making process by presuming the status quo to be the best option. generate as many different alternatives as possible. involve as many people in the decision-making process as possible. prioritize the option that is most innovative.
B
The nurse-manager who seeks to exemplify emotional intelligence should: Select one: a. prioritize emotion over reason when making decisions. b. regulate his or her own emotions and those of others. c. effectively manipulate the emotions of others to achieve goals. d. attempt to remove emotion from decision making.
B
What is one of the most important differences between case management and disease management? Select one: Disease management referrals begin in the hospital inpatient setting. High-cost population groups are specifically targeted in disease management. Disease management is a collaborative process to meet patient needs. Disease management treatment is episodic.
B
What is the best course of action to stimulate broad participation of employees in quality control efforts? Select one: Educate staff about the relationship between the organization's accreditation and their own licensure Engage closely with the frontline staff who provide client care Encourage regular meetings between middle management and upper management Educate staff about the correct way to document and report sentinel events
B
What is the best response for a nurse-manager to handle someone who has a pattern of lengthy chatter? Select one: "We'll need to make it brief since my schedule is tight today." "I can't speak with you now, but I'm going to have free time at 11 AM." "I am sorry but I do not have anytime today to talk with you." "Stop by and we can talk during your lunch break."
B
What task will best allow a health-care organization to benchmark its performance? Select one: Setting ambitious but realistic goals for the coming year Comparing the organization's performance with that of best performing institutions Seeking input from clients and families about the organization's performance Comparing its performance on key indicators to its performance the previous year
B
Which action is associated with the nursing leadership role in quality improvement? Select one: a. Being aware of the changes in quality control regulations b. Inspiring staff to establish and maintain high standards regarding patient care c. Identifying outcomes that support quality nursing care d. Reviewing research results upon which to base changes
B
Which activity best demonstrates a nursing unit manager's attention to ANA standards for ethics required of that position? Select one: Assures staff and patients that unit decisions are ethically sound Refers complex dilemmas to the institution's ethics board Maintains current licensure Terminates a staff member for absenteeism
B
Which historical event is known that have had a major effect on the delivery model of nursing care? Select one: Emergence of antibiotic-resistant microorganisms in the 1990s Shifts from home-based care to hospital-based care during the 1930s Increases in patient empowerment during the 1970s and 1980s High rates of infection, death, and disability during the Civil War
B
Which of the following workplace situations would be categorized as latent conflict? Select one: Two nurses were in conflict about inequities in their work assignment but were able to resolve the conflict. The most experienced nurses on a unit are allowed to self-schedule, but less experienced nurse are not. A nurse expresses frustration to a colleague who did not perform some tasks that were clearly delegated. A nurse expresses anger to the manager, accusing the manager of preferential treatment toward other nurses.
B
Which practice has the U.S. Food and Drug Administration suggested in order to decrease the risk of medication errors? Select one: Medications automatically dispensed to clients at predetermined times Computerized order entry with a drug bar code system Use of medication nurses to administer all ordered medications Have clients' medications secured at the bedside for self-administration
B
Which statement best defines conflict? Select one: Its basis is the violation of personal rights or values. It centers on either internal discord or external discord between individuals. It is the outcome of a visible struggle between individuals. It involves an internal struggle resulting from value-related discord.
B
Which statement is correct regarding the distinction between legal and ethical obligations in decision making? Select one: Ethical controls are clearer and philosophically impartial. Legal controls are clearer and philosophically impartial. Legal controls are much less clear and individualized. Ethical controls are much clearer and individualized.
B
The nurse has been navigating a difficult situation that involved an ethical dilemma. Which factors should be considered when assessing the quality of the nurse's ethical problem-solving process? Select all that apply. Select one or more: The process the nurse used for data gathering is not needed The process that was used to arrive at a decision The number of alternatives that the nurse initially generated The outcomes of the process Precedents in the organization involving similar situations were compared to this one
B C D
What actions by the nurse-manager are consistent with relationship age leadership? Select all that apply. Select one or more: Encouraging competition between staff members to increase overall efficiency Including committee representatives from all areas that will be affected by a change Communicating regularly and openly with employees Recognizing staff members who have contributed to the organization's goals Encouraging teamwork to solve problems and address issues
B C D E
A charge nurse has discovered that a medication error was made on the previous shift. What is the nurse's best action? Select one: Write a memo to the nurse who made the error requesting an incident report be written Document in the client's chart that an incident report will be completed Document the incident and follow it up as per hospital policy Share that information with the charge nurse on the previous shift
C
A hospital system is trying to address some of the deficits in care that were described in To Err Is Human. When addressing the errors that this report identified, the hospital's leaders should focus on what factor? Select one: Lack of education for health-care workers Increased use of nursing assistive personnel Systemic flaws in health-care delivery Malice on the part of some health-care providers
C
A manager is trying to get in the habit of creating a daily list of tasks. The manager should: Select one: keep the list highly structured, thus decreasing the possibility of procrastination. include all relevant short-term, intermediate, and long-term goals. include flexibility in the implementation of the list. avoid changing the list once initial planning is completed.
C
A nurse has been asked to stay after a shift and work overtime because three nurses have called in sick. The nurse is reluctant to work the overtime because of a social commitment. Duty-based reasoning would dictate that the nurse: Select one: carefully weigh the effect of the decision on workplace relationships. base the decision on recent precedents in the health-care organization. work overtime because of the responsibility owed to clients. contact the three nurses to remind them of their obligations.
C
A nurse has recognized that many older adult clients on the unit do not receive enough nutrition because they are unable to feed themselves independently. What action by a manager would be most likely to resolve the nurse's moral distress? Select one: Providing a reference so the nurse can seek new employment Arranging to have the clients' diets changed so they are more nutrient-dense Hiring more nursing assistants to help feed these clients Acknowledging and validating the nurse's observation
C
A nurse is integrating the Nursing 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: Guidelines that will help the nurse clarify his or her own values A model that will guide the nurse to make an ethical decision The principles that are most valued in nursing practice Legal guidelines to help the nurse make an ethical decision
C
A nurse-manager discovered that a nurse was retrieving narcotics from sharps containers and has been abusing these medications for several months. When addressing this behavior and assisting the nurse, what factor should the manager prioritize? Select one: The nurse's well-being The nurse's personal growth The safety of clients and families The integrity of the unit
C
A registered nurse reports to the nurse-manager that the team's nursing assistant regularly fails to complete assigned tasks. The nurse-manager responds that it is the nurse's initial responsibility to talk with the nursing assistant about this problem. The manager is engaged in what aspect of conflict? Select one: Conflict smoothing Encouraging competitive conflict resolution Facilitating conflict resolution Conflict avoidance
C
An employee has come to the manager with a long list of complaints about a coworker, all of which are attributable to personality factors rather than unsafe practice. What is the manager's best initial action? Select one: Acknowledge and document the employee's complaints Arrange for third-party mediation Encourage the employee to speak directly with the coworker Ask the employee to email or text message the complaints to the coworker
C
The A nurse is applying the ethical principle of justice when providing care for clients. What action best exemplifies this principle? Select one: Meeting continuing education requirements for license renewal Respecting clients' rights to make decisions about their care Ensuring that time and resources are distributed equitably to clients Prioritizing actions that will benefit the largest number of clients
C
The managers of a hospital unit have been approached by a nurse educator who wants to conduct research into a particular nursing intervention. In order to ensure that the rights of clients who may participate are protected, the managers should: Select one: ask the hospital ethics committee to approve or deny the application. compare the study methodology to the code of ethics. refer the educator to the institutional review board. discuss the educator's values, beliefs, and ethics.
C
The nurse-manager is applying the MORAL decision-making model to a decision around a client's plan of care. The manager has engaged all the necessary stakeholders and collected as much data about the situation as possible. What should the manager do next? Select one: Assess the client's values and beliefs. Arrange to meet with the institution's ethics board. Identify as many alternatives as possible. Choose the option that best aligns with ethical principles.
C
The nurse-manager is applying the decision-making process when addressing a nurse's high rate of absenteeism. This process should result in: Select one: a new understanding of the problem. an action that guarantees success. a chosen course of action. an outcome that is desired by all.
C
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: Defer the decision to a colleague with different values Try to base a decision on intuition rather than values Identify and reflect on his or her own values Set aside his or her values and make a rationale decision
C
The nurses on a medical unit are using several different techniques for performing wound care and the manager recognizes a need to implement evidence-based practice (EBP). What should the manager do first when applying the principles of EBP? Select one: Identify the main peer-reviewed journals in field of wound care Identify how expert nurses typically perform wound care Formulate a specific, searchable clinical question about wound care Perform a review of the literature about wound care
C
The principle of autonomy would have the greatest bearing on what clinical situation? Select one: A client is unable to afford the treatment that carries the best chance for a cure. A nurse is considering whether to report a colleague's rough treatment of a client. A client is discussing a do-not-resuscitate order with the care team. The nurse is caring for two clients in pain and must choose which to treat first.
C
Thirty-eight percent of the people who attended a smoking cessation clinic were not smoking 1 year after completing treatment. What type of audit provided this type of data? Select one: Concurrent Structure Outcome Process
C
Two nurses have approached the manager and have asked the manager to speak to a nurse on the unit who has a reputation for being difficult to get along with. How can the manager best implement authentic leadership? Select one: Encourage all three nurse to meet without the manager present. Meet with the "difficult" nurse to assess emotions. Analyze the facts of the situation before making a decision. Encourage all three nurses to disregard their emotions.
C
Two nurses in a small community are in conflict because the first nurse's son committed a violent assault on the second nurse's son. In recent weeks, workplace interactions between the two have become increasingly tense. What is the nurse-manager's best strategy for resolving this conflict? Select one: Responsibility charting Soothing Confrontation Structure change
C
What action should the nurse-manager perform when preparing for and conducting a disciplinary conference? Select one: a. Adopt a nurturing and counseling role to ensure the conference ends on a positive note b. Ask a small number of trusted employees to join the conference so it can be used as a teaching tool c. Schedule the conference in advance at a time agreeable to both the employee and the manager d. Soften criticisms to reduce the employee's defensiveness and emotional response
C
What event is most likely to result in an employee filing a grievance? Select one: a. An employee wants to have an impartial third party impose a solution. b. An employee knowingly breaks an established rule. c. The employee believes he or she has been disciplines unjustly. d. The manager and employee have a relationship that precedes an episode of discipline.
C
Which nurse is experiencing moral distress? Select one: The children of a terminally ill client do not want the client's prognosis communicated to the client. A nurse knows that a colleague called in sick to work because the colleague had a social engagement. A heavy workload prevents a nurse from providing the care that each client requires. A nurse witnesses a colleague using a racial slur in a conversation with another nurse.
C
Which statement best describes ethics? Select one: How people make decisions they see as legally and morally appropriate The conflict, power, and interdependency associated with the way we live What our conduct and actions should be regarding what is right and good How our lives and relationships are led in day-to-day circumstances
C
Which statement regarding the characteristics of a good leader is true? Select one: Charisma is their strongest attribute. They are by nature good-intentioned. They may have character flaws. They are brave in all situations.
C
A hospital is using the guidelines of the Leapfrog Group to inform safety improvements in the organization. What action will best incorporate these guidelines? Select one: Eliminating the use of high-risk medications and increasing the role of pharmacists Replacing practical nurses with registered nurses whenever possible Converting shared rooms to single-occupant rooms Purchasing a computerized physician-provider order entry system
D
A manager is preparing to confront an employee regarding suspected chemical impairment. What response should the manager anticipate? Select one: a. Gratefulness for finally being discovered b. Silence c. Reluctant acceptance d. Emphatic denial and defensiveness
D
A nurse has repeatedly witnessed a physician being dismissive of clients' reports of pain and anxiety. The nurse recognizes that the best action would be to address this behavior with the physician, but the nurse strongly suspects that these concerns would be dismissed. What phenomenon is this nurse experiencing? Select one: Ethical relativism Moral conflict Ethical universalism Moral outrage
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 has no realistic solution. b. The dilemma can be solved by applying empirical data. c. The situation involves a breach of the law. d. The situation involves two or more undesirable alternatives.
D
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 prevent this in the future? Select one: Consider all of the implications of an alternative before making a decision Collect only the minimum quantity of data before making a decision Delegate data gathering to a trusted colleague who has different values Make sure not to prioritize information that supports the manager's beliefs
D
A nurse-manager has to make some difficult decisions around the allocation of vacation time during the holiday season. When making a decision, what should the manager do first? Select one: Think of as many alternatives as possible Elicit ideas from as many staff members as possible Consider how the issues has been addressed in the past Clearly identify each of the desired objectives in the situation
D
A nurse-manager is discussing a proposed change in practice to the interdisciplinary team. What question by the manager best reflects a utilitarian perspective (teleological)? Select one: "Have we asked clients and families what they think?" "Does our code of ethics address this?" "Are the benefits greater than the risks?" "How many people will this benefit?"
D
What is the primary focus of case management in prioritizing client care? Select one: Applying the principles of team nursing Minimizing costs to the patient Minimizing costs to the organization Assessing each client's needs individually
D
A nurse-manager needs to discipline an employee and wants to ensure that it leads to constructive outcomes. What is the primary difference between constructive and destructive discipline? Select one: a. Constructive discipline excludes punishment, but destructive discipline is primarily focused on punishment. b. The person who has received constructive discipline always appreciates it, whereas destructive discipline is always resented. c. The manager is more empathetic to the employee in constructive discipline than in destructive discipline, so that their relationship becomes closer. d. Constructive discipline helps the person grow to meet organizational goals; destructive discipline focuses more on punishment.
D
A primary health-care teams (PHCT) has been established to coordinate the care of a patient with complex health-care needs. What should be the nurse's primary role in this team? Select one: Weigh the benefits of suggested interventions with their costs. Provide the patient's direct bedside care, whenever possible. Communicate the wishes of the patient to the other team members. Emphasize improved quality of life and patient-centered care.
D
A state Nurse Practice Act is an example of which source of law? Select one: Constitution Administrative Judicial Statutes
D
A state Nurse Practice Act is an example of which source of law? Select one: Judicial Administrative Constitution Statutes
D
During a quality improvement initiative, the leadership of a health-care organization have worked with senior managers to implement the principles of Lean Manufacturing. This initiative will focus on what factor? Select one: a. Engaging all staff members b. Performing root cause analysis of errors c. Identifying sentinel events d. Identifying and preventing waste
D
High-achieving nursing students were found to have studied in small groups, attended class 100% of the time, took frequent rest breaks during study sessions, and ate a balanced diet for one week before the examination. What type of audit provided data about the students' preparation? Select one: Concurrent Structure Outcome Process
D
One of the nurses on the unit said, "My Vietnamese patient won't look me in the eye, but I know that Asian patients avoid making eye contact as a way of showing respect." This nurse is demonstrating what type of illogical thinking? Select one: Arguing from analogy Affirming the consequences Deductive reasoning Overgeneralizing
D
The new nurse-manager has committed to modeling the leadership roles associated with applying ethics in the workplace. What is the manager's best action? Select one: Ensure that individual rights are always prioritized over collective rights. Ensure nurses are responsible for scrutinizing each other's behavior to monitor for ethical violations. Delegate ethical decision making to staff nurses whenever possible. Demonstrate self-awareness about his or her own beliefs, morals, and values
D
The nurse is practicing in a challenging environment where ethical and moral issues must often be dealt with. Which statement describes how moral uncertainty occurs? Select one: a. An individual knows the right thing to do, but organizational constraints make it difficult to take the right course of action. b. An individual witnesses the immoral act of another but feels powerless to stop it. c. An individual is forced to choose between two or more undesirable alternatives. d. An individual is unsure which moral principles or values apply and may even include uncertainty as to what the moral problem is.
D
The nurse-manager has learned there is conflict between a nonresponsive client's family members about the best plan of care. The manager recognizes the complex ethics of this situation. What is the manager's best action? Select one: Ask an impartial staff member to mediate. Base a decision on the most recent precedent in the organization. Refer the family to the hospital's spiritual care service. Make contact with the hospital's ethics committee.
D
The nurse-manager is addressing a nurse's suspected breach of client confidentiality in a social media posting. What function of the management process is this nurse-manager demonstrating? Select one: Staffing Organizing Directing Controlling
D
The nurse-manager of a hospital unit has categorized some tasks in the "do now" category. The tasks most likely reflect: Select one: I. problems that cannot be safely delegated. II. issues related to long-term goals. III. large, time-consuming tasks. IV. the unit's day-to-day operational needs.
D
The only treatment alternative left for a client diagnosed with advanced cancer is a rare, highly experimental bone marrow transfusion with a 10% success rate. Some individuals are arguing that the high cost of the procedure could be better spent providing well-baby screening for 2,000 residents in the service area. What ethical principle is most directly involved in this situation? Select one: Unethical conduct Maleficence Paternalism Utility
D
To decrease overtime, the manager of a surgical unit offers nurses who get their work finished on time for an entire 2-month period an extra day off with pay at regular time. The nurse is enacting what model of leadership? Select one: Quantum leadership Servant leadership Favoritism Principal agent theory
D
Two student nurses close to graduating are at their preceptorship with a nurses on a busy unit at the hospital. The students report they are only being allowed to take vital signs, pass out food trays, and provide basic hygiene instead of learning how to balance a full patient load providing total care and collaborate with the staff. The faculty report this to the unit manager, what is the unit manager's best course of action? Select one: Remind the nurses that they were students once and to try and give more nurse things for the students to do. Place a copy of the ANA's Code of Ethics highlighted with statements about incivility highlighted at the nurses personal areas at the nurses' station Tell the staff nurses she understands how busy they are lately and not to worry about it. Explain that there is zero tolerance for incivility even with students and that this could effect employment rates and quality of care.
D
What aspect of the way that work is organized on a nursing unit best reflects the management theories of Max Weber? Select one: Quarterly awards are granted to employees who have demonstrated exceptional service. Employees are allowed to self-schedule their vacation time and must work out any conflicts on their own. A committee that includes employees and managers has been established to plan the work on the unit. The hierarchy of authority and the policies and procedures on the unit are clearly posted.
D
What piece of data should the nurse-manager include in an outcome audit? Select one: Technology is acquired so documentation can be completed at the bedside. Client-nurse ratios are capped at 3:1 in the day and 4:1 at night. Nursing handoffs occur at the client's bedside and include family input. At discharge, a client was able to ambulate 40 feet unassisted.
D
What role has The Joint Commission assumed in ensuring quality at the organizational level? Select one: Establishing clinical practice guidelines Assessing monetary fines for organizations that fail to meet standards Reducing diagnosis-related group reimbursement levels Standardizing clinical outcome data collection
D
Which activity is associated with a leadership role in time management? Select one: Building time for time management planning into the work schedule Prioritizing day-to-day planning to meet short-term and long-term unit goals Utilizing technology to facilitate timely communication and documentation Assisting followers in working cooperatively to maximize time use
D
Which ethical principle is demonstrated when an adult child is legally given the right to make medical decisions for a cognitively impaired parent? Select one: Justice Beneficence Fidelity Paternalism
D
Which is a true statement about destructive negotiation tactics? Select one: I. Ridicule often takes the form of ambiguous or inappropriate questioning and is a diversionary tactic. II. Nurses are known to be particularly vulnerable to the tactic of flattery. III. Most managers successfully resist the helplessness tactic because of their nursing preparation. IV. Negotiation tactics can sometimes be manipulative; thus, managers must be cognizant of the other party's motives
D
Which is a true statement regarding TQM? Select one: It is based on the premise that the organization knows what is best for the consumer. It assumes that inspection and removal of errors lead to the delivery of quality services. Its guiding purpose is to save the organization money. It recognizes that the customer is the focal element on which production and service depend
D
Which statement best depicts leadership? Select one: Strong leaders can coerce people into following them. Leadership requires meeting organizational goals. A leadership position has a narrower scope than a management position. People will follow a person in a leadership position only by choice.
D
Which statement by a nurse most clearly demonstrates an intuitionist framework for ethical decision making, duty based? Select one: "I'll make the best decision if I choose the option that comes to mind first rather than overanalyzing the situation." "It's important that I consider the effect of my decision on the organization, not just the people who are directly involved." "I'm trying to think of as many different options as I can rather than focusing on those that look most attractive." "I've got to look at this situation on the basis of its unique characteristics, not by comparing it to other situations."
D
Which statement is correct regarding the distinction between legal and ethical obligations in decision making? Select one: a. Ethical controls are clearer and philosophically impartial. b. Ethical controls are much clearer and individualized. c. Legal controls are much less clear and individualized. d. Legal controls are clearer and philosophically impartial.
D
When monitoring medication inventories for possible diversion or theft by nurses who abuse chemicals, what medication classifications should the manager monitor most closely? Select all that apply. Select one or more: a. Antidepressants b. Anticholinergics c. Nonsteroidal anti-inflammatories d. Opioid analgesics e. Benzodiazepines f. Central nervous system stimulants
D E F
