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2014-10-14 08:01:45
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  1. Management is a process that is used today by nurses or nurse managers in health care organizations and is best described as
    planning, organizing, coordinating, and controlling.
  2. A participative leadership style is appropriate for employees who
    are able to contribute to decisions about getting the work done.
  3. If you applied the concepts of Theory Y to describe nurses, which of the following statements would be the best description?
    Nurses use self-direction and self-control to achieve work objectives in which they believe.
  4. Nurse retention is an important focus for health care organizations as we face a growing shortage of health care professionals in the future. According to Herzberg’s moti- vation factors, which of the following would most likely contribute to increased job satisfaction?
    The organization recognizes and rewards those nurses who advance their education and achieve certification, such as the CCRN certification for critical care RNs.
  5. Consider your role as a staff nurse in a patient care unit of a hospital. What factors are present that may serve as a substi-tute for your need for leadership from your nurse manager?
    Professional nursing standards, code of ethics, and the intrinsic reward you get from this important work.
  6. Leadership is defined as
    a process of interaction in which the leader influences others toward goal achievement.
  7. Why is leadership development important for nurses if they are not in a management position?
    Leadership is important at all levels in an organiza-tion because nurses have expert knowledge and are
  8. Which motivation theory allows the student to deter-mine the probability of achieving one’s goal?
    Vroom’s Expectancy Theory
  9. As both a manager and leader of patient care, how can you use feedback mechanisms to enhance your patient outcomes? Select all that apply.
    • A. Determine behavior needs of staff that need to change.
    • B. Give frequent feedback to the staff to sustain their new behaviors.
    • C. Portray feedback to staff as good or bad. D. Give staff feedback that is understandable and usable.
    • E. Give staff feedback that is measurable.
    • F. Give staff feedback that is usable, consistent, and correct.
  10. Which of the following leadership characteristics are important for the nurse to master to assure effective management of patients? Select all that apply.
    • A. Develop a professional and purposeful vision that provides direction toward the preferred future.
    • B. Portray a passion that involves the ability to inspire and align people toward the goal.
    • C. Display integrity that is based on knowledge of self, honesty, and maturity.
    • D. Know your strengths and weaknesses.
    • E. Be daring and curious when taking reason-able risks.
  11. The national organization that accredits health care organizations is known as which of the following?
    Joint Commission
  12. The largest purchaser of health care in America is which of the following?
    Medicare, Medicaid, and other governmental programs
  13. Who identified a structure, process, and outcome framework for quality?
  14. What is the top underlying cause of health care disparity in the United States?

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    Socioeconomic status
  15. Payment for health care services as a fixed dollar amount per member over a period of time is referred to as which of the following?
  16. The Patient Protection and Affordable Care Act provides comprehensive health care reform through a number of initiatives including which of the following? Select all that apply.
    • B. Expanding health insurance coverage
    • C. Targeting fraud, abuse, and waste in health care
    • D. Increasing access to primary care services
    • E. Promoting preventive health strategies
  17. Key factors contributing to rising health care costs in the United States include which of the following? Select all that apply.
    • A. An aging population
    • B. Advancements in technology
    • C. Increased utilization of pharmaceuticals
    • D. Rising costs of primary care
    • E. Administrative costs
  18. The competencies for the education of health care profession-als recommended by the Institute of Medicine to improve the quality of health care include all but which of the following?
    A. Primary care settings
  19. As a new nurse attending the hospital’s employee orienta-tion program, you are told that the hospital recognizes its employees as its most valuable asset. Which of the follow-ing does not demonstrate congruence between this state-ment and what you observe in the workplace?
    Employee suggestions are encouraged but are rarely acted upon.
  20. Magnet hospitals foster the philosophy that nurse leaders are needed at all levels of the organization. As a staff nurse and clinical leader on your unit, which of the following activities would not be viewed as supportive of the hospi-tal’s philosophy in a magnet facility?
    Medical practitioner serving in the role of chairperson of the nursing practice council.
  21. A body of evidence spanning two decades of research exists to support the value of magnet hospitals. Which of the following statements offers the strongest support for the pursuit of magnet hospital designation?
    In a longitudinal, multisite study of more than 2,000 U.S. hospitals, researchers reported that one year and three years following implementation of a magnet workplace culture, employee turnover dropped by 50%.
  22. A nurse evaluating an organization’s potential for long-term success knows that high-performance environments offer a competitive advantage. Which of the follow-ing examples does not exemplify a high-performance organization?
    The organization controls information available to employees and follows the company policy that what employees don’t know won’t hurt them.
  23. As a nurse, you are increasingly reading about magnet hospitals and noticing that these hospitals are also known as high-performance organizations. Which of the following most accurately characterizes why magnet hospitals may be classified as high-performance organizations?
    High-performance organizations such as magnet hospitals recognize the importance of attracting and retaining talented employees.
  24. A nurse was visiting with a relative who is not a nurse. The relative had been reading about the benefits of magnet hospitals in a recent issue of Reader’s Digest. She wanted to know more about these benefits. In responding to the relative’s question, which of the following outcomes listed on a magnet hospital’s Web site would the nurse not use to illustrate the benefits of magnet hospitals?
    Nurse-to-patient ratio of 1 nurse to 20 patients.
  25. Part of the role of the staff nurse champion for a hospital’s magnet journey is to prepare and present an in-service on the historical evolution of the Magnet Recognition Program. As part of this program’s discussion, which pri-mary goal should be presented to describe the main reason for creation of the Magnet Recognition Program?
    To promote excellence in the delivery of nursing services to patients.
  26. Demonstrating that all the Forces of Magnetism exist in an organization is crucial to meeting the magnet requirements. As a staff nurse working on a magnet committee, you have been asked to help evaluate the magnet evidence to be submitted with the hospital’s mag-net application. Which of the following information pieces is not evidence to support professional development, the fourteenth Force of Magnetism?
    A statement describing how decision making is done by the medical staff.
  27. As a new nurse seeking a supportive and collegial work environment, which of the following workplace cultures would be most consistent with your aspirations? Select all that apply.
    C. The unit has a staff retention committee that hosts a quarterly luncheon and an employee-of-the-quarter recognition event.

    E The organization has a defined nursing career ladder in place.
  28. A staff nurse just finished taking a course entitled “Becoming a Charge Nurse.” Organizational behavior was part of the course content. Which of the following statements most readily explains the reason such a course would be useful? Select all that apply.
    B. The course helps employees better under-stand themselves and others as a basis for good contributions toward achieving top organizational performance 

    E. The course incorporates a personal strengths inventory assessment to ascertain the nurse’s optimal career trajectory.
  29. Identify the health care insurer that contributes the largest proportion of the health care dollar in the United States.
    U.S. Government
  30. Compare the life expectancy of women in Canada to that of women in the United States.
    Canadian women can expect to die about three years after U.S. women.
  31. Select the most important reason for managing health care as a business.
    Profit must be assured for the system to continue.
  32. Differentiate which of the following documents articulates the purpose for which a health care organization is in business?
    Mission statement
  33. Distinguish which of the following nurse leaders was not mentioned in this chapter as having a perspective on economics?
  34. Select the concept that is synonymous with profit.
    Contribution to margin
  35. For Medicare patients, the “donut hole” describes which of the following? Select all that apply.
    A. Non-comprehensive prescription coverage by Medicare

    D. A gap in coverage for prescriptions after the maximum is paid
  36. The cost of nursing practice in hospitals is typically paid for through which of the following? Select all that apply.
    E. Room charges that include nursing care, housekeeping and laundry services

    F. Insurance companies that charge a daily rate for hospitalization
  37. What is the major purpose of evidence-based practice (EBP)?
    To provide EBP in support of clinical competency
  38. Which of the following is an accurate statement concern-ing EBP at this time?
    Generally speaking, EBP is recognized by nursing, medicine, and health policy makers as state-of-the-art science reports.
  39. Which of the following organizations develops clinical practice guidelines on multiple clinical conditions?
    Agency for Healthcare Research and Quality (AHRQ)
  40. Which of the following is true about evidence for use in clinical practice?
    It always needs to be interpreted for appropriateness for a specific patient.
  41. Which of the following is likely to provide the strongest evidence about diabetic patient care?
    A systematic meta-analysis of the literature on diabetic nursing care
  42. Assessment of evidence from what source must be sought first when a patient complains of pain?
    The patient
  43. Potential outcomes for organizations that adopt policies based on EBP include which of the following? Select all that apply.
    • A. Improved quality of care
    • B. Improved cost savings
    • D. Decreased lengths of stay
    • E. Improved patient outcomes
  44. Nurses must consider which of the following when working with patients?
    What the patient wants as well as what is medically best
  45. E-health includes which of the following activities?
    All of the above
  46. A person who is HIV positive and chooses not to reveal this information to a nurse during an admission assess-ment is keeping this information
  47. If a patient came to you asking for an Internet site where he could learn more about diabetes, which of the following would be appropriate for you to suggest?
    MEDLINE plus
  48. You are interested in learning more about amyotrophic lateral sclerosis (ALS). You find a Web site where the author states that he is a worldwide leading researcher into causes for this disease. As part of your evaluation of the author’s credentials, you will do which of the following?
    Do an author search on MEDLINE.
  49. Decipher the following URL: This is the URL for which of the following Web sites?
    A Web site published by medical librarians.
  50. Staff nurses at a hospital are extremely resistant to using the new automated medication administration system. This resistance most likely is due to the fact that the sys-tem did which of the following? Select all that apply.
    C. Did not consult end users during the design phase.
  51. Maintaining confidentiality of the computer-based patient record is complex due to which of the following? Select all that apply.
    • A. Storage technology required for the electronic record.
    • C. Complexity of patient and clinical data.
    • D. Access to medical records via telecommunica-tions networks.
    • E. Confusing security and privacy rules regard-ing health care.
  52. Informatics nursing is distinguished from other nursing specialties by its focus on which of the following?
    Content and representation of data and information.
  53. You have just attended a community hearing about the increasing rate of sexually transmitted infections (STIs) among adolescents in your community. The community is divided on what actions to take. You want to help the com-munity reach some consensus on a plan of action. What intervention would be the most appropriate to do first?
    Form a coalition of community leaders and interest groups to take action.
  54. The best indication that a community clinic is interested in providing culturally inclusive care is that the clinic does which of the following?
    Provides care for people from all cultures in the community
  55. Health status disparities among the poor, people of color, and American Indians persist in the United States. Which of the following changes in health determinants would help to reduce these disparities? Select all that apply.
    • A. Decrease in the poverty level
    • D. Increase in the availability of primary care
    • E. Improvement of housing conditions in poor neighborhoods
  56. The incidence of obesity among children and teenagers is increasing in the United States. In order to reduce the incidence of obesity, the risk factors that cause obesity need to be reduced. Elimination of candy, snack food, and high-sugar beverages from school vending machines is one action that many school districts have taken. What health determinants have been modified by changing the con-tents of the vending machine? Select all that apply.
    • B. Physical environment of the school building C. Policies and interventions of the school district
    • E. Individual choices available to students
  57. You want to increase the resilience of the people living in an inner city neighborhood where there are high rates of poverty and unemployment. Which of the following actions would help you achieve this goal?
    Use community-action research to identify the health priorities of the people.
  58. You have been given the charge to determine the health status of a group of children living in an inner city housing development. What health status data should you collect? Select all that apply.
    • A. Mortality data
    • B. Morbidity data
    • C. Health behaviors data
    • D. Health care access information
    • E. Family support information
  59. You are a county public health nurse. Many families in your community do not have health insurance, do not have a primary care provider, and their children are often not immunized against common childhood illnesses. You decide to hold a free immunization clinic at the local grade school during normal school hours. Which health system disparity are you trying to overcome?
    Access to child health services
  60. You are developing health teaching for fall prevention in the elderly. You plan to present this program to older adults at churches, community centers, and neighborhood clinics. This health teaching intervention is an example of nursing practice at which of the following levels?
    Individual level
  61. Your community is under a hurricane alert. The hurricane is expected to hit your community in approximately 10 hours. You are participating in the Predisaster Stage of the community Disaster Preparedness Plan. Activities you might carry out include which of the following?
    Setting up a shelter at a local school and evacuating a mobile home park
  62. You want to evaluate the effectiveness of a blood pressure (BP) screening clinic for the elderly. Which of the follow-ing measures would be best in determining the impact of the BP screening clinic on the health status of the people screened?
    Number of people with elevated BP who followed through with referral to their primary care provider and were placed on antihypertensive medications
  63. An RN asks the nursing assistive personnel (NAP) to take a set of vital signs on a patient who has just had an arterial venous shunt placement. The RN reminds the NAP not to take the blood pressure (BP) on the operative side. An hour later, the RN finds the deflated blood pressure cuff on the operative arm of the patient. The NAP has done this before and has been counseled about it. What should the RN do first?
    A. Assess the patient’s condition.
  64. A new graduate RN has received an unfamiliar treatment order from the physician. How should the nurse proceed?
    Inform the physician and ask the physician or charge nurse for assistance in doing the procedure.
  65. What part of the communication process returns input to the sender?
    A. Feedback
  66. Which of the following characteristics is most relevant to to verbal communication?
    Tone of voice
  67. All but which of the following are steps to improve com-munication using the SBARR technique?
    Assure patient safety.
  68. 6. Which of the following skills involves active listening and is a very important skill used by nurses to gain an understanding of the patient’s message?
    A. Attending
  69. 7. The most prevalent language spoken in the world is which of the following?
    Mandarin Chinese
  70. All but which of the following is a personal health identifier?
    Age (under 89) in years
  71. When administering medications, which items completed by the nurse during the medication administration pro-cess would increase the nurse’s risk of making a medica-tion error? Select all that apply.
    • A. Troubleshooting an IV infusion pump alarm
    • B. Answering questions from nursing colleagues
    • C. Calling pharmacy to check on a missing medication
    • E. Obtaining a handoff report on a patient returning from a diagnostic test
  72. Nurses can proactively create a safe and happy workplace by using which techniques? Select all that apply.
    A. Engage in self-care activities.

    C. Name the problem, labeling horizontal violence, as appropriate.

    D. Use reflection to raise self-awareness.
  73. Political methods inherently involve which of the following? Select all that apply.
    • A. Competition
    • C. Negotiation
    • D. Collaboration
    • E. Consultation
  74. Politics exist because of which of the following statements?
    Some people want to control more resources than others.
  75. The consumer movement in health care is characterized by which of the following statements?
    It is growing because of the Internet and organizations such as the AARP.
  76. In that the national expenditures on health care for the uninsured exceeds $100 billion annually, which of the following is true?
    Forty-three million Americans are uninsured.
  77. Many consumers are concerned about media reports of health care expenditures rising because of which of the following?
    Their individual share of expenses is rising.
  78. Which of the following is true concerning the minority population in the United States?
    It has resisted the consumer movement.
  79. Which of the following is true regarding the consumer movement in the United States?
    It challenges nurses to be more professionally accountable.
  80. ANA describes the essential elements of nursing. Which of the following is not an essential element?
    Delivering problem-focused care
  81. As a new school nurse, you become aware of some state laws that actually get in the way of providing the best care for your students. What are the best steps in becoming politically active and changing this? Select all that apply.
    • A. Join the state school nurse organization, become active, and partner with parent groups.
    • B. Vote in the next election, and encourage all your friends to do so.
    • C. Study politics, and run for political office.
    • D. Write your state legislators, describe your problem, and ask them to initiate laws that will resolve the problem.
  82. Nursing political influence is increased by:
    Pursuing lifelong learning and accountability to the public.
  83. A document that describes the institution’s purpose and philosophy is which of the following?
    the mission statement
  84. Which of these statements is true about a strategic plan? Select all that apply.
    • A. Requires focus on its mission and vision
    • C. Requires an assessment of the environment
    • D. Needs to be revisited periodically
    • E. Needs to be preceded by a SWOT analysis Copyright | CENGAGE Learning | Nursing Leadership & Management | | Printed from
  85. The most formal and hierarchical organizational structure would be expected to have an organizational chart with which of the following?
    Many layers of command
  86. SWOT means which of the following?
    A. Strengths, weaknesses, opportunities, threats

  87. The above figure is an example of what type of organiza-tional structure?
  88. Which of the following are steps of the strategic planning process? Select all that apply.
    • A. Stakeholder analysis
    • C. Identifying planning goals and objectives
    • E. Developing mission and vision statements
  89. A small hospital with 25 beds would probably be best served by which of the following organizational structures?
  90. Based on the Tuckman and Jensen team process, what stage of team development is it when team members work harmoniously together, have open communication, take risks, and trust each other to complete assigned tasks?
  91. A good leader does all except which of the following?
    Uses only an authoritative leadership style
  92. Which of the following is not a characteristic of groupthink?
    Free discussion of ideas
  93. Which of the following communication roles is used to protect the team from outside pressures from those above them in the organizational hierarchy?
  94. Which of the following showed that an individual’s per-formance is often determined in large part by the work group?
    Hawthorne experiments
  95. Which of the following are characteristics of a successful team? Select all that apply.
    • B. They understand the role of each team member.
    • C. They communicate effectively
    • E. They have an explicit
  96. According to Miller, et al., key nursing behavioral markers for interdisciplinary interaction include which of the fol-lowing? Select all that apply.
    C. Being prompt for shift duty
  97. If, as a new nurse, you propose a change in a long-standing unit routine, you can expect which of the following?
    resistance from anyone who is comfortable with the status quo.
  98. Which of the following can interfere with a new nurse’s ability to influence his or her peers? Select all that apply.
    • A. Seeking knowledge of recent advances in nurs-ing practice
    • E. Being unwilling to acknowledge errors when they are made
    • F. Being a loner who is unwilling to share infor-mation with coworkers
  99. Which of the following sources of power should a new nurse expect to increase during the first few months on the job?
    Expert power
  100. The most effective nurses use power is which of the following?
    to influence others or affect others’ thinking or behavior.
  101. When a person fears another enough to act or behave differently than he or she would otherwise, the source of the other person’s power is called which of the following?
    coercive power.
  102. How can a nurse’s personal power be enhanced? Select all that apply.
    • A. Collaborating with colleagues on special projects outside the work setting.
    • C. Volunteering to serve on organizational committees led by nonnurses.
    • D. Getting to know one’s coworkers off duty and sharing recreational activities together
    • E. Becoming more self-aware of personal nursing knowledge and skills
    • F. Identifying a competent coworker and learning from him or her
  103. 7. Three levels of power include all but which of the following?
  104. Power has been described in the literature
    in multiple ways, some not so positive.
  105. 9. Which of the following can most interfere with a new nurse’s base of personal power?
    Hesitating when giving instructions to a nursing aide
  106. How can a new nurse gain influence on a nursing unit within a few weeks on the job? Select all that apply.
    • A. Identify a mentor on the unit and ask for guidance.
    • B. Associate with competent and respected coworkers.
    • C. Suggest improvements in unit routines that seem unclear.
    • D. Consult the Internet for more information about patients’ diagnoses and treatment.
    • E. Steer clear of physicians and other nurses in daily nursing activities.
    • F. Seek information about patients from their family members and friends.
  107. What is often the most desirable conflict resolution technique?
  108. The change agent and the person responsible for conflict management have what characteristic in common?
    Trustworthy and a good communicator
  109. Select the best reason why change is necessary.
    To enhance the quality of health care
  110. Identify the theorist who first proposed the original change theory model.
  111. Identify the least reliable form of communication on a nursing unit.
    The grapevine
  112. Which of the following strategies will be least helpful to the nurse who is managing a change project?
    Selecting a team of personal friends to develop the project
  113. 7. The nurse leader develops an educational program for the unit personnel on a new policy for determining patient-to-nurse staffing ratios.
  114. 8. A nurse’s conflict with a peer regarding who will admit a patient at the change of shift is an example of what type of conflict?
  115. 9. Which of the following statements are true regarding innovation? Select all that apply.
    • B. Nursing practice innovation can improve patient outcomes.
    • C. Evidence-based practice is a valuable resource for the process of innovation.
    • D. Leadership projects can drive innovative
  116. As a nurse, you are asked to lead a change project that impacts the unit where you work. With your knowledge of the change process, identify the order in which you will do the following. Select all that apply.
    • A. Set up a schedule of meeting dates and times.
    • B. Define the problem.
    • C. Select a qualified team of individuals to examine the issue.
    • D Identify key players who have knowledge about the problem.
    • E. Brainstorm possible solutions to the problem.
    • F. Select a problem solution that is supported by evidence-based practice.