leadership final practice questions
Which action is associated with the nursing leadership role in quality improvement? Identifying outcomes that support quality nursing care Inspiring staff to establish and maintain high standards regarding patient care Reviewing research results upon which to base changes Being aware of the changes in quality control regulations
Inspiring staff to establish and maintain high standards regarding patient care
Measuring staffing adequacy: Is essential for Medicare certification Requires knowledge of recent research evidence Is a quarterly evaluation of evidence for nurse staffing, physician availability and reimbursement Is an ongoing evaluation of matching patient care needs with appropriate nurse staffing and outcomes achieved
Is an ongoing evaluation of matching patient care needs with appropriate nurse staffing and outcomes achieved
What is inferred if an item is "cost-effective?" It is the least expensive product available. It is worth the cost. It is reimbursable. Its cost was anticipated.
It is worth the cost.
A nursing student is preparing a care plan for an assigned patient. When accessing the electronic medical record, what is acceptable information to view? Select all that apply. Laboratory data of the assigned patient Admission diagnosis for a patient who is a former neighbor The patient's age, date of birth, and gender The history and physical of the assigned patient A classmate's brother's chest x-ray report
Laboratory data of the assigned patient The patient's age, date of birth, and gender The history and physical of the assigned patient
Which of the following is the intent of HIPAA? Release of patient information for purposes of insurance reimbursement. Prevent health care providers from billing for procedures done for the insured person. Protect patients from reviewing their own medical records. Limit the ability of health care providers to sell patient information to outside sources.
Limit the ability of health care providers to sell patient information to outside sources.
An outcome statement "Patients will experience a 10% reduction in urinary tract infections as a result of staff training and a toileting schedule is Measurable and nurse sensitive Patient care centered and non-measurable Physician sensitive and non-measurable Process measurable and physician sensitive
Measurable and nurse sensitive
A nurse is discussing disaster planning with the board members of a hospital. Which of the following individuals should the nurse expect to request extra supplies and staffing for the facility? Incident commander. Medical command physician. Triage officer. Media liaison.
Medical command physician.
The nurse finds a client on the previous shift received 10 mg of Morphine IV instead of the ordered 5 mg. Which statement should be documented in the client's chart? Morphine 10 mg given accidentally instead of Morphine 5 mg Morphine 10 mg given IV instead of the ordered dose of Morphine. Morphine 10 mg given IV at 0800. Client's vital signs unchanged. Morphine 10 mg given IV and client notified.
Morphine 10 mg given IV at 0800. Client's vital signs unchanged.
nurse on a sixth-floor medical-surgical unit is advised that a severe weather alert code has been activated. Which of the following actions should the nurse take? Select all that apply. Open window shades or drapes to provide better visibility of the external environment. Move beds of non-ambulatory clients away from the windows. Relocate ambulatory clients into the hallways. Use the elevators to move clients to lower levels. Turn the radio on for severe weather warnings
Move beds of non-ambulatory clients away from the windows. Relocate ambulatory clients into the hallways. Turn the radio on for severe weather warnings
What occurs when RN hours decrease in a unit's calculation of nursing care hours per patient day (NCH/PPD)? Decreased errors Decreased patient falls Adverse patient outcomes generally decrease Decreased patient satisfaction
Decreased patient satisfaction
A nurse is caring for a client who has chest pain. The client says, "I am going home immediately." Which of the following actions should the nurse take? Select all that apply. Notify the client's family of their intent to leave the facility. Document the client's intent to leave the facility against medical advice (AMA). Explain to the client the risks involved if they choose to leave. Ask the client to sign a form relinquishing responsibility of the facility. Prevent the client from leaving the facility until the provider arrives.
Document the client's intent to leave the facility against medical advice (AMA). Explain to the client the risks involved if they choose to leave. Ask the client to sign a form relinquishing responsibility of the facility.
Which explains why nurses must be leaders to be successful in client care? Nurses as leaders have physician respect Only nurses as leaders can function in functional model of care delivery Nurses must be effective at giving orders Nurses must direct client care activities to reach outcomes
Nurses must direct client care activities to reach outcomes
Forty-five percent of people with a BMI>30 met with a dietician and committed to walking for 30 minutes three times a week. After one year, 20 percent had achieved a significant reduction in their BMI reading. What type of audit provided these data? Structure Process Concurrent Outcome
Outcome
Which statement is true regarding the patient's perception of his or her care? Patent perception is just as important as the outcome of care. Patient perception is insignificant compared to the outcome of care. Patient satisfaction has no relation to quality of care. Patient satisfaction is insignificant compared to the outcome of care.
Patent perception is just as important as the outcome of care.
What is generally the area of most expenditures? Zero Based budgeting Incremental budgeting Personnel budget Capital budget
Personnel budget
Which factor is the greatest contributor to the resistance encountered with organizational change? Poor organizational leadership Presence of employee mistrust Ineffective organizational management Sufficient staff involvement in the process
Presence of employee mistrust
The qualities of leadership, clinical expertise and judgment, mentorship, and lifelong learning would best describe which type of nurse? Administrator Certified Nurse Specialist Professional Practitioner
Professional
Which action by a change agent is an integral part of implementing a change? Pulling individuals who are not persuaded into a talk about the benefits of the change. Ensuring there are no remaining pockets of disagreement when the change occurs. Continually rewarding those working toward the change and ignoring those who are not. Providing information and giving support to those undergoing the change.
Providing information and giving support to those undergoing the change.
A definition of health policy includes which of the following elements? Funding for public education Appropriation of funds for roadwork Selection of congressional members of committees Public policy made to support health-related goals
Public policy made to support health-related goals
Presenting employees with the pros and cons of a new system to be implemented is an example of which type of strategy? Affirmative Normative Power Rational
Rational
A nurse-manager is attempting to restructure the unit to prevent the understaffing of the nurses. The nurses agree this is a needed change. What type of change strategy would be most effective? Rational-empirical strategies Normative-reductive strategies Power-coercive strategies None of the above
Rational-empirical strategies
Which is the most important reason resistance to change must be addressed? Resistance allows others to take power from managers Resistance from the late majority can keep others from accepting the change. Resistance will keep the change from occurring at all. Resistance can negatively impact client care.
Resistance from the late majority can keep others from accepting the change.
A nurse manager is observing the actions of a nurse they are supervising. Which of the following actions by the nurse requires the nurse manager to intervene. Select all that apply. Reviewing the healthcare record of a client assigned to another nurse. Making a copy of a client's most current laboratory results for the provider during rounds, Providing information about a client's condition to hospital clergy Discussing a client's condition over the phone with an invidual who has provided the client's information code. about with a fellow student in the public cafeteria Participating in walking rounds that involve the exchange of client-related information outside clients' rooms.
Reviewing the healthcare record of a client assigned to another nurse. Discussing a client's condition over the phone with an invidual who has provided the client's information code. with a fellow student in the public cafeteria
The nurse gives an inaccurate dose of medication to a patient. After an assessment of the patient, the nurse completes an incident report. The nurse notifies the nursing supervisor of the medication error and calls the physician to report the occurrence. The nurse who administered the inaccurate medication understands that: Risk management programs are not designed to assign blame. The error will result in suspension. The error will be documented in her personnel file. An incident report is optional for an event that does not result in injury.
Risk management programs are not designed to assign blame.
What strategy facilitates the development of a plan of correction associated with health-care delivery errors? Root cause analysis Conflict management Quality assessment (QA) program Sentinel event
Root Cause Analysis
What are two major foci of The Joint Commission (TJC) in the delivery of health care? Cost containment; safety Safety; quality Quality; assessment Assessment; evaluation
Safety; quality
Which of the following components are included in health policy at the state level? Americans with Disabilities Act of 1990 Scope of nursing practice Health Insurance Portability and Accountability Act (HIPAA) of 1996 Patient Safety and Quality Improvement Act of 2005
Scope of nursing practice
Where does safety fall in Maslow's hierarchy of needs? Most basic Second most basic Middle of the hierarchy Top of the hierarchy
Second most basic
The new nurse correctly defines a law when stating which information? "Law is a mandate from the Joint Commission or other accrediting agency." "Law's rule is enacted by a government agency that defines what must be done in a given circumstance." "Law's rule is developed by the employee's organization." "Law is a fundamental concept for health care professionals."
"Law's rule is enacted by a government agency that defines what must be done in a given circumstance."
A student nurse and clinical instructor are discussing quality in health care. The instructor knows the student understands when the student makes which statement? "Quality is apparent in all health care." "Quality is an outcome of health care." "Quality is seen and unseen in health care." "Quality is achieved by collaboration in health care."
"Quality is seen and unseen in health care."
A student nurse is talking with his instructor. The student asks how the quality of care is evaluated. What is the best response by the instructor? "Quality of care is evaluated by the patient getting well." "Quality of care is evaluated on the basis of process and outcomes." "Quality of care is evaluated by the physician's assessment." "Quality of care is evaluated by the patient's satisfaction."
"Quality of care is evaluated on the basis of process and outcomes.
The new director of case management assessed the need to improve the organization's patient satisfaction with the discharge process. Which statement below illustrates the vision that would lead the team to this goal? "The department will deliver reliable, collaborative, and compassionate discharge planning services to all patients." "The department will hold weekly meetings every Tuesday at 11:00 AM." "There will be implementation of a new uniform policy so staff can be readily identified." "Staff are encouraged to complain about difficult patients, families, and physicians."
"The department will deliver reliable, collaborative, and compassionate discharge planning services to all patients."
A case manager is discussing critical pathways with a group of newly hired nurses. Which of the following statements indicates understanding? "The time to fill out the pathways often increases the cost of care." "The pathway shows an estimate of the number of days the client will be hospitalized." "Deviance from the pathway is a sign of improved care quality." "The pathway includes information about the client's history."
"The pathway shows an estimate of the number of days the client will be hospitalized."
A nurse in an acute care unit is caring for a client following a total hip arthroplasty. The client is confused, moving the affected leg into positions that could dislocate the new hip joint, and repeatedly attempting to get out of bed. After determining that restraint application is indicated, which of the following actions should the nurse take? Select all that apply. Secure the restraint to the frame of the bed. Get a prescription for restraints from the provider. Have a family member sign the consent for restraints. Tie the restraint to the side rail using a double knot. Ensure that only one finger can be inserted between the restraint and the client.
Secure the restraint to the frame of the bed. Get a prescription for restraints from the provider. Have a family member sign the consent for restraints.
Which of the following is a component of emotional intelligence? Self-reliance Assertiveness Self-regulation Charisma
Self-regulation
The effects of mandatory overtime are most detrimental in the: Short-term Model of patient care delivery Long-term Recruitment efforts
Short term
Which level of government is responsible for the regulation of a nurse's license? Federal government State government Local government International coalition
State government
A nurse manager is preparing the budget for the next fiscal year. Which of the following should the manager analyze to assist in preparing the budget? Equipment costs of items included within the capital budget Statistical data related to past year's census The amount of overtime staff worked on average each month Volume of supplies used over the past year
Statistical data related to past year's census
A nurse-manager notes how often a patient takes his medication to determine scheduling. This is an example of using which of the following systems? Critical indicator PCS Summative task PCS Staffing by acuity Staffing by census
Summative task PCS
Nurses can be health advocates in which of the following ways? (Select all that apply) Supporting their professional nursing organization when discussing upcoming legislation Discussing the upcoming classes with a neighbor Rallying for coverage for childhood immunizations Arranging for a patient to meet with case management for home health care Discussing a patient they are concerned about with a fellow student in the public cafeteria
Supporting their professional nursing organization when discussing upcoming legislation Rallying for coverage for childhood immunizations Arranging for a patient to meet with case management for home health care
t is 2 PM. You are calculating the nursing care hours for the 3 - 11 PM shift and must decide whether you need to call in additional help. You have three RNs, three nursing assistants and one ward clerk scheduled. You have 22 patients with the following acuity and nursing care hours allotted for the evening shift: Category 1, 4 patients @ 3.5 hours Category II, 2 patients @ 5.0 hours Category III, 10 patients @ 6.2 hours Category IV, 6 patients @ 8.0 hours What are the needed hours of nursing care? 61 hours 134 hours 82 hours 98 hours
134 hours
A nurse discovers that a client was administered an antihypertensive medication in error. Identify the appropriate sequence of steps that the nurse should take using the following actions. 1. Complete an incident report 2. Check the client's vital signs 3. Call the provider 4. Instruct the client to remain in bed until further notice 5. Notify the risk manager 2,5,1,4,3 a. 4, b. 5, c. 2, d. 3, e. 1 a. 3, b. 2, c. 4, d. 5, e. 1 a., 2, b. 4, c. 5, d. 3, e. 1
25143
The nurse is assigned to be a member of the Risk Management Team. Which events would be addressed by this team? Select all that apply. The client leaves the hospital against medical advice (AMA). A client's family is dissatisfied with the meals that are served. The family does not want the client to be transferred to the intensive care unit (ICU). The client has an allergic reaction to the preservative in the barium used in a barium swallow. The client sustained an injury during a procedure.
The client leaves the hospital against medical advice (AMA). The client has an allergic reaction to the preservative in the barium used in a barium swallow. The client sustained an injury during a procedure
The clinical nurse leader needs to identify the staff who must go home due to low census. Which answer below describes a democratic style of decision making? The clinical nurse leader identifies the staff person with the most vacation and asks them to go home. The clinical nurse leader tells the last person to show up for their shift to go home. The clinical nurse leader asks the group if any of them would like the opportunity to go home and selects staff who volunteer. The clinical nurse leader decides not to send anyone home because it is too difficult to decide who should lose hours.
The clinical nurse leader asks the group if any of them would like the opportunity to go home and selects staff who volunteer.
The nurse is caring for diverse population groups at a health clinic. Which of the following patients demonstrates a potential health disparity group? A 12 month old with an appointment for immunizations A 30 year old immigrant who does not speak English A 28 year old man who needs a tetanus booster A 26 year-old woman who is receiving follow up after a car accident
A 30 year old immigrant who does not speak English
A community experiences an outbreak of meningitis, and hospital beds are urgently needed. Which of the following clients should the nurse recommend for discharge? A client newly admitted with angina and a history of myocardial infarction 1 year ago. A client who was preadmitted for rotator cuff surgery and has diabetes Mellitus type 2. A client admitted the day before with pneumonia and dehydration A client who has a fractured hip and is scheduled for total hip replacement the next day
A client who was preadmitted for rotator cuff surgery and has diabetes Mellitus type 2.
A nurse manager is explaining the use of incident reports to a group of nurses in an orientation program. Which of the following information should the nurse manager include? Select all that apply. A description of the incident should be documented in the client's healthcare record. The client should sign as a witness on the incident report. Incident reports include a description of the incident and actions taken. A copy of the incident report should be placed in the client's health care record. The risk management department investigates the incident.
A description of the incident should be documented in the client's healthcare record. Incident reports include a description of the incident and actions taken. The risk management department investigates the incident.
In which of the following answers is the hospital in compliance with the Consolidated Omnibus Budget Reconciliation Act and Emergency Medical Treatment and Active Labor Act of 1986 (EMTALA)? A patient with chest pain is triaged directly to a room for evaluation and registration information is obtained after the patient is stabilized. The emergency department staff asks a patient to stay in the waiting room until the patients with insurance are treated. The emergency department physician discharges and instructs a patient who is actively suicidal to go the neighbor facility that has psychiatric services. The emergency registration personnel explain to a patient that they must have proper identification to receive treatment.
A patient with chest pain is triaged directly to a room for evaluation and registration information is obtained after the patient is stabilized.
A nurse manager is providing information about the audit process to members of the nursing team. Which of the following information should the nurse manager include? Select all that apply. A root cause analysis is indicated when a sentinel event occurs. An outcome audit evaluates the results of the nursing care provided. Retrospective audits are conducted while the client is receiving care. After data collection is completed, it is compared to a benchmark. A structure audit evaluates the setting and resources available to provide care.
A root cause analysis is indicated when a sentinel event occurs. An outcome audit evaluates the results of the nursing care provided. After data collection is completed, it is compared to a benchmark. A structure audit evaluates the setting and resources available to provide care.
The hospital must reduce the number of readmissions from 11% to 8% in the next year. Which of the following best represents the transformational leadership style in accomplishing this goal? The director communicates the goal of reducing readmissions to the hospital operations team and tells them to submit their action plan by the end of the week. The organization charters three work teams to identify solutions for the top three causes for readmissions. These teams are given full authority to implement their solution. The director of quality develops a vision statement and action plan to achieve the goal. The director works directly with the involved departments to implement the action plan. The CEO communicates the goal to the organizational directors and managers and states that they are entrusted to solve the problem.
The director of quality develops a vision statement and action plan to achieve the goal. The director works directly with the involved departments to implement the action plan.
Which activity is associated with the unfreezing state of change will have the greatest impact on the success of the movement stage of the change process? Accurate and precise identification of the problem requiring change Effective information gathering concerning the potential outcome. Management voicing their opinions regarding the need for change The need for change is perceived by all those affected by the problem
The need for change is perceived by all those affected by the problem
Which of the following is an example of a nurse violating the Health Insurance Portability and Accountability Act (HIPAA) of 1996? A group of fellow employees are discussing a patient's clinical status in a public place. The nurse manager requests that they step into private room to complete the discussion. As a family approaches the nursing desk, the nurse removes the patient census sheet from view on the counter. After entering the progress notes on a patient's electronic medical record, the nurse logs off the computer to allow her coworker to use the terminal. The nurse asks the unit clerk to look up lab values for her relative recently admitted to the hospital.
The nurse asks the unit clerk to look up lab values for her relative recently admitted to the hospital.
The nursing unit director exhibits the definition of leadership in which of the following responses? The nurse manager refers the concern to the director of the department. The nurse manager corrects the concern with the patient directly and does not communicate her actions to the staff. The nurse manager meets with the staff to discuss the concern and and identify solutions. The nurse manager tells the staff that they need to correct the situation by tomorrow and leaves the meeting.
The nurse manager meets with the staff to discuss the concern and and identify solutions
A nurse is caring for a child who is being treated in the emergency department following a head contusion from a fall. History reveals that the child lives at home with one parent. The provider's discharge instructions include waking the child every hour to assess for indications of a possible head injury. In which of the following situations should the nurse intervene and attempt to prevent discharge? The parent states they do not have insurance or money for a follow-up visit. The child states, " My head hurts and I want to go home." The nurse smells alcohol on the parent's breath The parent verbalizes fear about taking the child home and requests they be kept overnight.
The nurse smells alcohol on the parent's breath
A nurse is observing a newly licensed nurse and assistive personnel (AP) pull a client up in bed using a drawsheet. Which of the following actions by the newly licensed nurse indicates an understanding of this technique? The nurse stands with both feet together. The nurse uses their body weight to counter the client's weight. The nurse's feet are facing inward, toward the center of the bed. The nurse rotates the waist while pulling the client upward.
The nurse uses their body weight to counter the client's weight.
To be an effective nursing leader today requires effective collaboration, which is modeled by which answer below? The nursing manager of the observation unit was certain the psychology department would assist the unit with a motivational plan, so she did not request their assistance. The nursing manager of the observation unit worked with the psychology department and physical therapy to develop a motivational plan for patients on the unit. The nursing director of behavioral health services followed the administrative directive to reduce services and refused to provide services for patients on other units. Frustrated by the trend of patients unwilling to work with therapy, the unit manager recommended that these patients be placed on another unit.
The nursing manager of the observation unit was certain the psychology department would assist the unit with a motivational plan, so she did not request their assistance.
Which of the following is true about health care legislation? State laws are considered the highest source of health care law and trump the federal laws. The power of the US Constitution does not have a direct relationship to health care and reserves most of the power to the states. The federal government asserts its power over health care legislation through the US Constitution. The US Constitution addresses health care law specifically to give the federal government the ability to license professionals and institutions.
The power of the US Constitution does not have a direct relationship to health care and reserves most of the power to the states.
According to situational and contingency theory, which statement is true? The theory supports employee feelings, morale, and feedback during the change process. The theory challenges the concept that one leadership style is best. Motivation through inspiration and recognition is the focus for transforming employee behavior. A leader is someone who possesses great intelligence and decision-making authority.
The theory challenges the concept that one leadership style is best.
Which statement concerning nursing leadership functioning at its potential is true? The most important nursing leadership role is being charismatic There is a need to integrate nursing management and nursing leadership Leadership is most important in managing healthcare costs The leadership role is most important in managing access to healthcare services.
There is a need to integrate nursing management and nursing leadership
Which statement best describes critical pathways? They provide a means of standardizing care for clients with similar diagnoses They determine justifiable differences among clients They reduce administrative costs They decrease the amount of paper work required for reimbursement
They provide a means of standardizing care for clients with similar diagnoses
What are some advantages to an organization of using travel nurses? They command premium pay. They provide scheduling relief. They offer good continuity of care. All of the above
They provide scheduling relief.
What type of leader is the person who is committed, has a vision, and is able to empower others with this vision? Interactional Transactional Transformational Bureaucratic
Transformational
The nurse is caring for a patient experiencing an allergic reaction to a bee sting who has an order for diphenhydramine (BenaDRYL). The only medication in the patient's medication bin is labeled BenaZEPRIL. The nurse contacts the pharmacy for the correct medication to avoid what type of error? Preventive Diagnostic Communication Treatment
Treatment
A characteristic of leadership management is to negotiate to meet goals. True False
True
Staffing in a busy physician's office is performed by the unit manager. This is an example of an office managed using the decentralized model. True False
True
Team building is an aspect of staffing. True False
True
The nurse in the immunization clinic should place emphasis on educating and reaching which groups about the disease-preventing effects of immunizations? Select all that apply. Caucasian African-American Low income Middle income High income
African-American Low income Middle income
What aspect of the business should managers emphasize? Decision making Analysis Results Control All of the above
All of the above
What is the goal of a budget? To predict an organization's activities To maximize the use of resources To help with planning and control All of the above
All of the above
Which emotions are commonly associated with change? Pride Stress Loss Achievement All of the above
All of the above
Which is an example of why plans might fail? Not enough alternatives Low motivation levels False assumptions Lack of sound strategies All of the above
All of the above
A sentinel event refers to which situation? Select all that apply. An event that harms a patient as a result of underlying disease or condition An event that harms a patient by omission or commission, not an underlying disease or condition. An event that signals the need for immediate investigation and response. An event that could have harmed a patient, but serious harm didn't occur because of chance.
An event that harms a patient by omission or commission, not an underlying disease or condition.
What results from effective benchmarking? Minimum practice guidelines are established for each health-care organization Organizations compete for a "best practices" label from the National Committee for Quality Assurance (NCQA). An organization compares its performance with that of "best performing institutions." Two organizations become financially integrated under a capped model
An organization compares its performance with that of "best performing institutions."
The nurse who has been hired to work on an oncology unit identifies which group of women as being at the highest risk of developing breast cancer? African Japanese Asian Hispanic
Asian
Standards must be: Subjective Uniform across all organizations Attainable All of the above
Attainable
Which type of health disparities are most frequently encountered by nurses in clinical and community settings? Avoidable and acceptable Avoidable and unacceptable Unavoidable and acceptable Unavoidable and unacceptable
Avoidable and unacceptable
A nurse is serving as a preceptor to a newly licensed nurse and is explaining the role of the nurse as an advocate. Which of the following situations illustrates the advocacy role? Select all that apply. Verifying that a client understands what is done during a cardiac catherterization Discussing treatment options for a terminal diagnosis Informing members of the health care team that a client has a do-not-resuscitate status. Reporting that a health team member on the previous shift did not provide care as prescribed. Assisting a client to make a decision about his care based on the nurse's recommendations
Verifying that a client understands what is done during a cardiac catherterization Informing members of the health care team that a client has a do-not-resuscitate status. Reporting that a health team member on the previous shift did not provide care as prescribed.
A nurse is serving as a preceptor to a newly licensed nurse and is explaining the role of the nurse as an advocate. Which of the following situations illustrates the advocacy role? Select all that apply. Verifying that a client understands what is done during a cardiac catheterization Discussing treatment options for a terminal diagnosis Informing members of the health care team that a client has a do-not-resuscitate status Reporting that a health team member of the previous shift did not provide care as prescribed Assisting a client to make a decision about his care based on the nurse's recommendations
Verifying that a client understands what is done during a cardiac catheterization Informing members of the health care team that a client has a do-not-resuscitate status Reporting that a health team member of the previous shift did not provide care as prescribed
The nurse is caring for a Chinese patient diagnosed with cancer who is suffering from pain, yet refuses analgesia administration. What type of health disparities is this patient exhibiting? Avoidable and unacceptable Avoidable and acceptable Unavoidable and acceptable Unavoidable and unacceptable
avoidable and unacceptable
The young organization is characterized by low energy and resistance to change. True False
false
Nurses implemented a clinical practice guideline to facilitate assessment and prevention of skin breakdown. A task force reviewed documentation and determined that nurses were turning patients every two hours, utilizing a pressure relief mattress, completing a Braden score every shift, and requesting nutrition consult if the score is 12 or less. What type of audit provided these data? Process Concurrent Outcome Structure
process
An experienced nurse tells the student nurse, "I have found that most Hispanic immigrants live in unsanitary conditions but are hard workers." How should the student nurse best classify this statement? Misinformed Stereotyping Prejudice Discrimination
stereotyping
The manager identified that the census and patient acuity were higher than anticipated in the budget, however, nurse salary costs were as budgeted. These variances are an example of: Positive variances Non productive salary expenditures Efficiency Volume only
Efficiency
What is the best course of action to stimulate the broad participation of employees in quality control efforts? Educate staff about the relationship between the organization's accreditation and their own licensure Encourage regular meetings between middle management and upper management Educate staff about the correct way to document and report sentinel events Engage closely with the front line staff who provide client care
Engage closely with the front line staff who provide client care
The focus of quality health care should be on which of the following items? Select all that apply. Excellent services Comprehensive communication Private hospital rooms Health team collaboration Culturally competent care
Excellent services Comprehensive communication Health team collaboration Culturally competent care
Which branch of government is responsible for the execution of laws passed by legislatures? Legislative Judicial Executive Local
Executive
Cost containment is primarily the responsibility of the health-care organization as a whole. True False
False
For change to be effective, it should be immediate and sweeping. True False
False
The planning process differs depending on the period of time involved. True False
False
Thought leaders attract followers by the promise of representation or empowerment. True False
False
Which is a characteristic of a leader? Always assigned a position of authority Usually part of a formal organization Focus on group process, information gathering, and feedback Focus on decision making and results
Focus on group process, information gathering, and feedback
What are the main features of complex adaptive systems that are relevant to nursing leadership? Select all that apply. Focused on creating organizational change and looking at the whole versus individual parts. Defined by efforts of leadership to mandate organizational change. Autocratic in nature with a top-down structure for change. Dependent on employees knowing what change is necessary and acting independently. Non-linear and dynamic in nature, versus a static process.
Focused on creating organizational change and looking at the whole versus individual parts. Non-linear and dynamic in nature, versus a static process.
Patient care delivery models: Are best used in academic medical centers Are most commonly based on the team model Form the foundation for workforce management goals Are required for Medicare reimbursement
Form the foundation for workforce management goals
A new nurse requires further teaching when failing to identify which practice as a health disparity? Annual mammogram Early prenatal screening Blood pressure screening Frequent fast food meals
Frequent fast food meals
After reviewing her monthly budget report, the nurse manager sees that she has a negative variance, which prompts her to change the staffing schedule. A negative or unfavorable variance in a monthly expense report may result from: Not replacing staff who called in sick. Net revenue exceeding net expenses. Overestimation of inflation Higher than expected client acuity.
Higher than expected client acuity.
A home health nurse is assessing the safety of a client's home. The nurse should identify which of the following factors as increasing the client's risk for falls. Select all that apply. History of a previous fall. Reduced vision. Uses a night light. Impaired memory Kyphosis Takes rosuvastatin
History of a previous fall. Reduced vision. Impaired memory Kyphosis
With the rise in workplace violence in the emergency department, the nurse manager decides that she should work with the risk manager in violence prevention. The nurse manager should: Hold staff accountable for safe practices. Document inappropriate behavior. Request all staff to accept new risk management practices. Hire more police security
Hold staff accountable for safe practices.
a nurse is working on a unit with a blame-free environment, which is the initial action when the nurse makes an error? Make sure no one saw the incident and say nothing If there is a client involved, ensure the client's safety Discuss the situation with the other nurses on duty Report the incident to the supervisor when time permits
If there is a client involved, ensure the client's safety
Before beginning work on a culturally diverse hospital unit, the nurse should perform which action first? Attend an anti-discrimination rally or march Build rapport and trust with the patients Improve self-awareness of one's own biases Take a foreign language course
Improve self-awareness of one's own biases
Advocating against implementing a new hospital computer system is an example of which type of planning? Reactivist Inactivist Preactivist Proactivist
Inactivist
Within a healthcare environment, where the gap between revenues and costs can mean the difference between the sustainability of an organization and unsustainability of an organization or services, it is critical for nurse managers to: Maintain a clear vision of how to trim healthcare costs. Consistently delete programs that are of high cost. Implement programs that bring in additional revenues. Balance value-added services against costs and revenues.
Balance value-added services against costs and revenues.
An organization has hired six RNs who have recently immigrated to the United States. The manager has noticed they interact very little with other staff, often speaking in their own language during their breaks, although they speak English while on duty. Which intervention would be the most helpful action for the manager to help these new RNs better assimilate? Ask the established RNs to make an effort to include the new nurses in after-work activities Explain to the new nurses the problem that their isolating is causing Arrange to send them to an English language course at the local adult school Begin a short sharing session before client report, so all RNs can share information about their cultures and differences in client care
Begin a short sharing session before client report, so all RNs can share information about their cultures and differences in client care
A manager has proposed to the director that charge nurses are paid to attend management and leadership classes. What is this an example of? Using emotional intelligence Building human capital Using quantum leadership Transactional leadership
Building human capital
A nurse is participating in a quality improvement study of a procedure frequently performed on the unit. Which of the following information will provide data regarding the efficacy of the procedure? Select all that apply. Incidence of complications related to the procedure. Frequency with which the procedure is performed. Client satisfaction with performance of procedure. Accurate documentation of how the procedure was performed..
Incidence of complications related to the procedure. Client satisfaction with performance of procedure. Accurate documentation of how the procedure was performed.
Which is the best strategy the nurse manager should include when working to reduce health care disparities in a medical-surgical unit? Less diverse workforce Authoritarian leadership Annual staff training Increase interpreter availability
Increase interpreter availability
A healthcare provider whose native country is India is explaining the treatment plan to a patient. The patient tells the nurse she is having trouble understanding the provider but is embarrassed about asking to repeat the information over and over. The nurse should assess for which results due to this disparity in provider-patient communication? Select all that apply. A. Optimal health outcomes B. Increased patient confidence c. Poor adherence d. Improved communication e. Patient Dissatisfaction
C. poor adherence e. patient dissatisfaction
The nurse who is certified as a Critical Care Registered Nurse (CCRN™) represents the unit on the organizational performance improvement team. This is an example of which type of leadership? Formal System Informal Unit
Informal
Which is an example of the regulatory power to make law? Institute of Medicine (IOM) defining the approximate number of medication errors that result in significant patient harm or death. Centers for Disease Control and Prevention (CDC) developing recommendations for childhood immunizations. Centers for Medicare and Medicaid Services (CMS) enacting rules for restraint and seclusion for participating hospitals. Joint Commission establishing a medication reconciliation standard.
Centers for Medicare and Medicaid Services (CMS) enacting rules for restraint and seclusion for participating hospitals.
What is the focus of thought leadership? Keeping up with current nursing knowledge Challenging the status quo Learning new technology Being a transactional leader
Challenging the status quo
Two nurses are discussing health care quality. They agree that this event contributes to increased health care quality. Magnet status hospitals Fewer adverse events Collaboration of multiple health care agencies Increased patient education
Collaboration of multiple health care agencies
A balanced scorecard is used to (Select all that apply.) Collect data Gain clients Develop metrics Analyze data None of the above
Collect data Develop metrics Analyze data
Which of the following allows for greater staffing flexibility? Communicating among staff members Maximizing the availability of nursing staff A high RN-skill mix Overlapping shift handover
Communicating among staff members
What are the major attributes of health care quality? Select all that apply. Conforms to standards Sound decision making High acuity patients Low health care costs Identifies adverse events
Conforms to standards Sound decision making Identifies adverse events
