Leadership Exam 3

The purpose of learning how to negotiate conflict is to: Eliminate conflict entirely Resolve conflicts more effectively Win Reduce stress

Eliminate conflict entirely Resolve conflicts more effectively Win Reduce stress

ISBARR provides a framework for communicating critical client information. ISBARR is an acronym for: Identify, Study, Background, Assess, Recognize, Readback Issue, Situation, Better, Advise, Refer with Recommendations Introduce, Situation, Background, Assess, Recommend, Readback None of the above

Identify, Study, Background, Assess, Recognize, Readback Issue, Situation, Better, Advise, Refer with Recommendations Introduce, Situation, Background, Assess, Recommend, Readback None 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? Implicit bias forms during a lifetime. Implicit bias can influence clinical decision making and treatment. Implicit bias contributes to an individual's social behavior. 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. All of the above

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? It is independent of teamwork. It is a data-driven approach to improving process. Common safety indicators are not used to evaluate quality of care. Opportunities for QI are selected by organization leadership.

It is independent of teamwork. It is a data-driven approach to improving process. Common safety indicators are not used to evaluate quality of care. Opportunities for QI are selected by organization leadership.

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

Let the feelings flow. Cancel the negotiation. Deal with the feelings first. Tell them to ignore the feelings and deal with the issues.

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

Monitor the quality of patient care. Ensure that supplies and equipment are readily available. Assess the equity of nursing assignments. All of the above

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

Nursing tools designed to identify best practices and facilitate standards of care Used to create a stable set of performance indicators to measure outcomes Used to assist employees with wellness and injury prevention Helpful when making staffing assignments

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

Poor hygiene and hand washing Poor hand-off communication Poor work environment Lack of care

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? Post-acute care reform initiative National health-care research and quality indicators aimed at helping improve access to care NDNQI Health IT

Post-acute care reform initiative National health-care research and quality indicators aimed at helping improve access to care NDNQI Health IT

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? Protecting the right to fair treatment Creating an adversarial relationship between staff and management Lacking professionalism on the part of the collective bargaining unit members Failing to uphold important standards of care

Protecting the right to fair treatment Creating an adversarial relationship between staff and management Lacking professionalism on the part of the collective bargaining unit members Failing to uphold important standards of care

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? Talking to the staff Laughing with them Listening Crying

Talking to the staff Laughing with them Listening Crying

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

The resistance that comes from inertia: "We always do it this way." Active resistance to changing a preferred procedure Passive resistance to an unpopular change Resistance based upon fear of losing one's job

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? Union-management conflict Interpersonal problem Cultural differences Work intensification

Union-management conflict Interpersonal problem Cultural differences Work intensification

Who is responsible for accepting, transcribing, and implementing physician orders? Unit clerk Medical intern or resident Professional nurse Medical assistant

Unit clerk Medical intern or resident Professional nurse Medical assistant

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

When the need is immediate If the benefits will be realized years from now When the reward is immediate If it is change that keeps you in your comfort zone

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

A new assignment Tasks she's done many times Change to a different shift Addition of several new tasks

What is brainwriting? A strategy to encourage the free flow of ideas A mutually beneficial negotiation resultc. A winning approach to formal negotiationd. A devaluation reaction to negotiation

A strategy to encourage the free flow of ideas A mutually beneficial negotiation resultc. A winning approach to formal negotiationd. A devaluation reaction to negotiation

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: Immediately page the MD; it could be a pulmonary embolism, and time is of the essence. You will give him the particulars when the MD arrives. Wait for the MD to round on his patient because it should be within the next hour or so. Medicate the patient for pain and plan to contact the MD when he rounds.d 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.

Immediately page the MD; it could be a pulmonary embolism, and time is of the essence. You will give him the particulars when the MD arrives. Wait for the MD to round on his patient because it should be within the next hour or so. Medicate the patient for pain and plan to contact the MD when he rounds.d 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.

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? Nurses should never post protected health information on a social media site. Stories with good outcomes can be posted to your media page. Stories and photos can always be shared if the patient's name or face is not visible. Posting stories on personal time is OK because the nurse is not working.

Nurses should never post protected health information on a social media site. Stories with good outcomes can be posted to your media page. Stories and photos can always be shared if the patient's name or face is not visible. Posting stories on personal time is OK because the nurse is not working.

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

Refer each of them for employee counseling. Engage in problem resolution. Bring in a union representative Engage in a formal negotiation process.

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? Review the patient's medication administration record during bedside shift report. Ask your colleagues to get your medication so that you can give it on time. Call the pharmacist. Review the medication administration policy.

Review the patient's medication administration record during bedside shift report. Ask your colleagues to get your medication so that you can give it on time. Call the pharmacist. Review the medication administration policy.

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? Sentinel event Adverse event Near miss event Wrong procedure event

Sentinel event Adverse event Near miss event Wrong procedure event

Which of the following issues may be addressed in a collective bargaining agreement? Shift differentials Safe working environment Grievance procedures All of the above

Shift differentials Safe working environment Grievance procedures All of the above

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? 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. 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. All of the above

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? Tell the staff that their concerns about the new schedule are unfounded and plan to post the new schedule. Share information about the new schedule and discuss its impact on the unit. Post the schedule and deal with staff on an individual basis. Ask the staff to come up with an alternative for the nurse manager's consideration.

Tell the staff that their concerns about the new schedule are unfounded and plan to post the new schedule. Share information about the new schedule and discuss its impact on the unit. Post the schedule and deal with staff on an individual basis. Ask the staff to come up with an alternative for the nurse manager's consideration.

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? Tell them the change has been ordered by the administration. Present statistics proving the need to change. Tell a compelling story about why change is needed. Explain the importance of the change in simple terms.

Tell them the change has been ordered by the administration. Present statistics proving the need to change. Tell a compelling story about why change is needed. Explain the importance of the change in simple terms.

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? Telling the oncoming nurse what happened on the unit during the shift Introducing the client and his or her diagnosis to the oncoming nurse Sharing the nurse's personal opinion of the client Reviewing new medication orders and the medication administration record (MAR)

Telling the oncoming nurse what happened on the unit during the shift Introducing the client and his or her diagnosis to the oncoming nurse Sharing the nurse's personal opinion of the client Reviewing new medication orders and the medication administration record (MAR)

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? The charge nurse is unavailable to help the nurses when they have questions about policies. Some staff are afraid to ask particular charge nurses for help for fear of retribution. The use of acronyms is confusing to staff members who are new to the unit. All of the above

The charge nurse is unavailable to help the nurses when they have questions about policies. Some staff are afraid to ask particular charge nurses for help for fear of retribution. The use of acronyms is confusing to staff members who are new to the unit. All of the above

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

The nurses use evidence-based research to guide care delivery. The nurses are respectful and responsive to their clients' individual preferences. The nurses perform an independent double check when administering chemotherapy medication. All of the above

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? The patient's discharge was so recent that it is not available yet. EMRs are usually practice or hospital specific, so the patient's information would not be accessible to Jane. The patient was hospitalized out of state. The patient has not signed the necessary consents to give Jane access.

The patient's discharge was so recent that it is not available yet. EMRs are usually practice or hospital specific, so the patient's information would not be accessible to Jane. The patient was hospitalized out of state. The patient has not signed the necessary consents to give Jane access.

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

Transparency, openness, reporting of errors is rewarded, blame-free environment Honesty, studying of serious events Privacy, reporting of errors appreciated Blame-free environment, openness, error reporting is encouraged

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

When no one talks about it anymore If adoption occurred rapidly When resistance turns from active to passive When a full year has passed since the change was introduced

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

When the change is very complicated In an emergency When resistance is very high If the change is unimportant

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? All of the above

Will it work better than the old way? Is this change needed? Is there a simple way to do this? All of the above

What is the most desirable result of a problem resolution? Win-lose Lose-lose Win-win None of the above

Win-lose Lose-lose Win-win None of the above

Differences in status and authority within the health-care team can generate conflict. What is the most common cause of conflict? Disrespect and incivility Inappropriate language and sarcasm Blaming and finger pointing Physical violence

Disrespect and incivility Inappropriate language and sarcasm Blaming and finger pointing Physical violence

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

Shift in Medicare payment policies Change in shift differentials Opening a new unit Changing visiting hours

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 that your organization is committed to improving patient safety? The hospital has a good catch program for staff who recognize errors and near misses. The hospital subscribes to TJC safety publications. The hospital measures performance every month, monitors quality indicators, and regularly reports on quality. All of the above

The hospital has a good catch program for staff who recognize errors and near misses. The hospital subscribes to TJC safety publications. The hospital measures performance every month, monitors quality indicators, and regularly reports on quality. All of the above

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

Assign the new procedure to the newest staff member. Apologize for making their work more complicated. Provide them with a booklet on preparing for change. Give them time to learn the new procedure.

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? Budgeting adequate money for nursing salaries Preparing a patient for discharge Monitoring for infections Increasing time between clinic visits

Budgeting adequate money for nursing salaries Preparing a patient for discharge Monitoring for infections Increasing time between clinic visits