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Leadership Midterm

Terms in this set (115)

A staff nurse is having difficulty with problem solving in patient care and the nurse manager is counseling the nurse. What suggestions by the nurse manager may assist the staff nurse in improving problem solving skills? (Select all that apply?)

a. override bias
b. slow down thinking
c. combine personal and professional feelings
d. systematize data collection
e. ask closed-ended questions
a. override bias
b. slow down thinking
d. systematize data collection
A nursing instructor is discussing ways to improve critical thinking during a clinical rotation with a student. The student asks the nurse what critical thinking in. What is the best response by the nursing instructor?

a. it is a synonym for the problem-solving process.
b. it requires reasoning and creative analysis.
c. it is a simple approach to decision making.
d. it is narrower in scope than decision making.
b. it requires reasoning and creative analysis
A nurse manager is making a decision based on a problem with a staff member. What would be the optimal end product of the decision?

a. a restatement of solution
b. a chosen course of action
c. an action that guarantees success
d. an alternative problem
b. a chosen course of action
A nurse has a difficult decision to make regarding patient care. What should the nurse do to influence a positive outcome? (Select all that apply)

a. make a quick decision and act on it immediately
b. identify a number of different options
c. understand the repercussions of each option
d. gather data and input from a variety of sources
e. slow down the thinking process
b. identify a number of different option
c. understand the repercussions of each option
d. gather data and input from a variety of sources
e. slow down the thinking process
A nurse educator determines that the present classroom environment is ineffective in promoting critical thinking. What methods could the educator employ in the classroom to improve critical thinking? (Select all that apply)

a. case studies
b. simulation
c. study guides
d. problem-based learning exercises
e. lecture
a. case studies
b. simulation
d. problem-based learning exercises
A nurse manager is using the decision-making model "SWOT" to determine whether it is feasible to add another on-call team in perioperative services. What words does the acronym "SWOT" represent?

a. significance, wellness, operating, timing
b. strengths, weaknesses, opportunities, threats
c. superiority, work, opportunity, threats
d. strengths, worth, options, timing
b. strengths, weaknesses, opportunities, threats
A nurse caring for a patient that suddenly becomes short of breath and has a decrease in oxygen saturation to 86%. The nurse places the patient on 4L of oxygen via nasal cannula and elevates the head of the bed. What decision tree would the nurse have used in this situation?

a. a decision grid
b. intuitive judgement
c. consequence tables
d. SWOT
b. intuitive judgement
A nursing staff is presently using disposable biopsy forceps in the endoscopy suite, and the nurse manager is questioning the cost-effectiveness of this practice. What would be an appropriate decision-making model to find a cost-efficient solution?

a. consequence tables
b. intuitive judgement
c. SWOT
d. decision grid
d. decision grid
A nurse makes a decision using intuitive judgement regarding a patient's rapid change in condition. What action should the nurse take after the decision?

a. use evidence-based data to validate decision
b. examine alternatives visually and compare each against the same criteria
c. plot decision over time
d. quantify information
a. use evidence-based data to validate decision
When making a decision about using a prn pool for added staffing, what can the nurse manager do to make the best decision?

a. make a decision with all of the facts
b. make a decision and then question the facts
c. don't question the first impression
d. get multiple people to give input into the decision
a. make a decision with all of the facts
A nurse is using the nursing process in order to plan the care of a newly admitted patient that has had a stroke. What is the benefit of using the nursing process to devise a care plan?

a. the process will always lead to optimal patient care
b. the patient will have the best outcome from the stroke
c. this method of problem solving can be transferable to non-patient problems
d. the nurse will be able to diagnose the patient's medical problem immediately
c. this method of problem solving can be transferable to non-patient problems
The nurse is admitting a new patient and is collecting data through obtaining a health history and physical assessment. What phase of the problem-solving process is the nurse focusing on with the patient?

a. implementing
b. assessing
c. evaluating
d. planning
b. assessing
A nurse is determining whether the outcomes were met for a patient preparing for discharge with an open abdominal wound and reassessing if not met. What phase of the nursing process is the nurse performing?

a. implementing
b. evaluating
c. assessing
d. planning
b. evaluating
A nurse determines that action is justified for a patient with limited mobility after an injury. After a plan for a solution has been identified, what is the next step in the problem-solving process?

a. evaluating
b. implementing
c. assessing
d. diagnosing
b. implementing
A nurse is educating a patient who is scheduled to undergo an open cholecystectomy how to turn, cough, and deep breathe in order to prevent complications after the procedure. What phase of the nursing process is the nurse providing?

a. implementation
b. evaluation
c. assessment
d. planning
a. implementation
A nurse manager schedules a meeting with the staff to discuss policy changes. What does the manager hope to achieve by having some upper left-brain dominant staff members lend their input

a. logical and rational analysis
b. holistic input
c. creativity
d. an intuitive side
a. logical and rational analysis
The director of a busy outpatient department is meeting with staff to ask input and make decisions about the feasibility of a freestanding unit. What issue by the nurse manager can stop the entire process if not rectified?

a. allowing the group to participate in discussion and be free to voice opinion
b. keeping the objective and expectations for the group undefined
c. encouraging each other to have respect for the values of the team
d. having resources available to make informed decisions
b. keeping the objective and expectations for the group undefined
A nurse manager is mentoring a new facilitator. What decision-making models can the manager suggest to the facilitator that will help minimize the impact of an unskilled facilitator? (Select all that apply)

a. logic model
b. payoff table
c. consequence table
d. decision tree
e. decision grid
b. payoff table
c. consequence table
d. decision tree
e. decision grid
A nurse manager is having a difficult time making a decision about reprimanding a staff nurse who has exceeded the absentee policy. Why would the nurse manager's values cause personal conflict in making this decision?

a. some values are not realistic or healthy
b. not all values are of equal worth
c. values remain unchanged over time
d. values often collide with one another
d. values often collide with one another
A nurse manager is holding a meeting to discuss a sensitive issue with the staff. A previous meeting was held regarding he same issue and it ended in a negative manner. What action can the manager take in order to minimize the impact of leader/group style mismatch?

a. use a decision-making model
b. have more extroverts than introverts in the meeting
c. ensure adequate gender role participation
d. appoint a leader as a participant
a. use a decision-making model
An experienced nurse using contingency theory is orienting a new graduate to the unit. What needs will the nurse meet with the new graduate using this theory? (Select all that apply)

A. Developing
B. Discipline
C. Coaching
D. Team-building
E. Counseling
A. Developing
C. Coaching
E. Counseling
The manager of several related departments brings the team together to inform them that they will all be cross training to other units for the purpose of increasing productivity. What form of leadership does this manager demonstrate?

A. Contingency theory
B. Transactional
C. Laissez-faire
D. Transformational
B. Transactional
A nurse in a leadership role is committed to a vision for retention in the medical-surgical unit and is able to empower others with this vision. What form of leadership is this nurse demonstrating?

A. Transformational
B. Transactional
C. Bureaucratic
D. Interactional
A. Transformational
The nurse leader is considering using transformational leadership. What information with the nurse leader need to keep in mind?

A. Employees are expected to lead from their organizational position.
B. Empowerment of both the leader and follower occurs.
C. Informal leadership is highly recognized.
D. The locus of power rests with the employees.
B. Empowerment of both the leader and follower occurs.
A nurse educator in a college setting has developed leadership skills as a result of attaining further education and sharing positive change within the department. What transformational leadership characteristic is this nurse educator demonstrating?

A. Influencing others
B. Directing others
C. Guiding others
D. Empowering others
D. Empowering others
A nurse on the acute care unit demonstrates the positive traits of a good leader when working with new employees. What trait does the nurse manager cite when performing the nurse's evaluation?

A. Decides daily patient assignments
B. The assigned position
C. Planning a unit's goals
D. Role modeling
D. Role modeling
A nurse manager must make an important decision regarding a staff members continued employment on the unit. In order to avoid the pitfalls involved in decision-making, What should the nurse manager do?

A. Choose a decision making style that will best fit the situation
B. Make the decision based on past history
C. Involves several staff members on the unit to assist with the decision
D. Base the decision on the first impression of the staff member
A. Choose a decision making style that will best fit the situation
A staff nurse informs the nurse manager that the nurse would like to gain broader experience in other departments of the acute care facility. Well response by the nurse manager demonstrate effective leadership?

A. "Would you be willing to help on another unit? They need a shift leader for a couple weeks."
B. "I would like you to be a preceptor for the new nurse that was just hired."
C. "Would you be willing to work with one of the senior nurses for a while, until you learn how we operate here?"
D. "Getting broader experience isn't as valuable as specializing."
A. "Would you be willing to help on another unit? They need a shift leader for a couple weeks."
A nurse exhibits leadership traits associated with the role of nurse leader. What activities demonstrated by the nurse would demonstrate these leadership traits? (Select all that apply)

A. Advocating for an employee regarding personnel policies
B. Providing a motivational speech at the new employee orientation
C. Establishing goals for the coming year
D. Appointing a successor
E. Mentoring two new managers
F. Providing feedback about job performance
A. Advocating for an employee regarding personnel policies
B. Providing a motivational speech at the new employee orientation
C. Establishing goals for the coming year
E. Mentoring two managers
F. Providing feedback about job performance
A nurse leader is having a discussion with a team member about changes that will be made on the unit. Which statement by the team member demonstrates the greatest problem for the leader?

A. "Do you have an idea what direction we need to go?"
B. "I don't think you heard what the rest of us had to say."
C. "Your plans for the changes will be difficult to implement."
D."Can you tell me why my suggestion will not work?"
B. "I don't think you heard what the rest of us had to say."
According to the ANA code of ethics for nurses, what is the nurse's primary commitment?

A. Formulating ethically sound decisions when addressing patient care issues
B. Assuring that all healthcare providers address the care of patients in an ethical manner
C. Instructing other healthcare providers in the process of arriving at ethically sound healthcare decisions
D. The application of ethical standards to the delivery of patient care
D. The application of ethical standards to the delivery of patient care
When the care required of a patient comes into conflict with the nurse's personal beliefs, what situation exists?

a. an ethical dilemma
b. a moral conflict
c. moral distress
d. moral distress
a. an ethical dilemma
The nurse engages in actions to promote the good of the patient. The nurse is engaging in fulfillment of which ethical principle?

a. justice
b. beneficence
c. fidelity
d. nonmaleficence
b. beneficence
When considering the MORAL decision-making model, what step is the nurse engaging in when developing the plan of care?

a. massaging
b. outlining
c. looking back
d. affirming
d. affirming
What is the role of the nurse manager in assuring ethical nursing practice on the unit? (Select all that apply)

a. expert problem solver
b. addressing the results of undesirable consequences
c. identifying desired outcomes
d. implementing the best decision with attention to cost
e. primary decision maker
a. expert problem solver
c. identifying desired outcomes
d. implementing the best decision with attention to cost
e. primary decision maker
What information is accurate when describing the Nurse Practice Acts? (Select all that apply)

a. they need to be consistent with applicable federal statures
b. the focus of the acts can vary greatly from state to state
c. the identify actions that fall outside of the nurse's scope of practice
d. they focus on the practice of the professional nurse
e. when considering the law, they are an example of statute
a. they need to be consistent with applicable federal statures
c. the identify actions that fall outside of the nurse's scope of practice
d. they focus on the practice of the professional nurse
e. when considering the law, they are an example of statute
Which situations are necessary components for malpractice to occur? (Select all that apply)

a. a direct connection between care given and injury must be present
b. the practitioner has failed to meet a standard of care, also called a "breach of duty"
c. a perception that patient injury may occur
d. a standard of care must be in place whereby the provider has accepted duty for the patient
e. foreseeability of harm must exist
a. a direct connection between care given and injury must be present
b. the practitioner has failed to meet a standard of care, also called a "breach of duty"
d. a standard of care must be in place whereby the provider has accepted duty for the patient
e. foreseeability of harm must exist
Which steps will help the nurse minimize the risk of nursing malpractice? (Select all that apply)

a. attending relevant continuing education programs to upgrade clinical skills
b. asking each patient to sign an informed consent before care is given
c. maintaining liability insurance independent of that provided by the facility
d. periodically reviewing the scope of practice of nurses
e. observing all facility policies and procedures when providing care
a. attending relevant continuing education programs to upgrade clinical skills
c. maintaining liability insurance independent of that provided by the facility
d. periodically reviewing the scope of practice of nurses
e. observing all facility policies and procedures when providing care
What is the term used to identify the omission of doing something that a reasonable person would do, guided by the considerations that ordinarily regulate human affairs?

a. scope of practice
b. breach of duty
c. negligence
d. malpractice
c. negligence
A nurse manager must be aware of what is happening on the unit to prevent injury to the patient and exposing the staff to a potential malpractice situation. What steps would the nurse manager take to accomplish this? (Select all that apply)

a. regularly checking the credentials of current nursing staff
b. arranging for relevant staff in-services regarding the operation of equipment
c. assuring adequate staffing
d. providing disciplining to those who provide inappropriate care
e. personally monitoring the care provided by new nursing staff
a. regularly checking the credentials of current nursing staff
b. arranging for relevant staff in-services regarding the operation of equipment
c. assuring adequate staffing
d. providing disciplining to those who provide inappropriate care
How can the nurse manager best minimize the personal risk for legal liability?

a. possessing a working knowledge of current laws affecting nursing practice
b. upholding the enforcement of law, rules, and regulations affecting patient care
c. dealing with all members of the staff and all patients in a nondiscriminatory fashion
d. creating a work environment that prioritizes patient needs
d. creating a work environment that prioritizes patient needs
What must a person giving informed consent for surgery or a procedure fully comprehend in order to give informed consent? (Select all that apply)

a. the nurse's personal opinion about the treatment
b. expected or desired outcomes
c. expected complications or potential side effects that may occur as a result of the treatment
d. the risks involved
e. the procedure to be performed
b. expected or desired outcomes
c. expected complications or potential side effects that may occur as a result of the treatment
d. the risks involved
e. the procedure to be performed
Which legal act gives patients the right to determine their desired end-of-life care?

a. patient's bill of rights
b. HIPAA
c. Kassebaum-Kennedy Act
d. patient self-determination act
d. patient self-determination act
The HIPAA ensures strong privacy protections for the patient without threatening access to which areas of care? (Select all that apply)

a. exchange of patient information among appropriate health care providers
b. sharing of information with family
c. health care plans
d. health care clearing houses
e. legally reportable information
a. exchange of patient information among appropriate health care providers
c. health care plans
d. health care clearing houses
Which behaviors by a nurse can result in the suspension or revocation of the nursing license? (Select all that apply)

a. practicing on an expired nursing license
b. failing to report an incident of substandard nursing care
c. a felony conviction for drug use
d. conviction for failure to pay court-ordered child support
e. being convicted of professional negligence
a. practicing on an expired nursing license
b. failing to report an incident of substandard nursing care
c. a felony conviction for drug use
e. being convicted of professional negligence
What term is used to identify the type of law that covers most incidences of malpractice?

a. tort laws
b. legislative law
c. administrative law
d. statutory law
a. tort laws
a nurse is arrested for possesion of illegal drugs. what kind of law governs this type of activity?

a. private
b. criminal
c. civil
d. public
b. criminal
which type of law regulates the practice of nursing?

a. public law
b. criminal law
c. civil law
d. common law
c. civil law
a nurse does not assist with ambulation for a postoperative patient on the first day after surgery. the patient falls and fractures a hip. what charge might be brought against the nurse?

a. assault
b. negligence
c. fraud
d. battery
b. negligence
which statement is true regarding the good samaritan law? (select all that apply)

a. health care providers are required to stop and provide emergency care
b. protection provided is generally limited to emergency situations
c. all care needs are considered an emergency when situations occur out-of-doors
d. the provider may not exceed scope of practice limits
e. a volunteer at a free clinic is covered by this law
b. protection provided is generally limited to emergency situations
d. the provider may not exceed scope of practice limits
which labor standards were set in place by the fair labor standards act? (select all that apply)

a. minimum wage
b. overtime is required to be at least 2 times regular base pay
c. illegal employment of minors
d. a maximum of 80-hour regular pay period
e. guaranteed paid overtime
a. minimum wage
c. illegal employment of minors
d. a maximum of 80-hour regular pay period
e. guaranteed paid overtime
the equal employment opportunity commission defines discrimination as including which forms of discrimination? (select all that apply)

a. sexual harassment
b. age
c. political affiliation
d. pay/compensation
e. race or color
a. sexual harassment
b. age
d. pay/compensation
e. race or color
What is the focus of the Patient Self-Determination Act (PSDA)? (Select all that apply)

a. providing patients with written information about health care durable power of attorney
b. informing patients about advance directives
c. educating patients regarding the role of a health-care proxy
d. educating staff concerning end-of-life issues
e. educating the patient to the various spiritual and religious services the facility offers
a. providing patients with written information about health care durable power of attorney
b. informing patients about advance directives
c. educating patients regarding the role of a health-care proxy
d. educating staff concerning end-of-life issues
What is the primary focus of the HIPAA?

a. the patient's right to confidentiality
b. sharing medical records within the health care team
c. medical record storage
d. preventing families from accessing the medical information of patients
a. the patient's right to confidentiality
What is the nurse manager's focus when the addressing issues represented by Title VII?

a. disability discrimination towards staff
b. patient right to confidentiality
c. staff's right to fair wages
d. civil rights of staff and patients
d. civil rights of staff and patients
a newly employed nurse is reviewing the organizational chart of the facility, observing that there is shared governance. What type of organizational chart does the nurse recognize the facility follows?

a. flat
b. magnet
c. matrix
d. traditional
C. Matrix
the chief nursing officer (cno) at an acute care facility has weekly mandatory meetings with all managers and staff members to discuss what is going well, what could be better, and communication from the executive team. this cno is part of what type of organization?

a. flat
b. traditional
c. matrix
d. mission
A. Flat
The mission of the acute care facility is, "we are dedicated to creating a heathy community, one person at a time." what nursing leadership activities would correlate with that mission? (Select all that apply)

a. placing a staff member on probation for tardiness and excessive break times
b. reviewing heath care provider orders to guarantee the nursing staff is appropriately carrying them out
c. meditating a dispute between two nurses about the shift schedule
d. notifying nursing staff of an upcoming CEU seminar on health eating for low-income families
e. mentoring a nursing student who is interested in introducing smoking cessation to patients and patient families without being preachy
b. reviewing heath care provider orders to guarantee the nursing staff is appropriately carrying them out
d. notifying nursing staff of an upcoming CEU seminar on health eating for low-income families
e. mentoring a nursing student who is interested in introducing smoking cessation to patients and patient families without being preachy
A nurse leader has an idea for changing the intake flow in the ER to leverage more of the nursing staff. The leader knows that if they could implement the idea as a pilot program, they could prove it's effectiveness and then use it in all the ERs in the region. The nurse leader is frustrated, however, because in order to implement even a pilot of the idea, a proposal must be submitted to the ER supervisor with a start to finish scenario that details not only the process but also the risks, liabilities, and cost estimates. If the supervisor approves, the proposal would be sent to the chief nursing officer, who would then send it to the administrator and board of directors for review and approval. Which of these factors are influencing the nurse leader's ability to implement the pilot program?

A. State or national standards
B. Organizational philosophy and values
C. Organizational mission
D. Organizational structure
D. Organizational structure
A nurse on a busy medical surgical unit must delegate some care assignments to an experienced nursing assistant. What factor(s) does the nurse consider prior to delegating the care to the nursing assistant?

A. Organizational philosophy and values
B. State or national standards
C. Organizational structure
D. Organizational mission
B. State or national standards
You are the nurse manager of a medical surgical unit that is in need of change in staffing rotation patterns, which will lead to major changes in how the unit is staffed. According to Lewin's change theory, what forces are in play to enact these changes?

A. Refreezing forces
B. Restraining forces
C. Driving forces
D. Freezing forces
C. Driving forces
A single parent raising two children and relying on public transportation, is determined to become a registered nurse. What are the restraining forces in this situation? (Select all that apply)

A. Stress of being away from children
B. Relying on public transportation
C. Being a single mother
D. An advancement in medicine
E. Student success center established with in the nursing department
A. Stress of being away from children
B. Relying on public transportation
C. Being a single mother
The unit manager of a medical surgical unit is transitioning the unit to electronic charting. According to Lewin's model, which of the following rules describes you as the change agent?

A. The role player
B. The mover
C. The unfreezer
D. The refreezer
C. The unfreezer
The oncology unit has recently experienced a higher than normal patient census, which is requiring that nurses pick up an additional patient. The hospital CFO has indicated that there are no additional funds available to hire additional full-time nurses. As such, the unit manager anticipate some behavioral responses by the stakeholders of change (the nursing staff) within the unfreezing phase. What are some possible behavioral responses? (Select all that apply)

A. Withdrawal
B. Anger
C. Passivity
D. Discontentment
E. Acceptance
A. Withdrawal
B. Anger
D. Discontentment
The charge nurse of a step down unit is implementing a new procedure for charting, which will impact all of the nursing staff. According to Lewins model of change, the movement stage can be more successful if certain things are considered by the change agent. (Select all that apply)

A. Have flexible target dates
B. Include all stakeholders
C. Implement the change
D. Set target dates
E. Ignore resistance to change
B. Include all stakeholders
C. Implement the change
D. Set target dates
A nurse manager notices that supply carts are unorganized and could use some attention. What strategy can the manager use to help implement change in this area?

a. ensure that each subordinate knows there are no exceptions
b. allow each individual to decide how he or she will make the change
c. proceed slowly in making the change
d. encourage input from subordinates for potential options
d. encourage input from subordinates for potential options
The nurse manager for a medical surgical unit is implementing a change in unit procedures as it relates to patient discharge during the fourth phase of change known as action the manager should incorporate the major component known as:

A. Communication
B. Intervention
C. Assessment
D. Evaluation
A. Communication
A nurse manager is assigned to a new unit due to issues of administrative mismanagement, which has resulted in staff becoming disillusioned as to the mission of the unit. As a unit manager, you are expected to develop new policies for the staff to follow. What is one of the greatest factors that may contribute to resistance of change on this unit?

A. Resistance
B. Passivity
C. Lack of trust
D. Anger
C. Lack of trust
A nurse leader recently transferred to a different hospital that is much older than the hospital at which the nurse was previously employed. After working in the new hospital for a month, the nurse leader believes it would be a great idea to bring in the rooms with a lighter paint job, obtain new or hospital beds and curtains, and hang some fun artwork. However, the nurse leader doesn't want to be perceived as a threat to the team. How could these ideas be presented to minimize resistance? (Select all that apply)

A. Engage other nurses in a discussion about the benefits of exam room aesthetics, then present the idea
B. Make over one of the exam rooms and use it as a test case to collect data on patient satisfaction, then present the data along with the idea to the team if the experiment was successful
C. Tell the supervisor and demand of the change
D. Send a letter to the supervisors boss and report failures of the unit
E. Engage other nurses in a discussion about the benefits of exam room aesthetics, then solicit their ideas to improve aesthetics
A. Engage other nurses in a discussion about the benefits of exam room aesthetics, then present the idea
B. Make over one of the exam rooms and use it as a test case to collect data on patient satisfaction, then present the data along with the idea to the team if the experiment was successful
E. Engage other nurses in a discussion about the benefits of exam room aesthetics, then solicit their ideas to improve aesthetics
I nurse leader is thinking about approaching their manager with a new idea. To be properly prepared, the nurse leader should recognize this as a natural and expect a response to change:

A. Acceptance
B. Resistance
C. Blockage
D. Passivity
B. Resistance
After attending a healthcare research seminar, a registered nurse who works in the transplant unit became very interested in the ability of 3-D printing to help save lives. The nurse would really like to raise awareness and see the hospital invest in a 3-D printer. What are the different technical reasons for resistance that the nurse may encounter? (Select all that apply)

A. Unqualified personal
B. Power
C. Public education
D. Budget issues
E. Lack of resources
A. Unqualified personal
D. Budget issues
E. Lack of resources
The charge nurse for a postop treatment center believes that change needs to take place to make the nursing process smoother and the treatment center safer. The nurse's rationale for making change would include which reasons? (But all that apply)

A. To establish leadership power
B. To solve an existing problem
C. To improve staff productivity
D. To reduce unnecessary workload
E. To fill work quotas
B. To solve an existing problem
C. To improve staff productivity
D. To reduce unnecessary workload
The nurse is a member of the nursing staff at the hospital that is undergoing significant organizational change. Which factor is the greatest contributor to the resistance encountered with organizational change?

A. Ineffective organizational management
B. Insufficient staff involvement in the process
C. Employee mistrust of management
D. Poor organizational leadership
C. Employee mistrust of management
A new nursing graduate has just started working in a hospital unit that has had difficulty and staff retention. Which type of assistance may be a result of changes that will occur despite the believes of the workforce?

A. Political
B. Technical
C. Personal
D. Cultural
D. Cultural
A nursing staff member in the ED has noted where improvement of a procedure would bring about more efficiency. The staff members wants to share their idea with their supervisor. What would be the best option to facilitate the possibility of change?

A. Communicate with in a vacuum
B. Schedule a meeting with your supervisor and submit a concise plan related to your idea for consideration
C. Take initiative and implement the change without approval
D. Minimize the use of grassroots support from other staff
B. Schedule a meeting with your supervisor and submit a concise plan related to your idea for consideration
As the nursing manager of the unit, which key step should be performed before implementing a change effort? (Select all that apply)

A. Delay gathering input from team members
B. Encourage input from team members who would be impacted by the change
C. Use a roadmap as a guide to complete the change
D. Keep track of the pace and stress of the change
E. Investigate the magnitude and complexity of the intended change
B. Encourage input from team members who would be impacted by the change
C. Use a roadmap as a guide to complete the change
E. Investigate the magnitude and complexity of the intended change
A few months ago, a new nurse leader at a hospital discovered through evidence-based practice that tablet computers improved accuracy of documentation and decreased patient wait time. The leader noted that these outcomes are beneficial to the facility, staff, and patients, as tablets provide portable access to patient electronic medical records. The nurse leader is currently in the planning stage. Which activities are part of the planning stage? (Select all that apply)

A. Determining the scope of the change project, a schedule for its implementation, and a budget to submit to administration for approval
B. Anticipating resistance to the change by less tech-savvy staff
C. Keeping track of the pace and stress of change
D. Brainstorming the impact, pros and cons, and potential challenges to implementation with impacted teammates
E. Evaluating how to plan unfolds in real time
A. Determining the scope of the change project, a schedule for its implementation, and a budget to submit to administration for approval
B. Anticipating resistance to the change by less tech-savvy staff
A nursing staff member who is on a unit committee to bring about a plan to change is currently in the integrating phase of change. What activities are associated with the integrating phase? (Select all that apply)

A. Assessing how well the new process is accepted and becoming the norm
B. Brainstorming solutions by using your own skills and the skills of those who will be affected by the change
C. Assessing how well the change is working against an established measurement for success
D. Asking a lot of questions, such as "What can be done to overcome barriers?"
E. Investigating the magnitude and complexity of the intended change as it is implemented
A. Assessing how well the new process is accepted and becoming the norm
C. Assessing how well the change is working against an established measurement for success
A nurse leader is working in the ER when a patient presents with a deep head laceration requiring immediate suturing. The nurse leader went to the medical supply area for antibacterial ointments, gloves, and bandages. However, the nurse noticed that the medical supply cabinet was extremely disorganized, so it took much longer than it should have to find the necessary supplies. The next morning, the nurse leader began to ask team members if they had any input regarding the organization of the medical supplies, and then begin to brainstorm a few different ideas, such as rearranging the supplies and we labeling items. What is the next stage of change the nurse leader should address?

A. Implement
B. Design
C. Plan
D. Integrate
C. Plan
Last month, two nursing units were merged to save on staffing costs. The nursing manager is now inquiring among the staff about how the changes working and if any barriers remain. What stage of change is this?

A. Design
B. Plan
C. Implement
D. Integrate
D. Integrate
A nurse manager is considering the use of critical pathways for a nursing unit. Which statement regarding critical pathways is most accurate?

A. They reduce the need for utilization review
B. They can be used to monitor quality of care
C. They reduce the need for documentation
D. They accurately predict patient progress
B. They can be used to monitor quality of care
A nurse manager is preparing a presentation to be delivered to a group of nurses and a nursing unit about the current US healthcare system. Which statement about resource utilization is most accurate?

A. Limiting spending for healthcare resources will improve the quality of US health
B. Currently, there is a scarcity of resources available in the US healthcare system
C. The healthcare resources that are available in the United States are not used to cost effectively
D. Additional funding for healthcare resources would improve the status of US health
C. The healthcare resources that are available in the United States are not used to cost effectively
A nurse manager is considering the reasons for the current problems with the healthcare system. Which are negative consequences of higher spending in healthcare? (Select all that apply)

A. Higher spending may result in higher quality of care
B. Higher spending may result in overutilization of services
C. Higher spending a resort in duplication of services
D. Higher spending guarantees a higher quality of care
E. Higher spending may result in overuse of technology
B. Higher spending may result in overutilization of services
C. Higher spending a resort in duplication of services
E. Higher spending may result in overuse of technology
The new nurse managers learning about fiscal planning. Which are barriers for nurse managers' participation in physical planning? (Select all that apply)

A. Many nurses perceive that fiscal planning is difficult
B. Nursing input in fiscal planning is undervalued
C. Nursing education lacks preparation in fiscal planning
D. Nurses are directly involved in fiscal planning
A. Many nurses perceive that fiscal planning is difficult
C. Nursing education lacks preparation in fiscal planning
A nurse manager is considering how to gain more staff involvement in meeting budgetary goals. Which activity is most likely to result in staff understanding in participating in budgetary goals?

A. Comparing actual expenses with budgeted expenses
B. Forecasting or estimating needs using current data
C. Communicating budgetary planning goals to staff
D. Being held accountable for the units' financial results
C. Communicating budgetary planning goals to staff
A nurse manager is reviewing the budget for the nursing unit. Which budget covers the expenditures for the units workforce?

A. Capital
B. Operating
C. Volume
D. Personnel
D. Personnel
A nurse manager is considering revising the budget cycle for the nursing unit. Which budget cycle has the greatest probability for error?

A. Shortsighted planning
B. Calendar year budget
C. Planning for the distant future
D. Fiscal year budget
C. Planning for the distant future
A nursing manager is considering the budget for a nursing unit as compared with the overall institutional budget. Which is the most negative outcome of multiple nursing units padding or inflating their department budgets to cushion against administrative cuts?

A. The entire institutions budget may be ineffective
B. Some units may not have access to adequate resources
C. Some units may not have access to adequate resources
D. The entire institutions budget may be ineffective
A. The entire institutions budget may be ineffective
A nurse manager is preparing the annual budget for the coming fiscal year, and is considering what the goal is of using the allocated funds. What stage of the budgetary process is this?

A. Assessment
B. Diagnosis
C. Evaluation
D. Planning
B. Diagnosis
A nurse manager is evaluating the current fiscal year budget. Which statement regarding the evaluation stage of the budgetary process is most accurate?

A. The CEO is accountable for individual unit budgetary outcome
B. Most units will have no variation from the projected budget
C. Large variations from the projected budget must be examined
D. Budgets are usually created at the beginning and unchanged
C. Large variations from the projected budget must be examined
A nurse manager is performing a daily assessment of staffing needs. Which data would be needed in order to calculate the NCH/PPP? (Select all that apply)

A. Census for the entire calendar year
B. Patient census as of midnight on day two
C. Work hours for each staff member on duty
D. Staff on duty for 24 hours from 12 AM
E. Staff on duty for 24 hours from 11 PM
B. Patient census as of midnight on day two
E. Staff on duty for 24 hours from 11 PM
A nurse manager is performing a daily assessment of staffing needs. Which statement about calculating the NCH/PPP are most accurate? (Select all that apply)

A. The calculation should include all members of the nursing staff on duty
B. The first step is to calculate the number of staff for the 24 hour period
C. The calculation includes the total staff for any 12 hour shift that day
D. The calculation of the NCH/PPP absolutely determines staffing needs
E. The total staff for 24 hours is divided by the patient census at 12 AM
A. The calculation should include all members of the nursing staff on duty
B. The first step is to calculate the number of staff for the 24 hour period
E. The total staff for 24 hours is divided by the patient census at 12 AM
A nurse manager is performing a daily assessment of staffing needs, when determining if staffing adjustments are needed, which data should the current NCH/PPP calculation be compared to?

A. The unit's maximum NCH/PPP
B. An average of the unit's NCH/PPP
C. The unit's minimum NCH/PPP
D. The budgeted NCH/PPP for the unit
D. The budgeted NCH/PPP for the unit
A nurse manager is performing a daily assessment of staffing needs if the current NCH/PPP is greater than the budgeted NCH/PPP for the unit, which action should be implemented to keep staffing on track?

A. The nursing staff should be reduced for the current shift
B. The nursing staff should be increased for the coming shift
C. The nursing staff should remain the same for the current shift
D. The nursing staff should be reduced for the coming shift
C. The nursing staff should remain the same for the current shift
A nurse manager is performing a daily assessment of staffing needs. Which types of nursing units can successfully use a predetermined standard of nursing staffing for the patient census? (Select all that apply)

A. Specialty care units
B. Emergency department
C. Operating room
D. Home care
E. General medical surgical units
A. Specialty care units
C. Operating room
D. Home care
E. General medical surgical units
a nurse manager is using a budgeting approach that requires justification for each budgetary need. which approach is being used?

a. incremental
b. performance
c. zero-based
d. flexible
c. zero-based
which budgeting approach can foster overspending

a. incremental
b. flexible
c. zero-based
d. performance
a. incremental
a nurse manager wants to improve the efficiency and effectiveness of budgetary expenditures. which budgeting approach would be the best to use in this situation?

a. incremental
b. flexible
c. zero-based
d. performance
d. performance
a new nurse manager with limited budgeting expertise is considering what approach to use to determine the budget of the nursing unit for the upcoming fiscal year. which approach would be the easiest to implement?

a. zero based
b. flexible
c. incremental
d. performance
c. incremental
which of the following are steps included in the flexible budgeting process? (select all that apply)

a. separate the costs into fixed, variable, or mixed categories
b. forecast the cost for each of these categories of activities
c. determine the time period for the budget
d. analyze the cost patterns over that period of time
e. list all current and proposed objectives and activities in the department
a. separate the costs into fixed, variable, or mixed categories
b. forecast the cost for each of these categories of activities
c. determine the time period for the budget
d. analyze the cost patterns over that period of time
A nurse manager informed the staff that if they do not increase productivity by 15%, there will be people losing their jobs. What form of power is a nurse manager just playing with the staff members?

A. Coercive power
B. Reward power
C. Legitimate power
D. Expert power
A. Coercive power
A nurse educator has a very narrow power-authority gap when interacting with students in the clinical setting. What negative student outcome may occur because of this narrow gap?

A. The students will work independently without requiring educator input
B. The students will question everything the nurse educator says
C. The students were question their ability to make independent decisions
D. The students will not be productive in their clinical day
C. The students were question their ability to make independent decisions
What behavior should a nurse manager exhibit to narrow the power-authority gap that exists between the manager and the staff? (Select all that apply)

A. Asking personal questions of your staff
B. Holding others accountable
C. Withholding information about organizational and unit goals
D. Treating everyone the same
E. Being accountable
A. Asking personal questions of your staff
B. Holding others accountable
E. Being accountable
The nurse manager is aware that there will be critical changes made to staffing due to low census in an acute care facility, and staff is already lacking trust in administration. What would be the best way for the nurse manager to handle the situation?

A. Be sure to inform staff not to spread rumors to perpetuate fear
B. Inform the staff that everything will work out for the best
C. Be truthful regarding the situation about staffing and censes
D. Tell the staff that these things happen and administration will work it out
C. Be truthful regarding the situation about staffing and censes
A nurse has just been promoted to a managerial position in the ICU of a busy hospital, and is worried that members off the nursing staff will not treat the nurse's requests with the same respect and seriousness as they did the requests of the previous manager, who was well-regarded. What behaviors would reinforce the new managers authority and power in the eyes of the staff? (Select all that apply)

A. Withholding important information that might upset the staff
B. Demonstrating influence with the hospital senior leadership team
C. Frequently delegating critical decisions
D. Reminding staff how their efforts contribute to the unit's goals
E. Practicing making outright commands of the staff
B. Demonstrating influence with the hospital senior leadership team
D. Reminding staff how their efforts contribute to the unit's goals
A client who experienced a traumatic musculoskeletal injury to the right arm was transported to the local hospitals emergency department. The initial care was delivered by in interprofessional team. What specialized, patient focused care should this form of care delivery provide this patient?

A. Effective communication between individual team members and with the patient will be a priority
B. The patient will be assigned a primary nurse at the time of admission to the emergency department
C. A physician will assume the management of care
D. All physical care will be delivered by a registered nurse
A. Effective communication between individual team members and with the patient will be a priority
The role of the clinical nurse leader (CNL) is directly associated with the successful leader ship of an inter-professional healthcare team. Which statements made by the CNL expressed a component of that role? (Select all that apply)

A. "I've worked with clients from admission through discharge, and when necessary until their death"
B. "I've worked with client diagnosed with cardiac issues for nearly 15 years"
C. "The unit nurses have talked with the family and identified a need for a social services consult"
D. "I'll share the patient's care outcomes with the physical therapist today
E. "The client and I will discuss the healthcare insurance options available to the family"
F. "We need to determine what, if any, safety issues exist related to this clients ability to ambulate independently"
B. "I've worked with client diagnosed with cardiac issues for nearly 15 years"
C. "The unit nurses have talked with the family and identified a need for a social services consult"
D. "I'll share the patient's care outcomes with the physical therapist today
F. "We need to determine what, if any, safety issues exist related to this clients ability to ambulate independently"
Which statement to demonstrate the patient benefits derived from care provided by an interprofessional team? (Select all that apply)

A. "The physical therapist and my nurse work together to schedule my therapy before my wife came to visit"
B. "The nurses all seem to really care about each of their patients"
C. "The rooms are so nicely decorated and someone comes in daily to dust and clean the floor"
D. "We have been so pleased with the care of my mother has been given while she's recovering from her fall"
E. "All my medications are given to me by the same nurse and always on time"
F. "My doctor, the nurse, the social worker, and the dietitian had a meeting with me today about my discharge plan"
A. "The physical therapist and my nurse work together to schedule my therapy before my wife came to visit"
B. "The nurses all seem to really care about each of their patients"
D. "We have been so pleased with the care of my mother has been given while she's recovering from her fall"
F. "My doctor, the nurse, the social worker, and the dietitian had a meeting with me today about my discharge plan"
In an interprofessional team, the role of a nurse leader is elevated from caregiver to include which essential responsibilities? (Select all that apply)

A. Assuring the effective transition from facility to home care
B. Integrating all aspects of client care
C. Minimizing the role of technology in the delivery of care
D. Implementing a team approach to care delivery
E. Supporting client autonomy related to care decisions
F. Assuring client and client family satisfaction
A. Assuring the effective transition from facility to home care
B. Integrating all aspects of client care
D. Implementing a team approach to care delivery
F. Assuring client and client family satisfaction
What factors are considered when determining the appropriateness of implementing care via the interprofessional team? (Select all that apply)

A. The facility's yearly budget
B. The physical location of the facility
C. The complexity of the required patient care
D. Skill of the attending staff
E. The acuity level of the patient population
F. Physical design of the care facility
A. The facility's yearly budget
C. The complexity of the required patient care
D. Skill of the attending staff
E. The acuity level of the patient population
What factors contribute to the success of interprofessional teams? (Select all that apply)

A. Establishing an interpersonal relationship with team members
B. Having role clarity
C. Acknowledging the shared vision
D. Forming clear and efficient communication
E. Enjoying the work experience
B. Having role clarity
C. Acknowledging the shared vision
D. Forming clear and efficient communication
What is the best focused response when I asked, "What does clear and efficient communication mean?" (Select all that apply)

A. Information is presented in language the receiver can understand
B. Checking for the receivers understanding before moving on
C. Giving as much information as possible about everything related to the patient on hand off
D. Always presenting information in a concrete manner
E. A thorough hand off of the situation, including background, your assessment, and any recommendations
A. Information is presented in language the receiver can understand
B. Checking for the receivers understanding before moving on
E. A thorough hand off of the situation, including background, your assessment, and any recommendations
In an interprofessional team, what do you teammates need to understand in order to have a shared vision? (Select all that apply)

A. Cost of the implemented services
B. Why certain members are included
C. Desired outcomes
D. After care options
E. Potential challenges to meeting outcomes
C. Desired outcomes
D. After care options
E. Potential challenges to meeting outcomes
What does an interprofessional team member need to understand about role clarity for the team to be successful?

A. The role and responsibilities of all teammates
B. Individual roles and responsibilities
C. Roles and responsibilities of those outside the team
D. Why the roles and responsibilities exist
A. The role and responsibilities of all teammates
What is considered to be the greatest challenge to the implementation of an inter-professional primary healthcare team?

A. Getting nurses to actively participate in the planning of patient care using this model
B. Assuring patient acceptance of the care model
C. The cost of implementation of such a varied team
D. Overcoming the traditional provider dominated role of determining patient care
D. Overcoming the traditional provider dominated role of determining patient care
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