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Leadership Exam 4
Terms in this set (34)
Which of the following is a macro-level change?
1. Shift in Medicare payment policies
2. Change in shift differentials
3. Opening a new unit
4. Changing visiting hours
Which of the following best describes what is most likely to be within a nurse's comfort zone?
1. A new assignment
2. Tasks she's done many times
3. Change to a different shift
4. Addition of several new tasks
How can you increase your staff's receptivity to an important change in procedures?
1. Assign the new procedure to the newest staff member.
2. Apologize for making their work more complicated.
3. Provide them with a booklet on preparing for change.
4. Give them time to learn the new procedure.
A new nurse manager plans to implement a new scheduling process. This was met with resistance from the staff who were very happy with the current scheduling process. How can the nurse manager lower their resistance to this change?
1. Tell the staff that their concerns about the new schedule are unfounded and plan to post the new schedule.
2. Share information about the new schedule and discuss its impact on the unit.
3. Post the schedule and deal with staff on an individual basis.
4. Ask the staff to come up with an alternative for the nurse manager's consideration.
There has been a sudden increase in catheter-associated urinary tract infections that must be addressed on Jane's unit. What is the best way for Jane to persuade the staff to implement a new Foley catheter care protocol?
1. Tell them the change has been ordered by the administration.
2. Present statistics proving the need to change.
3. Tell a compelling story about why change is needed.
4. Explain the importance of the change in simple terms.
What type of resistance to a change is the hardest to overcome?
1. The resistance that comes from inertia: "We always do it this way."
2. Active resistance to changing a preferred procedure
3. Passive resistance to an unpopular change
4. Resistance based upon fear of losing one's job
When is it most appropriate to dictate (order) change?
1. When the change is very complicated
2. In an emergency
3. When resistance is very high
4. If the change is unimportant
In which of the following situations would a personal change probably be the hardest to make?
1. When the need is immediate
2. If the benefits will be realized years from now
3. When the reward is immediate
4. If it is change that keeps you in your comfort zone
When designing a technical change, which of the following should be considered?
1. Will it work better than the old way?
2. Is this change needed?
3. Is there a simple way to do this?
4. All of the above
Which of the following is the best indication that a change has been integrated?
1. When no one talks about it anymore
2. If adoption occurred rapidly
3. When resistance turns from active to passive
4. When a full year has passed since the change was introduced
You are a new nurse. The hospital where you work is committed to providing safe, high quality care. Which of the following activities would let you know that your organization is committed to improving patient safety?
1. The hospital has a good catch program for staff who recognize errors and near misses.
2. The hospital subscribes to TJC safety publications.
3. The hospital measures performance every month, monitors quality indicators, and regularly reports on quality.
4. All of the above
Your new organization is committed to quality patient care. Which of these are considered characteristics of quality health care?
1. The nurses use evidence-based research to guide care delivery.
2. The nurses are respectful and responsive to their clients' individual preferences.
3. The nurses perform an independent double check when administering chemotherapy medication.
4. All of the above
Medical errors account for 250,000 deaths per year. It is estimated that as many as 50% of these errors may be preventable. What steps would you take to avoid a medication error?
1. Review the patient's medication administration record during bedside shift report.
2. Ask your colleagues to get your medication so that you can give it on time.
3. Call the pharmacist.
4. Review the medication administration policy.
Studying errors and identifying how they occur helps organizations improve patient safety. Which category of errors is the most useful in identifying and remedying vulnerabilities in an organization?
1. Sentinel event
2. Adverse event
3. Near miss event
4. Wrong procedure event
Nursing standards of care and the organization's policies and procedures greatly decrease risk to patient safety. Which of the following steps can a nurse take to further reduce risk?
1. Submit event or incident reports for near misses.
2. Follow medication administration policies and procedures.
3. Always report significant data on care to patients and providers in a timely manner.
4. All of the above
To achieve safe patient care, a culture of safety must exist. What are characteristics of an organization with a culture of safety?
1. Transparency, openness, reporting of errors is rewarded, blame-free environment
2. Honesty, studying of serious events
3. Privacy, reporting of errors appreciated
4. Blame-free environment, openness, error reporting is encouraged
The purpose of QI is to continuously improve the capability of everyone involved to provide safe, high-quality patient care. What is important to know about the QI process?
1. It is independent of teamwork.
2. It is a data-driven approach to improving process.
3. Common safety indicators are not used to evaluate quality of care.
4. Opportunities for QI are selected by organization leadership.
Structured care methodologies (SCM) are:
1. Nursing tools designed to identify best practices and facilitate standards of care
2. Used to create a stable set of performance indicators to measure outcomes
3. Used to assist employees with wellness and injury prevention
4. Helpful when making staffing assignments
When evaluating the quality of care, a health-care organization must consider structures, processes, and outcomes of care delivery. Which of the following is a good example of an organizational process?
1. Budgeting adequate money for nursing salaries
2. Preparing a patient for discharge
3. Monitoring for infections
4. Increasing time between clinic visits
The HHS is charged with protecting the health of all Americans and providing essential health services. Which of the following HHS quality initiatives is currently under way?
1. Post-acute care reform initiative
2. National health-care research and quality indicators aimed at helping improve access to care
4. Health IT
OSHA, a federal government agency, is responsible for:
1. Providing training to handle difficult clients and their families
2. Providing research and education training
3. Upholding the standards of nursing practice
4. Developing and enforcing workplace safety and health regulations
A surprisingly dangerous job in the United States is working:
1. In a coal mine
2. As a window cleaner in New York City
3. In a health-care facility
4. As a police officer
A federal agency that partners with other agencies throughout the nation to investigate health problems, conduct research, implement prevention strategies, and promote safe and healthy environments is known as the:
Actions to address violence in the health-care workplace include: (SELECT ALL THAT APPLY)
1. Identifying the factors that contribute to violence and controlling as many as possible
2. Allowing the violence to escalate
3. Assessing staff attitudes and knowledge regarding responses to violence
4. Providing weapons training to those identified as having a potential for physical violence
According to NIOSH, a common reaction to latex allergy is:
1. Increased appetite
2. Allergic contact dermatitis
3. Increased falls
4. An increase in violent outbursts
A common ergonomic occupational-related risk in the health-care environment is:
1. Indoor air pollution
2. Active shooters
3. Nosocomial infection
4. Back injuries
A suburban hospital recently announced that staff nurses could no longer choose their shift. Instead, they would be assigned to either a 12-hour day shift or a 12-hour night shift on an as-needed basis. An informal group of staff nurses met to discuss this new policy. They
came up with several arguments against it. Which of the following suggestions would help to alleviate the deleterious effects of this new policy? (SELECT ALL THAT APPLY)
1. Allow self-scheduling by staff nurses in each unit.
2. Provide free dinner for nursing staff at the end of the night shift.
3. Allow staff members to request consistent days off .
4. End visiting hours before the day shift ends so that the night shift nurses do not have to deal with visitors.
Which of the following are considered reasonable accommodations for an employee with a disability? (SELECT ALL THAT APPLY)
1. Modification of the work schedule
2. Salary reduction to reflect lower output
3. Additional days off and extended vacations
4. Adjustment of work procedures
Which of the following procedures and modifications contributes to reducing indoor air pollution?
1. Windows that may be opened by staff as needed
2. More powerful ventilation systems and air filtration
3. Selection of products with more polyvinyl chloride (PVC)
4. Increased use of medical waste incinerators
Stephanie Beals was a little nervous during her first week of work as a licensed nurse. Distracted by a lead nurse behind her, her hand slipped, and she was stuck by the needle she had just used. What is most important for Stephanie to do?
1. Disinfect the site of the needlestick.
2. Apologize to the patient, clean the site, and properly dispose of the needle.
3. Update her hepatitis B immunization.
4. Report the incident and obtain post exposure prophylaxis (PEP) within 2 hours.
Which of the following best describes safety in health care?
1. A registered nurse who made a serious medication error was terminated.
2. An organization focuses on efficiency on the nursing units.
3. After a medication error, a team works to prevent similar errors in the future.
4. Safety indicators are reported regularly.
A nurse manager of a busy emergency department is working to reduce the potential for violence on the unit. Which of the following will most likely reduce the potential for violence?
1. Ensure post-assault treatment and support is available to all staff.
2. Implement procedures to speed up the discharge process for mentally ill patients.
3. Decrease the number of visible security guards to avoid antagonizing patients.
4. Propose a plan to expand and update the waiting room.
Which of the following should be included in training for the prevention of needlestick injuries and other exposures to health risks?
1. Clean all contaminated work surfaces according to established guidelines.
2. Recap needles before disposal to avoid accidental pricks when emptying containers.
3. Staff should be treated within 24 hours of a needlestick injury.
4. Although sharps injuries have significantly declined in most areas, the long term care facilities are still the most at risk when it comes to needlestick injuries.
Nurses are advocates for their patients and have a duty to report any behaviors that may negatively impact patient outcomes. Which of the following is true regarding reporting quality and safety issues?
1. Whistleblower laws protect nurses from reprisals by employers.
2. As long as nurses do the right thing for their patients, they will be protected.
3. A health care facility may terminate the employment of a nurse who reports quality and safety issues.
4. The state nurse practice act will have information about whether there are whistleblower laws in the state to protect nurses.
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