Leadership ch 7-12 Davis Workbook

Nursing and respiratory departments both experienced job cuts. The nurse manager notices that members of his staff are having more trouble getting a fast response from a respiratory therapist. What source of conflict is probably operating here? 1. Union- management conflict 2. Interpersonal Problem 3. Cultural Differences 4. Work Intensification

4. Work intensification

When designing a technical change, which of the following should be considered? 1.Will it work better than the old way? 2. Is this change needed? 3. Is there a simple way to do this? 4. All of the above

All of the above

A common ergonomic occupational-related risk in the health-care environment is: 1. Indoor air pollution 2. Active shooters 3. Nosocomial infection 4. Back injuries

Back Injuries

Which of the following are considered reasonable accommodations for an employee with a disability? Select all that apply. 1. Modification of the work schedule 2. Salary reduction to reflect lower output 3. Additional days off and extended vacations 4. Adjustment of work procedures

1. Modification of the work schedule 4. Adjustment of work procedures

The EMR has many advantages compared with paper charting. It helps track data through time and can help monitor things such as preventative care in primary care practices. Jane is the office nurse in a local practice. She is meeting a new patient for the very first time who informs her that he was recently hospitalized. Jane pulls up the patient ' s EMR and sees no information regarding his recent hospital stay. How could this have happened? 1. The patient's discharge was so recent that it is not available yet 2. EMRs are usually practice or hospital specific, so the patient ' s information would not be accessible to Jane 3. The patient was hospitalized out of state 4. The patient has not signed the necessary consents to give Jane access

2. EMRs are usually practice or hospital specific, so the patient ' s information would not be accessible to Jane.

Florence has two team members who continually criticize each other despite being told to stop. Which approach is the most appropriate for this situation? 1. Refer each of them for employee counseling 2. Engage in problem resolution 3. Bring in a union representative 4. Engage in a formal negotiation process

2. Engage in problem resolution

Which of the following procedures and modifications contributes to reducing indoor air pollution? 1. Windows that may be opened by staff as needed 2. More powerful ventilation systems and air filtration 3. Selecti ofon products with more polyvinyl chloride (PVC) 4. Increased use of medical waste incinerators

2. More powerful ventilation systems and air filtration

What is the most desirable result of a problem resolution? 1. Win-lose 2. Lose-lose 3. Win-win 4. None of the above

3. Win-win

The hospital has recently reorganized; therefore, several departments were closed. The patient census on the unit has increased. The staff have always had a strong team spirit, but the nurse manager knows that workflow changes can cause conflict. What can the nurse manager do to reduce the possibility of conflict among her team? 1. Monitor the quality of conflict among her team? 2. Ensure that supplies and equipment are readily available. 3. Assess the equity of nursing assignments 4. All of the Above

4. All of the Above

As Jane speaks with the team, she learns why the staff members have had difficulty following policies. Which of these would be considered barriers to effective communication? 1. The charge nurse is unavailable to help the nurses when they have questions about policies. 2. Some staff are afraid to ask particular charge nurses for help for fear of retribution. 3. The use of acronyms is confusing to staff members who are new to the unit. 4. All of the above

4. All of the above

Implicit bias affects our understanding in an unconscious manner. A person ' s ability to recognize these biases can improve communication with patients and colleagues alike. Which of the following statements is true about implicit bias? 1. Implicit bias forms during a lifetime. 2. Implicit bias can influence clinical decision making and treatment. 3. Implicit bias contributes to an individual ' s social behavior. 4. All of the above

4. All of the above

Which of the following issues may be addressed in a collective bargaining agreement? 1. Shift Differentials 2. Safe Working Environment 3. Grievance Procedures 4. All of the above

4. All of the above

Organizational culture is best defined as: 1. The stated vision and mission of an organization 2. Policies and procedures 3. The type of decor that was chosen for the facility 4. An enduring set of shared values and beliefs

4. An enduring set of shared values and beliefs

You are working on the trauma unit today, and your new patient with a femur fracture complains of leg pain and seems a little diaphoretic and short of breath. You assess the patient and prepare to contact the surgeon. In preparation for contacting the physician, you: 1. Immediately paged the MD; It could be a pulmonary embolism, and time is of the essence. You will give him the particulars when the MD arrives. 2. Wait for the MD to round on his patient because it should be. Within the next hour or so. 3. Medicate the patient for pain and plan to contact the MD when he rounds. 4. Jot down notes about the situation as it is presented to you, review the patient's history, focus on your assessment, and determine what you need for the patient.

4. Jot down notes about the situation as it is presented to you, review the patient ' s history, focus your assessment, and determine what you need for the patient.

How can you increase your staff ' s receptivity to an important change in procedures? 1. Assign the new procedure to the newest staff member 2. Apologize for making their work more complicated 3. Provide them with a booklet on preparing for change 4. Give them time to learn the new procedure

Give them time to learn the new procedure.

In which of the following situations would a personal change probably be the hardest to make? 1. When the need is immediate 2. If the benefits will be realized years from now 3. When the reward is immediate 4. If it is change that keeps you in your comfort zone

If the benefits will be realized years from now

Jane is a new nurse manager who will be holding her first staff meeting tomorrow. She has learned that the staff members have not been following important patient care policies. What is the most important communication skill that she should use at the meeting? 1. Talking to staff 2. Laughing with them 3. Listening 4. Crying

3. Listening

Studying errors and identifying how they occur helps organizations improve patient safety. Which category of errors is the most useful in identifying and remedying vulnerabilities in an organization? 1. Sentinel event 2. Adverse event 3. Near miss event 4. Wrong procedure event

Near miss event

You have been asked to serve on your unit practice council. This is an important role and one that you are excited to perform. What should you know about professional governance so that you are prepared for this work? Professional governance in nursing involves: 1. Working longer hours 2. Attending a lot of meetings 3. Nurses setting nursing standards for daily practice 4. Changing the organization's culture

Nurses setting nursing standards for daily practice

Which of the following is a characteristic of a bureaucratic organization? 1. Organic Structure 2. Flexible Teams 3. Rigid Unit Structures 4. Self- correction and self- control

Rigid unit structures

Which of the following best describes what is most likely to be within a nurse ' s comfort zone? 1. A new assignment 2. Tasks she's done many times. 3. Change to a different shift 4. Addition of several new tasks

Tasks she ' s done many times

There has been a sudden increase in catheter-associated urinary tract infections that must be addressed on Jane ' s unit. What is the best way for Jane to persuade the staff to implement a new Foley catheter care protocol? 1. Tell them the change has been ordered by the administration. 2. Present statistics proving the need to change. 3. Tell a compelling story about why change is needed 4. Explain the importance of the change in simple terms

Tell a compelling story about why change is needed.

You are a new nurse. The hospital where you work is committed to providing safe, highquality care. Which of the following activities would let you know that your organization is committed to improving patient safety? 1. The hospital has a good catch program for staff who recognize errors and near misses. 2. The hospital subscribes to TJC safety publications. 3. Th e hospital measures performance every month, monitors quality indicators, and regularly reports on quality. 4. All of the above

The hospital has a good catch program for staff who recognize errors and near misses.

Which of the following is the best indication that a change has been integrated? 1. When no one talks about it anymore 2. If adoption occurred rapidly 3. When resistance turns from active to passive 4. When a full year has passed since the change was introduced

When no one talks about it anymore

Nurses who feel empowered can make significant contributions to a health-care organization. Feeling empowered includes feeling as if you make a difference, that colleagues value your opinion, and that your voice is important. What is essential to nurse empowerment? 1. Belonging to a professional organization 2. Participating on a unit practice council 3. Reasonable work assignments 4. A rewards and recognition program

Participating on a unit practice council

If you are employed at a hospital owned by a corporation listed on the stock market, in which category does your facility belong? 1. Publicly (government) supported 2. Voluntary, not-for-profit 3. For-profit 4. All of the above

3. For-profit

ISBARR provides a framework for communicating critical client information. ISBARR is an acronym for: 1. Identify, study, background, Assess, recognize, readback. 2. Issue, situation, Better, advise, refer with recommendations. 3. Introduce, situation, background, assess, recommend, read back. 4. None of the above.

3. Introduce, Situation, Background, Assess, Recommend, Readback

Who is responsible for accepting, transcribing, and implementing physician orders? 1. Unit Clerk 2. Medical Intern or Resident 3. Professional Nurse 4. Medical Assistant

3. Professional nurse

Nursing standards of care and the organization ' s policies and procedures greatly decrease risk to patient safety. Which of the following steps can a nurse take to further reduce risk? 1. Submit event or incident reports for near misses. 2. Follow medication administration policies and procedures. 3. Always report significant data on care to patients and providers in a timely manner. 4. All of the above

All of the above

According to NIOSH, a common reaction to latex allergy is: 1. Increased appetite 2. Allergic contact dermatitis 3. Increased falls 4. An increase in violent outbursts

Allergic contact dermatitis

A federal agency that partners with other agencies throughout the nation to investigate health problems, conduct research, implement prevention strategies, and promote safe and healthy environments is known as the: 1. FDA 2. IOM 3. ANA 4. CDC

CDC

Actions to address violence in the health-care workplace include: Select all that apply. 1. Identifying the factors that contribute to violence and controlling as many as possible 2. Allowing the violence to escalate 3. Assessing staff attitudes and knowledge regarding responses to violence 4. Providing weapons training to those identified as having a potential for physical violence

Identifying the factors that contribute to violence and controlling as many as possible Assessing staff attitudes and knowledge regarding responses to violence

When is it most appropriate to dictate (order) change? 1. When the change is very complicated 2. In an emergency 3. When resistance is very high 4. If the change is unimportant

In an emergency

Stephanie Beals was a little nervous during her first week of work as a licensed nurse. Distracted by a lead nurse behind her, her hand slipped, and she was stuck by the needle she had just used. What is most important for Stephanie to do? 1. Disinfect the site of the needlestick. 2. Apologize to the patient, clean the site, and properly dispose of the needle. 3. Update her hepatitis B immunization. 4. Report the incident and obtain post exposure prophylaxis (PEP) within 2 hours.

Report the incident and obtain post exposure prophylaxis (PEP) within 2 hours.

Medical errors account for 250,000 deaths per year. It is estimated that as many as 50% of these errors may be preventable. What steps would you take to avoid a medication error? 1. Review the patient ' s medication administration record during bedside shift report. 2. Ask your colleagues to get your medication so that you can give it on time. 3. Call the pharmacist. 4. Review the medication administration policy.

Review the patient's medication administration record during bedside shift report.

Which of the following is a macro-level change? 1. Shift in Medicare payment policies 2. Change in shift differentials. 3. Opening a new unit 4. Changing visiting hours

Shift in Medicare payment policies

Several of your colleagues are going to join the American Nurses Association (ANA). You know the annual dues are a little more than you can afford right now, but you want to learn more. Your friends think that joining the ANA will help empower them. How do professional organizations empower nurses? 1. They represent nurses in the political arena 2. They equalize power between employees and staff 3. They provide opportunities for promotion 4. They provide health insurance

They represent nurses in the political arena.

To achieve safe patient care, a culture of safety must exist. What are characteristics of an organization with a culture of safety? 1. Transparency, openness, reporting of errors is rewarded, blame-free environment 2. Honesty, studying of serious events 3. Privacy, reporting of errors appreciated 4. Blame-free environment, openness, error reporting is encouraged

Transparency, openness, reporting of errors is rewarded, blame-free environment

Structured care methodologies (SCM) are: 1. Nursing tools designed to identify best practices and facilitate standards of care 2. Used to create a stable set of performance indicators to measure outcomes 3. Used to assist employees with wellness and injury prevention 4. Helpful when making staffing assignments

Used to create a stable set of performance indicators to measure outcomes

The Joint Commission (TJC) attributes 80% of all medical errors to: 1. Poor hygiene and hand washing 2. Poor hand-off communication 3. Poor work environment 4. Lack of Care

2. Poor hand-off communication

If an informal negotiation session becomes too highly emotional, what should the nurse manager do? 1. Let the feelings flow 2. Cancel the negotiation 3. Deal with the feelings first 4. Tell them to ignore the feelings and deal with the issues

3. Deal with the feelings first.

OSHA, a federal government agency, is responsible for: 1. Providing training to handle difficult clients and their families 2. Providing research and education training 3. Upholding the standards of nursing practice 4. Developing and enforcing workplace safety and health regulations

Developing and enforcing workplace safety and health regulations

A surprisingly dangerous job in the United States is working: 1. In a coal mine 2. As a window cleaner in New York City 3. In a health-care facility 4. As a police officer

In a health-care facility

The purpose of QI is to continuously improve the capability of everyone involved to provide safe, high-quality patient care. What is important to know about the QI process? 1. It is independent of teamwork. 2. It is a data-driven approach to improving process. 3. Common safety indicators are not used to evaluate quality of care. 4. Opportunities for QI are selected by organization leadership.

It is a data-driven approach to improving process.

What is the best explanation of authority? 1. It is position dependent 2. It is based upon the ability to lead others 3. It is expertise- driven 4. It resides primarily in the clients served

It is position dependent.

What is brainwriting? 1. A strategy to encourage the free flow of ideas 2. A mutually beneficial negotiation result 3. A winning approach to formal negotiation 4. A devaluation reaction to negotiation

1. A strategy to encourage the free flow of ideas

A suburban hospital recently announced that staff nurses could no longer choose their shift. Instead, they would be assigned to either a 12-hour day shift or a 12-hour night shift on an as-needed basis. An informal group of staff nurses met to discuss this new policy. They came up with several arguments against it. Which of the following suggestions would help to alleviate the deleterious effects of this new policy? SATA 1. Allow self-scheduling by staff nurses in each unit. 2. Provide free dinner for nursing staff at the end of the night shift. 3. Allow staff members to request consistent days off. 4. End visiting hours before the day shift ends so that the night shift nurses do not have to deal with visitors.

1. Allow self-scheduling by staff nurses in each unit. 3. Allow staff members to request consistent days off.

Differences in status and authority within the health-care team can generate conflict. What is the most common cause of conflict? 1. Disrespect and Incivility 2. Inappropriate language and Sarcasm 3. Blaming and Finger Pointing 4. Physical Violence

1. Disrespect and incivility

The purpose of learning how to negotiate conflict is to: 1. Eliminate Conflict 2. Resolve Conflicts more effectively 3. Win 4. Reduce Stress

2. Resolve conflicts more effectively

Creating a culture of safety requires organizational commitment to preventing harm. Which of the following is not a key feature of a culture of safety? 1. Provision of adequate resources to provide care and service 2. Use of interprofessional collaboration to solve problems and assess risk 3. Adherence to staffing ratios 4. Encourages the reporting of errors and near misses

3. Adherence to staffing ratios

Communities and regulatory agencies continually challenge hospitals, skilled nursing facilities, and home health companies to enhance, improve, or change care delivery and the care environment to ensure safe, high-quality care. Which factors are important in improving a hospital ' s care environment? 1. Adequate staffing 2. Collegial relationships among staff 3.Emphasis on staff development 4. All of the Above

4. All of the Above

The HHS is charged with protecting the health of all Americans and providing essential health services. Which of the following HHS quality initiatives is currently under way? 1. Post-acute care reform initiative 2. National health-care research and quality indicators aimed at helping improve access to care 3. NDNQI 4. Health IT

Post-acute care reform initiative

When evaluating the quality of care, a health-care organization must consider structures, processes, and outcomes of care delivery. Which of the following is a good example of an organizational process? 1. Budgeting adequate money for nursing salaries 2. Preparing a patient for discharge 3. Monitoring for infections 4. Increasing time between clinic visits

Preparing a patient for discharge

A new nurse manager plans to implement a new scheduling process. This was met with resistance from the staff who were very happy with the current scheduling process. How can the nurse manager lower their resistance to this change? 1. Tell the staff that their concerns about the new schedule are unfounded and plan to post the new schedule 2. Share information about the new schedule and discuss its impact on the unit 3. Post the schedule and deal with staff on an individual basis 4. Ask the staff to come up with an alternative for the nurse manager's consideration

Share information about the new schedule and discuss its impact on the unit.

Your new organization is committed to quality patient care. Which of these are considered characteristics of quality health care? 1. The nurses use evidence-based research to guide care delivery. 2. The nurses are respectful and responsive to their clients' individual preferences. 3. The nurses perform an independent double check when administering chemotherapy medication. 4. All of the above

All of the above

Social media is commonly used to update friends and groups on things we have going on in our lives. Health-care organizations routinely use social media to promote medical facts, services, and recognitions. What is important for nurses to remember when deciding to post something work related on a social media site? 1. Nurses should never post protected health information on a social media site. 2. Stories with good outcomes can be posted to your social media page 3. Stories and photos can always be shared if the patient's name or face is not visible 4. Posting stories on personal time is OK because the nurse is not working

1. Nurses should never post protected health information on a social media site.

Nursing management and the nursing union are having differences on several issues. There may be a need for negotiation. Which of the following is a serious disadvantage to using collective bargaining to resolve this conflict? 1. Protecting the right to fair treatment 2. Creating an adversarial relationship between staff and management 3. Lacking professionalism on the part of the collective bargaining unit members 4. Failing to uphold important standards of care

2. Creating an adversarial relationship between staff and management

What type of resistance to a change is the hardest to overcome? 1. The resistance that comes from inertia: "We always do it this way" 2. Active resistance to changing a preferred procedure 3. Passive resistance to an unpopular change 4. Resistance based upon fear of losing one's job

Resistance based upon fear of losing one ' s job

There are numerous sources of power in an organization. Several are available to nurses. Which one is not? 1. Authority 2. Reward 3. Control of information 4. Coercion

Authority