Leadership Exam 3

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?

- ALL OF THE ABOVE - implicit bias forms during a lifetime - implicit bias can influence clinical decision making and treatment - implicit bias contributes to an individual's social behavior

Bedside shift report is one of the things that Jane reviews at the staff meeting. She stresses the way she would prefer the report to start. Which of these would be the LEAST important to share with the oncoming nurse? 1. Telling the oncoming nurse what happened on the unit during the shift 2. Introducing the client and his or her diagnosis to the oncoming nurse 3. Sharing the nurse's personal opinion of the client 4. Reviewing new medication orders and the medication administration record (MAR)

- introducing the client and his or her diagnosis to the oncoming nurse - sharing the nurse's personal opinion of the client

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?

- monitor the quality of patient care - ensure that supplies and equipment are readily available - assess the equity of nursing assignments ALL OF THE ABOVE

Which of the following issues may be addressed in a collective bargaining agreement

- shift differentials - safe working environment - grievance procedures

When designing a technical change, which of the following should be considered?

- will it work better than the old way? - Is this change needed? - Is there a simple way to do this?

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

What is brain writing?

A strategy to encourage the free flow of ideas

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?

ALL OF THE ABOVE - submit event or incident reports for near misses - follow medication administration policies and procedures - always report significant data on care to patients and providers in a timely manner

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

All of the above

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

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?

Creating adversarial relationship between staff and management

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

Deal with the feelings first

Differences in status and authority within the health care team can generate conflict. What is the most common cause of conflict?

Disrespect and incivility

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?

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

How can you increase your staff's receptivity to an important change in procedures?

Give them time to learn the new procedure

In which of the following situations would a personal change probably be the hardest to make?

If the benefits will be realized years from now

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, Readback 4. None of the above

Introduce, Situation, Background, Assess, Recommend, Readback

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:

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

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 the staff 2. Laughing with them 3. Listening 4. Crying

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

TJC attributes 80% of all medical errors to: a. Poor hygiene and hand washing b. Poor hand-off communication c. Poor work environment d. Lack of care

Poor hand off communication

Who is responsible for accepting, transcribing, and implementing physician orders?

Professional nurse

What type of resistance to a change is hardest to overcome?

Resistance based upon fear of losing one's job

Medical errors account for 250,000 deaths a 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?

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

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?

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

Which of the following is a macro-level change?

Shift in Medicare payment policies

Which of the following best describes which is most likely to be within a nurse's comfort zone?

Tasks she's done many times

There has been a sudden increase in catheter associated UTI 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

Tell a compelling story about why change is needed

You are a new nurse. The hospital where you work is committed to providing safe, high quality care. Which of the following activities would let you know your organization is committed to improving patient safety?

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

The purpose of learning how to negotiate conflict is to

To resolve conflicts more effectively

Which of the following is the best indication that a change has been integrated?

When no one talks about it anymore

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

Work intensification

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?

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

When is it most appropriate to dictate (order) change?

an emergency

What is the most desirable result of a problem resolution?

Win- win