Week 5 Reading Quiz

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Question #1

A necessary, basic condition for successful integration of clinical information systems is:

A software.

B standard medical nomenclature.

C strong interdisciplinary cultures.

D confirmatory evidence from nursing-led studies.

Question #2

To project staffing needs and to avoid understaffing, it is important that nurse managers consider which of the following?

A Maximum productive hours

B Minimum benefit hours

C Average nonproductive hours

D Maximum vacation time

Question #3

Sandra, an RN on the surgery unit, is assisting with a procedure in the patient examination room. The physician orders a medication to be given through IV. Sandra questions the order, based on her knowledge of the patient’s history and of other medications that the patient has been given. The physician reiterates the order and Sandra refuses to give it. In this instance, Sandra is demonstrating:

A accountability.

B autonomy.

C authority.

D best practice.

Question #4

A primary care clinic is established in Pleasantville to provide comprehensive services to infants, children, and families within the community. The executive director of the clinic oversees physician and nursing services for infants, children, and families; a neurodevelopmental clinic; psychology, family counseling, and social work services; nutritional counseling; speech and hearing services; and physiotherapy. This type of organizational structure is known as:

A hierarchical.

B matrix

C service-line.

D bureaucratic.

Question #5

Your colleague Mary, a recent graduate, announces that she intends to leave nursing in 3 to 4 months to pursue a position in marketing. While at your agency, she plans to give patients excellent care and to learn as much as she can, because “Who knows? Nursing is a great job with a great pay and I may return someday.” Mary’s statements most accurately exemplify which orientation to the concept of nursing? Nursing as a(n):

A flexible discipline.

B profession.

C career with off and on ramps.

D occupation.

Question #6

To prepare for the orientation of newly hired nurses, the nurse manager plans a presentation outlining the concept of healthcare networks. Healthcare networks are:

A a feature of all public institutions.

B units that serve large populations.

C owned by the institutions.

D units that provide only primary care services.

Question #7

Which of the following would be most in line with Hersey model and concepts?

A The nursing supervisor asks one of her charge nurses to lead a technology integration project. The supervisor continuously demands involvement in decisions that the charge nurse is making in the project.

B The team of caregivers on day shift are familiar with their roles and with the patients. The nurse manager decides to work on the unit budget in her office.

C After a year of working on the unit, Shari, an LPN, is still hesitant about many policies and procedures. The charge nurse decides to challenge Shari with more difficult patients.

D Team members complain that Alysha, an RN, is unmotivated, and that she refuses assignments that are complex or difficult. The charge nurse suggests that Alysha is relatively new and that she needs time to adjust.

Question #8

The day shift nurse asks an LPN/LVN to complete a task for a patient. The day shift nurse is engaging in what function?

A Assigning

B Sharing

C Authorizing

D Delegating

Question #9

A manager relies on his director (immediate supervisor) for advice about enrolling in graduate school to prepare for a career as a nurse executive. The director may exercise what kinds of power in the relationship with the manager in this advisory situation?

A Expert, coercive, and referent

B Reward, referent, and information

C Referent, expert, and information

D Reward, connection, and information

Question #10

Politics is identified in what areas?

A Found in all social organizations

B Confined to legislatures

C Seen in dysfunctional workplaces

D A representation of self-interest

Question #11

While making rounds, a night supervisor finds a unit with a low census and too many staff members. The night supervisor is performing as a statutory supervisor when he or she:

A recommends transferring a nurse to another service.

B assigns nurses to care for specific clients.

C develops a protocol for unlicensed personnel.

D teaches a nurse to use a new piece of equipment.

Question #12

For a nurse manager in the functional nursing model, an approach that will assist in maintaining staff satisfaction in this specific model is:

A team social events in off hours.

B rotation of task assignments.

C orientation to job responsibilities and performance expectations.

D frequent opportunities for in-service education.

Question #13

Two nurses approach their manager about a conflict regarding the next month’s schedule. The nurses are talking loudly and at the same time. The manager most effectively uses communication skills to resolve the conflict by:

A calling an emergency scheduling committee meeting and asking volunteers to resolve the conflict between the two nurses.

B separating the nurses, instructing each to decide how the problem can be resolved, and meeting with them the next day.

C taking both nurses aside, separately and then together, and charging them with resolving the problem without her direct intervention.

D listening to each nurse speak to the other without interruption and asking clarifying questions to help them resolve the issue themselves.

Question #14

A nurse staffing plan takes into account:

A the occupancy load of a unit.

B specific nurse-to-patient ratios per shift.

C participation of nurses in projecting staffing needs.

D compensation and benefits for each level of staff.

Question #15

A nurse manager is excited by the possible use of speech recognition (SR) systems for documentation of patient care, especially during crisis situations when staff members need to focus on performing rapid assessments and implementation of procedures. She learns, however, that SR systems would be impractical at this point. What would lead to this conclusion?

A SR systems are not available outside pilot projects.

B The hands-free function has not been perfected in SR technology.

C Wireless communications are prone to unreliability in transmission.

D The type of speech required for voice recognition is unlikely to occur in a pressured situation.

Question #16

In reviewing the current delivery model, the nurse manager is aware that a demographic change that will have a significant effect on healthcare delivery systems of the future is:

A the increasing percentage of the population that will be over age 65.

B escalations in the cost of health care.

C increasing reports of violence in the workplace.

D changes in staffing patterns.

Question #17

A strategy to increase RN staff retention at Valley Hospital includes:

A lay-offs of nursing assistants.

B clearer position descriptions.

C adequate staffing to meet acuity levels.

D better compensation and benefits.

Question #18

The chief nursing officer utilizes the hospital’s workplace advocacy to help the overwhelmed Emergency Department staff. Workplace Advocacy is designed to assist nurses by:

A equipping them to practice in a rapidly changing environment.

B representing them in labor-management disputes.

C creating professional practice climates in their institutions.

D negotiating employment contracts.

Question #19

In the Unity Healthcare organization, decisions, including those at the unit level, are made by a group of senior executives. Rules for employees are clear, and nursing care is delineated by procedures and protocols. This exemplifies:

A transformational leadership.

B transactional leadership.

C Chaos theory.

D bureaucratic organization.

Question #20

The Emergency Department staff members are concerned that working long hours without rest puts patient safety at risk. One staff member decides that she will risk her job and become a whistleblower. Whistle-blowing is an appropriate recourse when management:

A delays responding to repeated efforts to provide safe care.

B disregards due process when disciplining a nurse.

C refuses to bargain in good faith with the elected bargaining agent.

D hires nurses who are not a part of the union during a strike.

Question #21

A nurse manager must also consider a number of internal variables that will affect staffing patterns. An internal variable to be considered is:

A consumer expectations.

B American Nurses Association.

C state licensing standards.

D organizational staffing policies.

Question #22

A factor evaluation system:

A utilizes financial data to determine number of staff-to-patient ratios.

B utilizes DRGs to determine acuity on a unit.

C combines interventions and time required for interventions to determine levels of care required.

D combines financial resources and nursing interventions to determine patient contact hours.

Question #23

Lucy, head nurse on the surgical unit, works with her staff to find ways in which they can work together with other disciplines to provide more effective care for patients on the unit. Lucy likely knows her power is:

A restricted, which necessitates finding alternative means to achieve strong patient outcomes.

B limited, thereby necessitating involvement of others in implementing ideas.

C of unlimited capacity when shared with others.

D directed primarily toward those who are subordinate to her.

Question #24

Because of rapid turnover and the ongoing hiring of new graduates, the skill levels of staff in a busy CCU are varied. Senior staff are becoming burned out with the need to provide mentorship and guidance to new staff. As the manager, you propose the addition of a nurse in advanced practice to provide consultation and education for staff. What is this position considered?

A Staff position

B Ancillary

C Hierarchical position

D Line position

Question #25

Nurses in an Emergency Department, in an inner-city neighborhood characterized by high levels of violence, are concerned with low levels of security presence in their department. Security levels have recently been decreased and the nurses question why this has occurred. An appropriate action would be to:

A provide mentors who can help nurses diffuse aggressiveness.

B provide nurses with information about rationale for recent changes in security staffing.

C refer the matter to the head of security and let her deal with it.

D accept the security levels as a consequence of funding realities.

Question #26

A new CEO has been hired at Valley Hospital who proposes to change the centralized organizational structure that was put in place 10 years ago, based on widespread consultation with staff. The proposed structure involves substantial flattening of the organizational structure, with significant decision making being made at the point-of-care and an emphasis on interprofessional collaboration. There is a great deal of discussion about the balance between hospital-wide budget decision making and unit-based decision making. This discussion represents:

A Chaos theory.

B organizational redesign.

C organizational reengineering.

D restructuring.

Question #27

You are in the process of designing a patient education program that will provide education and monitoring for patients with hypertension. To support your planning, you draw out and present patient data from:

A Internet sources.

B a clinical database.

C e-mail.

D biomedical technologies.

Question #28

A staff nurse asks the nurse manager for a few days off for personal reasons. The nurse manager turns in the request to the human resources office with a note indicating that the staff nurse has demonstrated excellent working skills and is a valued employee. The nurse manager has used the influence of her position to help this staff member. Influence is the process of:

A empowering others.

B using power.

C moving past apathy.

D understanding power.

Question #29

The charge nurse is making patient assignments for the next shift on the unit. There is one critical patient on the unit, who is going to require more care than the other patients. Before delegating this patient in an assignment, what is the appropriate action by the charge nurse?

A Delegate the admission assessment to the LPN.

B Review the employee’s performance assessment for the most recent period.

C Create a task analysis of critical behaviors for the individual.

D Assess the amount of guidance and support needed for the nursing care of the patient.

Question #30

In looking at an organizational chart for her institution, Jennifer notes that nursing is led at the senior level by a non-nurse executive. Jennifer expresses concern that this is a reflection of how nursing is viewed within the organization. Jennifer’s comments reflect:

A the dissatisfaction that occurs when lack of autonomy is given to nurses.

B concern with the nonadvancement of nursing practice in the institution.

C an awareness of how organizational culture is reflected in organizational structure.

D a concern that resource allocation will be made on a business and not a professional model.

Question #31

Sarah is a clinical nurse educator in the dialysis unit at Pines Health Center and provides education, consultation, and training support. Sarah has:

A an authority relationship to staff.

B an influence over patient outcomes.

C direct responsibility for patient care.

D direct accountability for patient outcomes.

Question #32

In matrix organizational structures, a nurse manager understands that this type of structure:

A has both a functional manager and a service or product-line manager.

B arranges departments strictly according to function.

C promotes harmony in organizational decision making.

D is a simplified organizational structure.

Question #33

A Magnet® hospital surveys the staff about job satisfaction. This type of environment, in which nurses have authority and autonomy, is linked with:

A client satisfaction with the healthcare organization.

B sophisticated academic health sciences universities.

C private, specialty organizations in urban areas.

D organizations with a limited number of nurse managers.

Question #34

You ask Evelyn, a new UNP, to check what is left in Mrs. N.’s inhaler when Evelyn makes visits to Mrs. N. and also to check whether Mrs. N. is receiving any positive effect from the medication. Evelyn reports for 3 weeks that Mrs. N. is using the inhaler and that there is enough medication left in the device. The day of her last visit to Mrs. N., Mrs. N. is admitted to the hospital in severe respiratory distress. When she is admitted, she tells the physician that she has not been using the inhaler for 4 weeks. Determination of Evelyn’s educational preparation and certification is related to the concept of:

A accountability.

B authority.

C role performance.

D assignment.

Question #35

A rural-urban health consortium enables physicians in a rural remote setting to consult with specialists in care through electronic conferencing, which includes consultation using intranet radiology images. This system may be in which phase of electronic medical technology adoption, according to the Healthcare Information and Management Systems Society (HIMSS)?

A 1

B 6

C 3

D 5

Question #36

In transitioning to a primary nursing model, it is important for a nurse manager who enjoys a high level of control over patient care to understand that his or her decision making at the patient care level:

A remains the same.

B is increased.

C is decreased.

D is relinquished.

Question #37

What interaction is MOST consistent with the idea of networking?

A Join a nurse executive interest group to meet other executives for support and for sharing ideas of expertise.

B Suggest that you and a new team member meet after work for coffee to review unit guidelines.

C Meet with the same colleagues daily to have coffee and share concerns about the workplace and stories about colleagues.

D Join an online workplace forum to gain ideas about how to handle workplace conflict.

Question #38

The work group on Nursing Unit 23 is marked by apathy toward the ward’s patients, high absenteeism, open conflict among team members, and high turnover of personnel, including managers. The underlying behavior in this situation may be characterized as:

A anger.

B oppression.

C apathy.

D powerlessness.

Question #39

Staff members on your unit raise concern that there is rising acuity on the unit and lack of responsiveness in addressing these needs through appropriate staffing. They point to increased incidences of adverse and sentinel events on the unit. To address this concern, your hospital organization would do best to:

A implement a patient-classification system immediately.

B ignore such concerns because acuity is variable.

C participate in databases that compare the outcomes and staffing levels versus those of similar institutions.

D provide increased numbers of staff to the unit.

Question #40

An outpatient surgery manager is evaluating new infusion pumps for purchase to use in the operating room. The manager should:

A ask the nursing staff which brand they prefer.

B select the vendor the institution usually buys from.

C select the least expensive brand.

D use a decision-making tool to evaluate brands.

Question #41

John Smith, one of three managers at BSG Labs, drafted a policy that would allow his department to do more testing in his lab. This policy included the times for regular collection as well as a new process for emergency laboratory testing. The policy and procedures were never followed. The reason was that:

A the staff did not believe that the new policy would be effective.

B testing should not be done in the lab.

C the policy was too lengthy and inundated readers with too much detail.

D the policy made decisions for other departments in the company.

Question #42

When confronted with the controversy and the apparent poor morale of the evening staff, the unit manager decided the staff needed to take some time off. He scheduled holidays for the staff without consulting them. A couple of the staff nurses approached the manager and indicated that the problem was not scheduling, but rather the team leader and her patient assignments. What was the unit manager’s first missed step in problem solving?

A Poor evaluation of outcomes

B Incorrect problem identification

C Not considering a number of alternatives

D Not using a problem-solving model

Question #43

As a nurse manager, you have been asked to be part of a design team for health services that have vertical integration. In planning for these services, your team will design a proposal that will:

A plan for the smooth transition of patients from the emergency services department to other units in the hospital.

B cluster like services together, such as outpatient clinics for the care of children with various developmental and medical needs.

C bring together acute care, ambulatory, home care, and palliative care services for the management of patients diagnosed with cancer.

D ensure that funding follows the patient from acute care to long-term care services.

Question #44

As a nurse manager, you have been asked to assist in designing a subacute facility for open heart patients who require further complex care after hospitalization. In setting up the facility, what would require reassessment?

A A local nurse education program asks you if nursing students can gain clinical experience with recovering surgical patients in the facility.

B The facility is an older house that is more than 30 minutes away from the acute care center.

C Patients admitted to the facility must have adequate health insurance to cover the services provided.

D Public funding will be provided to enable care of patients who have an ordinary course of recovery.

Question #45

In a nurse managers’ meeting, strategies for ways to help retain staff are discussed. One strategy for assisting nurses in developing collective action skills is:

A accepting the practice of “going along to get along.”

B spending as much time as possible in clinical settings.

C attending as many workshops as practical.

D taking the opportunity to work with a mentor.

Question #46

Sondra, a new graduate, recently began a position as a registered nurse in a rural hospital, where she is the youngest and newest staff member. Although she has limited experience, she has a strong knowledge base, is confident, and was considered to have strong entry-level skills on graduation. Sondra meets with her former instructor and confides that she is very frustrated that others do not seem to accept her leadership. What might you suggest that would help Sondra to understand what is happening in terms of power and influence?

A Identify the informal leaders on her unit and how they affect care decisions.

B Morale on her unit can be improved by engaging in shared decision making.

C As a new graduate, it is unlikely that she has acquired the experience and knowledge of other staff, including aides and practical nurses.

D Rural settings tend to be closed systems and therefore are, not welcoming of those who are not from their community.

Question #47

In an acute care unit, the nurse manager utilizes the functional nursing method as the care delivery model. The nurse manager’s main responsibility is the needs of the:

A staff.

B unit.

C department.

D patient.

Question #48

A nurse manager must consider a number of external variables when preparing the personnel budget and projecting the unit’s staffing needs. An external variable to be considered is:

A changes in services that will be offered.

B organizational staffing policies.

C staffing models.

D department of Health licensing standards.

Question #49

Your healthcare organization has a decentralized system for scheduling. As part of this process, after you have developed a draft schedule, you may need to:

A seek budgetary approval.

B balance personal schedules against institutional needs.

C submit the schedule to a centralized staffing office for review.

D negotiate the schedule with unit staff.

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