Week 5 Reading Quiz

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Question #1

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

C testing should not be done in the lab.

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

Question #2

Which of the following indicates safe delegation?

A The nurse supervisor asks the head nurse for Unit A to make do without a replacement for an ill staff member because Unit A was originally overstaffed anyway. Patient acuity levels are very high on Unit A and two staff are orientating.

B The nurse supervisor asks the charge nurse on Unit B to cover Unit F, which is two floors up, because the charge nurse for Unit F is ill. The charge nurse for Unit B is an experienced manager but has no experience with the nursing care required on Unit F.

C The nurse supervisor for a large urban acute care department asks the unit manager to accept two new acutely ill patients, which the manager does. The unit is short two staff, and the replacement is inexperienced.

D A unit manager agrees to release a staff from her unit to Unit B. The staff member she agrees to release is experienced on Unit B and is agreeable to the change. The unit manager’s unit is fully staffed and patients are stable.

Question #3

As a nurse manager in a for-profit hospital, you are interested in promoting teaching programs for physicians, because evidence suggests that hospitals with teaching programs tend to promote better care for patients. Your administration indicates that it cannot support your ideas or proposal because of:

A potential damage to reputation through learner error, increased salary costs

B increased salary costs, duplication of tests and procedures, graduate medical education

C increased salary costs, duplication of tests and procedures, potential damage to reputation through learner error

D duplication of tests and procedures, potential damage to reputation through learner error

Question #4

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

A select the least expensive brand.

B use a decision-making tool to evaluate brands.

C select the vendor the institution usually buys from.

D ask the nursing staff which brand they prefer.

Question #5

The chief nursing officer is given the task of reviewing and proposing revision of the organization’s mission, philosophy, and technology. In reviewing them, the chief nursing officer understands that they should be reflected in:

A the policies and procedures.

B government regulations.

C line and staff responsibilities.

D the organizational structure.

Question #6

A facility that provides care for patients whose average length of stay is less than 30 days and to patients whose average length of stay is longer than 30 days, and who require inpatient and ambulatory care for addictions, through a spectrum of wellness and illness services and providers, would be considered:

A rehabilitative.

B long-term care.

C a tertiary care institution.

D a healthcare network.

Question #7

You are hired as a new manager. When the offer of employment is made, you agree to at-will employment. Later, you become very concerned about the policies and practices of your organization and their impact on patient care. You speak with your supervisor several times about your concerns, but no action is taken. In considering your next steps, you:

A consider your increased vulnerability under the terms of your employment.

B are more likely as a leader to take action because you are well protected from repercussions by federal and state regulations.

C contact your union to discuss your concerns and review your options.

D recognize that your supervisor is more vulnerable than you are because of her more senior position.

Question #8

What has the literature on oppression in nursing demonstrated?

A Failed to establish that oppression is present in nursing groups.

B Indicated that nurses use oppression negatively.

C Verified the presence of behaviors associated with oppression within nursing.

D Suggested that oppression leads to bullying but has little or no effect on patient outcomes.

Question #9

When interviewing an applicant for an RN position, the nurse manager describes the unit’s care delivery system as one in which the nursing assistants are cross-trained to perform specific tasks and the RNs complete all treatment, medication administration, and discharge teaching. The nurse applicant knows this nursing care delivery strategy to be:

A functional nursing.

B the case method.

C nurse case management.

D primary nursing.

Question #10

A nurse manager is experiencing poor staff morale on her unit. While participating in a baccalaureate course, the nurse manager had learned that one of the reasons nurses lack power today is related to the past. In the early decades of the profession, nurses lacked power because:

A the first nursing licensure laws prohibited nurses from making most decisions.

B women lacked legal, social, and political power because of legal and cultural barriers.

C nurses freely chose to defer to physicians and administrators with more education.

D nurses astutely recognized the risks of grabbing too much power too soon

Question #11

Your organization has made a decision to implement TCAB in your hospital. As a manager, what strategies would you use to implement TCAB?

A Encourage recognition among staff of their knowledge of the patient-care environment. With staff, select small changes for consideration. Present ideas based on best practices and ask staff for advice on implementation.

B Select only projects that have widespread impact. Secure external advisors to evaluate innovation. With staff, select small changes for consideration.

C Encourage recognition among staff of their knowledge of the patient-care environment. With staff, select small changes for consideration. Select only projects that have widespread impact.

D Select only projects that have widespread impact. Secure external advisors to evaluate innovation.

Question #12

On Unit 62, the nurses and the unit manager have been involved in shared decision making related to the model of nursing care delivery that the unit will adopt. All individuals have participated and been involved in decision making and implementation of changes. When issues arise during implementation, it is expected that:

A accountability resides entirely with the unit manager.

B individual expertise will be utilized to provide solutions, but that responsibility for the change is shared.

C this will contribute to widespread skepticism among the staff about the probability of success.

D no one really has any accountability or responsibility for the changes.

Question #13

The case method of care delivery could be best justified in which of the following scenarios?

A Home healthcare environment with patients at varying levels of acuity

B Stable patient population with long-term care and family needs

C Pediatric intensive care unit that heavily involves families as well as patients

D Acute care surgical unit with predictable postsurgical outcomes and many technical procedures

Question #14

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 of unlimited capacity when shared with others.

C directed primarily toward those who are subordinate to her.

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

Question #15

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 creating professional practice climates in their institutions.

C representing them in labor-management disputes.

D negotiating employment contracts.

Question #16

The maintenance department wishes to have the nursing lounge renovated, so the lounge will be more “user-friendly.” The department asks the nursing staff to make a wish list of everything that they would like to see in the new lounge. This process is an example of which part of the decision-making process?

A Data interpretation

B Assessment/Data collection

C Planning

D Generating hypotheses

Question #17

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

B implement a patient-classification system immediately.

C provide increased numbers of staff to the unit.

D ignore such concerns because acuity is variable.

Question #18

Scheduling is a function of implementing the staffing plan by assigning unit personnel to work specific hours and specific days of the week. To retain nursing staff, the nurse manager must incorporate into the schedule plan:

A a variety of scheduling options.

B all holidays off.

C rotating shifts.

D all weekends off.

Question #19

The nursing manager of a surgical unit has been asked by administration to evaluate client outcomes post cardiac catheterization. Using data about client outcomes post cardiac catheterization for the past 6 months in order to modify practice is an example of:

A meeting standards.

B evidence-based practice.

C information.

D cost-effective care.

Question #20

As the unit manager, you post the staffing plan and compliance reports. This initiative is aimed at:

A maintaining unit morale.

B demonstrating patient outcomes.

C inviting staff participation in decision making.

D complying with national requirements.

Question #21

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 unit.

B patient.

C staff.

D department.

Question #22

To effectively delegate in a team nursing environment, the RN team leader must be familiar with the legal and organizational roles of each group of personnel and must:

A adapt in communicating information to her supervisor.

B build relationships with physicians.

C be able to effectively communicate with patients.

D be able to adapt to daily changes in staffing.

Question #23

What patients would most likely be covered under Medicare?

A Karen, a housewife, 45 years of age, whose husband recently abandoned the family

B Dan, who is 68 years of age and in good health

C Alysha, who is on social assistance and has a 5-year-old daughter with frequent ear infections

D Jim, who lives on the street and has occasional infections

Question #24

A nurse belongs to several professional organizations, serving on a state-level committee of one group and on two task forces at work. The nurse is committed to a range of health issues and knows the state senator from the nurse’s district, as well as the name of the representative in Washington, DC. This nurse exemplifies which level of political activism in nursing?

A Self-interest

B Gladiator

C Buy-in

D Political astuteness

Question #25

Nurses who engage in infighting, seek physician support against nursing colleagues, and avoid political advocacy through membership in nursing organizations:

A refuse to believe that they are acting like members of groups that suffer socioeconomic oppression.

B suffer from learned helplessness as a result of abuse by powerful nurse executives.

C purposefully choose to exercise their power in the workplace through indirect means.

D do not understand how their failure to exercise power can limit the power of the whole profession.

Question #26

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 is decreased.

B is increased.

C is relinquished.

D remains the same.

Question #27

A nurse manager uses many sources of data when planning the unit’s workload for the year. Which of the following data must be considered in the planning?

A Maximum work stretch for each employee

B Weekend requirements

C Trends in acuity on the unit

D Hours of operation of the unit

Question #28

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 Chaos theory.

B bureaucratic organization.

C transformational leadership.

D transactional leadership.

Question #29

In a job interview for a staff position, which of the following indicates your knowledge of patient safety?

A “I see no reason why I wouldn’t be able to work overtime.”

B “Is there a strategy in place to reduce the number of overtime hours on the unit?”

C “If there is an opportunity to work extra shifts, I would really like that.”

D “Will I be able to get overtime hours on your unit?”

Question #30

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 profession.

B flexible discipline.

C career with off and on ramps.

D occupation.

Question #31

As a nurse manager in a hospital, you would expect what to be the major contributor to funding and revenues in your organization?

A The federal government

B Medicare

C Blue Cross/Blue Shield

D Medicaid

Question #32

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

A 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.

B 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.

C 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.

D 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.

Question #33

County Hospital has position descriptions for all staff, including RN Team Leaders. Sarah, a team leader on the rehab unit, assesses the needs of the patients in her area, assesses the skills and backgrounds of each of the individuals on her team, and then assigns and delegates the appropriate care provider to each patient and task. Sarah’s activity in the example described is termed:

A active delegation.

B passive delegation.

C passive accountability.

D active responsibility.

Question #34

The number of adverse events such as falls and pressure ulcers on the unit is increasing. An ideal staffing plan to address this issue would include which of the following? Increasing the:

A total number of staff and implementing 12-hour shifts.

B number of RNs and number of RNs with experience on the unit.

C total number of staff on the unit.

D staff and RN hours per patient.

Question #35

Justin is a nurse manager in a rehabilitation unit in a small urban center. There is a high turnover rate among rehab-assistants because of the heavy work assignments. Despite his need for staff, Justin decides to review each application thoroughly and interview candidates carefully because he recognizes that it is important to hire staff who can best provide high-quality care and who will fit well with the team. Which of the following decision-making models did Justin use in making his decision?

A Optimizing model

B Objective model

C Subjective model

D Satisficing model

Question #36

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 Ancillary

B Staff position

C Hierarchical position

D Line position

Question #37

A home health nurse has been assigned to cover a 300-square-mile area of remote Montana. Mrs. Baker has just been discharged home following bowel surgery and has a new colostomy. She will need daily contacts for at least 2 weeks and then regular weekly contact following that week. Because it is not possible to visit Mrs. Baker in person every day and see all of the other clients, the nurse gives her a laptop computer with net meeting software installed. Each morning, both dial in at an agreed-upon time and discuss her progress. The home health nurse assesses whether or not the client needs to be seen that day and is able to view the colostomy site. This type of technology is called:

A knowledge software.

B biomedical technology.

C telecommunications.

D distance learning.

Question #38

Several nurses on an adolescent psychiatric unit complain that the teens are becoming unmanageable on the 0700-1900 shift. To resolve this problem, the nurse manager decides that the staff should have a brainstorming session. The goal of brainstorming is to:

A identify only practical and realistic ideas.

B critique the ideas of others.

C evaluate problem solutions.

D generate as many solutions as possible.

Question #39

A nurse manager questions the true difference between primary nursing and total patient care. After careful consideration of both models, the nurse manager concludes that primary nursing differs significantly from total patient care in:

A levels and types of assessment.

B intention to provide holistic nursing.

C breadth of nursing knowledge and expertise required.

D degree of task orientation.

Question #40

You are the nurse manager for a not-for-profit health service for the homeless and for drug users in an impoverished neighborhood. As the manager, your concern about sustainability is related to:

A decisions of the public board.

B the possibility of violence.

C an increase in uncompensated care events.

D an increase in prescription drugs available for abuse.

Question #41

What would be the most appropriate focus in developing a business plan for a nurse-owned home healthcare service?

A Reduction of falls among seniors

B Pain management for patients with low back pain

C Programs to educate the community on preparing healthy meals for a limited cost

D Reduction of injuries from alcohol-related accidents

Question #42

The nurse case manager is working with a client admitted for end-stage renal disease. The case manager’s major goal during this hospitalization for this patient is to:

A prevent additional hospitalizations resulting from complications of the client’s disease.

B provide direct nursing care throughout the hospitalization.

C implement the care pathway on admission.

D supervise the nursing staff members who implement the care map.

Question #43

Leaders in nursing must advocate for information and knowledge systems that support nursing practice. This is best accomplished by:

A requesting budgetary funds needed for systems.

B participating in organizational information technology committees.

C submitting written requests for needed information systems.

D sending staff nurses to conferences that discuss cutting-edge technologies.

Question #44

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 Incorrect problem identification

B Not using a problem-solving model

C Not considering a number of alternatives

D Poor evaluation of outcomes

Question #45

With the help of a federal grant, the local school nurse has established a spreadsheet that contains relevant nursing data so that she can analyze children’s health. School health programs are:

A providing only health education programs for children and their parents.

B capable only of providing referrals for health problems to primary care providers.

C funded exclusively by local authorities.

D increasingly seen as primary care sites for children.

Question #46

Organizational culture includes:

A behaviors, traditions

B norms, traditions

C behaviors, values

D norms, traditions, behaviors, values

Question #47

Government and third-party payers announce reduction of compensation for the delivery of patient services. Hospital STV has a flat organizational structure. After the funding announcements, senior officials at the hospital meet and make decisions regarding cost containment of new revenue streams. This action is consistent with:

A the practice of leaving financial decisions with senior officials who understand the total context of funding.

B a need to make expedient decisions that are likely to be poorly received by staff.

C ensuring that decisions with regard to cost are made equitably across all departments.

D a tendency to concentrate decision making during economic downturns at the top administrative level.

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 staffing models.

B changes in services that will be offered.

C organizational staffing policies.

D department of Health licensing standards.

Question #49

At a newly built outpatient surgical center, an integrated information system has been purchased. The chief nursing officer creates a series of staff development classes to orient the staff to this new system. One of the advantages of an integrated information system is that client-care data from all sites can be stored in and retrieved from a:

A nurse expert system.

B nursing information system.

C central data repository.

D handheld device.

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