Leadership and Management in Nursing

Self-Study Examination

Instructions: After studying the text answer the following true/false or multiple choice questions.  Remember, there's only one answer to each question.

1. An RN staff nurse in the intensive care unit has acquired a significant amount of personal power within the hospital organization. This acquisition of power is due in part to regularly attending local meetings of the Association of Critical Care Nurses and reading the American Journal of Critical Care. Power gained from participation in these activities has resulted from an increase in the nurse’s:

a) interpersonal relations
b) credibility
c) persuasion
d) communication network

2. The nurse is studying the difference between a manager and a leader. Which of the following is the major difference between managers and leaders?

a) leaders do not make good managers
b) managers seldom are leaders
c) managers always have legitimate power
d) leaders always have legitimate power

3. The unit manager of a 32-bed medical-surgical unit allows the staff nurses to do self-governance for scheduling, client care assignments, and committee work. This sometimes leads to confusion, which the staff must correct. The manager would be considered which type of leader?

a) autocratic
b) democratic
c) laissez-faire
d) bureaucratic

4. A bus accident has occurred, with multiple trauma clients being sent to an Emergency Department at once. The unit manager is preparing the staff for the arrival of the trauma victims. Which type of leadership would be most effective in this situation?

a) laissez-faire
b) bureaucratic
c) democratic
d) autocratic

5. The nurse manager is aware of the changing health care environment. Which of the following is an important emerging challenge to changes in health care?

a) increased surgical procedures
b) decrease in immigration
c) nursing staff shortages
d) use of advanced practice nurses

6. The nurse manager is talking with the CAN about her time management. Which of the following is an example of nurse manager as coach?

a) “Your timely response to patients’ call lights is exemplary.”
b) “You never report AM blood sugar levels on time.”
c) “Your appearance is seldom professional.”
d) “You must get the vital signs taking on time or you will be disciplined.”

7. Which of the following skills is essential for nurses, who are non-managers in today’s health care environment?

a) personal ethics
b) focus on chronic care vs. prevention
c) focus on one area of care
d) works alone

8. In each of the following situations, a nurse manager will be leading a group toward an identified goal. With which group would an autocratic style of leadership behavior be most effective?

a) evacuation of the pediatric unit during a fire
b) evacuation of change-of-shift report practice used between day, evening, and night shifts
c) planning a unit holiday party that is inclusive and encourages all staff to attend
d) revision of hospital policies regarding vacation and holiday scheduling

9. The practice of nursing is changing. Which of the following is true with regard to future nursing care and management?

a) nurses must allow the managers to solve all problems
b) nurses must allow the senior staff to initiate the change, as they have the most experience
c) nurses must allow the leaders to carry out the change process
d) nurses must make a commitment to change and take active roles in this process

10. The health care environment is restructuring to improve the provision of patient care. Which of the following is a concept of reengineering?

a) developing new services
b) improving systems
c) discontinuous thinking
d) restructuring the organization

11. The nurse manager is determining ways to improve patient care for the unit. Which of the following is an example of redesigning the workforce?

a) decreasing the number of LPNs/LVNs
b) use of nursing-focused care
c) increasing educational needs
d) cross training

12. Quality management and benchmarking are two approaches used to improve the quality of care. Which of the following is the major difference between these two approaches?

a) quality management is used only in the primary care setting
b) benchmarking looks only at the outcomes specific to nursing
c) quality management is not useful in the outpatient setting
d) benchmarking compares outcomes in a variety of settings and disciplines

13. During the educational seminar, the staff nurse learns that nursing needs to make changes to maximize participation in the future health care environment. Which of the following is an important factor in the changing health care environment?

a) age stabilization in the work force
b) need for only managers to coordinate services
c) decreasing demand for nurses
d) need for greater integration of research and nursing practice

14. The nurse manager is studying the organization’s plan for change. Which of the following would be considered a key factor for change?

a) overabundance of providers
b) external factors outside the health care organization
c) overabundance of technology
d) overabundance of research

15. During a seminar, the nurse learns of Lewin’s Force Field model of change. Which of the following is a stage in this model?

a) create a sense of urgency
b) readiness for change
c) unfreezing
d) slow death

16. When comparing critical thinking, decision-making, and problem solving, which of the following is an aspect of critical thinking?

a) it allows the person to think outside the box
b) decisions might not involve a problem
c) decisions are made on a daily basis by nurses
d) decisions require a choice between alternatives

17. The nurse manager is working through the decision-making process. Which of the following is a type of decision?

a) judgment
b) informed
c) programmed
d) uniformed

18. A staff nurse develops an innovated documentation system for postop patients. The nurse manager grants her paid leave to develop one for medial patients. What type of power is the nurse manager using?

a) legitimate power
b) expert power
c) informational power
d) reward power

19. The goals of managers and leaders might be the same, but the power they use might differ. Which type of power would a leader who is not a manager most likely exercise?

a) reward power
b) informational power
c) connection power
d) personal power

20. A staff nurse wants to become instrumental in changing a policy regarding scheduling. Which of the following might be helpful in this situation?

a) complaining to the Director of Nursing
b) compiling data that would support the policy change
c) demonstrating positional power
d) using image power

21. A nurse tells other staff nurses that the manager is ineffective in order to move herself into the manager position. Which of the following would describe her actions?

a) using personal power
b) using punishment power
c) using a power play
d) using informational power

22. A decision has been made that the unit no longer will offer both 8- and 12- hour shifts. All nurses are required to work 12-hour shifts, which causes concern among nurses with school-age children at home. This decision most likely will create:

a) competing role conflict
b) professional/bureaucratic conflict
c) nurse/nurse conflict
d) nurse/doctor conflict

23. The staff of medical-surgical unit is in disagreement about holiday scheduling. The nurse manager knows that this is what type of conflict?

a) intrapersonal conflict
b) intergroup conflict
c) interpersonal conflict
d) intragroup conflict

24. The babysitter calls the staff nurse to let him know that she will not be able to take care of his children on the day the nurse is scheduled to work. The nurse is presenting important material at a committee meeting that day. What type of conflict is the staff nurse experiencing?

a) role conflict
b) perceived conflict
c) intergroup conflict
d) structural conflict

25. In dealing with a conflict on a unit, the nurse manager decides to ask one of the staff nurses who is not moving towards resolution to transfer to another unit. What tactic has the manager implemented?

a) competition
b) suppression
c) withdrawal
d) avoidance

26. The nurse manager has two employees with a longstanding conflict that is affecting the groups’ productivity and cohesiveness. She decides to meet with the employees in private and bring the conflict out into the open, and to attempt to resolve it through knowledge and reason. Which conflict management strategies did she employ?

a) intervention
b) suppression
c) confrontation
d) collaboration

27. A group of physicians comes into conflict with the nursing staff regarding the time morning vital signs are recorded. What type of technique might be used that respects the professionalism of both parties?

a) competing
b) accommodating
c) collaboration
d) avoiding

28. A nurse manager informs the nursing staff at a unit meeting, “Due to the current critical staff shortage on our unit, no additional vacation time will be granted until further notice.” What aspect of this message is least important to conveying the meaning?

a) facial expression
b) movement of hands
c) tone of voice
d) words chosen

29. A nurse serving as committee chair realizes that an important message she delivered in a previous meeting was misunderstood by the group. Who is responsible?

a) both the committee chair and the group members share a responsibility for the misunderstanding
b) if the words were clearly spoken, it was the group’s responsibility to decode the message properly
c) it was the committee chair’s responsibility to encode the message with appropriate gestures and expressions
d) the committee chair would be responsible for the poorly delivered transmission

30. A nurse manager has asked a small group of unit nurses to meet to discuss a specific patient complaint. Which behavior used by the nurse manager is most likely to result in a defensive (negative) environment?

a) the nurse manager actively listens to each nurse’s description of the events in question
b) the nurse manager encourages members of the group to problem-solve
c) the nurse manager gives advice on how the problem could have been avoided
d) the nurse manager shows empathy as nurses express hurt feelings

31. A group of six experienced and respected nurses from various areas of the hospital were asked to be part of a task force to recommend changes to the staffing policies. After a series of meetings, the group had made little progress. What is the likely reason that the group was nonproductive? Group members:

a) did not have enough interest in the problem to maintain motivation
b) felt they would not be provided adequate resources to address the problem properly
c) had their own hidden agendas that were unexpressed and that distracted them from problem-solving
d) recognized that they would not have any real influence on hospital policy

32. The nurse manager can use several strategies to improve communication when giving directions. Asking the subordinate to repeat the instructions would be which of the following strategies?

a) getting positive attention
b) knowing the context of the instruction
c) follow-up communication
d) verifying through feedback

33. Nurse managers often need to attend to the complaints of their clients. In communicating with the client who has a complaint, what principle is important to keep in mind?

a) supervisors always should be involved
b) avoid discussion of complaints
c) the client’s physician often is the cause of the problem
d) clients and families should be treated with respect; communication should be open and honest

34. The staff on a medical-surgical unit is in conflict with the occupational therapy department. What type of communication will be used to discuss the problems?

a) upward communication
b) distorted communication
c) downward communication
d) lateral communication

35. The new staff nurse is demonstrating difficulty with basic communication principles. Which of the following situations shows a violation of basic principle of communication?

a) “I noticed that for four weeks, all the IVs have been alarming off-schedule. You need to check them.”
b) the nurse manager tells you to check the IVs frequently
c) ignoring the IV issue, hoping that it will go away
d) tell the nurse that you should check on the problem together to decide on a solution.

36. The nurse manager is applying the principle of scalar chain. The theory that best supports this principle is the:

a) integrated delivery system
b) systems theory
c) contingency design theory
d) classical theory

37. The policy and procedure committee is reviewing the processes of an organization. Which of the following should be included in this review?

a) mission and vision statements
b) goal attainment and results
c) policies and procedures
d) job performances

38. During the Quality Improvement committee meeting, it was decided that all parts of a new process have to be synchronized. Which element of the process does this decision define?

a) coordination
b) delegation
c) decision making
d) evaluation

39. A group of nurses is studying the organization’s philosophy of nursing. Who is responsible for implementing this philosophy?

a) the unit manager
b) the CEO (chief executive officer)
c) all nursing personnel
d) the nurse executive

40. The organization’s leaders are reviewing the new vision statement. This statement:

a) clarifies the organization’s purpose
b) describes what the organization wants to be
c) identifies the organizational plans
d) describes what the organization is

41. The nurse is teaching a hospice client how to keep his skin intact to prevent breakdown. This is an example of which level of healthcare?

a) home health care
b) primary care
c) tertiary care
d) secondary care

42. A nursing student needs to include an example of care at the secondary level in a project. The best example of this would be:

a) monitoring a diabetic’s method of self-injection techniques
b) setting up an immunization clinic
c) performing an environmental assessment
d) selection of appropriate wound care products for surgical clients

43. The nurses in one organization own stock in their own company. These nurses are employed by which type of system?

a) public health
b) not-for-profit
c) managed care organization
d) for-profit

44. A nurse is concerned about transportation problems surrounding the clinic. In which of the four “P’s” of marketing is this nurse interested?

a) pricing
b) products
c) place
d) promotion

45. A group of advanced practice nurses purchased a van to provide health care for clients who do not have access to the clinic. These nurses are demonstrating which marketing expansion approach?

a) market expansion
b) diversification
c) market penetration
d) market development

46. The nursing student provides the total care of an assigned client during the clinical shift. This nursing student is modeling:

a) care management
b) functional nursing
c) total patient care
d) primary nursing

47. A staff nurse is able to provide nursing care, as well as monitor and operate laboratory equipment and perform phlebotomy. This nurse is demonstrating:

a) care and service
b) cross-training
c) interdisciplinary practice
d) primary nursing

48. An acute care hospital is planning to re-evaluate and draft a new mission. Which level of management would be responsible for this action?

a) board of trustees
b) first-line management
c) middle management
d) top management

49. An organization has made the decision to become a teaching hospital. This decision would fall under which characteristic of organization?

a) organizational
b) patient
c) outcome
d) system

50. An organization considers itself a tertiary hospital. This hospital most likely is:

a) an organization that provides services to the public on an as-needed basis.
b) a hospice care hospital
c) an ambulatory surgery center
d) a pediatric hospital

51. A client is receiving nutrition via a port-a-cath. Which department would be most involved with this client?

a) Medical Equipment Management
b) Diagnostic Procedures
c) Dietetic Services
d) Infusion Therapy Services

52. A hospital is implementing a change in its information technology system. Which of the following committees would be involved with this change?

a) interdisciplinary
b) ad hoc committee
c) medical record committee
d) policy and procedure committee

53. The staff nurses are drafting policies and procedures. A procedure differs from a policy in that a procedure:

a) provides a detailed format for researching a specific goal
b) provides guidelines for decision making
c) communicates to the staff the expectations and vision/mission of the organization
d) provides a total picture of the particular department’s beliefs concerning its management and the care it provides

54. The staff nurse is a member of the policy and procedure committee. Which of the following would be considered a responsibility for this nurse?

a) ensure that policies and procedures are evaluated and implemented
b) review policies and procedures for committee approval
c) participate in staff development related to policies and procedures
d) prepare the annual report

55. The staff nurses are preparing to collect data to help with policy and procdure change. One method of data collection that does not require much preparation would be a(n):

a) survey
b) interview
c) observation
d) questionnaire

56. An organization had decided to expand the usage of ACNPs and CNSs. This decision most likely was driven by:

a) reduction in the length of stay
b) the benefits to the hospital and payers
c) pressure for hospitals to reduce costs
d) reduced risk of liability

57. The organization wants to reduce costs while ensuring quality as clients move through the continuum of care. Which of the following is a common strategy to accomplish this goal?

a) case management
b) use of primary care providers
c) alternative/complimentary therapies
d) use of intensivists

58. Key factors in the surveillance system that assist in identifying medical errors and adverse events include:

a) management decisions
b) skill mix
c) nursing leadership
d) autonomy of the staff
e) staffing

59. An organization has gained Magnet status. In order for this organization to maintain its recognition, it would be expected to:

a) invite appraisers to visit with staff, administration, patients, and families
b) conduct an environmental assessment
c) notify the program office of a significant increase in nurse vacancy rates
d) provide documentation review for ANCC

60. The nurse manager is trying to determine if the nursing staff are functioning as a team or a group. Which of the following distinguishes a team from a group?

a) a group contains a majority and minority point of view
b) reliance on individual contributions
c) better decision-making capabilities with difficult issues
d) sharing, acceptance, and openness to the team process

61. A hospital is developing a new intake flow sheet for new admissions health history. The team most appropriate to develop this would be a:

a) self-managing team
b) task team
c) semi-autonomous team
d) functional team

62. A new nurse is having difficulty with one leadership approach. This leadership approach most likely is:

a) participative
b) “hand-off”
c) dictatorial
d) direct

63. The team leader is successful when working with team members. Which of the following might this leader most likely do?

a) schedule staff with little changes
b) fill in for regular staff during times of need
c) dictate to other members of a day-to-day regime
d) provide rigid criteria for the team to stay on task

64. Several staff nurses are considered effective followers. Which of the following characteristics would these staff nurses most likely demonstrate?

a) passivity, critical thinking
b) compliance, dependence, nurturing
c) use of expertise, sharing, collaboration
d) dominance, objectivity, rationality

65. The nurse who encourages staff on her floor to seek out new ways to handle increased workload would carry out which key team role?

a) external contact
b) critic
c) coordinator
d) ideas person

66. The member who suggests that the team wear the same color uniform to develop an identity would be acting in which key team role?

a) team builder
b) ideas person
c) inspector
d) implementor

67. During a staff meeting, the nursing staff identified problems, clarified areas of improvement, and provided ideas and strategies to improve. This group demonstrated the function of:

a) giving information
b) evaluating or criticizing
c) initiating
d) energizing

68. A job maintenance factor included in Herzberg’s theory of motivation would be:

a) status
b) advancement
c) responsibility
d) achievement

69. A team is focusing on sharing the meaning and mission of a project. This team is exhibiting which stage in the process of team building?

a) visioning
b) claiming
c) communicating
d) initiating

70. A nurse is unsure about what tasks can be delegated to UAP (unlicensed assistive personnel). The best source to follow would be:

a) job description within the health care organization
b) that state practice act
c) the policy and procedure manual of the hospital
d) the chief nurse manager

71. A nurse inappropriately delegates a task to a UAP that the UAP is not able to perform, following the example set by other nurses on the unit. Ultimately, the person accountable for this is the:

a) UAP
b) nurse
c) nurse manager
d) organization

72. A nurse delegates a task to a UAP; the task is done improperly and the client suffers an injury. The nurse, UAP, and organization all may be held liable for this injury. The principle under which the hospital would be liable is based on:

a) policy/procedure standards of the organization
b) state law
c) standards of practice
d) vicarious liability

73. The nurse decides to delegate measurement of vital signs to a UAP. The nurse understands that this task is within the scope of practice for this person, and the nurse also has witnessed this person completing this task capably with expertise. Which of the five “rights” of delegation has this nurse implemented? The right:

a) task
b) circumstance
c) direction
d) person

74. An LPN is working in a critical care area, and has been assisting in the care of a client who underwent extensive thoracic surgery. The client’s condition has deteriorated, and the need for ventilation is being considered. Delegating potential care of the client to the LPN in this case would be inappropriate based on:

a) stability
b) extent of patient interaction
c) level of supervision
d) potential for harm

75. The nurse is determining if certain tasks can be delegated to a UAP. The National Council of State Boards of Nursing recommends tasks that can be delegated are those that are frequently occurring, are considered technical in nature, are considered standard and unchanging, and:

a) are repetitive
b) have no potential for harm
c) are within the environment of care
d) have predictable outcomes

76. The nurse manager is made aware of a situation between a new nursing and an experienced nurse serving as a mentor. The first step in handling difficulties during mentoring is to:

a) determine if the goals and timelines were appropriate
b) analyze the difficulties before jumping to conclusions
c) assess the directions for clarity
d) understand the role of the delegator

77. The nursing student tries unsuccessfully to initiate an IV access in a client. The instructor then completes the task. Which of the following is the best initial statement by the nursing instructor, even though progress was not made by the student?

a) “You might have to put warm compress on the site first.”
b) “Next time you’ll do better.”
c) “Your equipment was well organized for the task.”
d) “You should have tried a more proximal site.”

78. The nurse is supervising the performance of a delegated task. Which of the following can the nurse do while supervising this task?

a) intervene, if necessary
b) identify the needs of the client
c) evaluate the performance
d) verify that the delegate accepts the delegation and accountability for carrying out the task correctly

79. The nurse manager is assigning a nurse to an activity that includes the responsibility and accountability for completion. This manager is making the assignment based upon the staff member’s skill, knowledge, judgment, and on:

a) the accountability of the nurse manager
b) legal scope of practice
c) policies and procedures of the organization
d) the transfer or responsibility from one individual to another

80. The nurse manager is delegating completion of an indirect patient care activity to a UAP. According to the ANA position statement regarding UAP-delegated activities, examples of indirect patient care activities would include:

a) collecting data
b) reporting and documenting data
c) socializing
d) transporting clients

81. The client needs to be taught how to change the dressing over his wound before discharge. The RN understands that this:

a) will have to be done by the charge nurse.
b) may be performed after discharge
c) can be delegated to a nurse aide
d) requires nursing knowledge, skill, and judgment

82. The nurse has provided instructions to a UAP about a task. Which comment by the nurse would be the most appropriate after giving the directions?

a) “Follow me while I finish explaining the activity.”
b) “Do you have any questions before I leave?”
c) “Will you be able to complete this without problems?”
d) “Make sure you do this right the first time.”

83. The nurse manager is trying to find critical pathways to use for her patient care area, but is unsuccessful. Why are pathways difficult to share between institutions?

a) they are not comprehensive because of their lack of emphasis on interdisciplinary care.
b) they focus on the general treatment for specific illness or condition
c) they do not use case management
d) they are individualized for patients and meet the practice concerns of the provider

84. The documentation committee at an organization is planning to create critical pathways. What is the purpose of these pathways?

a) they do not restrict timelines for interventions
b) they do not take into account the use of new technology
c) pathways provide direction in the coordination of care and ensure that outcomes are met within a designated time frame
d) they increase cost without increasing quality of service

85. A group of nurses is reviewing critical pathways written for a specific group of patient care diagnoses. What are the advantages of clinical pathways?

a) they increase the need for home care visits
b) they minimize the coordination between services
c) they make documentation for Joint Commission on Accreditation of Healthcare Organizations more difficult
d) they improve outcomes, organize data logically, improve quality of care, and identify trends

86. A group of staff nurses is disappointed to learn that their patient care area will begin using critical pathways. What are the disadvantages of clinical pathways?

a) they do not give direction to the staff for implementation
b) they are costly to develop and implement, in both time and money
c) they are used to identify staff performance problems
d) they are highly individual for each client

87. The critical care pathways committee is starting to work for creating crucial pathways. What are the first steps necessary in the development of these pathways?

a) evaluation of the proposed project is always the first step in project development.
b) open and consistent communication with all staff must come before pathways development
c) several projects need to be developed at the same time
d) a project committee develops the framework that will be used for all pathways and oversees the project

88. The critical pathway committee needs data to assist the creation of the pathways. What type of data does this committee need?

a) frequency of admissions, medication error reports, and readmission data
b) length of stay, common admissions diagnoses, laboratory tests, and incident data
c) infection control data and quality assurance records
d) average census data, staffing grids, and unit-specific diagnosis

89. The organization’s project development committee has Medical Records staff as  members. Why should these employees be included on this committee?

a) Medical Records staff select what records are kept in the chart
b)  staff from every department in the agency should be included on the project committee
c) Medical Records staff are most familiar with the International Classification of Diseases (ICD-9-CM).
d) Medical Records staff develop the forms to be used in charting 

90. The critical pathway committee wants to create pathways for the target population. What criteria should be used to identify the target population?

a) low volume, low risk, and low cost conditions
b) high volume, high risk, and high cost conditions
c) conditions that meet the “norm” or benchmarks
d) conditions that are unusual for the patient population

91. In creating a critical pathway, the committee has designed a flow chart. What is the purpose of a flow chart when designing a new pathway?

a) it helps determine which outcomes are undesirable
b) it identifies the unnecessary steps in the care of an illness or condition
c) it helps determine which practices are outdated
d) it helps determine the routine care of an illness or condition

92. During the implementation of a critical pathway, the staff are instructed about variance  issues.  What is the purpose of identifying variance issues prior to actively pursuing  needed  changes?

a) finding fault with the health care facility
b) reducing cost and improving care
c) identifying reasons for renewing contracts
d) limiting access to clients 

93. The nurses are concerned that critical pathways will lead to more malpractice issues. What are the legal issues surrounding the use of clinical pathways?

a) clinical pathways prevent negligent care
b) clinical pathways can be introduced as evidence in court to demonstrate a standard of care or what the outcomes should be for a client
c) clinical pathways cannot be applied incorrectly
d) clinical pathways can conflict with each other, thus relieving the provider of responsibility

94. The nurse manager has determined a system variance exists for one critical pathway being used on the care area. An example of this type of variance would be:

a) mislabeled medications
b) misread orders
c) inadequate or ill-prepared nursing staff
d) lack of supplies

95. The quality improvement committee is reviewing practice guidelines and written  standards of care. What is the difference between these two items?

a) standards of care save money for the health care systems
b) standards of care pull together research information from the literature
c) practice guidelines define treatment
d) practice guidelines provide information and options 

96. A client tells the nurse that he is a member of the diabetes disease management program. The purpose of a disease management program is:

a) to address issues regarding clients with comorbidities
b) to provide a desktop reference to practitioners
c) to target low-risk patients
d) to promote client education and prevention care

97. A group of nurses is overheard talking about health care policy. Why is this relevant to nurses?

a) it keeps health care from becoming a monopoly
b) it determines what health care services are provided, who receives them, and who pays for them
c) it keeps the cost of health care down
d) it allows legislators to control health care

98. A client tells the nurse that he is worried about his health care and what it will be like in the future. What are the primary concerns of consumers regarding health care services?

a) increased costs, decreased access and quality, and lack of competence of caregivers
b) increased access to care, decreased costs, and improved communication with providers
c) increased communication with health care providers, improved trust in the system, and improved quality of care
d) better communication with third-party payers, improved quality of care, and decreased costs

99. The organization is reviewing the private and public health care policies. How do these two types of policies differ?

a) private policy is developed by politicians
b) private policy provides the greatest good for the greatest number of people
c) private policy is health care policy that is developed by either health care organizations or a profession
d) private policy has no input from health care organizations

100. The nurse is meeting with her state senator regarding health care policy issues in the state. How is this nurse impacting the development of health care policy?

a) by working longer under mandatory overtime requirements to meet client care needs
b) by creating new titles and licensure requirements to indicated various levels of preparation
c) by demonstrating that nurses provide cost-effective, high-quality, measurable care
d) by encouraging nurses to remain at the bedside giving total care to clients

101. The nurse wants to become more involved in health care decision-making. How can this be done?

a) by active participation in nursing organizations
b) by electing officials with minimal interest in health care
c) by keeping up with new health care developments
d) by charging for nursing care services

102. An attorney for the organization is sponsoring an educational seminar about legal issues affecting nurses. What type of case involving nurses falls under the category of civil law?

a) informed consent, confidentiality, and DNR
b) assault and battery, murder, robbery, and rape
c) living wills and durable power of attorney for health care
d) negligence, personal injury, and medical malpractice

103. During orientation to a new position, the new nurse receives a copy of the ANA’s Code of Ethics. What is the significance of this code for nurses?

a) it differentiates between the practice of nursing and the practice of medicine
b) it sets forth the practice guidelines for developing clinical pathways
c) it sets forth the primary goals, values, and obligations of the profession
d) it determines who can enter the profession of nursing

104. During a seminar, a group of executives were discussing the high-priority ethical dilemmas they face in their organizations. What are these highest-priority ethical dilemmas?

a) incompetent physicians, demotion/termination of employees, and employee relations
b) promotion of employees, diversification of services, and downsizing services
c) staffing levels and mix situations, developing/maintaining standards of care, and allocating/rationing of scarce resources
d) incompetent nurses, selection/hiring of employees, and treatment versus non-treatment

105. The nursing student does not understand why each state has a separate Board of  Nursing.  What is the mission of the Board of Nursing in each state?

a) to determine where nurses should practice
b) to lobby for nursing rights
c) to protect the public
d) to determine criteria for admission to schools of nursing

106. The staff nurse contacted hospital administration about a situation regarding fraud and abuse. This nurse will be protected by which law?

a) The American Nurses Association Code of Ethics
b) The False Claims Act
c) The Public Health Act of 1944
d) The Social Security Act of 1935

107. The nurse is coping with an ethical dilemma. Which of the following traps should this nurse avoid?

a) recognition of your own value system
b) taking time to gather all the data before making a decision
c) lack of confidence in your own judgment
d) inability to recognize the conflict between what is best for the client and what is best for the organization

108. A client says, “I really don’t like the changes with my health insurance.” In what area has managed care affected patient satisfaction?

a) decreased emphasis on preventive care
b) less involvement of consumers
c) quality and access to services
d) decreased legislative involvement

109. When being admitted to the hospital, a client receives information about the Patient Self-Determination Act of 1990. What type of services must follow this law?

a) all health care organizations that participate in Medicare or Medicaid
b) any health care facility not covered by the patient’s insurance
c) private-pay physicians only
d) all mental health facilities and psychiatrists

110. A nurse demonstrates patient advocacy by becoming involved in which of the following activities?

a) engaging in nursing research to justify nursing care delivery
b) teaching in a school of nursing to help decrease the nursing shortage
c) taking a public stand on quality issues and educating the public on “public interest” issues
d) supporting the status quo when changes are pending

111. The Patient’s Bill of Rights affects nursing care delivery by requiring which of the following?

a) the right to the lowest-cost care available for medical conditions
b) the right to have someone other than the client make decisions; the right to confidentiality
c) the right to refuse treatment; the right to make medical decisions; the right to confidentiality
d) the right to the least-restrictive care available for mental health conditions

112. After the 1998 Pew Health Professions Commission report was published, changes occurred in managed care organizations. Which changes occurred?

a) less emphasis on goals and objectives of care
b) more emphasis on improvement of care, the reimbursement process, and expanded access
c) a return to older values and educational processes
d) less emphasis on the one-to-one relationship between the caregiver and the patient

113. An example of a nurse working to implement the Healthy People 2010 initiative would be becoming involved in which of the following?

a) giving anticipatory guidance to adolescents and young adults about high-risk behaviors and injury prevention
b) supporting legislation allowing for assisted suicide
c) working in a nursing home for patients with dementia
d) assisting people to obtain workman’s compensation when injured on the job

114. When making decisions about health care needs in a community that involve reducing health disparities, the nurse would collect which of the following data first?

a) the number of health care professionals available in that community
b) the tax base of the community
c) census data on illness or disease prevalence in each zip code area of that community
d) the number of hospitals in a 50-mile radius of that community

115. Managed health care organizations require prior authorization for certain treatments and services, while allowing automatic authorization for other treatments and services. It is important for the consumer to know the treatments and services are included in each category when making health care decisions. As a nurse manager, for which of the following treatment services would you tell the consumer to get prior authorization?

a) vaccinations
b) hospital admission
c) mammogram
d) pap test

116. Customer satisfaction surveys often are used to measure quality of patient care. Which of the following indicators is/are most important to consumers in determining quality nursing care?

a) the availability of health care services
b) the consumer’s attitude toward health care
c) the consumer’s background in medical knowledge
d) patient education, communication, and interpersonal relationships

117. In the role of patient advocate, the nurse would do which of the following?

a) support a patient’s decision, even if it is not the decision desired by the nurse
b) override a patient’s decision when the patient refuses the recommended treatment
c) emphasize the need for cost-containment measures when making health care decisions
d) foster patient dependence on health care providers for decision making

118. The nurse functions as a patient advocate. Which of the following would be the first step the nurse should take when functioning in this role?

a) ensure that the nursing process is complete and includes active participation by the patient and family
b) become creative in meeting patient needs
c) empower the patient by providing needed information and support
d) help the patient understand the need for preventive health care

119. What is the first step in retention of staff?

a) recruiting the right staff for the right job
b) tracking actual turnover
c) word-of-mouth communication of the best places to work
d) a strong organizational culture

120. What were the consequences of the Americans with Disabilities Act for employers?

a) it does not allow people to be fired due to poor work performance
b) it prohibits employers from hiring people with a history of mental illness
c) an employer may refuse to hire someone with a history of substance abuse.
d) it prohibits discrimination in hiring and job assignments based on disability

121. The Employment Equal Opportunity Commission (EEOC) has the power to do all of  the following except:

a) require an employer to pay back pay to an employee
b) require an employer to pay an employee’s legal fees
c) make an employer keep an employee
d) demand to see employee records without a search warrant or subpoena

122. Affirmative action regulations that require hiring people from “protected classes” involve which of the following type of agencies?

a) any federal contractors with contracts totaling less than $50,000 or with fewer than 50 employees
b) all private health facilities
c) all health care organizations that accept Medicare and Medicaid
d) all managed care organizations

123. Which of the following situations would allow the employee to receive 12 weeks of unpaid leave based on the Family Medical Leave Law of 1996?

a) the birth or adoption of a child
b) care for an aunt who was in an automobile accident with serious injuries
c) care for a grandparent with dementia
d) care for a significant other who has had a stroke

124. When an employer asks a job applicant for an example of a situation when the applicant made an extra effort to get something done at work, the employer is assessing the applicant’s:

a) passion for success
b) leadership style
c) personal values
d) critical thinking ability

125. In which of the following situations has an employment practice law most likely been violated?

a) a male and female nurse working on the same nursing unit begin dating
b) a nurse manager who is filling three staff nurse positions, all vacated by nurses who recently have had babies, decided to interview only men
c) a register nurse permanently confined to a wheelchair after an auto accident is replaced on an orthopedic unit and offered a position in risk management on nursing education
d) an obstetrician with a staff of seven employees choose not to employ a 62-year-old nurse as office manager primarily because of advanced age.

126. A physician has a habit of telling sexually oriented jokes to the team in the operating room during surgery after the patients are “asleep.” Some nurses laugh, considering the jokes humorous. Several nurses consider the jokes offensive and find it extremely uncomfortable to assist with this physician’s surgeries. One nurse says that the physician is engaged in sexual harassment. Is this interpretation correct?

a) No, the physician is not the direct supervisor and cannot influence employment decisions.
b) No, the physician is not directing the jokes specifically to one individual.
c) Yes, the physician’s joking is creating an intimidating and offensive work environment.
d) Yes, the patient might wake up and hear the jokes.

127. Which of the following employees would not be eligible for job-protected leave under the Family and Medical Leave Act of 1993?

a) a 12-month, 32-hour-per-week employee requesting 12 weeks of unpaid leave after accepting placement of a foster child
b) a 2-year, 36-hour-per-week employee who requests 4 weeks of unpaid maternity leave
c) a 6-month, 40-hour-per-week employee requesting 8 weeks of unpaid leave while receiving cancer treatments
d) a 6-year, 40-hour-per-week employee who requests 4 weeks of unpaid leave to care for her seriously ill mother

128. Matching a job with an experienced RN first requires a selection process. What is the first step in this process?

a) selection techniques
b) methods of recruiting
c) job analysis
d) assurance of legal requirements

129. Who can best describe the job to an applicant?

a) the nursing manager
b) the human resource manager
c) the chief operating officer
d) a previous employee

130. What is the main purpose of recruitment activities?

a) assess an applicant’s skill
b) generate a pool of qualified applicants
c) assess an applicant’s motivation
d) assess an applicant’s ability

131. The most important factor that baccalaureate graduates look for when seeking their first job is:

a) location
b) vacation
c) money
d) orientation

132. While responding to an employment advertisement, the nurse sees the organization is asking for a resume. Which of the following should the nurse include in this document?

a) publications
b) education and credentials
c) honors and awards
d) listing of continuing education programs

133. The nurse has a license as an RN, has completed a master’s degree in nursing, and is certified. When creating a cover letter for employment, which credential should appear first after the nurse’s last name?

a) MSN
b) BSN
c) C, RN
d) RN

134. During the latest diabetes seminar, the nurse approached two different people about questions asked during the conference. Which of the following is this nurse demonstrating?

a) coaching
b) mentoring
c) networking
d) precepting

135. The nurse approaches another nurse in an effort to establish a mentoring relationship. Which of the following needs to exist prior to beginning this relationship?

a) the mentor needs to be a protégé’s supervisor
b) the two nurses need to be friends
c) the mentor needs to have the time and skills to invest in the relationship
d) the mentor needs to select the protégé

136. A new nurse is demonstrating performance issues. Which of the following techniques can the nurse manager use to help this nurse?

a) coaching
b) preceptoring
c) networking
d) mentoring

137. A nurse is licensed to practice nursing in one state and learns that for another state in which licensure is needed, the nurse is “already covered.” The second state is practicing:

a) mutual recognition
b) continuing licensure
c) mutual reciprocity
d) mandatory licensure

138. The nurse manager wants to ensure that there are other nurses prepared to function as unit manager. Which of the following can the nurse manager use to prepare nurses in the role of management?

a) continuing education classes
b) preceptoring
c) coaching
d) succession planning

139. The staff nurse is asked to complete a questionnaire about training topics for the next year. This questionnaire is a part of which educational activity?

a) staff development
b) orientation
c) continuing education
d) inservice

140. A nurse has decided to return to school and earn a master’s degree in nursing. Which of the following would be the next step for this nurse to take?

a) complete the required testing
b) consider financial issues
c) go for an interview
d) complete the application

141. A nurse is planning to return to school to complete a bachelor’s degree in nursing and wants to take the program on-line. Which of the following characteristics should the nurse demonstrate in order to be successful with this type of learning environment?

a) the desire to be anonymous with others in the program
b) the desire to do less work
c) the ability to function as an independent learner
d) the need to have one-to-one contact

142. A nurse is planning to attend a hospital-sponsored competency testing session. The nurse realizes this session will:

a) evaluate the nurse’s skill level when providing care
b) assess skills for the purpose of enhancing performance
c) introduce goals for the nurse to function in the work environment
d) offer a systematic learning experience

143. The nurse wants to manage her time better by using the Pareto Principle. This means the nurse will:

a) do 20 percent of the activities to generate 80 percent of the results
b) handle each piece of information only once
c) graciously say “no”
d) do 80 percent of the activities to generate 20 percent of the results

144. The nurse manager is trying to complete a budget review, but continues to be interrupted. Which of the following can this nurse manager do to reduce these interruptions?

a) answer the phone when it rings
b) take more time to find materials for the budget
c) redo the budget to improve it
d) close the door

145. A nurse manager has a tendency to procrastinate when working on projects. One technique this nurse manager can use to help with procrastination would be to:

a) worry about it
b) solve problems when they become larger
c) reassess backlogs
d) use the Swiss cheese method

146. During a staff meeting, the nurse learns that the hospital is receiving less reimbursement money for some diagnostic related groupings. One impact of this financial reduction on the staff nurse would be:

a) not having requested days off
b) not having medications for the patients on the unit
c) not having enough nursing staff
d) not having doctors available for emergencies

147. The nurse is admitting the Caucasian 8-year-old client to the pediatric unit for an exacerbation of asthma. With the most recent information about insurance coverage in the United States, the nurse realizes this client:

a) most likely does not have any health insurance coverage
b) most likely has health insurance coverage
c) has a 69% chance of having health insurance coverage
d) has an 80% chance of having health insurance coverage

148. The nurse is helping a postoperative client out of bed the evening of the day of surgery. This nursing intervention will contribute to:

a) an increase in postoperative infections
b) a decrease in nursing care needed
c) an increase in postoperative pneumonia
d) a decrease in hospital costs

149. While reviewing a client’s insurance information, the nurse notices that the client recently changed employment. What does this information provide to the nurse?

a) the client is a new enrollee in the health plan
b) the client is a new customer to the health place
c) this means nothing to the nurse
d) the providers have changed

150. A client says to the nurse, “I don’t have health insurance. I think it’s a waste of money.” Which of the following would be an appropriate response for the nurse to make to this client?

a) “The money for the premium is pooled among all of those covered to pay for health care costs.”
b) “You really could use it right now.”
c) “I agree!!”
d) “The health plans make money off the insurance premiums.”

151. The nurse knows that the hospital will receive a certain amount of money for a client based upon the client’s diagnosis. This financial arrangement is also known as:

a) retrospective payment system
b) prospective payment system
c) managed care system
d) point-of-service payment system

152. A client is admitted to the hospital with a traditionally indemnity insurance plan. The nurse realizes that this means:

a) the hospital will assume all financial risk for the client’s care
b) the health plan controls which providers the client can use
c) there are rigid quality improvement indicators for this health care
d) there are no financial incentives to be cost-effective with this health plan

153. The nurse is assessing a client in the physician’s office, and notes that the client’s health insurance follows a capitation rate. Which of the following will this information affect in regard to this client’s care?

a) nothing
b) this client can come and see the doctor for services any time he wants
c) the physician may file a claim for more payment if the client has more health issues
d) the physician has to provide care within the amount of money the insurance company has paid; otherwise the doctor will lose money

154. A client tells the nurse, “I don’t like this new health insurance. I had to change doctors, and I can only go to one hospital if I need to.” The nurse realizes this client is describing:

a) a carve out
b) a point-of-service organization
c) a preferred provider organization
d) a health maintenance program

155. A client tells the nurse “I have information about my diagnosis being mailed to me by a group of nurses who phone me and talk about ways for me to improve my health.” The nurse realizes this client is describing:

a) specialty care
b) resource management
c) utilization management
d) health promotion and disease prevention

156. The nurse is working for a non-profit organization. The nurse realizes this means:

a) all profits will be shared with the shareholders
b) there are no profits; each year the budget is zero
c) profits are reinvested into the organization
d) profits are reinvested into new technology

157. The nurse manager is working on the next fiscal year’s budget. During this time, the manager realizes that many dollars are categorized as fixed costs. This means:

a) these costs are indirectly related to patient care
b) these are costs that cannot be associated with specific patient care provided or a support service
c) these costs do not increase or decrease as a result of changes in volume of patient days
d) these are costs incurred while providing direct patient care

158. The nurse manager is planning to renovate a section of the patient care unit and to purchase new equipment. These renovations need to be placed on which budget?

a) capital
b) operational
c) wage
d) salary

159. The nurse manager is creating the budget for the care area. Which one of the following categories would not typically be part of the budget?

a) revenues
b) salaries and wages
c) operational
d) capital

160. The staff nurse says, “I don’t like using all of these computers. I don’t feel like I am in touch with my patients.” This staff nurse is experiencing:

a) disappointment with computers
b) loss of emotional connectivity
c) baby boomer apathy
d) the inability to use technology correctly

161. The inservice trainer is reviewing a new computer assessment concept, and is finding one nurse having difficulty because the answer is not “black and white.” The inservice trainer realizes this nurse is:

a) a member of the Net Generation
b) not familiar with fuzzy logic
c) having difficulty seeing the computer screen
d) an expert computer user

162. A nurse is deciding if she wants to work for a company that provides patient care through the use of computers and a telephone. This type of company is an example of:

a) telehealth
b) home care
c) managed care
d) case management

163. The nursing staff is to attend a conference about the newest medications to treat heart failure, but the lecturer is located 1000 miles away. The nurses most likely are going to be participating in:

a) videoconferencing
b) telenursing
c) telemedicine
d) telepresence

164. During the course of patient care, a nurse consults a diagram that explains the next step in the decision-making process. This nurse most likely is using:

a) a protocol
b) a guideline
c) an algorithm
d) a policy

165. A nurse provides telenursing care differently from that which is described in the written protocol. During the evaluation of patient care, a nurse sees the outcome is an unexpected one. Which of the following should the nurse do at this time?

a) consult the protocol to where the deviation occurred
b) videoconference with the supervisor
c) consult with a physician
d) consult with another nurse

166. The nurse is planning to provide telenursing care to a client in another state that does not have mutual licensure recognition. Which of the following should be done?

a) contact the client on another day
b) provide the care anyway
c) find another nurse who has the same state licensure as the client to provide the care
d) contact the physician

167. After providing care to a client, the nurse stops outside of the client’s hospital room to input data. This nurse most likely is using:

a) a remote telemetry unit
b) e-mail
c) a handheld communication device
d) a point-of-care documentation system

168. A clinical instructor is guiding a class of nurses through a new client care concept by asking questions and leading the nurses to discovering the answers. The teaching approach this instructor is using is:

a) traditional pedagogy
b) facilitation of learning
c) a protocol
d) demonstration, return demonstration

169. A nurse is beginning an on-line master’s degree in a nursing program. Her first degree was earned two decades ago in a traditional university. Which of the following most likely will assist this nurse?

a) reviewing the texts studied during the bachelor’s degree program
b) contacting a colleague and asking if he has any materials from his master’s degree program
c) mastering the use of the computer and on-line search tools
d) talking with her supervisor about the program

170. During an organizational survey, the senior leadership staff learn that the nursing staff feel isolated from them. Which of the following can improve these feelings of isolation?

a) schedule meetings to discuss these feelings
b) create participative workgroups consisting of both leadership and direct care staffs to analyze these feelings
c) appoint one leadership member to talk with the staff
d) nothing, this is the way staff feels today

171. A client tells the nurse, “I checked on the Internet about my diagnosis and it’s not the same information that my doctor said to me.” Which of the following would be an appropriate response for the nurse to make?

a) “Let’s check the Internet site together to see what the difference in information might be.”
b) “Your doctor can be wrong.”
c) “Never trust what you read on the Internet.”
d) “Maybe your doctor needs to read the information on the Internet.”

172. While interviewing for a staff position, the nurse tells the human resources director that it was odd that there was little information on the hospital’s Web site about the organization. What would be the best approach to handle this information?

a) thank the nurse and end the interview
b) thank the nurse, and then proceed with verbal information about the hospital
c) nothing, this is only the nurse’s opinion
d) acknowledge the information and plan to discuss it with the Web site committee.

173. A nurse wants to obtain a telenursing position. Which of the following activities could the nurse do to increase his skill level for this position?

a) practice client assessment skills
b) practice talking with the family face-to-face
c) read journal articles about telenursing
d) practice talking with friends and family over the telephone

174. The nurse is going to telephone a client who had a surgical procedure done the day before. Which of the following interventions will this nurse be providing?

a) triage via telephone
b) telephone follow up
c) telephone consultant
d) surveillance via telephone

175. The nurse sees that a client was prescribed to begin an antibiotic but did not receive the first dose as planned. This situation is an example of:

a) overuse
b) error of planning
c) misuse
d) error of execution

176. A client says to the nurse, “I’ve been to see the doctor about this problem for six months. Finally, something is going to be done to help me.” The nurse realizes this client has experienced which of the following issues with quality care?

a) underuse
b) misuse
c) error of planning
d) overuse

177. After completing his second 16-hour shift, the nurse says, “ I’m not sure if I did everything right. I hope all of the clients are OK.” This nurse is demonstrating:

a) fatigue
b) low self-esteem
c) worker remorse
d) low self-confidence

178. The staff of an emergency department are implementing a quality improvement plan to reduce the period between arrival and beginning of treatment for clients. This department is attempting to improve which aim for improvement of health care system?

a) effective
b) equitable
c) safe
d) timely

179. A client says to the nurse, “I want to know what I need to do to control my diabetes.” The nurse realizes this client is demonstrating:

a) lack of faith in the physician’s plan of care
b) a consumer element for getting better or living with the illness of diabetes
c) concern for the health care system
d) denial over the disease

180. The nurse manager proposes to redesign the client care area in an effort to maximize client contact by the nursing staff. This manager is focusing on:

a) transforming the work environment to keep clients safe
b) improving the medical management of the clients
c) ways to improve care coordination
d) efforts to improve nursing documentation

181. The client tells the nurse, “I was in the hospital for three weeks, and I’m still having leg pain. That was just a waste of time.” The nurse realizes this client is questioning the quality of the hospital experience by:

a) the structure
b) the outcome
c) the process
d) the accessibility

182. The nurses on a care area are upset because “the only thing administration cares about is the number of clients on the unit, and not the quality of care given.” This belief is indicative of:

a) a customer-focused organization
b) a culture of quality to improve
c) a culture of financial status over quality
d) a lack of understanding about the budgeting process

183. During the team meeting the nurse manager states, “We had another chemotherapy error last week.” How could this medication error be categorized?

a) team
b) institutional
c) patient
d) task

184. A staff nurse makes errors when working on one particular area of the unit but does not make errors on other care areas. Which of the following should the nurse manager do regarding the frequency of errors by this staff nurse?

a) study the area of the unit to analyze why this nurse makes errors
b) terminate this nurse
c) contact the state board of nursing to have the nurse’s license suspended
d) suspend this nurse from work

185. From the implementation of the recommendations of the unit’s quality improvement committee, there has been a reduction in client treatment errors. The nurse manager realizes these outcomes are indicative of:

a) safety of client care
b) timeliness of client care
c) continuity of client care
d) effectiveness of client care

186. The hospital’s quality improvement committee is preparing for the next Joint Commission on Accreditation of Healthcare Organizations site visit. Which of the following should be done to ensure a positive site visit?

a) identify three quality improvement studies to implement
b) ensure all of the quality improvement processes conducted from the last survey are categorized
c) document which staff were terminated since the last survey due to inability to provide quality client care
d) hold in-services for all the staff so all are aware of the accreditation standards

187. The nurse manager is concerned about the increase in nursing staff sick time, and about salary overtime subsequently being paid. In which category of quality indicator would these issues be placed?

a) outcome
b) process
c) structure
d) access

188. The managed care organization created a document that lists seven organizational values. Which of the following would be the purpose of these values?

a) to establish lines of authority
b) to establish a consonant organizational culture
c) to establish rigid rules
d) to establish quality improvement indicators

189. The staff nurse says, “Why bother talking with the manager about issues? Nothing changes.” This nurse’s statement can indicate:

a) a culture of bureaucratic caring
b) a consonant organizational culture
c) a culture of care quality
d) a culture of mistrust

190. A nurse works in an organization where rules must be followed and there are procedures written for every possible client-care interaction. Which of the following orientations is this organization’s culture?

a) group/clan
b) hierarchy
c) developmental/adhocracy
d) irrational/market

191. The organization has hired a consulting firm to change the culture. Which of the following should be done first by the consultants?

a) decide the desired culture and plan steps to implement the changes
b) review the financial statements of the organization
c) access the current culture
d) study the policy and procedure manual of the organization

192. The nurse is admitting a client to a care area and learns that the client does not speak or understand English. Which of the following should the nurse do to provide care to this client?

a) use sign language to communicate
b) contact the social services department to locate an interpreter
c) point to areas on the body and watch was the client says about each area
d) ask the client’s husband to be the interpreter

193. The nurse with an ambulatory disability arrives at an interview for a telephonic nursing position. Which of the following should the nurse manager consider about the nurse’s disability?

a) does the nurse meet the essential job function?
b) will this nurse cause an increase in organizational insurance?
c) will this nurse call in sick because of the disability?
d) what caused the nurse’s disability?

194. The nurse manager sees another staff nurse helping other care providers with enthusiasm and support. The manager realizes this staff nurse is demonstrating the behavior style of:

a) constructiveness
b) aggression-defensiveness
c) bureaucratic caring
d) passive-defensiveness

195. A nurse is having difficulty working with clients from a minority culture. Which of the following can the manager do to assist the nurse?

a) provide a list of educational resources to help the nurse understand the client’s culture
b) suggest the nurse find another place to work
c) implement a plan to have the nurse transfer to another care area
d) remind the nurse that everyone is not as fortunate as the nurse

196. During the latest employee survey, it was established that the staff find the hospital “dirty” and non-conducive to health and healing. Which of the following can be done to help with the staff’s perception of the health care organization?

a) study the financial statements and determine which areas can be closed due to poor revenue generation
b) recognize the findings and determine a method to change
c) contact the director of Environmental Services and expect an action plan to address the findings
d) acknowledge the findings and ask the staff what role they play in the appearance of the organization

197. The results of a client discharge questionnaire show that an organization is not easy to navigate and is not physically comfortable for visitors. Which of the following can be done to address these findings?

a) nothing, the clients are no longer in the hospital and the information doesn’t help
b) contact a local furniture company to change the chairs in the waiting rooms
c) create a multidisciplinary committee to analyze the navigation of the organization and look at the comfort characteristics
d) appoint a committee to review the questionnaire

198. On an anonymous note left in the hospital’s suggestion box was written, “There are many errors made with client care but the nurses are afraid to tell anyone.” What can the hospital’s leadership do with this information?

a) take the information seriously and begin a focus group to analyze reasons why the staff do not report errors
b) write and provide a copy of a letter to each staff nurse, reinforcing the disciplinary process for staff who violate client care procedures
c) call the nurse managers together to find out which of their staff nurses wrote the note
d) nothing, it was an anonymous note

199. Over the last year, the organization made all client care rooms private and changed the design of the nurses’ common work areas. How effective were these changes to the organization?

a) minimally effective
b) the results of these changes need to be studied before deicing the effectiveness
c) very effective
d) not effective at all

200. During a staff meeting, the manager encourages the nurses to talk about the organization’s values, and acknowledges a recent information mistake made. Which of the following outcomes will these methods achieve?

a) serve as an effective smoke screen to avoid talking about the real issues
b) nothing
c) demonstrate the organization is a culture of caring
d) the organization is always changing