Leadership Exam 4

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

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

Which of the following best describes safety in health care? A. A registered nurse who made a serious medication error was terminated. B. An organization focuses on efficiency on the nursing units. C. After a medication error, a team works to prevent similar errors in the future. D. Safety indicators are reported regularly.

C. After a medication error, a team works to prevent similar errors in the future.

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? A. Sentinel event B. Adverse event C. Near miss event D. Wrong procedure event

C. Near miss event

Studying errors and identifying how they occur can help nurses and health care organizations improve patient safety. Which category of errors is the most useful in identifying and remedying vulnerabilities in an organization? A. Sentinel event (serious event, death) B. Adverse event (bad but didn't die) C. Near miss event (almost wrong meds, good catch) D. Wrong procedure event (bad but didn't die)

C. Near miss event (almost wrong meds, good catch)

Which of the following best describes what **TASKS** are most likely to be within a nurse's comfort zone? A. Change to a different shift B. A new assignment C. Tasks that he or she has completed many times D. Addition of several new nursing tasks

C. Tasks that he or she has completed many times

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

D. Developing and enforcing workplace safety and health regulations

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? A. Allow self-scheduling by staff nurses in each unit. B. Provide free dinner for nursing staff at the end of the night shift. C. Allow staff members to request consistent days off. D. End visiting hours before the day shift ends so that the night shift nurses do not have to deal with visitors.

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

Which of the following should be included in training for the prevention of needlestick injuries and other exposures to health risks? A. Clean all contaminated work surfaces according to established guidelines. B. Recap needles before disposal to avoid accidental pricks when emptying containers. C. Staff should be treated within 24 hours of a needlestick injury. D. Although sharps injuries have significantly declined in most areas, the long term care facilities are still the most at risk when it comes to needlestick injuries.

A. Clean all contaminated work surfaces according to established guidelines.

Actions to address violence in the health-care workplace include: *SATA*. A. Identifying the factors that contribute to violence and controlling as many as possible B. Allowing the violence to escalate C. Assessing staff attributes and knowledge regarding responses to violence D. Providing weapons training to those identified as having a potential for physical violence

A. Identifying the factors that contribute to violence and controlling as many as possible C. Assessing staff attributes and knowledge regarding responses to violence

Which of the following are considered reasonable accommodations for an employee with a disability? *SATA* A. Modification of the work's schedule B. Salary reduction to reflect lower output C. Additional days off and extended vacations D. Adjustment of work procedures

A. Modification of the work's schedule D. Adjustment of work procedures

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

A. Post-acute care reform initiative

According to our text, medical errors account for 250,000 deaths per year. It is estimated that as many as 50% of these errors may be preventable. What action should nurses take to avoid a medication error? A. Review the patient's medication administration record during bedside shift report. B. Ask your colleague to get your medication, so that you can give it on time. C. Call the pharmacist. D. Review the medication administration policy.

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

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

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

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

A. Shift in Medicare payment policies.

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

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

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

A. When no one talks about it anymore

According to NIOSH, a common reaction to latex allergy is: A. Increased appetite B. Allergic contact dermatitis C. Increased falls D. An increased in violence outbursts

B. Allergic contact dermatitis

Nurses are advocates for their patients and have a duty to report any behaviors that may negatively impact patient outcomes. Which of the following is true regarding reporting quality and safety issues? A. Whistleblower laws protect nurses from reprisals by employers. B. As long as nurses do the right thing for their patients, they will be protected. C. A health care facility may terminate the employment of a nurse who reports quality and safety issues. D. The state nurse practice act will have information about whether there are whistleblower laws in the state to protect nurses.

B. As long as nurses do the right thing for their patients, they will be protected.

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

B. If the benefits will be realized years from now

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

B. If the benefits will be realized years from now.

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

B. In an emergency.

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

B. It is a data-driven approach to improving process.

Nurse managers understand that which of the following are considered reasonable accommodations for an employee with a disability? (select all that apply) A. Reduction in salary to reflect lower output B. Modification of the work schedule C. Additional days off and extended vacations D. Adjustment of work procedures

B. Modification of the work schedule D. Adjustment of work procedures

Which of the following procedures and modifications contributes to reducing indoor air pollution? A. Windows that may be opened by staff as needed B. More powerful ventilation systems and air filtration C. Selecti ofon products with more PVC D. Increased use of medical waste incinerators

B. More powerful ventilation systems and air filtration

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? A. Budgeting adequate money for nursing salaries B. Preparing a patient for discharge C. Monitoring for infections D. Increasing time between clinic visits

B. Preparing a patient for discharge

People are often resistant to change. During the process of workplace change, based on Maslow's Hierarchy of Needs, what type of resistance is the **MOST** difficult to overcome? A. Active resistance to changing preferred procedure. B. Resistance based upon fear of losing one's job. C. "That's the way we've always done it" (inertia). D. Passive resistance to an unpopular change.

B. Resistance based upon fear of losing one's job.

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

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

Which of the following best describes what is the most likely to be within a nurses comfort zone? A. a new assignment. B. Tasks shes done many times. C. change to a different shift. D. addition of several new tasks.

B. Tasks shes done many times.

You are a new registered nurse. The health care facility where you've been hired is committed to providing safe care. Which of the following activities would let you know that your organization is committed to improving patient safety? A. The facility monitors quality indicators and regularly reports on quality. B. The facility has a good catch program for staff who recognize errors and near misses. C. The organization subscribes to TJC safety publications. D. None of the above.

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

In order to achieve safe patient care, a culture of safety must exist. What are some characteristics of an organization with a culture of safety? A. Honesty, and investigation of serious events B. Transparency, openness, blame-free environment, reporting of errors is rewarded C. Privacy, and reporting of errors appreciated D. None of the above

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

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

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

Nurse managers are aware that which of the following is the best indicator that a change has been integrated? A. If adoption occurred rapidly B. When no one talks about it anymore C. When a full year has passed since the change was introduced D. When resistance turns from active to passive

B. When no one talks about it anymore

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? A. Tell the staff that their concerns about the new schedule are unfounded and plan to post the new schedule. B. share info about the new schedule and discuss its impact on the unit. C. post the schedule and deal staff on an individual basis. D. Ask the staff to come up with an alternative for the nurse managers consideration.

B. share info about the new schedule and discuss its impact on the unit.

Which are the following are ways that nurse leaders can address violence in the workplace? (select all that apply) A. Provide weapons training for nurses. B. Allow violence to escalate. C. Assess staff knowledge regarding responses to violent behavior. D. Identify risk factors for violence on the nursing unit.

C. Assess staff knowledge regarding responses to violent behavior. D. Identify risk factors for violence on the nursing unit.

Staff receptivity is critical to the successful introduction of an important practice change. How can a nurse manager increase the staff's **receptivity** to an important change in nursing procedures? A. Provide them with a booklet on preparing for change. B. Assign the new procedure to the newest staff member. C. Give them time to learn the new procedure. D. Apologize for making their work more complicated.

C. Give them time to learn the new procedure.

A *surprisingly* dangerous Jon in the United States is working: A. In a coal mine B. As a window cleaner in NYC C. In a health-care facility D. As a police officer

C. In a health-care facility

Sometimes it becomes necessary for a nurse manager to issue an order to the staff. Effective nurse managers understand that the most appropriate time in which to dictate (order) change would be: A. When resistance is very high. B. When the change is very complicated. C. In an emergency. D. If the change is unimportant.

C. In an emergency.

Change occurs on multiple levels in health care. Our text discusses macro and micro level changes. Which of the following is an example of a **MACRO-LEVEL** change? A. Change in shift differentials B. Change in a hospital's visiting hours C. Shift in Medicare payment policies D. Opening a new unit at a health care facility

C. Shift in Medicare payment policies

There has been a sudden increase in catheter-associated urinary tract infections that must be addressed on janes unit. What is the best way for Jane to persuade the staff to implement a new Foley catheter care protocol? A. Tell them the change has been ordered by the administration. B. present statistics proving the need to change. C. tell a compelling story about why change is needed. D. Explain the importance of there change in simple terms

C. Tell a compelling story about why change is needed.

Nursing leaders understand that structured care methodologies (SCM) are: A. Helpful when making staffing assignments B. Nursing tools designed to identify some good practices C. Used to create a stable set of performance indicators to measure outcomes D. Used to assist employees with wellness and injury prevention

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

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? A. Submit event or incident reports for near misses. B. Follow medication administration policies and procedures. C. Always report significant data on care to patients and providers in a timely manner. D. All of the above

D. All of the above

When designing a technical change, which of the following should be considered? A. Will it work better than the old way? B. If the change is needed. C. Is there a simple way to do this? D. All of the above.

D. All of the above

You recently joined a health care organization that is committed to quality patient care. Which of these are considered characteristics of quality health care? A. The nurses use data driven, evidence-based research to guide care delivery. B. The nurses are respectful and responsive to their clients' individual preferences. C. The nurses perform an independent double-check when administering chemotherapy medications. D. All of the above

D. All of the above

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

D. All of the above

A common ergonomic occupational-related risk in the health-care environment is: A. Indoor air pollution B. Active shooters C. Nosocomial infections D. Back injuries

D. Back injuries

A federal agency that partners with other agencies throughout the nation to investigate health problems, conduct research, implement prevention strategies, and promote dafe and healthy environments is known as the: A. FDA B. IOM C. ANA D. CDC

D. CDC

How can you increase your staffs receptivity to an important change in procedure? A. Assign the new procedure to the newest staff member. B. apologize for making their work more complicated. C. provide them with a booklet on preparing for change. D. Give them time to learn the new procedure.

D. Give them time to learn the new procedure.

A nurse manager of a busy emergency department is working to reduce the potential for violence on the unit. Which of the following will most likely reduce the potential for violence? A. Ensure post-assault treatment and support is available to all staff. B. Implement procedures to speed up the discharge process for mentally ill patients. C. Decrease the number of visible security guards to avoid antagonizing patients. D. Propose a plan to expand and update the waiting room.

D. Propose a plan to expand and update the waiting room.

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? A. Disinfect the site of the needlestick. B. Apologize to the patient, clean the site, and properly dispose of the needle. C. Update her hepatitis B immunization. D. Report the incident and obtain PEP within 2 hours.

D. Report the incident and obtain PEP within 2 hours.

What type of resistance to a change is the hardest to overcome? A. The resistance that comes from inertia: "we always do it this way." B. Active resistance to changing a preferred procedure. C. Passive resistance to an unpopular change. D. Resistance based upon fear of losings one Job.

D. Resistance based upon fear of losings one job.

Describe the phase of refreezing according to Lewin's change theory.

The stage of Refreezing is the ultimate stage in which people accept or internalize the new ways of working or change, accept it as a part of their life and establish new relationships.