Show:
Patient Care/Patient Safety
Recruitment
Leadership
Work Environment/
Nursing Models
Technology
100
The NQF provides a model for advancement of healthcare quality that could be used in healthcare organizations. The use of this model by the Centers for Medicare & Medicaid Services specifically affects the interaction between adverse events and: a. Staffing. b. Funding. c. Composition of executive councils. d. Composition of consumer-based councils.
What is B. The Centers for Medicare & Medicaid Services (CMS) have adopted a policy based on the NQF’s “never events.” The CMS will no longer pay for patient conditions or events that result from poor practice while patients are under the care of a health professional. REF: Page 28
100
Recruiting among the emerging workforce (18- to 35-year-olds) is a challenge for healthcare agencies. Marketing brochures should address the leadership and vision of the healthcare agency. Which of the following workplace environments will attract applicants in the emerging workforce? a. A highly professional environment b. A nurturing and receptive environment c. An environment highlighted by lots of meetings, so staff members can have lots of input d. A totally online environment, so staff members will not have to interface with uncaring colleagues
What is B. A study of student nurses who represent this age group indicates that they want a leader who is receptive, approachable, a team player, and motivating. REF: Page 43
100
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 declares the intent and goals to enhance productivity and assumes that the unit also wishes to increase productivity, which allows nurses to feel in control of the environment. b. If staff members increase productivity, then they are given opportunity to engage in learning events such as workshops and conferences. 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.
What is A. Stephen M.R. Covey suggests that Smart Trust is a method for restoring trust in organizations. Smart Trust Actions include declaration of the leader’s intent and assumption by the leader that others also have positive intentions. Building trust involves signaling goals and intended actions in advance. Actions such as promising external rewards such as additional learning opportunities, workload relief, and compensation are consistent with transactional leadership, which leads to low to stable commitment and limited satisfaction. REF: Page 38, 42
100
In planning a new wing, the nurse manager complies with the workplace safety requirements of the Occupational Safety & Health Administration (OSHA). Which of the following groups is considered to be at high risk for violence in the workplace? a. Pediatric staff b. Postsurgical unit staff c. Emergency Department staff d. Medical oncology unit staff
What is C. Nurse managers have responsibility for both patient and staff safety. High-risk areas, such as the Emergency Department, require special attention. REF: Page 60
100
The successful integration of informatics into healthcare settings is key to: a. Quality decision making related to management of resources and patient care. b. Accessing current information about business practices. c. Meeting the modern-day expectations of staff regarding technology use. d. Speeding up calculations and decisions in budget development.
What is A. The use of informatics to research evidence and alternative models of delivery, to compare data and solutions with those of other managers, and to enhance the coordination and delivery of patient care can assist managers in making solid decisions about resource utilization. The use of informatics is embraced by Generation X-ers and Millennials who grew up with technology, but may be more difficult for older staff. REF: Page 63-64
200
The SBAR approach to patient safety encourages: a. Consistency in assessment and practices. b. Continuing education. c. Multidisciplinary approaches. d. Patient feedback.
What is A. The use of SBAR (Situation, Background, Assessment, and Recommendation) checklists are designed to decrease omission of important information and practices. REF: Page 30
200
An important aspect of managing the costs on a unit is to plan accurately for staffing needs. Nurse managers use staffing plans to: a. Assign staff on the unit on a daily basis. b. Ensure that days off are planned for the staff. c. Outline the number of individuals by classification on a per-shift basis. d. Predict the numbers and classifications of float staff needed to augment regular staff.
What is C. A nurse manager needs to manage financial resources by developing staffing plans. Staffing plans plan for minimum number of professional nurses required on a unit at a given time or to the amount of minimum staffing in an extended-care facility or prison, based on regulatory guidelines. REF: Page 263
200
A nurse executive who considers herself a Baby Boomer will have the challenge of convincing the emerging workforce of the necessity of committee meetings. One of the primary reasons that the Baby Boom generation appears to have so many meetings in the work environment is that: a. They feel more comfortable in a group. b. They find that the journey to the solution is as important as the solution itself. c. They were deprived of collective action opportunities in the past and now feel that solutions are better when many people have input. d. Baby Boomers are aging and need the respite from work that meetings offer, so they can recuperate from the physical demands of the work environment.
What is b. Baby Boomers mistrust authority and trust in collective action, based on successes with social movements in their formative years. REF: Page 43
200
A patient complains to you that she has no idea who “her nurse” is on any given day. “I ask one nurse for my pills and she says, ‘That’s not my job.’ I ask the pill nurse about my lab tests and she says that I should ask another nurse.” The nursing care delivery model most likely employed in this situation is: a. Differentiated practice. b. Team nursing. c. Functional nursing. d. Case management.
What is C Functional team nursing involves licensed and unlicensed personnel who perform specific tasks for a large number of patients. A disadvantage of functional team nursing is the fragmentation of care. The physical and technical aspects of care may be met, but the psychological and spiritual needs may be overlooked. Patients become confused with so many different care providers per shift. These different staff members may be so busy with their assigned tasks that they may not have time to communicate with each other about the patient’s progress. REF: Page 235
200
In an ICU, you order new devices to measure heart rhythm and rate, respiratory rate, oxygen levels, and intracranial pressure. These devices involve: a. Biomedical technology. b. Telecommunications. c. Retrieval of patient history information. d. Internet.
What is A Physiologic monitoring devices and patient surveillance systems involve biomedical technology. REF: Page 188
300
A client requires an appendectomy. The surgeon explains the procedure and asks the client to sign the consent. The patient speaks very little English and looks worried. As a nurse, you would: a. Suggest that an interpreter explain the procedure to the client and answer any questions. b. Ask the client if he has any questions. c. Draw a picture to show the incision. d. Not intervene.
What is A. The Five Steps to Safer Patient Care identifies that encouraging patients to ask questions when there are doubts and concerns and ensuring understanding before surgery is performed are ways in which nurses can support patients in having greater influence in their own care. In this situation, asking an interpreter to help enables access to information for the patient and active assessment of his understanding. REF: Page 27
300
In a job interview for a staff position, which of the following indicates your knowledge of patient safety? a. “Will I be able to get overtime hours on your unit?” b. “If there is an opportunity to work extra shifts, I would really like that.” c. “Is there a strategy in place to reduce the number of overtime hours on the unit?” d. “I see no reason why I wouldn’t be able to work overtime.”
What is C. Overtime, whether voluntary or mandatory, to fill staff vacancies is seen as a risk to both patients and nurses because it is more likely to lead to compromised decision making and technical skills because of fatigue. REF: Page 265
300
A group of managers is meeting to discuss ideas related to the successful implementation of evidence-based practice on their units. Susan has been asked by the director of care to assume leadership of these discussion groups. After two such sessions, Susan expresses disappointment to her mentor that the group seems disinterested in her ideas and that they are listening to Ken, who has much less experience with leadership. In discussing this with Susan, the mentor understands that leadership: a. Is a designated role. b. Must be earned. c. Is more likely to be taken by someone who is more talkative. d. Rarely is taken over by someone with less experience.
What is B. A person can have an impressive title, but title or designation does not make the person a leader. A leader must have the ability to inspire others to follow. REF: Page 35
300
For a nurse manager in the functional nursing model, an approach that will assist in maintaining staff satisfaction in this specific model is: a. Rotation of task assignments. b. Frequent opportunities for in-service education. c. Orientation to job responsibilities and performance expectations. d. Team social events in off hours.
What is A Although repetition of tasks increases confidence and competence, it can also lead to boredom. Rotation of tasks can assist specifically in this model to reduce the boredom that is a potential disadvantage of this model. REF: Page 236
300
As part of an information technology implementation team, you are implementing a clinical decision support system. Particular considerations for successful implementation of this project include: a. Ensuring that the system is reliable. b. Ensuring that patient information is reliable. c. Developing unique identifiers for individuals. d. Developing rules that support inferences.
What is D Clinical decision support systems provide support for novice nurses, in particular, as they enable entry of real-time data from patient situations and inferences that apply the logic that expert nurses would use. These inferences require rules to be developed for the system. REF: Page 192
400
A primary care clinic in a small urban center sees a high volume of cardiology patients. Patients who attend the clinic have smart cards that they use at hospitals, clinics, and emergency departments within that region of the state. A primary benefit of the smart card for these patients would be: a. Rapid and accurate treatment in emergency situations. b. Reduced wait times to see specialists. c. E-mail notification of test results. d. Readily available information regarding medications.
What is B. Credit card–like devices called smart cards store a limited number of pages of data on a computer chip and serve as a bridge between the clinician terminal and the central repository of the electronic health record (EHR), making patient information available to the caregiver quickly and cheaply at the point-of-service. Smart cards provide information to healthcare providers regarding the patient’s demographic and contact information, allergies, immunizations, lab results, and past patient care encounters and are presented at the point-of-service. REF: Page 198
400
The biggest challenge in the recruitment of staff is: a. Finding well-qualified candidates who can function well within your particular work culture. b. Recruiting individuals with the appropriate qualifications and experience. c. Screening out candidates who are unable to function well within a team. d. Determining if candidates have had previous negative experiences in a work environment.
What is A. Choosing the right individual is the challenge for managers and involves finding qualified candidates who will work well within your culture. REF: Page 281
400
The nurse manager was upset with the staff nurse and said, “You did not understand what I said.” Which element in the communication process was she referring to? a. Feedback between receiver and sender b. A message channel c. A receiver who decodes the message d. A set of barriers that may occur between sender and receiver
What is D. Problems can occur at any point in communication and result in miscommunication. In this instance, it can be assumed that there was a sender, a receiver, a channel, and feedback. In this scenario, barriers such as distractions, inadequate knowledge, differences in perceptions, and emotions and personality may have resulted in misunderstanding between the manager and the staff nurse. REF: Page 326-327
400
What is not a key concept in a well-functioning team? a. Absence of disagreement or conflict b. Special work that is understood and supported by all c. Willingness to work together respectfully d. Dedication to a mission
What is A The challenge in teams is not to eliminate disagreement or conflict but to recognize when a breakdown in communication occurs. Singleness of mission, willingness to cooperate, and commitment are all key concepts in a well-functioning team. REF: Page 328; 333
400
In designing a program for young adults regarding safe sexual practices, which of the following might reach the greatest number in your target group? a. Web-based applications b. Print-based media such as newspapers c. Television advertisements d. Brochures in kiosks in malls
What is A Mobile technology is changing the digital divide, with young adults, minorities, those with no college experience, and those with lower household incomes being more likely to indicate that phones are their main source of Internet access (Zickuhr & Smith). REF: Page 412
500
One means of ensuring that nurses floated to other patient care areas in healthcare organizations are qualified to work in those areas is: a. Employing additional staff to assist with orientation processes. b. Cross-educating staff members to other areas of the institution. c. Transferring patients to units where the staffing pattern is optimal. d. Orienting staff members to all patient care areas as part of their general orientation to the institution.
What is B. Nurses should be floated to units as similar as possible to their own to decrease the potential for liability. Negotiating cross-training, a proactive approach to temporary staffing problems, reduces the potential for liability. REF: Page 80
500
The chief nursing officer decided that the nurse managers need a series of staff development programs on team-building through communication and partnerships. She understood that the nurse managers needed to build confidence in ways of handling various situations. The greatest deterrent to confidence is: a. Lack of clarity in the mission. b. Lack of control of the environment. c. Fear that one can’t handle the consequences. d. Fear that the boss will not like one’s work.
What is C. Fear of not being able to manage consequences undermines confidence and a sense of competency. REF: Page 341
500
A nurse manager wants to decrease the number of medication errors that occur in her department. The manager arranges a meeting with the staff to discuss the issue. The manager conveys a total quality management philosophy by: a. Explaining to the staff that disciplinary action will be taken in cases of additional errors. b. Recommending that a multidisciplinary team should assess the root cause of errors in medication. c. Suggesting that the pharmacy department should explore its role in the problem. d. Changing the unit policy to allow a certain number of medication errors per year without penalty.
What is B. Quality management stresses improving the system, and the detection of staff errors is not stressed. If errors occur, reeducation of staff is emphasized rather than imposition of punitive measures such as disciplinary action or blaming. REF: Page 365-366
500
Sarah is a nurse manager in a surgical unit. She is concerned about a conflict between Lucy (a staff nurse) and one of the maintenance personnel. Sarah explains to Lucy that unsatisfactory resolution of the conflict is typically destructive and will result in: a. Decreased frustration between the maintenance worker and her. b. A good relationship with the maintenance department. c. Eventual resolution of the problem without further intervention. d. Decreased productivity on her part.
What is D Research by Saltman et al. (2006) determined that productivity decreases with destructive conflict, whereas constructive conflict strengthens relationships. REF: Page 435