Week 7 Reading Quiz

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Question #1

As a result of Amy’s coaching, Sarah, a nursing graduate of 5 years, completes a ROLES assessment. This assessment is helpful in:

A identifying her clinical knowledge, areas of conflict in expectations and role development

B identifying her clinical knowledge, areas of conflict in expectations and expected work time commitments.

C role development, areas of conflict in expectations and expected work time commitments

Question #2

As a nursing leadership student, you have had the opportunity to develop a palliative care manual that will be utilized by the palliative care network (PCN) in your region for teaching healthcare professionals. The PCN has requested that you provide a prioritized plan of action for marketing the manual on a regional and state basis. What is the first priority?

A Communicate benefits to the target group.

B Package the product.

C Motivate the target market.

D Research the target market.

Question #3

Patient perceptions are useful in:

A establishing blame for poor-quality care.

B providing one source of data for QI initiatives.

C establishing the competitive advantage of QI decisions.

D determining disciplinary actions in QI.

Question #4

Sarah is a nursing graduate of 5 years who is very confident in her clinical skills. She has taken some certificate courses in leadership and management and has considered beginning a graduate degree with this focus. She is excited about being able to use her knowledge and interest by being hired as a nurse manager. Before beginning her new position, Sarah spends time with her nurse executive to clarify the executive’s expectations of her and of the unit that she has been hired to manage. Sarah finds that she is comfortable with the expectations of staff and her supervisor regarding her management role and responsibilities and has been able to effect a strong commitment to quality clinical care on the unit. At this point, Sarah has likely attained this role:

A acceptance.

B development.

C internalization.

D symmetry.

Question #5

Elizabeth is an example of a(n):

A late majority.

B early adopter.

C resister.

D laggard.

Question #6

John, a new graduate, reviews the employee evaluation for his new position. The first section requires that he list his own specific objectives to be accomplished. This is an example of:

A the traditional rating scale.

B a forced distribution scale.

C learning goals, or management by objectives.

D a behavior-anchored rating scale.

Question #7

A nurse is explaining the pediatric unit’s quality improvement (QI) program to a newly employed nurse. Which of the following would the nurse include as the primary purpose of QI programs?

A Determination of the appropriateness of standards

B Evaluation of staff members’ performances

C Improvement in patient outcomes

D Preparation for accreditation of the organization by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO)

Question #8

The wound care nurse decided to involve those to be affected by change early in the change management process. This can positively result in:

A resistance.

B anticipation.

C participation.

D coordination.

Question #9

A nurse manager notices that Nathan, an RN who has been on the unit for approximately 3 years, has an interest in health technology and seems to be very enthused about working with software and hardware at home. She speaks with Nathan and asks him if he would lead investigation of software applications on the unit. This is an example of:

A role transition.

B opportunity.

C delegation.

D role negotiation.

Question #10

Shifts such as changes in the percentage of seniors in the population, governmental initiatives in health care, and the influence of income on health status are factors in the __________ environment.

A social

B macro

C competitive

D public

Question #11

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:

A higher than expected client acuity.

B not replacing staff who called in sick.

C overestimation of inflation.

D net revenue exceeding net expenses.

Question #12

As the unit manager, you spend a day performing direct patient care and work with a new system that is designed to capture patient documentation at the bedside. During discussions with staff while giving care, you discover that the number of screens that need to be opened during documentation makes charting more complex and time consuming than traditional manual charting approaches. On the basis of this feedback, you:

A provide reassurance to staff that the unit has achieved its goals in implementation of the system.

B ask some of the staff if they have had similar experiences with the system.

C assume that the system is doing what it needs to do.

D consult chart audit data and end user consultation reports to determine if errors and problems are occurring.

Question #13

Sarah is a nursing graduate of 5 years who is very confident in her clinical skills. She has taken some certificate courses in leadership and management and has considered beginning a graduate degree with this focus. She is excited about being able to use her knowledge and interest by being hired as a nurse manager. Before beginning her new position, Sarah spends time with her nurse executive to clarify the executive’s expectations of her and of the unit that she has been hired to manage. Sarah finds that she has begun to think negatively about the way nursing care is delivered on her nursing unit. She often wishes that she was back on her old unit and in her familiar staff nurse role. This behavior:

A reflects Sarah’s astuteness as a clinician.

B is justified if practices are deficient on the new unit.

C diverts energy from internalization of Sarah’s new role.

D is natural when assuming a new position.

Question #14

The unit leader on an inpatient psychiatric unit of a large hospital has been in the position for 3 months. The unit leader is frustrated by how little time is available to work with clients and how few changes have been implemented in that time. The phase of role transition being experienced is the role of:

A internalization.

B negotiation.

C acceptance.

D discrepancy.

Question #15

The mediator suggested to the unit staff that a group agreement needed to be made so meetings could become productive. For example, the group agreement, “We will speak supportively,” prevents:

A votes that oppose motions.

B expression of opposing ideas.

C efforts to ensure that everyone thinks alike.

D gossip and making negative comments about absent team members.

Question #16

The new nurse manager feels pulled between the expectations of staff, the demands of hospital administrators, and family obligations. According to the theory by Hardy (1978), unrelieved role stress and strain will lead to:

A physical symptoms and acute illness.

B alienation of family and friends.

C frustration and anger.

D low productivity and performance.

Question #17

When goals/outcomes are somewhat unclear in early preparation for a complex change, the manager and the change management team develop several acceptable goals/outcomes. This change in management approach is termed:

A cybernetic.

B linear.

C nonlinear.

D unfreezing.

Question #18

Healthcare organization X is committed to improving patient outcomes and, as part of the QI process, examines its executive structure and organizational design. This approach recognizes:

A that structure influences nurse burnout and participation in quality improvement initiatives.

B that a narrow hierarchy ensures accountability for errors and outcomes.

C the need to ensure sufficient supervisory staff to respond in a corrective manner when mistakes occur.

D the importance of decentralized structure in QA.

Question #19

A survey of staff satisfaction is conducted. The survey indicates that staff members are satisfied, are loyal to the organization, and feel that they have reasonable control in their individual responsibilities. The findings best exemplify:

A satisfaction but not empowerment.

B clarity in roles and valuing of contributions.

C role attachment.

D effective coaching of new staff.

Question #20

Assessment of the needs of the consumer or client (in developing a strategic marketing plan) focuses on:

A present and future needs.

B present needs only.

C secondary analysis of existing data.

D the development of surveys.

Question #21

Anecdotal notes:

A can be used to support and justify fairness in termination discussions.

B should be completed only when there are performance concerns.

C are unnecessary if the evaluation instrument is thorough.

D need to be completed at the end of a performance period.

Question #22

As the unit manager on the unit that is leading changes to heparin locks, you find that Elizabeth is very valuable in terms of her observations about other units and her knowledge of organizational processes, and now in discussing the new procedure with others. Elizabeth might be considered an:

A engager.

B innovator.

C informal change agent.

D informant.

Question #23

To engage your staff in awareness of their current practice and how it is affirmed or not by evidence, you plan a short series of learning presentations on evidence and use of heparin and saline to maintain IV patency. You meet with the educator to plan out the goals for each session with the overall purpose of increasing knowledge and awareness of staff in readiness to consider questions related to the IV practice. This learning approach is an example of which change management approach?

A Facilitative

B Integrative

C First-order

D Linear

Question #24

The nurse manager used a mediator to help resolve conflicts on the unit. During the mediation process, the nurse manager saw signs of potential team building. One key concept of an effective team is:

A a designated leader.

B commitment.

C task clarity.

D conflict.

Question #25

Which of the following would not be a characteristic of an effective team nurse leader?

A A genuine interest in team members

B Awareness of everyone’s abilities

C Excellent communication skills

D An autocratic perspective

Question #26

A nursing-led classification system that has led to greater reliability and standardization in data utilized for QI processes is:

A NIOSH.

B AHRQ.

C NANDA.

D nursing process.

Question #27

To conduct assessment of the internal environment, the strategic planning team for Pacific Hospital:

A discusses what it sees as the primary threats and opportunities in demographic shifts affecting the hospital.

B asks the board to provide a summary of major opportunities for the future.

C invites all levels of staff to focus groups on the effectiveness of the hospital environment, including information systems and staffing.

D invites community members and staff of the hospital to an evening focus group session.

Question #28

The nurse gives an inaccurate dose of medication to a patient. After 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:

A the error will be documented in her personnel file.

B risk management programs are not designed to assign blame.

C the error will result in suspension.

D an incident report is optional for an event that does not result in injury.

Question #29

You anticipate that your region will soon move toward an e-health record system. You begin to discuss this with your staff and are disappointed that you receive little positive response from the staff about this possibility. One staff member, in particular, seems to sum it up by saying “e-health? Won’t happen in my working life! There are too many problems with it, like privacy issues.” This response is most likely motivated by:

A lack of organizational support for change.

B lack of evidence to support importance of technology.

C lack of urgency regarding the need to change.

D deficits in education and experience.

Question #30

Seth is hired as the nurse manager for a surgical unit. After a year, the hospital reorganizes, and his position is lost. In leaving the unit, it is important for Seth to:

A engage in clarifying why the hospital did not state its expectations for the unit at the time of hiring.

B hire a lawyer to represent his interests during this unexpected role transition.

C negotiate a reasonable settlement.

D seek counseling to deal with his shock and anger.

Question #31

The chief nursing officer works with her nurse managers by helping them understand how to develop and implement a budget. A nurse manager can best describe a budget as a:

A day-to-day plan for operations.

B unit of service.

C financial plan.

D statement of revenues and services.

Question #32

As an experienced nurse manager who is new to an organization, it would be important to:

A know why a budget is essential to the well-being of an organization.

B understand the budget timetable and level of involvement expected of individual managers in budget preparation.

C know the difference between operating and capital budgets.

D understand what factors drive up healthcare costs in the healthcare system.

Question #33

The reasons cited by nursing administrators for not planning in a systematic manner include:

A lack of understanding of the planning process.

B not enough hours in the day for both day-to-day operations and planning.

C lack of knowledge regarding the internal and external operations of the organization.

D delegation of the task to subordinates.

Question #34

An example of one strategy to improve participation in the change process by staff fitting the behavioral descriptions of laggards, early majority, late majority, and rejecters is to:

A encourage teamwork.

B transfer to a different unit.

C delegate the roles and tasks of change.

D require attendance at staff meetings.

Question #35

The outcome statement “Patients will experience a ten percent reduction in urinary tract infections as a result of enhanced staff training related to catheterization and prompted voiding” is:

A physician-sensitive and nonmeasurable.

B patient care–centered and nonmeasurable.

C measurable and nursing-sensitive.

D precise, measurable, and physician-sensitive.

Question #36

Which of the following might best conclude an interview?

A “We have several excellent candidates so I am not sure about the outcome of the interview, but I will let you know. Thank you for coming.”

B “Before you go, we will make sure that we have your contact information. Thank you for coming.”

C “Thank you for your interest. Someone will be in touch with you soon.”

D “I will be in contact with all candidates by telephone by next Friday. It has been a pleasure to meet you.”

Question #37

Which of the following factors is not implicated in rising healthcare costs?

A Marketing of drugs to consumers

B Rising expectations of consumers for cure and care

C Rising Medicare costs

D Large administrative staffs to process medical billings

Question #38

The new head nurse on telemetry has been in the position for 3 months. The head nurse and the administrator disagree on how much time the head nurse should allot to various aspects of the role. Staff members on the unit complain that the head nurse is unavailable for clinical concerns because of being off the unit while attending meetings. To facilitate the process of role transition, the head nurse should:

A decide to give the position 3 more months and then leave if things do not improve.

B attend a workshop on how to deal with difficult people.

C develop policies consistent with the head nurse’s prior workplace.

D schedule a series of meetings with staff and the administrator to clarify expectations.

Question #39

The SBAR system of communications is one of the most used communication systems in health care because:

A it honors an unstructured transfer of information.

B the nurse is on the same communication level as administration.

C it honors a familiar, structured transfer of information among health professionals.

D it deals with all aspects of communications in patient care except communication with the physician.

Question #40

Sarah is a nursing graduate of 5 years who is very confident in her clinical skills. She has taken some certificate courses in leadership and management and has considered beginning a graduate degree with this focus. She is excited about being able to use her knowledge and interest by being hired as a nurse manager. Before beginning her new position, Sarah spends time with her nurse executive to clarify the executive’s expectations of her and of the unit that she has been hired to manage. After beginning her new position, Sarah finds that she spends a great deal of time in direct patient care. Her staff begins to complain that they are never able to find her when they need her, and that some aspects of her responsibilities fall behind, such as scheduling. Sarah is most likely:

A attempting to prove her clinical skills to the nursing staff.

B lacking an understanding of the nurse management role.

C lacking enjoyment in her new role.

D experiencing difficulty in unlearning old roles.

Question #41

Based on Elizabeth’s insights and suggestions, you involve pharmacy, only to discover that the change in practice involves practice committees, a medical practice committee, and concerns from administration about potential costs and safety of the proposed change to the IV protocols. The change process at this point is:

A neutralized.

B nonlinear.

C linear.

D sabotaged.

Question #42

During an employment interview for the manager’s position in a home health agency, the applicant asks questions about the medical director and about retention of staff. The nurse executive assures the applicant that the agency has few personnel problems and receives excellent support from the medical director. The applicant knows that the agency has a 50% turnover rate and has had three medical directors in the past year. The nurse executive is:

A lying about the problems and hoping to resolve them by hiring the applicant.

B unaware of the turnover rate and difficulties with the medical director.

C denying that the agency has a turnover problem with staff or medical directors.

D minimizing the challenges of the position to make a positive impression on the applicant.

Question #43

A nurse manager in the ICU works with his staff to develop an appraisal instrument that includes quantitative data and respects standards for an RN working on that unit. This type of appraisal is a:

A behaviorally anchored rating scale.

B narrative instrument.

C collaboratively based appraisal system.

D rating scale.

Question #44

With the rise of violence in the psychiatric department, the nurse manager decides that she should work with the risk manager in violence prevention. The nurse manager should:

A hold staff accountable for safe practices.

B request all staff to accept new risk management practices.

C document inappropriate behavior.

D hire more police security.

Question #45

A nurse manager is planning to request three new infusion pumps at a cost of approximately $1500 each. This item would typically be included in which budget?

A Strategic

B Operating

C Capital

D Unit of service

Question #46

A nurse manager is experiencing conflicts between herself and staff members. She had tried to develop a team by using a shared leadership model to empower the staff. Staff members are functioning:

A interdependently.

B as a group.

C as a team.

D independently.

Question #47

The state of being emotionally impelled, demonstrated by a sense of passion and dedication to a project or event, describes:

A control.

B communication.

C willingness to cooperate.

D commitment.

Question #48

The nurse educator of the pediatric unit determines that vital signs are frequently not being documented when children return from surgery. According to quality improvement (QI), to correct the problem, the educator, in consultation with the patient care manager, would initially do which of the following?

A Document which staff members are not recording vital signs and write them up.

B Talk to the staff individually to determine why this is occurring.

C Have a group of staff nurses review the established standards of care for postoperative patients.

D Call a meeting of all staff to discuss this issue.

Question #49

A community-based pain management program is being planned for your region. As a coordinator of a home care agency, you have been requested to develop a conceptual framework, mission statement, philosophy, and objectives for the program. In what order will you pursue this endeavor?

A Philosophy, objectives, and mission statement

B Objectives, philosophy, and mission statement

C Mission statement, philosophy, and objectives

D Philosophy, mission statement, and objectives

Question #50

The final section of a performance appraisal is a rating scale. This scale is very detailed and relates to competency standards specific to surgical clients. The scale is a summary of performance directly observed or documentation reviewed and is specific to client care situations in which the employee has been involved. This type of evaluation is most commonly known as:

A a behaviorally anchored rating scale.

B a traditional rating scale.

C management by objectives/learning goals.

D a forced distribution scale.

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