Leadership assessment 3
An older adult patient fell out of bed 2 days after a hip replacement and had to return to surgery. What process should be done in order to prevent future negative outcomes such as this? Patient outcome evaluations Benchmarking An audit Critical event analysis
Critical event analysis
Quality control tools used by the nurse leader include which of the following
Process audits and structure audits
A nurse leader works at a facility that has total quality management (TQM) as the backbone of its organizational goals and objectives for quality control. Which activity reflects how the leader can practice TQM on their unit?
Promote teamwork rather than individual accomplishments.
A nurse leader at a long-term care facility wants to determine if vital signs are being checked according to policy. What can the leader do to measure this process of care? A critical event analysis A process audit Patient outcome evaluation Benchmarking
A process audit
the nurse manager on a busy unit that has recently been experiencing shift conflicts. As the staff can have different opinions on conflicts, what is the best first step to take to resolving conflict?
Assessing what factors are affecting the judgment of the people involved in the conflict
A health care team has been challenged to determine what other facilities are doing to decrease the number of hospital-acquired infections so that an action plan can be created to decrease the rate in their facility. What will the health care team do to achieve this challenge? Benchmarking Best practices Root cause analysis Patient outcome evaluation
Benchmarking
Which of the following creates the potential for successful delegation as emphasized by the National Council State Board of Nursing? Effective communication Monitoring difficult tasks very closely Evaluating difficult tasks very closely Determining how to monitor and supervise
Effective communication
What is the final step of the quality improvement process that the nurse bleeder must complete in order to improve patient care?
Evaluation
Which statement about total quality management is correct?
It considers the individual as the focal element on which production and service depend.
A nurse is to provide an in-service training on cultural factors that influence delegation and enhance nursing care. Which step to acquiring cultural competence does the nurse determine will involve learning how to read verbal and nonverbal messages? Becoming culturally aware Learning specific communication strategies Identifying biases in one's own self Interacting with different cultures
Learning specific communication strategies
An ICU supervisor is about to enter an important negotiation with the hospital CEO. Which actions can the supervisor perform during the negotiation to increase its likelihood of success? (Select all that apply.)
Role-model good communication skills Take a break if either becomes tired or angry
After a patient had a negative outcome related to a medical error, the nurse follows the policy for sentinel events. What organization does the nurse recognize monitors the adherence to this type of policy for accreditation? American Nurses Association (ANA) Leapfrog The Joint Commission (JC) Institute of Medicine (IOM)
The Joint Commission (JC)
A nurse manager is implementing a quality control tool that is systematic and will allow the official examination of a record for patients with postoperative infections. What type of tool is the nurse manager using to collect and evaluate this data
an audit
Nurse leaders understand that there are various stages of conflict. What is the final stage? Conflict aftermath Latent conflict Manifest conflict Conflict resolution
conflict aftermath
Workplace violence is decreasing among health care workers. TRUE FALSE
false
A nurse informs the nurse leader that it would be beneficial to delegate more to the UAP, but the nurse leader is reluctant to do so, stating, 'Whenever I do, they always come back with so many questions. I need them to just do it!' What kind of delegation error is the nurse making? Underdelegating Overdelegating Improperly delegating Delegating the wrong task
improper delegation
Nurse leaders need to understand that in order to be effective, the quality control process must be _______. Ongoing Reflective Formative Cyclical
ongoing
A nurse is tasked with performing an audit on patients in the long-term care facility who are developing pressure ulcers. After identifying the information relevant to the criteria, what is the nurse's next action?
Determine ways to collect data
A nurse leader is trying to bring about change on the unit. Which intervention is associated with the nurse leader role?
Inspiring staff to maintain high standards regarding patient care
An older adult patient recently had a hip replacement with an indwelling catheter inserted. The patient developed symptoms of a urinary tract infection (UTI) postoperatively, and the nurse placing the catheter was reeducated by the nurse leader regarding avoidance of UTIs when inserting catheters. Which quality approach did the nurse leader use? Quality assurance techniques Total quality management techniques Continuous quality improvement techniques Continuous quality management technique
Quality assurance techniques
A charge nurse has delegated a task to unlicensed assistive personnel (UAP). When the nurse is met with resistance after delegating, what is the best action to be taken? The charge nurse should just complete the task. The charge nurse should ask someone else to do the task. The charge nurse should meet with the person to find out why the task was not completed. The charge nurse should report the staff member to the nurse manager
The charge nurse should meet with the person to find out why the task was not completed.
A nurse manager determines that a nurse on the team comes from a future-oriented culture. What task may be best delegated to this nurse? Working on a strategic team plan for the unit Overseeing the daily stocking of supplies Performing a retrospective study on infection rates on the unit Making assignments for the unit for the day
Working on a strategic team plan for the unit
The nurse-manager of a surgical unit must hire travel RNs to work during busy times. Knowing that travel nurses typically receive higher hourly salaries as well as completion bonuses for the 13-week assignment, the manager anticipates regular staff will have animosity toward these nurses. The manager has a plan to allow the regular staff to have every weekend off (because part of the travel nurse's contract states that the nurse may be required to work each weekend during the contracted time frame). What type of conflict resolution strategy is the manager using?
compromising
A nurse manager is attempting to ensure adequate resources are available in order to meet changing patient needs. What would be the best type of audit for a manager to perform
A structure audit
Nurse liters make use of quality control tools to identify various types of errors as outlined by the IOM report. What are some of the most common types of errors reported in today's healthcare system
Medication errors Diagnostic errors Communication errors Equipment errors
Health care shifted focus from patient care to issue of cost and quality TRUE OR FALSE
True
Total quality management is referred to as continuous quality improvement and is used to meet health people living 2020 goals TRUE FALSE
True
In order to determine when not to delegate, the nurse needs an in-depth understanding of _____. The nurse practice act The patient privacy act Informed consent Legal issues
the nurse practice act
The unit manager of a medical-surgical unit undergoing restructuring changes realizes that to create a more controlled transition for your staff, it will be necessary to incorporate the conflict resolution strategy known as 'smoothing'. Smoothing is best defined as:
Looking toward something that the parties in conflict are in agreement about.
A nurse leader wants to ensure that the team is always practicing proper hygiene after caring for a patient. A complaint was filed against a nurse for not washing the hands before examining a wound a child's knee. What is the nurse leaders control criteria
Whether the team is practicing proper hand hygiene
Conflicts resulting from differing or contradictory beliefs among two or more individuals are known as _____. Intergroup conflicts External conflicts Interpersonal conflicts Organizational conflicts
intergroup conflicts
A patient is planning to have a surgical procedure but is concerned about poor patient care quality at the local hospital, and performed a quality check and comparison of several hospitals. What conglomeration of non-healthcare Fortune 500 companies defined quality measurements to allow consumers to compare hospitals? Leapfrog Patient Safety Center National Quality Forum Prevention of Medical Errors, Inc.
leapfrog
Why is conflict an expected occurrence on a large medical-surgical unit? (Select all that apply.) People with different values People of comparable beliefs People of similar backgrounds People who have different goals People with shared interests
people with different values people who have different goals
Two nurses were selected to learn about a new piece of technology that could improve the accuracy of patient assessments. This training was to be provided at a long distance from the hospital, and the nurses' employer could only afford travel expenses for one nurse. The hospital chose to send the nurse who had historically shown more proficiency in teaching others about new technology. This displeased the nurse who was not selected, who was then unfriendly to the nurse who was selected. What is the likely source of conflict between these nurses?
professional competition
The nurse leader should respond to resistance of authority in a calm but firm fashion. true false
true
the nurse leader's optimal goal in conflict resolution is to create a win-win situation. TRUE FALSE
true
A new charge nurse is leaving work each day feeling overwhelmed and not completing tasks. What kind of delegation error is the charge nurse making? Underdelegating Overdelegating Improperly delegating Not delegating the right task
underdelegating
A nurse leader identifies that a competent RN is incapable of completing a task that falls within the RN scope of practice. The RN's inability is due to lack of training. Which of the following actions should the nurse leader take next? Assign a mentor or coach to the RN to achieve competence. Suggest the RN transfer to another place of work. Cease delegating to this particular RN. Delegate a different task to the RN.
Assign a mentor or coach to the RN to achieve competence.
new nurse from a foreign country is training in the surgical unit. After working and meeting with the nurse, the charge nurse observes that there is a discomfort in making eye contact while speaking. What task would the charge nurse avoid delegating to this nurse? Starting an IV prior to a patient going to surgery Educating a patient and ensuring full understanding Obtaining blood for transfusion Inserting an indwelling catheter
Educating a patient and ensuring full understanding
Which of the following is considered a nursing leadership role with regard to quality control? Embraces, supports, and champions the quality improvement process Uses findings to determine educational staff needs Selects and uses quality control tools Establishes measurable patient outcomes
Embraces, supports, and champions the quality improvement process
The RN on a medical-surgical unit that has experienced several changes in its administrative structure due to conflicts with the mission of the hospital. The RN realizes that conflict should be managed to allow for what outcomes? (Select all that apply.) Growth within the organization Reduced employee satisfaction Enhanced productivity Diminished productivity innovation
Growth within the organization Enhanced productivity innovation
A health care team is implementing the Toyota Production System (TPS) because the facility is having financial difficulty and may have to consider minimizing its workforce. Prior to implements TPS, what should the team considered?
How it will change the organizations culture values and roles The commitment of time and resources from the facility's leadership The level of staff preparation and involvement that will be required
A nurse manager is faced with a conflict situation. One of the nurse manager's team members is confused about their hospital responsibilities. This team member is shy and doesn't ask for direction, leading to a lack of communication that decreases the quality of patient care. What questions should the nurse manager ask to analyze the situation? (Select all that apply.)
What individual factors are involved? What environmental factors are involved? Who are the people involved?
Negotiation closure ends with restating the final decision in order to assess individual understanding of the resolution. TRUE FALSE
false
Quality control is the process of being reactive in order to minimize continued risks or hazards. TRUE FALSE
false
The nurse leader understands when delegating, subordinate resistance should never occur among staff members. TRUE FALSE
false
A nursing unit in a busy hospital is planning to undergo a major restructuring, and several staff members have expressed anxiety about the impending change. What type of conflict exists in this situation? Latent conflict Perceived conflict Felt conflict Manifest conflict
felt conflict
A patient on a busy neurosurgical unit who just returned from surgery requires neurological checks every hour, but the nurse is too busy to do it and delegates this task to the unlicensed assistive personnel (UAP). What error in delegation has the nurse made? Delegation at the wrong time Underdelegation Improper delegation Overdelegation
improper delegation
Elements that affect the nurse leader's ability to properly delegate to members of the diverse work force include which of the following? Social organization Social benefits Socializing Social responsibility
social organization
The ICU and ED director of a small hospital has recently experienced conflict with the ED staff and ICU staff related to patient transfers occurring at the end of the shift. The ED nursing staff work 12-hour shifts from 11am to 11pm, while the ICU nursing staff work 12-hour shifts 7am to 7pm. The director realizes that the two nursing departments must negotiate to resolve the conflict. What is a critical goal in negotiation? (Select all that apply.)
that both parties perceived that they have won something they value that both parties feel like they have gained something they wanted
A nurse leader is performing a process audit which would be a consideration on a process audit
Comparing a patients medication order to the medication they have been taking Checking the completeness of a patient's medical record Ensuring that machines are re-calibrated according to department policy
A nurse delegates a task to unlicensed assistive personnel (UAP). After the UAP informs the nurse that the task is complete, what is the appropriate action by the nurse? Evaluate the outcome of the task. Redo the task if not acceptable. No further action is required since the task is complete. Inform the UAP that you will confirm that the work is complete.
Evaluate the outcome of the task
A member of a nursing team reports that being given too much to do, and that the member will not be able to complete the work on time. What action will the RN take to effectively manage this situation? Assign the work to another team member. Take on the responsibility of the tasks. Have the team member perform only the necessary tasks. Examine the workload and assist the individual in reprioritizing.
Examine the workload and assist the individual in reprioritizing.
Which of the following are delegation errors made by nurse leaders? (Select all that apply.) Failure to delegate Failure to release control of task Failure to provide clear directions Failure to provide adequate directions Failure to follow up
Failure to delegate Failure to release control of task Failure to provide clear directions Failure to provide adequate directions Failure to follow up
A nurse is planning to delegate tasks to the transcultural team. What situation would be considered appropriate delegation to the team members? Select all that apply.
Giving a task that requires independent thinking to a nurse who believes in an internal locus of control as a result of her cultural tradition. Holding a negative performance evaluation in private for a nurse whose cultural tradition puts emphasis on avoiding "losing face". Delegating the interviewing of a reticent patient to a nurse who is outgoing and inquisitive as a result of her cultural tradition.
A new nurse on a medical-surgical unit has an uncomfortable encounter with one of the RNs. Both the RN and the new nurse realize that the encounter was trivial and decide to ignore that it occurred. What type of conflict strategy management is being used? Avoidance Smoothing Competing Cooperating/Accommodating
avoidance
A nursing educator at a local hospital is responsible for assigning nursing interns to specific units to begin orientation while they simultaneously complete their last nursing school clinical course. Eight interns want to be assigned to the ICU, but there are only 2 slots available. As a result, the nursing educator decides that the 2 interns with the highest GPAs and who interview the best will be assigned to the ICU. The interns agree this is a fair solution. What strategy did the educator employ?
consensus
A nurse manager discusses with the health care team the importance of performing core measures for the designated areas of implementation. What should the manager be sure to inform the team may be the consequence of noncompliance? The hospital will lose accreditation by The Joint Commission Discontinuation of participation in Medicaid and Medicare. A 5% reduction in the Medicaid annual payment. A 2% reduction in the Medicare annual payment.
A 2% reduction in the Medicare annual payment.
There are hallmarks that are associated with effective quality control programs. Select those hallmarks from the following list: Administration support, organizational support, process is ongoing Annual process, community support, organizational support Organizational support, community support, fiscal support Fiscal support, administrative support, annual process
Administration support, organizational support, process is ongoing
A nurse manager would like to determine how well the team is doing in terms of meeting the hospital's goal of increased patient satisfaction. What action should the manager take after determining best practices? Reevaluate. Capture when the team is and is not using best practices and the outcomes. Take corrective action. Make a judgment about the quality of the team's work
Capture when the team is and is not using best practices and the outcomes.
A nurse manager is implementing the National Patient Safety Goals (NPSG) for the acute care unit. What will the manager have the staff implement to meet these goals? (Select all that apply.)
Check identification bracelet and ask the patient name and date of birth prior to medication administration. When handing off report to other staff, use SBAR format. Have patient identify surgical site prior to going to the perioperative suite. Ensure that urinary catheters are properly secured to promote unobstructed urine drainage.
For a nurse leader, what is the optimal goal in resolving conflict between team members? Create a win-win solution for all Demonstrate managerial skills Prevent further conflict on the same issue Prevent violence
Create a win-win solution for all
A charge nurse is preparing to delegate tasks to unlicensed assistive personnel (UAP). What is the first action the nurse should do before delegating? Determine whether the task is within the scope of UAP. Determine whether there is enough time to adequately supervise the task. Determine who would be the best person for the task. Ask which UAP are interested in the task.
Determine whether the task is within the scope of UAP.
The diversity in current health care work force affects how each member approach specific assigned goals which influences completion of delegated tasks. This is thought to be related to the _____. Differences in approach to tasks related to priority setting Differences in approach to tasks related to religious preferences Differences in approach to tasks related to gender differences Differences in approach to tasks related to day or night shift preference
Differences in approach to tasks related to priority setting
What are the focus areas of the to err is human recommendations
Enhance knowledge Identify errors and provide solutions for prevention Set performance standards for safety Implement safety systems Enhance leadership
A charge nurse is delegating to a staff member who is resistant to authority. After delegating a task to the staff member, what action should the charge nurse have the staff member do to ensure compliance? Submit a progress report to the charge nurse. Follow the charge nurse's directions exactly. Ensure the staff member has a voice in how the task is completed. Decide the best time to complete the tas
Ensure the staff member has a voice in how the task is completed.
The six aims for improving quality health care as directed by the Institute of Medicine include safe, effective, patient-centered, timely, efficient, and _____. Equitable Holistic Naturalistic Alternative
Equitable
The nurse leader must be aware of barriers that can prevent effective mediation. These include which of the following? (Select all that apply.) Intimidation Manipulation Ridicule Active listening Negative body language
Intimidation Manipulation Ridicule Negative body language
A nurse is struggling with time management and thinks it might help alleviate stress and strengthen leadership skills if some tasks are delegated to unlicensed assistive personnel (UAP). What would be important for the nurse to consider when delegating to UAP? (Select all that apply.) Whose turn it is to be delegated to Qualifications of the person who will carry out the task The monetary cost of the delegation What can and can't be delegated safely If the UAP wants to do the task
Qualifications of the person who will carry out the task What can and can't be delegated safely
A nurse is planning to delegate tasks to members of a transcultural team. Which tasks would the nurse consider environmental control when delegating to these members? (Select all that apply.) Routine tasks that are done every day Tasks that require imagination, vision, and strategic planning Tasks with a degree of predictability requiring independent thinking to accomplish Tasks that require direct supervision Tasks that are ambiguous
Routine tasks that are done every day Tasks that require imagination, vision, and strategic planning Tasks with a degree of predictability requiring independent thinking to accomplish
For the nurse leader to be effective in their role, the leader does not need to identify the stages of conflict but only acknowledge its existence to begin the resolution. TRUE FALSE
false
It is not imperative for nurse leaders to understand how to delegate to a diverse workforce because all health care workers receive similar training. TRUE FALSE
false
The members of a nursing staff claim that the lab department is not reporting patients' critical values fast enough, but the lab department claims that it is. The nursing manager and the lab department director are sent to conflict resolution to come to a solution that will be in the best interest of patient continuity. Based upon this scenario, which type of conflict exists? Interpersonal conflict Intrapersonal conflict Transpersonal conflict Intergroup conflict
intergroup conflict
Conflict can have a negative or positive influence on those involved. TRUE FALSE
true
Conflict is needed to promote organizational growth. TRUE FALSE
true
It is the charge nurse's responsibility to effectively delegate and provide the right direction and communication for the delegated task for the staff nurses. TRUE FALSE
False
A new graduate nurse has been assigned to a RN preceptor with a history of being tough, uncivil, and intimidating to new nurses. During the first day on the job, the graduate nurse has a harsh exchange with the RN. What type of conflict is this? Interpersonal conflict Resolution conflict Intergroup conflict Intrapersonal conflict
Interpersonal conflict
A new graduate RN has a desire to work in a trauma hospital facility located in Los Angeles but has an aging mother who lives in small town in Pennsylvania and is reluctant to leave her alone. What type of conflict is this? Intergroup Interfunctional Interpersonal Intrapersonal
Intrapersonal
a unit manager is tasked with developing a new organ procurement team. This type of team involves multiple entities within the hospital, as well as community partners and surgical groups that will need to be brought together. Which actions should be practiced during the preparation stage of a negotiation? (Select all that apply.)
Knowing the issue, the other parties involved, and their possible agendas Knowing the unit manager's own possible agendas
The nurse is the manager of a telemetry unit that is undergoing restructuring, resulting in the need for the nursing staff to accommodate both the telemetry unit and the medical rehab unit. Most of the staff on the telemetry unit have worked there for many years, and this change will create conflict. At what stage does this conflict exist? Perceived conflict stage Felt conflict stage Manifest conflict stage Latent conflict stage
Latent conflict stage
The nursing director of a cardiovascular surgical intensive care unit has received reports from staff members that one of the cardiovascular physician groups is not willing to follow some of the recently instituted procedures related to initial admission orders. This group is at odds with the unit staff. What attributes of negotiation must the director employ to foster a successful outcome between the two groups? (Select all that apply.)
Maintaining a professional stance Maintaining neutral facial expressions Maintaining neutral body language
A nurse manager is considering delegating an important task. What steps should the manager take in the delegation process? (Select all that apply.) Monitor the person until the task is done Train the person delegated for the task Communicate the time frame in which the task should be completed Communicate what the task is Ask for volunteers
Monitor the person until the task is done Train the person delegated for the task Communicate the time frame in which the task should be completed Communicate what the task is
The nurse manager of an acute care unit determines the increase in the incidence of medication errors over the last six months and identifies this as a focus area for improvement. What is the next action by the nurse manager?
Organize a total quality management (TQM) meeting
Common causes of organizational conflict are (select all that apply): Poor communication Unclear expectations Diversity in the workplace Changes Assertive communication
Poor communication Unclear expectations Diversity in the workplace Changes
What action can a nurse take to ensure that when delegating to unlicensed assistive personnel (UAP), creativity and independent thinking is encouraged for task completion? Assign the same routine tasks. Provide consistent and constructive feedback. Be sure the task is completed the nurse's way. Have the UAP report to the nurse several times.
Provide consistent and constructive feedback.
A new graduate asks the nurse manager what organization develops the standards of the nursing profession so that the quality of practice can be measured. What is the best response by the manager? The Joint Commission (JC) The American Medical Association (AMA) The American Nurses Association (ANA) The Institute of Medicine (IOM)
The American Nurses Association (ANA)
The nurse delegates a task to an incompetent individual. Who is held accountable for the outcome of the task? The nurse delegator The individual who was delegated to Both individuals It depends on the situation or circumstance
The Nurse delegator
A charge nurse is delegating to a LPN/LVN. What would be considered improper delegation for the charge nurse to delegate? The employee is given highly detailed exact instructions to complete the task. Momentary authority is given to support completion of a delegated task. The person to whom a task is delegated considers it a challenge. The charge nurse and the person to whom the task is delegated exchange regular updates on the task.
The employee is given highly detailed exact instructions to complete the task
A charge nurse has delegated specific tasks to the team and feels as though one of the nurses is resistant to the task delegated. What might be reasons that the nurse is resistant? (Select all that apply.) The nurse feels overloaded. The nurse feels incapable. The nurse has an inherent resistance to authority. The task is well communicated. The task has a specific time frame.
The nurse feels overloaded. The nurse feels incapable. The nurse has an inherent resistance to authority.
A nurse manager believes that the nursing unit is experiencing too little conflict. What signs within the organization would indicate that this is true? The organization has become static. The organization has become less effective. Employees have become immobilized. Employees feel motivated.
The organization has become static.
A new nurse leader has the opportunity to delegate to a member of the staff. What criteria should the nurse leader be sure are followed before doing this? (Select all that apply.) The right person The right communication The right time The right level of supervision The right task The right circumstance
The right task The right person The right communication The right level of supervision The right circumstance
A nurse manager has a high turnover rate of assistant managers in the unit. The current assistant manager states to the manager, 'I may not be the right fit for this position. I can't keep up with the amount of work and delegated tasks.' What delegation error is the manager making? Delegating to the wrong person Improper delegating Underdelegating Overdelegating
overdelegating
Delegation by a licensed professional such as the registered nurse to an unlicensed professional can assist with time management if the delegation has been correctly accomplished. TRUE FALSE
true
Nurse leaders should encourage or establish an appropriate amount of conflict in the workplace. TRUE FALSE
true
Nurse leaders should understand the criteria or standards that are needed to establish effective quality control process. TRUE FALSE
true
The negotiation strategies mirror that of the nursing process. TRUE FALSE
true
