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Test Bank Nursing Leadership Management 3rd Edition, Kelly
Chapter 1: Nursing Leadership and Management
1. According to Henri Fayol, the functions of planning, organizing, coordinating, and controlling are considered which aspect of management?
a. Roles c. Functions
b. Process d. Taxonomy
2. Which of the following is considered a decisional managerial role?
a. Disseminator c. Leader
b. Figurehead d. Entrepreneur
3. A nurse manager meets regularly with other nurse managers, participates on the organizations committees, and attends meetings sponsored by professional organizations in order to manage relationships. These activities are considered which function of a manager?
a. Informing c. Monitoring
b. Problem solving d. Networking
4. A nurse was recently promoted to a middle-level manager position. The nurses title would most likely be which of the following?
a. First-line manager c. Vice president of patient care services
b. Director d. Chief nurse executive
5. A nurse manager who uses Frederick Taylors scientific management approach, would most likely focus on which of the following?
a. General principles c. Labor productivity
b. Positional authority d. Impersonal relations
6. According to Vrooms Theory of Motivation, force:
a. is the perceived possibility that the goal will be achieved.
b. describes the amount of effort one will exert to reach ones goal.
c. describes people who have free will but choose to comply with orders they are given.
d. is a naturally forming social group that can become a contributor to an organization.
7. According to R. N. Lussier, motivation:
a. is unconsciously demonstrated by people.
b. occurs externally to influence behavior.
c. is determined by others choices.
d. occurs internally to influence behavior.
8. According to R. N. Lussier, there are content motivation theories and process motivation theories. Which of the following is considered a process motivation theory?
a. Equity theory
b. Hierarchy of needs theory
c. Existence-relatedness-growth theory
d. Hygiene maintenance and motivation factors
9. The theory that includes maintenance and motivation factors is:
a. Maslows hierarchy of needs. c. McGregors theory X and theory Y.
b. Herzbergs two-factor theory. d. Ouchis theory Z.
10. A nurse is appointed to a leadership position in the local hospital. The nurses position would be considered which of the following?
a. Informal leadership c. Leadership
b. Formal leadership d. Management
Chapter 2: The Health Care Environment
1. Which of the following individuals observed that noise, food, rest, light, fresh air, and cleanliness were instrumental in health and illness patterns?
a. W. Edwards Deming c. Isabel Hampton Robb
b. Florence Nightingale d. Dorothea Dix
2. A nursing instructor asks a student what discoveries are attributable to Florence Nightingale. The instructor determines that further teaching is needed if the student responds:
a. the need to monitor health care practitioners.
b. the importance of structuring hospitals around care.
c. the importance of collecting and using data for quality assessment.
d. the importance of being informed regarding the activities of government policymakers.
3. A new graduate wants to explore the three components of each heath care system before applying for a position. The graduate would plan to explore which of the following?
a. Strategy, outcome, and performance c. Structure, process, and outcome
b. Process, strategy, and opportunity d. Outcome, procedure, and structure
4. Which of the following organizations has set forth three primary goals for good health care?
a. The Institute of Medicine
b. The Centers for Disease Control and Prevention
c. The Agency for Healthcare Research and Quality
d. The World Health Organization
5. A nurse working on the unit budget would recognize that the resources needed to deliver quality health care such as nurses, practitioners, medical records, buildings, and pharmaceuticals are considered which aspects of health care?
a. Process c. Organization
b. Structure d. Practice
6. The human resource manager understands that an example of a quality performance outcome measure involves which of the following?
a. Patient satisfaction c. Staff satisfaction
b. Return on assets (ROI) d. Organizational climate
7. A nurse is on vacation visiting a number of countries. If the nurse becomes ill, in which country will the nurse most likely be hospitalized in a government hospital, with the government paying the bills.
a. Canada c. Taiwan
b. New Zealand d. Germany
8. An instructor wants to determine if a group of nursing students know the important features related to the benefits of primary care. Which of the following responses by the students would indicate that further teaching is necessary?
a. Care that is continuous
b. Care that began at first contact with the patient
c. Care that is integral
d. Care that is community orientated
9. A group of nursing students are given a test on Starfields (1998) foundations of primary care. Which of the following responses by the students describing the foundations of primary care would indicate that further teaching is necessary?
a. Comprehensiveness c. First contact
b. Organization d. Coordination
10. Which agency/division is not a part of the U.S. Department of Health and Human Services?
a. Food and Drug Administration (FDA)
b. Centers for Disease Control and Prevention (CDC)
c. Institute of Medicine (IOM)
d. Indian Health Service (HIS)
Chapter 3: Organizational Behavior and Magnet Hospitals
1. Schermerhorn, Hunt, and Osborn define organizational behavior as the study of:
a. human behavior in organizations.
b. the organizations output or end product.
c. systems theory within an organization.
d. strategic planning for long-term survival.
2. According to Lynn and Redman, organizational behavior emphasizes:
a. products, sales, and revenue generation.
b. job satisfaction, loyalty, and productivity.
c. economic constraints, customer base, and sales.
d. machine-like or assembly line work process.
3. A nursing instructor wants to determine whether the nursing students understand the principles that scientific management emphasizes. Which response by the students would indicate that they understand scientific management?
a. Products, sales, and revenue generation
b. Job satisfaction, loyalty, and productivity
c. Economic constraints, customer base, and sales
d. Machine-like or assembly line work processes
4. The nursing staff of the medical unit recognize that according to Schermerhorn et al., an organization can be considered effective if it:
a. maintains a growth rate of no less than 10 percent per year.
b. can continue to grow and have a healthy bottom line.
c. has a quality workforce and commitment to success.
d. can increase productivity without increasing employees.
5. Intellectual capital can be defined as:
a. work created by an individual but owned solely by the organization.
b. an individuals knowledge, skills, and abilities that have value and portability.
c. ideas and creations formulated at work and sold for profit by the organization.
d. an organizations collective information, which is in written, electronic, or cryptic format.
6. In order to increase productivity, the nurse manager of the surgical unit removes obstacles for motivated and empowered individuals. This behavior is common in which type of organizational model?
a. Autocratic c. Collegial
b. Custodial d. Technological
7. Organizational behavior has impacted the autocratic model of behavior by moving from:
a. dependence on the organization to responsibility for self.
b. dependence on the boss to empowering the individual.
c. passive cooperation by the employee to active participation.
d. motivation by money, security and benefits to motivation by job performance.
8. A high-performance organization can be characterized by which of the following characteristics?
a. Brings out the best in people
b. Values knowledge and pays top salaries
c. Continues to change with consumer demands
d. Is job centered to guarantee efficiency of work
9. Maintaining high quality-of-work-life environments requires the commitment of:
a. owners and stockholders of a company.
b. human and financial resource departments.
c. leaders and employees of the organization.
d. maintenance, housekeeping, and other service departments.
10. Saint Cecils hospital recently achieved magnet status. This means that the hospital has met the:
a. AHA distinguished service award for excellence in community service.
b. JC patient care performance measures with no deficiencies.
c. OSHA compliance with all guidelines and no deficiencies.
d. ANCC nursing excellence requirements.
Chapter 4: Basic Clinical Health Care Economics
1. A student in an economics course is aware that the three premises that the study of economics is based upon would involve which of the following?
a. Price elasticity, choice, and scarcity
b. Scarcity, choice, and preference
c. Choice, price elasticity, and preference
d. Price elasticity, scarcity, and cost maximization
2. The concept of _____ does not work well when applied to health care because the general rule that when the price of an item or service goes up, the demand goes down does not necessarily impact the publics demand for (or belief in their right to obtain) this item or service.
a. Price elasticity c. Economics
b. Scarcity d. Cost maximization
3. A nurse educator evaluates the students understanding of the current factors influencing health care reform. Which response by a student would indicate that further teaching is required?
a. Interest groups c. Altruism
b. Political ideology d. Policy entrepreneurs
4. A nurse manager recognizes that methods used to account for the cost of health care expenditure include which of the following?
a. Regression analysis, flowcharts, and relative value points
b. Patient classification systems, regression analysis, and flowcharts
c. Relative value units, regression analysis, and patient classification systems
d. Relative value points, process improvement, and quality management
5. An instructor wants to determine whether a nursing student knows during which era the cost of health care began to be questioned. Which response by the student would indicate that the student knows?
a. 1940s c. 1960s
b. 1950s d. 1990s
6. During an in-service training, the speaker evaluates the attendees knowledge of the term cost plus. Which response by the attendees indicates they understand?
a. An international discount store
b. The amount of monies spent on health care plus the current inflation factor
c. The cost to the provider plus a profit incentive for being in business
d. The expenditure for being in the health care business plus benefits from pharmaceutical companies
7. A newly hired staff nurse understands that the organizations vision statement provides which goals for the organization?
a. Short-term c. Short-term and long-term
b. Long-term d. Anticipated, short-term, and long-term
8. A local hospital has no stockholders. This type of organization is most likely:
a. for-profit. c. monopoly.
b. not-for-profit. d. fiefdom.
9. Nurses should be familiar with the concept of ethics and understand that it represents the concern for which of the following?
a. Others instead of oneself
b. Oneself instead of others
c. The general welfare of society as the proper goal of actions
d. The welfare of the individual as opposed to groups as the proper goal of actions
10. An accountant at the local hospital would understand that which of the following government organizations is responsible for the administration of Medicare and Medicaid?
a. Health Care Financing Administration (HCFA)
b. Social Security Department
c. Tax Equity and Fiscal Responsibility Act (TEFRA)
Chapter 5: Evidence-Based Health Care
1. When engaging in evidence-based health care, the nurse understands that it was originally started as a way to:
a. teach medical students the art and science of medicine.
b. promote technological advances in medicine.
c. integrate individual experience with clinical research.
d. incorporate collaboration within all health care disciplines.
2. A nurse manager is preparing to develop a research proposal. The manager reviews the Iowa Model of Evidence-based Practice to Promote Quality Care and decides to base the research question around one of the problem-focused triggers identified in the model. The nurse manager will most likely choose which of the following triggers?
a. Philosophies of Care
b. New Research or Other Literature
c. Identification of Clinical Problem
d. National Agencies or Organizational Standards and Guidelines
3. A nurse researcher is planning a study using a procedure for quantitatively combining the results of many research studies that measure the same outcome. The data will be combined into a single pool or summary estimate of results. The nurses research will most likely involve which of the following designs?
a. Correlation c. Follow-up study
b. Meta-analysis d. Longitudinal research
4. A nurse researcher is conducting a study that has as its main objective the accurate portrayal of the characteristics of people, situations, or groups, and the frequency with which certain phenomena occur. The research is implementing which type of study?
a. Comparative research c. Correlation research
b. Descriptive research d. Research utilization
5. As part of your research, you wish to combine study results and thus integrate the results of multiple studies on a given topic. This action is referred to as:
a. qualitative analysis. c. meta-analysis.
b. quantitative analysis. d. matched case-control study.
6. You decide to conduct a study that begins with cigarette smoking and then looks at lung cancer. Which type of study will you conduct?
a. Outcome study c. Retrospective study
b. Prospective study d. Time series study
7. In developing research, a possible variable the nurse may be considering would be which of the following?
a. Study intervention c. Body temperature
b. Placebo d. Control group
8. When using available evidence, the nurse must be aware of what two major challenges?
a. Balancing the benefits and harm to justify a recommendation of the evidence
b. Reviewing the body of knowledge and evaluating for clinical decision making
c. Recommending or not recommending the research evidence for clinical practice
d. Reviewing the clinical trials and grading the research according to the AHRQ scale
9. The nurse is engaged in a process approach of reviewing, interpreting, critiquing, and evaluating research and other relevant literature for direct application to patient care. When asked by a coworker, the nurse explains that this process is called:
a. evidence-based medicine. c. evidence-based care.
b. evidence-based practice. d. critical thinking.
10. The nurse is aware of the growing development of evidence-based care. The nurse would recognize that an issue driving this development is:
a. increased variability in implementation of practice and variance analysis.
b. requirement of evidence-based standards of care by PEW.
c. decreased numbers of well-designed RCTs.
d. growth of advanced practice roles.
Chapter 6: Nursing and Health Care Informatics
1. Approximately how many Americans rely on the Internet when choosing a school for themselves or a child?
a. 10 million c. 21 million
b. 17 million d. 28 million
2. A nurse manager tells the staff that there will be an increasing use of nursing informatics in the clinical setting. The nurse manager explains that, according to the 1998 definition formulated by the International Medical Informatics Association-Nursing Informatics (IMIA-NI), nursing informatics is defined as:
a. a formal educational program in nursing informatics or a graduate program with a nursing informatics focus by an institution of higher learning.
b. differentiated practice representative of the specialty and recognized for certification by at least one organized body through external testing.
c. the integration of nursing, its information, and information management with information processing and communication technology to support the health of people worldwide.
d. a designation applied to any nurses who have successfully educated themselves using formal and/or informal resources and taken a credentialing test for specialty designation.
3. Nurses use informatics in order to:
a. play computer games for entertainment.
b. foster collaboration among nurses and others who are interested in nursing informatics.
c. provide management training for nurses interested in communication technology.
d. substitution, innovation, and transformation of patient care, nursing administration, or educational preparation.
4. The Informatics Nurse Specialist is expected to:
a. demonstrate the competencies enumerated in the Standard of Practice for Nursing Informatics, as outlined by the ANA.
b. serve as the departments IT go-to person.
c. have a bachelors degree in nursing informatics.
d. share knowledge and best practices of informatics by teaching seminars and holding training sessions for hospital employees.
5. Interoperability is:
a. the success of the health team in working cooperatively to address patient health care needs.
b. hospital managements means of communicating directives and protocols to staff.
c. the integration of differing health care systems, such as paper charts, point-of-care data entry, PDAs, and medication orders, to all function together to increase patient health and reduce provider error.
d. the ability of a computer to connect with other computers in various settings in a secure, accurate, and efficient way without special effort on the part of the user and without any restricted access or implementation.
6. Many industries have reaped the benefits of their Information Technology (IT) investments. The adoption and diffusion of information systems in the health care arena has been growing:
a. more slowly. c. twice as fast.
b. more quickly. d. about the same.
7. The position of National Coordinator for Health Information Technology was created through an Executive Order in:
a. 2000. c. 2004.
b. 2001. d. 2010.
8. A nurse is helping implement the recommendations of the Institute of Medicines (IOM) sweeping quality initiative for reform of the health care system. The nurse is focusing on the recommendation that requires care to be based on continuous healing relationships. In order to do this, which of the following should occur?
a. Access to care should be provided over the Internet, by telephone, and by other means in addition to face-to-face visits
b. Care should be based on the best available scientific knowledge and not vary illogically from clinician to clinician
c. Information should be available to patients and their families that allows them to make informed decisions
d. Health system should not waste resources or patient time
9. Which group offered the following definition of nursing informatics? Nursing informatics is a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge and wisdom into nursing practice.
a. AMIA c. NSNA
b. ANCC d. ANA
10. The Informatics Nurse Specialist functions in the role of:
a. entrepreneur, patient advocate, ethics committee member, and lobbyist.
b. policy developer, patient advocate, social worker, and researcher.
c. project manager, consultant, educator, and researcher.
d. development supporter, physician advocate, ethics committee member, and lobbyist.
Chapter 7: Population Based Health Care Practice
1. In working as an advocate for specific population groups, the nurses recognize that they are engaging in population-based nursing, which was established by:
a. Florence Nightingale. c. Clara Barton.
b. Faye Abdellah. d. Jane Delano.
2. The development, provision, and evaluation of multidisciplinary health care services to population groups experiencing increased health risks or disparities in partnership with health care consumers and the community in order to improve the health of the community and its diverse population groups is called:
a. population-focused nursing practice. c. population-based health care practice.
b. population-based nursing practice. d. population-based care.
3. The nurse recognizes that there are certain variables that increase or decrease the probability of illness or death, and that these variables can be modified. Such variables are called:
a. health determinants. c. vulnerable population groups.
b. underserved. d. health risk factors.
4. When engaging in population-based health care, a goal of the nurse would be to do which of the following?
a. Maintain access to health care services c. Reduce health care disparities
b. Maintain quality of health care services d. Increase health care delivery costs
5. During the course of practice, the nurse must be aware of the health of an individual, family, group, population, or community, also known as their:
a. health status. c. health needs.
b. quality of life. d. health assets.
6. While caring for a population, the nurse recognizes that differences in health risks and health status that reflect the groups poor health status are known as:
a. illness prevention. c. health promotion.
b. health disparities. d. minority health.
7. According to the report Healthy People 2020, which of the following has occurred?
a. Significant reduction in both smoking and obesity
b. Significant reduction in smoking cessation
c. Significant reduction in obesity
d. Significant increase in smoking cessation
8. The nurse understands that the current U.S. Population is a diverse one according to the U.S.Census data for 2005, with what percentage of people identifying themselves as members of an ethnic minority group?
a. 21 percent c. 29 percent
b. 25 percent d. 33 percent
9. A staff nurse asks the nurse manager, How can I tell if our organization provides culturally inclusive health care? The most appropriate response by the manager is that the organization:
a. includes multiple methods of providing health care.
b. will focus on serving two to three minority populations only.
c. has more men than women in the health care workforce.
d. uses standard interventions for all populations as a safeguard.
10. As the nurse, if you were going to determine the health status of a community, as opposed to assessing the health system or assessing the population, you would assess which of the following factors?
a. Level of education and socioeconomic status
b. Availability of health resources 24 hours per day
c. Age, gender, and ethnic patterns
d. Housing and safety of neighborhoods
Chapter 8: Personal and Interdisciplinary Communication
1. Principles of communication allow nurses to adapt to which of the following trends?
a. Generation X c. Telephone technology
b. Cultural diversity d. Kinesthetic communication
2. When the nurse asks the client a question, the nurse is considered the:
a. sender. c. receiver.
b. message. d. feedback.
3. The Health Insurance Portability and Accountability Act (HIPAA) was developed to:
a. make it easier to transport and transmit your personal health information.
b. guard against insurance companies selling their client list of names and addresses.
c. protect all individuals identifiable health information held or transmitted.
d. make health insurance companies more accountable for payment of claims.
4. Nonverbal communication is considered:
a. conscious. c. written documents
b. unconscious. d. wireless e-mail.
5. When communicating using technology such as e-mail, it is important to proofread your correspondence for appropriate use of:
a. spelling, grammar, punctuation, and accuracy.
b. inclusion of emoticons for nonverbal cues.
c. design, length of message, color, and font size.
d. notation for an acceptable response time.
6. A staff nurse remembers an important piece of information that should have been relayed to the supervisor before the nurse left the unit. Since the message is urgent, the nurse would consider which communication tool as primary, in order to transmit the message to the supervisor?
a. Fax c. Blackberry
b. E-mail d. Telephone
7. The unit secretary is sending an e-mail message to all staff. Recognizing e-mail etiquette, the secretary would do which of the following?
a. Use capital letters generously for emphasis
b. Respond immediately to an angry message
c. Refrain from forwarding e-mail messages from others without their permission
d. Include a joke at the end of the e-mail so readers will be more likely to read the entire message
8. When the nurse says to himself, I can do this procedure, it is a form of what level of communication?
a. Interpersonal c. Nonverbal
b. Intrapersonal d. Nonpublic
9. Verbal communication relies on which of the following to convey a message?
a. Facial expression c. Gestures
b. Posture d. Speaking words
10. The level of communication that is concerned with communication between individuals is:
a. interpersonal. c. public.
b. intrapersonal. d. physiological.
Chapter 9: Politics and Consumer Partnerships
1. A staff nurse is speaking with a nurse manager regarding politics and nursing. The nurse manager explains that politics exists in any system where which of the following conditions exists?
a. Abundant resources c. Competing interests for resources
b. Unlimited control of resources d. Unlimited distribution of resources
2. A beginning college student is exploring career options. The advisor informs the student that opinion polls have consistently shown that which of the following professionals have been rated the number one most trusted professionals?
a. Firemen c. Physicians
b. Policemen d. Nurses
3. A nurse intern asks the unit manager how nurses can become more politically involved in the consumer movement in health care to support the advancement of nursing service. The nurse manager responds by saying that the majority of nurses can accomplish this by:
a. becoming a member of their professional organization.
b. becoming a lobbyist to interested government agencies.
c. supporting legislation for more government control.
d. supporting physicians to direct health care policy.
4. According to the Center for Responsive Politics 2010, where did the American Nurses Association rank in the top 20 spenders for lobbying between 1998 and 2010?
a. Ranked 1st in the top 20 c. Ranked 12th in the top 20
b. Ranked 5th in the top 20 d. Not ranked in the top 20
5. A nurse understands that the experience of health care should be built around consumer:
a. resources. c. values.
b. perceptions. d. needs.
6. A nursing student asks the teacher, How will health care be defined in the future? The most appropriate response by the teacher is that Ultimately, health care will be defined and controlled by:
a. the American Medical Association.
b. those wielding the most political influence.
c. consumer activists groups (e.g., AARP).
d. the National Institutes of Health.
7. When considering the issue of the politics behind health care in the United States, the nurse identifies one of the third-party payer stakeholders as:
a. health care provider. c. special interest group.
b. government. d. the National Institutes of Health.
8. You have been a staff nurse for 5 years. One of your goals has always been to become more politically involved. Which of your roles has had the least impact on your achieving that goal?
a. Voted and wrote members of congress and state legislators
b. Participated as a member of a professional nursing organization
c. Ran for a political office and served society as a whole
d. Educated patients about their medications before discharge
9. In the role of patient advocate, you would:
a. ensure the patient does not make risky health decisions.
b. interpret the health care environment for culturally diverse patients.
c. act as a proxy for the patient in understanding and signing important consents.
d. educate the patient to ensure compliance with the health care organizations goals.
10. According to U.S. Census Bureau (2009b), there are how many uninsured Americans?
a. 10 million c. 45 million
b. 22 million d. 86 million
Chapter 10: Strategic Planning and Organizing Patient Care
1. You decide to make it a priority to read the semiannual report by the Institute of Medicine entitled To Err Is Human. The report will enhance the care that you provide because it deals with:
a. FDA drugs that have been recalled each year.
b. preventable adverse events and deaths each year.
c. patient safety regarding system failures and human failures.
d. National Advisory Council in Medicine.
2. When developing a strategic plan, the nurse manager is aware that a critical competency for 21st century health care organization is:
a. maintaining costs. c. continuous quality improvement.
b. leadership. d. systems management.
3. A nurse manager is developing the value statement of the principles and beliefs that direct the behavior on the unit. The value statement is consistent with that of the organization and will become the units:
a. mission. c. purpose.
b. philosophy. d. strategic plan.
4. You are seeking your first nursing position and decide to review the mission statement of each hospital. You realize that each organizations mission statement addresses which of the following?
a. Providing care c. Educating professionals
b. Promoting research d. Providing quality of care
5. A nurse manager decides to engage in some strategic planning with the staff that will require the staff to focus on which aspect of the unit?
a. Ethics c. Employees
b. Customers d. Mission
6. The nurse manager understands that one of the purposes of strategic planning is to:
a. develop a coordinated vision.
b. concentrate on higher productivity.
c. emphasize a marketing strategy.
d. eliminate competitive threats.
7. A nurse researcher has identified several individuals who will become members of four different groups. These individuals share common characteristic and will be asked to respond to questions on a topic about which they are expected to have interest or expertise. These groups are an example of which of the following?
a. Stakeholders c. Focus groups
b. Stakeholder assessments d. Managerial epidemiology
8. You are the nurse manager of a pediatric unit. During which stage of your strategic planning process will you perform a SWOT analysis?
a. Environmental assessment
b. Stakeholder assessment
c. Review of literature and best practices
d. Prioritizing according to available resources
9. As part of each nurses evaluation, the nurse manager requires them to complete a self-assessment by rating their skill level on a Likert scale. The scale ranges from 1 (no experience) to 5 (proficient). The managers assessment tool is an example of which of the following?
a. Review of the literature c. Focus group or interview
b. Survey or questionnaire d. Advisory board
10. A nurse researcher brings a group of breast cancer survivors together to discuss their experience with chemotherapy side effects and treatment. The nurse researcher is using which form of assessment to collect the data?
a. Review of the literature c. Focus group or interview
b. Survey or questionnaire d. Advisory board
Chapter 11: Effective Team Building
1. A team is a:
a. small number of people with complementary skills who are committed to a common purpose, performance goals, and approach for which they are mutually accountable.
b. group of people who wear the same T-shirt and have the same goals.
c. small number of people who share common goals and like to get things done in an organized and timely manner.
d. group of people who work together to accomplish stated goals over the long run.
2. A new graduate complains to the charge nurse, I dont see why we have to work in teams. The best response by the charge nurse regarding advantages of teamwork would include:
a. increased interpersonal skills, communication, and delegation of responsibility.
b. collaboration, communication, and job satisfaction.
c. innovation, collaboration, and socialization.
d. increased interprofessional communication, collaboration, and job satisfaction.
3. After a class discussion on teamwork, the instructor asked the participants if they could identify some of the disadvantages of teamwork. Which of the following responses would indicate that further teaching is needed?
a. Teams may take longer to accomplish a task or achieve a goal.
b. Teams equalize power through shared governance.
c. Team process takes time, effort, and resources.
d. Team members may disagree on the best course of action to take for a specific situation.
4. Which comment by a staff nurse would indicate to the nurse manager that further clarification regarding the concept of shared governance is needed? Shared governance:
a. formalizes and insists upon collaboration among the health care team members.
b. affirms that the patient is the center of care.
c. distributes power more evenly among nursing staff and leaders.
d. provides an outlet for the recognition of inappropriate processes.
5. A nurse manager states to the staff nurses, This group has such synergy! One of the new nurses asks, What does that mean? The most appropriate response by the nurse manager is that synergy is:
a. a stage of team development.
b. when luck and circumstance work together.
c. a bonus when things work together harmoniously.
d. a philosophical term relating to sharing of visions and goals.
6. A nurse manager compliments one of the staff nurses on demonstrating the skills that an effective team leader must possess. On which qualities of the staff nurse is the nurse manager most likely focusing?
a. Conflict resolution, communication, and interpersonal skills
b. Leadership, communication, and control
c. Control, communication, and conflict resolution
d. Communication, conflict resolution, and leadership skills
7. A nursing instructor has just completed teaching a class on activities that promote effective communication among team members. When grading the post-test the instructor recognizes that further teaching is needed if the students chose which of the following as an activity to promote effective team communication?
a. Scout activities c. Ambassador activities
b. Task-coordinator activities d. Coordinator activities
8. You have been appointed team leader for one of your organizations marketing teams. You recognize that a key to success for effective teams is:
a. political environment. c. timeliness of goal setting.
b. diversity of members. d. status distribution of team members.
9. The Institute of Medicines report Keeping Patients Safe: Transforming the Work Environment of Nurses determined that which of the following factors in nurses work environments may have a significant negative impact on patient outcomes?
a. Education level c. Status
b. Experience d. Culture
10. The Tuckman and Jensen Conceptual Model of team process development includes:
a. six stages. c. four stages.
b. five stages. d. three stages.
Chapter 12: Power
1. While reading an article on power, a nurse would most likely hypothesize that power can be described as which of the following?
a. Authority and influence
b. Accountability and responsibility
c. Personal and professional approaches to life
d. Ability to create, get, and use resources to achieve ones goals
2. One day a colleague asked you, What made you choose nursing as a profession? You replied that your mother and teachers encouraged you to choose this profession. Your colleague would most likely hypothesize that your mother and teachers possessed personal power because they:
a. perceived themselves as having personal power.
b. were individuals who could influence others and events.
c. had extensive buying power or wealth.
d. were individuals in powerful positions.
3. Your supervisor comments that you have a great deal of personal power. The supervisors comment is most likely related to which of your assets?
a. Decision-making ability c. Charisma when speaking to people
b. Connections to other nurses d. Expertise as a nurse
4. As a nurse you possess professional power. This type of power is that which:
a. comes from ones position in a hierarchy.
b. comes from a persons buying power or wealth.
c. is perceived by a person with extensive knowledge.
d. is conferred on members of a profession.
5. As the nurse manager, you have organizational power that:
a. comes from ones position in a hierarchy.
b. comes from a persons buying power or wealth.
c. is perceived by a person with extensive knowledge.
d. is conferred on members of a profession.
6. As a new employee, you can wield influence as an expert nurse by doing which of the following?
a. Demonstrating nursing skills c. Achieving position status
b. Proclaiming yourself an expert d. Networking with expert nurses
7. Your agency hires a nurse consultant who is certified in wound care. The consultant is scheduled to work with staff nurses on methods to promote wound healing. Which type of power does the nurse consultant possess?
a. Legitimate power c. Referent power
b. Expert power d. Reward/coercion power
8. You have been appointed president of your states local nursing association. The power derived from this appointment is referred to as which of the following?
a. Legitimate power c. Referent power
b. Expert power d. Reward/coercion power
9. One of the nurses on your unit serves as a member of the hospitals budget committee. Each month the nurse updates the unit staff on issues that may affect them. This nurse possesses which type of power?
a. Expert power c. Information power
b. Connection power d. Legitimate power
10. Visible reciprocal acknowledgement of expertise among group members:
a. maintains productivity. c. balances power.
b. enhances power. d. decreases productivity.
Chapter 13: Change, Innovation, and Conflict Management
1. Sullivan and Decker (1997) define change as:
a. planned and purposeful.
b. voluntary and for ones own reasons.
c. making something different from what it was.
d. voluntary and carries intrinsic or extrinsic rewards.
2. During a job interview, the nurse recruiter informs you that the organization is undergoing several significant changes. As a new graduate, you recognize that one characteristic of organizational change is:
a. improving efficiency. c. mandatory on an annual basis.
b. spontaneous action. d. voluntary for self-improvement.
3. Which of the following is the change theory proposed by Lewin?
a. Phases of change c. Diffusion of innovations theory
b. Six-step change model d. Force-field model
4. Rogerss Diffusion of Innovations theory of change includes which of the following steps?
a. Diagnose problem, assess motivation and capacity for change, assess change agents motivation and resources, select progressive change objective, choose appropriate role of change agent, maintain change, and terminate helping relationship
b. Unfreeze, move, refreeze
c. Awareness, interest, evaluation, trial, adoption
d. Build relationship, diagnose problem, acquire resources, choose solution, gain acceptance, and stabilization/self-renewal
5. Your organization is planning to make educational and cultural changes. Which model of change is most often used in this type of situation?
a. Force-field model
b. Phases of change model
c. Six-step change model
d. Diffusion of innovations theory of change model
6. The model that emphasizes the participation of key personnel and the change agent in designing and planning the intended change project is:
a. force-field model.
b. phases of change model.
c. six-step change model.
d. diffusion of innovations theory of change model.
7. The theory that is based on responsiveness and flexibility is:
a. chaos theory. c. diffusion of innovations theory.
b. learning organization theory. d. change theory.
8. One discipline that is needed for an organization to achieve the learning organization status to deal effectively with chaos is:
a. systems thinking. c. self-learning.
b. group mastery. d. physical models.
9. During which step in the change process would the who, how, and when of the change be determined?
a. Assessment c. Implementation
b. Planning d. Evaluation
10. As a new graduate, you recognize that one of the reasons to introduce change is to:
a. solve a problem. c. sort out the causes of chaos.
b. maintain relationships. d. acknowledge that change is inevitable.
Chapter 14: Budget Concepts for Patient Care
1. A nurse manager is preparing a budget that outlines anticipated revenue and expenses over the next fiscal year. This is an example of which of the following?
a. Operational budget c. Construction budget
b. Capital budget d. Accounting
2. An expense that is associated with patient care is:
a. fixed. c. direct.
b. indirect. d. variable.
3. A department managers budget concerned with the income and expenses associated with day-to-day activities of the unit is a(n):
a. operational budget. c. construction budget.
b. capital budget. d. balanced budget.
4. The radiology department has requested that the hospital purchase a new mammogram machine. This equipment would be included in which of the following budgets?
a. Operational budget c. Construction budget
b. Capital budget d. Balanced budget
5. When planning the budget for the unit, the nurse manager recognizes that equipment depreciation, utilities, fringe benefits, and salaries are considered:
a. fixed costs. c. direct expenses.
b. variable costs. d. indirect expenses.
6. Medical and surgical supplies, drugs, laundry, and food are considered:
a. fixed costs. c. direct expenses.
b. variable costs. d. indirect expenses.
7. Gas, electricity, and phones are considered:
a. fixed costs. c. direct expenses.
b. variable costs. d. indirect expenses.
8. If an organization takes donations, this money is considered a:
a. profit. c. dashboard.
b. revenue. d. variance.
9. In the budget preparation phase, obtaining information regarding other hospitals performance is considered:
a. demographic information. c. strategic initiatives.
b. regulatory influences d. competitive analysis.
10. Obtaining information on Medicare services is considered:
a. demographic information. c. strategic information.
b. regulatory information. d. competitive information.
Chapter 15: Effective Staffing
1. A new staff nurse is hired as a full-time employee who works 40 hours a week. The nurse would be referred to as which of the following?
a. .5 FTE c. .9 FTE
b. .8 FTE d. 1.0 FTE
2. A full-time employee works how many hours per year?
a. 1,040 c. 1,664
b. 2,080 d. 1,872
3. At the end of the shift, nurses document the care provided each of the clients. The time spent on this type of accounting activity would be considered which of the following?
a. Direct care c. Indirect care
b. Productive time d. Nonproductive time
4. When completing the staffing assignment, the nurse manager must include holiday time for the staff members. In terms of financial budgeting, holiday time is considered which of the following?
a. Productive time c. Direct care
b. Nonproductive time d. Indirect care
5. A measurement tool to articulate the nursing workload for a specific patient or group of patients over a specific period of time is called:
a. benchmarking. c. staffing pattern.
b. skill mix. d. patient classification.
6. A patient classification system that uses units of measure that equate to nursing time is called:
a. prototype. c. factor system.
b. seven domain. d. scorecard.
7. An advantage of the factor-type patient classification system is:
a. ongoing workload for nurses to classify patients.
b. capturing holistic patient needs.
c. data are readily available.
d. capturing typical nursing time.
8. An advantage of the prototype patient classification system is:
a. reduction of work.
b. ongoing data to monitor accuracy of the nursing requirements.
c. ongoing measure of the actual nursing work required.
d. commonly used system.
9. Acuity data and nursing hours per patient day (NHPPD) are concrete data parameters that are primarily used to:
a. benchmark. c. develop a nursing budget.
b. adjust staffing levels. d. review patient care outcomes.
10. How many FTEs per day would you need if your target NHPPD was 8, and you expected to have 22 patients on your 24-bed unit?
a. 20 c. 24
b. 22 d. 26
Chapter 16: Delegation of Patient Care
1. The provision of guidance, direction, evaluation, and follow-up by a licensed nurse for tasks provided by an NAP (nursing assistive personnel) is:
a. delegation. c. authority.
b. accountability. d. supervision.
2. Three types of supervision identified by Hansten and Washburn (2004) are:
a. unsupervised, supervised, and periodic inspection.
b. unsupervised, initial direction, and assessment.
c. continuous supervision, periodic inspection, and initial assessment.
d. initial direction, unsupervised, and continuous supervision.
3. As an RN, you recognize that delegation involves which of the following?
a. Assigning your staff to tasks that need to be completed
b. Transferring responsibility for the performance of a task from one individual to another while retaining accountability for the outcome
c. Identifying the appropriate individual to give care and demonstrate accountability for that care
d. Transferring accountability for the provision of care to the individual assigned to give the care
4. As the nurse manager of the unit, it is important for you to consider which of the following when making patient assignments?
a. Staff education levels, skill sets, cultural traditions, willingness to be a team player
b. Staff education levels, scope of practice, experience, and patient acuity
c. Staff skill sets, education levels, timeliness, and patient acuity
d. Patient acuity, staff experience, education, and ethnicity
5. Delegation is important for which reason?
a. It is a means to organize the patient care needs according to acuity, desired outcomes, and staff levels.
b. It provides a way to assign difficult patients to uncooperative nurses.
c. It enables new nurses to gain experience with difficult patients by themselves.
d. It is a means to organize the patient care needs according to acuity, desired outcomes, and staff levels, and it provides a way to assign difficult patients to uncooperative nurses.
6. As an RN, you maintain accountability for overall patient care on the unit. The obligation of the NAPs to correctly perform their assigned duties is the NAPs:
a. accountability. c. assignment.
b. delegation. d. responsibility.
7. According to the ANA (2005), delegation is:
a. the transfer of responsibility for the performance of an activity from one individual to another without transfer of the accountability for the outcome.
b. a legal and management concept and process that involves assessment, planning, action, intervention, and evaluation.
c. trust, empowerment, responsibility, and authority to perform the task.
d. the responsibility for the completion of tasks is given to others as a means of saving time, energy, and leader blame.
8. A nursing instructor evaluates whether the students know the five rights of delegation. The students would be correct if they responded that these rights are which of the following?
a. Right task, right circumstance, right route, right communication, and right person
b. Right task, right circumstance, right person, right communication, and right supervision
c. Right communication, right person, right task, right time, and right evaluation
d. Right time, right task, right person, right communication, and right supervision
9. The act of being responsible for the actions or inactions of yourself and of others in nursing is:
a. accountability. c. assignment.
b. authority. d. delegation.
10. A new graduate RN assigns a NAP to provide basic ADL (activities of daily living) to several patients on her unit. The NAP obtains vital signs and helps to bathe and feed the patients assigned. The nurse is:
a. accountable only for the actions done by herself.
b. accountable for all her own actions and those of the NAP.
c. accountable only for the basic ADL provided by the NAP.
d. not accountable for anything the NAP does outside of the NAPs scope of practice.
Chapter 17: Organization of Patient Care
1. A nurse manager is engaged in a process designed to achieve goals in dynamic, competitive environments through allocation of resources. This process is called:
a. process improvement. c. strategic planning.
b. total quality improvement. d. market analysis.
2. A student asks a nurse manager why they should use a SWOT analysis. The nurse manager explains that a SWOT analysis is:
a. useful in strategic planning.
b. an acronym for a type of quality improvement technique.
c. a financial management term.
d. a human resource process.
3. A nurse manager is composing a vision statement for the organization. The nurse should include which of the following of the four elements of a sound vision statement?
a. It is written down.
b. It is written in the present tense using action words.
c. It covers a variety of activities and spans specific short-term time frames.
d. It balances the needs of providers, patients, and the environment.
4. A nurse has just started to work for an organization that employs a shared governance organizational framework. The nurse understands that this type of framework is grounded in a philosophy of decentralized leadership; however, the nurse understands that which of the following may not necessarily be correct regarding shared governance?
a. It implies the allocation of power and control.
b. It fosters autonomous decision making.
c. It consists of mutually interested or vested parties.
d. It encourages professional liaisons among all hospital levels.
5. The nurse is informed that the clinic employs all four principles of the whole-systems shared governance. The nurse knows that which of the following is NOT one of these four principles?
a. Partnership c. Accountability
b. Collaboration d. Ownership
6. A nurse works for an organization using a shared governance model, and she understands that, under such a model, structures are generally divided into multiple councils. Which council would the nurse join in order to participate in establishing practice standards for a workgroup?
a. Education council c. Clinical practice council
b. Quality council d. Management council
7. A nurse manager is a strong proponent of the concept of learning organizations as a means to promote professional practice through the encouragement of personal mastery and awareness of ones mental models. This concept was developed by:
a. W. Edwards Deming. c. Florence Nightingale.
b. Peter Senge. d. Philip B. Crosby.
8. The nurse manager is aware that situational leadership maintains there is no one best leadership style, but rather effective leadership lies in matching the appropriate leadership style to the individuals or groups level of task-relevant readiness. The nurse manager wishes to help promote and develop the managers staff and followers. Under the situational leadership model, which of the following is not necessarily correct to achieve this outcome?
a. Coaching c. Collaborating
b. Supporting d. Delegating
9. A nurse manager is trying to develop a means to facilitate professional staff development by building upon the skills, abilities, and experience of each practitioner. This method is otherwise known as:
a. career enhancement. c. the novice to expert model.
b. clinical ladder. d. situational leadership model.
10. A nurse manager is attempting to devise a statement that reflects the purpose of a health care agency. This statement is referred to as which of the following?
a. Core values c. Vision
b. Philosophy d. Mission
Chapter 18: Time Management and Setting Patient Care Priorities
1. A nurse is deciding on an appropriate time management strategy. Which of the following time management strategies does not belong?
a. Outcome delivery c. Focus on priorities
b. Analysis of time cost and use d. Visualization of the big picture
2. The nurse manager is trying to plan the shifts in the most effective manner. The manager knows that one characteristic of effective shift planning includes which of the following?
a. Getting the job done in the least amount of time
b. Nobody died
c. Everybody showed up for work
d. Evaluation of optimal and reasonable outcomes
3. A nurse manager is providing instruction on related commonsense skills that can help nurses to use their time in the most effective and productive manner possible. These skills are best known as which of the following?
a. Pareto principle c. Shift planning
b. Time management d. Effective leadership
4. A nursing instructor wants to determine whether a nursing student understands the importance of the Pareto principle. Which of the following responses would indicate that the student understands?
a. It is the principle that 80 percent of unfocused effort results in 20 percent of outcome results.
b. It is a way to record your activities over a period of time to see how your time is spent.
c. It is the principle that 20 percent of focused efforts equals 20 percent of outcome results.
d. It is the principle that 80 percent of focused efforts results in 80 percent of focused time.
5. A nurse manager observes that a few of the new employees continue to mismanage their time, which results in a flurry of activities that do not achieve the expected outcome goals for the time spent. The most likely cause of this behavior is that the nurses:
a. want to appear busy.
b. love crises.
c. know about time management but do not think it applies to them.
d. think they are far too superior to need to plan their time.
6. When developing long-term goals, the nurse manager is always aware that these goals should remain:
a. long. c. flexible.
b. short. d. inflexible.
7. The nurse manager suggests that a subordinate nurse use a time management tool that may benefit the nurse when determining how much time is spent. Which time management tool would the manager most likely suggest?
a. Shift assignments c. Shift action plan
b. Nursing chart d. Activity log
8. You are planning your schedule for the day. Your plan includes a list of objectives that should be achieved given less-than-optimal circumstances and limited resources. These objectives are called:
a. optimal outcomes. c. reasonable outcomes.
b. general outcomes. d. unreasonable outcomes.
9. A nurse preceptor wants to determine if a novice nurse is able to organize tasks and categorize them according to patient needs and conditions. Which of the following categories, if included by the novice, would indicate to the preceptor that further teaching is needed?
a. Life-threatening or potentially life-threatening conditions
b. Activities essential to patient safety
c. Activities essential to the plan of care
d. Activities essential to hospital/governmental regulation
10. A nurse manager is trying to implement the Joint Commission (JC) patient safety goals for 2006 pertaining to time organization. One of those goals is to:
a. improve the effectiveness of critical alarm systems.
b. eliminate wrong-site, wrong-patient, and wrong-procedure.
c. improve the safety of infusion pumps.
d. standardize the approach to hand off communication.
Chapter 19: Patient and Health Care Education
1. A nursing instructor asks, What are the stages of standard educational methodologies? Which response by the student would indicate that further teaching is needed?
a. Design c. Process
b. Development d. Evaluation
2. A clinic nurse is planning to teach a group of clients procedures for administering their own medications. The two types of objectives the nurse will use to help clarify learning include which of the following?
a. Behavioral and terminal c. Cognitive and terminal
b. Affective and sequencing d. Terminal and enabling
3. A nursing instructor has asked a group of students to develop teaching plans for their clients according to Gagnes nine elements. If the instructor asks the students about some of the components of Gagnes events of instruction, which response by a student would indicate that further teaching is needed?
a. Gain attention c. Implement performance
b. Present stimulus materials d. Provide feedback
4. During an in-service program, the nurses are taught that learning can be classified according to several types of learning domains. When asked to name the domains, which responses by one of the nurses would indicate that further teaching is needed?
a. Cognitive c. Affective
b. Psychomotor d. Effective
5. When developing behavioral objectives, the nurse recognizes that an essential component would be which of the following?
a. Design c. Implementation
b. Performance d. Evaluation
6. Some elements of taxonomies based in the cognitive domain are listed here. Which does not necessarily belong?
a. Knowledge c. Process
b. Comprehension d. Synthesis
7. The majority of learning theories fall into three categories. Which is correct?
a. Cognition, perception, and information
b. Psychomotor, cognitive, and affective
c. Perception, information processing, and personality
d. Behavioral, psychosocial, and affective
8. During which phase of learning would a nurse conduct teaching based upon the lesson plan?
a. Implementation c. Evaluation
b. Development d. Execution
9. A nurse is using Kolbs experiential learning style (Kolb, 1984). Which of the following thinking styles would the nurse least likely employ?
a. Sensing c. Doing
b. Abstracting d. Perceiving
10. When establishing behavioral learning objectives, the nurse educator would consider which of the following four components?
a. Audience, behavior, condition, and degree
b. Performance, behavior, design, and condition
c. Behavior, audience, situation, and design
d. Audience, condition, design, and behavior
Chapter 20: Managing Outcomes Using an Organizational Quality Improvement Model
1. The plan-do-study-act cycle begins with:
a. three questions. c. five agendas.
b. four stages. d. two concepts.
2. A staff nurse asks the nurse manager, What does the mnemonic FOCUS in FOCUS methodology stand for? The best response by the nurse manager is that it stands for:
a. Focus, Organize, Clarify, Understand, Substantiate.
b. Focus, Opportunity, Continuous, Utilize, Substantiate.
c. Focus, Organize, Clarify, Understand, Solution.
d. Focus, Opportunity, Continuous (process), Understand, Solution.
3. The nurse manager recognizes that the goal of studying outcomes is to:
a. determine staff needs. c. predict the quality of patient care.
b. identify potential problems. d. incorporate change in nursing practice.
4. An educator wants to determine if the nursing students know the work of W. Edwards Deming. Which statement by the students would indicate that the students know the focus of Demings work?
a. Pioneer of the continuous quality improvement movement
b. Quality expert known for his studies on surgical and ambulatory care
c. Father of risk management
d. Guru of the PDSA movement
5. A local hospital is implementing a systematic process of organization-wide participation and partnership in planning and implementing improvement methods to test evidence-based practices at all levels of the services. The hospital is most likely implementing which of the following?
a. QI c. QM
b. QA d. TM
6. A nursing instructor is evaluating a students understanding of the primary difference between QA and QI. Which response by the student would indicate that the student understood?
a. QI is reactive, and QA is proactive.
b. QAs emphasis is on maintaining minimum standards of care, and QIs emphasis is upon identifying real and potential problems.
c. QA documents quality, and QI reports incidents and errors.
d. QI is more a single program, and QA is more a management approach.
7. Which of these general principles of total quality management does not necessarily belong?
a. Quality is achieved by the participation of everyone.
b. Focusing on the work process develops improvement opportunities.
c. Improving the service of quality is a continuous process.
d. Decisions to improve or change a process are based on the majority rule.
8. A staff development trainer wants to determine if a group of nurses knows the primary difference between QA and TQM. Which response by the nurses would indicate that further teaching is needed?
a. There is no difference between QA and TQM since the primary focus of both is doing it right.
b. The primary focus of TQM is doing the right thing.
c. The primary focus of QA is doing it right.
d. The primary focus of QA is doing it right. The primary focus of TQM is doing the right thing.
9. An effective nurse manager adopts several quality improvement methods in the management of the ICU. The managers approach is based on the understanding that some of the primary benefits to this approach includes which of the following?
a. Empowers staff and provides an outlet for critical theory
b. Views every problem as an opportunity to improve and to improve staff satisfaction
c. Decreases necessary expenses from lost business and helps customers think you care about them
d. Involves staff in how work is planned and done and increases the customers perception that you care by designing processes that meet the providers needs
10. A set of causes and conditions that repeatedly come together in a series of steps to transfer inputs into outcomes is called:
a. CQI. c. QA.
b. a process. d. a movement.
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