Leadership Exam 2 Test Blanks

Which budgeting method is reflected by establishment of prioritization at the start of each fiscal year? 1. Zero based 2. Performance 3. Incremental 4. Flat percentage

1

Which self-care techniques could be incorporated by a nurse to help solidify the role of a "healthy nurse"? Select all that apply. 1.Make sure that you have enough sleep and rest between shifts. 2.Focus only on individual viewpoints to frame your beliefs and practices in the clinical setting. 3.Plan to work a shift even though you are not feeling well. 4.Focus on establishing relationships that do not contain toxic people. 5.Adapt to change based on personal reflection

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What element should not be included in nurse leaders' and managers' responses in handling conflict in the clinical care setting? 1.Assessing needs versus wants 2.Reminding staff that every member should be treated with respect 3.Emphasizing the importance of listening 4.Focusing on "we" rather than "I"

4

A charge nurse is preparing staffing for the upcoming shift on a medical-surgical unit. Which factor would take priority in planning? 1.Productive time 2.Adequate staffing mix 3.Average daily census 4.High patient acuity

4

According to clinical research findings, what is a higher registered nurse (RN) skill mix associated with? 1.Increased missed care 2.Increased patient complications 3.Increased assessment time 4.Better time management

4

Nursing management observes team members picking up assignments from others in order to complete the designated task. How would the nurse manager categorize this action? 1.Mutual trust 2.Closed-loop communication 3.Shared mental models 4.Backup behavior

4

Which action supported by current research contributes to the existence of workplace violence in the clinical setting? 1.Most nurses report incidents that have occurred without fear of retaliation. 2.Nurses are more aware of the likelihood that workplace violence will occur. 3.There are strong organizational support and zero tolerance policies for bullying. 4.There is no support from administration.

4

Which information is represented by the framed question, "how" of change? 1.Participant stakeholders 2.Rationale 3.Timing 4.Technique

4

A nurse observes a nurse and patient having a loud conversation. The nurse is yelling at the patient and is pointing a raised finger at the patient stating that "he'd better behave." How would the nurse who is observing this interaction categorize this type of behavior in terms of violence? 1.Lateral 2.Third party 3.Vertical 4.Horizontal

2

A registered staff nurse is working with an experienced registered nurse who has transferred from an ambulatory surgical care unit to a medical-surgical unit as a preceptor. Which activity is not appropriate to be delegated by the preceptor? 1.Admitting a new patient to the unit who is scheduled for elective surgery in the morning 2.Titrating anticoagulant therapy for a patient who is being treated for thrombosis 3.Inserting a Foley catheter. 4.Performing a pain assessment in order to administer prn pain medication

2

In order to facilitate a healthy working environment for nurses, which option would not be included? 1.Opportunities for education 2.Focus on limiting communication 3.Opportunities to outreach to local communities 4.Self-identification of personal challenges

2

Nurse managers from different departments within the hospital are meeting to discuss requests to be submitted for consideration for the hospital's capital budget. Which information should be submitted for budgetary approval? 1. Requests for additional staffing 2. Need for equipment that is projected at a cost greater than nursing unit budget 3. Salaries for staff 4. Advertising requests to promote nursing unit

2

Nurses on a medical-surgical unit are reluctant to suggest any changes at a staff meeting as to how policies and procedures are implemented on the unit because in the past, the nurse manager has listened but not included any of their suggestions and just places her own ideas to direct change. The nurse manager views this process as being evidence of compromise, but the staff does not feel that this has occurred. What type of conflict are the staff nurses experiencing? 1.Avoiding 2.Competing 3.Compromising 4.Collaborating

2

Team members are becoming disillusioned with the group performance. The team leader is seeking a method to get team members engaged. Which option would help to promote engagement among team members? 1.Time of the meeting should be based on the team leader's schedule. 2.Agenda should be sent out to team members prior to the meeting of the team. 3.Team members should be allowed to have off-topic chats during the meeting to increase participation. 4.The meeting should end without providing a summary of what transpired during the session.

2

What statement represents the highest level of collaboration? 1.A group of nursing students are working together on a project and submitting their individual work that was assigned to each of them. 2.A group of nursing students working on a project are reviewing all submitted work from individual members and critiquing the work as it applies to the learning objectives for the assignment. 3.Assignments are handed out at a group meeting to individual participants who are going to work on a group project. 4.Individual participant members of the group are starting to work on their individual assignments.

2

When calculating a full-time equivalent (FTE), which information is needed? 1. Productive hours of nursing staff per nursing shift 2. Amount of time that an employee works during the period of a year 3. Average number of patients on a nursing unit on any given day 4. Number of staff who have worked during a 24-hour period

2

When monitoring the productivity of any nursing unit, it is important to consider whether there is evidence of what critical factor? 1.Job satisfaction of staff 2.Quality of care delivered 3.Stable economic costs 4.Adequate staffing

2

Which action by a nurse manager would be viewed as a barrier to change in the clinical setting? 1.Instilling confidence in staff by acknowledging competence 2.Limiting communication among members of staff 3.Allowing staff members to apply for another job in the facility 4.Fostering a collaborative approach among staff

2

Which activity would indicate reflective learning? 1.Meeting learning objectives in a nursing course 2.Seeking opportunities for improvement 3.Completing a continuing education (CE) activity 4.Making sure that all requirements for license renewal have been satisfied

2

Which description best supports the "S" in the TEEAMS approach? 1.Recognizing individual team members 2.Showing excitement about the team's work 3.Promoting an engaging work environment 4.Holding team members accountable

2

Which factor would be considered to be most critical for its potential impact on leadership- and management-related barriers on delegation in the clinical setting? 1.Policies and procedures manual is up to date on unit. 2.Job description was updated 2 years ago. 3.Credentials of nurses on unit are verified. 4.All nursing positions are currently filled on the unit

2

Which factors are seen as being critical to evaluating staffing patterns based on nurse-sensitive quality indicators (National Database of Nursing Quality Indicators [NDNQI])? 1.Only the skill mix of nurses in the clinical setting 2.Skill mix and amount of nursing hours per patient per day 3.Acuity of patients and number of physicians 4.Skill mix and nurse job satisfaction

2

Which statement provides an accurate description of mutual performance monitoring? 1.It describes a singular function whereby team performance is assessed based on attainment of goals. 2.Awareness of environment and appropriate task strategies are used to evaluate performance. 3.Positive reinforcement is used to evaluate performance. 4.Team behaviors are considered to evaluate performance.

2

Which task could be delegated to a licensed vocational nurse (LVN) by a registered nurse (RN) who is working with a LVN and unlicensed assistive personal (UAP) as part of the team? 1.Performing oral hygiene 2.Feeding a patient with dysphagia 3.Collecting a urine specimen 4.Obtaining daily weight

2

When planning a budget for a nursing unit, some variables cannot be controlled but yet still must be accounted for in order to prepare a fiscally responsible budget. Which variables cannot be controlled by nurse managers? Select all that apply. 1. Number of beds on unit 2. Patient acuity 3. Benefit package for staff members 4. Amount of money that the unit makes 5. Inventory of supplies

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Which behaviors are considered to be common human responses to change? Select all that apply. 1.Universal equivocal acceptance 2.Adjustment period needed 3.Resistance 4.Feeling threatened by the change 5.Not needing further explanations

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Which characteristics are attributed to emerging change theories? Select all that apply. 1.Are linear in nature 2.Have inherent complexity 3.Exhibit flexibility 4.Can be classified as simplistic and cyclical in appearance 5.Are dynamic

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Which factors contribute to the present nursing shortage in the United States? Select all that apply. 1.Increased access to health care 2.Decreased clinical sites 3.Staffing patterns within hospital settings 4.Newer nurses less likely to remain employed in clinical practice settings compared to more experienced nurses 5.Shortage of nurses that exists only in specialty areas of practice

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The nurse manager observes that the nursing staff on the unit who had previously undertaken the task of reviewing electronic documentation is now actively engaged in the process. Which part of the team development process is represented by this observation? 1.Norming 2.Storming 3.Forming 4.Adjourning

1

Which action would contribute to nurse fatigue in a staff nurse who is working a 12-hour shift on a medical unit and who has been assigned to take care of five patients based on a primary care model? 1.Nurse eats lunch meal at the nurse's station while answering unit phone 2.Nurse leaves the unit on time at the end of the scheduled shift 3.Nurse does not sign up for additional shifts to cover unit vacancies 4.Nurse states she typically sleeps 8 hours a night

1

Which activity should only be performed by a registered nurse (RN) even if there are additional staff members present on a medical-surgical unit, such as licensed practical nurses (LPNs) and unlicensed assistive personnel (UAPs)? 1.Initiation of blood transfusions 2.Tracheostomy care 3.Vital signs on a new patient to be admitted to the unit 4.Insertion of a Foley catheter

1

Which statement is inaccurate with regard to leading and managing teams? 1.Management personnel must assume team leadership positions. 2.Reminders should be included in team meetings. 3.Nurse managers play a key role in helping to build a team. 4.Utilization of enhanced communication skills helps to keep group members focused on task.

1

Which traditional change model would be indicated for a health-care organization that is looking to implement technological changes? 1.Innovation decision process 2.Force-field model 3.Phases of change model 4.Eight-stage model of creating change

1

Which rules should be incorporated by nurse managers and leaders in order to maintain synergy when working with team development? Select all that apply. 1.Each member of the team should be able to state the intended purpose of the team. 2.Team members should share objective feedback. 3.Team members are encouraged by leadership to share ideas. 4.Selected individuals who have shown high intensity in past projects should participate. 5.Team members should be allowed to leave the meeting if they are not interested in the presentation.

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Which description best illustrates a type of care delivery model? Select all that apply. 1.Primary nursing focused on the registered nurse being responsible for total patient care at the bedside. 2.A team nursing approach consisted of all registered nurses providing complex care to a group of high acuity patients. 3.Nontraditional models of patient care incorporate non-nursing personnel to deliver patient care. 4.Partnership models focused on decreasing health-care costs while providing patient care. 5.Functional care model focused on the use of registered nurses as the basis for providing total care.

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Which teams utilize an intraprofessional approach? Select all that apply. 1.Nurses from different units in the hospital that are members of a quality improvement committee 2.Ethic committee members in the hospital including physicians, nurses, and social workers 3.Students from different nursing schools who are part of a Nursing Education Committee 4.Nurse managers and clinical nursing supervisors who are members of a committee looking how to improve efficiency of the nursing units within a facility 5.Respiratory therapists, nurses, and lab technicians in a facility who are members of a committee to look at how to improve delivery of care to patients

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A nurse manager has to submit a budget for the medical-surgical unit. Which considerations should the nurse manager include when planning the budget? Select all that apply. 1. Amount of resources that are available to support the nursing unit 2. Responsibility for cost centers within the hospital facility 3. Awareness of patient needs 4. Staffing patterns 5. Identification of the type of nursing care delivered

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What factors would help to prevent injury to nurses involved with delivery of patient care? Select all that apply. 1.Support of a "no lift" policy in the clinical facility 2.Using body mechanics properly in every lift, transfer, or positioning activity 3.Adequate staffing on units 4.Focus on manual handling as the primary method to lift, transfer, or position patients 5.Employment of ergonomic techniques

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When considering implementing a traditional change theory in clinical practice, what expectations would be evident? Select all that apply. 1.Expected change would be sequential. 2.No further action is required once the change has been implemented. 3.Stakeholders must be vested in the change process. 4.The change can be applied without additional instruction. 5.In order to integrate the change, each step of the process must be completed

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Which elements are critical for a nurse to consider with regard to using delegation in the clinical setting on a medical-surgical unit within a clinical facility? Select all that apply. 1.Knowledge of state's practice act 2.Number of patient beds in the clinical facility 3.Assessment of patient acuity 4.Whether or not the health-care providers belong to a health maintenance organization (HMO) 5.Number and type of staff scheduled to work on the unit for that shift

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Which statements are accurate with regard to preceptors or mentors? Select all that apply. 1.Preceptors serve as role models. 2.Mentors are nurses who provide instruction to their mentees. 3.The use of mentors can benefit nurses across all levels of practice and/or experience. 4.Preceptors typically are viewed as advanced beginners. 5.Mentored relationships are considered to be long term in nature

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A nurse manager is educating a staff nurse with regard to the five rights of delegation. Which statement by the staff nurse indicates that additional training is needed? 1.Environmental issues should be taken into consideration before delegating tasks. 2.Client assessment does not impact the ability to delegate tasks. 3.The focus is on maintaining competency throughout the delegation process. 4.Delegation should never be done in the presence of an unsafe observation.

2

A group of new graduate nurses are discussing what they will do following graduation. One of the new graduate nurses has identified that she will focus her clinical practice pathway in hospital-based bedside nursing as that was what her family had expected her to do upon graduation. What type of future is demonstrated by this statement? 1.Preferable 2.Plausible 3.Possible 4.Probable

2

A group of nurses are working on an obstetrical unit and are discussing how the Nurses' Bill of Rights can be incorporated into the day-to-day operations of the nursing unit. Which suggestion could be implemented that would reflect compliance? 1.Protocols on nursing unit are based on physician preference. 2.Nurses act as patient advocates. 3.Compensation for work is based on personal preference recommendations of management. 4.Nurses are not involved in collective bargaining conversations.

2

A nurse is receiving a telephone order from a physician related to a patient concern. How would the nurse manager classify this nurse activity? 1. Value care 2. Necessary care 3. Nonvalue added care 4. Indirect care

2

Which measures would help to reduce stress levels experienced by new graduate nurses? Select all that apply. 1.Graduation from an accredited nursing program 2.Inclusion of a nurse residency program 3.Utilization of unit-specific orientations 4.Anticipation that the new graduate nurse is ready to assume the role of a registered nurse (RN) in clinical practice 5.Incorporation of education as well as clinical training

2 3 5

Which characteristics are included in the Clinical Nurse Leader (CNL) model? Select all that apply. 1.The CNL assumes an administrative role in the clinical setting. 2.The aim of the CNL model is to improve outcomes for the patient across the health-care continuum. 3.Evidence-based practice (EBP) is not incorporated into the CNL model. 4.The functioning CNL in the clinical setting obtains certification upon graduation from a Master's program by passing a certification exam. 5.The entry level of practice requires a doctoral degree.

2 4

In order to create an effective team approach on a nursing unit, which strategies would facilitate a sense of collaboration and teamwork? Select all that apply. 1.Promoting passive listening 2.Creating a safe environment 3.Displaying authenticity only when appropriate 4.Paying attention to other team members' strengths 5.Questioning what has gone on before

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Which actions are not appropriate to be delegated by a registered nurse (RN) to unlicensed assistive personnel (UAP) on a medical unit in a hospital setting? Select all that apply. 1.Taking a patient to the bathroom who has no activity restrictions 2.Administering pain medication 3.Assisting the registered nurse in performing a dressing change for a postoperative patient 4.Asking the physician for a new order for the patient who needs a change in diet 5.Monitoring postoperative dressing for bleeding

2 4 5

Which information is needed to be able to calculate FTEs for a nursing unit? Select all that apply. 1. Acuity level of patients 2. Staffing of unit 3. Physicians with hospital privileges who provide care to patients on nursing unit 4. Staff needed to cover days off 5. Productive as well as nonproductive time

2 4 5

Which statements illustrate the "right person" in the context of the five rights of delegation? Select all that apply. 1.Assessing the patient population 2.Being aware of competence standards 3.Reporting and documenting 4.Having knowledge of educational requirements 5.Conducting performance evaluations

2 4 5

Which situation would constitute an example of "bullying" in the nursing environment? 1.The nurse manager instructs a member of the nursing staff in a better way to perform a nursing task. 2.The unit secretary repeatedly talks to nurses and staff in a rude manner. 3.The unlicensed assistive personnel (UAP) on the unit continues to make jokes about another staff member in the presence of others as well as when alone in the staff member's presence. 4.The nurse on the unit gossips about another staff nurse on the unit.

3

Which statement is accurate in describing care delivery models? 1.Total patient care is an example of a contemporary care delivery model. 2.Functional nursing model and team nursing are equivalent models. 3.Lateral communication exists in primary nursing model. 4.Integrated models utilize registered nurses to provide primary care to patients.

3

he nurse manager is having a staff meeting so as to improve patient outcomes in terms of delegation of care. Staffing includes four registered nurses (RNs), three licensed vocational nurses (LVNs), two certified nurse's aides (CNAs), and two unit secretaries. Which observation if noted by the nurse manager would indicate a concern relative to effective delegation? 1.Staff is openly discussing frustrations about occasional staffing issues on the unit. 2.Delivery of quality care is a major focus of staff members. 3.Nursing staff and CNAs have a different view of what needs to be done and by whom. 4.Understanding of policies and procedures should be consistent among all staff members.

3

Which actions would directly affect nurses' participation in clinical decision making within a clinical care system? Select all that apply. 1.Reimbursement for educational programs 2.Centralized framework structure 3.Inclusion in hospital committees 4.Utilization review of established practices on nursing units by nursing staff 5.Provision of incentive programs for nurses who are interested in furthering their education

3 4

A group of nursing students are discussing how staffing affects patient safety. Which nursing student comment if observed by the nursing instructor would warrant intervention? 1.Research has indicated that if staffing is adequate then patients are less likely to develop nosocomial infections. 2.If staffing is adequate with registered nurses (RNs), then patient mortality is decreased. 3.There is little evidence to support that adequate staffing leads to improved patient outcomes. 4.Adequate staffing helps to prevent nursing fatigue leading to better clinical decision making.

3

A nurse manager is described by the nursing staff as having a keen insight into the day-to-day operations of the nursing unit. What is the best description of the nurse manager's communication skill? 1.Candid 2.Authentic 3.Mindful 4.Reflective

3

A nurse manager is viewed by the nursing staff as exhibiting avoidance behavior relative to any identified conflict on the unit. What type of conflict management strategy is being displayed? 1.Accommodating 2.Competing 3.Avoidance 4.Collaborating

3

A nursing student who is going to graduate from a Bachelor of Science Nursing Program (BSN) is preparing a résumé. Which notation should not be included? 1.Educational background 2.Volunteer history 3.Interest in position 4.Awards or certification

3

A nursing unit is being educated on methods to prevent workplace violence from occurring on the nursing unit. Which statement by a nursing staff member indicates that adequate instruction has been provided? 1."I will work on maintaining a culture of incivility." 2."The responsibility for whether or not workplace violence occurs rests with management." 3."I will remain accountable for all of my behaviors and actions while working on the nursing unit." 4."I will keep to myself and focus only on my immediate environment while at work"

3

In a hospital setting, there appears to be conflict between two nurses, one who works in the emergency department and the other who works in the operating room. What type of conflict could be applied to this situation? 1. Intrapersonal 2.Organizational 3.Interpersonal 4.Intergroup

3

Inspection of a medical-surgical nursing unit reveals that the unit is understaffed, with several of the nurses asked to continually sign up for overtime to fulfill staffing needs. Prior to this staffing pattern request, nurses were called off due to low patient census. The present situation has now been occurring for several months, and the nurse manager has just received a 2-week notice from one of the staff nurses assigned to the unit. What would one suspect to be occurring based on this observed situation? 1.Teamwork and solidarity on the part of the nursing staff 2.Consistent patient outcomes 3.Poor morale of nursing staff 4.Decrease in nosocomial infections

3

Nurse managers are attending a training session to help them understand and apply concepts relative to budget planning. Which statement by a nurse manager would indicate that the training session has been effective? 1. "Incremental budgeting reflects prioritization of care." 2. "Performance budgeting focuses on individual measurement." 3. "Performance budgeting requires considerable time to implement." 4. "Zero-based budgeting encourages waste."

3

Which nursing action can have a direct impact on budgeting for the nursing unit? 1. A nurse administers pain medication to a patient after performing a pain assessment. 2. A registered nurse (RN) delegates the task of performing a dressing change to a licensed practical nurse (LPN). 3. A nurse makes an attempt to initiate intravenous therapy on a patient only to find that one of the catheters was defective, and thus an additional catheter had to be used. 4. A nurse calls the respiratory therapy department to request a breathing treatment for a patient.

3

Which nursing action reflects a culture of competence? 1.A student nurse reads only what is required for classroom assignments. 2.A staff nurse does not attend clinical in service on unit due to her own evaluation of established clinical judgement. 3.Staff nurses on the unit all sign up for a physical assessment class to review procedures and policies. 4.A graduate nurse who has recently become licensed is waiting to meet continuing education requirements until her license is due to be renewed to prevent distraction from being oriented to her new role as a registered nurse.

3

Which research evidence supports the Institute of Medicine (IOM) mandate of 2020 to support the growth of baccalaureate (BSN) prepared nurses? 1.Associate degree nursing programs are not needed. 2.Medication errors by nurses have increased, regardless of the nurses' educational level. 3.Better patient outcomes have been realized with BSN nurses. 4.No difference in length of stay (LOS) for patients is seen regardless if taken care of by nurses with different educational backgrounds.

3

Which activities would be included in the evaluation phase of budget planning? Select all that apply. 1. Estimating cost of supplies 2. Exploring productivity 3. Examining for variance 4. Comparing actual versus projected results 5. Starting once the budget has been implemented

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Which situations would help to promote a healthy work environment in the clinical setting? Select all that apply. 1.Staff nurses complain of fatigue with having to work additional hours 2.The nurse manager has received complaints of bullying occurring on the unit arising from one staff member 3.Nurses perceive that a culture of physiological safety exists on the nursing unit 4.Staff adhere to the American Nurses Association (ANA) Nurses Bill of Rights as part of nursing unit policy 5.Staff feel that their efforts are valued by management

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Which actions should nurse leaders and managers take that would foster a healthy work environment in the clinical setting? Select all that apply. 1.Identify specific roles and responsibilities of nursing staff with narrow functions. 2.Limit availability of continuing education resources available for nursing staff. 3.Create an interdisciplinary team approach to manage and deliver patient care. 4.Only involve charge nurses and nurse managers in clinical decision making. 5.Encourage staff to attain additional certification in their chosen specialty area.

3 5

Which statement best reflects a difference between patient assignment and patient supervision? 1.Assignment can be handled at the patient level, whereas supervision is handled at the management level. 2.Assignment refers to how work is distributed among staff, whereas supervision refers to evaluating complexity of care. 3.Assignment focuses on complexity of care, whereas supervision focuses on delivery of care. 4.Assignment is based on care delivered by participant members, whereas supervision is based on monitoring and follow-through of all provided care to patients.

4