Final

Question 1

The home health agency hired an expert to evaluate and propose a plan for reversing growing expenses and decreasing revenues. The expert is well respected. To be effective for the home health agency, staff will need to perceive this change agent as:

a. Trusted, quiet.
b. Flexible, informal.
c. Credible, legitimate.
d. Communicative, personable.

Answer 1

c. Credible, legitimate.

Question 2

The clinical coordinator expects the position description of the new wound care specialist to change nurses’ responsibilities in caring for clients with skin integrity problems. The best approach to address this need for change, yet to have the best outcomes for clients, staff nurses, and the organization, is to:

a. Select one of the change models.
b. Use Lewin’s model and principles of change.
c. Apply both planned and nonlinear approaches.
d. Form a task force of nursing staff and wound care specialists.

Answer 2

c. Apply both planned and nonlinear approaches

Question 3

An example of one strategy to improve participation in the change process by staff fitting the behavioral descriptions of laggards is to:

a. Encourage teamwork.
b. Transfer to a different unit.
c. Require attendance at staff meetings.
d. Delegate the roles and tasks of change.

Answer 3

d. Delegate the roles and tasks of change.

Question 4

Continuous quality improvement has:

a. Empowered employees to make decisions
b. Lightened employees’ workload
c. Diminished the needs of the employees
d. Provided overtime payment for employees

Answer 4

a. Empowered employees to make decisions

pg. 362-363

Question 5

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. As a team.
b. Independently.
c. Interdependently.
d. As a group.

Answer 5

d. As a group.

Question 6

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. Conflict.
b. Task clarity.
c. Commitment.
d. A designated leader.

Answer 6

c. Commitment.

Question 7

A mediator suggested that the nurse manager and staff members decide on a method to resolve conflicts. It is important to have agreements about how team members will work together because:

a. If there are no agreements, each member will make up his or her own procedures without consensus.
b. People are naturally difficult and will not work well together without such agreements.
c. People will naturally ask for agreements about how to be together.
d. A way to eliminate nonproductive team members must be available.

Answer 7

a. If there are no agreements, each member will make up his or her own procedures without consensus.

Question 8

Marcy, a new staff nurse, is very concerned about “fitting in” on the rehabilitation unit. She addresses her concerns and speaks with the head nurse. The head nurse speaks with the rest of the staff and reminds them how important it is for a staff member to feel that he or she is part of the group. Which of the following statements would she not include in her talk? “Staff members who feel included:

a. Are more cooperative.”
b. Are harder workers.”
c. Are part of the 50% who feel their strengths are used.”
d. Bring enthusiasm and commitment to the group.”

Answer 8

c. Are part of the 50% who feel their strengths are used.”

pg. 331

Question 9

In Hospital STV, senior administration is strongly oriented toward fiscal and social conservatism. The nursing department is deeply concerned with the provision of quality to the community, which includes a high number of poor and unemployed. Nursing and administration:

a. Are engaged in shared governance.
b. Are involved in an irreconcilable conflict of interests.
c. Represent separate subcultures in the institution.
d. Represent union and nonunion conflict.

Answer 9

c. Represent separate subcultures in the institution.

Question 10

The emergency department staff decides to use a collective bargaining model for negotiation, rather than a traditional trade union model. A traditional trade union model is characterized by:

a. An adversarial relationship.
b. Management support of labor’s initiatives.
c. A spirit of trust between management and labor.
d. An ability to resolve complaints.

Answer 10

a. An adversarial relationship.

Question 11

The nurse manager decides to change staffing schedules in the intensive care unit. She chooses to use Rogers’ Diffusion of Innovations Theory to implement the change. What are the elements of Rogers’ Diffusion of Innovations Theory?

a. Assessment, planning, intervention, and evaluation
b. Preparation, validation, synthesis, and evaluation
c. Knowledge, persuasion, decision, implementation, and evaluation
d. Scanning, diagnosis, decision making, application, and reevaluation

Answer 11

c. Knowledge, persuasion, decision, implementation, and evaluation

Question 12

To help staff nurses adjust to using research in practice inexpensively, what strategy would the nurse manager use?

a. Attendance at a regional research conference
b. Formal classes in electronic search techniques
c. Establishing a journal club
d. Issuing reports on the adverse consequences of outdated practices

Answer 12

c. Establishing a journal club

Question 13

Marie is a long-term staff nurse on the rehab floor. Her unit manager has been eager to adopt evidence-based recommendations related to family-centered care on the unit. Marie’s response has been that she rarely has time to provide care to patients, let alone families. An approach that may gain Marie’s support of the idea is to:

a. Invite Marie to review the studies for herself.
b. Suggest that she does not need to provide family-centered care.
c. Avoid discussion of the idea with her until she initiates it.
d. Secure the support of her closest colleagues on the unit.

Answer 13

d. Secure the support of her closest colleagues on the unit.

Question 14

Which of the following has been identified as a significant factor in moving EBP into patient care?

a. Strong utilization models
b. Development of stronger opinion leaders
c. Technology
d. Support by other disciplines

Answer 14

p. 385
* d support by other disciplines - “the translation of evidence into practice involves all healthcare disciplines”

(quizlet says c. Technology)

What role does technology play in promoting EBP?

Technology makes the location of and the dissemination of the research possible and necessary

When assessing evidence reports, nurses should ask themselves 3 questions.

1. is this the best available evidence? Best sources include peer reviewed journals and reports no more than 3 to 5 years old.
2. will the recommendations work for my practice given the client population and problems?
3. Do the recommendations fit well with the preferences and values of the clients I commonly work with?

Question 15

Once evidence related to the use of prompted voiding in patients with cognitive impairment has been appraised and integrated with practice, it is important to:

a. Consider whether patients’ families see this as necessary for the well-being of family members.
b. Search large databases such as CINAHL to amass further evidence.
c. Clarify the clinical practice question.
d. Solicit input regarding integration with practice.

Answer 15

a. Consider whether patients’ families see this as necessary for the well-being of family members.

Question 16

Before terminating an employee, a nurse manger must:

a. Be an expert in all legal aspects of termination and discipline practices.
b. Know the organization’s specific policies for addressing disciplinary problems
c. Function as a counselor for problem employees.
d. Do everything to assist and protect the employee by adjusting standards and policies.

Answer 16

b. Know the organization’s specific policies for addressing disciplinary problems
p. 460

Question 17

Collaborative partnerships between hospitals and schools of nursing are examples of hybrid organizational structures. A hybrid organizational structure:

a. Has many divisions of labor.
b. Best fits long-term care units.
c. Has a mixture of the characteristics of various organizational types.
d. Places the authority for decision making closest to the places where workers perform.

Answer 17

c. Has a mixture of the characteristics of various organizational types.

Question 18

• *Which of the following challenges least describes health care and the profession of nursing in the 21st century?
  a. Evidence-based
  b. Technology-limited
  c. Population-based
  d. Outcome-focused

Answer 18

**b. Technology-limited

-can’t find in book but makes most sense out of available options

Question 19

Nurses need to know how to operate a computer, compare data across time, and look for patterns in client responses to treatments. These are examples of:

a. JCAHO standards.
b. Information systems.
c. Informatics competencies.
d. Requirements for nursing licensure.

Answer 19

c. Informatics competencies.

p. 187

Question 20

Mr. Cruiser has been surfing the web. He is looking for healthcare information on low back pain. He shows the clinic nurse a Webpage he thinks is great and tells her that he has been following the exercises recommended by the author. He wants to know what she thinks about the site. When the clinic nurse evaluates this site, she discovers that its author is a personal trainer. No credentials are listed. In several testimonials on the page, people (their pictures are included) say how wonderful they feel after having done these exercises. The exercises all have animated demos when you click on the pertinent highlighted text or icon. They seem easy to follow. The site was posted five years earlier and was last updated three years before. The clinic nurse advises Mr. Cruiser to:

a. Avoid this site.
b. Check with his primary healthcare provider.
c. Continue with the exercises.
d. Contact the author for additional exercise and feedback.

Answer 20

a. Avoid this site.

Question 21

The new graduate nurse joins the 5W nursing unit and is anxious to fit in. She learns that some of her “book learning” is being criticized by her colleagues, so she adapts her practice to what others on the unit are doing. She is demonstrating:

a. Cultural awareness
b. Cultural sensitivity
c. Acculturation
4. Cultural marginality

Answer 21

c. Acculturation

p. 155 - “acculturation refers to adapting to a particular culture”

Question 22

Which of the following statements best defines an accomplished team? Effective teams:

a. Can create a form of synergism in which the outcome is greater than the sum of the individual performances.
b. Do not necessarily need goals, objectives, vision, and a clearly stated purpose.
c. Do not always have effective communication patterns.
d. May or may not have a clear plan that is followed and revisited and has an ongoing evaluation scheme.

Answer 22

a. Can create a form of synergism in which the outcome is greater than the sum of the individual performances.
p. 335 “effective teams work together to produce extraordinary results… often described as synergy”

Question 23

A unit manager of a 25-bed medical/surgical area receives a phone call from a nurse who has called in sick five times in the past month. He tells the manager that he very much wants to come to work when scheduled but must often care for his wife, who is undergoing treatment for breast cancer. According to Maslow’s need hierarchy theory, what would be the best approach to satisfying the needs of this nurse, other staff, and patients?

a. Line up agency nurses who can be called in to work on short notice.
b. Place the nurse on unpaid leave for the remainder of his wife’s treatment.
c. Sympathize with the nurse’s dilemma and let the charge nurse know that this nurse may be calling in frequently in the future.
d. Work with the nurse, staffing office, and other nurses to arrange his scheduled days off around his wife’s treatments.

Answer 23

d. Work with the nurse, staffing office, and other nurses to arrange his scheduled days off around his wife’s treatments.

Question 24

During a fire drill, several psychiatric patients become agitated. The nurse manager quickly assigns a staff member to each patient. This autocratic decision style is most appropriate for:

a. Routine problems.
b. Crisis situations.
c. Managers who prefer a “telling” style.
d. Followers who cannot agree on a solution.

Answer 24

b. Crisis situations.

Question 25

The STAR approach to patient safety encourages:

a. Focus and reflection.
b. Continuing education.
c. Multidisciplinary approaches.
d. Patient feedback.

Answer 25

a. Focus and reflection.

Question 26

As a nurse manager on the West Surgery Unit, you are interested in increasing patient safety on your unit. Your initial focus is on the two encounters that the Chasm series identified as most likely to generate concerns about patient safety. As a result, you initiate which of the following?

a. Questions on the pre-admission history that specifically explore details of substance use
b. Careful monitoring of all patients who are ambulating postoperatively
c. Rigorous patient teaching related to deep breathing and coughing
d. Systematic follow-up with patients to ensure that they understand details of surgery

Answer 26

a. Questions on the pre-admission history that specifically explore details of substance use

Question 27

• *Activities that a nurse leader or manager might conduct to support nurse-sensitive care standards established by the National Quality Forum for improved patient safety included: (Select all that apply)
  a. Investigate a patient death on an inpatient mental health unit
  b. Organize a health fair for employees about the risk factors underlying cerebral vascular accidents
  c. Conduct a department staffing survey of trends in patient acuity to adjust staff mix
  d. Prepare a graph for staff showing central line infection rates of newborns during the first month after birth

Answer 27

**Not sure yet, look up in evolve/testbank

A, C, D

• specific answers not in book/ googled and other group had it too p.28 NQF r/t quality measurement and reporting

Question 28

A nurse executive is hired to restore a unit’s productivity, which has decreased as the result of low staff morale. The nurse executive utilizes which of the following leadership principles?

a. The leader sets the tone, which allows nurses to feel in control of the environment.
b. If the staff members are not satisfied, they will insist on a different leader, who will get them what they want.
c. Leaders at the national level who are seeking relief for nurses in the workplace are seen as the solution to the nursing shortage.
d. Workplace satisfaction depends on staffing ratios, adequate pay, and tuition reimbursement, and these are things the leader can control.

Answer 28

a. The leader sets the tone, which allows nurses to feel in control of the environment.

Question 29

Managers are responsible for resource utilization in their department. In order to meet this responsibility they may

a. Develop a critical pathway to manage a frequently admitted medical diagnosis
b. Decide the amount of a staff nurse’s salary increase
c. Design the architectural layout of the unit
d. Determine the hours staff work on the unit

Answer 29

a. Develop a critical pathway to manage a frequently admitted medical diagnosis
p. 243

Question 30

The nurse manager, as the leader of the unit’s “customer (client) first” initiative, has asked the staff nurses to develop and administer a survey to every client before discharge. In asking the staff nurses to accomplish this task, the nurse manager is demonstrating:

a. Accountability.
b. Shared leadership.
c. A common purpose.
d. Independence in the nursing manager’s role.

Answer 30

b. Shared leadership.

Question 31

• *Select the best option that demonstrates the main concept of complexity theory
  a. Hierarchal decision-making
  b. Systematic evaluation of patient complaints
  c. Use of cause-effect analysis for a variance in department performance
  d. Network relationship development

Answer 31

d. Network relationship development
pg. 8 complexity science promotes the idea that the world is full of patterns that interact and adapt through relationships.

Question 32

Which of the following is an infraction of the Privacy Rules outlined in HIPAA? Select all that apply.

a. Reviewing the chart of a client assigned to another nurse
b. Making a copy of a client’s most current laboratory results for the primary care provider during rounds
c. Answering questions about a client’s condition with the client’s daughter
d. Discussing a client’s condition over the phone with an individual who has provided the client’s information code
e. Participating in walking rounds as long as verbal exchanges occur outside the client’s room and in soft whispers

Answer 32

a. Reviewing the chart of a client assigned to another nurse
b. Making a copy of a client’s most current laboratory results for the primary care provider during rounds
c. Answering questions about a client’s condition with the client’s daughter
e. Participating in walking rounds as long as verbal exchanges occur outside the client’s room and in soft whispers

Question 33

A group of staff nurses is dissatisfied with the new ideas presented by the newly hired nurse manager. The staff wants to keep their old procedures, and they resist the changes. Conflict arises from:

a. Group decision-making options.
b. Perceptions of incompatibility.
c. Increases in group cohesiveness.
d. Debates, negotiations, and compromises.

Answer 33

b. Perceptions of incompatibility.

Question 34

Sarah, a staff nurse on your unit, witnesses another nurse striking a patient. Sarah wants to remain friends with her colleague and worries that confrontation with her colleague or reporting her colleague will destroy their relationship. Sarah is experiencing which type of conflict?

a. Intrapersonal
b. Interpersonal
c. Organizational
d. Professional

Answer 34

a. Intrapersonal

Question 35

The most important approach that a nurse manager can take with an emotionally troubled employee is to:

a. Act as a therapist for the employees
b. Adjust the standard of care to assist the employee
c. Assist the employee in obtaining professional help
d. Adjust the employee’s work schedule to decrease stress

Answer 35

c. Assist the employee in obtaining professional help.

Question 36

The chief nursing officer understands that clinical incompetence is best prevented by a:

a. flexible protocol for evaluating competency skills
b. Standardized clinical skills checklist
c. Newly established peer review process
d. Formalized competency program with established standards for practice

Answer 36

d. Formalized competency program with established standards for practice.

(from test bank ch 24)
The competency program with established standards of practice outlines what the nurse must do to achieve desired competencies in her current position. Competency assessment and goal­setting should help the nurse identify how to excel and which competencies the nurse wants to achieve in the future.

Question 37

During coffee and other breaks, Rosalie, the new RN, is shut out of conversations with the other staff. When she approaches other staff on the unit to ask questions, they turn and walk off in the other direction. The behavior of the staff is characteristic of:

a. Dislike.
b. Lack of trust in Rosalie’s abilities.
c. Horizontal violence.
d. Cultural incompetence

Answer 37

c. Horizontal violence.

Question 38

The nurse manager is setting up the room assignments for the unit. She has one critical patient on the unit, who is going to require more care than the others. Before delegating a task, a nurse manager should:

a. Delegate the admission assessment to the LPN.
b. Review the employee’s performance assessment for the most recent period.
c. Assess the amount of guidance and support needed in a particular situation.
d. Create a task analysis of critical behaviors for the individual.

Answer 38

c. Assess the amount of guidance and support needed in a particular situation.

Question 39

When determining if a nursing assistant understands how to safely complete a procedure correctly, which rights of delegation must the nurse assess? (Select all that apply)

a. The environment
b. The person
c. The task
d. The circumstance

Answer 39

b. The person
c. The task
d. The circumstance

Question 40

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. This nurse exemplifies which level of political activism in nursing?

a. Gladiator
b. Buy-in
c. Self-interest
d. Political sophistication

Answer 40

d. Political sophistication

correct - chapter 10 tests bank

Question 41

What is the impact of nurses who engage in in-fighting, seek physician support against nursing colleagues, and avoid membership in nursing organizations:

a. They refuse to believe that they are acting like members of groups that suffer socioeconomic oppression.
b. They do not understand how their failure to exercise power can limit the power of the whole profession.
c. They purposefully choose to exercise their power in the workplace through indirect means.
d. They suffer from learned helplessness as a result of abuse by powerful nurse executives

Answer 41

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

Question 42

The difference between a nurse practitioner’s charge of $45 for an office visit and the insurance company’s payment of $34 is:

a. A contractual allowance
b. A profit
c. A flat rate
d. Revenue

Answer 42

a. A contractual allowance

Question 43

• *When finalizing the unit’s operating budget, the nurse manager has the most difficulty forecasting which type of items?
  a. Salary and benefits
  b. Vacation coverage expenses
  c. Units of service and supply costs
  d. Major equipment purchases

Answer 43

c. Units of service and supply costs

Question 44

In a nurse managers’ meeting, the chief nursing officer encourages the managers to brainstorm ways to reduce costs. Nurse managers have the greatest impact on reducing costs by managing:

a. Supplies
b. Staffing
c. Fixed Costs
d. Medication costs

Answer 44

b. Staffing

Question 45

A nurse manager approves two staff nurses to attend a national conference. When reviewing the budget, the nurse manager looks at which line item?

a. Cash budget
b. Capital budget
c. Operating budget
d. Supply and expense budget

Answer 45

c. Operating budget

chapter 12 test bank

Question 46

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 schedule:

a. All weekends off.
b. All holidays off.
c. A variety of scheduling options.
d. Rotating shifts.

Answer 46

c. A variety of scheduling options.

Question 47

To prepare staffing schedules, a nurse manager needs to calculate paid nonproductive time. When calculating paid nonproductive time, the nurse manager considers:

a. Work time, educational time, and holiday time.
b. Paid hours minus worked hours.
c. Vacation time, holiday time, and sick time.
d. Paid hours minus meeting time.

Answer 47

c. Vacation time, holiday time, and sick time.

Question 48

In comparing team and functional models of care, a nurse manager favors the team model. In particular, she finds that the team model:

a. Can be effective in recognizing individual strengths and backgrounds of staff
b. Promotes autonomy and independence for the RN
c. Avoids conflicts because of role clarity
d. Is efficient in delivering care to a large group of patients, utilizing a staffing mix

Answer 48

A. Can be effective in recognizing individual strengths and backgrounds of staff

Question 49

delivery system as one in which each nursing assistant is cross-trained to perform specific tasks, and the RNs do all treatment, medication administration, and discharge teaching is what type of system:

a. The case method
b. Functional nursing
c. Primary nursing
d. Nurse case management

Answer 49

b. Functional nursing

Question 50

Which of the following might best conclude an interview?

a. “Thank you for your interest. Someone will be in touch with you soon”
b. “Before you go, we will make sure that we have your contact information. Thank you for coming”
c. “I will be in contact with all candidates by telephone by next Friday. It has been a pleasure to meet you”
d. “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”

Answer 50

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