NUR 425 Exam 1 Questions and Answers, Exams of Nursing

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NUR 425 exam 1 questions with 100% correct answers graded A+ already passed Medicare - correct answer ✔✔most expensive healthcare program quality management - correct answer ✔✔a program to prevent problems total quality management - correct answer ✔✔a program where everyone in the organization must contribute benchmarking - correct answer ✔✔a strategy used by organizations to compare performance outcomes average age of nurse - correct answer ✔✔46.8 years evidence-based practice - correct answer ✔✔applying scientific evidence to practice drives decision making process: identify issue, find evidence, evaluate evidence, apply evidence, evaluate outcome electronic health records - correct answer ✔✔integrates information from all sources, can be accessed from remote locations, increasing confidentiality, improves efficiency, reduces errors contingency leadership theory - correct answer ✔✔suggest that managers adapt their leadership styles in relation to changing situations. Leadership behaviors range from authoritarian to permissive and vary in relation to current needs and future probabilities trait theory of leadership - correct answer ✔✔in the earliest studies, researchers sought to identify inborn traits of successful leaders common traits: striking physical appearance and personality, ability to speak persuasively, intelligence, self-confidence, self-discipline behavioral leadership theory - correct answer ✔✔research focused on what leaders do. Personal traits provide only a foundation for leadership, real leaders are made through education, training, and life experiences transactional theory of leadership - correct answer ✔✔based on the principles of social exchange theory. Premise of social exchange theory: individuals engage in social interactions expecting to give and receive social, political, and psychological benefits or rewards. Leaders are successful in understanding and meeting the needs of followers and use incentives to enhance employee loyalty and performance. Aimed at maintaining equilibrium (status quo) by performing work according to policy and procedures, maximizing self-interests and personal rewards, emphasizing interpersonal dependence, and routinizing performance transformational leadership theory - correct answer ✔✔goes beyond transactional leadership to inspire and motivate followers. emphasizes the importance of interpersonal relationships. Not concerned with the status quo, but with effecting revolutionary change in organizations and human service. Focuses on merging the motives, desires, values, and goals of leaders and followers into a common cause. The goal is to generate employee's commitment to the vision or ideal rather than to themselves. The leader inspires followers and uses power to instill a belief that followers also have the ability to do exceptional things. authoritarian leadership - correct answer ✔✔type of leadership style; the leader exerts strong control over the group. The leader may be either dictatorial or benevolent. But when he gives orders, he expects them to be obeyed. Rules are numerous and creativity is firmly discouraged. This leadership style can create stress for employees. democratic leadership - correct answer ✔✔type of behavioral leadership; The leader encourages and supports group involvement in decision making. Creativity is encouraged. The leader guides and facilitates the work, but does dominate the workers. Laissez-faire leadership - correct answer ✔✔type of behavioral leadership; The leader is passive and non-directive. Most control and decision making are left to the group. This style works if the group members are self-directed and motivated but does not work well if the members are not able to work without some guidance and direction, such as new graduates. functional nursing - correct answer ✔✔developed in the 1940s, uses staff for specific jobs such as medication nurse, treatment nurse, care giver, charge nurse; NAs give all the baths and pass ice water, LPNs do the treatments, and RNs pass medications and assess patients. Functional nursing is economical, uses fewer RNs, and uses unlicensed personnel more effectively. But care is fragmented and the lack of RN interventions may lead to poorer patient outcomes. team nursing - correct answer ✔✔developed during the 1940's to reduce the fragmentation with functional nursing, evolved from functional nursing; the unit is divided into teams, staff work on a team to provide total patient care to a group of patients, team consists of RNs, LPNs, and UAP total patient care - correct answer ✔✔established in 1920s, nursing students use this model, a nurse assumes the care of a patient or group of patient for the shift worked primary care nursing - correct answer ✔✔developed in 1960s to place RNs back at bedside; nurses have 24 hr responsibility, nurse admit patients and follow through to discharge; focus of primary nursing is increased autonomy for professional nurse care givers and holistic patient care. But a major problem with primary care is how it is implemented. Often professional nurses are not willing to take on the high degree of responsibility and accountability differentiated practice - correct answer ✔✔places the emphasis on the educational level, clinical experience, and competency of the nurse; an example of differentiated practice would be different job descriptions for nurses who are graduates of BSN programs and ASN programs. The BSN would be in a supervisory position and the ASN more involved with the technical aspects of care. practice partnership - correct answer ✔✔places an experienced RN with a novice RN, LPN, or UAP; they work the same shifts and days and share the workload; The senior partner plans patient care activities and directs the work of his/her partner. The two work together to meet and exceed patient expectations and needs. patient centered care - correct answer ✔✔developed to bring services closer to the patients (unit based); small pharmacies, kitchens, labs and radiology centers are established on nursing units, staff are cross trained to do a variety of jobs; nursing care is usually provided by two workers, a care pair. One is usually a registered nurse. The other may be a UAP who is cross trained to provide respiratory treatments and physical therapy. Or maybe the second person is a radiation technologist who has been cross trained to work on the nursing unit. Two potential problems with patient focused care are: cost and the blurring of responsibility in the care pair. transforming care at the bedside - correct answer ✔✔evolved in 2003 from a joint venture between the Robert Wood Johnson Foundation and the Institute for Healthcare Improvement; framework for change on med surg units in hospitals, four main points: safe and reliable care, vitality and teamwork, patient centered care, value added care process use of rapid response teams, specific communication models, and professional support programs (preceptorships and educational opportunities), liberalized diet plans and meal schedules for patients, redesigned workspace that enhances efficiency and reduces waste resulted from the initiative case nursing - correct answer ✔✔one nurse caring for one patient, was popular in the 20's and 30's when many nurses worked in patients' homes. When used in a hospital nurses care for a small group of patients. They may or may not be assigned to the same patients the next day. case management - correct answer ✔✔finds ways to improve patient outcomes, reduce patient hospital days, responsible for lowering costs in general. Develops a care plan or care map that illustrates patient care; The focus of care management is organizing the care around the patient, not around the organizational structure. authority - correct answer ✔✔the right to act; to delegate you must transfer the authority steps to delegation - correct answer ✔✔1. Define the task 2. Choose the right time 3. Choose the right person 4. fully transfer the authority 5. check to make sure the task was completed necessitating - correct answer ✔✔belief that you are the only person who can do the job an obstacle to delegation under delegation - correct answer ✔✔full authority is not given over-delegation - correct answer ✔✔too much delegation is given; Delegating responsibilities only the manager is accountable for to a staff RN ineffective delegation - correct answer ✔✔correct steps not followed reverse delegation - correct answer ✔✔someone lower delegating to higher authority five rights of delegation - correct answer ✔✔Right task Right person Right direction/communication Right supervision or feedback Right circumstances mission statement - correct answer ✔✔provides customers and employees with a clear statement of what the organization plans to do philosophy - correct answer ✔✔includes beliefs, concepts, values objectives - correct answer ✔✔specific statements of what managers plan to accomplish; They are action statements that are aimed to fulfill the mission and philosophy of the nursing unit(s) chain of command - correct answer ✔✔hierarchical with authority flowing from upper administration down to staff. Communication flows downward from upper administration to staff. There have been many attempts to flatten the chain of command and reduce the number of managers. unity of command - correct answer ✔✔In the traditional bureaucratic organization employees have only one manager. This is the most common model for nursing organizations. span of control - correct answer ✔✔One person manages a group of employees who are basically in the same geographic area and have similar functions. This is changing in that managers are now managing groups of employees in different geographic areas and employees that have a variety of functions. division of labor - correct answer ✔✔Each person has a special function. In today's organizational structures this is changing with cross training of personnel. Hazel W. Johnson-Brown - correct answer ✔✔the first African-American female Brigadier General in history in 1979 and Chief of U. S. Army Nurse Corps, in charge of 7,000 men and women nurses, 8 Army medical center, 56 community hospitals and 143 free standing Clinics in the U.S. and abroad. Mary Todd Lincoln - correct answer ✔✔wife of Abraham Lincoln, served during the American Civil War caring for wounded soldiers Dr. Loretta Ford and Dr. Henry Silver - correct answer ✔✔together created the first Nurse Practitioner (NP) program at the University of Colorado in 1965, which paved the way for more advanced practice nurse and additional NP programs Jane Delano - correct answer ✔✔established the Red Cross Nursing Service with the threat of WW1; She was superintendent of the Army Nursing Services from 1909-1912, Chairman of the National Committee on Red Cross Nursing Services, created a plan for the first Volunteer Nursing Unit of the American Red Cross and the enduing legacy of Red Cross nurses, the national symbol of care during crises. Today, more than 20,000 nurse volunteers response to disasters, educate the public through health and safety programs innovator - correct answer ✔✔love change early adopters - correct answer ✔✔open to change, adopt changes early in the process early majority - correct answer ✔✔adopt change before the average person late majority - correct answer ✔✔hesitant to adopt change, more questions, more negative laggards - correct answer ✔✔openly dislike changes, eventually accepts change but are the last to do so rejecters - correct answer ✔✔oppose change, sabotage change and may leave organization, refuse to accept change Lewin's Theory of change - correct answer ✔✔three components: unfreezing: diagnose the problem, introducing the problem moving: putting the change into place refreezing: reinforces the new change, change now becomes status quo stages of creativity - correct answer ✔✔preparation: carefully designed plan incubation: meeting or taking time insight: knowing when or what to do verification: approval of ideas decision making steps - correct answer ✔✔1. identify the purpose 2. set the criteria (what is the goal) 3. rank the criteria 4. seek alternatives 5. try them out 6. troublesoot (what problems might occur?) 7. evaluate steps to problem solving - correct answer ✔✔1. gather information 2. define the problem 3. analyze the information 4. develop solutions 5. make a decision 6. implement the decision 7. evaluate autonomy - correct answer ✔✔freedom of choice or accepting responsibility for one's choices. People make choices regarding their behavior and should be responsible for their behavior. These choices determine the decision. fidelity - correct answer ✔✔keeping promises. Most ethicists believe breaking a promise is wrong regardless of the consequences. virtue theory - correct answer ✔✔Doing what a reasonable person would do in a given situation. For instance: If you were at a swimming pool and witnessed a child drowning would you attempt to save the child? Most people would make some effort to save the child from drowning managed care: HMO - correct answer ✔✔provides an agreed upon healthcare and service package preferred provider organizations (PPO) - correct answer ✔✔managed-care organizations contracts with independent practitioners to provide enrollees with established discounted rates; contracts with physicians etc at a discounted rate point of service (POS) - correct answer ✔✔may use different providers outside of the network but pay higher cost capitation - correct answer ✔✔a set monthly free provided to care providers for services to patients