Chapter 10

Question 1

You decide to make it a priority to read the semiannual report by the Institute of Medicine entitled “To Err Is Human.” The report will enhance the care that you provide because it deals with:

a. FDA drugs that have been recalled each year.
b. preventable adverse events and deaths each year.
c. patient safety regarding system failures and human failures.
d. National Advisory Council in Medicine.

Answer 1

B: The report by the Institute of Medicine (IOM) reports that preventable adverse events cause loss of lives INTRODUCTION

Question 2

When developing a strategic plan, the nurse manager is aware that a critical competency for 21st century health care organization is:

a. maintaining costs. c. continuous quality improvement.
b. leadership. d. systems management.

Answer 2

C: Planning for continuous improvement of quality, service, and cost-effectiveness are critical competencies of successful 21st century health care organizations. Leadership in the health care organizations of the 21st century demands competent nurses. Functioning in a leadership role requires an understanding of how systems function. INTRODUCTION

Question 3

A nurse manager is developing the value statement of the principles and beliefs that direct the behavior on the unit. The value statement is consistent with that of the organization and will become the unit’s:

a. mission. c. purpose.
b. philosophy. d. strategic plan.

Answer 3

B: The philosophy of an organization is a value statement of the principles and beliefs that direct the organization’s behavior. The mission is a formal expression of the purpose or reason for existence of the organization. A strategic plan is the sum total or outcome of the processes by which an organization engages in environmental analysis, goal formulation, and strategy development with the purpose of organizational growth and renewal. PHILOSOPHY

Question 4

You are seeking your first nursing position and decide to review the mission statement of each hospital. You realize that each organization’s mission statement addresses which of the following?

a. Providing care c. Educating professionals
b. Promoting research d. Providing quality of care

Answer 4

D: Most health care organizations have mission statements that speak to providing high quality or excellence in patient care. Some mission statements focus on providing care, educating health care professionals, promoting research, and offering community-based activities. ORGANIZATIONAL VISION, MISSION, PHILOSOPHY

Question 5

A nurse manager decides to engage in some strategic planning with the staff that will require the staff to focus on which aspect of the unit?

a. Ethics c. Employees
b. Customers d. Mission

Answer 5

D: The pivotal value of strategic planning is that it requires an organization to focus on its raison d’être, its mission, and to test how its operations are contributing to accomplishing that mission. RELATIONSHIP OF STRATEGIC PLANNING TO THE ORGANIZATIONS MISSION

Question 6

The nurse manager understands that one of the purposes of strategic planning is to:

a. develop a coordinated vision.
b. concentrate on higher productivity.
c. emphasize a marketing strategy.
d. eliminate competitive threats.

Answer 6

A: The purpose of a strategic plan is twofold. First, it is important that everyone has the same idea or vision, and second, a good plan can help ensure that the needed resources are available to carry out the initiatives that have been identified as important to the unit or agency. PURPOSE OF STRATEGIC PLANNING

Question 7

A nurse researcher has identified several individuals who will become members of four different groups. These individuals share common characteristic and will be asked to respond to questions on a topic about which they are expected to have interest or expertise. These groups are an example of which of the following?

a. Stakeholders c. Focus groups
b. Stakeholder assessments d. Managerial epidemiology

Answer 7

C: Focus groups are small groups of individuals selected because of a common characteristic who are invited to meet as a group and respond to questions on a topic about which they are expected to have interest or expertise. Stakeholders are any person, group, or organization that has a vested interest in the program or project under review. Stakeholder assessments consist of a would-be group of people with similar experiences who come together to discuss their experiences at an institution in the hope that the discussion will lead to insights or information that might not have been considered by the health care team, but could be used for improving care or marketing service in the future. Managerial epidemiology is the ability to effectively manage the health of a population with the broadest set of resources available. OTHER METHODS OF ASSESSMENT

Question 8

You are the nurse manager of a pediatric unit. During which stage of your strategic planning process will you perform a SWOT analysis?

a. Environmental assessment
b. Stakeholder assessment
c. Review of literature and best practices
d. Prioritizing according to available resources

Answer 8

A: A SWOT analysis is a tool that is frequently used to conduct environmental assessments. SWOT stands for strengths, weaknesses, opportunities, and threats. A stakeholder assessment consists of a would-be group of people with similar experiences who come together to discuss their experiences at an institution in the hope that the discussion will lead to insights or information that might not have been considered by the health care team, but could be used for improving care or marketing services in the future. A review of the literature identifies similar programs, structures, organizations, potential problems and pitfalls, and successes. Prioritizing according to available resources is needed once all strategic goals and objectives have been identified.
SWOT ANALYSIS

Question 9

As part of each nurse’s evaluation, the nurse manager requires them to complete a self-assessment by rating their skill level on a Likert scale. The scale ranges from 1 (no experience) to 5 (proficient). The manager’s assessment tool is an example of which of the following?

a. Review of the literature c. Focus group or interview
b. Survey or questionnaire d. Advisory board

Answer 9

B: Surveys or questionnaires are used when individuals might be polled with a Likert scale rating of how the participants rated a question on a scale of 1 to 5, 1 being no experience and 5 being proficient. SURVEYS AND QUESTIONNAIRES

Question 10

A nurse researcher brings a group of breast cancer survivors together to discuss their experience with chemotherapy side effects and treatment. The nurse researcher is using which form of assessment to collect the data?

a. Review of the literature c. Focus group or interview
b. Survey or questionnaire d. Advisory board

Answer 10

C: Focus groups are small groups of individuals selected because of a common characteristic. The focus group is invited to meet as a group and respond to questions about a topic of common interest or in which they have expertise. FOCUS GROUPS AND INTERVIEWS

Question 11

A nurse has a meeting with an advisory board. The nurse would recognize that which of the following is a common characteristic of advisory boards?

a. Formal authority c. Similar stakeholders
b. Randomly selected d. Expertise varies

Answer 11

D: An advisory board is deliberately selected to reflect representation from various stakeholders and areas of expertise that are needed to have a broad perspective. An advisory board does not have formal authority. OTHER METHODS OF ASSESSMENT

Question 12

A group of nurse practitioners is opening a clinic. During a preliminary meeting, they assess their external environment for threats and opportunities. Which of the following would they consider a threat?

a. Competition c. Advanced technology
b. New markets d. Population growth

Answer 12

A: Competition is considered a threat. New markets, advanced technology, and population growth are considered opportunities. DEVELOPING A MARKETING PLAN

Question 13

A group of nurse practitioners is opening a clinic. During a preliminary meeting, they assess their external environment for threats and opportunities. Which of the following would they consider an opportunity?

a. Unionization c. Decreased reimbursement
b. Staffing shortages d. New programs and services

Answer 13

D: New programs and services are considered opportunities. Unionization, staffing shortages, and decreased reimbursement are considered threats. DEVELOPING A MARKETING PLAN

Question 14

A group of nurse practitioners opened a nurse-run clinic a year ago. During a regular staff meeting they assess their internal environment for strengths and weaknesses. Which of the following would they consider an internal weakness?

a. Patient satisfaction c. Equipment and technology
b. Unprofitable services d. Programs and services

Answer 14

B: Unprofitable services are considered weaknesses within the internal environment of the clinic. Patient satisfaction, equipment and technology, and programs and services are strengths. DEVELOPING A MARKETING PLAN

Question 15

A nursing instructor has completed a lecture on the nursing shortage. Which comment by a nursing student would indicate that further teaching is needed? “Some of the factors affecting the nursing shortage include:

a. an aging nursing workforce.”
b. stress and low job satisfaction of nurses.”
c. decreased number of opportunities for nurses.”
d. a shortage of faculty to teach students.”

Answer 15

C: Decreased number of opportunities is not a reason. Reasons for the nursing shortage are increased number of opportunities, aging workforce, stress and low job satisfaction, and faculty shortages in nursing education. EVIDENCE FROM THE LITERATURE

Question 16

One of the main focuses of a nurse recruiter is to:

a. facilitate unit transfers. c. track turnover data.
b. provide in-services. d. increase staff satisfaction.

Answer 16

C: One of the main focuses of the nurse recruiter is to track turnover data. Other nurse recruiter responsibilities may include facilitating potential unit transfers, providing in-services, and increasing staff satisfaction. EVIDENCE FROM THE LITERATURE

Question 17

A nurse wants to gain a better understanding of the organization’s structure and lines of communication. The nurse should begin by reviewing which of the following?

a. Centralization pattern c. Hierarchical structure
b. Decentralization pattern d. Organizational chart

Answer 17

D: An organization’s structure is communicated by means of an organizational chart. This chart depicts reporting relationships. A hierarchical organization structure is a formal, top-down reporting structure. Centralization and decentralization refer to the degree to which an organization has spread its lines of authority, power, and communication. REPORTING RELATIONSHIPS

Question 18

You have been asked to develop an organizational chart for your unit. You are aware that the one thing that must be depicted on the chart would include which of the following?

a. Management responsibilities c. Job duties and responsibilities
b. Personnel contact information d. Reporting structure or chain of command

Answer 18

D: An organizational chart may specify divisions and/or a reporting structure, but exact roles and responsibilities, specific duties, and job requirements are found in other documents such as job or position descriptions. REPORTING RELATIONSHIPS

Question 19

A nurse works in a hospital which employs a functional division of labor practice. In such an organization, the nurse understands that work is:

a. divided by job title. c. globalized.
b. specialized. d. individualized.

Answer 19

B: Division of labor by function tends to be specialized and efficient. Work is divided by job activity, and individuals carrying out their functional activities were intended to function as a cohesive team. A danger with functional division of labor is that each individual may be so focused on their specific area that there is no perspective on the global picture. FUNCTIONAL DIVISION OF LABOR

Question 20

A nurse administrator in a large urban city divides the nursing labor force by geographic area. An example of such a division is:

a. discharge planner role. c. patient diagnosis.
b. West team. d. cardiology service.

Answer 20

B: An example of division of labor by geographic area is the West team. The discharge planner role is an example of division of labor by job activity. Functional division of labor by patient diagnosis or service is called division of labor by product lines. DIVISION OF LABOR BY GEOGRAPHIC AREA

Question 21

A nurse is preparing for a job interview. In doing so, it is critical that the nurse develop an understanding of the institution’s:

a. unit structure. c. staffing model.
b. mission. d. pay.

Answer 21

B: In preparation for an interview, you must understand the institution’s mission and whether this fits with your beliefs and values. During the interview, understanding the unit structures, staffing model, and pay will be discussed.
EVIDENCE FROM THE LITERATURE

Question 22

A nurse is being interviewed for a position as manager of a pediatric unit. During the interview, the nurse asks the recruiter about the nurse’s span of control. The best response by the recruiter is that the nurse’s span of control will include:

a. all of the children on the unit.
b. the number of individuals reporting to nurse manager.
c. any visitors to the unit.
d. all patients and family members of the patients

Answer 22

B: Span of control is used to designate the number of individuals that report to the nurse manager. The nurse manager does not have supervisory responsibilities over patients, family members, and visitors because these individuals do not have a direct reporting relationship with the nurse manager. SPAN OF CONTROL

Question 23

Which of the following organizational structures would be the most centralized?

a. Matrix structure c. Flat structure
b. Tall structure d. Compromised structure

Answer 23

B: The tall structured organization would most likely be the most centralized. A tall organization would have many layers in the chain of command. The Flat structure has fewer layers, and the matrix structure may have at least two different reporting paths. There is no structure called a compromised structure. TYPES OF ORGANIZATIONAL STRUCTURES

Question 24

A small rural hospital with 30 beds, would most likely have which type of organizational structure?

a. Flat c. Matrix
b. Tall d. Product line

Answer 24

A: A small rural hospital with only 30 beds would most likely have a flat structure. The flat structure has few layers while a tall structured organization would have many layers in the chain of command. The matrix, or product line structure, may not be appropriate because of the limited number of patients cared for. Additionally, a small rural hospital would probably have a limited number of staff members. ORGANIZATIONAL STRUCTURE

Question 25

The nurse practitioners of a nurse-run clinic would conduct a review of the literature prior to adding a new program. Which of the following would not be a major reason for conducting the review?

a. Identifying the structure and organization of similar programs
b. Identifying potential problems and pitfalls
c. Identifying the nurse practitioners’ level of productivity
d. Identifying the existence of similar programs

Answer 25

C: A review of the literature should be completed prior to strategic planning or beginning any new project or program. This allows the project team to identify similar programs, their structure and organization, their potential problems and pitfalls, and their successes. REVIEW OF LITERATURE ON SIMILAR PROGRAMS

Question 26

A nurse educator conducts a staff development training on marketing. Which response by one of the nurses would indicate that further teaching is needed when the educator asks, “What are the four Ps of marketing”?

a. Patient c. Price
b. Product d. Provider

Answer 26

D: If a nurse responded “provider,” the educator would realize that additional teaching is needed because provider is not one of the four Ps of marketing. The four Ps are patient, product, price, and placement. DEVELOPING A MARKETING PLAN