Leadership Roles and Management functions in Nursing theory and application 10th edition C, Exams of Nursing

Download Leadership Roles and Management functions in Nursing theory and application 10th edition C and more Exams Nursing in PDF only on Docsity! Leadership Roles and Management functions in Nursing theory and application 10th edition Chapter 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19 ,20,21 The selected starting point in negotiations should be at the upper limits of the negotiator's expectations, within reason. However, negotiators must realize they may have to come down to a lesser goal. The other options are not reflective of accepted tactics used in successful negotiations. - correct Answer1. Which action is an accepted tactic when engaged in a negotiation? A) Being willing to win at any cost B) Communicating only when asked direct questions C) Compromising only as a last resort D) Beginning with a high but realistic expectation Ans: B Feedback: In collaboration, all parties set aside their original goals and work together to establish a common goal. None of the other options are examples of the described outcome. - correct Answer2. A charge nurse assists a group of personnel to resolve their conflict, with the outcome being that the two opposing goals were discarded and new goals were adopted. What is this an example of? A) Smoothing of conflict by the leader B) Facilitating collaboration among personnel C) A majority rule approach D) A good lesson in compromising Ans: C Feedback: Destructive negotiation tactics are never a part of a successful collaborative conflict resolution. A good manager will be alert for such tactics. None of the other options are true statements regarding negotiation tactics. - correct Answer3. Which is a true statement about negotiation tactics? A) Ridicule often takes the form of ambiguous or inappropriate questioning and is a diversionary tactic B) Most managers successfully resist the illness/wellness tactic because of their nursing preparation. C) Negotiation tactics can be manipulative; thus, managers should know how to identify and counter destructive tactics D) The tactic of paternalism allows both parties in the negotiation to reach a consensus of opinion Ans: B Feedback: The interactionist movement encouraged organizations to promote conflict as a means of producing growth. The remaining options were not necessarily supported by the interactionist theorists. - correct Answer4. What did the interactionist theorists of the 1970s believe about organizational conflict? A) It should be dealt with immediately B) It should be encouraged C) It was an indication of poor management D) It should be avoided Ans: A Feedback: Some level of conflict in an organization appears to be desirable since it appears to prevent organizational stagnation. None of the other options reflect contemporary thinking about conflict. - correct Answer5. Which statement reflects the contemporary thinking about conflict? A) It can lead to new ideas B) It leads to decreased motivation C) It should be avoided whenever possible D) It is neither qualitative nor quantitative Ans: D Feedback: Interpersonal conflict happens between two or more people with differing values, goals, and beliefs. No other option is used to describe this situation. - correct Answer6. What term is used when two or more people have conflict about values or goals? A) Intergroup conflict B) Common control C) Intrapersonal conflict D) Interpersonal conflict Ans: C Feedback: Perceived or substantive conflict is intellectualized and often involves issues and roles. The person recognizes it logically and impersonally as occurring. None of the other options are true statements concerning perceived conflict. - correct Answer7. Which statement is true concerning perceived conflict? A) It develops during the first stage of the conflict process B) It is sometimes referred to as antecedent conflict C) It occurs if the conflict is intellectualized D) It occurs when the conflict is emotionalized Ans: B Feedback: C) Arranging for the RNs to air their views at the next staff meeting. D) Sharing with the RNs that they need to address the issue with upper management Ans: A Feedback: When a supervisor delineates job duties to persons in conflict, it is called responsibility charting. The other options are not related to job description conflict. - correct Answer16. The nurse-manager facilitates a conflict that involves the delineation of staff job descriptions. What is this an example of? A) Responsibility charting B) Smoothing conflict C) Alternate dispute resolution D) Mediation counseling Ans: A Feedback: Self-scheduling is not generally associated with common causes of organizational conflict. The most common sources of organizational conflict are communication problems, organizational structure, and individual behavior within the organization. - correct Answer17. What are the least common sources of organizational conflict? A) Communication problems B) Organizational structure C) Individual behavior within the organization D) Self-scheduling Ans: A Feedback: Too little conflict results in organizational stasis and decreased productivity, whereas too much conflict reduces the organization's effectiveness and eventually immobilizes its employees. - correct Answer18. What occurs when there is very little conflict in an organization? A) Stasis B) Increased productivity C) Decreased effectiveness D) Employee immobilization Ans: A Feedback: The first stage in the conflict process is called latent conflict, which implies the existence of antecedent conditions. Latent conflict may proceed to perceived conflict or to felt conflict. Manifest conflict may also ensue. The last stage in the process is conflict aftermath. - correct Answer19. What is the name given to the first stage in the conflict process? A) Latent B) Perceived C) Felt D) Manifest Ans: A Feedback: Mediation uses a neutral third party; is a confidential, legally nonbinding process designed to help bring the parties together to devise a solution to the conflict. None of the other options accurately describes the process of mediation. - correct Answer20. Considering dispute resolution, which statement is true regarding what occurs during mediation? A) It uses a neutral third party; is a confidential, legally nonbinding process designed to help bring the parties together to devise a solution to the conflict B) It asks questions to clarify the issues C) It makes a final decision for the parties in conflict D) It involves presentation of evidence including that of expert witnesses Ans: A Feedback: Consensus means that negotiating parties reach an agreement that all parties can support, even if it does not represent everyone's first priorities. Consensus decision making does not provide complete satisfaction for everyone involved in the negotiation as an initially unanimous decision would, but it does indicate willingness by all parties to accept the agreed-upon conditions. Mediation is not a required factor in arriving at a consensus. - correct Answer21. What is the result of arriving at a consensus? A) All involved parties agree to support the way a conflict has been resolved B) A conflict is resolved by meeting the goals of all involved parties C) It resolves a conflict by an initial unanimous decision D) Conflict is resolved through the mediation process Ans: C Feedback: A function of an ombudsperson is to assure that those involved in a conflict understand their rights as well as the process that should be used to report and resolve the conflict. This role is not appropriately described by any of the other options. - correct Answer22. What is the function of an ombudsperson? A) Providing expert testimony in conflict cases B) Mediating disputes between an organization and its employees C) Educating individuals involved in a grievance situation of their rights D) Monitoring the implementation of the terms of a conflict's compromise Ans: A Feedback: Once a compromise has been reached, restate it so that everyone is clear about what has been agreed upon. A compromise by its natural requires a change in original goals. The evaluation for fairness needs to have been done prior to the compromise being agreed upon. Thanking all involved is appropriate but would not be the initial action. - correct Answer23. After a compromise has been made, what is the manager's initial action? A) Clearly restating the compromise's specific outcomes to all involved B) Thanking all involved for their cooperation on reaching the compromise C) Evaluating the compromise's outcomes for fairness to all involved parties D) Assuring all involved that the compromise will not cause a change in goals Ans: B Feedback: Some people win in negotiation simply by rapidly and aggressively taking over and controlling the negotiation before other members realize what is happening. If managers believe that this may be happening, they should call a halt to the negotiations before decisions are made. Saying simply, I need to have time to think this over is a good method of stopping an aggressive takeover. The other options are much less effective and may even lead to increased aggressiveness among team members. - correct Answer24. A nurse-manager is engaged in a negotiation with staff representatives when the discussion becomes controlled by a particularly aggressive member. Which action will the nurse-manager take to assure that the process is successful? A) Asks that the aggressive individual recognize the rights of all the other members B) States, I need to have time to think over all that we have discussed. C) Halts any discussion until new representatives can be appointed D) Shares with the members that aggressiveness negatively impacts the negotiations Ans: B Feedback: Negotiation is psychological and verbal. The effective negotiator always appears calm and self-assured. The other options are not as impactful when considering the psychological aspects of the negotiation process. - correct Answer25. Which personal characteristics will best help meet the psychological needs of conflict negotiation? A) Perseverance and assertiveness B) Calmness and self-assuredness C) Compassion and reflectiveness D) Organization and preparedness 1. What is the best combination that characterizes the communication process? A) Sender receiver message B) Receiver message sender C) Sender message receiver D) Message sender receiver - correct AnswerAns: C Feedback: The combination that best characterizes the communication process is sender message receiver. The other options would result in the likelihood of miscommunication. 2. When does communication have the greatest likelihood of being accurately interpreted? A) More than one mode is used B) Face-to-face communication is used C) Written communication is used D) The sender repeats the message using the same mode - correct AnswerAns: A B) Information exchange is initiated by subordinates and directed upward C) Information is conveyed unofficially by administration through department heads D) The exchange of information initiated by someone in a staff position to someone in a line position - correct AnswerAns: A Feedback: Informal communication through the ìgrapevineî occurs when most personnel are involved in the unofficial exchange of information. This process is not accurately described by any of the other options. 11. Which statement regarding a memo is true? A) A memo makes it main point at least twice B) A memo is written using an authoritative format C) Headings are not used in a memo to avoid confusing the reader D) Only essential information is included in a memo - correct AnswerAns: D Feedback: Only essential information is included in a memo since extraneous information will detract from the message. None of the other options presents correct information concerning a memo. 12. Regarding group building, what is the responsibility of the gatekeeper? A) Mediating, harmonizing, and resolving conflict B) Accepting and praising the contributions and viewpoints of group members C) Facilitating and promoting open communication of all group members D) Recording the group's process and providing feedback to the group - correct AnswerAns: C Feedback: The gatekeeper makes sure all voices in the group are heard in order to facilitate and promote open communication. The role of gatekeeper is not accurately described by any of the other options. 13. What statement about the maintenance of confidentiality is true? A) It must never be breached B) It is made easier with electronic technology C) It is primarily the duty of the medical records staff D) It can be breached when necessary for legitimate professional need - correct AnswerAns: D Feedback: Confidentiality of patients must be upheld, unless there is a legitimate professional need to know, such as when a provider must share information about a patient with another provider so that the other provider can assume care. None of the other options is an accurate statement regarding confidentiality. 14. What is important to remember about gender differences in communication? A) Men are more collaborative communicators B) It rarely impacts nursing care C) It affects the quality of organization communication D) Women are more competitive communicators - correct AnswerAns: C Feedback: Men are usually more competitive and less collaborative than women in their communication patterns, and differences often impact the quality of organization communication. 15. What location of the SBAR charting tool states the patient's problem? A) Situation B) Background C) Assessment D) Recommendation - correct AnswerAns: C Feedback: Assessment is where the nurse states the patient's problem. The problem is not documented in any of the other SBAR locations. 16. What is the traditional form of communication in organizations that helps to coordinate activities in various levels of the hierarchy? A) Upward B) Downward C) Horizontal D) Diagonal - correct AnswerAns: B Feedback: In downward communication, the manager relays information to subordinates. This is a traditional form of communication in organizations and helps to coordinate activities in various levels of the hierarchy. The other forms are not as effective as the various levels of an organization's hierarchy. 17. What portion of GRRRR (greeting, respectful listening, review, recommend or request more information, and reward) is being used when the speaker summarizes the information conveyed to make sure the message was understood correctly? A) Greeting B) Respectful listening C) Review D) Recommend or request more information - correct AnswerAns: C Feedback: Review occurs when the speaker summarizes the information he/she has conveyed to make sure the message was understood correctly. Once the speaker is finished conveying this summary and the other party has validated or clarified it, the listener has enough information to recommend or request more information. This does not occur in any of the other portions of the model. 18. What communication mode is considered most reliable in conveying the emotional component of the message? A) Written B) Verbal C) Nonverbal D) Telephone - correct AnswerAns: C Feedback: Nonverbal communication is considered more reliable because it conveys the emotional part of the message. The other modes are not as effective with conveying emotion. 19. What is the most significant barrier to effective interpersonal communication? A) Incongruence between verbal and nonverbal messages B) Incongruence between telephone and written messages C) Incongruence between verbal and written messages D) Incongruence between telephone and nonverbal messages - correct AnswerAns: A Feedback: The incongruence between verbal and nonverbal messages is the most significant barrier to effective interpersonal communication. 20. Which method best provides a structured orderly approach to communicating accurate, relevant information, in emergent patient situations as well as routine handoffs? A) GRRRR listening model B) SBAR tool C) Hospital information system D) Wireless, local area networking - correct AnswerAns: B Feedback: SBAR provides a structured, orderly approach to provide accurate, relevant information, in emergent patient situations as well as routine handoffs. The other options are not as focused on providing information in all the described situations. 21. How can the Internet be best used as a means of improving one's personal nursing practice? A) Accessing the latest research and best practice information B) Communicating with other health-care team members C) Minimizing the need for paper documentation D) Securing patient information for confidentially - correct AnswerAns: A Feedback: As an information source, the Internet allows nurses to access the latest research and best practice information so that their care can be evidence based. The remaining options are not focused on personal nursing practice. 22. Which behavior by a team member is demonstrated through cynicism and a nonchalance attitude about the group's work? A) Blocker B) Playboy C) Dominator D) Recognition seeker - correct AnswerAns: B Feedback: The playboy remains uninvolved and demonstrates cynicism, nonchalance, or horseplay. The blocker persists in expressing negative points of view and resurrecting dead issues. The dominator attempts to control and manipulate the group while the recognition seeker works to focus positive attention on himself. B) Workers are diligent, responsible, and helpful C) Workers are lazy, uncreative, and indifferent toward work D) Increased rewards will motivate workers - correct AnswerAns: C Feedback: McGregor believed that how the manager views the employees will affect motivation and productivity. Theory Y managers thought workers were motivated, but Theory X managers thought they were lazy, uncreative, and indifferent. The remaining options are not addressed by these assumptions. 7. What is the implication in a hierarchy of needs? A) All needs have equal power in motivation B) Unsatisfied needs trigger behavior C) Lower level needs are less valued D) Some individuals have hereditary needs - correct AnswerAns: B Feedback: Hierarchy of need implies that people are motivated to satisfy certain needs, ranging from basic survival to complex psychological needs, and people seek a higher need only when the lower needs have been predominantly met. 8. What did Victor Vroom emphasize the importance of? A) Managers knowing each employee's expectation of reward B) Managers being honest with their employees C) Making sure that the employees' lower-level needs are met D) Understanding that individuals react in a stimulusñresponse mode - correct AnswerAns: A Feedback: Victor Vroom emphasized the importance of managers knowing each employee's expectation of reward. The other options are not related to Vroom's theory. 9. What did the motivational theorist Saul Gellerman argue? A) Individuals should be stretchedî on a regular basis to increase their productivity and motivation levels B) Stretchingî should be used as a motivational strategy only for affiliation-oriented individuals C) Stretchingî should be used as a motivational strategy only when an individual is already demotivated D) Employees should be stretchedî intermittently to complete tasks more difficult than what they are used to doing - correct AnswerAns: D Feedback: Gellerman suggested stretching, which involves assigning tasks that are more difficult than what the person is used to doing. Stretching should not, however, be a routine or daily activity. The remaining options are not true statements regarding stretching 10. According to Skinner, how should rewards used as a way to reinforce behavior be given? A) At established intervals B) Specific to a particular performance C) Sometime after the event for maximum reinforcement D) Very sparingly to make them more valuable - correct AnswerAns: B Feedback: If rewards are to succeed as motivational strategies, they should represent genuine accomplishment on the part of the employee. Rewards can be spontaneous, as long as they are truly deserved. The other options are not supportive of Skinner's thoughts on rewards. 11. What is the purpose for a manager to engage in networkingî? A) To bolster self-esteem B) To unwind from work C) To further professional goals D) To meet altruistic needs - correct AnswerAns: C Feedback: A manager networks by joining a professional group to which one can contribute and that serves to further professional goals. The goal of networking is not stated by any of the other options. 12. Which statement is typically true of job satisfaction levels? A) They are higher for subordinates than for management staff B) They decline as the level of participation in unit decision making increases C) They are related to the degree of work life control subordinates perceive they have D) They are fairly static given that unit cultures are traditionally very difficult to change - correct AnswerAns: C Feedback: Job satisfaction levels can be correlated with the degree of control subordinates perceive they have over their work life. The remaining statements are not true regarding job satisfaction. 13. Which course of action would be most apt to help a demotivated RN with personal and professional renewal? A) Begin job hunting in a new field B) Start practicing self-care C) Take a management class D) Start leaving work early - correct AnswerAns: B Feedback: For self-care, the manager should seek time off on a regular basis to meet personal needs, have recreation, form relationships outside the work setting, and have fun. Friends and colleagues are essential for emotional support, guidance, and renewal. A proper diet and exercise are important to maintain physical as well as emotional health. The remaining options are not practical and lack the focus on self. 14. What managerial characteristic is essential in assuring that employees will find joy at work? A) Attending to the organizational climate B) Forming respectful relationships C) Effectively supervising employee work D) Partitioning for salary increases - correct AnswerAns: B Feedback: Employees value a trusting and helpful manager who lets them know their uniqueness is understood. The remaining options are not essential to facilitating employee work- related joy. 15. What is intrinsic motivation directly related to? A) Work environment B) External rewards C) Personal aspiration D) Completion of work - correct AnswerAns: C Feedback: Intrinsic motivation comes from within the person, driving him or her to be productive such as personal goals and aspirations. Rewards resulting from extrinsic motivation (which is motivation that is enhanced by the work environment) occur after the work has been completed. 16. Which is an example of a hygiene factor according to Herzberg? A) Achievement B) Recognition C) Salary D) Work - correct AnswerAns: C Feedback: A hygiene factor is salary. Motivators include achievement, recognition, and work. 17. McClelland's studies state that all people are motivated by three basic needs. What are these needs? A) Physiological, security, esteem B) Safety, social, self-actualization C) Achievement, affiliation, power D) Responsibility, supervision, job security - correct AnswerAns: C Feedback: McClelland's studies state that all people are motivated by three basic needs: achievement, affiliation, and power. McClelland does not include the other options as needs associated with motivation. 18. What did Gellerman state about most managers in organizations? A) They undermanage subordinates B) They define responsibilities too broadly C) They stretch employees' comfort levels too much D) They fail to give employees sufficient decision-making power - correct AnswerAns: D Feedback: Gellerman states that most managers in organizations over-manage, making the responsibilities too narrow and failing to give employees any decision-making power or to stretch them often enough. Intrinsic motivation comes from within the individual. It is driven by a need to improve and be more productive such as attending a nursing conference. Extrinsic motivation is motivation enhanced by the job environment or external rewards. Rewards and reinforcements are given to encourage certain behaviors and/or levels of achievement. The remaining options are examples of extrinsic motivations. 1. What is the most fiscally responsible method for determining staffing needs for a hospital unit? A) Maximum patient load capacity of the unit B) Numbers of patients present for an upcoming shift C) An agreed-upon staffing formula currently in use D) Total beds on the unit - correct AnswerAns: C Feedback: A staffing formula is the best way to determine staffing needs, provided it is based on an accurate patient classification system (PCS). The remaining options are not as fiscally responsible since they involve uncontrollable factors. 2. Which statement about PCSs is accurate? A) Classification systems are able to solve staffing problems B) Nursing care hours assigned to a classification system should remain constant C) A good classification system is without fault D) Internal and external forces may affect classification systems - correct AnswerAns: D Feedback: Examples of internal and external forces that may affect a PCS are a sudden increase in nursing or medical students using the unit, a lower skill level of new graduates, or cultural or language difficulties of recently hired foreign nurses. None of the remaining options is totally accurate because of uncontrollable factors. 3. Which statement accurately reflects self-scheduling? A) Self-scheduling requires greater worker accountability B) The manager has little responsibility in self-scheduling C) Self-scheduling has few or no shortcomings D) Self-scheduling works in most organizations - correct AnswerAns: A Feedback: Self-scheduling requires greater worker participation in decision making and shared responsibility for adequate staffing. None of the remaining options is accurate. 4. Which is an outcome of decentralized staffing? A) Increased fairness to employees through consistent, objective, and impartial application B) Cost-effectiveness through better use of resources C) Greater manager autonomy to control the staffing on the units, resulting in an increase in self-esteem and teamwork D) Increased availability of data for monitoring the effect of staffing size and composition, quality of care, and costs - correct AnswerAns: C Feedback: In an institution that has no human resources department and no nurse recruiters, the unit manager does the hiring and has greater autonomy in personnel matters. The other options are not associated with decentralized staffing. 5. It is 2 PM. You are calculating the nursing care hours for the 3 to 11 PM shift and must decide whether you need to call in additional help. You have three RNs, three nursing assistants, and one ward clerk scheduled. You have 22 patients with the following acuity and nursing care hours allotted for the evening shift: Category I, 4 patients - correct Answer2.0 hours Category II, 2 patients @ 2.3 hours Category III, 10 patients @ 2.8 hours Category IV, 6 patients @ 3.4 hours What are the needed hours of nursing care? A) 61 hours B) 52.6 hours C) 68.4 hours D) 48.4 hours @Ans: A Feedback: Four category I patients require 8 hours of care; two category II patients require 4.6 hours of care; 10 category III patients require 28 hours; six category IV patients require 20.4 hours; total nursing care hours equal 61. 6. What is the priority goal for a manager with regard to staffing and scheduling? A) Schedule staff so there is no overtime B) Ensure that there is adequate staff to meet the needs of each patient C) Develop trust in staff by seeing that staffing is carried out in a fair manner D) Ensure that staff members usually have days off and special requests granted - correct AnswerAns: B Feedback: The manager is tasked with seeing that patient care needs are met first and foremost. While the other options are relevant, they are not the priority goal of the manager. 7. Which is the most accurate statement regarding staffing and scheduling policies? A) It is more important to communicate policies verbally than in writing B) It is necessary that policies are written in a manner that allows some flexibility C) Policies should focus on the process D) Managers should have autocratic control over scheduling and staffing policies - correct AnswerAns: B Feedback: To retain employees, the staffing policies must allow some flexibility, which could include job sharing, flextime, a part-time staffing pool for weekends, or allowing employees to exchange hours of work among themselves. 8. Which statement accurately identifies a concern associated with decentralized staffing? A) It carries risks that employees may be treated unequally or inconsistently B) It uses one individual or a computer to do the staffing C) The manager's role is that of making minor adjustments or providing input D) It provides good control for the organization - correct AnswerAns: A Feedback: A manager being perceived as granting special treatment to some employees is a risk of decentralized staffing. None of the other options identifies an associated concern. 9. What outcome is associated with a good PCS? A) It eliminates most staffing problems B) It decreases the amount of overtime C) It provides an understanding of staffing problems D) It eliminates the need for adjustment or review - correct AnswerAns: C Feedback: The main strength of the PCS is that it provides data with which to make staffing decisions. It will not solve all staffing problems, and it will not replace a manager's judgment. 10. What positive impact do new practice models have on the staffing mix? A) Automatically cancel the PCS B) Will result in fiscal savings C) Require no changes in scheduling policies D) Impact patient care assignment methods - correct AnswerAns: D Feedback: As new practice models are introduced, there must be a simultaneous examination of the existing staff mix and patient care assessments to ensure that appropriate changes are made to the staffing and scheduling policies. They are not associated with the impact suggested by the other options. 11. What term identifies a system that allows employees to select among variations in work start-time schedules to meet their personal needs? A) Self-scheduling B) Flextime C) Decentralized staffing D) Cyclical staffing - correct AnswerAns: B Feedback: When a hospital uses flextime, employees arrive at the unit and leave at many different times. The other options are not associated with the system described. 12. Which statement is correct concerning prenegotiated budget management? A) It is incompatible with ethical accountability B) It is only the responsibility of the centralized staffing office C) It is inappropriate with new practice models D) It is a critical responsibility of managers - correct AnswerAns: D Feedback: Accountability for a prenegotiated budget is a management function. The other options are incorrect regarding this function. 13. Which statement is true regarding legislated minimum staffing ratios? These nurses are usually directly employed by an external nursing broker and work for premium pay (often two to three times that of a regularly employed staff nurse), without benefits. While such staff provide scheduling relief, especially in response to unanticipated increases in census or patient acuity, their continuous use is expensive and can result in poor continuity of nursing care. 21. What is a leadership role associated with staffing and scheduling? A) Role models the use of evidence in making appropriate staffing and scheduling decisions B) Uses organizational goals and patient classification tools to minimize understaffing C) Periodically examines the unit standard of productivity to determine if changes are needed D) Evaluates scheduling and staffing procedures and policies on a regular basis - correct AnswerAns: A Feedback: Role modeling is a leadership responsibility. The other options are recognized management responsibilities associated with staffing and scheduling. 22. What is an advantage of centralized staffing? Select all that apply A) It is flexible B) It is staff focused C) It is cost-effective D) It is consistent and impartial - correct AnswerAns: C, D Feedback: Centralized staffing is generally fairer to all employees because policies tend to be employed more consistently and impartially. In addition, centralized staffing frees the middle-level manager to complete other management functions. Centralized staffing also allows for the most efficient (cost-effective) use of resources because the more units that can be considered together, the easier it is to deal with variations in patient census and staffing needs. Centralized staffing, however, does not provide as much flexibility for the worker, nor can it account as well for a worker's desires or special needs. In addition, managers may be less responsive to personnel budget control if they have limited responsibility in scheduling and staffing matters. 23. Since 2008 what is the legal minimum staffing radios for a medicalñsurgical nursing unit? A) 1:4 B) 1:5 C) 1:6 D) 1:7 - correct AnswerAns: B Feedback: The expected legal ratio is 1:5. 24. Which statement is true regarding the float pool nurse? Select all that apply. A) They are classified as per-diem staff B) The nurse trades increased personal flexibility for less pay C) Float pool nurses do not receive usual staff benefits D) They are crossed trained on multiple units - correct AnswerAns: A, D Feedback: Some hospitals have created their own internal supplemental staff by hiring per-diem employees and creating float pools. Per-diem staff generally have the flexibility to choose if and when they want to work. In exchange for this flexibility, they receive a higher rate of pay but usually no benefits. Float pools are generally composed of employees who agree to cross-train on multiple units so that they can work additional hours during periods of high census or worker shortages. Float pools are adequate for filling intermittent staffing holes but, like agency or registry staff, they are not an answer to the ongoing need to alter staffing according to census since they result in a lack of staff continuity. 25. Which external and internal forces must a manager adjust for when implementing the PCSs associated with unit staffing? Select all that apply. A) Presence of nursing students on the unit B) The hiring of two graduates as staff C) The increase of scheduled medical students D) Language barriers presented by nursing staff - correct AnswerAns: A, B, C, D Feedback: Regarding PCS, the middle-level manager must be alert to internal or external forces affecting unit needs that may not be reflected in the organization's patient care classification system. Examples of such forces could be a sudden increase in nursing or medical students using the unit, a lower skill level of new graduates, or cultural and language difficulties of recently hired foreign nurses. The organization's classification system may prove to be inaccurate, or the hours allotted for each category or classification of patient may be inaccurate (too high or too low). An anxious patient is not a force that should affect the staffing process. Which statement best describes mentorship? A) The intensity and duration of relationships are similar in mentorship and preceptorship B) Staff cannot be assigned to become mentors. It is a role voluntarily chosen by the mentor C) Mentees must be willing to put aside their personal goals and beliefs in an effort to identify more closely with their mentor D) Most nurses will have the opportunity for many mentor relationships during their careers - correct AnswerAns: B Feedback: The mentor makes a conscious decision to assist the protegee in career development, with the relationship usually lasting several years. The remaining statements are not accurate regarding mentorships. 2. What would be the most helpful intervention to take to help a new RN adjust to the professional nursing role? A) Advise the new RN to avoid confrontations with doctors whenever possible B) Advise the new RN that this is the real world not the textbook one C) Be alert to signs and symptoms of the shock phase of role transition D) Be alert to signs that the new RN has not shed nursing school values - correct AnswerAns: C Feedback: Managers should be alert to signs and symptoms of the shock phase of role transition. Managers should also ensure that some of the new nurse's values are supported and encouraged so that work and academic values can blend. The remaining options do not address the needs of the new RN appropriately. 3. Which statement best describes the manager's role in socialization? A) Providing the employee with organizational rules and regulations B) Providing the new employee with a good preceptor C) Ensuring that there are sufficient numbers of good role models D) Sharing organizational values, expected attitudes, and history - correct AnswerAns: D Feedback: New group members must be socialized into the group, and these socialization efforts are led by the manager. 4. You overhear an experienced nurses say to a new nurse, Sorry you won't be able to join us for our weekly get-together at the local yogurt shop. I see you are going to be here charting for a while yet. What is this an example of? A) Behavior that supports positive sanctions B) An application of a sanction regarding group norms C) Constructive feedback about expected group norms D) Role modeling desired behavior - correct AnswerAns: B Feedback: Negative sanctions provide cues that enable people to evaluate their performance and modify behavior when needed. In this case, the experienced nurse is letting the new nurse know that the group's weekly outing is important, and on that day the staff makes sure they finish their work on time. It may also suggest that detailed charting is not valued. 5. Which action would be the most likely to result in encouraging evidence-based practice? A) Stress the need to base practice on research findings during orientation of new graduates. B) Include a statement of the need for evidence-based practice in the philosophy. C) Reprimand nurses who do not use research during the annual evaluations. D) Provide a computer program to nurses for access to the latest nursing research. - correct AnswerAns: D Feedback: Providing available research for the staff is the most concrete action an organization could take to encourage nurses to incorporate research in practice. None of the remaining options provides the staff with the tools to implement or encourage evidence- based practice. A) Identifying the resources available to meet the needs B) Identifying the desired skills or knowledge the staff should have C) Explaining to the team that human resources should be doing this work D) Assessing the staff's willing to learn new skills - correct AnswerAns: B Feedback: Identifying the desired skills or knowledge the staff should have is the first step in developing an educational program. While the other options are relevant, they lack the organizational priority of the correct option. 16. What is the best method for determining the effectiveness of a staff development program for managing IV puncture sites? A) Having class participants evaluate the instructor and the class B) Giving participants an examination or test at the conclusion of the course C) Having a documented decrease in the unit's IV site infections D) Observing staff implement and document the changes recommended - correct AnswerAns: D Feedback: Instructor evaluation supports effective teaching but not learning of the new skills. Testing someone at the end of educational training does not confirm that the learning changed behavior, which is the primary goal of staff development. There needs to be some method of follow-up to observe whether a behavior change occurred, showing that the education was effective. Observation of the staff will fulfill this need. Having a decrease in IV site infections may or may not be the result of the staff implementing the educational program. 17. Which is a common feature of a learning organization? A) A tolerance of mistakes B) Hiring RNs with baccalaureate degrees C) Encouraging a variety of visions D) Stressing individual learning - correct AnswerAns: A Feedback: Learning organizations have a shared vision and promote team learning. A common feature of learning organizations is their tolerance for mistakes. The mistakes should be learning opportunities. The remaining options do not support this aspect of a learning organization. 18. What are often neglected areas of the indoctrination process? 1. Induction 2. Orientation 3. Socialization 4. Re-socialization A) 1, 2 B) 1, 3 C) 2, 4 D) 3, 4 - correct AnswerAns: D Feedback: Socialization and re-socialization are often neglected areas of the indoctrine process. 19. What contributes to a nurse's difficult resocialization? Select all that apply. A) Role ambiguity B) Role overload C) Inability to meet job demands D) Past work experience - correct AnswerAns: A, B, C, D Feedback: Difficulties with resocialization usually center on unclear role expectations (role ambiguity), an inability to meet job demands, or deficiencies in motivation. Role strain and role overload contribute to the problem. Past work experience is not a factor in creating a difficult resocialization. 20. Training and education are important parts of staff development. Who is responsible for the education and training of staff? A) Preceptor B) Education department C) Manager and preceptor D) Manager and education department - correct AnswerAns: D Feedback: Managers and education department staff have a shared responsibility for the education and training of staff. It is not the responsibility of the other options. 21. Which action demonstrates the leadership role to the socialization and education of new nursing staff during their orientation? A) Discusses the value the unit places upon patient satisfaction B) Addresses all questions regarding the responsibilities of the RN C) Schedules orientation sessions at times when patient acuity is at its lowest D) Plans for budget constraints so that educational needs are minimally impacted - correct AnswerAns: A Feedback: Clarifying unit norms and values to all new employees is a leadership responsibility; the remaining options are appropriate management responsibilities. 22. What negative outcome can result from the decentralization of the responsibilities of staff development? A) Poor staff retention B) Deficient nursing care C) Increased role ambiguity D) Decreased nursing autonomy - correct AnswerAns: C Feedback: Some difficulties associated with decentralized staff development include the conflict created by role ambiguity whenever two people share responsibility. Role ambiguity is sometimes reduced when staff development personnel and managers delineate the difference between training and education. None of the other options are recognized as a result of decentralization of staff development. 23. What term is used to identify previously acquired skills that are necessary for further learning? A) Experiential factors B) Transfer of learning C) Reinforcement D) Chunking - correct AnswerAns: A Feedback: Experiential factors are skills previously acquired that are necessary for the next stage of learning. Transfer of learning refers to the goal of training to transfer new learning to the work setting. Once the behavior or skill is learned, it needs continual reinforcement until it becomes internalized. Chunking occurs when two independent items of information are presented and then grouped together into one unit. 24. Which statement demonstrates understanding of the concept of the knowledge of results? A) These are the goals for today's lecture. B) Today each of you demonstrated an understanding of patient focused care. C) As RNs on this unit, you will need to be proficient in assessing for depression. D) There will be a short quiz on today's material to assure you understand the material. - correct AnswerAns: B Feedback: Research has demonstrated that people learn faster when they are informed of their progress. The knowledge of results must be automatic, immediate, and meaningful to the task at hand. People need to experience a feeling of progress, and they need to know how they are doing when measured against expected outcomes. The other options failed to demonstrate an understanding of that need. 25. The nurse-manager stresses the importance of learning a new skill to achieving the unit's goal of patient satisfaction. This demonstrates understanding of which concept of learning? A) Readiness B) Motivation C) Task learning D) Transfer of learning - correct AnswerAns: C Feedback: If learners are informed in advance about the benefits of learning specific content and adopting new behaviors, they are more likely to be motivated to attend the training sessions and learn. Telling employees why and how specific educational or training programs will benefit them personally is a vital management function in staff development. None of the other options demonstrates association with this concept of learning. 1. What should managers do to maintain adequate staff in their organization? A) Proactively plan to hire two RNs for each unit each year B) Use knowledge of turnover rates on their units for planning and hiring C) Look at staff-to-patient ratios at other health-care organizations in the area Feedback: Some managers prefer to verify credentials and references before the interview; others do it after the interview. Either way, doing a comprehensive check of credentials and references is of absolute importance. None of the other options identify the selector's processing role. 9. Which statement about the proper placement of employees within the organization is correction? A) It occurs when an attempt is made to place employees in units where they have the greatest chance of success B) It is overrated as a retention strategy because most employees readily adapt to whatever unit on which they are placed C) It refers to placing employees on units that have the greatest need for new staff D) It occurs when employees are able to modify their own personal values and beliefs to coincide with that of the unit on which they are placed - correct AnswerAns: A Feedback: If employees are placed where they have the greatest chance of success, employee morale and retention will be positively affected. None of the other options are accurate statements. 10. Which statement describes the induction phase of employee indoctrination? A) It occurs after hiring but before performing the role B) It includes the activities performed by the personnel department C) It relates to the information included in the employee's handbook D) It is the responsibility of the staff development department - correct AnswerAns: A Feedback: Induction, the first phase of indoctrination, includes all activities that educate the new employee about the organization and personnel policies and procedures before actually assuming nursing responsibilities. None of the other options identify that phase accurately. 11. Which question asked during an interview is acceptable? A) Are you married? B) Have you ever been arrested? C) What is your religious preference? D) What professional organizations do you belong to? - correct AnswerAns: D Feedback: It is lawful for an interviewer to ask about professional organizations, but the interviewer cannot ask the interviewee to produce a list of all memberships. None of the other options identify an acceptable question. 12. In checking the background of a potential candidate for hire, which is the least frequently checked source? A) Academic credentials B) References of former employers C) References of recent teachers D) Verification of work history - correct AnswerAns: A Feedback: Academic credentials are the least frequently checked background information. All of the other options are frequently checked. 13. When do nursing shortages historically occur? A) When the economy is beginning an upswing B) When the economy is receding C) When nursing salaries decline D) When patient acuity increases - correct AnswerAns: A, B Feedback: Historically, nursing shortages occur when the economy is on the upswing and decline when the economy recedes. Historically, salaries were not a factor in existing nursing shortages. Currently, as the nursing pool ages, there is a nursing shortage projected. 14. What contributed to beginning of an acute shortage in many health-care settings in the late 1990s? 1. Hospital downsizing 2. National businesses downsizing 3. Shortsightedness regarding recruitment 4. Shortsightedness regarding retention A) 1, 2, 3 B) 1, 2, 4 C) 1, 3, 4 D) 2, 3, 4 - correct AnswerAns: A Feedback: Hospital downsizing and shortsightedness regarding recruitment and retention contributed to the beginning of an acute shortage of RNs in many health-care settings by the late 1990s. Retention was not considered a factor. 15. From an economic perspective, what is driving the current nursing shortage? A) Supply side of the supply/demand equation B) Demand side of the supply/demand equation C) Both the supply and demand sides of the supply/demand equation D) Short-term rise in demand in nursing services - correct AnswerAns: A Feedback: From an economic perspective, the current nursing shortage is being driven more by the supply side of the supply/demand equation than the demand side. None of the other options identify that connection. 16. The manager may be greatly or minimally involved with recruiting, interviewing, and selecting personnel. What factors are important to consider in this process? 1. Size of the institution 2. Existence of a separate personnel department 3. Presence of a nurse recruiter within the organization 4. Use of decentralized nursing management system only A) 1, 3, 4 B) 1, 2, 3 C) 1, 2, 4 D) 2, 3, 4 - correct AnswerAns: B Feedback: The manager may be greatly or minimally involved with recruiting, interviewing, and selecting personnel depending on (a) the size of the institution, (b) the existence of a separate personnel department, (c) the presence of a nurse recruiter within the organization, and (d) the use of centralized or decentralized nursing management. 17. What type of interview is a predictor of job performance and overall effectiveness? A) Unstructured B) Semistructured C) Structured D) Informal - correct AnswerAns: C Feedback: As a predictor of job performance and overall effectiveness, the structured interview is much more reliable than the unstructured, semistructured, or informal interviews. 18. What type of interview questions are difficult to respond to without some advance thought? 1. Personal philosophy of nursing 2. Professional organizations membership 3. Individual strengths and weaknesses 4. Career goals A) 1, 3, 4 B) 1, 2, 3 C) 1, 2, 4 D) 2, 3, 4 - correct AnswerAns: A Feedback: It is difficult to spontaneously answer interview questions about your personal philosophy of nursing, your individual strengths and weaknesses, and your career goals if you have not given them advance thought. 19. What must be completed before a position is offered? A) Physical examination B) Preemployment testing C) Reference check D) Personal interview - correct AnswerAns: C Feedback: Positions should never be offered until information on the application has been verified and references have been checked. 20. What does indoctrination include for an employee? 1. Induction 2. Orientation 3. Socialization 4. Continuing education A) 1, 3, 4 In primary nursing, the sole RN would not plan the care without others' input or be responsible for care planning for 24 hours. Neither would the RN carry out the majority of personal care. 4. With modular nursing, who checks the completion of tasks assigned to a team member? A) The charge nurse B) The area manager C) The team leader D) Another team member - correct AnswerAns: C Feedback: The team leader should check the work of team members. None of the other options identify the role correctly. 5. Which statement is correct concerning primary nursing care? A) Requires minimal RN staffing B) Is easy to implement C) Provides challenging work D) Has proved to be a failure - correct AnswerAns: C Feedback: Primary care provides challenging work for nurses; however, it is not easy to implement and requires an all-RN staff. None of the other options accurately describes the concept of primary nursing care. 6. What is the goal of case management? A) Containing health-care costs B) Providing challenging work C) Enhancing professionalism D) Decreasing length of hospital stays - correct AnswerAns: A Feedback: The ANA maintains that case management is designed to contain health-care costs. None of the other options identify a goal of casement. 7. What is the most important component in being well organized and increasing productivity on the unit? A) Adequate resources B) A well-trained staff C) A well-thought-out plan D) Time to carry out your duties - correct AnswerAns: C Feedback: Unless the plan is well thought out, patient care has the potential to be disorganized. None of the other options identify that connection. 8. Which statement best describes case management? A) Clinical outcomes should occur within a prescribed time frame B) Case managers do not provide direct patient care C) Managed care practice is a unit-based model of care D) The goal is outcome management for every patient - correct AnswerAns: A Feedback: In case management, clinical outcomes need to occur within prescribed time frames. Case managers do not provide care; neither is managed care unit based. The goal is outcome management for specific patients, but not every patient needs case management. 9. What is necessary when implementing care multidisciplinary action plans (MAPs)? A) Caregivers alter the plan as they deem necessary B) Variances be indicated for patient deviations C) Time frames for implementation be left open D) Critical paths not be considered in care planning - correct AnswerAns: B Feedback: In care MAPs, it is necessary to provide variances when there are patient deviations, because this is a major component to case management. None of the other options identify that connection. 10. Which is a true statement about the patterns of patient care management? A) Functional nursing is organized according to the desires of the worker B) Primary nursing and total patient care are synonymous C) Team leading includes the concept of patient care conferences D) Case load nursing provides little autonomy for nurses - correct AnswerAns: C Feedback: Team leading includes the need for patient care conferences. None of the other options identify that need. 11. Where did critical pathways originate from? A) Case management B) Functional nursing C) Team nursing D) Primary care nursing - correct AnswerAns: A Feedback: Critical pathways were developed as a result of the case management system. None of the other options identify that original connection. 12. What nursing model provides the foundation for matching patient needs with nursing competencies? A) Primary nursing practice B) Differentiated nursing practice C) Modular nursing D) Case management - correct AnswerAns: B Feedback: To facilitate the effective use of nursing resources, patient needs and nursing competencies should be matched. None of the other options identify that connection. 13. What is one of the most important differences between case management and disease management? A) Disease management referrals begin in the hospital inpatient setting B) Disease management is a collaborative process to meet patient needs C) High-cost population groups are targeted in disease management D) Disease management treatment is episodic - correct AnswerAns: C Feedback: Although there are many similarities between disease management and case management, the primary goal of disease management is to target high-cost disease populations. 14. What is the oldest form of organizing patient care that is still widely used today? A) Total patient care B) Functional nursing C) Team or modular nursing D) Primary care nursing - correct AnswerAns: A Feedback: Total patient care, utilizing the case method of assignment, is the oldest form of patient care organization and is still widely used today. 15. What type of nursing uses mini teams, typically an RN and unlicensed health-care workers, to provide care to a small group of patients who are centralized geographically? A) Total patient care B) Functional nursing C) Modular nursing D) Primary care nursing - correct AnswerAns: C Feedback: Modular nursing and model RN line use mini teams, typically an RN and unlicensed health-care worker(s), to provide care to a small group of patients, centralized geographically. None of the other options provide that staffing format. 16. Primary care nursing is organized so that the patient is at the center of the structure. How many nurses have 24-hour responsibility for care planning and coordination? A) One B) Two C) Three D) Four - correct AnswerAns: A Feedback: Primary care nursing is organized so that the patient is at the center of the structure. One nurse has 24-hour responsibility for care planning and coordination. 17. What was the focus historically for case management? A) Individual patient B) Care for populations C) Group of patients with same chronic illness D) Group of patients with same acute need for surgery - correct AnswerAns: A 24. Which concept should a care delivery system support? Select all that apply. A) Organization B) Nursing process C) Cost effectiveness D) Patient satisfaction - correct AnswerAns: A, B, C, D Feedback: Each unit's care delivery structure should facilitate meeting the goals of the organization, be cost-effective, satisfy the patient, provide role satisfaction to nurses, allow implementation of the nursing process, and provide for adequate communication among health-care providers. While important, nursing research is not a concept that is considered when selecting a care delivery system. 1. What type of power does a professional nursing certification provide? A) Legitimate B) Expert C) Charismatic D) Organizational - correct AnswerAns: B Feedback: A nursing certification n provides the proof of earned expert power such as having knowledge or skill not possessed by all nurses . 2. Which statement about power is correct? A) It is a finite quality and, once gained, is very difficult to lose B) It is destructively manipulative but is necessary for effective management C) Women generally view power more positively than do men D) Having power generally results in the gain of additional power - correct AnswerAns: D Feedback: The only true statement here is that power is likely 10 bring more power in an ascending cycle, whereas powerlessness often generates more powerlessness. 3. Which statement represents a powerful image of a team leader? A) I'm in charge here, and so all requests need to come to me. B) I'm too tired to deal with Dr. Jones today. When he gets here, tell him I've gone to lunch C) Is it okay with the rest of you if I do all the charting and you do the direct patient care? D) We have a great deal to accomplish today, but I am confident that, by working together, we can do it and do it well. - correct AnswerAns: D Feedback: The empowerment of staff is a hallmark of transformational leadership. To empower means to enable, develop, or allow. Empowerment can be defined as decentralization n of power. Empowerment occurs when leaders communicate their vision; employees are given the opportunity 10 make the most of their talents; and learning, creativity, and exploration are encouraged. Empowerment plants seeds of leadership, collegiality, self- respect, and professionalism 4. Which power-building strategy would be the appropriate for a new employee? Select all that apply A) Maintaining a sense of humor B) Gaining additional nursing certifications C) Learning the institution's organizational culture. D) Attending a training seminar on a new piece of unit equipment - correct AnswerAns: A, B, C, D Feedback: Trying to induce change when one is a new employee is not an appropriate power building strategy while the other options are all appropriate for a new employee to engage in. 5. What determines the size of the authority gap between a manager and an employee? A) The organizational philosophy B) The degree of rigidity in the corporate chart C) How credible the manager is perceived to be D) How much informal power the manager possesses - correct AnswerAns: C Feedback: When a manager loses credibility, the authority power gap widens. None of the other options are relevant. 6. What does proactive political strategy include? A) Assuming authority to do something if it is not expressly prohibited B) Using competitive approaches to the decision-making process C) Attempting 10 appear as a victim so future gains can be made D) Verbalizing discontent with the politics of an organization - correct AnswerAns: A Feedback: Assuming authority to do something that is not prohibited allows the individual to accomplish goals for the organization, which will lead to greater empowerment. None of the remaining options are associated with the proactive political strategy. 7. Which strategy is most effective in empowering staff? A) Serving as a role model of an empowered nurse B) Following a rigid but consistent rule enforcement policy C) Providing all employees with an annual cost-of-living raise D) Encouraging staff to establish a strong unit culture with turf boundaries - correct AnswerAns: A Feedback: By serving as a role model of an empowered nurse, the individual encourages others to become empowered. 8. Which statement concerning the queen bee syndrome is true? A} It occurs more often with women than with men B) It encourages the empowerment of subordinates C) It prevents the sharing of power D) It is an informal leadership role - correct AnswerAns : C Feedback: Individuals who have the queen bee syndrome do not empower others, because they want to keep all the power for themselves. None of the other options are associated with the queen bee syndrome. 9. What is one of the most politically serious errors one can make? A) Dispensing fictitious information B) Promoting the advancement of subordinates C) Withholding or refusing to divulge information D) Delaying decision making until there is additional information - correct AnswerAns: A Feedback: Lying to others is a serious political error . The other options represent appropriate behaviors. 10. Which statement describes both self-power and feminist power? A) The militant express ion of power by assertive women B) The power gained from knowing other powerful people C) The narrowing of the authority gap between nurses and physicians D) Personal awareness that is demonstrated by having power over one's life - correct AnswerAns: D Feedback: Self-power, sometimes referred to as feminist power, is power over self rather than over other people. The concept of self-power/feminist power is not described accurately by any of the other options. 11. A nursing administrator believes that the organization supports an inadequate distribution of power. What is the administrator's initial action to combat this situation? A) To form a coalition to extend administrative networking B) To pose a plan for organizational restructuring. C) To gain entry in to an informal power group. D) To improve one's personal power base - correct AnswerAns: C Feedback: To gain power one needs entry in to informal lines of communication provided by informal power groups. The other options would be effective only after the correct option is achieved . 12. What does empowerment encourage? A) Delegation of responsibility B) Sharing authority with others C) Relinquishing informal power D) Successful authoritarian leadership - correct AnswerAns: B Feedback: Empowerment is sharing power or authority with others but not relinquishing either power inherent in a position or its responsibility. Authoritarian leadership is not associated with empowerment Power gained may be lost because one is politically naïve or fails to use appropriate political strategies. The other options are not major factors in the loss of power. 21. Which statement regarding the view of power held by some women is true'? Select all that apply. A) Power is inherently possessed by men B) Power is associated with personal attributes C) Power is viewed as dominance versus submission D) Power is associated with personal qualities not accomplishment - correct AnswerAns: A, B, C, D Feedback: As a result, some women view power as dominance versus submission; associated with personal qualities, not accomplishment; and dependent on personal or physical attributes, not skill. Also, some women believe that they do not inherently possess power but instead must rely on others to acquire it. Thus, rather than feeling capable of achieving and managing power, some women feel that power manages them. The end result has been that so far 100 many women have remained unskilled in the art of the political process. 22. What is the foundation of reference power? A) Association with others B) Ability to grant favors C) Personality D) Fear - correct AnswerAns: A Feedback: Referent power is power that a person has as others identify with that leader or with what that leader symbolizes. Referent power also occurs when one gives another person, feelings of personal acceptance or approval. It may be obtained through association with the powerful. Reward power, charismatic, and coercive are the powers associated with the other options. 23. Which is the positive outcome for a manager perceived to possess manager power? A) Staff have trust in the manager B) Unit staffing tends to remain stable C) The manager will be a leader as well D) Administration supports the manager's decisions - correct AnswerAns: A Feedback: The term 'manager power' may explain subordinates' response to the manager's authority. The more power subordinates perceive a manager to have, the smaller the gap between the right to expect certain things and the resulting fulfillment of those expectations by others. None of the other options present a positive outcome of manager power. 24. A staff member asks the manger for a particular day off on the next schedule. Which response demonstrates the concept of under promising and help the manager retain the staff's trust? A) I will do my best to give you the time off. B) Be sure to get the written request in early C) If staffing stays the same, I will arrange for your request. D) If you don't take any sick time before then, I'll give it to you - correct AnswerAns: C Feedback: Less trust is lost between the manager and the subordinate when underpromising occurs. 25. Which statement supports the manager's commitment to staff empowerment? A) Unit goals include hiring an additional 2 nursing assistants B) A staff committee will be formed to address that unit issue . C) We can arrange for you to spend 2 months working on another unit. D) I've got funding to support staff who are interested in earning certifications. - correct AnswerAns: A, B, C, D 1. What is the advantage of recruiting from outside the organization? A) Promotes long-term retention of employees B) Tends to increase the number of candidates C) Provides well-motivated candidates D) Attracts well-qualified candidates - correct AnswerAns: B Feedback: Recruiting from outside the organization provides an opportunity to increase the pool of candidates for positions but is no guarantee that these candidates will be more qualified or motivated than those who come from within the organization. 2. Anew graduate who began their nursing career 6 months ago and who completed orientation 3 months ago is in what stage of professional development? A) Experimentation B) Entry C) Mastery D) Disengagement - correct AnswerAns: B Feedback: The nurse is still in the entry stage and will be until necessary skills are learned. It generally takes an extended period of time to obtain the skills necessary for mastery. The remaining options are not relevant to this questions. 3. Which reason qualifies as organizational justification for a career development program?? A) Employee attrition can be reduced B) Personnel can be used more effectively C) Employee scan increase earning power D) Employment benefits are increased - correct AnswerAns: C, D Feedback: Organizational justification for career development programs includes attrition reduction, improved productivity, and general improved quality of life. Although employees may earn more money and additional benefits as a result of career development they are not the reason that organizations undertake career development programs. 4. Which statement is true regarding career planning? A) It is the emp lo ye r's responsibility B) It results in the spontaneous assessment of goals C) It requires the development of a long -term plan D) Functions best when the planning is episodic in nature - correct AnswerAns: C Feedback: Effective career planning requires long-term planning; it is the responsibility of the individual and requires constant attention to function properly. 5. Which principle le is key in resumes' construction? A) Emphasize strong and weak points equally B) Be at least four to five pages in length C) Reflect complex, schola rly language D) Be concise and easy to read - correct AnswerAns: D Feedback: The content of a resume should be able to be grasped quickly by the individual doing the hiring, so conciseness and readability are of key importance. 6. Which activity is a personal responsibility for career management? A) Developing career ladders B) Establishing career paths C) providing challenging assignments D) Developing a career plan - correct AnswerAns: D Feedback: Only the development of a career plan is the responsibility of the individual. The first 3 choices are management responsibilities. 7. Which state ment is true regarding long-tem1coaching for career development? A) It occurs annually at performance appraisal reviews B) It focuses on employee performance deficits C) [I requires the same intensity as a mentoring relationship D) It occurs over the entire employment tenure of an employee - correct AnswerAns: D Feedback: Long-term coaching should occur over the entire employment of the employee 8. A nurse has been transferred to another unit in the hospital to perform the same type of duties. What type of transfer is this called? E) Accommodating F) Lateral G) Diagonal H) Downward - correct AnswerAns: B Doing the same type of duties in another location is called a lateral transfer 17. The manager should have a well-developed, planned system for career development for all employees . What should be included in this program ? I . Policies communicated to administrators 2. Ap propriate use of transfers 3. How promotions are handled 4. Long-term coaching A) 1,2,3 B) 1, 2, 4 C) 1, 3, 4 D) 2, 3, 4 - correct AnswerAns: D Feedback: The manager should have a well-developed , planned system for a career development for all employees; this system should include the appropriate use of transfers, how promotions are to be handled, and long-term coaching. These policies should be fair and communicated effectively to all employees. 18. What is a management function associated with career development? A) ls self-aware of personal values influencing career r development B) Encourages employees to lake responsibility for their own career planning C) Identifies, encourages, and develops future leaders D) Works cooperatively to arrange intra-organizational transfers - correct AnswerAns: D Feedback: Management function is to work cooperatively with other departments in arranging for the release of employees to take other positions within the organization. Leadership functions associated with career development are self-aware of personal values influencing career development; encourage employees to take responsibility for their own career planning, and identifies, encourages, and develops future leaders. 19. The promise phase of career development typically reflects how many years of initial nursing employment'? A) 1 B) 2 C) 5 D) 10 - correct AnswerAns: D Feedback: Promise is the earliest of the career phases and typically reflects the first 10 years of nursing employment. 20. What is the name of the stage of a career where nurses are experienced clinicians with expert knowledge, skills, abilities, credentials, and education base? A) Promise B) Momentum C) Harvest D) Legacy - correct AnswerAns: B Feedback: Momentum is the middle career phase and typically reflects the nurse with 11 to 29 years of experience. Nurses in this phase are experienced clinicians with expert knowledge, skills, abilities , credentials, and education base. 21. What is the focus of a nursing portfolio? A} Career r goals B) Salary expectations C) Professional growth D) Educational background Ans: C Feedback: All nurses should maintain a professional portfolio (a collection of materials that document a nurse's competencies and illustrate the expertise of the nurse) to reflect their professional growth over their career. The other options are not the focus of a professional portfolio. - correct Answer 22. What is the purpose of competency assessment regarding a nurse's career? A) Identifying ways to exceed minimal licensing requirements B) Fulfilling state requirements for minimal nursing practice C) Facilitating advancement up the facility's career ladder D) Satisfying institutional employment qualification - correct AnswerAns: A Feedback: Competency assess ment and goal setting in career planning should help the employee identify how to exceed the minimum levels of competency required by federal, state, or organizational standards. The remaining options do not describe the purpose of competency assessments. 23. Which activity represents a commitment to career planning? Select all that apply. A) Introduces evidence-based practice changes regarding wound dressings B) Discussing the health needs of the homeless with local politicians C) Earning a bachelor r's degree(BSN) in nursing D) Working with a seasoned mentor - correct AnswerAns: A, B, C, D Feedback: Career planning should include, at minimum, a commitment to the use of evidence based practice, learning new skills or bettering practice through the use of role models and mentors, staying aware of and being involved in professional issues, and furthering one's education. Full-time employ ment is not a necessary commitment. 24. An effective transition program for new nursing graduates will address which issue? Select all that apply. A) Supporting practice autonomy B) Strengthening new clinical skills C) Introducing time management skills D) integrating into the nursing unit environment - correct AnswerAns: A, B, C, D Feedback: A well-designed transition-to-practice program strengthens new graduates skills and competencies and prepares the new nurse for the demands of caring for patients. Fu11hermore, a systematic app roach to transition not only facilitates ion-boarding (integration into staffing on the nursing unit to prov ide direct patient care), it reduces turnover by decreasing the toll associated with insufficient preparation for the work environment. Satisfying nursing position needs is not a focus of a transition program for new graduates. 25. Which activity is directed toward a new graduate's responsibility to their nursing career? SATA A) Earning a professional nursing certification B) Gaining expertise in a specific field of nursing C) Being a member of a professional nursing association D) Earning an advanced nursing degree within 5 years of initial licensure - correct AnswerAns: A, B, C, D Feedback: New graduates also have responsibility during the crucial first few years of employment to gain the expertise they need to have more opportunities for career divergence in the future. This includes becoming an expert in one or more areas of practice, gaining professional certifications, and being well informed about professional nursing and health-care issues. This is also a time where participation in professional associations has great value as a result of the opportunities for mentoring and networking. Finally, all new graduates should consider at what point, continued formal education will be a part of their career ladder and professional journey. 1. Which information is too much in flux to identify on an organizational chart? A) Grapevine lines of communication B) Line and staff authority C) Span of control D) Scalar chains - correct AnswerAns: A Feedback: The grapevine lines of communication cannot be placed on an organizational chart because they are constantly in flux. The remaining information is stable and so identified on the chart. 2. Max Weber, as part of the scientific management era, contributed immensely to the development of organizational theory. Which statement is NOT representative of his beliefs? A) Bureaucracy could provide a rational basis for administrative decisions B) Worker satisfaction was integral to productivity C) Organization charts could depict the hierarchy of authority D) Impersonality of interpersonal relationships should exist in organizations - correct AnswerAns: B Feedback: Max Weber's theories did not address worker satisfaction. The other options do represent the Weber organizational theory. 3. Which statement concerning organizational culture is true? A) It presents how employees perceive an organization B) It defines how power is used by organizations to direct the work of others C) It describes the predictable stages of group and organizational development A) 1, 2, 3 B) 1, 2, 4 C) 1, 3, 4 D) 2, 3, 4 - correct AnswerAns: A Feedback: Affiliation, self-actualization, and encouragement are all characteristics of a constructive culture, whereas perfectionist norms are a characteristic of destructive organizational cultures. 13. What is needed to change a unit culture that has become firmly entrenched? A) New leadership B) A change agent with management skills C) Identification with a unit that is not entrenched D) Administration support - correct AnswerAns: A Feedback: It is extremely difficult to change a unit culture without new leadership. The remaining options are directly involved in the change out of entrenchment. 14. Which would suggest that flattening of the organization is occurring? A) There is a collective spirit B) There is reduction in the administration levels C) There are shared work goals across units D) There are formal and informal systems are in place to address conflicts - correct AnswerAns: B Feedback: Reducing the numbers of administration levels is called flattening the organization. The remaining options are not related to organizational flattening. 15. What occurs during implementation of a shared governance model? A) Lines of authority are altered B) Joint practice committees are formed C) Participatory management is initiated D) The roles of first-level managers are stabilized - correct AnswerAns: B Feedback: In shared governance, the organization's governance is shared among board members, nurses, physicians, and management. Joint practice committees are developed to assume the power and accountability for decision making, and professional communication is egalitarian rather than hierarchical. Shared governance is not associated with the other options. 16. What is the primary responsibility of the committee chairperson during a committee meeting? A) Keeping members on task B) Asking questions C) Resolving conflicts D) Providing information on each agenda item - correct AnswerAns: A Feedback: Although all the items may be something the chairperson does, the primary responsibility is to keep members on task so committee work gets completed. 17. What is the leadership role when a unit is attempting to overcome the decentralization of patient care? A) Determining what changes will be made to the plan of care B) Facilitating the group's work C) Identifying the patient care problems D) Selecting solutions to problems - correct AnswerAns: B Feedback: In a patient-centered focused activity, the team leader should facilitate the work of the group and should not be the sole decision maker. 18. What should the leader remember when forming committees? A) Committees work best when there is an adequate supply of workers, with 10 members being the minimum B) Willingness to work hard is the most important criterion for appointment C) Written agendas provide excessive structure and stifle committee creativity D) There should be sufficient expertise among committee members to accomplish the assigned task - correct AnswerAns: D Feedback: The most important criterion for committee selection is overall adequate expertise to accomplish the agenda. The remaining options are not as relevant as the correct option. 19. During a strategic planning committee meeting to develop futuristic technology goals, several unit managers spend a considerable amount of time discussing current staffing problems. What is the primary action of the chairperson of this committee? A) Take the remainder of the meeting time to discuss staffing with all members B) Adjourn the meeting and reschedule at a time when there are no staffing problems C) Request that committee members return to discussing items on the agenda D) Excuse those discussing staffing from the remainder of the meeting - correct AnswerAns: C Feedback: Committee time is wasted when agendas are not adhered to. The remaining options do not address the issue of wasted time effectively. 20. Which characteristics are associated with Magnet hospital status? 1. Centralized environment 2. Open, participatory management 3. Improved patient outcomes 4. Higher staff nurse satisfaction A) 1, 2, 3 B) 1, 2, 4 C) 1, 3, 4 D) 2, 3, 4 - correct AnswerAns: D Feedback: Magnet designation is conferred by the ANCC to health-care organizations exemplifying well-qualified nurse executives in a decentralized environment, with organizational structures that emphasize open, participatory management. Magnet- designated organizations demonstrate improved patient outcomes and higher staff nurse satisfaction than organizations that do not have Magnet status. 21. Which component is considered a part of an organizational structure? Select all that apply. A) Group formation B) Lines of communication C) Decision-making process D) Channels of legitimate authority - correct AnswerAns: A, B, C, D Feedback: Organizational structure refers to the way in which a group is formed, its lines of communication, and its means for channeling authority and making decisions. 22. What is an institutional grapevine? A) Organizational gossip B) An informal channel of communications C) An institution's informal authority chain D) The connecting format used on an organizational chart - correct AnswerAns: B Feedback: The informal structure also has its own communication channels, often referred to as the grapevine. None of the remaining options accurately describes an organizational grapevine. 23. Research supports that organizational restructure affects nursing in what manner? A) It decreases nursing autonomy B) It decreases nursing's formal authority C) It increases the effectiveness of patient care D) It increases patient autonomy - correct AnswerAns: C Feedback: Current research suggests that changing an organization's structure in a manner that increases autonomy and work empowerment for nurses will lead to effective patient care. The remaining options failed to describe the research supported effect of organizational restructure on nursing. 24. When considering the interprofessional approach to healthcare, to whom does the nurse owe accountability? A) The physician B) Their patients C) Their unit manager D) Their director of nursing - correct AnswerAns: A, B, C, D Feedback: G) Diagonal H) Downward - correct AnswerAns: B Doing the same type of duties in another location is called a lateral transfer 9. Which statement is accurate concerning management development classes? A} They are not cost-effective, but increase worker sat is faction B) They are necessary for advancement to management positions C) They require the inclusion of social learning activities D) They are a responsibility of middle-le vel management - correct AnswerAns: C The inclusion of social learning activities in management development increases the possibility for employee retention. Management development is cost-effective for the organization but may not be necessary for all managers. Top executives in the organization have a responsibility to support the management development program. 10. Research supports that which factor may lead nurses to become disengaged in their careers? A) They do not feel that nursing is valued as a career B) Boredom increases with time on the same job C) Many nurses interrupt their careers for childrearing D) Nursing is low paying compared with ot her careers - correct AnswerAns: B Feedback: Research has shown that boredom and job indifference leading to disengage ment increase with time on the same job. While the o the r options may be factors they are not research supported. 11. Why would an experienced nurse voluntarily opt for a self-selected downward transfer? A) Doing so increases the chances of long- term career success B) It allows for keeping a similar salary while decreasing energy expenditure C) lo times of downsizing, it al lows a nurse to stay employed D) It occurs when a nurse is physically impaired and productivity is affected - correct AnswerAns: A Feedback: For individuals to gai n experience in a new area and to enhance long-term career goals, a self-selected downward transfer may be used. None of the other options accurately describe the reason for a self-selected downward transfer. 12. How is competency of an employee best determined? A} An examination of patient records by a review team B) Self-reporting on an administered skills checklist C) Evidence of attendance in continuing education classes D) Documentation of effectively meeting role demands - correct AnswerAns: D Feedback: Competency relates to role and is determined by each role demand. None of the other options are able to determine competency as effectively as documentation of performance. 13. What is the focus of the entry job stage? A) Skill development B) Job es tee m C) Sense of purpose D) Indifference - correct AnswerAns: A Feedback: During the entry phase of learning a job, an individual concentrates on skill development. None of the other options is the focus of this stage. 14. What is the purpose of a cover letter? I. introduce the applicant 2. . Briefly highlight key points of career 3. Make a positive first impression 4. Always used when submitting a resume A) I, 2, 3 B) I, 2, 4 C) 1, 3, 4 D) 2, 3, 4 - correct AnswerAns: C Feedback: Cover letters (whether by mail or e- mail) should always be used when submitting a resume. Their purpose is to introduce the applicant, briefly highlight key points of the resume, and make a positive first impression. 15. How can a nursing professional demonstrate advanced achievement of competencies? A) Lateral transfer B) Professional specialty certification C) Transfer to a new department D) Professional registered nursing licensure - correct AnswerAns: B Feedback: Professional specialty certification is one way that an employee can demonstrate advanced achievement of competencies. The transfer, when used appropriately, may be an effective way to provide career development but a lateral transfer does not demonstrate advancement. A transfer to a new department often requires the acquisition of new skills before advance can occur. A nursing license signifies entry- level skills. 16. What arc restraining forces for specialty certification in professional nursing? I . Decreased collaboration with other health-care providers 2. Cost 3. Lack of recognition 4. Increased retention A) 1, 2 B) 1, 4 C) 2,3 D) 3, 4 - correct AnswerAns: C Feedback: Cost coupled with lack of institutional reward and support kept some nurses from pursuing certification. The impact of certification on absenteeism and retention was unclear. 17. The manager should have a well-developed, planned system for career development for all employees . What should be included in this program ? I . Policies communicated to administrators 2. Ap propriate use of transfers 3. How promotions are handled 4. Long-term coaching A) 1,2,3 B) 1, 2, 4 C) 1, 3, 4 D) 2, 3, 4 - correct AnswerAns: D Feedback: The manager should have a well-developed , planned system for a career development for all employees; this system should include the appropriate use of transfers, how promotions are to be handled, and long-term coaching. These policies should be fair and communicated effectively to all employees. 18. What is a management function associated with career development? A) ls self-aware of personal values influencing career r development B) Encourages employees to lake responsibility for their own career planning C) Identifies, encourages, and develops future leaders D) Works cooperatively to arrange intra-organizational transfers - correct AnswerAns: D Feedback: Management function is to work cooperatively with other departments in arranging for the release of employees to take other positions within the organization. Leadership functions associated with career development are self-aware of personal values influencing career development; encourage employees to take responsibility for their own career planning, and identifies, encourages, and develops future leaders. 19. The promise phase of career development typically reflects how many years of initial nursing employment'? A) 1 B) 2 C) 5 D) 10 - correct AnswerAns: D Feedback: Promise is the earliest of the career phases and typically reflects the first 10 years of nursing employment. 20. What is the name of the stage of a career where nurses are experienced clinicians with expert knowledge, skills, abilities, credentials, and education base? A) Promise B) Momentum B) Personnel can be used more effectively C) Employee scan increase earning power D) Employment benefits are increased - correct AnswerAns: C, D Feedback: Organizational justification for career development programs includes attrition reduction, improved productivity, and general improved quality of life. Although employees may earn more money and additional benefits as a result of career development they are not the reason that organizations undertake career development programs. 4. Which statement is true regarding career planning? A) It is the emp lo ye r's responsibility B) It results in the spontaneous assessment of goals C) It requires the development of a long -term plan D) Functions best when the planning is episodic in nature - correct AnswerAns: C Feedback: Effective career planning requires long-term planning; it is the responsibility of the individual and requires constant attention to function properly. 5. Which principle le is key in resumes' construction? A) Emphasize strong and weak points equally B) Be at least four to five pages in length C) Reflect complex, schola rly language D) Be concise and easy to read - correct AnswerAns: D Feedback: The content of a resume should be able to be grasped quickly by the individual doing the hiring, so conciseness and readability are of key importance. 6. Which activity is a personal responsibility for career management? A) Developing career ladders B) Establishing career paths C) providing challenging assignments D) Developing a career plan - correct AnswerAns: D Feedback: Only the development of a career plan is the responsibility of the individual. The first 3 choices are management responsibilities. 7. Which state ment is true regarding long-tem1coaching for career development? A) It occurs annually at performance appraisal reviews B) It focuses on employee performance deficits C) [I requires the same intensity as a mentoring relationship D) It occurs over the entire employment tenure of an employee - correct AnswerAns: D Feedback: Long-term coaching should occur over the entire employment of the employee 8. A nurse has been transferred to another unit in the hospital to perform the same type of duties. What type of transfer is this called? E) Accommodating F) Lateral G) Diagonal H) Downward - correct AnswerAns: B Doing the same type of duties in another location is called a lateral transfer 9. Which statement is accurate concerning management development classes? A} They are not cost-effective, but increase worker sat is faction B) They are necessary for advancement to management positions C) They require the inclusion of social learning activities D) They are a responsibility of middle-le vel management - correct AnswerAns: C The inclusion of social learning activities in management development increases the possibility for employee retention. Management development is cost-effective for the organization but may not be necessary for all managers. Top executives in the organization have a responsibility to support the management development program. 10. Research supports that which factor may lead nurses to become disengaged in their careers? A) They do not feel that nursing is valued as a career B) Boredom increases with time on the same job C) Many nurses interrupt their careers for childrearing D) Nursing is low paying compared with ot her careers - correct AnswerAns: B Feedback: Research has shown that boredom and job indifference leading to disengage ment increase with time on the same job. While the o the r options may be factors they are not research supported. 11. Why would an experienced nurse voluntarily opt for a self-selected downward transfer? A) Doing so increases the chances of long- term career success B) It allows for keeping a similar salary while decreasing energy expenditure C) lo times of downsizing, it al lows a nurse to stay employed D) It occurs when a nurse is physically impaired and productivity is affected - correct AnswerAns: A Feedback: For individuals to gai n experience in a new area and to enhance long-term career goals, a self-selected downward transfer may be used. None of the other options accurately describe the reason for a self-selected downward transfer. 12. How is competency of an employee best determined? A} An examination of patient records by a review team B) Self-reporting on an administered skills checklist C) Evidence of attendance in continuing education classes D) Documentation of effectively meeting role demands - correct AnswerAns: D Feedback: Competency relates to role and is determined by each role demand. None of the other options are able to determine competency as effectively as documentation of performance. 13. What is the focus of the entry job stage? A) Skill development B) Job es tee m C) Sense of purpose D) Indifference - correct AnswerAns: A Feedback: During the entry phase of learning a job, an individual concentrates on skill development. None of the other options is the focus of this stage. 14. What is the purpose of a cover letter? I. introduce the applicant 2. . Briefly highlight key points of career 3. Make a positive first impression 4. Always used when submitting a resume A) I, 2, 3 B) I, 2, 4 C) 1, 3, 4 D) 2, 3, 4 - correct AnswerAns: C Feedback: Cover letters (whether by mail or e- mail) should always be used when submitting a resume. Their purpose is to introduce the applicant, briefly highlight key points of the resume, and make a positive first impression. 15. How can a nursing professional demonstrate advanced achievement of competencies? A) Lateral transfer B) Professional specialty certification C) Transfer to a new department D) Professional registered nursing licensure - correct AnswerAns: B Feedback: Professional specialty certification is one way that an employee can demonstrate advanced achievement of competencies. The transfer, when used appropriately, may be an effective way to provide career development but a lateral transfer does not demonstrate advancement. A transfer to a new department often requires the acquisition of new skills before advance can occur. A nursing license signifies entry- level skills. 16. What arc restraining forces for specialty certification in professional nursing? I . Decreased collaboration with other health-care providers 2. Cost 3. Lack of recognition 4. Increased retention A) 1, 2 B) 1, 4 C) 2,3 D) 3, 4 - correct AnswerAns: C Feedback: Cost coupled with lack of institutional reward and support kept some nurses from pursuing certification. The impact of certification on absenteeism and retention was unclear. 17. The manager should have a well-developed, planned system for career development for all employees . What should be included in this program ? I . Policies communicated to administrators 2. Ap propriate use of transfers 3. How promotions are handled 4. Long-term coaching A) 1,2,3 health-care issues. This is also a time where participation in professional associations has great value as a result of the opportunities for mentoring and networking. Finally, all new graduates should consider at what point, continued formal education will be a part of their career ladder and professional journey. 1. What is fiscal planning? A) A learned skill that improves with practice B) A job role of the facility business manager C) Part of the organizing phase of the management process D) Reactive based on political, social, and economic forces Ans: A Feedback: Fiscal planning is a learned skill and must include nursing management input. It should never be reactive, and it is part of the planning process of management. 2. What is the basic principle of responsibility accounting? A) An organization's revenues, expenses, assets, and liabilities are someone's concern. B) Managers have a responsibility to submit their budgets on time. C) The organization's financial officer works with department heads regarding budget approval. D) Fiscal accounting should be honest and accurate. Ans: A Feedback: Responsibility accounting requires that someone must be responsible for all revenue, expenses, assets, and liabilities. While true, the other options are not the basic principle of responsibility accounting. 3. Which activity is a responsibility of the unit manager regarding fiscal planning? A) To assume responsibility for achieving budgetary planning goals B) To monitor and evaluate all aspects of the unit's budget control C) To streamline the number of subordinates involved in the budgetary process D) To control unpredictable census variations that may undermine the personnel budget Ans: B Feedback: The manager's responsibility is to monitor all aspects of the unit's budget. The other options fail to identify a manager's responsibility. 4. Which is a leadership role in fiscal planning? A) Coordinating the monitoring aspects of budget control B) Accurately assessing personnel needs using agreed-on standards or an established patient classification system C) Assessing the internal and external environment of the organization in forecasting to identify driving forces and barriers to fiscal planning D) Being visionary in identifying short- and long-term unit fiscal needs Ans: D Feedback: Leaders are visionary; the other roles are management related. 5. What type of budget requires rejustification for yearly fiscal needs? A) Incremental budgeting B) Perpetual budgeting C) Zero-based budgeting D) Managed care Ans: C Feedback: Zero-based budgeting begins each year with zero and requires rejustification. This is not true of the other options. 6. Equipment depreciation, the number and type of supplies needed by patients, and overtime that occurs in response to an emergency are all examples of what type of expenses? A) Controllable B) Fixed C) Capital budget D) Noncontrollable Ans: D Feedback: The items mentioned are noncontrollable as these cannot be controlled or fixed and are not parts of capital costs. 7. What is inferred if an item is ìcost-effectiveî? A) It is the least expensive product available B) It is worth the cost C) It is reimbursable D) Its cost was anticipated Ans: B Feedback: Cost-effective does not necessarily imply the cheapest, but it requires that the expenditure be worth the cost. The other options are not characteristic of the term cost effective. 8. What is the largest budget expenditure for health-care organizations? A) The personnel budget B) Short-term capital acquisitions C) The operating budget D) Supplies and equipment Ans: A Feedback: Health care is labor intensive; therefore, the personnel budget makes up the largest expense. The other options represent less expensive expenditures. 9. Determine the nursing care hours per patient day (NCH/PPD) if the following staffing existed for a 24-hour period (unit census = 10): 12 midnight to 12 noon, 1 registered nurse, 1 licensed vocational nurse 12 noon to 12 midnight, 1 registered nurse, 1 licensed vocational nurse, 1 unit clerk (8 hours only) A) 5.6 NCH/PPD B) 4.8 NCH/PPD C) 5.0 NCH/PPD D) 6.2 NCH/PPD Ans: A Feedback: A total of 56 hours of nursing was worked in 24 hours (unit clerks are counted in NCH/PPD) and the census was 10 patients. Dividing the total number of nursing care hours by the census (56 divided by 10) yields an NCH/PPD calculation of 5.6 NCH/PPD. 10. The measurement of NCH/PPD will provide what information? A) The acuity level of the patients on a particular unit in a 24-hour time span B) The total number of hours worked by nursing personnel on a particular unit in a 24-hour time span divided by the patient census C) The specific amount of money spent on staffing during a 24-hour period D) The quality of nursing care that was provided on a particular unit in a 24-hour time span Ans: B Feedback: The Personnel Budget NCH/PPD refers to number of nursing care hours worked in 24 hours divided by the patient census. 11. What is the name for a provision of health care in an organized system to subscribing members in a geographical area with an agreed-on set of basic and preventive supplemental health maintenance and treatment services for a fixed, prepaid charge? A) Preferred provider organizations (PPOs) B) A traditional third-party payer indemnity plan C) A health maintenance organization (HMO) D) Diagnostic-related groupings (DRGs) Ans: C Feedback: HMOs provide health care in an organized system to subscribing members in a geographical area with an agreed-on set of basic and preventive supplemental health maintenance and treatment services for a fixed, prepaid charge. That definition does not apply to the other options. 12. What was the primary reason for the development of the prospective payment system? A) Skyrocketing health-care costs following the advent of Medicare and Medicaid B) The passage of the Health Maintenance Act of 1973 C) The introduction of the Health Security Act to Congress D) A coalition held by the three largest private insurers in 1975 Ans: A Feedback: Prospective payment systems were the result of skyrocketing medical costs in the United States. That is not true of the other options. 13. What is capitation? A) A reimbursement schema whereby health-care organizations receive a predetermined amount (based on a patient's diagnosis for services provided) B) The limited availability of services to patients in managed care organizations 21. Which statement concerning a budget is true? A) A budget's reliability is related to how far in advance it was created B) Budgets should be created as far in advance is possible C) A budget is revised every 3 months during a fiscal year D) Budgets are reliable only when expenses are fixed Ans: A Feedback: A budget that is predicted too far in advance has greater probability for error. The other options are incorrect statements regarding a budget. 22. Which statement regarding fiscal planning is true? Select all that apply. A) Social influences affect fiscal planning B) The successful fiscal planner is creative C) An understanding of economic forces is necessary D) Practical experience is a key to being a good fiscal planner Ans: A, B, C, D Feedback: Fiscal planning is not intuitive; it is a learned skill that improves with practice. Fiscal planning also requires vision, creativity, and a thorough knowledge of the political, social, and economic forces that shape health care. 23. Which statement about American health-care budget spending is correct? A) A large health-care budget equals quality health-care outcomes B) America spends less than any other industrialized country on health care C) The outcomes related to lowñbirth-weight infants have not been successfully met D) The scarcity of resources is the biggest factor in the failure to reach outcomes Ans: C Feedback: Spending more does not always equate to higher-quality health outcomes. The United States spends more per capita on health care than does any other industrialized country, and yet our outcomes in terms of teenage pregnancy rates, lowñbirth-weight infants, and access to care are worse than many countries that spend significantly less. The problem then is not a scarcity of resources. The problem is that we do not use the resources we have available, in a cost-effective manner. 24. Which factor is primarily important when budgeting for a healthcare facility? A) Services provided B) Budget time frame C) Size of organization D) Acuity of patients being served Ans: B Feedback: Selecting the optimal time frame for budgeting is important. Errors are more likely if the budget is projected too far in advance. The other options are considered but not of primary importance. 25. Which statement regarding a budget is true? Select all that apply. A) A budget contains an estimate of both expenses and income for a year. B) It allows for an institution to plan for the effective use of its resources C) The cost of supplies is an example of a variable expense D) A mortgage is an example of a fixed expense Ans: A, B, C, D Feedback: A budget is a financial plan that includes estimated expenses as well as income for a period of time. Accuracy dictates the worth of a budget; the more accurate the budget blueprint, the better the institution can plan the most efficient use of its resources. Because a budget is at best a prediction, a plan, and not a rule, fiscal planning requires flexibility, ongoing evaluation, and revision. In the budget, expenses are classified as fixed or variable and either controllable or noncontrollable. Fixed expenses do not vary with volume, whereas variable expenses do. Examples of fixed expenses might be a building's mortgage payment or a manager's salary; variable expenses might include the payroll of hourly wage employees and the cost of supplies. 1. Which is the FIRST step in the time management process? A). Completing the highest priority task. B) Allowing enough time for sufficient daily planning C). Reprioritizing based on new information received D). Delegating work that cannot be accomplished in a day - correct AnswerB). Daily planning is essential if the manager is to manage by efficiency rather than by crisis. The remaining options are steps that occur after planning. 2. What is the reason that first- and middle-level managers experience more interruptions than higher-level managers? A). They generally interact directly with a greater number of subordinates in daily planning. B). They seldom have the clerical and secretarial help assigned to higher-level managers. C). They are more social in nature and personal interactions D). They are busier than higher-level managers - correct AnswerA). Frequent interruptions are common for first-and middle-level managers, who have a larger number of direct reports than do higher-level managers. The other options are not generally true statements. 3. Which time waster does the manager have LEAST control over? A). Failure to set objectives B). Inability to say no C). Procrastination D). Paperwork overload - correct AnswerD). Excessive paperwork is an external time waster; the others are time wasters created by the manager (internal) 4. What does the good manager have to remember about creating a daily list? A). It should remain changed once initial planning is completed B). It is a planning tool, and thus must have flexibility in its implementation C). It should include all the planner's short-term, intermediate, and long-term goals D). It should be highly structured, thus decreasing the possibility of procrastination - correct AnswerB). The daily list should be flexible, changeable, leave some time for the unexpected, and include appropriate short-term goals. 5. Which policy implemented by a manager will minimize unproductive socialization A). An open-door policy B). Scheduled appointments C). Informal, impromptu meetings D). Maintaining strict professional boundaries - correct AnswerB). Appointments will discourage unproductive socialization since time will be allotted and a schedule maintained. Open-door policies and impromptu meetings encourage socialization while strict professional boundaries may actually interfere with communications. 6. Which plan is an effective way of handling a large task? A). Plan to finish the task with few breaks. B). Delegate portions of the task to qualified staff C). Break the task into smaller, less intimidating units D). Delay beginning the task until it has your undivided attention - correct AnswerC). Breaking down a task, or chunking, prevents the person from becoming overwhelmed by the size of the task. It may not be possible or advisable to finish the task without breaks or delegating it to staff. 7. Which statement about time management is true? A). Mos people have an accurate perception of the time they spend on a particular task or the total amount of time they are productive during the day B). Nurses who are self-aware and have clearly identified personal goals and priorities have greater control over how they spend their time. C). Writing goals down is not necessary if the goals are limited to fewer than five in number. D). A time inventory for 2 or 3 days is sufficient to identify a time management pattern - correct AnswerB). Nurses, who are self-aware and have clearly identified personal goals and priorities have greater control over how they spend their time. The other options are not true statements regarding time management. 8. Which task should the team leader INITIALLY engage in when planning care for a group of patients? A). Plan so that each patient on the team receives equal amounts of nursing care B). Prioritize the amount and type of nursing care each patient requires C). Identify the staff who will compromise the individual care teams. D). 2, 3, 4 - correct AnswerC). Time management can be rescued to three cyclic steps (a) allow time for planning and establish priorities; (b) complete the highest priority task, and whenever possible, finish one task before beginning another, and (c) reprioiritize based on remaining tasks and new information that may have been received. 16. When is the best time of day for the manager to spend appropriate time on planning? A). Whenever a block of time is available B). Beginning of the day C). Middle of the day D). End of the day - correct AnswerB). Setting aside time at the beginning of each day to plan the day allows the manager to spend appropriate tie on high-priority tasks. 17. What is the most critical skill in good time management? A). Allow adequate time for planning B). Recognizing the need for daily planning C). Priority setting D) Handling situations as they arise - correct AnswerC). Priority setting is perhaps the most critical skill in time management because all actions taken are some type of relative importance. 18. What category of prioritizing will an item that will take care of itself be placed? A). Squeaky wheel B). Don't do C). Do later D). Do now - correct AnswerB). One simple means of prioritizing what needs to be accomplished is to divide all requests into three categories: "don't do; do later; & do now" items probably reflect problems that will take care of themselves, are already outdated, or better accomplished by someone else. 19. What do the "do now" requests reflect? A). A units day-to-day operational needs B) Issues R/T short-term goals C). Large, time-consuming tasks D). Problems that cannot be delegated - correct AnswerA). The "do now" requests most commonly reflect a unit's day-to-day operational needs. These "do now? Requests are not necessarily R/T short-term goals or time-consuming. Nor are they also non- delegatable. 20. In prioritizing all the "do now" items, the manager may find preparing a written list helpful. What is important to remember about the written list? 1. It is a plan. 2. It is a product 3. It is a planning tool 4. It is the final goal to be accomplished. A). 1, 2 B). 1, 3 C). 2, 3 D). 3, 4 - correct AnswerB). In prioritizing all the "do now" item, the manager may find preparing a written list helpful. The list is a planning tool. Remember, however, that a list is a plan, not a product, and that the creation of the list is not he final goals. 21. Which statement identifies a common mistake made R/T daily planning? A). "Crisis always come up so my plan is always changing" B). "I have always handled my patients needs as they arise" C). "Sometimes its difficult to reserve tie for daily planning" D). "Patient care requires a lot of reassessment by nursing" - correct AnswerB). Two mistakes common in. Planning, are underestimating the importance of a daily plan and not allowing adequate time for planning. The remaining options reflect an understanding of the importance of planning. 22. How does the effective nurse-management. MOST effectively deal with the ever- changing nature of the nursing work environment? A). Evaluating the management skills of the nursing team leaders B). Providing time management classes for staff members C). Frequently reassessing personally established priorities D). Encouraging staff to engage in daily planning - correct AnswerC). Setting new priorities or adjusting priorities to reflect ever-changing work situations is an ongoing reality for the unit manager. While the other options are apppropriate, they are not directed to the management rol in dealing with the ever-changing nature of the environment of nursing. 23. Which statement demonstrates adherence to habits that support good time management skills? SAA A). "It's important to me to be professional" B). "I can spend on the members of my team" C). "Ive learned that I'm most energetic in the morning" D). "Ill adjust my sleep schedule now that I'm on night shift" - correct AnswerA, B, C, D). Habit 1: strive to be authentic. Be honest with yourself about what you want and why you do what you do. Habit 2: favor trusting relationships. Build relationships with people you can trust and count on, and make sure those same people can trust and count on you. Habit 3: maintain a lifestyle that wil give you maximum energy. Exercise, eat well, and get enough sleep. Habit 4: Listen to your biorhythms and organize your day accordingly. Pay attention to regular fluctuations in your physical and mental energy levels throughout the day and schedule tasks accordingly. Habit 5: set very few priorities and stick to them. Select a max of two things that you are your highest priority, and work on them. 24. What is the PRIOIRITY reason for documenting nursing interventions as soon as possible after an activity is completed. A). Decreasing the risk of inaccurate documentation B). Implementing effective time management skills C). Demonstrating professional nursing behavior D). Observing an established nursing principle. - correct AnswerA). document your nursing interventions as soon as possible after an activity is completed. Waiting nail the end of the workday to complete necessary documentation increases the risk of inaccuracies and incomplete documentation. The remaining options are accurate but lack the primary focus of patient safety. 25. What is suggested perception of a nurse-manager who is consistently late for appointments? A). The manager is overworked with too many responsibilities B). The manager needs additional management training C). The manager does not value other people times D). The manager lacks time management skills - correct AnswerC). A lack of punctuality suggests that one does not value other people s time. The other options may be true but the perceptions is the more emotional perception. What determines the functions and priorities of an organization? A) The organization's mission statement B) The organization's budget C) Consumer satisfaction surveys D) The organization's policy and procedure statements - correct AnswerAns: A Feedback: The mission statement is a brief statement identifying the reason the organization exists and its future aim or function. This is not the function of the other options. What is the best definition for the process of planning? A) Problem oriented B) Short-term goal setting C) Continuous with cyclic evaluation checkpoints D) A long-range needs assessment - correct AnswerAns: C Feedback: Planning can be short term or long term, but should always include built-in evaluation checkpoints so there can be a midcourse correction if unexpected events occur. Which is a true statement about planning? A) All plans should be defined well so that changes aren't necessary Feedback: Personal values are shaped by the socialization processes experienced by that person, and values change with time. The remaining statements are not true regarding individual values. What is a characteristic of strategic planning? Select all that apply. A) Requires managerial expertise in health-care economics B) Should reflect political issues related to health care C) Human resource expertise is required D) Should be based on a planning theory - correct AnswerAns: A, B, C, D Feedback: Strategic planning generally forecasts 3 to 10 years into the future and requires managerial expertise in health-care economics, human resource management, and political and legislative issues affecting health care, as well as planning theory. Which statement describes an emerging paradigm that is likely to influence strategic planning for health care in the twenty-first century? A) Reduced emphasis on cost containment B) Reduced regulatory oversight of health-care organizations C) A shift from interdependence of health-care professionals to greater autonomy D) A movement from client-as-customer to population-as-customer - correct AnswerAns: D Feedback: Health services are increasingly being provided to large groups of people, usually defined by employers, through managed care or capitated contracts. The other options do not describe an influential twenty-first-century paradigm. Which element influences the nurse executive most heavily when assessing the organization's philosophy for nursing services for possible revision? A) Consumer surveys B) Financial resources C) Mission statement D) Policy statements - correct AnswerAns: C Feedback: The philosophy flows from the mission statement, the highest priority in the planning hierarchy. The other options are not as influential. How are preactive planners described? A) They consider and value the past, the present, and future B) They use evolving technologies to accelerate change C) They consider the status quo as a stable environment D) They direct planning in response to a crisis - correct AnswerAns: B Feedback: Dissatisfied with the past and present, preactive planners do not value experience and believe the future is always preferable. Their focus is not necessarily crisis response. Benefits of effective planning include timely accomplishment of higher quality work and the best possible use of capital and human resources. Because planning is essential, managers must be able to overcome barriers that impede planning. What is an important point for successful organizational planning? A) The organization can be more effective if movement within it is directed at specified goals and objectives B) Plans to reach a goal must be rigid and not be distracted by current events C) The manager should include in the planning process the leadership people of units that could be affected by the plan D) A global plan and outline is sufficient to encourage and motivate employees - correct AnswerAns: A Feedback: The organization can be more effective if movement within it is directed at specified goals and objectives. Because a plan is a guide to reach a goal, it must be flexible and allow for readjustment as unexpected events occur. The manager should include in the planning process all people and units that could be affected by a plan. A plan that is too global or unrealistic discourages rather than motivates employees. A good plan incorporates which characteristic? A) A midterm evaluation B) Built-in evaluation checkpoints C) The rejection of plans that originally failed D) Over-planning to arrange required details - correct AnswerAns: B Feedback: Good plans have built-in evaluation checkpoints so that there can be a midcourse correction if unexpected events occur. A final evaluation should always occur at the end of the plan. If goals were not met, the plan should be examined to determine why it failed. This evaluation process assists the manager in future planning. One who overplans may devote excessive time to arranging details that might be better left to those who will carry out the plan. At the unit level, what time frame may be considered long-range planning? A) 3 months B) 4 months C) 5 months D) 6 months - correct AnswerAns: D Feedback: At the unit level, any planning that is at least 6 months in the future may be considered long-range planning. One of the most commonly used tools in health-care organizations is SWOT analysis. What is the definition for S? A) Internal attributes that help an organization achieve its objectives B) Internal attributes that challenge an organization in achieving its objectives C) External conditions that promote achievement of organizational objectives D) External conditions that challenge or threaten the achievement of organizational objectives - correct AnswerAns: A Feedback: Strengths are internal attributes that help an organization achieve its objectives. Weaknesses are internal attributes that challenge an organization in achieving its objectives. Opportunities are external conditions that promote achievement of organizational objectives. Threats are external conditions that challenge or threaten the achievement of organizational objectives. One of the most commonly used tools in health-care organizations is SWOT analysis. What is the definition for opportunities? A) Internal attributes that help an organization achieve its objectives B) Internal attributes that challenge an organization in achieving its objectives C) External conditions that promote achievement of organizational objectives D) External conditions that challenge or threaten the achievement of organizational objectives - correct AnswerAns: C Feedback: Opportunities are external conditions that promote achievement of organizational objectives. Strengths are internal attributes that help an organization achieve its objectives. Weaknesses are internal attributes that challenge an organization in achieving its objectives. Threats are external conditions that challenge or threaten the achievement of organizational objectives. Which factor contributes to the difficulty health-care organizations are having in planning for identified long-term needs? Select all that apply. A) Government regulations B) Rapidly changing technologies C) Decreased provider autonomy D) Changing population demographics - correct AnswerAns: A, B, C, D Feedback: Because of the rapidly changing technology, increasing government regulatory involvement in health care, changing population demographics, and reduced provider autonomy, health-care organizations are finding it increasingly difficult to appropriately identify long-term needs and plan accordingly. Consumer distrust is not a current factor contributing to the difficulty health-care organizations are experiencing with long-term planning. What makes an organizational philosophy useless? A) Being expensive to implement B) Viewed as being impossible to implement C) Not having the support of all the involved parties D) Involving a change in the organizational point of view - correct AnswerAns: B Feedback: An organizational philosophy that is not or cannot be implemented is useless. While what excellence approach refers to the need to seek customer satisfaction above all else? Active input is sought on a regular basis from those who are served. - correct AnswerClose to the customer what excellence approach refers to the encouragement of risk-taking and a tolerance for failure among employees? - correct AnswerAutonomy and entrepreneurship what excellent approach concerns the emphasis of respect for individuals in the workplace? Enthusiasm, trust, and a family feeling are fostered. - correct AnswerProductivity to people what excellence approach refers to a clear company philosophy that is decimated and followed? The organization's belief system is really forced. Leaders are positive role models, not rigid authoritative managers. - correct AnswerHands-on value driven what excellence approach means that managers manage and employees do what they do best? Emphasis is on the internal growth of the company. - correct AnswerStick to the Knitting what excellence approach were first to decentralizing authority as much as possible? Management staffs are are kept to a minimum, and talented employees are at the worksite. - correct AnswerSimple form, lean staff what management approach refers to stringent strategic and financial control, counterbalance but decentralized authority, autonomy, and opportunities for creativity? - correct AnswerSimultaneous loose-tight properties what is an excellent approach? - correct AnswerA conducted study of the 62 best run companies in America in which eight principles of excellence were concluded by Peters and Waterman. what differentiates nursing management for professional management and other fields? - correct AnswerA philosophy of service Concept introduced in the 1980s changed the nursing management's role from an authoritative hierarchy to what it is today? - correct AnswerConcept of shared governance or shared decision-making what is the most basic and essential activity of management? - correct AnswerPlanning when a manager holds monthly meeting, weekly staff sessions, and daily review of patient/client services they're using what type of planning strategy? - correct Answerstanding plan planning that occurs at an administrative level and includes an in-depth analysis of factors within them outside of the organization is what type of planning strategy? - correct AnswerStrategic planning methods to increase revenue, consolidate services, reduce loss of profit, and provide income producing services is what type of planning? - correct AnswerStrategic planning Refers to the establishment of a higher fee, number of levels, needed to do work of the organization. - correct AnswerVertical differentiation results from the speed to separate activities for more efficient and effective performance. Example is forming departments within an organization, enabling work to be accomplished through different services. - correct Answerhorizontal differentiation The management activity that provides for appropriate and adequate personnel to fulfill the organizations objectives. - correct Answerstaffing function of the manager who gets work done through others - correct Answerdirecting giving directions, supervising, leading, motivating, and communicating our specific concepts of what? - correct AnswerDirecting Pre-shift team report occurs with each shift change at the acute care facility where a nurse is employed as a LPN/LVN. The team takes report together and discusses the upcoming duties for the nurse's shift, making sure delegated tasks are clearly understood and all questions are answered. During this time, which management technique is being employed? - correct Answercollaboration In light of the recent transition to a new skill mix that increases the role of unlicensed care providers, the nurse manager of the unit has enacted new policies and procedures to maximize both patient safety and staff performance during the transition to the new model. Which of the following skills has the nurse demonstrated? - correct AnswerManagement skills An LPN wishes to take up the position of team leader and asks for suggestions from an experienced nurse. What role should the experienced nurse suggest the LPN to take? - correct AnswerSupervise unlicensed assistive personnel (UAP) Jon is the only registered nurse at the hospital who is certified to insert percutaneous intravenous catheters. What type of power does this certification provide? - correct AnswerExpert What is important for the nurse to do when assigning tasks to UAP? - correct AnswerNeeds to assess carefully the skills and knowledge of each UAP A new nurse asks a mentor for advice about the best ways to manage time. Which of the following techniques would the nurse mentor be most likely to recommend? - correct AnswerUse a worksheet to identify specific tasks. The nurse accidentally left a confidential lab report on a table in one of the exam rooms. The nurse is attending to another client in that room and realizes the mistake when the client says, "I didn't know that my neighbor was one of your patients. I must have just missed her!" The nurse plans to tell her supervisor about the mistake immediately upon finishing with this client. This is an example of: - correct Answeraccountability. As part of effective time management, a nurse should prioritize items needed to: - correct Answermaintain life. The RN who is assisting a new LPN/LVN team leader to understand the five rights of delegation knows that this new team leader needs further teaching if what is identified as one of the five rights of delegation? - correct AnswerRight price Prior to delegating any task to a UAP, which information must be known by the LPN/LVN team leader? - correct AnswerThe nurse practice act of the state the LPN/LVN practices A team leader in a healthcare facility is using an autocratic leadership style. What should the team leader do when dealing with a life-threatening emergency situation? - correct AnswerInstruct the staff members on duties they need to do Which statement about time management is true? - correct AnswerNurses who are self- aware and have clearly identified personal goals and priorities have greater control over how they spend their time; expend their energy, and what they accomplish. A nurse is considered powerful by her peers because her mother is a well-known community leader and her aunt is an administrator at the same hospital. Which of the following is the power this nurse has? - correct AnswerReferent power Due to many changes within the healthcare facility, employee morale is low. High client loads, frequent call-offs, and increasing acuity levels all contribute to the sense of discouragement within the unit. An LPN begins to place small, anonymous "thank-you" gifts in staff members' mailboxes a few times a week and monitors their reactions. Within a month, attitudes are more positive, staff members are bringing treats to share, and teamwork has improved. These actions represent: - correct Answerleadership. An LPN has just been named team leader, and is determined to establish a leadership style that encourages input from staff and focuses on effective communication and teamwork. Which leadership style will the LPN be using? - correct Answerdemocratic Preshift team report occurs with each shift change at the acute care facility. The team discusses the upcoming duties for the shift, making sure delegated tasks are clearly