Download ANCC Study Guide: Nursing Philosophy and Policy Questions and Answers and more Exams Medicine in PDF only on Docsity!
Questions And Answers
In assessing the philosophy for nursing services for possible revision, the nurse executive is most heavily influenced by the organization's: a. mission statement b. consumer surveys c. financial resources d. policy statements - Correct answer is: a. mission statement The organization's philosophy must always be consistent with the mission of the enterprise. In this way, there is clarify of intent about what the organization stands for and what it intends to accomplish. In planning for change, the successful change agent makes a commitment to: a. help followers arrive at total consensus regarding the change. b. encourage subgroup opposition to change so many viewpoints can be heard c. utilize change by drift if resistance to change is too strong d. be available to support those affected by change until refreezing occurs. - The Correct answer is: d Unless there is support until the desired change has replaced the status quo, the likelihood of "backsliding" is high. The successful change agent
Questions And Answers
recognizes the need to help her or his clients remain with the process until the desired change has replaced the prior way of doing things. Strategic planning: a. focuses on the long-range goals for the organization b. requires a broad range of management expertise c. is synonymous with tactical planning d. is generally a middle-management function. - The Correct answer is: a. Strategic planning, in contract to tactical planning, is future-directed and concerned primarily with putting in place the resources to achieve long-term goals. In planning for managed care, which of the folllowing goals would be most appropriate for the nurse manager? a. Clinical outcomes should occur within a prescribed time frame. b. Case managers should not function as providers of patient care. c. Managed care practice should be unit-based and unit-specific. d. Outcome management should be carried out for each patient. - The Correct answer is: a.
Questions And Answers
departments periodically review the current patient classification process. When evaluating the nursing service philosophy, the most important thing to ascertain is that the philosophy: a. is congruent wit the mission of the organization b. can be implemented in a cost-effective manner c. flows from organizational goals d. is brief and simply worded. - Correct answer is: a. Congruency among the organization's mission, vision, philosophy, goals, and objectives is essential to the success of the entity. Critical pathways are: a. a patient's expected progress from admission to discharge based upon her or his diagnosis. b. mandated professional care standards. c. the essential feature of the Nursing Minimum Data Set (NMDS). d. prospective structure audits that look at costs as well as quality. - Correct answer is: a. Critical pathways are (or should be) derived from evidence-based studies and suggest the trajectory the patient will follow, in the absence of unanticipated complications, from admission to discharge.
Questions And Answers
Healthcare professionals have formed a state coalition to propose legislation to change the state's nursing practice act. Controversies have surfaced regarding entry into nursing practice, the role of the license practical nurse, and the definition of professional nursing. To communicate information about the proposed changes, it would be most effective for the coalition to: a. form a network of all categories of nurses in the state. b. mail minutes from coalition gorup meetings to all constituencies. c. work with groups that have lobbied in the past for changes in the nurse practice act. d. request that coalition members put the proposed changes on the meeting agendas of other groups to which they belong. - Correct answer is: a. This step will reach the widest audience and generate the greatest response. The network concept also allows for connectivity and relatively quick dissemination of information. The nurse executive attends all high-level meetings. However, he or she seems to have limited access to the organization's true power base and believes there is inequitable distribution of power among executives of the same rank. To change this situation, the nurse executive's most appropriate first step would be to: a. propose a plan for organizational restructuring. b. form a coalition within the organization to extend her or his network of power.
Questions And Answers
This statement shows an awareness of the importance of data gathering and analysis. This person is beginning to understand the performance improvement process. In evaluating the nursing administration's philosophy statement, the nurse executive's most important step would be to: a. assess whether the statement provides for flexibility. b. assess whether there is consistency between the statement and actual practice. c. create a task force of registered nurses to review the statement d. solicit input from peers about the statement's relevance. - Correct answer is: b. The reputation and integrity of the organization is judged by the consistency between its stated philosophy and its actual practices. The nurse executive at a hospital maintains contracts with affiliated educational institutions whose nursing students want to acquire clinical experience. The nurse executive should ensure that each contract includes a: a. copy of the nursing program curriculum b. provision that all nursing faculty members be licensed. c. provision that each student carry individual malpractice insurance d. provision that the hospital's nursing department retains responsibility for nursing care provided by the students. - Correct answer is: d.
Questions And Answers
Ensuring that the hospital retains responsibility for patient care assures accountability and is consistent with the hospital's regulatory requirements. Which of the following use of limited resources would most likely result in increased reiumbursement revenues? Increasing the: a. number of clinical nurse specialists b. educational paid days for licensed staff c. educational programs on documentation d. mix and number of clinical staff - Correct answer is: c. Adequate documentation of patient acuity and complexity may translate to better reiumbursement for the organization. Reimbursement processes such as prospective payment (DRGs) are adjusted for acuity. Coders rely on the accuracy and adequacy of clinicians' documentation to code correctly. Which of the following has the strongest potential for moving the United States toward a national healthcare system? a. Dissatisfaction Americans feel toward healthcare quality. b. The American Medical Association's dissatisfaction with the present system. c. Skyrocketing cost of private insurance premiums d. The rationing of services due to federal healthcare costs. - Correct answer is: c.
Questions And Answers
d. Managed care budgeting. - Correct answer is: c. Zero-based budgeting The zero-based budgeting approach asks managers/department heads to begin each budget year with a clean slate and to justify expenditures accordingly. The nurse executive who is implementing a hospital's cost containment program should realize that the most important step is to: a. develop an inservice curriculum that focuses on cost containment. b. develop methods for determining nursing care costs for each patient category. c. Negotiate redistribution of non-nursing tasks to other departments. d. Ask nurses to become a part of the decision-making process in the areas of patient care, unit management, and hospital governance. - Correct answer is: b. By knowing the specific cost of care of various patient categories, the nurse executive, along with others withint the department, has needed knowledge upon which to base a cost-containment plan. Costs per unit of service will increase as: a. volume decreases below the break-even point. b. volume increases c. acuity increases
Questions And Answers
d. management turnover occurs. - Correct answer is: a. This model is based on the premise that a certain volume is needed to maintain cost balance. When the volume decreases below the break- even point, costs go up. For example, staffing for a 50-bed unit is calculated for an occupancy rate of 85%, with a break-even point of 80%. Downward adjustments in staff numbers occur only when the occupancy rate dips to 75%. Any occupancy rate between 76% & 79% results in a "loss" based on the cost model. When nurse executives examine job classifications as they plan salary adjustments, they must remember that there are equal-pay tests that must be met to justify such determinations. Therefore, they would examine jobs for which of the following? a. Equal danger on the job, equal intelligence for hire, equal responsibility, and indentical working conditions. b. Equal skill, equal effort, equal responsibility, and similar working conditions. c. Equal job requirements, same working conditions, equal job duties, and equal responsibilities. d. Equal effort, equal working conditions, identical job duties, and equal job requirements. - Correct answer is: b. This statement accurately reflects the equal-pay test requirements. Use of the ______________ is the most fiscally responsible method for determining daily staffing needs.
Questions And Answers
b. Interpret the job description for a newly hired registered nurse c. Facilitate the dissemination of research in nursing and management systems d. Review the orientation schedule for newly graduated registered nurses - Correct answer is: c. Such an activity is within the purview of the executive. By ensuring that systems are in place to disseminate research in both nursing and management, the nurse exectuive helps set expectations for the organization's leadership group. A staff nurse at a unionized agency reports that overtime pay for an after-duty class requiring mandatory attendance was coded as straight pay instead of time and one half as called for in the union contract. Unit managers certify the type and amount of overtime pay. Appropriate action by the nurse exectuive would be to: a. follow up with the nurse's manager to make certain she or he is familiar with the contractual overtime requirements b. accompany the nurse to the payroll office and tell them to make the adjustment c. request that the nurse file a grievance so that payroll adjustment can occur d. turn the matter over to the personnel department for corrective action. - Correct answer is: a. Managers are responsible for knowing the legalities and contract requirements regaridng overtime. By encouraging the manager to
Questions And Answers
become more familiar with the contract, the nurse executive helps the manager fulfill her or his responsibilities and adds to the manager's competency. The union contract in the facility where you are a manager requires that discipline be progressive in all areas except for substance abuse and theft. When an employee commits a first offense of not coming to work as scheduled and neglecting to notify anyone regarding the absence, you would: a. give the employee a written reprimand b. counsel the employee verbally (verbal warning). c. suspend the employee with pay d. suspend the employee without pay - Correct answer is: b. The first action by the manager in the progressive discipline process is a verbal warning. A labor union is attempting to organize the employees of an institution. It would be considered an unfair labor practice if management: a. removed outside organizers from the institution's premises b. refused to allow employees to attend a meeting held by labor organizers during work hours c. supplied the union with information requested about specific employees of the institutions
Questions And Answers
b. confidentiality c. utility d. autonomy - Correct answer is: b. confidentiality HIPAA promises stringent adherance to the principles of confidentiality and includes stiff penalties in the face of violation of its tenets. In terms of professional ethics, the nurse executive is responsible for ensuring that: a. ethics education programs are provided for the nursing staff on an ongoing basis. b. a nursing ethics committee is convened and meets regularly. c. each nurse is provided with a copy of the Code for Nurses with Interpretive Statements published by the American Nurses Association d. nursing's perspective is represented in the organization's formal mechanisms for addressing ethical dilemmas. - Correct answer is: d The nurse executive ensures that nursing is well-represented within whatever formal framework the organization has in place to deal with ethical issues. Nursing is generally represented on the organization's multidisciplinary ethics committee. Policies and procedures are in place to guide nurses faced with ethical dilemmas in the course of their practice. Under Title VII of the Civil Rights Act, the employer:
Questions And Answers
a. is not responsible for discrimination on the part of individual supervisors b. is responsible for discrimination on the part of individual supervisors c. can terminate a supervisor for practices determined to be discriminatory d. can se the individual supervisor to recover monetary loss suffered because of discrimination settlements against the organization because of a supervisor's behavior. - Correct answer is: b The act stipulates that the employer remains responsible for the acts of its employees. A physician who performs a procedure upon a patient without proper consent has committed: a. assault b. invasion of privacy c. battery d. false imprisonment - Correct answer is: c Except in emergency situations, where consent is implied, the prfomrance of a procedure upon a patient without his or her explicit consent, or the explicit consent of his or her agent where indicated, constitutes battery on the part of the practitioner. Battery is defined as "the deliberate touching of another without authorization." The major anti-discrimination legislation is the:
Questions And Answers
A physician who promises to use a certain procedure in performing an operation and uses a different procedure instead may be liable for: a. negligence b. invasion of privacy c. breach of contract d. libel - Correct answer is: c. The physician has violated the contract agreed to with the patient, whether or not the alternative procedure is preferable, or more advantageous, to the procedure that the physician contracted to perform. Carter, a physicain specializing in internal medicine, treated Jones for a broken arm. Should Jones later bring a suit for malpractice, Carter will be held liable to the standard of care required for: a. his specialty b. the specialty in which he was treating Jones c. a general practitioner d. ordinary medical care - Correct answer is: b. The patient can reasonably expect that his broken bone will be set according to the standards of orthopedic practice. If the internal medicine physician cannot perform to this standard, then she or he should ensure that the care of the patient is transferred to someone who can practice accordingly.
Questions And Answers
The authority to license healthcare practitioners is found in the regulating power of: a. the individual hospital b. the appropriate training program c. the state d. the licensing board - Correct answer is: c. the state The state issues regulations pertaining to licensure of various professions. Nurse executives have a responsibility to know and understand legislation affecting nursing practice in order to: a. prevent administrative personnel malpractice actions b. respond quickly and appropriately to necessary changes in nursing services c. protect the organization from lawsuits d. ensure that procedures in nursing practice are carried out correctly. - Correct answer is: b. As legislation that affects nursing practice becomes law, nurse executives must be cognizant of the changing statutes, their impact, and the modifications that must be made in their organizations in order to comply. Nurse executives become the "translators" of legislative change for staff.
