Leadership 2
Which change is easier to make? 1. A) Personal behavior 2. B) Group behavior 3. C) Group knowledge 4. D) Personal attitudes
A
Which would be a normal and expected behavioral response during the unfreezing phase of change? 1. A) Anger 2. B) Withdrawal and acceptance 3. C) Open acceptance 4. D) Active collaboration
A
Which activity best demonstrates a nursing unit managers attention to the ethics standards of practice required of that position? 1. A) Membership on the institutions ethic board 2. B) Terminates a staff member for absenteeism 3. C) Assures staff and patients that unit decisions are ethically sound 4. D) Holds membership in the local and state American Nurses Association (ANA)
A
Which behavior/attitude makes it likely that a planned change will be unsuccessful? 1. A) The suggested change is brought forward after the plan has been formalized 2. B) Individuals affected by the change are involved in planning for the change 3. C) The change agent is aware of the organizations internal and external environment 4. D) An assessment of resources to carry out the plan is completed before unfreezing
A
1. How is the question of whether a nurse acted with reasonable care generally proven? A. A) The expert testimony of nursing witnesses B. B) The defendants explanation of what the nurse did C. C) The trial judge, after checking the outcome of prior similar court cases D. D) The testimony of expert medical witnesses
A
16. What document permits a registered nurse to offer special skills and knowledge to the public in a particular jurisdiction when such practice would otherwise be unlawful? A. A) A state nursing license B. B) Institutional licensure C. C) ANA certificate D. D) ANA practice standards
A
16. What is one way to promote open communication between patients and practitioners? A) Involving health-care consumers as active members of the health-care team B) Promoting the creation of cultures of patient safety in health-care organizations C) Establishing a federal leadership locus for advocacy of patient safety and health-care quality D) Building an evidence-based information and technology system that impacts patient safety and pursue proposals to offset implementation costs
A
A state Nurse Practice Act is an example of which source of law? 1. A) Statutes 2. B) Constitution 3. C) Administrative 4. D) Judicial
A
Distributing flyers that charge arbitrary action on the part of an employer in an effort to garner interest in employee unionization would be a part of what phase of planned change? 1. A) Unfreezing 2. B) Movement 3. C) Refreezing 4. D) Resistance
A
In planning strategies to prevent stagnation and promote renewal, which action would most likely result in the desired outcome? 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 longevity to determine committee selection
A
Refusing to work with a staff member who dresses unprofessionally most closely represents which change strategy? 1. A) Power/coercive 2. B) Normative/reeducative 3. C) Rational/empirical 4. D) Resistance/withdrawal
A
The nurse witnesses a patient sign an operative permit form. Legally, what does the nurses signature imply? 1. A) Observed the client sign the consent form 2. B) Is certain the client understands the proposed procedure 3. C) Believe the client is capable of understanding the proposed procedure 4. D) Assumes the client has had an adequate evaluation to agree to the procedure
A
There are many terms used to describe moral issues faced by nurses, including moral uncertainty, moral conflict, moral distress, moral outrage, and ethical dilemmas. Which statement describes how moral uncertainty occurs? 1. A) Occurs when an individual is unsure which moral principles or values apply and may even include uncertainty as to what the moral problem is 2. B) Occurs when the individual knows the right thing to do but organizational constraints make it difficult to take the right course of action 3. C) Occurs when an individual witnesses the immoral act of another but feels powerless to stop it 4. D) Occurs when being forced to choose between two or more undesirable alternatives
A
What is NOT considered as intentional tort? 1. A) Professional negligence 2. B) Assault 3. C) Battery 4. D) False imprisonment
A
What is considered unintentional tort? 1. A) Professional negligence 2. B) Assault 3. C) Battery 4. D) False imprisonment
A
What is the basic argument for the use of rational/empirical change strategies? A) Information supports change B) Peer influence brings about change C) Reward-based incentives influence change D) Punishment supports the acceptance of change
A
Which action is reflective of the leadership role necessary for a successful planned change to occur? 1. A) Demonstrates flexibility in goal setting 2. B) Recognizing the need for a planned change 3. C) Identifying the resources that are available to support a change 4. D) Support the staff during the implementation of a planned change
A
Which action demonstrates appropriate management regarding legal issues? Select all that apply. 1. A) Remains current on all institutional policies and procedures 2. B) Delegates with consideration to appropriate scopes of practice 3. C) Requires physical proof of appropriate professional licensure each year 4. D) Provides yearly in-services on the operation of newly acquired equipment
A, B, C
Which characteristic of an organization has influence on the ethical decisions its managers make? Select all that apply. 1. A) Purpose 2. B) Societal role 3. C) Societal constraints 4. D) Values
A, B, C
Which statement is true regarding criminal law cases? Select all that apply. 1. A) Incarceration is a likely consequence of being found guilty of a criminal offense 2. B) Intentionally giving an overdose of a potent narcotic is a criminal offense 3. C) A guilty verdict requires evidence beyond a reasonable doubt 4. D) Most malpractice cases are tried in criminal court
A, B, C
Which statement is true regarding planned change? Select all that apply. A) Resistance to change should be expected as a natural part of the change process B) Change should be viewed as a chance to do something innovative C) Technical changes are more resisted by staff than social changes are D) Change affects the homeostasis of a group
A, B, D
Which statement is true concerning the refreezing phase of the change process? Select all that apply. A) The focus of this phase is to integrate the change into the status quo B. Stabilization of change requires a 6- to 9-month period of time C. If refreezing is incomplete, prechange behavior will be resumed D. The change agent must remain involved until the refreeze stage is complete
A, C, D
Professional organizations generally espouse standards of care that have what relationship to those required by law? Select all that apply. 1. A) Higher than those required by law 2. B) The same as those required by law 3. C) Are established after those required by law 4. D) Are established prior to those required by law
A, D
1. It is appropriate to make a change for which reason? Select all that apply. A. A) To solve an existing problem B. B) To increase staff efficiency C. C) To reduce unnecessary workload D. D) To improve staff productivity
ALL
A lawsuit pertaining to professional negligence must include duty, breach of duty, injury, and a causal relationship between breach of duty and injury. What else must be included? Which element is necessary to prove professional negligence? Select all that apply. 1. A) Breach of duty 2. B) Presence of injury 3. C) Ability to foresee harm 4. D) Causal relationship
ALL
Which force is driving change in today's health-care environment? Select all that apply. 1. A) Increased cost of health-care services 2. B) Decrease in health-care professionals and providers 3. C) Decreased third-party reimburse of health-care services 4. D) Increased need to update health-care related technologies
ALL
Which situations is a nurse-manager illegally responsible for reporting? Select all that apply. 1. A) Suspected incidents of elder abuse 2. B) Examples of substandard medical care 3. C) Client-reported incidents of child abuse 4. D) Confirmed case of a communicable disease
ALL
Which statement concerning autonomy and the employee is true? Select all that apply. 1. A) It is a form of personal liberty 2. B) Its legal equivalent is self determination 3. C) It is based on a persons right to make a choice 4. D) It is supported by the process of progressive employee discipline
All of above
What does the morale principle of autonomy govern? A) A persons right to make his or her own decision B) The obligation to do good and prevent harm C) Doing what is right and fair D) Truth telling
Ans: A Feedback: Autonomy, or self-determination, is also referred to as freedom of choice and accepting the responsibility for ones choice. None of the other options addresses this concept.
Collecting data about the ethical problem and identifying who should be involved in the decision-making process is accomplished in which phase of the MORAL decision- making model? 1. A) Massage the dilemma 2. B) Outline options 3. C) Review criteria and resolve 4. D) Affirm position and act
Ans: A Feedback: Massage the dilemma: Collect data about the ethical problem and who should be involved in the decision-making process. Outline options: Identify alternatives, and analyze the causes and consequences of each. Review criteria and resolve: Weigh the options against the values of those involved in the decision. This may be done through a weighting or grid. Affirm position and act: Develop the implementation strategy.
Which factor should be considered when assessing the quality of ethical problem solving? Select all that apply. 1. A) Outcomes 2. B) Decision-making process 3. C) Multiple alternatives 4. D) Data gathering
Ans: A, B Feedback: Outcomes should never be used as the sole criterion for assessing the quality of ethical problem solving, because many variables affect outcomes that have no reflection on whether the problem solving was appropriate. Quality, instead, should be evaluated both by the outcome and the process used to make the decision. If a structured approach to problem solving is used, multiple alternatives are analyzed, and data gathering is adequate, then, regardless of the outcome, the manager should feel comfortable that the best possible decision was made at that time with the information and resources available. The satisfaction of the involved parties is not a reliable factor.
To make appropriate ethical decisions the nurse-manager must have knowledge of what items to assist in making decisions? Select all that apply: 1, 2, 3, 4. 1. A) Organizational processes 1, 2 2. B) Proven decision-making models 1, 2, and 3 3. C) Professional approach that eliminates trial and error 4. D) Ethical principles and frameworks
Ans: A, B, C, D Feedback: To make appropriate ethical decisions then, the manager must have knowledge of ethical principles and frameworks, use a professional approach that eliminates trial and error and focuses on proven decision-making models, and use available organizational processes to assist in making such decisions. Knowledge of the involved parties wishes is not a focus of the decision-making process.
Which description best describes the theory behind nonlinear change? A) It occurs in organized steps B) It must have a logical sequence C) It results in equilibrium D) It has unpredictable outcomes
D
Which statement is true regarding the philosophy of nonlinear change theories? 1. A) Change occurs in sequential steps 2. B) Change is predictable 3. C) Change success relies on policies and hierarchies 4. D) Change is necessary because organizational stability is brief
D
Which member of the health-care team is often placed in situations where they are expected to be agents for patients, physicians, and the organization simultaneously, all of which may have conflicting wants and goals? 1. A) Physicians 2. B) Nurses 3. C) Nurse practitioners 4. D) Social workers
Ans: B Feedback: Nurses are often placed in situations where they are expected to be agents for patients, physicians, and the organization simultaneously, all of which may have conflicting needs, wants, and goals. The nature of the patient contact of a nurse is more direct and involves more time than the other members of the health-care team.
What is the role of the American Nurses Association Code of Ethics and Interpretive Statements? 1. A) Outlines minimum levels of ethical behavior that nurses must maintain 2. B) Functions as a guide to the highest standards of ethical practice for nurses 3. C) Is a legally binding document that directs a nurses ethical and moral behavior 4. D) Mandates the ethical behavior prerequisite for maintaining a nursing licensure
Ans: B Feedback: The ANA Code of Ethics outlines the important general values, duties, and responsibilities that flow from the specific role of being a nurse in order to achieve and maintain the highest standards. The document is not legally binding nor is it a mandate of behavior.
Which ethical framework would most likely be used to arrive at the nurses decision to work overtime in spite of previous social plans? 1. A) Utilitarianism 2. B) Duty based 3. C) Rights based 4. D) Intuitionism
Ans: B Feedback: The duty framework says that some things should be done just because there is a duty to do them or refrain from doing them. Utilitarianism states that the good of the many outweighs the wants or needs of the individual. The remaining options are not relevant to the situation.
10. Protecting patient confidentiality respects the clients right to A. A) self-esteem B. B) self-defense C. C) self-determination D. D) self-incrimination
Ans: C Feedback: Confidentiality is a foundation of both medical and nursing ethics, and it respects the clients right to self-determination. While the other options are worthy of respect, they are not associated with confidentiality.
Which statement regarding the MORAL decision-making model is true? 1. A) It is a problem-solving model 2. B) It does not include an evaluation step 3. C) The identification and analysis of multiple alternatives for action is required D) The decision is arrived upon with only the involvement of the decision maker
Ans: C Feedback: MORAL is a decision-making model that is useful in clarifying ethical problems, and it requires the identification and analysis of multiple alternatives for action. The other options are not true statements regarding this decision-making model.
Much of the difficulty people have in making ethical decisions results from a lack of formal education about problem solving. Research at the University of Pennsylvania found what percentage of the nurses and social workers reported having no ethics training?
Ans: C Feedback: Research done at the University of Pennsylvania found that nearly 25% of the nurses and social workers reported having received no ethics training.
Which statement is correct regarding the distinction between legal and ethical obligations in decision making? 1. A) Ethical controls are clearer and philosophically impartial 2. B) Ethical controls are much clearer and individualized 3. C) Legal controls are clearer and philosophically impartial 4. D) Legal controls are much less clear and individualized
Ans: C Feedback: In general, legal controls are clearer and philosophically impartial; ethical controls are much less clear and individualized.
Which statement best describes ethics? 1. A) How our lives and relationships are led in our reality 2. B) How people make decisions they see as legally and morally appropriate 3. C) The conflict, power, and interdependency associated with the way we live 4. D) What our conduct and actions should be regarding what is right and good
Ans: D Feedback: Ethics is the systematic study of what a persons conduct and actions should be with regard to self, other human beings, and the environment; it is the justification of what is right or good and the study of what a persons life and relationships should be, not necessarily what they are.
Using both a systematic approach and proven ethical tools and technology allows managers to make better decisions and increases the probability that they will feel confident about the decisions they have made. Leadership roles and management functions are involved in management ethics. What is an example of a leadership role? 1. A) Uses a systematic approach to problem solving and decision making when faced with management problems with ethical ramifications 2. B) Identifies outcomes in ethical decision making that should always be sought or avoided 3. C) Uses established ethical frameworks to clarify values and beliefs 4. D) Role models ethical decision making, which is congruent with the American Nurses Association Code of Ethics and Interpretive Statements and Professional
Ans: D Feedback: A leadership role is role models ethical decision making, which is congruent with the American Nurses Association Code of Ethics and Interpretive Statements and Professional standard. Uses a systematic approach to problem solving and decision making when faced with management problems with ethical ramification, identifies outcomes in ethical decision making that should always be sought or avoided, and uses established ethical frameworks to clarify values and beliefs are examples of management functions.
Which statement regarding ethical decision making is true? 1. A) Outcomes are the basic criterion for evaluating ethical decision making 2. B) Only desirable alternatives are identified when solving ethical dilemmas 3. C) Critical ethical decisions are made quickly so the situation does not worsen 4. D) Accepting some ambiguity and uncertainty are a part of ethical decision making
Ans: D Feedback: Ethical decision makers choose between two or more undesirable alternatives, and because they can use only the information and resources available at the time, they must live with some ambiguity and uncertainty. The remaining options are not true statements regarding the ethical decision-making process.
Which ethical framework involves an individualized decision-making framework? 1. A) Duty based 2. B) Rights based 3. C) Utilitarian 4. D) Intuitionist
Ans: D Feedback: Intuitionist states that each case weighed on a case-by-case basis to determine relative goals, duties, and rights. Utilitarian provides the greatest good for the greatest number of people. Duty based is a duty to do something to refrain from doing something. Rights- based individuals have basic inherent rights that should not be interfered with.
The practice of allocating organs for transplantation based on a persons iworth to societyi is an example of what ethical principle for decision making? 1. A) Autonomy 2. B) Beneficence 3. C) Utility 4. D) Justice
Ans: D Feedback: Justice: Seek fairness, treat iequalsi equally, and treat iunequalsi according to their differences. Autonomy: Promotes self-determination and freedom of choice. Beneficence: Actions are taken in an effort to promote good. Utility: The good of the many outweighs the wants or needs of the individual.
What is an ethical dilemma? 1. A) A problem that can be solved using empirical data 2. B) A situation that has clearly delineated facts for decision making 3. C) A problem that when handled effectively has a mutually agreed-upon solution 4. D) A situation that requires choosing between two or more undesirable alternatives
Ans: D Feedback: The most difficult of all moral issues is termed a moral or ethical dilemma, which may be described as being forced to choose between two or more undesirable alternatives. The problem is not generally solved with a solution that is mutually satisfying nor does it lend itself to empirical or delineated facts.
The only treatment alternative left for a patient diagnosed with advanced cancer is a rare, highly experimental bone marrow transfusion with a 10% success rate. The insurance company refuses to authorize payment for the $200,000 procedure, arguing that the money could be better spent providing well-baby screening for 2,000 residents in the service area. What does this decision by the insurance company reflect? 1. A) Unethical conduct 2. B) Maleficence 3. C) Paternalism 4. D) Utility
Ans: D Feedback: The principle of utility states that what is best for the common good outweighs what is best for the individual. There is no indication of unethical or maleficence behavior on the part of the insurance company. Paternalism would be characterized by the insurance company making treatment decision without the patient having input
Which factor is the greatest contributor to the resistance encountered with organizational change? A) Poor organizational leadership B) Presence of employee mistrust C) Ineffective organizational management D) Insufficient staff involvement in the process
B
1. What defines the legal boundaries of nursing at the state level? A) The states Attorney General B) The Nurse Practice Act C) The ANA standards of practice D) The ANA Code for Nurses
B
Historically, many of the changes that have occurred in nursing or have affected the profession are the result of what type of change? 1. A) Planned 2. B) Change by drift 3. C) Rational/empirical 4. D) Normative/reeducative
B
What characteristic is associated with organizational groups assigned to manage the change process? 1. A) Both formulate and implement the change 2. B) Have representation from all key stakeholders 3. C) Are made up of quality circles 4. D) Are teams of resistance breakers
B
What is the best reason that nurse-managers have an ongoing responsibility to be aware of legislation affecting nursing practice? 1. A) This will prevent them from getting sued 2. B) Laws are fluid and subject to change 3. C) It will protect the agency from a lawsuit 4. D) It will ensure that correct procedure is carried out
B
What made on the previous shift? A) Share that information with the charge nurse on the previous shift B) Document the incident as per hospital policy C) Write a memo to the nurse who made the error requesting incident report be written D) Write a note in the clients chart that an incident report will be completed
B
What should the nurse manager do of an error made on the previous shift? 1. A) Share that information with the charge nurse on the previous shift 2. B) Document the incident as per hospital policy 3. C) Write a memo to the nurse who made the error requesting incident report be written 4. D) Write a note in the clients chart that an incident report will be completed
B
Which behavior will best minimize a nurses risk for a malpractice claim? 1. A) Always carry a personal liability insurance policy 2. B) Always function with the states nursing practice act 3. C) Ask for assistance when engaged in complicated procedures 4. D) Devote time to establishing an effective nursen patient relationship
B
Which statement best describes the impact that the concept of respond eat superior has on the issue of nursing liability? 1. A) It allows for joint liability among physicians, nurses, and health-care organizations 2. B) It supports the sharing of blame among all involved sources of health-care services 3. C) It encourages legal intervention when health care is thought to be substandard 4. D) It implies that the institution is responsible for the acts of its employees
B
Which statement reflects an important factor to consider when implementing a planned change? A) Change should be implemented suddenly B) Change should be implemented gradually C) Change should be implemented arbitrarily D) Change should be implemented sporadically
B
Which term is used to identify a persons feelings of powerlessness to stop unethical behavior in another person or institution? 1. A) Moral conflict 2. B) Moral outrage 3. C) Ethical relativism 4. D) Ethical universalism
B
Which characteristics are associated with change by drift changes? Select all that apply. 1. A) They are planned 2. B) They are accidental 3. C) They are unplanned 4. D) They are a result of a threat
B, C
A doctor orders a medical procedure that the staff nurse has reason to believe will harm the patient. Which statement accurately states the legal consequences of carrying out, or refusing to carry out, the procedure? 1. A) The staff nurse cannot be held legally liable for any harm to the patient if the procedure is carried out with due care 2. B) The nurse may lose his or her license by refusing to carry out the procedure 3. C) The nurse can be held legally liable for any harm if the procedure is carried out without question 4. D) The nurse can be held accountable for practicing medicine without a license
C
A doctor orders a medical procedure that the staff nurse has reason to believe will harm the patient. Which statement accurately states the legal consequences of carrying out, or refusing to carry out, the procedure? 1. A) The staff nurse cannot be held legally liable for any harm to the patient if the procedure is carried out with due care 2. B) The nurse may lose his or her license by refusing to carry out the procedure 3. C) The nurse can be held legally liable for any harm if the procedure is carried out without question 4. D) The nurse can be held accountable for practicing medicine without a license
C
A verdict of suspension or loss of licensure represents what type of law? 1. A) Criminal 2. B) Civil 3. C) Administrative 4. D) Judicial
C
A verdict of suspension or loss of licensure represents what type of law? 1. A) Criminal 2. B) Civil 3. C) Administrative D) Judicial
C
Malpractice or professional negligence is the failure of a person with professional training to act in a reasonable and prudent manner. How many components must be present for an individual to be found guilty of malpractice? 1. A) Three 2. B) Four 3. C) Five 4. D) Six
C
What component of professional negligence is represented when a nurse fails to look up an unfamiliar medication before administering it? A. Duty to use due care B. Failure to meet standard of care C. Foreseeability of harm D. A direct relationship between failure to meet the standard of care (breach) and injury can be proved
C
What is informed consent? 1. A) A timeline of when the treatment is expected to occur 2. B) Written information on what the post procedure outcomes will be 3. C) Information regarding the risks involved in the proposed procedure 4. D) An explanation of the nature of all associated treatment provided by the nurse
C
Which characteristics are required of a reasonable and prudent nurse? 1. A) Years of clinically focused nursing experience 2. B) Specialized nursing skills 3. C) Average nursing judgment and skills 4. D) Earned advanced nursing degree
C
Which characteristics are required of a reasonable and prudent nurse? 1. A) Years of clinically focused nursing experience 2. B) Specialized nursing skills 3. C) Average nursing judgment and skills D) Earned advanced nursing degree
C
Which ethical principle associated with an adult child is legally given the right to make medical decisions for a cognitively impaired parent? 1. A) Justice 2. B) Fidelity 3. C) Paternalism 4. D) Beneficence
C
Which situation is associated with and aging organization? 1. A) Retired staff is replaced with new graduate nurses 2. B) State-of-the-art cardiac monitoring equipment is placed in the ICU 3. C) The unit functions with strict adheres to institutional rules and policies 4. D) A suggestion committee composed of staff and management meets monthly
C
Which statement is true regarding the implications of a Good Samaritan law for a registered nurse? Select all that apply. 1. A) A nurse has a legal responsibility to provide emergency services 2. B) Such laws are universally worded so as to minimize state-to-state differences 3. C) In order for protection to apply, the nursing care cannot be considered negligent 4. D) A nurse who provided out-of-scope care is not protected by the Good Samaritan law
C, D
1. What is required to successfully implement the chaos theory of change? A) Most stakeholders accepting the need for change B) Finding solutions to resistance to change C) Changing attitudes more than increasing knowledge D) Finding underlying order in random data
D
How is the legal expansion of nursing roles accomplished? 1. A) The expansion of job descriptions in an agency 2. B) Written contracts between the nurse and the client 3. C) A written agreement between the nurse and the physician 4. D) Revision of the Nurse Practice Act
D
Using both a systematic approach and proven ethical tools and technology allows managers to make better decisions and increases the probability that they will feel confident about the decisions they have made. Leadership roles and management functions are involved in management ethics. What is an example of a management function? 1. A) Is self-aware regarding own values and basic beliefs about the rights, duties, and goals of human beings 2. B) Accepts that some ambiguity and uncertainty must be a part of all ethical decision making 3. C) Accepts that negative outcomes occur in ethical decision making despite high- quality problem solving and decision making 4. D) Identifies outcomes in ethical decision making that should always be sought or avoided
D
What component of professional negligence is represented when a patient experiences a seizure resulting from a medication error? 1. A) Duty to use due care 2. B) Failure to meet standard of care 3. C) Foreseeability of harm 4. D) A causal relationship
D
Which action represents a management function in planned change? 1. A) Inspiring group members to be involved in planned change 2. B) Visionary forecasting 3. C) Role modeling high-level interpersonal communication skills in providing support for individuals undergoing rapid or difficult change 4. D) Recognizing the need for planned change and identifying the options and resources available to implement change
D
Which activity associated with the unfreezing state of change will have the greatest impact on the success of the movement stage of the change process? A) Accurate identification of the problem requiring change B) Effective information gathering concerning the problem C) Key personnel voicing their opinions regarding the need for change D) The need for change is perceived by all those affected by the problem
D
Which activity does a change agent make a commitment to in order to best assure a successful implementation of a change? 1. A) Helping followers arrive at total consensus regarding the change 2. B) Encouraging subgroup opposition to change so many viewpoints can be heard 3. C) Using change by drift if the resistance to change is too strong 4. D) Being available to support those affected by a change until the change is complete
D
Which activity is associated with the movement stage of the development of a plan? A) Gather data B) Accurately diagnose the problem C) Decide if change is needed D) Develop a plan
D